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Herbal Preparations Are Not Necessarily Safe

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 33 in the August 21, 2013 issue of The Mississauga News
under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Any substance that is ingested or applied to the body to produce a desired change is a drug in my view.

Many drugs that I prescribe today originate from plants. Active ingredients once identified are then purified, and run through clinical trials to determine the appropriate dose, unwanted actions and so forth.

A herb is a plant or part of a plant that may be used for its medicinal values. Herbs are also used for aromatic or industrial purposes such as dyes.

A herb can contain one active substance or numerous substances. The attraction to herbs is that they can be obtained without prescription or advice from your doctor. There is a wrongful assertion that this implies safety.

Most processed herbal preparations are marketed as food supplements. This does not imply safety, but is one way to circumvent rigid testing and controlled trials.

One chooses to use a herb in the hopes of exerting a change in a body system. This makes a herb and drug synonymous by definition. Most major breakthroughs in the last twenty years began with examining natural ecosystems often in tropical rainforests where immense diversity exists.

It is a disservice to generalize about herbs. They must be evaluated on a herb-by-herb basis.

Naturopaths are persons trained to use herbs. A Naturopath, trained and certified in Canada, will be the first to tell me that the actions of herbs and drugs are similar, and must be employed with caution and wisdom. Currently, no regulatory body for Naturopaths exists in Canada. For every properly trained and certified Naturopath, there are about 10 others claiming to have the same wisdom. Buyer beware is the rule. There are immense profits at stake.

A vendor of food supplements only needs to withdraw a product if complaints about injury and death start to mount. A new product can be marketed quickly without need for clinical trials. In comparison, a prescription medicine implies potency, care and liability.

One of my pet peeves is the large scale use of impressive sounding terms in the marketing of these herbal products. Terms such as detoxifier, liver scrubber, all natural, kidney cleaner, blood purifier and revitalizer. These phrases are without meaning and can misguide individuals to make wrongful conclusions when trying to understand the mechanism of action.

A few simple tips. Do not equate herbs with safety because the list of harmful ones continues to grow. Ask yourself what you are seeking to change by ingesting a foreign substance. Seek advice from qualified independent sources, whose profit does not depend on sales. Politely ask for their qualifications and what training they have, and especially find out what their liability is, should the substnace have a particularly negative effect. Above all, admit to your doctor that you used a herbal product, so that interactions with other medicines and long-term problems can be recorded and tracked. Or, take my mother's advice, consume your herbs in the dining room and your pills in the bathroom!

Related resources:

Is Herbal Medicine Safe? From Healthy Life Journal.

Herbal Medicine Safety by Marian Anne Eure, former About.com Guide.

Just how safe are herbal medicines? by Tammy Cohen from The Telegraph.co.uk. "... herbal remedies can ... be deadly".

Herbal medicine from University of Maryland Medical Center.

Drugs, Supplements, and Herbal Information from MedlinePlus.

Natural Health Products - Drugs and Health Products from Health Canada.

Herbal Medicines An Evidence Based Look from Therapeutics Letter. "The medical use of herbs is widespread. In a multi-ethnic group of patients attending an emergency department in New York 22% reported that they used herbal medicines; use was highest among Asians, 37%. It is important therefore for clinicians to document use of herbal medicines as part of the patient s drug profile.

Plants synthesize complex (organic) molecules for their structure and function, and therefore are a rich source of chemicals. Active chemicals purified from plants are accepted effective medications e.g. digoxin, and morphine. When parts of plants or crude extracts of plants are used for medicinal purposes they are called herbal medicines. What problems are specific to herbal medicines? How are herbal medicines standardized? Do herbal medicines cause adverse effects? Table of Commonly Used Herbal Medicines."

Herbal Remedies: Adverse Effects and Drug Interactions from American Family Physician, by Melanie Johns, CUPP, PHARM.D., West Virginia University School of Pharmacy, Morgantown, West Virginia.

Herbalism from Wikipedia. "Herbal medicine (or "herbalism") is the study and use of medicinal properties of plants. Plants have the ability to synthesize a wide variety of chemical compounds that are used to perform important biological functions, and to defend against attack from predators such as insects, fungi and herbivorous mammals. Many of these phytochemicals have beneficial effects on long-term health when consumed by humans, and can be used to effectively treat human diseases."

Herbal Products and Supplements: Are herbal health products and supplements safe because they re naturals? from Family Doctor.

Herbal Medicine and Drug Interactions from Singapore Magazine of Research, Technology and Education, by Shufeng Zhou. Reports of adverse effects in combining herbal medication and drugs bring up the need for safety monitoring and understanding of such treatment. World Scientific Publishing and National University of Singapore.

"Herbal products are becoming popular as alternative medicines worldwide. According to a 2004 update on the health risks of herbal remedies in Clinical Pharmacology and Therapeutics, about one third of adults in the developed countries and more than 60% Asians use herbal medicines for health promotion or treatment of various chronic diseases.

The World Health Organization (WHO) in 1991 estimated that there were some 11,000 species of herbal plants for medicinal use and about 500 species of them are commonly used in complementary medicine. WHO defines herbal medicines as finished, labelled medicinal products that contain active ingredients from aerial or underground parts of plants, or other plant material, or combinations thereof, whether crude state or as other preparations."

Many patients take herbal products in combination with prescribed drugs without advising their doctors. The combined ingestion of herbs with drugs may raise the potential of herb drug interactions. Recent medical literature has recorded an increase in herb drug interactions ..."

Herbal Medicines: Its Toxic Effects and Drug Interactionsby Dr. Vandana Parmar, DA, MD, Associate Professor, Department of Anaesthesiology, PDDU Government Medical College, Civil Hospital Campus, Rajkot-360001 Gujarat, India.

Interactions between herbal medicines and prescribed drugs: an updated systematic review. Abstract. By Izzo AA, Ernst E. Department of Experimental Pharmacology, University of Naples, Italy.

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