Researchers warn of dire effects of herbal remedies

Herbal products, portrayed as softer and more ‘natural’ alternatives to prescription medication, can have “dire effects” on users, including acute hepatic and renal failure, exacerbation of pre-existing conditions and diseases, and even death.

These are the worrying results presented in a paper by four Australian university researchers, published recently in the Medical Journal of Australia.

Titled “What risks do herbal products pose to the Australian community?”, the paper says that an estimated 70–80 per cent of the world’s population use non-Western medicine in the form of herbal preparations for their primary health care. The proportion of the Australian population using herbal products as mono or ancillary therapy increased from 48 per cent in 1996 to 69 per cent in 2005, with spending on complementary medicine increasing by more than 100 per cent between 1996 and 2004. Similar increases have been reported in many Western countries; in the United States, spending on herbal preparations doubled between 1997 and 2007.

The predominant user group of complementary medicines in Australia comprises younger women (under 35 years old) with a tertiary education. People with chronic diseases or co-morbidities such as cancer, diabetes, musculoskeletal disorders or mental illness, frequently use complementary medicines.

A study of 10,011 Australian women aged 59–64 years found that 39 per cent of those with menopausal symptoms consulted complementary medicine practitioners, and that 75 per cent used self-prescribed complementary therapies; 53 per cent of 1037 people with HIV attending specialist clinics also used complementary medicines; and as many as 65 per cent of Australian people with cancer in 2010 used some form of complementary medicine, more than half of whom did so in combination with conventional therapy.

“Despite these trends”, the authors say, “there have been few recent investigations of the specific problems associated with the use of herbal medicines, and assessments of their safety rely on older studies.

“Some traditional herbal preparations contain heavy metals and toxic chemicals, as well as naturally occurring organic toxins.

“While many may be safe, it is worrying that the specific effects and harmful interactions of a number of their components with prescription medications is not well understood.

“The content and quality of herbal preparations are not tightly controlled, with some ingredients either not listed or their concentrations recorded inaccurately on websites or labels.

“Herbal products may also include illegal ingredients, such as ephedra, Asarum europaeum (European wild ginger) and endangered animal species, such as snow leopard.

“An additional problem is augmentation with prescription medications to enhance the apparent effectiveness of a preparation.

“Toxic substances may also be deliberately or inadvertently added: less expensive, more harmful plants may be substituted for more expensive ingredients, and processing may not be adequate.

“The lack of regulation and monitoring of traditional herbal preparations in Australia and other Western countries means that their contribution to illness and death is unknown. We need to raise awareness of these problems with health care practitioners and with the general public.”

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