An estimated 40 million Americans take herbal supplements assuming that they are safe and effective. They often are, but a new journal article highlights the very real dangers of herbal remedies.
In their new article "Global hazards of herbal remedies: Lessons from Aristolochia," published this month in "EMBO Reports" Arthur Grollman and Donald Marcus note that "the history of herbal use shows that not all herbs are benign and sometimes are deadly. Moreover, we cannot know whether all herbal medicines are safe because only a few have been tested systematically for toxicity or carcinogenicity."
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The authors highlight a widely-used herb called Aristolochia, also known as birthwort or pipevine. Various species of the herb are used in alternative and Chinese medicines, where it is claimed to treat edema and arthritis and used as a disinfectant. As Grollman and Marcus note, "The recognition of Aristolochia's profound toxicity and carcinogenicity in humans began in the early 1990s, when about 100 otherwise healthy Belgian women developed a rapidly progressing chronic kidney disease that ultimately required dialysis or renal transplantation."
If the plant can be toxic, why weren't the health dangers known earlier? As an article on "Science Daily" notes, "Almost all carcinogens and many toxins require a long period of time before symptoms appear. This makes it very difficult for a layman or a professional to identify a particular compound as the cause of an illness when it was taken months or years earlier."
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Though most people think of poisoning as being a sudden event (such as by an accidental ingestion or single serving of contaminated food), people can unknowingly poison themselves over the course of several years. Residents of Flint, Mich., for example, drank lead-poisoned water for years without being aware of the problem. Similarly, a person may unknowingly consume small doses of a toxic-but seemingly harmless or even beneficial-herb that builds up in the body and causes disease months or years later.
Herbal supplements are not regulated by the Food and Drug Administration because they are not marketed as drugs. According to the Dietary Supplement Health and Education Act of 1994 herbal supplement manufacturers are entirely responsible for ensuring the safety and effectiveness of their products. Health officials typically only intervene when illnesses or deaths are reported, and of course by then the damage has been done.
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An investigation into the herbal supplement industry led by the New York Attorney General discovered that four out of five bottles of herbal pills sold in national drugstore chains didn't in fact contain any of the herbs indicated on their labels. In other cases they existed in dosages so small as to be ineffective, and were often diluted with cheap filler including powdered rice.
Many people think of herbs as being harmless, assuming that "natural" means "healthy," though that is not necessarily the case. Grollman and Marcus note in their article that they are not arguing against the use of traditional healing practices in general, but instead raising awareness of the potential harms and to "encourage the global health community to take actions that will evaluate both long- and short-term safety, as well as the efficacy of botanical products in widespread use." While many herbs are beneficial (or at least not harmful), others may interfere with the effectiveness of prescription drugs, so patients should always tell their doctors about all medicines and herbal supplements they are taking.