Herbal supplements: if you’re buying, be informed

Huperzine A, kava, ginseng, curcumin, ginkgo, elderberry, ashwagandha, garcinia. What do these all have in common? They’re all herbs with alleged health benefits. They’re packaged up and marketed as herbal supplements, because the word ‘supplement’ makes them sound so healthy, so beneficial.

The term “herbal supplement” makes me crazy. Why? The word ‘supplement’ creates a Health Halo. It implies that herbs are beneficial and essential for health. This is false. No one needs herbs. Certainly not in the same way that we need nutrients.

No government agency or organization regulates herbal pills. They’re not tested for efficacy, safety or quality. If someone happens to have a bad reaction to one of these products and connects the problem to the herb, and then reports it to the FDA, well then maybe someone will investigate. But not until there’s a bad outcome. Unfortunately people may have adverse reactions to these products but not make the connection.

Consider the case of garcinia cambogia, which supposedly helps with weight loss. As reported by ConsumerLab (subscription), that claim is based on a few poorly designed studies, backed up by a lot of hype marketing. And of course, people think that, because it’s an herb, it’s safe so why not try it. ConsumerLab tested a number of products and found that many did not contain what the label said. And recently there have been case reports of severe liver damage linked to garcinia use, including liver failure that necessitated a liver transplant. Garcinia is suspected of causing serotonin toxicity in people taking certain types of anti-depressants.

Most herbal preparations contain biologically active substances, which may have drug-like effects. Key word: drug. In fact many common prescription drugs were developed from traditional herbal remedies. Now it seems like any herb with suspected biological activity is packaged up for sale as a fix for some health problem, based on not much evidence. And, as noted above, companies can do this because no one is monitoring the efficacy of safety of this stuff.

Currently popular herb marketing schemes target weight loss, brain health, arthritis and inflammation, all hot topics for an aging population. It’s really tempting to believe you can reduce your risk for dementia by taking some herbal pill. Again, the word “herb” makes it sound natural and safe. Why not try it? What could go wrong?

Well, for many people, a lot could go wrong. Here are just some of the medical problems linked to herbs in case reports:

  • electrolyte imbalances
  • liver toxicity and liver failure
  • interference with medications — a big one for older adults who take several prescription drugs. Herbs can make your medications more potent, or render them ineffective.
  • kidney stones
  • gall bladder and digestive dysfunction
  • pancreatitis
  • addiction

In addition, many companies were cited for promoting their products with non-existent “clinical data”, phony testimonials, and false treatment claims. Some herbal products don’t even contain what the label says. How is the consumer supposed to know?

So what’s my point? Herbs are not necessarily safe or effective. And you can’t believe all the glowing testimonials and so-called data used to promote the products. But the lure of herbal treatments is very seductive. Why bother going to the doctor, when you can take control of your health with a ‘natural’ product that you buy at the grocery store.

Maybe you disagree with me, because you’ve been taking some herbal pill and you believe it helps you. That’s your choice. But I would strongly suggest that you inform your doctor about your herbal supplements. Prescription drug databases sometimes cross check known adverse reactions with herbs, so you could be warned about any potential problems. And certainly if you suspect an adverse reaction to an herbal product, you need to report that to your doctor.

My final point: herbs are not nutrients. You don’t have a requirement for herbs that needs to be supplemented, they way you’d supplement your calcium intake. Herbs behave like drugs, not like nutrients. They should be used with as much caution as any prescription drug.