Herbal Products
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Herbal Medications
and Dietary Supplements

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A growing national health problem

"Natural" is an abused and overused word and has become a tool of a booming, and rapidly growing, multimillion dollar industry.  Herbal drugs, claiming to provide gentle, safe and natural relief of common ailments, line many shelves of grocery stores and pharmacies. 

People tend to think the word "Natural" means it's safe. It is important to be aware that many prescription drugs also come from natural sources, such as digitalis, penicillin, morphine, and aspirin.

Herbal remedies are manufactured into pills, sold in a bottle, and enter the blood stream once swallowed, just like prescription drugs. They can either add to or work against the effects of other drugs that you might be taking. Even when used by themselves, herbal preparations can also be unsafe and cause complications or toxic side effects. When people are taking herbal products along with other medications, possible side effects can be difficult to anticipate, and this is especially serious for elderly people.

A recent survey found that15% of Americans regularly use herbal supplements and these numbers are quickly growing. This rate has jumped by 380 percent between 1980 and 1997.  That rapid increase has slowed somewhat, but is still on the rise and is contributing to a national health problem for the following reasons:

  1. There are no Federal quality controls for herbal and dietary supplements and there is a lack of consistency in dose and quality of many products that appear on the market. In other words, the label may not necessarily match the ingredients
  2. Unlike prescription or over-the-counter drugs, which must be proven safe before they're sold, federal laws allow the sale of supplements unless the Food and Drug Administration proves that they're harmful.
  3. Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods.
  4. Many of the dietary supplements on the market have adverse effects and interact with commonly prescribed drugs, including those used for anesthesia during surgery.
  5. Many regular users of dietary supplements do not inform their doctors of their use and this can be dangerous.
References

(1) Dietary Supplements, Warnings and Safety Information, from the FDA. U.S. Food and Drug Administration (FDA), Center for Food Safety and Applied Nutrition, Web site: www.cfsan.fda.gov. Toll-free in the U.S.: 1-888-723-3366 Also: "Tips for the Savvy Supplement User: Making Informed Decisions and Evaluating Information" and updated safety information on supplements. If you have experienced an adverse effect from a supplement, you can report it to the FDA's MedWatch program, which collects and monitors such information (1-800-FDA-1088 or www.fda.gov/medwatch).
(2) Kava Consumer Advisory from the FDA
(3) The National Institutes of Health’s web site for Complimentary and Alternative Medicines
(4)
Are You Considering Using Complementary and Alternative Medicine (CAM)?
(5)10 Things To Know About Evaluating Medical Resources on the Web
(6)Office of Dietary Supplements (ODS), NIH Web site: ods.od.nih.gov E-mail: ods@nih.gov ODS supports research and disseminates research results on dietary supplements. It produces the International Bibliographic Information on Dietary Supplements (IBIDS) database on the Web, which contains abstracts of peer-reviewed scientific literature on dietary supplements.
(7) CAM on PubMed Web site: www.nlm.nih.gov/nccam/camonpubmed.html CAM on PubMed, a database on the Web developed jointly by NCCAM and the National Library of Medicine, offers abstracts of articles in scientifically based, peer-reviewed journals on complementary and alternative medicine. Some abstracts link to the full text of articles.
(8) The Cochrane Library Web site: www.cochrane.org/reviews/clibintro.htm The Cochrane Library is a collection of science-based reviews from the Cochrane Collaboration, an international nonprofit organization that seeks to provide "up-to-date, accurate information about the effects of health care." Its authors analyze the results of rigorous clinical trials (research studies in people) on a given topic and prepare summaries called systematic reviews. Abstracts (brief summaries) of these reviews can be read online without charge. You can search by treatment name (such as the name of an herb) or medical condition. Subscriptions to the full text are offered at a fee and are carried by some libraries.

--Written by N Thompson, ARNP in collaboration with C Thompson and M Thompson, MD, Internal Medicine, July 2004; Last updated February 2007

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