Avoid herbal supplements: column


  • Many believe that since these products are advertised as% 2C natural and legally sold% 2C, they are safe.
  • But some herbal supplements can cause real damage to health.
  • And they are not% 2C regulated as many think% 2C by the FDA.

I once diagnosed a patient with high cholesterol and prescribed a drug commonly called a statin. When I saw him for a follow-up months later, he admitted that he had not filled the prescription.

He said he had taken red yeast rice rather. When I asked him why, he said he was wary of the long list of side effects from statins and felt that taking an over-the-counter “natural” cholesterol-lowering supplement was safer.

When it comes to taking herbal supplements, I generally advise patients that most have little evidence to suggest that they actually work, but I leave the final decision to the patients. But two recent studies suggest that patients are better off avoiding supplements altogether.

Americans spend $ 5 billion per year on pills such as echinacea to ward off colds, ginkgo biloba to improve memory, or black cohosh to improve postmenopausal hot flashes. More … than 29,000 herbal products are sold throughout North America, with approximately half of Americans using some form of alternative medicine. Many believe that because these products are touted as natural or organic and sold legally, they are safe.

Not what they seem

This is not necessarily true. A review of the journal BMC Medicine, published last month, used DNA analysis to provide the most definitive evidence to date that herbal supplements are not what they appear to be. The researchers randomly selected 44 supplements and found that most were “of poor quality, including considerable product substitution, contamination, and the use of fillers.”

Consider two bottles of St. John’s Wort used to treat depression. One contained pills that had no evidence of the herb advertised, while the other substituted another herb that has been shown to be a known laxative.

But it goes beyond false advertising. Herbal supplements can cause real damage to your health. The Food and Drug Administration recently tested 21 “100% natural” food supplements and found that nine of them contained unlabeled amphetamine-like compounds. Uncontrolled use of these stimulants can lead to increased blood pressure, increased heart rate and even heart attacks.

FDA issued warning

In 2012, the FDA criticized the herbal industry for causing more 50,000 adverse events annually. Some pills use fillers made up of rice, or worse, black walnut, which can severely affect people with allergies to nuts, while others contain unlabeled toxic ingredients. Many, including garlic and ginkgo biloba, also interact with prescription drugs, which can affect the effect blood thinners and cause life-threatening bleeding.

Back to my patient. Like most Americans, he mistakenly believed that herbal supplements had to be approved by the FDA before they were sold. And he didn’t know that until 70% of herbal medicine producers violated manufacturing guidelines to prevent adulteration of their pills. I shared the results of the recent study with him and he decided to stop taking the supplement.

I then addressed her concerns about statins and recognized the potential for rare and, in rare cases, serious side effects that many prescription drugs share. But these drugs are FDA regulated, so at least we know what’s inside, and what’s inside is working. This is far more than what we can say about the vast majority of herbal supplements patients take today.

Kevin Pho, primary care physician in Nashua, NH, blogged on MedPage Today’sKevinMD.com and is a member of the USA TODAY Contributors Council.

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