What are herbal supplements?
Herbs have been used for thousands of years as a source of medicines, salves and teas. Many are still in use today as botanicals -- part of the plant is valued for medicinal qualities. Today, 20 percent of Americans use either an herbal or non-herbal supplement.
Products manufactured from botanicals that are reportedly used to maintain or enhance health are called “herbal products, botanical products, phytomedicines, herbal supplements or natural supplements.” Typically, these natural medicines are either taken by mouth or placed on the skin and come in a variety of forms such as ointments, oils, tablets, capsules and teas.
Are they safe?
But does “all natural” necessarily mean “safe?” Most experts will tell you that many herbal supplements have side effects and drug interactions with over-the-counter (OTC) medications and prescription drugs. “Some people think herbal supplements really work but [that] they are harmless,” but if it acts like a drug in the body, then it can have a negative effect, says Dr. Adriane Fugh-Berman, an expert on medicinal herbs and a professor at Georgetown University’s School of Medicine.
Who regulates supplements?
Surprisingly, in the U.S., there is no close oversight of the phytomedicine industry. The Food and Drug Administration (FDA) doesn’t regulate herbal products as it does physician-prescribed medications. Traditional meds are required to meet FDA-mandated guidelines attesting to safety and efficacy of that drug before it hits the marketplace. Botanicals are not required to meet these regulations because manufacturers are exempt from these rules. But the FDA does provide for some regulation of supplements.
Manufacturers of phytomedicines must follow sound practices to ensure consistency of the product and to meet quality standards. But no FDA approval is required before introducing the supplement to the marketplace. Companies are free to make various claims that natural products enhance health. Once on the market, the FDA monitors the supplement for safety, issuing recalls for those deemed unsafe for the public.
There are always dangers associated with medications, and herbal products are no different. The most commonly used herbal supplements in the U.S. are garlic, echinacea, St. John’s Wort, ginseng, black cohosh and ginkgo. These phytomedicines have a reputation for helping those with mild depression to insomnia. But depending on the type of prescription or OTC medications you are taking, adding a supplement can be dangerous.
For example, those who take anticoagulants, NSAIDS and antiplatelet agents, it’s a good idea to avoid garlic, ginkgo, cranberry, St. John’s Wort and ginseng. These supplements may make the prescription drugs less effective.
Four Common Herbal Supplements That Could Harm You
Pennyroyal – This plant is a type of mint and commonly used as a tea. Modern medicine has proven that this herb isn’t effective for any use. Historically, it was used to induce abortions but required such large dosages that the mother also could be killed. There is the danger of irreversible liver damage, and it is unknown if the tea is safe. This plant has been listed on the FDA poisonous plants database since 1997.
St. John’s Wort – This herbal supplement has a reputation for easing mild to moderate depression. But there is no evidence that it is helpful in major depressive cases. Because of St. John’s Wort’s ability to interfere with a prescribed drug’s effectiveness, consult a doctor before starting on a course of this herb. One consequence of taking this supplement could be unintended pregnancy. Studies have shown that St. John’s could diminish the efficacy of birth control pills.
Kava – This herbal product reputedly works well as an anti-anxiety drug for some people. The downside is that it may take up to eight weeks to work. The National Institutes of Health (NIH) and the FDA urge people not to take kava at all because of the risk of liver damage and even death. Dr. Andrew Weil, founder and director of the Arizona Center for Integrative Medicine at the University of Arizona, only recommends kava for three to four weeks for those patients with healthy livers.
“I do not recommend kava for people at risk for or who have liver disease, regularly drink alcohol, or take drugs with known adverse effects on the liver, including statins and acetaminophen,” said Weil. The herbal supplement has effects similar to alcohol and should not be mixed with booze. This botanical may worsen depression and is not safe for pregnant or breastfeeding women.
Comfrey – Reputedly heals injured tissues such as wounds, bone fractures and inflammation that accompanies such injuries. This herb should never be taken orally because of the risk of liver and possibly lung damage. Dr. Weil recommends applying a salve of comfrey to stubborn wounds, such as diabetic ulcers or open bed sores. However, the U.S. Pharmacopeia (USP), an organization that sets standards for supplements, recommends against placing comfrey on open wounds because of the risk of absorption of liver toxins.
How to Choose Safe, Effective Herbal Supplements
First and foremost, do your homework. Research herbal supplements for side effects and drug interactions. Ask yourself the following questions: is it safe; is it effective; are dosing instructions clear and understandable?
Talk to all your doctors, if you have more than one. Discuss your interest in natural supplements with both your physical- and mental-health practitioners. This is especially important if you already take medications. Some phytomedicines may inhibit or lessen the effectiveness of prescription meds and should not be taken.
Get quality products. Check labels for quality seals given out by three companies: USP, National Sanitation Foundation (NSF) and Cooperman’s Consumer Lab (CL). These seals guarantee that the product ingredients are correctly listed on the label.
Remember, BEFORE you take any supplements, the most important conversation you can have is with your physician(s). Finally, listen to your body. If it doesn’t feel right, something is wrong. Call or visit your doctor right away for advice.