FX Excursions

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To Herb Is Human

Aug 1, 2008
2008 / August 2008

With 1,500 herbal and dietary supplements on the market and an increase in their popularity — about 15 million American adults take them regularly — I have to ask: Are they safe for everyone? Are they effective?

Herbal supplements are not put through the same rigorous FDA review process as new drugs. The FDA only monitors the labeling of supplement packages to ensure appropriate information is provided — supplement name, manufacturer’s name and address, total quantity, serving size, active and inactive ingredients. In some cases, the label includes a disclaimer from the FDA that the product has not been evaluated and “is not intended to diagnose, treat, cure or prevent any disease.”

Beware of claims that seem too good to be true. Look for standardized herbal supplements, such as the U.S. Pharmacopeia’s “USP Dietary Supplement Verified” seal of approval. This means that the supplement has been tested for cleanliness, uniformity and absence of contaminants such as lead or mercury. Be cautious about herbal remedies manufactured outside the United States — many European products are highly regulated and standardized, but traces of toxic ingredients and prescription drugs have been found in some supplements manufactured overseas.

As with over-the-counter and prescription medications, herbal supplements have active ingredients that cause chemical reactions in the body. For certain individuals, the use of herbal supplements can be unsafe.

In fact, many surgeons and anesthesiologists will cancel an elective surgical procedure if they know the patient is taking herbal therapies. Some herbs may decrease the effectiveness of the anesthesia or cause complications such as bleeding or hypertension. It’s wise to tell your surgeon about any herbal supplements you are taking and discontinue use one to two weeks before surgery.

As a general rule, do not take any medications (prescription, OTC or herbal) when you are pregnant or breast feeding unless approved by your doctor. Medications that may be safe for you as an individual may be harmful to your developing fetus or your nursing baby. Avoid herbal supplements if you are younger than 18 or older than 65. Older adults metabolize medications differently, and few herbal therapies have been tested on children to establish safe doses.

Check with your physician about possible dangerous interactions with herbal supplements if you are taking prescription or OTC medications. When mixed with aspirin, blood thinners or blood pressure medications, some herbal remedies can cause serious side effects. In my opinion, it is better to rely on a proven medical treatment or medication that has been proven safe and effective than it is to opt for herbal remedies.

Depending on your overall health, specific herbal medications may be appropriate for you. But keep in mind that you may achieve the same results by changing your lifestyle — following a heart-healthy diet, for instance, or sticking with an exercise program.

Although there have been few scientific studies on the effectiveness of herbal therapies, more physicians are learning about them in order to help their patients make informed decisions. If your physician is not comfortable discussing or endorsing herbal remedies, ask for a referral to a pharmacist or a specialist who is knowledgeable in this area.

It is easy to see why supplements are so tempting. The “cure” seems fast and simple. But good health does not come in a package — supplements are never a substitute for a good diet, regular exercise and high-quality medical care. For more information, visit http://www.fda.gov .


If you’re having surgery, avoid these herbs:

• Ephedra — banned in 2004 — is a potent stimulant that causes an abnormal heart rate, high blood pressure and coma when used with antidepressants and anesthetics

• St. John’s Wort may decrease or increase the effects of some drugs used during surgery

• Garlic, ginkgo or ginger can cause bleeding disorders

• Ginseng can cause alterations in blood glucose, high blood pressure, increased bleeding and a rapid heart rate

• Licorice and ephedra cause blood pressure and heart rate elevations

• Kava or valerian may prolong the effects of anesthesia

• Licorice and senna may cause fluid and electrolyte imbalances


If you decide to purchase herbal preparations:

• Buy only preparations with the plant ingredients listed

• Be careful about taking similar types of herbs if you are allergic to certain plants, pollen or flowers

• Beware of false claims — many herbal products are sold by people with limited clinical knowledge

• Do not take large quantities of any herbal preparation

• Rely on established, evidence-based research and factual information on herbs

• Read labels and look for products that are standardized

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