Herbal Product Contamination and Toxicity

With Nearly 47 million Americans or 16 percent of the population without health insurance, many are flocking to health food stores to either supplement or replace expensive prescription medication with herbal medicine. Advertising tells us that “natural” is better and “herbal” is safer. Why put “drugs” in your body when you can use a safe, natural product?

Dr. Saul Green, a biochemist and board member of the nonprofit US National Council against Health Fraud, notes: Natural doesn’t mean safe. You can find a dozen or more poisons that are totally natural. Although natural made from natural ingredients, herbal medicines can cause serious organ damage and their carcinogenicity is comparable to synthetic chemicals.

Worldwide, the herbal supplement industry represents a market value of about $43 billion a year, according to WHO (World Health Organization). In the United States alone sales exceed $5.8 billion and represent the fastest growing sector of the US pharmaceutical market.

Such widespread use of botanicals raises the serious questions concerning the quality and safety of these products.

Herbal supplements are marketed with labeling that appears intended to give a level of security that the product has been approved by a regulatory body. But the herbal supplement market has a dirty little secret: their products are not standardized or regulated by the FDA. In fact, in spite of the FDA recommending warnings labels be placed on certain herbal supplement products the majority of manufacturer’s do not include the warnings.

Who are these manufacturers? They cover the spectrum of 200 acre farms in the hills of North Carolina to small mom & pop companies; they are both US based and foreign based. In some cases, products regularly sold in the US have been previously banned in other countries. WHO estimates that of the 35 000-70 000 species of plants that are used for medicinal purposes around the world, some 5000 have been submitted to biomedical scrutiny. According to Susan C. Smolinske, PharmD, DABAT of Children’s Hospital of Michigan Regional Poison Control Center is that “Herbal poisoning exposures reported to poison centers increased by 344% after passage of the Dietary Supplement Health and Education Act, with 24412 exposures reported in 2003. Increased toxicity is speculated to be related to lack of child-resistant packaging, new issues of contamination, proliferation of multiple ingredient products, excessive concentration of active ingredients, and discovery of new drug-herb interactions.” Herbal manufacturing is exposed to issues involving microbes, environmental chemicals, and misidentification of herbs.

A 1994 study published in the Journal of Tropical Medicine and Hygiene had reported that “25% of corneal ulcers in the United Republic of Tanzania were linked to the use of traditional eye medicines, of which many are based on herb extracts.” Another study in 1976 published in the British Journal of Ophthalmology 26% of childhood blindness cases in Malawi were associated with herbal supplements extracts and medicines. “The cause for this high number was attributed to lack of proper sterilization, along with inclusion of urine, saliva, or breast milk in some of these medicines, gives pathogens ample opportunity to thrive in eyes already hard hit by injury or infection.”

Beverly H. Cohen, MHS, RD, LD, is a renal dietitian for DaVita Corporation in Rockville, MD. recommends the following:

• Only buy from reliable sources. Make sure the label has a list of ingredients, precautions, address of the manufacturer, and the expiration date.
• Use special caution with herbs purchased in foreign countries and through mail or Internet orders. Be especially careful with Oriental herbs.
• Start with low doses. Do not take more than the recommended amount.
• Take only one herb at a time. Do not combine herbs.
• Monitor interactions, if any, between prescription drugs and herbal supplements. Stop taking herbs if there is any type of problem or side effect and contact your physician.
• Remember that self-medication involves potential risk. Never substitute herbal supplements for traditional medical therapy when treating what may be a serious illness such as kidney disease.
• “Natural” does not mean harmless!
• Be wary of anyone who steers you away from standard medical treatment. If a promise sounds too good to be true, it probably is too good to be true!