Complementary Medicines The Risks Of Buying Online

Overview

Complementary medicines are products people use alongside or instead of standard medical treatment. They include herbal remedies, vitamins and minerals, food supplements, traditional plant medicines, teas, powders and 'natural' tonics. Many are sold online through websites, apps and social media adverts. Buying them this way can be convenient and cheaper, but it also skips many of the safety checks that come with medicines sold in a pharmacy. A product bought online may not contain what the label says, may contain more or less of the active ingredient, or may be mixed with something harmful that is not listed at all.

Yes. Surveys in many countries suggest that a large share of adults have bought vitamins, herbal remedies or supplements online at some point. Reports of harm from these products are rising, but many people who use them have no problems at all.

Symptoms

Common symptoms

• Stomach upset, nausea, loose stools or constipation after starting a new product
• Headache, dizziness or feeling unusually tired
• Skin rash, itching or hives
• Trouble sleeping, feeling jittery, or an unusual change in mood
• A faster heartbeat or a fluttering feeling in the chest
• Unusual bruising or bleeding, such as nosebleeds or bleeding gums
• Yellowing of the skin or eyes, dark urine, or pale stools (possible signs of liver strain)
• Symptoms that match the effect of a prescription medicine you were not told was in the product, such as strong drowsiness or a big drop in blood sugar

Symptoms in children

• Vomiting, drowsiness or unusual sleepiness
• Being very restless, irritable or hard to settle
• Refusing food or drinks, or fewer wet nappies
• Rash or swelling
• Getting hold of an adult's supplement by accident and swallowing it — treat this as an emergency

Symptoms in older adults

• New confusion, unsteadiness or falls
• A change in blood pressure, such as feeling faint on standing
• Easy bruising or bleeding, especially if also taking blood-thinning medicines
• Extra strain on kidneys or liver, which are more sensitive with age
• Interaction with several prescribed medicines taken at the same time

Causes

Main causes

• Products made or stored in places that are not inspected, so quality and cleanliness cannot be confirmed
• Counterfeit or fake products that copy a well-known brand or a pharmacy product
• Hidden ingredients, such as prescription medicines, steroids or stimulants, that are not on the label
• Contamination with heavy metals, pesticides, mould or bacteria
• Labels that list the wrong plant, the wrong strength, or no strength at all
• Sellers who give no pharmacist advice and no warning about interactions with your other medicines
• Adverts on social media and 'miracle cure' websites that use urgent language and pressure to buy fast

Risk factors

• Taking prescribed medicines, especially for heart conditions, blood thinning, diabetes, epilepsy, HIV or after an organ transplant
• Having a long-term liver or kidney condition
• Being pregnant or breastfeeding
• Being an older adult or giving the product to a child
• Having allergies or asthma
• Having surgery planned in the next few weeks
• Buying from an unknown website, an online marketplace seller, or a social media advert rather than a registered pharmacy
• Buying products that claim to cure cancer, dementia, diabetes or other serious illnesses
• Buying prescription-only medicines without a prescription

When to see a doctor

See a doctor urgently if:

• You have any emergency symptom listed above — call your local emergency number straight away
• You feel very unwell after starting an online-bought product — stop taking it and seek same-day medical advice
• You are taking a prescribed medicine and think the supplement may be changing how it works
• You notice unusual bruising, bleeding, dark urine or yellowing of the skin or eyes

Book a routine appointment if:

• You want to check whether a supplement is safe with your current medicines — your pharmacist can help
• You are planning to start a herbal product and have a long-term condition
• You are pregnant, breastfeeding, or planning a pregnancy
• You have been taking a product for weeks and are not sure it is helping
• You want help reporting a side effect or a suspicious product

Diagnosis

There is no single test for problems caused by complementary medicines. A doctor or pharmacist will usually start by asking what you take, in what amount, for how long, and where you bought it. They will look at the packaging, the batch number and any ingredient list, and compare your symptoms with what the product is meant to do. If a reaction is possible, they may check how well your liver, kidneys and blood are working, and look for signs of an allergic reaction. In serious cases, the product itself may be sent to a government medicines regulator for testing.

Tests that may be done

• A careful medicine history, including supplements, teas, powders and traditional remedies
• Blood tests to check liver and kidney function, blood count and blood clotting
• Allergy testing in some cases
• Blood pressure and heart rhythm checks
• Laboratory analysis of the product by a regulator if a batch is suspected to be unsafe

What to expect at your appointment

You will be asked open, non-judgemental questions — the aim is to keep you safe, not to criticise your choices. Bring the bottle, box or a photo of the label if you can. Your clinician will explain what they think may be happening, advise whether to stop the product, and arrange follow-up or blood tests if needed.

Treatment

Treatment depends on what is happening. Often it simply means stopping the product under guidance, watching your symptoms, and letting your body recover. If the product has affected your prescribed medicines or caused a reaction, your clinician will treat that specific problem and adjust your care plan.

Self-care at home

• Stop taking the product if you feel unwell, and tell your doctor or pharmacist what you took
• Keep the packaging, batch number and any receipt — these help with reporting and with your care
• Write down your symptoms and when they started
• Do not restart the product, even at a lower amount, until you have spoken to a healthcare professional
• Report suspected side effects to your national medicines regulator — your pharmacist can show you how
• Drink plenty of fluids and rest if you have mild stomach upset, and seek advice if it does not settle

Medical treatments

Your clinician will focus on the problem the product has caused. This may include treatment for an allergic reaction, fluids and monitoring if you are dehydrated, medicines to control nausea or heart rhythm problems, and a review of your existing prescriptions so that any interaction is managed. If your liver or kidneys have been affected, you may need blood tests and follow-up appointments. The exact approach is always tailored to you, and no specific medicine is recommended here.

When is surgery considered?

Some herbal products can affect bleeding or blood pressure during an operation or increase the effect of anaesthetic. If you have surgery coming up, tell your surgical and anaesthetic team about everything you take, including supplements bought online. They will advise you on when to stop. Do not stop prescribed medicines on your own.

Living with this condition

The main day-to-day habit is to know exactly what you are taking. Keep a simple list of all your medicines and supplements on your phone or in your bag, and update it whenever something changes. Before buying anything new online, take a moment to check who is selling it and whether the site is a registered pharmacy or a recognised retailer.

Lifestyle tips

• Buy from a registered pharmacy or a retailer you can contact and trace
• Be wary of products with dramatic claims, fake countdown timers, or 'before and after' photos
• Check whether the product has a recognised registration or traditional-use marking in your country
• Show your pharmacist any new product before you start it, especially if you take prescribed medicines
• Avoid sharing supplements with friends or family, and keep them out of reach of children
• Be careful with herbal teas and powders bought from unknown sellers — they are medicines too

Diet and exercise

A balanced diet with plenty of vegetables, fruit, whole grains and protein gives most people the nutrients they need, so supplements are often not necessary. Regular movement, good sleep and staying hydrated support your body's natural repair systems, including your liver and kidneys. If you are thinking about a supplement because you feel tired or run down, it is worth asking your doctor to check for common causes first rather than guessing.

Mental health and emotional wellbeing

People often turn to online remedies when they feel anxious, exhausted or hopeless about a health problem, and adverts can target exactly those feelings. It is understandable, and you deserve support rather than blame. If worry about your health, low mood, or pressure to buy 'cures' is affecting your daily life, please talk to a healthcare professional. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis support service in your country straight away — you do not have to cope alone.

Prevention

You cannot control what is inside a product made somewhere you cannot check, but you can greatly lower your risk. Buying from a registered pharmacy, avoiding unknown sellers and social media adverts, and telling your pharmacist about everything you take will prevent most problems.

Screening programmes

There is no screening test for this. Instead, treat each new purchase as a quick safety check: who is selling it, is the site registered, does the label list amounts clearly, and does it interact with anything I already take?

Complications

If left untreated

• Dangerous interactions with prescribed medicines, such as bleeding with blood thinners or a change in heart rhythm
• Liver or kidney damage from contamination or from too high a dose of a plant ingredient
• A delay in getting the right treatment because a 'natural cure' was tried first
• Serious allergic reactions
• Harm from hidden prescription medicines in the product, including dependence or withdrawal
• In children, accidental poisoning from products left within reach

Long-term outlook

The good news is that most people recover fully once the product is stopped and any effects are treated. Being open with your healthcare team is the single most helpful thing you can do, and there is no judgement in it — clinicians see this often and are there to help you feel well again.

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