Herbal supplements are taken by nearly 18% of US adults. Despite this popularity, - I have some concerns about their use…

  • Research has yet to show whether many of these products have any clear benefit. Few herbal products have been rigorously tested to determine whether they relieve symptoms or otherwise improve health. Many studies that have been done tended to be small and/or to have design flaws.
  • Labels can be misleading. Half of herbal products sold online erroneously and illegally claim to prevent, treat, diagnose or cure specific diseases.
  • Supplements are subject to little regulatory oversight. Those containing agents that were on the market before 1994 are exempt from FDA review...with newer agents, manufacturers must notify the FDA but need not wait for approval before selling products. Many manufacturers fail to report to the FDA any supplement-related adverse reactions,
  • Some products are contaminated with heavy metals or bacteria...or adulterated with controlled substances, such as stimulants. Buying organic products may reduce, but is unlikely to eliminate, these risks.

Big concern: An estimated 40% to 70% of patients do not report their herbal supplement use to their doctors. This is a mistake because some herbs can confer serious health risks-for example, by thinning the blood or interacting with medications.

Self-defense: The following herbs are among the most widely used. If you choose to take them (or any herbal supplement), do so under guidance from a knowledgeable health-care practitioner.

  • Echinacea. Some studies show that echinacea slightly shortens the duration of colds and flu, but results are inconsistent. There is limited evidence suggesting that the herb may help prevent colds and flu, though more research is needed.

Be aware: Echinacea may exacerbate asthma ...people with ragweed allergy also may be allergic to echinacea.

  • Ginkgo biloba. Users take this to protect memory.

But: A six-year clinical trial of more than 3,000 seniors found ginkgo no more effective than a placebo at reducing dementia risk.

Caution: Ginkgo can increase bleeding, which is risky if you take an anticoagulant, such as clopidogrel (Plavix) or warfarin (Coumadin)... use any nonsteroidal anti-inflammatory, such as aspirin or ibuprofen (Motrin)...have a bleeding disorder...or need surgery or a dental procedure, such as a tooth extraction.

  • St. John's wort. Studies suggest that this eases symptoms of mild-to-moderate (but not severe) depression.

Risks: It reduces blood levels of cholesterol-lowering statin drugs and the blood pressure drug verapamil (Verelan). Taking St. John's wort with an antidepressant, such as fluoxetine (Prozac), may increase risk for serotonin syndrome, an excess of serotonin that can cause blood pressure changes, hallucinations and kidney damage.

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