• What’s Wrong With Herbal Supplements?

What’s Wrong With Herbal Supplements?

Herbal supplements, used by many people for weight loss and bodybuilding purposes but also to improve well-being and reduce symptoms of chronic diseases, have recently come under investigation because of uncertainty about their contents, safety, and efficacy.

On February 3, the New York Times wrote that the New York State attorney general’s office accused 4 major retailers of selling fraudulent and potentially dangerous herbal supplements and demanded that they remove the products from their shelves.

In a Review article published in the March issue of Gastroenterology, Leonard B. Seeff et al summarizes the history, current uses, and potential risks and benefits of herbal products.

Seeff explains that because herbal products have been used for centuries to treat symptoms and illnesses, many people believe they are effective and safe.

However, he says that their efficacy, safety, and claims are not assessed by regulatory agencies, and discusses the uncertainty about their reported and unreported contents.

According to the New York Times, tests conducted on top-selling store brands of herbal supplements at GNC, Target, Walgreens, and Walmart found that 80% of products did not contain any of the herbs listed on their labels. Pills labeled ‘medicinal herbs’ often contained little more than cheap fillers like powdered rice, asparagus and houseplants, and in some cases substances that could be dangerous to people with allergies.

Walgreens announced it will remove the products from its shelves nationwide, even though only New York State had demanded it, and reach out to the suppliers of its supplements to “take appropriate action.”

In Western countries, the use of herbal products has grown significantly since the 1990s, rivaling that of prescription medications. Seeff says that, nonetheless, few herbal products have been studied in well-designed controlled trials of patients with liver or other diseases, despite testimony to the contrary. Seeff lists the products that have been tested or are being tested in clinical trials for liver disease.

However, some herbal products have caused liver injury severe enough to require transplantation or cause death. Seeff summarizes additional concerns about herbal products, which include lack of standardization, contamination, deceptive marketing. He lists products associated with hepatoxicity, and also those that interact with medications. Seeff writes that among 839 patients enrolled by March 2013 with confirmed drug-induced liver injury 130 (15.5%) had taken herbal products.

Types of herbal products implicated in liver injury

He concludes that many people believe that because herbal products are natural, they must be effective and safe, but few data are available to support beneficial effects in liver disease despite anecdotes and testimonials to the contrary. Seeff explains the safety of herbal products is compromised in part by the fact that they are not regulated by the US Food and Drug Administration (FDA).

According to The New York Times, the FDA requires that companies verify that every supplement they manufacture is safe and accurately labeled. But the system essentially operates on the honor code.

Under a 1994 federal law, supplements are exempt from the FDA’s strict approval process for prescription drugs, which requires reviews of a product’s safety and effectiveness before it goes to market.

 

 

 

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