Herbal supplements are a leading consumer industry in the United States. The notion that these are more natural products assures many people to feel a sense of comfort and security in taking the supplements themselves, or giving them to their children. However, the reality is quite the contrary in many instances.
A standard medication will go through rigorous phases of safety and efficacy trials under FDA regulations before entering the market. Manufacturers must follow strict protocols as well, ensuring correct dosing and labeling of medication packaging, along with adverse reaction warnings.
In contrast, herbal supplements have been marketed through a loophole in the system; not claiming to be medications, but rather “dietary supplements”, they fall out of the regulatory constraints of the FDA and other agencies. As a result, there are no requirements for proof of efficacy or safety, nor regulation to prevent contamination of ingredients with other substances, or inaccurate dosing or labeling by the manufacturer. In essence, the consumer is picking up an unknown, unregulated drug off the shelf.
In reality, every medication – be it a pharmaceutical or homeopathic – are types of drugs made from chemicals found in nature. One of the most potent cancer chemotherapeutic agents, Tamoxifen (Taxol), was derived from the Pacific Yew tree, and has become an essential treatment for breast cancer, despite its many side effects. The advertisement of products as being more “natural’ and hence safer, is a misnomer. Flip to the back ingredients label of many herbal cough and cold remedies, and one will find a list of several chemical components in the product. Below is an example of one popular over the counter homeopathic remedy for children:
Hyland’s Cold ‘n Cough, Ingredients:
Allium Cepa 6X HPUS, Hepar Sulph Calc 12X HPUS, Hydrastis 6X HPUS, Natrum Muriaticum 6X HPUS, Pulsatilla 6X HPUS, Sulphur 12X HPUS. (Nighttime): Allium Cepa 6X HPUS, Chamomilla 6X HPUS, Coffea Cruda 6X HPUS, Hepar Sulph Calc 12X HPUS, Hydrastis 6X HPUS, Natrum Muriaticum 6X HPUS, Nux Vomica 6X HPUS, Phosphorus 12X HPUS, Pulsatilla 6X HPUS, Sulphur 12X HPUS
Moreover, the amount of active ingredient actually present in a given herbal supplement has been shown t be highly variable. A large study in Canada tested 31 different melatonin supplements from 16 different brands. They found that the actual melatonin content of those products ranged from 83% less to 478% more than the amount advertised on the label. Many of these pills when tested contained contamination with serotonin as well.*
Similar findings have been noted for ginseng and other herbal supplements.
The primary question for the consumer when choosing between a standard medication and herbal supplement is not whether one is more natural than the other, but rather, whether one has been tested to be safe and effective. Because of the lack of randomized controlled trials on homeopathic medicines before market, we do not have any way of knowing their risks or benefits.
So are all herbal supplements bad?
Herbs and spices have been used for centuries in the treatment of various illnesses. And to this day there is known benefit of their use for health and wellness; the use of honey for cough, turmeric as an antioxidant, dill for GI issues, and ginger for anti-inflammatory effects, are some among many such benefits. The key is understanding as an educated consumer the nature of products sold over the counter. Moreover, it is important to be aware that all medications, both pharmaceutical and homeopathic, have the potential for serious interactions and adverse side effects. For example, patients with underlying cardiac disease taking blood pressure or anticoagulant medication can suffer from fatal complications by taking a “natural” homeopathic supplement due to the chemical interactions involved. The Cleveland Clinic has a good summary of the cardiac risks and interactions associated with some of these supplements. Read more here.
Risks associated with herbal supplements:
Medication interaction, particularly cardiac complications
Lack of data proving efficacy (i.e. does it really work)
Lack of data proving safety
Lack of regulation of dosing during manufacturing, with some pills having little to no active ingredient advertised and others having 5 times the dose advertised – sometimes within the same bottle
Lack of regulation from contamination with other potentially harmful substances or chemicals
Just as with any medication, one should understand the risks and benefits associated with homeopathic and herbal supplements, and discuss these decisions with your doctor. An educated consumer is a safe and healthy consumer.