Although she complained of the sort of headaches that could have indicated a cancer or circulatory disorder, less than one in four of the staff in the shops recommended she see a GP. All but two recommended a specific alternative treatment.
The anonymous survey was carried out in 29 shops in London by the Research Council for Complementary Medicine, a leading organisation in the alternative medical movement. It says few, if any, of the recommendations were backed by scientific evidence and there was little consistency.
The woman carried a concealed tape recorder and her conversations with staff were analysed later. She said she had been getting a lot of headaches recently and asked what they would advise. If questioned, she said the headaches had started three to four weeks previously, were most severe in the morning and occurred almost every day. The symptoms were chosen because they could indicate serious disease.
Many of the shops offered possible causes, which included the weather and "using the brain too much".
The remedies proposed ranged from essential oils, to vitamin tablets and bitter foods to aid digestion. Specific treatments included feverfew, Bach flower remedies and Ginkgo-kola complex. Headaches are mostly caused by tension or migraine and are rarely serious. However, a new and persistent headache should be investigated, especially if it is accompanied by problems with vision, vomiting, weakness or paralysis. A headache which has been happening for years is unlikely to be dangerous.
The study, published in the Journal of the Royal College of Physicians, found 17 out of 18 of the shops contacted later claimed to have a policy on giving advice to customers. In some this included asking the customer whether they had seen a doctor. However, in many cases the advice had been ignored.
Andrew Vickers, director of the Research Council, says in the Journal that it is likely shops outside London would respond in a similar way to the same customer. Other research suggests a small but significant section of the public consults health food shops and relies on their advice. "Health food shops should re-evaluate their practices, paying particular attention to staff competence and referral to conventional care."
In an editorial in the Journal, Edzard Ernst, professor of complementary medicine at Exeter University, said: "The results suggest that the advice given is often inadequate and may at times be outright dangerous." Professor Ernst added that most people believed complementary medicine was virtually risk free. The study showed that there were significant indirect risks linked to the advice given.
"Shop assistants should always be competent whatever product they're selling, but this is much more important when the customer is buying health- related products."