ASA Complaints: Punga Tails, Magic Bracelets, and Bad Appeals

2 days ago, the Advertising Standards Authority published 4 more decisions regarding complaints I’d made. Each of these decisions was focused on a different type of product, but they were all therapeutic products. The decisions released were:

13/177 Amber Teething Beads – Punga TailsSettled
13/180 Energy Bracelet – 6ShooterSettled
13/190 Mohdoh – Punga TailsSettled
13/011 Infrared Sauna – Innate HealthAppeal dismissed; complaint upheld

13/177 Amber Teething Beads – Punga Tails

Punga Tails is a New Zealand business that, as far as I can tell, is owned and operated by naturopath Lydia Dorotich. It sells products for infants and has a focus on therapeutic products, including Baltic amber teething necklaces.

Mrs Dorotich has made various public statements claiming that Baltic amber can relieve teething, and that she personally recommends them. For example, from one of her listings on Trade Me:

As a qualified Naturopath and Medical herbalist (see my profile), I highly recommend the use of Baltic Amber for teething babies. Many parents have found that by wearing a Baltic Amber teething necklace the symptoms of teething have reduced.

On a Grabone deal some months ago, a customer stated that she was “a little unsure what these are for”. Given that Grabone generally tries very hard to avoid therapeutic claims and had not mentioned any in this deal (although the listing was for “Authentic Baltic Amber Teething Beads”), that confusion can be understood. In response, Lydia posted this:

Amber teething necklaces are to be worn against the skin. When amber is worn against the skin the benefits from the amber are absorbed into the skin and help to soothe the pain and inflammation caused by teething. They reduce drooling, red cheeks, nappy rash, swollen gums, low-grade fevers and sleeping problems associated with teething.

I have already thoroughly dealt with claims such as these in my previous post on amber teething necklaces. If you’re interested in why claims such as these are completely implausible, have a read of that post. Of course, even if these claims were plausible, it would still not be reasonable to believe them given that they are entirely unsupported by evidence.

Although both of these advertisements were in blatant violation of the Advertising Standards Authority’s Therapeutic Products Advertising Code, in that they made unsubstantiated therapeutic claims, they are not the advertisements I have complained about. Instead, I complained about the advertisements on the Punga Tails website itself.

There are various advertisements on the Punga Tails website, and they all link back to the Baltic amber FAQs page. It is on this page that most of the therapeutic claims were made. Here are some of the claims from that page that I highlighted in my complaint:

“The therapeutic effects of Baltic amber come from the succinic acid contained in it.”
“Baltic amber warms against the skin, releasing it’s therapeutic properties safely and naturally.”
“The therapeutic properties of Baltic amber include analgesic, calmative, anti-inflammatory, antispasmodic, expectorant, and febrifuge (reduces fever).”
“[Baltic amber teething necklaces] can boost the immune system and ease many ailments such as eczema, fatigue, fibromyalgia, carpal tunnel syndrome, migraines, psoriasis, menstrual cramping, pain, all types of arthritis, reduces stress, anxiety and depression.”
“Baltic amber is a natural analgesic so is ideal for pain relief with no side effects!”
“[Hazelwood] will help with the teething just as well.”

A couple of other pages on the site also made therapeutic claims regarding these products, such as:

Baltic amber is a natural way to reduce pain & inflammation WITH NO SIDE EFFECTS!

In response to my complaint, Punga Tails changed a lot of the content on their advertisements for Baltic amber teething necklaces. All of the claims that were not on the FAQs page seem to have been removed, and the FAQs page itself had quite a content overhaul. In light of this, the chairman of the ASA decided that the complaint should be considered settled.

When a complaint is settled that means the chairman has decided that as a result of the advertiser’s self-regulatory action “it would serve no further purpose to place the matter before the Complaints Board.”

Disappointingly, the FAQs page is still misleading on the subject of amber teething necklaces. The therapeutic claims it still contains are no longer as explicit, but they are still clearly there. They have generally been changed to claims about what is commonly believed, and references to its “effectiveness” remain. For example:

Succinic acid is the component of amber that is believed to contribute to the beneficial effects on teething.

This could explain why some amber teething necklaces are less effective.

Looking on the bright side for once, in the remnants of the FAQs page there is still one small part that I am mostly happy to see. One small piece of grudging honesty:

Because Baltic amber teething necklaces have not been scientifically proven we cannot make any claims as to their effectiveness.

I’ve uploaded my complaint and the details of the complaints board’s decision for you to read if you’re interested: 13/177 complaint and decision details

13/180 Energy Bracelet – 6Shooter

A friend on Facebook alerted me to this one. 6Shooter is a deals website, and they’d posted a deal for an “Health Nano Quantum Energy Bracelet/ Wristband”. Given the name of this product, you might not be surprised to hear that it can basically turn you into a superhero. Here are some of the unsubstantiated therapeutic claims I listed in my complaint:

“It will transmit nutrients and oxygen to cell and expel toxin in our body,people wont have feel cold with hand and feet any more”
“It will provide energy to blood corpuscle and lower viscosity,then reduce the chance to get cardiovascular disease,heart disease and wind-stroke”
“Strengthen human body BIO energy field to prevent harmful electromagnetic wave.”
“Protect us from electromagnetic waves from computer, mobile phone, electrical appliance, telecommunications and so on,recover our body with balance and coordination.”
“Stabilize oxygen supply in blood, activate blood corpuscle”
“Provide relief from allergies and respiratory related illnesses.”
“Normalize hormonal imbalances.”

I also brought up the fact that the advertisement misused a lot of scientific terms. This was relevant to my complaint as the Therapeutic Products Advertising Code requires that:

Scientific terminology must be appropriate, clearly communicated and able to be readily understood by the audience to whom it is directed.

I explained that the product name misused the terms “nano”, “quantum”, and “energy”. It seems quite clear that whoever is trying to sell these bracelets has simply put some sciencey-sounding words in the name to help convince their target audience: innocent people who simply don’t know any better.

The advertisement also refered to a “human body BIO energy field”, yet there is no such thing as far as we’ve ever been able to detect. Finally, I referred the following as “an example of gratuitous use of pseudoscience”:

Negative ion is the basic element to maintain good health.It can neutralize oxidized substance,such as cells.So the cells are revived and improved the immunity of human body.

I also mentioned that the claim that the product would offer protection from “electromagnetic waves from computer, mobile phone, electrical appliance, telecommunications and so on” constituted playing on consumers’ fair without justifiable reason, since there is no evidence to suggest that such electromagnetic radiation is harmful to humans.

This complaint was settled, after the advertiser responded by permanently removing the product from their stock. They also stated that they never intended to mislead consumers.

I think this case is a good example of why it is important to support science information and to point out pseudoscience for what it is. There are many products such as these which rely on people’s ignorance in order to convince them by sounding like science without having any of the actual substance. If more people can be educated in how to tell the difference between science and pseudoscience, scammers like the people who make and sell these bracelets will have less of a chance for success.

I’ve uploaded my complaint and the details of the complaints board’s decision for you to read if you’re interested: 13/180 complaint and decision details

13/190 Mohdoh – Punga Tails

After submitting my complaint about their amber teething necklaces, I found this product as well on the Punga Tails website. It’s basically smelly playdough, which is claimed to provide certain specific health benefits via aromatherapy and colour therapy. I submitted a complaint about this not so much because I was worried about health fraud, since this product appears to be harmless in that aspect, but because I also feel committed to fighting pseudoscience.

Similar to their amber teething necklaces advertisements, the majority of claims here were on an FAQs page. The misleading information here mostly related to aromatherapy and colour therapy, instead of being specific to the products being advertised, although there were a few specific claims as well. Here are a couple of the most egregious pseudoscience that were on that page:

“Colour therapy is a holistic and non-intrusive form of healing, which introduces the optimum balance of colour energies into the human organism in order to promote harmony between the body, mind and spirit.”
“If our energy centres (Chakras) become blocked or depleted, then our body cannot function properly and this, in turn, can lead to a variety of problems.”

The products also used to have specific indications. Bizarrely, even though they appeared to be marketed toward infants (including being in the “Babies Natural Care” section), one of the products was given the following indication:

Helps you quit smoking

This complaint was settled, after the advertiser removed most of the pseudoscience and therapeutic claims from the page. I was happy to see the introduction of the following disclaimers:

While Aromatherapy is not scientifically proven…

Colour therapy is not a scientifically proven therapy.

I’ve uploaded my complaint and the details of the complaints board’s decision for you to read if you’re interested: 13/190 complaint and decision details

13/011 Infrared Sauna – Innate Health

Recently, I wrote about 3 complaints against Innate Health. One of these complaints, number 13/011, was about an advertisement in Coffee News for an infrared sauna that made various unsubstantiated therapeutic claims, and bizarrely stated that the product could:

Activate every cell in your body to increase your sense of well-being

The complaint was originally upheld on the 18th of March. On the 9th of May, I received a notice from the ASA saying that an appeal that had been submitted on this complaint had been accepted. This doesn’t mean the complaint had been successfully upheld, it just means that the appeal will be heard by the complaints board and they would then decide whether or not their decision should be changed. I was contacted because, as the complainant, I was to be given an opportunity to respond to this appeal.

The appeal claimed to present new evidence, and was basically just one really long citation of a bad review. I got the impression that Barbara Good Hammond, owner of Innate Health, came across this article some time after the complaint was upheld and thought she saw an opportunity to have the decision changed.

The article in question is a review published in Alternative Medicine Review in 2011, entitled Sauna as a Valuable Clinical Tool for Cardiovascular, Autoimmune, Toxicant-induced and other Chronic Health Problems. It was written by a naturopath called Walter Crinnion.

The article was a (non-systematic) review of the evidence regarding saunas as a therapeutic intervention. It seemed to rely very heavily on pilot studies and unpublished research, and seemed to be a rather unreliable source.

In the original complaint, the complaints board decided that “Activate every cell in your body” could be considered puffery. This means that it is obviously meant to be a ridiculous exaggeration and would not be taken seriously by anyone, so does not require substantiation. As part of the appeal, the advertiser disagreed with this analysis, claiming that the statement is not puffery and could be substantiated. They then proceeded to attempt to substantiate the claim:

With the whole body being effected [sic] during therapy, circulation is enhanced to every cell. The modality of Far Infrared sauna therapy has been substantiated world wide [sic] for improving cardia-vascular [sic] function, and with the heart being directly responsible for pumping and circulating blood to every cell in the body (as reported in Anatomy & Physiology books and being general knowledge) this would have a direct impact to increase the bodies [sic] sense of well-being, as proven and shown in published clinical studies worldwide.

She then went on to quote a paragraph from Crinnion’s review that seemed to be pretty much irrelevant to the claim, then declared that the statement “is legitimate and should not be considered puffery”.

This appears to be the one thing on which both Ms Hammond and I can agree: that statement should not be considered puffery. Bizarrely, even though the advertiser specifically said the statement is not puffery the complaints board reiterated their previous decision on this statement, saying that it should be considered puffery and therefore doesn’t need to be substantiated.

The rest of the text of the appeal is fairly benign and unconvincing, but there are 38 references listed at the end of it. At first, I thought that seemed pretty intimidating. However, after a minute or so I noticed that they were copied and pasted directly from the review, including spelling mistakes and formatting errors. Worse than that, many of them were duplicates, and there were actually only 25 unique references.

I got the distinct impression that Barbara Good Hammond didn’t even attempt to find these references to look at them herself. I’m not sure how else I can explain the fact that she cited the same piece of unpublished research 3 separate times. Nonetheless, with the help of a contact at the University of Auckland, I was able to get my hands on the full text of 12 of the references, and the abstracts of a further 6 references.

I went through each reference one by one, and found them all to be either irrelevant or inadequate substantiation for the claims made in Innate Health’s advertisement. In their decision, the complaint board seemed to agree with me, stating that:

Turning to the Advertiser’s evidence, the Complaints Board considered the Advertiser had not adequately substantiated the claims. It noted that one research authority was a naturopath, not a doctor or scientist, and the saunas about which the research was done were not infra red saunas but Finnish saunas. While the Complaints Board noted the research said there may be some merit in using Finnish saunas, this did not reach the threshold to validate the very strong claims in the advertisement, particular [sic] as that research discussed a different type of sauna.

If you’re interested, you can read the entire appeal application and my response: Complaint 13/011: appeal 13/013, response to appeal, and decision details

ASA Appeal: U-GO’s Amber Teething Necklaces

A week ago I published my write-up of a complaint I made to the Advertising Standards Authority about an advertisement for amber teething necklaces on the U-GO website.

In my write-up, I explained how I had appealed the ASA’s decision to settle the complaint without the advertisement being removed or changed, and that my appeal had been declined but I was not sure why. As it turned out, I received the details as to why my appeal had been declined in the mail on the same day as I published my write-up. I edited my previous post to explain this, but the vast majority of people who have read it did so before I made that edit.

Usually I receive correspondence from the ASA regarding my complaints both via email and on paper, but for some reason this was only sent to me via the post. Whenever they send out details of their decisions, they ask that they not be made public until the ASA has released them to the media, which is why I’ve waited until now to publish this write-up.

It turns out that my victory was bigger than I’d realised. When U-GO removed their advertisement on the 19th of February (the date my appeal was declined), I thought that it was still going to be later republished after they had attained the approval of TAPS, the Association of New Zealand Advertisers’ Therapeutic Advertising Pre-vetting System, as this had been implied in their original response to my complaint:

Also, because our business has taken us in to other areas of advertising we have employed the services of TAPS adjudicators and understand more the seriousness of making therapeutic claims in our advertising.

When we make these necklaces available again we will ensure the standards are met.

However, the response to my appeal revealed that U-GO has decided to stop selling these necklaces. Here is the entirety of the correspondance from U-GO that the ASA forwarded to me in relation to my appeal:

… [T]he Baltic Amber Teething Necklaces have been withdrawn from sale. We will not be offering these for sale again.

Because these necklaces were a very minor part of U-GO’s business, they were easily able to withdraw them from sale in response to the complaint. While I am very happy with this result, the fact that they were willing to informally resolve the complaint instead of requiring the Advertising Standards Complaints Board (ASCB) to make an adjudication and choose whether or not to uphold the complaint means that no useful precedent has been set.

Since receiving this news, I have made 2 more complaints about advertisements for practically identical products. One of these advertisers’ businesses relies entirely on the sale of amber necklaces for therapeutic purposes, so I anticipate that the ASCB will have to uphold that particular complaint instead of it being informally settled. Once a precedent has been set, it should make it much easier and quicker to have future complaints about advertisements of these products upheld.

The advertisements that I have complained about are on the Belly Beyond website and the Baby Amber Teething New Zealand website. You can expect to see write-ups for each of these complaints here eventually.

I feel as though I should acknowledge that it’s possible that U-GO only didn’t remove the advertisement immediately because they thought it should be left in place for the duration of my ASA complaint in order to help the ASA’s process. I can’t say for sure, but this seems implied by a couple of things they said in their original response to my complaint:

I would like to say that had I seen this advertisement on our website I would have changed it immediately.

We have left the advertisement as it is on the website for the duration of this complaint but have made it unavailable for sale.

If they had no problem with removing the advertisement then they should have removed it as soon as they received the complaint, but I can believe that they may have misunderstood this.

The full details of my appeal and the decision to have it declined are available on the ASA’s website and on Honest Universe.

ASA Complaint: U-GO’s Amber Teething Necklaces

In my previous post on amber teething necklaces, I described the problems with the therapeutic claims commonly associated with them. One of the websites I quoted is a New Zealand website, “U-GO” Products, that sells amber teething necklaces (among other things) online.

Late in 2012, I made a complaint about the content of their site. Took a screenshot of the site as it was at that point, with the offending phrases highlighted. Here’s what the advertisement said:

Wearing Baltic amber close to the skin is a traditional European remedy for baby teething.

Considered a natural analgesic, Amber is reported to help calm a baby without resorting to drugs. Used for centuries in Europe, amber’s natural anti-inflammatory and pain relieving properties are perfect to soothe teething babies.

Amber is a fossilized resin containing high levels of succinic acid, attributed for its pain relief and anti-anxiety properties.

When worn the bead warm against the skin, releasing its therapeutic properties safely and naturally.

After reading this, I wrote up a complaint to the ASA, which is included at the end of this post. The complaint followed this format:

Explained how this product is a therapeutic product as defined in the ASA’s Therapeutic Products Advertising Code.
Identified the therapeutic claims made in the advertisement.
Stated that these claims lack substantiation, which is required by the code.
Explained why these claims are unlikely to be true.
This product has associated risks (I was able to cite the Ministry of Consumer Affairs here) but lacks warning labels and therefore also does not demonstrate the high degree of social responsibility required of such advertisements.

It took quite some time for me to hear back from the ASA. My complaint was accepted on the 11th of December 2012 to be put before the Advertising Standards Complaints Board (ASCB), but I did not received the full details of the decision until the 12th of February.

The advertiser’s initial response to my complaint was not to change the content of the advertisement. Instead, they changed the page to show the product as being “SOLD OUT” and said my concerns are dealt with on the supplier’s website. Their entire response has been included at the bottom of this post.

Amazingly, the ASCB considered this action to be sufficient to consider the complaint to be settled and not bother to uphold it or ask them to remove the advertisement or the unsubstantiated claims contained within it. I was quick to see that this precedent provided a massive loophole through which advertisers could make whatever therapeutic claims they want (so long as they don’t draw too much attention to themselves) while effectively escaping all regulation. I did all I could do in response to this decision: I appealed.

In my appeal I addressed both my concern with the poor precedent set by the decision and the claims made by the advertiser that the supplier’s website addressed my concerns. The website did partially address my safety concerns, but not enough to justify a lack of safety warnings. However, their attempt to address my claims as to efficacy and plausibility were laughable, and I reveled in the opportunity to use that wonderful word “quackery” in my appeal. You can see my appeal in its entirety at the bottom of this post.

After making my appeal on the 13th of February 2013, I checked the advertisement daily. On the 18th, it still appeared unchanged, but on the 19th the page was removed entirely. Soon after this, on the 21st, I heard back from the ASA that my appeal had been declined. Although the complaint’s decision is now listed on their website, I have received no more information regarding my appeal, and it is not mentioned alongside the complaint on their website.

I have set up a Google Alert so that if U-GO ever lists amber teething necklaces on their website again, I’ll know about it as soon as Google does. I also hope to use this complaint as precedent to have other similar advertisements removed. I’d hope to be able to have such complaints upheld without having to wait over 2 months for a decision on each complaint, but as this complaint was settled and not upheld I don’t know whether or not the ASCB will treat it as setting a strong precedent.

I encourage anyone else reading this to do the same if you ever see an advertisement for amber teething necklaces in New Zealand (or elsewhere, it’s just that this precedent is specific to New Zealand). For reference, the complaint’s identifier is 12/611.

The full details of the decision can be seen on the ASA’s website here. I have also hosted the Complaint Decision Details, including complaint and advertiser’s response, here on Honest Universe.

Here is the content of my appeal:

I would like to appeal the decision of complaint 12/611 on the basis that it is in the interests of natural justice that the matter be reheard.

While I appreciate that the advertiser apologised for the advertisement, the primary concern is that the therapeutic claims made in the advertisement are unsubstantiated and this still has not changed. If the advertiser is willing to admit that “had I seen this advertisement on our website I would have changed it immediately” then I expect they would not be opposed to changing it immediately now that it has been drawn to their attention.

I also appreciate the advertiser’s obvious wish to comply with the ASA’s standards, presumably as they have no wish to mislead consumers. However, leaving the advertisement unchanged until the product is made available again does nothing to address the concerns with unsubstantiated therapeutic claims. If they wish to make the product unavailable for any duration then that’s their prerogative, but regardless they should also remove the unsubstantiated therapeutic claims made about it.

The advertisement about which the complaint was made has not been altered or removed. This means that the unsubstantiated therapeutic claims made in the advertisement remain published and continue to potentially mislead consumers.

That the product being advertised is currently listed as “SOLD OUT” should have no effect on the decision made about this complaint. The issue at the heart of the complaint is the content of the advertisement, not the availability of the product. As that has not changed, the complaint should not be considered to be settled, in the same manner as a complaint made about the content of an advertisement for a product temporarily listed as “SOLD OUT” should not be dismissed as having no grounds to proceed.

If the content of the advertisement is to be changed in the future to comply with the ASA’s codes in that it will only make therapeutic claims if they have been substantiated then that is good, but in the meantime the unsubstantiated claims made in the current advertisement should not remain published. In lieu of being changed, the advertisement should be taken down so as not to mislead the public further.

By utilising the tactic used by U-GO in response to this complaint, it would be possible for any business to advertise a product with misleading information, potentially even intending to defraud consumers, but escape regulation by listing the product as “SOLD OUT” for as long as such content remains published. This does not prevent consumers from being misled by such an advertisement, and they may be influenced to return to purchase the same product when it becomes available again in the future, or to purchase an identical or similar product elsewhere. This behaviour does not exhibit the high standard of social responsibility required by the ASA’s Therapeutic Products Advertising Code principle 3.

As written in the ASA’s constitution, the primary object of the ASA is:
“To seek to maintain at all times proper and generally acceptible standards in advertising and any other activity regulated by the Code of Practice” (emphasis mine).
Providing advertisers with a loophole such as this that they might be permitted be publish misleading and unacceptable advertisements free of industry regulation goes counter to this goal.

==========

With regard to the advertiser’s claim that “The complaints raised by M. Hanna regarding strangulation and succinic acid are explained on the suppliers [sic] website”, upon reading the pages provided by the advertiser I am unconvinced. While my safety concerns are dealt with to a small degree (despite existing safeguards a warning would still be pertinent) the issues of substantiation and the plausibility of the succinic acid hypothesis are not.

I realise that, not being a New Zealand website, the content of the Amberizon website does not fall under the ASA’s jurisdiction, but for completeness’ sake I will discuss this here.

———-

On the “Healing properties of amber” page (http://www.amberizon.com/page/healing_properties_of_amber_healing_gemstone.html), the following is stated:

“Amber is a powerful chakra cleanser and healer. At a physical level, is [sic] imbues the body with vitality and has the power to draw disease out of the body. By absorbing pain and negative energy, amber allows the body to rebalance and heal itself. Amber alleviates stress.

Amber provides decisiveness. It strengthens your memory and intellect and helps with emotional calming and centering. It is an excellent grounding crystal, and transmutes negative energy to positive. Amber radiates a warm and bright energy.”

The vast majority of this content is meaningless pseudoscience. For example, there is no high-quality scientific evidence that “chackras” exist at all, let alone that they are relevant to health and can be affected by objects such as this.

“is [sic] imbues the body with vitality and has the power to draw disease out of the body” is similarly nebulous pseudoscientific nonsense, lacking both credibility and substantiation.

“By absorbing pain and negative energy” again is utter nonsense. Pain is not some substance that can be absorbed, and the phrase “negative energy” is inappropriate and, in this context, undefined.

I hope that it is absolutely clear to everyone that the second paragraph quoted above contains absolutely no sense or science. In fact this looks like a brilliant example of quackery, in which pseudoscientific nonsense is used to peddle a probably useless product. Although I am happy to note that U-GO has not quoted any of this nonsense in their own advertisement, that it considers this group “experts for this product” is concerning, to say the least.

That page also has this to say about amber teething necklaces:
“Wearing baltic amber close to the skin is a traditional European remedy for baby teething. A natural analgesic, amber will help calm a baby without resorting to drugs. Used for centuries in Europe, amber’s natural anti-inflamitory [sic] and pain relieving properties are perfect to soothe teething babies. Amber is fossilized resin, which warms against the skin, releasing it’s [sic]theraputic [sic] properties safely and naturally.”

This paragraph is practically identical to the one currently used by U-GO in their advertisement, which I have already discussed in my original complaint.

———-

The “Baby Teething Necklaces” page (http://www.amberizon.com/shop/amber_teething_necklaces_baby_teething_necklace_teething_beads_babies.html) says this:

“As a safety feature there is a knot before and after each bead, so that even in the extremely unlikely event of the string being torn, no beads are lost and there is no risk of choking. Amber teething necklaces are secured with a traditional screw clasp, not a hook and ring!”

I am glad to hear that the products have these safeguards in place, but I also feel it is important to note that they do not entirely negate the significant risks of choking and strangulation. It would be pertinent to include a similar warning to the one issued by the Ministry of Consumer Affairs about amber teething necklaces (http://www.consumeraffairs.govt.nz/for-consumers/goods/product-safety/keeping-kids-safe/amber-teething-necklace), namely that infants should be supervised at all times while wearing these necklaces.

It also seems relevant to point out that a consumer has previously complained about these necklaces (purchased from Amberizon) citing safety concerns despite the website’s reassurances after testing the necklaces themselves: http://www.scambook.com/report/view/36179/Amberizon-Complaint-36179-for-$113.15

It seems relevant that the Therapeutic Products Advertising Code part B2 requirement 2(a) specifies that:
“If the medical device has… specific warnings that may affect the safe use of the device… an appropriate warning must be given.”

———-

I have not been able to find any information on those 2 pages of the Amberizon website that respond to my complaints regarding the succinic acid hypothesis. Since originally making this complaint and researching the issue further, I have uncovered several more serious issues with this hypothesis that I have not seen dealt with and would be happy to detail if necessary.

After submitting my appeal, I was asked to clarify the “supplementary material” included in my appeal application. They seemed satisfied when I told them I was responding to the claims made by the advertiser in their response to my complaint, and that the information I discussed was found by following the links provided by the advertiser in their response.

I also sent them information regarding the recent decision by the UK’s ASA on another advertisement for amber teething necklaces, which was passed on to me by Autismum:

I thought it might be worth mentioning that new evidence relating to complaint 12/611 has been brought to my attention in the form of advice published by the UK’s Committee of Advertising Practice in response to a complaint upheld against an advertisement similar to the one in this complaint. I realise that regulation in the UK is not identical to here in New Zealand, but the information still seems relevant.

This advice can be found published online at this location: http://www.cap.org.uk/Advice-Training-on-the-rules/Advice-Online-Database/Amber-Jewellery.aspx

UPDATE:

After arriving home after this post was published and checking the mail, I now have the details of why my appeal was declined. I’m not sure why this information was not emailed to me, but at least I have it now.

The ASA ask that the details of their decision not be released publicly until after they’ve released them publicly themselves, so I’ll publish a follow-up post with this information once that has happened, on the 4th of March.

Amber Teething Necklaces

When infants are born, both sets of teeth are concealed in their gums. Usually when they’re around 6 months old, their first teeth begin to protrude from their gums in a process known as teething. All of their teeth don’t come through at once, but for most babies all 20 of their deciduous teeth (colloquially called “baby teeth” or “milk teeth”) will have come through by their 3rd birthday.

During this time, some babies develop symptoms like irritability and disrupted sleeping. This can be frustrating and distressing for parents. While adults have the option of taking drugs for pain relief, parents generally feel understandably hesitant to pick the same solution for their babies’ discomfort. One common solution that is offered is “amber teething necklaces” – a necklace strung with beads of amber that supposedly can decrease the symptoms of teething.

Claims about how these work vary quite widely. Many sources cite completely implausible mechanisms, such as those described on Baby Amber Teething’s “About Us” page and Teething Made Easy’s “Amber Info” page:

The amazing quality of amber is ionization which helps protecting [sic] human body from various magnetic fields (amber absorbs some waves, including radioactive ones).

It is thought that amber is electromagnetic and produces large amounts of organic, natural energy

However, the most common claim I can find seems plausible. For example, here is what AmberTeethingNecklace.org’s “How Do Amber Teething Necklaces Work?” page says:

When a teething necklace made of authentic baltic amber lies against your baby’s skin, his body heat will warm the fossilized resin and allow the release of naturally-occurring succinic acid. When contact between the teething necklace and skin is maintained, succinic acid is absorbed and the healing, pain-relieving properties begin to take effect.

This claim seems to be repeated on the majority of sites selling amber teething necklaces. For example, here is what “U-GO” Products has to say on their Genuine BALTIC AMBER Teething Necklace product page:

Amber is a fossilized resin containing high levels of succinic acid, attributed for its pain relief and anti-anxiety properties.

When worn the bead warm [sic] against the skin, releasing its therapeutic properties safely and naturally.

Here is a simplified list of the claims involved in this explanation:

Baltic amber contains succinic acid
When worn against the skin, the amber is warmed up
When the amber is warmed up, it releases succinic acid
When the succinic acid is released, it is absorbed through the baby’s skin
When the succinic acid is absorbed through the baby’s skin, it relieves teething symptoms

1. Baltic amber contains succinic acid

According to Anderson et al., amber can be classified into 4 classes. The most abundant ambers are “Class I”, and amber in this class is further classified into 3 sub-classes. Baltic ambers are “Class Ia”, and “incorporate significant amounts of succinic acid into their macromolecular structure”[1]. This quality also seems to be where another name for Baltic amber, succinite is derived.

2. When worn against the skin, the amber is warmed up

This seems straightforward. Skin temperature is generally slightly above room temperature (around 32-35 °C compared with 20 °C), and apparently teething can cause a slightly elevated temperature as well[2].

3. When the amber is warmed up, it releases succinic acid

This is a bit harder to believe. The melting point of succinic acid is 188 °C[3], so it definitely isn’t seeping out of the amber in liquid form, as generally implied in the descriptions of how amber teething necklaces work. However, it is soluble in water[3] so presumably it could dissolve in sweat but considering that sweat is used in part as an excretory process this seems unlikely to be an effective method of absorbtion.

Both of these mechanisms of absorption seem unlikely, however, when the age of amber and its exposure to the elements are considered. Amber is fossilised tree resin, and the process of fossilisation. Baltic amber in particular seems to be around 34-56 million years old[4]. In order for it to still contain succinic acid after all this time, it would seem reasonable to assume that it will not yield it easily. It doesn’t seem particularly plausible to me that raising its temperature a few degrees and moistening it slightly could do what 30 million years could not.

4. When the succinic acid is released, it is absorbed through the baby’s skin

This claim strikes me as slightly bizarre after finding out that succinic acid is an irritant[3].

5. When the succinic acid is absorbed through the baby’s skin, it relieves teething symptoms

The only documented therapeutic effect of succinic acid I was able to find is an antiallergenic effect[3]. There appears to be a paper entitled The Therapeutic Action of Succinic Acid, published in 1976 by The Academy of Sciences of the USSR, but unfortunately I can’t seem to find a version of it online anywhere.

Many sites selling amber teething necklaces cite Robert Koch, the winner of the Nobel Prize in Physiology or Medicine in 1905 “for his investigations and discoveries in relation to tuberculosis”[5], as having analysed succinic acid in 1886, when he “confirmed its positive influence and discovered that there is no risk of the accumulation of surplus amounts of succinic acid in the human organism, even after the introduction of considerable amounts into the body.”[6]

Pretty much every mention of Robert Koch I could find on a page about amber teething necklaces used very similar wording, especially something along the lines of “positive effect on the human body”. Because of this, I think they’re all coming from essentially the same initial source, but I’ve been unable to find that.

Although the majority of sites selling amber teething necklaces cite Koch’s research on succinic acid as occuring during 1886, as far as I’ve been able to tell what this is referring to is that in 1865 he studied the secretion of succinic acid in animals fed entirely on fat, under the supervision of Georg Meissner. During this time he also self-experimented with succinic acid, apparently eating half a pound of butter each day. However, he became so sick after continuing this for 5 days that he decided to limit his study to animals. In 1866 he graduated from medical school with the findings of this study being his dissertation.[7]

His dissertation, entitled Ueber das Entstehen der Bernsteinsäure im menschlichen Organismus, was published in 1865 in a journal called Zeitschrift für rationelle Medizin[8]. I was able to find an online copy of his dissertation, in its original German, here.

I’ve read a machine translated copy, but unfortunately the machine translation is difficult to understand. It seems that the dissertation describes the appearance of succinic acid in the urine of rabbits, dogs, and humans after certain meals. Presumably this is the origin of the claim that “there is no risk of the accumulation of surplus amounts of succinic acid in the human organism, even after the introduction of considerable amounts into the body”. I haven’t been able to find the source of the claims of it having a “positive effect on the human body”.

In terms of how long amber necklaces are supposed to last, the information I could find tends to say that they should last indefinitely, potentially even being used across multiple generations. However, this seems incompatible with the idea that the amber works by essentially being a drug dispenser. Without an unlimited supply of the drug, succinic acid in the case, the dispenser should be expected to eventually run out and no longer be effective.

I actually managed to find one website, Teething Tots, that claimed that amber is “ideal as a natural (no drugs) homeopathic product for babies and children”. I find it quite ridiculous that a site purporting to sell homeopathic products describes the mechanism of action of this product as being precisely counter to how homeopathy supposedly works, i.e. that the active ingredient is actually present and counters symptoms, as opposed to no active ingredient being present and using an ingredient that would cause similar symptoms to those being treated.

About 3-8% of Baltic amber is succinic acid[6]. The necklaces apparently weigh around 5.5-8 g[9], which means they contain between 165 and 640 mg of succinic acid. Supposedly, this is enough to remain effective over multiple generations. In comparison, a single recommended dose of the common analgesic paracetamol for infants aged 6-24 months is 120 mg[10]. If an effective dose of succinic acid were assumed to be the same amount (I don’t mean to actually make this assumption, I’m just using it as an illustrative comparison) then an amber necklace would contain between 1.5 and 5.5 doses. Essentially about a day’s worth.

It’s not unheard of for taking a very low dose of a drug over a long period of time to have benificial effects, however. Fluoride, for example, is generally present in low levels in drinking water, and fluordating drinking water in this way is a well-documented way to reduce dental cavities. I have not been able to find any evidence, however, to support the hypothesis that chronic low dosages of succinic acid is an effective treatment for pain relief.

I have also not been able to find any evidence that supports the hypothesis that skin contact with Baltic amber is an effective treatment for the symptoms of teething. The evidence simply is not there. In fact, when searching for information on amber teething necklaces in the medical literature, the only mentions I could find were those describing it as “a quack remedy”[11][12].

Although it’s generally recommended that babies don’t wear the necklaces while unsupervised[13], various sources recommend wrapping it around their ankle while they’re sleeping.

I submitted a complaint to the Advertising Standards Authority regarding the advertisement on the U-GO website, which can be seen archived here – Genuine BALTIC AMBER Teething Necklace – MULTICOLOUR (as of 14 December 2010).

I have received the details of the decision but the ASA has asked me not to disclose them until they release the decision to the media. Once that has happened, you can expect to see a follow-up post here.

I’d like to mention that my initial interest in this topic was motivated by a post made on the Skeptoid blog by Autismum. Here’s a link to that post: The Prettiest Strangulation Device for Your Baby. She’s also written a follow-up post: Amber for Teething Update.

[1] Anderson, K; Winans, R; Botto, R (1992). “The nature and fate of natural resins in the geosphere—II. Identification, classification and nomenclature of resinites“. Organic Geochemistry 18 (6): 829–841. doi:10.1016/0146-6380(92)90051-X

[2] Teething Tots KidsHealth. Retrieved on 2012-12-09

[3] SUCCINIC ACID – National Library of Medicine HSDB Database Hazardous Substances Data Bank. Retrieved on 2012-12-09

[4] Fossil Amber The Virtual Fossil Museum. Retrieved on 2012-12-09

[5] The Nobel Prize in Physiology or Medicine 1905 Nobelprize.org. Retrieved on 2012-12-09

[6] Amber Information All About Amber. Retrieved on 2012-12-09

[7] Koch, Robert (1843-1910) (World of Microbiology and Immunology) Study Guide & Homework Help eNotes.com. Retrieved 2012-12-09

[8] Robert Koch Facts, information, pictures Encyclopedia.com. Retrieved on 2012-12-09

[9] amber teething necklace Huckleberry Baby Shop. Retrieved on 2012-12-09

[10] Doses change for child paracetamol medicines like Capcol – Health News NHS Choices. Retrieved 2012-12-09

[11] Taillefer, A; Casasoprana, A; Cascarigny, F; Claudet, I (2012). “Infants wearing teething necklaces“. Archives de Pédiatrie 19 (10); 1058-1064. doi:10.1016/j.arcped.2012.07.003

[12] Doherty, F (1990). “The anodyne necklace: a quack remedy and its promotion.” Medical History 34 (3); 268-293.

[13] Amber teething necklace – Keeping Kids Safe Ministry of Consumer Affairs. Retrieved on 2012-11-29