FOOD INTOLERANCE NETWORK
FACTSHEET
Additives
in medication
Why aren't all
ingredients listed on the label?
What DO they have to list on
the label?
What about artificial and
other colours?
How can I find out if my medication contains nasty additives?
Why can't I understand the names of the colours in my medication?
Other additives that can cause problems
Help! My medication contains
nasty additives - what can I do?
Reactions to active
ingredients
Reader Questions and Reader Reports
References and further
reading
·
Medications, supplements and dental
products often contain additives that are regarded as ‘inactive’ ingredients
yet they can cause troubling reactions in adults and children
·
Many of these additives do not have
to appear on the label or may appear in ways you do not recognise
·
Your doctor, pharmacist or dentist
may not know about the effects of these additives
·
It is up to you to protect yourself
and your children
Why aren't all
ingredients listed on the label?
The Australian TGA (Therapeutic Goods Administration) says there isn't
enough space on the label. Yet you can see medicated lollies with inadequate
labelling on supermarket shelves next to unmedicated
lollies that list full ingredients. If food manufacturers can
do it, so can drug manufacturers.
In
What DO they have to list on
the label?
For a non-prescription oral medicine the following ingredients must be
listed:
·
All active ingredients
·
The following non-active
ingredients: saccharin, sugars, preservatives, gluten or lactose [but not
colours, flavours or synthetic antioxidants]
If you find a preservative listed on the CMI but not the label, let us
know and/or complain to 1300 134 237 (the very supportive Adverse Medication
Events Hotline).
What about
artificial and other colours?
Declaration of other non-active ingredients (excipients) including colours
is considered commercially sensitive to the sponsor of the product and may only
be disclosed by the sponsor. As far as I can see, this approach contravenes the
1985 UN Consumer Bill of Rights (the right to safety, the right to be informed,
the right to choose).
How can I find out if my
medication contains nasty additives?
·
Look on the internet: you can do a Google search for the exact name of your medication (e.g.
“LPV capsules”). If provided, look in the CMI (Consumer Medicine Information)
leaflet or Datasheet. The list of ingredients is usually at the end. If you are
lucky, the CMI will include a list of the additives used in words you can
understand.
·
Ask your pharmacist – although many failsafers complain that their pharmacists haven’t a clue
about additives
·
Contact the manufacturer – go to
their website and click on Contact Us
Q. If the label says "no
tartrazine or other azo dyes" is it safe?
A.
No. There are many other colours that can cause problems, see table below.
Q. Are there any safe
colours?
A. Yes!
Natural colours Iron Oxides (172) and Titanium Dioxide (171) are well tolerated
and are used increasingly in medications.
Why can't I
understand the names of the colours in my medication?
Pharmaceutical companies often use Colour Index (CI) numbers, names or
other ways of describing colours. Colours can be hidden behind proprietary
brand names for example the Opadry range of drug
colorants made by Colorcon. Opadry
colorants may include artificial colours and/or natural colours but you can’t
tell by the name. There are many different Opadry
colorants. The CMI may list the ingredients in the Opadry
colorant, for example Opadry Blue Y-5-10544 contains
FD&C Blue No. 2 which is artificial colour (132). However, when a CMI lists
Opadry Blue and Opadry
Yellow (e.g. for Sertraline-GA tablets in
|
Colours that can
cause problems |
|||||
|
EU |
|
Name |
Alternative names |
|
Colour Index C.I. |
|
E |
102 |
Tartrazine |
|
Yellow #5 |
19140 |
|
E |
104 |
Quinoline Yellow |
Food Yellow 13 |
|
47005 |
|
E |
107 |
Yellow 2G |
|
|
18965 |
|
E |
110 |
Sunset Yellow |
Orange Yellow S |
Yellow #6 |
15985 |
|
E |
122 |
Azorubine |
Carmoisine |
|
14720 |
|
E |
123 |
Amaranth |
Acid Red 27, Food Red 9 |
|
16185 |
|
E |
124 |
Ponceau 4R |
Brilliant Scarlet |
|
16255 |
|
E |
127 |
Erythrosine |
Food Red 14, Acid Red 51 |
Red #3 |
45430 |
|
E |
128 |
Red 2G |
|
|
18050 |
|
E |
129 |
Allura Red |
Food Red 17 |
Red #40 |
16035 |
|
E |
132 |
Indigotine |
Indigo Carmine |
Blue #2 |
73015 |
|
E |
133 |
Brilliant Blue |
|
Blue #1 |
42090 |
|
E |
142 |
Green S |
Acid Brilliant Green, Food Green, Lissamine |
|
44090 |
|
E |
143 |
Fast Green FCF |
Green 1724, Solid Green, Food Green 3 |
Green #3 |
42053 |
|
E |
151 |
Brilliant Black |
Brilliant Black PN |
|
28440 |
|
E |
155 |
Brown HT |
Chocolate Brown |
|
52028 |
|
E |
160b |
Annatto |
Annatto extracts, bixin, norbixin |
|
75120 |
Other additives that can
cause problems
Preservatives
200-203 sorbates
210-213 benzoates
214- 219 hydroxybenzoates, parabens
220-228 sulphites
280-283 propionates
249-252 nitrates, nitrites
Synthetic antioxidants
310-312 Gallates
319-320 TBHQ, BHA, BHT
Added flavours and perfumes
Strong flavours especially fruit or mint whether artificial or natural
can cause intolerance reactions from asthma to behaviour problems in children.
Inhaled salicylates in strong perfumes (e.g. in masks used for anaesthetics)
could also cause reactions in sensitive children, see more in reader reports.
Sugar free sweeteners
Called polyols, these additives may be used as
sweeteners, humectants, stabilisers or texturing agents. They can cause gas,
flatulence, abdominal distention and/or diarrhoea
when consumed frequently, in large quantities or by sensitive consumers
including babies and young children. For example, an outbreak of so-called
'pink diarrhoea' that was reported in a medical journal turned out to be due to
sorbitol in a vitamin supplement. Polyols do not
cause the other side effects of additives and are safe for some people.
420
sorbitol
421
mannitol
953 Isomalt
965 Maltitol or
hydrogenated glucose syrup
966 Lactitol
967 Xylitol
968 Erythritol
1200 Polydextrose
What kinds of reactions could I expect?
The same kinds of reactions as can be caused by additives in foods:
·
Irritability, restlessness, short
fuse, tantrums
·
ADHD-type symptoms, oppositional
defiance
·
Difficulty falling asleep, frequent
night waking
·
Mood swings, anxiety, depression,
panic attacks
·
Inattention, difficulty
concentrating, fatigue
·
Eczema, urticaria and other itchy
skin rashes
·
Swelling (angioedema) e.g. of the
lips often associated with rashes
·
Reflux, colic, stomach aches,
bloating and other irritable bowel symptoms including constipation and/or
diarrhoea, sneaky poos, sticky poos, bedwetting
·
Headaches or migraines
·
Asthma, breathing difficulty, cough
(especially from sulphite preservatives but others including benzoate
preservatives and colours can be to blame)
·
and many others
Unlike true allergies, reactions to additives and drugs are usually
delayed or build up slowly over days or weeks. How bad can it be? Very. See the
reader report below: Two years of behaviour problems related to unlisted
artificial colour in fluoride tablets.
Help! My medication contains
nasty additives - what can I do?
Some options
·
Don't take the medication unless it
is essential (if your medication is essential e.g. for asthma you must take it)
·
Ask your pharmacist for an
alternative with no nasty additives if possible
·
Ask a compounding pharmacist (under
Compounding in the Yellow Pages) to make up additive free medication
·
Empty out coloured capsules and take
the contents with a spoonful of failsafe icecream or
maple syrup
·
Rub colouring off hard pills in
running tap water
·
Ask for our children's flavour-free paracetamol
recipe
Reactions to active
ingredients
As well as additives, active ingredients in your medication may cause
adverse reactions too. All medications have side effects that may be listed on
the CMI. Some are riskier than others, e.g: the US
FDA estimates that Vioxx painkillers may have
contributed to 27,000 heart attacks and sudden cardiac deaths between 1999 and
2003; Stilnox sleeping pills have been associated
with suicides. More information in further reading below. People who are
sensitive to salicylates or amines in foods need to avoid salicylates or amines
in medications too
Salicylate containing drugs
People who are sensitive to salicylates need to avoid any prescription
or over the counter medication which contains salicylic acid or salicylates or
lists sensitivity to aspirin as a warning or contraindication on the CMI. This
includes many painkillers (except paracetamol), oil of wintergreen, arthritis
creams, sports creams like Dencorub, Vicks Vaporub, teething gel and oral gels like Bonjela and Ora-Sed, wart removers, acne cleansers and some
insect repellents. Nurofen and other non steroidal
anti inflammatory drugs (NSAIDs) while technically
not salicylates can affect consumers who are salicylate sensitive. Herbal
remedies like Echinacea and herbal preparations such as bioflavonoids
in multivitamin supplements can cause salicylate reactions.
Amine containing drugs
People who are sensitive to amines should avoid any medication which
mentions taking MAIOs (monoamine oxidase inhibitors)
as a warning or contracindication on the CMI. Drugs
that can contain amines include over the counter cold tablets, decongestants,
nasal drops or sprays, some pain relievers, general and local anaesthetics and
monoamine oxidase inhibitors.
Reader Questions and Reader
Reports
key words for search using CTRL F: Amoxycillan,
Amoxil, antibiotic, anaesthetic, colour, compounding, contraceptive, dental,
doctor, epilepsy, Fergon, fluoride tablets, hives, ibuprofen, iron, iron oxide,
iron supplement, Losec, Nilstat, Opadry,
Panamax, paracetamol, parabens,
benzoate, penicillin, perfume, pharmacist, preservative, Robitussin,
supplement, tooth mousse
Q. My dentist wants me to use
GC Tooth Mousse - I phoned the supplier to ask whether there are preservatives
or colours and she said it contains propylene glycol, titanium dioxide and xylitol sugars. I seem to react to very small amounts of
any preservatives, colours or flavours so I believe I would be in trouble if I
used this mousse (it has to be left on every night to help my gums and teeth).
What are your views?
A.
The list of ingredients from the supplier didn't seem long enough so I searched
the internet for "GC Tooth Mousse ingredients". According to the
Material Safety Data Sheet the product contains three hydroxybenzoate
preservatives. Also known as parabens or
preservatives (214-219), these preservatives are known to affect people who are
sensitive to artificial colours and salicylates. The European MSDS warns
"Do not use this material on patients with a proven or suspected milk
protein allergy and/or with a sensitivity or allergy to benzoate
preservatives". This product is NOT FAILSAFE.
Feedback: ‘Well I have tried the "plain" GC
Tooth Mousse three times and have reacted each time with the usual symptoms. It
appears to stay in my system for two days. I react with insomnia, then my body
gets "the jumps". I have even gone back to having the jumps in my
legs and arms during the day (two days after using the tooth mousse)!’
[797] Behaviour and
night terror induced by potassium sorbate (202) in Panamax (June 2009)
When my son had
a nasty chest infection/bronchitis I gave him crushed up Panamax
paracetamol 4-hourly for a couple of days, as well as
the inners of amoxil capsules.
A couple of
days later, his behaviour was absolutely shocking and
it culminated in him having a night terror one evening, the most severe one he
has had since being failsafe since last September.
I knew
something was going on, and I decided to check up about Panamax
– and discovered it has potassium sorbate (202) in
it. We have not yet done any challenges on additives as we already avoid dairy
and salicylates, so decided to pretty much stay
additive-free. However, we do seem to be okay with moderate amounts of pure MSG
and amines.
I strongly
suspect that his behaviour and night terror were
induced by the preservative 202. What angers me more is that I was completely
unaware of the existence of the preservative in this product, due to the lack
of these medicine companies having to label their products. Our kids are
already sick when we need to give these drugs to them, and they need to get better,
but how can they when their body is also trying to fight against an artificial
preservative?
Even when I
asked at the chemist for a preservative-free paracetamol,
they were not able to tell me what was in the products they sold. If only we
could have good information about what is in these medical items, ie. through labelling.
I don’t accept the excuse that there isn’t enough room on the packaging – if a
box of soap can list its numerous chemical ingredients, so should a box of pain
relief or any other medicine.
Please use our
experience in your endeavours to fight for better
information labelling on medicines – it’s our kid’s
future. – Joanne, Vic
Update: this
reader was using an old box of Panamax. The
formulation hasn’t changed but the labelling has: Panamax boxes now list potassium sorbate
on the label. For young children, ask for our recipe for additive-free
children’s paracetamol. (We would like to hear any
other reports of reactions to sorbates – email suedengate@ozemail.com.au)
[261] Unlabelled sulphites in
paracetamol (June 2003)
I have done some investigating and was horrified to find that the brand
of paracetamol at the hospital that I work at, Febridol,
has sulphite preservative in it. This could be a problem for asthmatics admitted
to the hospital! Many other brands I looked at also contained sorbates and benzoates as preservatives. Herron tablets are
colour free, gluten free and preservative free (see product updates.) - from
the failsafe group
Q. I seem to be reacting to
NEO-MERCAZOLE tablets with the following ingredients: lactose, maize starch,
sucrose, magnesium stearate, talc, microcrystalline cellulose, gum acacia,
ferric oxide, propyl hydroxybenzoate, gelatin. They
are coloured pink. The pharmacist at the company that distributes the neo-mercazole said the colour was ferric oxide (Fe2O3) also
known as Iron (III) oxide, Pigment red 101 or Diiron
Trioxide; colour index (C.I.) 77491.
Colour 101 isn't on the list of nasty additives. Does that mean I can discount
colour as a cause of problems?
A.
Under TGA (Therapeutic Goods Administration) regulations colours do not have to
be listed on medication labels - due to lack of space - leaving consumers to
rely on dodgy word-of-mouth advice from suppliers or pharmacists. The pharmacist
who advised you was either ignorant or misleading. Pigment red 101 is not the
same as Food Colour 101 (riboflavin, a B vitamin). Ferric oxide, the colour
used in your medication, is also called iron oxide or food colour (172). Iron
oxides are available in red (and pink), yellow and black. Although iron is
toxic in large doses, the small amounts of iron oxide used as colours are
considered safe - in the past many failsafers have
consumed iron oxide as the colour in Macro M Vitamins. The additive most likely
to cause problems in the list above is propyl hydroxybenzoate (also known as
preservative 216). Benzoates include preservatives 210-213 especially sodium
benzoate (211) in foods and drinks, and parabens or
hydroxybenzoates (216, 218) in drugs. All benzoates can cause the same adverse
effects. See also question above. Please
report all adverse reactions to additives in medications in
Q. The doctor gave him
Nilstat, but it is bright yellow, which puts me off a bit. Is it safe?
A.
I did a Google search for Nilstat. On the Australian
CMI for Nilstat Drops it says "The colouring agent in NILSTAT tablets is
Quinoline Yellow CI 47005." Yet on the Nilstat datasheet in
Q. My 12 yr old son has taken
penicillin for tonsillitis twice in the last two months. Both times I have
noticed my son’s behaviour became much more moody and disobedient. The
medication was LPV capsules. Could there be a problem with the drug itself or
am I looking for an unlisted culprit?
A. I
did a Google search for <LPV capsules> in May
09 and found the CMI (Consumer Medicines Information) leaflet at
http://www.mydr.com.au/medicines/cmis/lpv-capsules. The "inactive"
ingredients are listed at the bottom of the CMI. They include three artificial
colours which are listed by names and Colour Index (CI) numbers but are also
known as colours 110, 127 and 133 all
artificial colours we recommend to avoid. At that time, the CMI claimed
"LPV does not contain gluten, sucrose, tartrazine or any other azo dyes" but this is incorrect as sunset yellow (110)
is an azo dye. I notified the manufacturer and they
promised to change it. You can see more information and a list of Colour Index
numbers on our Medications factsheet.
Q. My daughter recently went
from taking 10mg Losec to 20mg (half twice a day). I
noticed the colour of the tablets is quite different. When I contacted the
manufacturer they told me that the darker colour in the 20mg is due to the fact
that it has iron oxide red and iron oxide yellow in it (although they did say
there is also a small amount of iron oxide red in 10mg) do you know anything
about these colours and whether they are OK or should be avoided?
A.
Iron oxides (red, yellow and black) are all variations on natural colour 172.
They are considered to be well tolerated by failsafers
and were consumed without problems for years in the RPA-recommended Macro M
vitamin supplements that have since been discontinued.
Q. My 4 year old son has a
middle ear infection prescribed Amoxycillin Syrup and
since taking it his behaviour has been awful, yelling at us, talking back, not
listening etc. Is there something in this medicine which could cause this
reaction?
A.
At the time of writing (2004) Amoxcil syrup contains
sodium benzoate and peach, strawberry and lemon flavours which are probably
very strong. Either the benzoate preservative or the strong flavours or both
could cause the behaviours you are talking about. We receive constant reports
of reactions like this to children's medicinal syrups. It is ridiculous that
parents can't easily buy safe medications. I would be very grateful if you
could report this reaction, see below.
Q. My 12 yr old son has taken
penicillin for tonsillitis twice in the last two months. Both times I have
noticed my son’s behaviour became much more moody and disobedient. The
medication was LPV capsules. Could there be a problem with the drug itself or
am I looking for an unlisted culprit?
A.
I did a Google search for “LPV capsules” and found
the CMI (Consumer Medicines Information) leaflet at
http://www.mydr.com.au/medicines/cmis/lpv-capsules. The "inactive"
ingredients are listed at the bottom of the CMI. They include three artificial
colours which are listed by names and Colour Index (CI) numbers but are also
known as sunset yellow (colour 110), erythrosine (colour 127), and brilliant
blue (133). The CMI claimed "LPV does not contain gluten, sucrose, tartrazine
or any other azo dyes" but this is incorrect as
sunset yellow (110) is an azo dye. I contacted the
manufacturer and they have promised to change it. (
Q. My failsafe 3 year old was
going great until he had to go to the doctor for an infected eyelid from a mossie bite. Now he is once more driving me crazy -
restless, won't listen, wants to be naughty. The antibiotics contain tutti frutti, orange and menthol flavourings and sodium benzoate
(preservative 211). Both the pharmacist and doctor told me there was no
alternative better suited to the elimination diet.
A.
There are alternatives. You can ask your doctor for white tablets or capsules
(for adults), and crush or empty the ingredients out of the capsule, mix with a
teaspoon of golden syrup or a dessertspoon full of additive-free vanilla icecream, this is the best because the cold numbs the taste
buds. For children you would need to discuss the dose (eg half, quarter of a
tablet or capsule) with your pharmacist; or you can ask a compounding pharmacist
to make up medication to order, search under Compounding in the online Yellow
Page, see comments below.
Q. My son had a severe
outbreak of hives while taking Robitussin ME for a cough. The doctor was
surprised with the reaction to the Robitussin, but as soon as we discontinued
using the product the hives went away.
A.
It is very difficult to find the ingredients for over-the counter remedies so I
don’t know what’s in Robitussin ME. However, this is the second time we have heard
about severe reactions to Robitussin ME, so it is definitely worth reporting,
see the end of this factsheet.
Q. Our pediatrician
recommended Fergon elixir iron supplement. I was wondering if my daughter can
take this while on the elimination diet? This supplement contains Glucose
liquid, Ethanol and Saccharin Sodium.
A.
You can't trust labels on pharmaceutical products, because they don't have to
declare all additives. The real contents of Fergon, as listed on the CMI
(Consumer Medication Information) leaflet, available from your pharmacy or at www.myDr.com.au: active ingredient: ferrous
gluconate, other ingredients: glucose liquid, glycerol, ethanol (alcohol),
saccharin sodium, gluconolactone, apricot superarome and purified water. The strong apricot flavour
('super-aroma') is not failsafe. All strong fruit flavours are very high in
salicylates. For more details, see the Supplements factsheet
on the website.
Q. I recently started my two
year old son on an elimination diet as advised by my paediatrician to see what
effects foods are having on his behaviour. We were going quite well over the
last four weeks until his doctor prescribed antibiotics for an ear infection
and his behaviour started to deteriorate. My paediatrician also put my son on
an iron supplement Ferro-Liquid (Ferrous Sulfate Oral
Liquid Solution 30mb/ml) and Roche Pentavite Liquid
which says it has no artificial colours or preservatives but has a citrus fruit
flavour. Since his ear infection he has had a cough from a runny nose at night
and in the early hours of the morning.
A. Many
doctors, dentists and pharmacists do not seem to understand that children's
flavoured vitamin, antibiotic and other medicinal syrups are never failsafe and
will prevent the diet from succeeding. The antibiotic syrup probably contained
strong artificial flavours, benzoate preservatives and possibly artificial
colours. The Ferro liquid contains both sulphite and benzoate preservatives
that could be causing your son's cough and nasal problems. FGF iron tablets do
not contain these additives. Ask your pharmacist about the correct dose of
supplements for your child, it is usually half the adult dose for children
under 12 but you should check. See the vitamins
and supplements factsheet on the website for how
to get tablets into kids.
Q I've noticed that my brand
of contraceptive pill has artifical colouring. I
really don't want to be consuming this every single day! Do you know of any
brands of the contraceptive pill that are failsafe or where I might find out?
A. Contraceptive
pills aren't great for women with food intolerance because female hormones can
make symptoms of food intolerance worse, i.e. premenstrually
and when taking oestrogen in medication. For pills without artificial colour,
you can browse through the Consumer Medicine Information (CMI) sheets for
ingredients of oral contraceptives at
http://www.mydr.com.au/drugs/mediresults.asp.
Q. I have been on the
failsafe for one month. Yesterday I took 2 Ibuprofen for menstrual cramps. Last
night I woke up with my heart pounding and little muscle tics and twitches all
over my body. I felt agitated and depressed, and have felt bad all day. I am
trying to figure out what caused this reaction. Ibuprofen is a non-steroidal
anti-inflammatory drug, not aspirin, and it doesn’t have salicylates in it.
What caused the reaction?
A.
People who are sensitive to aspirin (which is a non-steroidal anti-inflammatory
drug) and salicylates generally react to other NSAIDs
as well. Although Ibuprofen doesn't list salicylates as an ingredient, you need
to avoid this and any medication which says ‘if you have an allergy to aspirin
you should tell your doctor’ on the CMI leaflet.
[591] Help from compounding
pharmacists (November 2007)
Additive-free antibiotics from compounding pharmacist : Our 3 month old
breastfed baby has to take oral antibiotics so I explained to our local
pharmacist that I wanted no added colours, preservatives or flavours. He had no
idea what was in antibiotics other than the active ingredient, conceded that I
knew more about it than he did, and gave me a contact for a compounding
pharmacist. They made me up a liquid that is just the antibiotic suspended in
water, with nothing else added and made it concentrated so that I could give
her less at one time. It tastes bitter but she takes it squirted into her mouth
with a syringe with no problems. – by email
Additive-free supplements from compounding pharmacist : When my son
needed an iron supplement with Vitamin C, I spoke to our compounding chemist -
a very useful person, I think everyone with dietary issues should have one! He
went through everything and came up with three alternatives - two were the
supplements listed on your web site, the third was to put his skills to work
and make up a special mixture in the necessary dose for my child. I think I
need to get a tattoo on my eyelids that says ‘if child requires medicine -
speak to Compounding Chemist’. [Search the Yellow Pages online under Compounding,
there are 66 Australia-wide]. – by email
[670] Behavioural reaction to
medications in hospital (September 2008)
Recently my failsafe 6-year-old son went into hospital to have grommets
in and his adenoids removed. Right up until he went into the operating theatre
he amazed us with his great behaviour and how he dealt with the whole process.
The minute he woke up he was so aggressive, rude, would not co-operate and was
back to our little monster again. We
couldn't wait to slink out of the hospital with him and get home. The next day
he was still agitated and demanding. Do you think the anaesthetic and
medication he received for this procedure could cause these sort of
reactions? I know kids do react to going
into hospital etc but the change in him from before and after was so dramatic I
just have to wonder if it could affect him. – by email, NSW (General
anaesthetics are usually OK but medications before and after the procedure can
cause bad side effects. You can discuss this with your anaesthetist beforehand, see the free introduction to Friendly Food on www.cs.nsw.gov.au/rpa/Allergy/default.
Problems with anaesthetics include preservatives, worse when injected, and
amines in the drug itself).
[671] Extreme reaction to
local anaesthetic (September 2008)
On the second day of school, my 12-year-old cut his knee badly exposing
the tendons. The doctor said he had to really pump him full of anaesthetic as
it was so bad. The effects seemed to really throw him out. Instead of getting
physical though as he would have a few years ago, he brought it into himself.
He just sobbed his heart out and couldn't talk. He had very bad headaches and
the shakes. He slept non-stop for about two days before we started getting him
back on track. At school the teacher said that my son had been so happy before
but after his accident he turned into into a sullen,
seldom speaking young lad. - by email, Qld (Local including dental anaesthetic
injections usually contain preservatives that can cause worse problems when
injected than consumed by mouth. It is possible to get preservative-free local
anaesthetics if you ask).
[799] Warning: Perfumes in masks for kids’ anaesthetics (June 2009)
I work in an
operating theatre. One day last week we had a few kids on the list and I asked
what the awful smell was. The result after process of elimination was, it was the oxygen masks. It seems that the kid size oxygen
masks now come scented. I'm referring to the masks they hold over the face as
the patient is going to sleep. I asked why they are scented and apparently it's
supposed to be less stressful for the kid if it can smell something nice.
SO, to the
parents of kids that are sensitive to smells, make sure you ask the anaesthetist about the masks if your child needs an
operation. I don't know if we've still got unscented ones, I couldn't find any
(but that doesn't mean anything). I made a point of letting them know it could
cause major issues for kids with problems and all I could get as a response
was, "but it's non allergenic". AARRGGGHHHH!! We've got cherry and strawberry, which don't
really smell like they should. - Jane, by email (Like the fruit they represent,
strong fruit flavoured perfumes will be high in salicylates).
[798] 2 years of behaviour
problems related to unlisted artificial colour in fluoride tablets (June 2009)
On
We have been involved with your network for some time now, whilst trying
to overcome our daughter’s intolerance to the numerous additives found in foods
and other products. Although we have worked with a dietician and followed all
the recommended advice in relation to elimination diets and food challenges, we
never seemed to achieve the results we hoped for.
It was only a fortnight ago that it occurred to us to check the
ingredients of the fluoride tablets. There was no information on the actual
bottle and no information available on the manufacturer's website, so I called
their Consumer Information Service. I requested they forward a list of ingredients
to me, to which they promptly refused, stating such details were confidential
for ‘proprietary reasons’. Only through sheer persistence was I able to get the
ingredients list ... it was not sent to me, it was read out over the phone.
I was initially given the colouring agent as CI 15985. I complained that
this number was used within the industry but not widely known by consumers.
They reluctantly told me CI 15985 was also known as FD&C yellow. Further
prompting was required to get the equivalent term Sunset yellow. Finally they
told me Food additive 110 is also another name for it.
We can see we had been making a huge mistake and stopped the tablets
immediately. Over the past two weeks we have seen our daughter’s behaviour and
learning abilities progressively improve to the point where she is a different
little girl; happier, more co-operative and less oppositional.
We are now very angry that we mistakenly trusted a recommended
pharmaceutical product that effectively has contributed to diminishing our daughter’s
general well being.
Since the launch of the Kids First Campaign calling for the phasing out
of additives such as 110, I was curious to find out if I could get the same
information from the manufacturer and called their Consumer Information Service
once again.
This time I was not so successful. I asked the representative where I
could find information about the tablets on their website. I was pointed to
another website which listed the product (copy of page supplied) but still no
declaration of ingredients. When questioned, she replied that the tablets do
not contain sugar or alcohol. I told them I needed a full list of ingredients
to be emailed to me. Only after much persistence and placing me on hold to
check with her ‘colleague’, did she take my email address, agreeing to forward
the information I had asked for.
She also asked me for a contact number should the need arise. Sure
enough, about two hours later I received a call from the representative,
informing me that she had since been advised by her ‘supervisor’ she was not
allowed to send the information after all.
Next I asked to speak to her supervisor. I asked the supervisor why the
representative was told not to send the information after saying that she
would. The supervisor replied "oh she's just new here and didn't
know." The supervisor went on to say that their product is listed with the
Therapeutic Goods Administration and they are not required by legislation to
reveal the ingredients. After pursuing that matter further with her I was
informed the only way to get the information is to go to a GP or a registered
health professional who can then request the information from the manufacturer
direct. She informed me that our GP could request the information by writing to
her (the supervisor).
Despite the fact that we were able to source the ingredients in the
first instance and have since stopped using the tablets, there is an underlying
major issue that clearly needs addressing. As parents we are continually
battling to find out the necessary information about such additives and
preservatives to ensure the health and well being of our children, only to find
that manufacturers hide behind terms such as ‘proprietary information’ or
‘trade secret’. I hope you find this information equally disturbing. I would
like to know what we can do to evoke change in the regulations around the
labelling of food and medicines. – Darren, Vic
[568] Epilepsy and additives
(August 2007)
I am a new convert to failsafe eating and I am a sufferer of epilepsy. We
initially began the diet for my son's problems but having read the information
on the effects of additives I am also taking care to follow it myself. My
doctor recently changed my medication back to Lamictal
and I was surprised and annoyed when I found the drug has had blackcurrant
flavouring added to it so that it can be dispersed in water or chewed. This
hasn't always been the case. A number of years ago I was taking this tablet and
it was free of artificial flavours. I continue to swallow the tablets whole as
they are not large or difficult to swallow and find this new format totally
unnecessary. I am very disappointed with the fact I have no option to take a
tablet that does not contain flavourings as I need this medication for seizure
control. I believe many sufferers of epilepsy are sensitive to additives and I
remember as a child of 12 when I first started having seizures that I made a
connection with dark coloured icy poles and the simple partial seizures I
suffered. I voluntarily stayed away from the raspberry flavours.
Many of the anti-convulsants used for seizure control are coloured to
differentiate the strengths of the tablets so this problem is not just peculiar
to my medication. I would be interested to know if you can help in this area.
Please report if you notice a reaction to additives in medication to any
or preferably all of the following.
It is the only way we can get change – slow but better than nothing.
1.
Adverse Medicines Events Line
This is a national phone hotline run by the
2. The
manufacturer – through their website, click on Contact Us
3. Tell
us so we can share it with others (suedengate@ozemail.com.au)
4.
The health commissioner in your
state (this is a new service)
|
Community
and Health Services Complaints Commissioner Telephone:
02 6205 2222 Website: www.healthcomplaints.act.gov.au/c/hcc
Email: health.complaints@act.gov.au |
Health
Care Complaints Commission Telephone:
02 9219 7444 Telephone:
1800 043 159 (freecall) Fax: 02
9281 4585 Email: hccc@hccc.nsw.gov.au |
|
Health and
Disability Commissioner Telephone:
0800 11 22 33 (national freephone) Email: hdc@hdc.org.nz |
Commissioner
for Health and Community Services Complaints Telephone:
08 8999 1969 Telephone:
1800 806 380 (freecall) Email: hcscc.omb@nt.gov.au |
|
Health
Quality and Complaints Commission Telephone:
07 3120 5999 Queensland
Toll Free 1800 077 308 (outside the Email: info@hqcc.qld.gov.au |
Telephone:
08 8226 8666 Toll free
in SA 1800 232 007 |
|
Office of
the Health Complaints Commissioner Telephone:
03 6233 6348 Telephone:
1300 766 725 www.healthcomplaints.tas.gov.au/
Email: health.complaints@justice.tas.gov.au |
Office of
the Health Services Commissioner Telephone:
03 8601 5200 Telephone:
1800 136 066 (Toll free) www.health.vic.gov.au/hsc/index.htm
Email: hsc@dhs.vic.gov.au |
|
The Office
of Health Review Phone:
(08) 9323 0600 Country Free
Call: 1800 813 583 Email: mail@healthreview.wa.gov.au |
|
References and
further reading
Labelling requirements for medicines
in Australia
The Therapeutic Goods Order No. 69 “General requirements for labels for
medicines” (TGO69) is the standard (under the Therapeutic Goods Act 1989) which
specifies the information that must be included on the labels of medicines
supplied in
Additive health warnings for
European medications
Health warnings are required on packet inserts for European medications
when certain additives are used in medications. The warnings apply to the use
of azo dyes such as tartrazine (E102), sorbate, benzoate and sulphite preservatives and
antioxidants BHA (E320) and BHT (E321). They include potential ‘allergic
reactions’, ‘mild irritation to the skin, eyes and mucous membranes’,
‘bronchospasm’ (difficulty breathing) and possible ‘severe hypersensitivity
reactions’. European Commission Volume 3B Guidelines: excipients in the label
and package leaflet of medicinal products for human use July 2003 http://www.foodcomm.org.uk/PDF%20files/EU_guidelines.pdf
Additive warnings for
European foods
From 2010, foods in the EU that contain any of the so called Southampton
Six artificial colours (102, 104, 110, 122, 124, 129) must include a warning on
the label "may have an adverse effect on activity and attention in
children" http://www.epha.org/a/3171
Additives permitted in
Australian Food
The
This study showing that additives can affect children’s behaviour and
learning ability - not only children with ADHD, but children in the general
population – led to a voluntary ban on artificial colours in the
How additives affect children
The main behavioural effects of additives are irritability,
restlessness, inattention, sleep disturbance: Rowe, K.S. and Rowe K.L. (1994)
'Synthetic food colouring and behaviour: a dose response effect in a
double-blind, placebo-controlled, repeated-measures study'. Journal of Pediatrics 1994;125:691-8.
Perfumes
About 30 per cent of adults report adverse reactions to fragranced
products. In 2007, fragrances were named "allergen of the year" by
the American Contact Dermatitis Society to highlight the 'real but potentially
avoidable' problems caused by these allergens. Fragrance ingredients have been
listed by the US National Academy of Sciences as one of six categories of
neurotoxic chemicals that should be more thoroughly investigated as primary
causes of disease in humans (along with insecticides, heavy metals, solvents
and food additives). More information: Read the Label: Fragrances by Pat
Thomas, The Ecologist Magazine http://www.theecologist.org/archive_detail.asp?content_id=676
Salicylates in medication
One of the most commonly used teething gels for babies has been linked
to a potentially fatal disease. British authorities say the active ingredient -
choline salicylate - in Bonjela may put children at
risk of Reye's syndrome, a rare brain and liver disease. http://www.abc.net.au/news/stories/2009/04/24/2552251.htm
Don't take the medication unless
it is essential
‘Giving either “over-the-counter” or prescription medications
unnecessarily to young children is an increasing concern’: Oberklaid,
F Giving Medication. Childcare and Children’s Health Series, RCH, 2005 http://www.rch.org.au/emplibrary/ecconnections/CCH_P_April2005_English.pdf
Food Intolerance
Clarke L, McQueen J, Samild A, Swain A. The
dietary management of food allergy and food intolerance in children and adults.
Aust J Nutr
Diet 1996;53(3):89-94.
Dengate S, Fed Up: Understanding how food affects your child and what
you can do about it, Random House Australia, 2008
Sugar free sweeteners (polyols)
Pink diarrhoea: Hill RE and Kamath KR,
"Pink" diarrhoea: osmotic diarrhoea from a sorbitol-containing
vitamin C supplement. , Med J Aust, 1982;1(9):387-9
and more information about polyols http://www.fedupwithfoodadditives.info/factsheets/Factsugarfree.htm
Side effects of medication
No drug is completely safe. In the
Third leading cause of death - Starfield
B, Is US health really the best in the world? JAMA
2000;284(4):483-484.
Medication side effects - Lazarou J and
others, Adverse drug reactions in hospitalised patients, JAMA
1998;270(15);1200-1205.
Safety of new drugs not guaranteed - Lasser, Timing
of new black box warnings and withdrawals for prescription medications, JAMA
2002;287(17):2215-20.
Vioxx - http://www.consumeraffairs.com/news04/vioxx_estimates.html
The information given is not intended as
medical advice. Always consult with your doctor for underlying illness. Before
beginning dietary investigation, consult a dietician with an interest in food
intolerance. You can find a supportive dietitian through the Dietitians
Association of
© Sue Dengate June 2009
