How many times have you heard the phrase, “It is safe! It’s all natural“? This statement (usually expressed by a doped consumer) is probably my most dreaded conversation starter. There are plenty of “all natural” things that are not good for you; castor beans, hemlock, corn lily, various mushrooms- these natural items all have an upsetting side effect called “death”.
This article released by the National Council on Strength and Fitness adds 5 more hazardous “all natural” supplements to the list of things to avoid.
Five Risky “All Natural” Herb Supplements
The common health claim “all natural” has been exploited on product labels with the purpose of clouding association as most consumers believe that “natural” must equate to healthy and safe. The claim is being used on a growing number of foods, cosmetics, cleaning products, and over-the-counter herbal remedies/supplements. Herbal medicine suggests the use of plants or plant parts for medicinal purposes. Herbal supplements are either ingested or applied to the skin in forms such as ointments, oils, tablets, or teas. The consumer must understand that even though herbal/dietary supplements are fundamentally considered “natural”, they not regulated by the FDA like prescriptions and registered medicinal drugs; and therefore are not always completely safe to use without first referring to a legitimate health care provider. Potentially dangerous herbs may be readily available in stores, online venues, gas stations, and social locals such as coffee shops due in part to lack of governmental oversight and control.
Furthermore, consumers should be aware that many herbal supplement claims:
- Are not backed by validated scientific study
- Portray research findings in a way that makes the product appear effective when the findings do not necessarily apply to the product for the population that will use it
- Declare unrealistic effects or benefits
- Would never be recommended by legitimate medical physicians
Adriane Fugh-Berman, MD, an expert on medicinal herbs and dietary supplements and professor at Georgetown University School of Medicine explains, “Some people think herbal supplements really work and that they are harmless; but if it acts like a drug in the body, then it can also have a negative effect.” She goes on to explain that most herbs sold in the US are relatively benign, but some can be dangerous if consumed in high quantity or used incorrectly. Common logic should dictate that any compound which works like a drug is going to provide some risks. According to authors on the subject, the most common risks associated with herbal supplementation are liver and kidney damage or dangerous drug interactions. Five common herbs with known risks are addressed below.
St. John’s Wort
St. John’s Wort can ease mild to moderate depression, but there is not enough evidence to suggest it helps with major depression. Depression cannot usually be treated by simple herbal supplementation, but rather through comprehensive healthcare assistance. In fact, routine exercise has demonstrated to be an effective component in the therapy. The major risk of St. John’s Wort supplementation is the potential for drug interactions as the plant can make many other drugs less effective. There have been cases of unintended pregnancies among women also taking birth control pills and cases of organ rejection among those taking anti-rejection drugs after a transplant. Andrew Weil, MD, the founder of the Arizona Center for Integrative medicine at the University of Arizona warns, “If you are taking any prescription drug and are interested in trying a course of St. John’s Wort for mild to moderate depression, first discuss possible interactions with your doctor or pharmacist.”
For some individuals, kava appears to be able to reduce anxiety just as efficiently as prescription anti-anxiety pills. It should be noted that the compound has been shown to work in as little as one week among women experiencing anxiety during menopause, whereas in other populations has taken up to eight weeks to exert its effects. Despite its potential benefits, the National Institutes of Health (NIH) and the FDA urge people to refrain from supplementing the compound due to the associated risk for serious illnesses, liver damage, and even death which has been seen during short-term use at normal dosages. Kava use has been directly linked to:
- Liver transplants
- Nerve damage
- Skin changes
- Worsening of depression
- Premature death (with 1-3 months of use)
Kava is also not safe for women who are pregnant or breastfeeding and should not be combined with alcohol. A number of prescription drugs should not be combined with kava; the two drugs with the greatest risk for drug interactions include Xanax (anxiety medication) and sedatives. Weil recommends limiting kava use to a maximum of three to four weeks among healthy patients with healthy livers; providing the warning, “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.” Other experts have completely ruled out kava use based on its potentially unfavorable benefit to risk ratio.
Comfrey is believed to reduce the recovery period of tissue injuries such as bed sores, bruises, sprains, and bone fractures. It reduces swelling and inflammation-related symptoms that occur with injury in general. However, due to the risk for severe liver and possibly lung damage, experts strongly suggest that comfrey should never be taken orally. In 2001, the FDA recommended that manufacturers remove comfrey products from the market, but the compound is still easy to find. For example, some coffee shops still serve comfrey tea – even after clear evidence pointing towards the risk for liver toxicity. Weil recommends only applying comfrey to the skin for the benefit of wounds that do not heal easily, such as diabetic ulcers. On the other hand, the U.S. Pharmacopeia, a scientific organization that sets standards for dietary supplements, advises against even using comfrey on broken skin as toxins that negatively affect the liver can still be absorbed. The risk to benefit ratio for using comfrey appears unfavorable when all of the data is examined.
Chaparral is claimed to reduce pain, inflammation, and general skin irritation as well as function as a cancer-fighting herb. According to the American Cancer Society and herbal experts however, these claims are unfounded. In fact, chaparral has been shown to cause serious drug interactions with prescription and over-the-counter drugs including:
- Blood thinners
- Anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen
- Diabetes medications
- Certain antidepressants
The compound is easily found online in many forms even though it is listed in the FDA’s poisonous plant database due to the risk of severe, and in some cases, irreversible liver damage.
Pennyroyal oil has not been proven effective for any suggested uses. It was first used as an agent for noninvasive abortion, but the large dosages required placed the mother’s life at risk, or had the potential to cause irreversible damage to the liver and kidneys, according to the NIH. The compound is not considered safe for any population at any dosage, and it is unknown whether pennyroyal tea is safe. Fugh-Berman warns, “It’s a mint, and you don’t get that much poison in a tea, but I wouldn’t risk it. Go for spearmint. Why go for the liver-toxic mint?” The herb is also listed in the FDA’s poisonous plant database.
What Steps Can a Consumer Take to Choose a Safe Herbal Supplement?
The first question one has to ask is – what is the purpose of the herbal supplement? The second is, if an herb is applicable for a particular purpose. In almost all cases, the best course of action is to ask a qualified medical doctor; many people represent themselves as experts but lack the training to make prudent and intelligent decisions regarding these products. Consumers should investigate the product of interest and critically examine claims applied to herbal supplements, including the “scientific evidence” that supports the claims. Ask yourself:
- Does peer reviewed research demonstrate that the product it is safe and effective?
- What dosage has been shown to promote the claimed benefits?
- What part of the plant exerts the beneficial effects (root, stem, leaf), and is that component actually in the marketed product?
- Is the manufacturer credible
Again deciding on an herbal supplement involves collaboration with one’s health care team. It is recommended to discuss whether the supplement of interest is safe and effective in general, and for the individual specifically. Healthcare providers may be able to specify if any current conditions or prescription/over-the-counter medication being used may negatively react with the herb. If the herb is approved by the physician one must then identify and properly select a quality product. The herb supplement label should be checked for the following:
- That the beneficial component of the plant is being used (stem vs. leaves)
- A quality seal such as the USP seal (US Pharmacopeia), the NSF seal (National Sanitation Foundation) or the CL seal (Cooperman’s Consumer Lab)
- Each of these seals indicate that the ingredients match the label and if there are contaminants present, they do not exceed safe levels
- The USP and NSF ensure that the product meets Good Manufacturing Practices set by the FDA
- The CL holds to standard set by the state of California, which are more rigorous than those enforced by the FDA
It is also recommended to purchase supplements from larger companies such as major store brands or manufacturers of FDA-regulated drugs, as they will be more likely to uphold quality standards. The final and potentially extra step involves pre-testing the supplement, if in tablet form, to see if it will break apart in the body to release the potentially beneficial ingredients. Herbals in powder-form capsules do not need to be tested, but tablets can be placed in body-temperature water for 45 minutes to see if they fall apart. If the tablet does not fall apart during the test, it will probably stay relatively intact within your digestive tract limiting the absorption rate.
When investigating your supplements, do not simply take the first internet article you find as truth- check MULTIPLE, peer reviewed, scientific sources. When a product is involved, your health is not an interest to the seller, only your money.