title: Clinic at the health food store? Employee recommendations and product analysis.
abstract: OBJECTIVE
  To determine what products health food store employees recommend for depression, to analyze the content of these products based on label claims, and to evaluate employee statements or recommendations for accuracy and safety.
  
  
  METHODS
  Twelve health food stores were selected for the study. One investigator approached an employee in each store and asked what they recommended for depression plus five additional questions regarding product use. Thirteen products containing St. John's wort were purchased and analyzed for hypericin and pseudohypericin content using high-performance liquid chromatography (HPLC). Total hypericin content was calculated by adding the values for hypericin and pseudohypericin.
  
  
  RESULTS
  All 12 health food store employees recommended a St. John's wort supplement for treatment of depression. Furthermore, numerous comments made by employees regarding St. John's wort and the treatment of depression were unsafe and inaccurate. The HPLC analysis revealed that no product contained +/- 10% of the stated label claim for hypericin content, and two products contained 0% hypericin. The total hypericin content (hypericin plus pseudohypericin) of only two products was within +/- 10% of the label claim for hypericin.
  
  
  CONCLUSIONS
  Health food store employees offer health care advice regarding treatment of depression with dietary supplements without proper scientific and medical training. Their comments could cause significant harm to customers. In addition, the inconsistencies of dietary supplement content continue to raise concern for individuals who use these agents as medical treatment.
authors.affiliation: Department of Internal Medicine, University of Mississippi Medical Center, Jackson 39216, USA.
authors.forename: James K
authors.initials: JK
authors.lastname: Glisson
authors.forename: Holly E
authors.initials: HE
authors.lastname: Rogers
authors.forename: Ehab A
authors.initials: EA
authors.lastname: Abourashed
authors.forename: Richard
authors.initials: R
authors.lastname: Ogletree
authors.forename: Charles D
authors.initials: CD
authors.lastname: Hufford
authors.forename: Ikhlas
authors.initials: I
authors.lastname: Khan
mesh_terms: D000873:Anthracenes; D002851:Chromatography, High Pressure Liquid; D003257:Consumer Product Safety / Q000592:standards*; D003863:Depression / Q000188:drug therapy; D004348:Drug Labeling; D004650:Employee Performance Appraisal; D058870:Food, Organic / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020902:Hypericum / Q000737:chemistry*; D010569:Perylene / Q000031:analogs & derivatives* / Q000032:analysis*; D011795:Surveys and Questionnaires
chemical_list: D000873:Anthracenes; D010569:Perylene; C004965:hypericin