Many people take some form of naturopathic or alternative remedy for a wide variety of reasons – a whopping $14.8 BILLION has been spent in the United States on herbal remedies in a single year.  For most people, it’s the idea that the product is ‘natural’ that is attractive – it makes it seem as though these substances can only do good, and can do no harm.  Be warned – it is due to the unfortunate lack of regulation of these products that this ‘do no harm’ idea has been successfully disseminated – but it is not true at all.

As nicely summarized in a recent article which I highly encourage you to read, dietary supplements are exempt from the usual medication regulation by the American FDA.  This means that a product does not have to be proven effective or safe before it is put on the market.  The only information we have about potential side effects of a herbal remedy is from voluntary reporting after the product is in use, which only represents a small fraction of the side effects that are happening but not being reported.

As an example from the world of herbal treatments of obesity, the article notes:

Even when the agency identifies an unsafe product, it lacks authority to mandate its removal from the market because it must meet the very high legal requirement to demonstrate “significant or unreasonable” risk. That is why it took the FDA more than 10 years to remove from the market ephedra-containing herbal weight-loss products that had caused hundreds of deaths and thousands of adverse events.   

Other problems that limit the ability to understand these chemicals and herbs include:

  • Inadequate labeling of the supplement – in other words, it’s not clear exactly what the product contains.
  • Frequent unsound and illegal claims made by websites – a study investigating this found that staff at retail outlets have even been caught telling patients to take their herbs instead of prescription medications – which could have life threatening consequences.
  • Herbal remedies can be tainted with undeclared prescription drugs and heavy metals – as noted in the recent article – “These tainted products can cause serious adverse events, including strokes, organ failure and death.”
The internet and TV media tend to overblow the potential benefits and downplay potential harms of herbal supplements, while the reverse publicity is true for prescription medications.  As such, many people have a trust in herbal remedies that they don’t have for prescription medications. 
The bottom line is that just like for a prescription medication, the decision to take a herbal remedy should be made with a careful evaluation of the benfits vs the risks.  The unfortunate reality is that this information for naturopathic remedies is just not available, so it’s impossible to make this assessment.  
The only solution to this problem is much stricter regulation of these substances, with careful evaluation of their benefits vs risks, before they are put on shelves.  The FDA has recently issued a draft proposal to gain authority to regulate supplements – let’s hope that this goes through.  
As a final note – the beautiful, naturally occuring plant pictured above is the digitalis plant.  The extract from this plant (also called Digoxin) is a cardiovascular drug that is used to treat certain heart problems.  When digoxin is prescribed to patients, levels are monitored very carefully, as high levels can cause very dangerous side effects, including heart rhythm disturbances, which can be life threatening.  This example reminds us that just because a substance is natural, does not mean that it is free of possible side effects.
Dr Sue Pedersen © 2012

Follow me on Twitter for daily tips! @drsuepedersen