Herbal Medicines: Boon or Bane?

The Philippine Food and Drug Administration (FDA) recently warned the public of three “voodoo” anti-cancer products by the name of Aro Baro Churo Organic Tea, Aro Guyabano Tea, and Aro Baro Churo Guyabano Capsules. These products are not registered with FDA either as herbal medicines or food supplements. DOH-FDA Advisory No. 2013-004, stated that these products are now distributed throughout the country with boasts that they are 100,000 times stronger than chemotherapy and that they contain Adriamycin that can kill cancer cells, among other claims.

Acting on the issue, the FDA with the help of local government units implemented measures such as strict monitoring and on the spot inspections to remove these products from the market nationwide.

Unfortunately, this incident is just one of the several instances when herbal products are sold without FDA approval or with sales talks not consistent with the FDA approval.

Since many popular health products in the market are registered with the FDA, the question would be: are they safe and effective or they would risk our health?

Plants had been used since time immemorial for medicinal purposes. The Neanderthal man found in the Shanidar Cave of Northern Iraq was surrounded with clusters of flowers and herbs. The Ebers Papyrus in Egypt dating back to the 16th century BC contained drug formulas chiefly botanical. African and American indigenous people used herbs in their healing rituals. Others developed traditional medicinal systems using herbal therapies, such as Ayurveda and Traditional Chinese Medicine. In the Philippines, the “albularyo” used to be the general practitioner knowledgeable in most of the folkloric modalities, especially in the use of medicinal herbs.

In the early 19th century, chemical analysis was introduced and scientists began extracting and modifying the active ingredients from plants. In the meantime, chemists began making their own version of plant compounds which resulted, eventually, in the decline of the use of herbal medicines. Still, most of the manufactured drugs today are derived from botanicals.

The current proliferation of herbal products in the market arose from the government’s advocacy of traditional and alternative medicine.

Be that as it may, the law requires that the safety and efficacy of a medicine must first be established before it can be sold in the market. Thus, it is also mandatory for any manufacturer of herbal products to indicate in their label’s the product’s potential dangers which may include the phrase “No Approved Therapeutic Claims”.

Unfortunately, unlike the conventional drugs, herbal medicines and the food supplements lack pharmacologic and toxicologic studies to establish their biologic effects, potency, metabolism, elimination, and dosing. There had also been disputes about the purity of herbal medicines.

Since these products have become increasingly popular, sufficient information must be relayed to the consumers. The consuming public had been too often misled to believe that one food supplement, for instance, could cure almost all of known non-communicable diseases such as diabetes, hypertension, and kidney problems.

The consumers should be informed of the potential risks of using the products, including drug-to-herbal medicine interaction. This is particularly important to someone who is self-medicating or taking certain medicines without first informing his or her doctor.

Potential allergic reactions might also occur while in herbal therapy.

According to Science Daily forwarded on February 12, 2010, a University of Adelaide forensic pathologist made a global warning of the potential lethal dangers of herbal medicines taken in large quantities, injected, or combined with prescription drugs.

“There’s a false perception that herbal remedies are safer than manufactured medicines, when in fact many contain potentially lethal concentrations of arsenic, mercury, and lead. These substances may cause serious illnesses, exacerbate pre-existing health problems or result in death, particularly if taken in excess or injected rather than ingested,” Professor Roger Byard explained.

In such study, an analysis of 251 Asian herbal products found in the United States stores identified arsenic in 36 of them, mercury in 35, and lead in 24 of the products.

In one documented case, a 5-year-old boy who had ingested 63 grams of “Tibetan herbal vitamins” over a period of four years was diagnosed with lead poisoning.

Another case involved a young boy with cancer of the retina whose parents resorted to a traditional Indian remedy that caused arsenic poisoning.

Likewise, an herbal medicine known as Chan su, used to treat sore throats, boils, and heart palpitations, contains the venomous secretions of Chinese toads which can cause cardiac arrest or even coma.

Moreover, herbal medicines can also lead to strokes, movement disorders, muscle weakness, seizures, and failure of the liver, kidneys, and heart.

Professor Byard furthermore detailed that herbal medicines are frequently mixed with standard drugs, presumably to make them more effective but which can lead to devastating results. In his paper, he cited the case of an epileptic patient on prescription medicine who had also ingested a Chinese herbal preparation and lapsed into a coma.

Cushing’s Syndrome, a hormonal disorder, has also been linked to the ingestion of steroids and herbal cures when mixed together. What’s more is that some herbal medicines may also have a variety of effects on standard drugs. The herbal St. Jon’s Wort, for example, can reduce the effects of warfarin and may cause intermenstrual bleeding in women taking oral contraceptive pills.

Ginkgo and garlic, on the other hand, can also increase the risk of bleeding with drugs acting on the blood such as Aspirin which is often used for headache and could be bought over the counter.

Professor Byard also mentioned that the American Society of Anesthesiologists had recommended its patients to discontinue using herbal medicines at least two weeks before surgery because of the risks of herbal and drug interaction, including an increased chance of hemorrhaging.

He advised that forensic pathologists over the world need to become more aware of the contribution that herbal medicines are playing in a range of deaths, which is not currently recognized.

There are herbal products in the Philippines and neighboring countries that are still marketed but already banned in the US and certain parts of Europe.

Science Daily posted on March 18, 2013 that millions of people in Asia are potentially exposed to health risks of popular herbal medicines. It is stated that scientists from King’s College London are giving warnings to those herbal medicines used for a wide range of conditions including slimming, asthma, and arthritis.

These herbal medicines are said to be derived from a botanical compound containing aristolochic acids. Sadly, these products containing the toxic acid can still be purchased in China and other Asian countries but are now banned in the USA and many European countries.

Worse, these herbal medicines are available worldwide via the internet.

*This article was originally published in The Northern Metro Manilan (Vo. 1, No.2, April 2013).