Aging Begins at 30

Beware the Lure of Herbs

A recent conversation wandered from flowers for the church to herbal remedies. My friend’s daughter had visited from Los Angeles and brought 12 vials of Chinese herbs. They took one a day for five days and developed a sense of well-being. After she returned home he took the last two vials. "I itched, I scratched, itched again, then I broke out in the worst red rash you ever did see."

Herbal medicines are unpurified and only roughly quantified. Though herbs are of natural origin they are otherwise like other medicines. They can be overdosed and are not without side effects. A study in rural Mississippi found that 70% of households used at least one herbal medicine during the course of a year.

Severe and even fatal poisonings have occurred with herbs from aconite (monkshood or wolfsbane), podophyllum (May apple), and anticholinergic herbs like belladonna (a parasympathetic blocker). Heavy metals (cadmium, lead, arsenic, and mercury) also found in folk medicine are very toxic. Medical journal reports of brain damage, heart toxicity, kidney or liver scarring followed by organ failure are not uncommon. Shutdown of blood production (agranulocytosis) is also possible. Many herbal medicines have an unacceptable risk-to-benefit ratio. Of the 150 species commonly used (out of 7,000 medicinal plant species used in China) 10 are particularly poisonous like scopolamine, hyocyamine, and atropine. Infants and children are especially susceptible because of their lower body weight and inadequate liver detoxifying enzymes. Sleeping Buddha (estazolam for sleep) can cause fetal damage, and castor oil can cause miscarriage. Some herbs can displace bile pigment from blood proteins and cause it to be deposited in the brain (kernicterus or brain nuclear jaundice) reducing intelligence. Newborns have also died from liver failure caused by commercially available herbal teas.

I love licorice (touted for ulcers or asthma) and can eat my way through a 1/4 or 1/2 pound, but I know that in large quantities it can act like steroids lowering potassium and increasing retention of sodium and water in my body.

Sometimes retailers mistake one herb for another. Adulteration with cheaper often more poisonous herbs is common. Synthetic steroids, phenylbutazone, lead or mercuric sulphide can be added. Another problem with the idea that herbs are benign is the notion that, "If one dose is good more might be better."

A high index of suspicion is needed. Beneficent nature is a myth. Little if anything that works as a medicine is risk free. The World Health Organization (WHO) has estimated that herbal and other plant-derived remedies are the most frequently used treatments worldwide. On the benefit side many drugs we use in medicine like ephedrine, digitalis, morphine, and taxol are derived from plants, but they are purified, standardized, and tested.

Some sensible rules about herbs are: Don’t take herbs if you are pregnant or nursing. Don’t give them to your baby. Do not take a large quantity of any one herbal medicine and don’t take any on a daily basis. Buy only preparations with listed ingredients. Never take anything containing comfey (symphytium), which is banned in Germany where many herbs are licensed. Herbs after all are medicines. Yet they are neither well regulated nor well quantified.

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See related Patient Topics Herbal Medicine, Procedures and Therapies or Wellness and Lifestyle.

See related Provider Topics Procedures and Therapies or Wellness and Lifestyle.

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