Herbal Medicines Pose Health Risk to Millions in Asia

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A commonly used herbal remedy that is banned in the U.S. and many European countries may still be harming users in Asia.

Since researchers connected an epidemic of kidney disease among Belgium women in the early 1990s to herbal medicines from a weight loss clinic, scientists have monitored the remedy for other potential health risks.

During the initial outbreak, scientists traced the kidney problems to aristolochic acid (AA), which belongs to a group of plants known as birthwort or Dutchman’s pipe. The agent is used for weight loss and to treat asthma and arthritis. But since the epidemic, herbs with aristolochic acid have been banned for medicinal uses in many countries, including the U.S. Researchers at King’s College London, however, now report in the Annals of Internal Medicine that millions of people are still being exposed, especially in Asia.

The scientists, led by Graham Lord, the director of the National Institute for Health Research Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, found that herbal medicines containing the acid are still found in China and other Asian countries and can be purchased online. “The reason we wrote this paper is to provide a diagnostic classification for aristolochic acid nephropathy (AAN) [the type of kidney failure associated with the agent]. For countries that haven’t asked the question of whether this is present, here is diagnostic criteria. We just don’t know what the levels of exposure are throughout the world,” he says.

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After reviewing 42 case studies and one trial related to caring for the disease, Lord and his colleagues came up with guidelines to help doctors to recognize cases of AAN, as well as treat the disease’s symptoms. They concluded that aristolochic acid could be linked to a variety of kidney diseases and urothelial cancer. More research, however, is needed to improve understanding of the risks of aristolochic acid.  They write:

We see an urgent need for research addressing many key areas, including determining the true worldwide extent of exposure; defining genetic variants that might confer increased sensitivity or resistance to the nephrotoxic effects of AA; testing the accuracy and utility of diagnostic criteria and optimum screening strategies, including the use of noninvasive biomarkers; and developing therapeutic agents that can reverse or delay progression of the disease.

An international herbal reference center equipped to assess the composition and risks of products available to consumers would provide substantial public health benefit.

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And given the wide availability of aristolochic acid, on the internet and in Asia, the authors say holes in regulation of herbal remedies need to be addressed. “The globalization of the distribution of these substances makes it very difficult to control,” says Lord.

Lord urges everyone using herbal medicine to be cautious. Active agents in familiar treatments can change over time, or new information on the risks and benefits of specific ingredients may also become available. Checking the ingredients is an important and often overlooked step. “Generally, a lot of people don’t ask. There are a lot of ingredients in [the remedies] that can change over time because they are complex. You need to check each time. It never hurts to check.” And, when in doubt, ask a physician about whether an herbal remedy is safe to take.

51 comments
charles66
charles66

Hi Alexandra Sifferlin, Greetings from Fr. Alphonse Charles! I read your article on herbal medicines' health risks. I am glad that you have initiated further discussion on this topic. Being a trained counselling psychologist and a Capuchin Priest hailing from India I have the following obervations for your further research. -Herbal and natural medicines are good alternatives in the field of medicine. I am recommeding some these medicines with the Ayurvedic and other naturopathy experts help. They infact help people, specially people with psychosis are helped. Some of the alternative therapies out of these schools help people a lot in relieving the pain and reduce depression. We recommend them a lot for the poor people who cannot afford other treatments. -These natural medicines seem to have also some side effect but comparatively less. It is to be taken with the proper guidance of a good physician who is well informed. He\she has to periodically examine the physiology of the patient and come out with feedbacks. -I work with some of the Naturopahty and Ayurvedic experts from India, Always getting their insights. I take those insights to the medical practioners and ask them to do the diagnosis before and after the treatment. I also conduct a course on 'Mood Designing' with a specific reference on Mental Health at our Institute in India (www.anugraha.info). (this course's inspiration from Dr. Liz Millers (from Edinberg) reflections on Modd Mapping) And there I recommend more natural way of living, physical exercises and other preventive natural care methods for well-being. I Always tell them to have a GP to accompany scientifically but not all are not able to afford that especially the poor. And so for such people I carefully recommend some of the good medical practioners. Presently I am in Rome and if you are interested I would share more about my experiences and introduce some of our good naturopathy experts. I know you have a long way to go but I wish you all the best in your research. God bless you Fr. Alphonse Charles Ofm Cap.,

charlesalph@gmail.com

lilylongflower
lilylongflower

so much misinformation and misunderstanding. 

herbs ARE traditional medicines that are way safer than pharmaceuticals (which by the way became popular in the 1930's).  i  have used herbs for years then trained for many more to become a certified herbalist and nutritionist....i have more schooling than an MD.    the clients i see in my clinic have been to several doctors, are on many meds and are still getting sicker instead of better.


yes there are poisonous plants out there, common sense is required folks,  and hello rapier1, herbal products ARE regulated for consistency and good manufacturing processes.  good to know what you are talking about before letting it fly in a public forum.

visit the national poison control site and see that nsaids and rx drugs kill tens of thousands every single year.  herbs have killed 1 in the past 5 years....and that woman purposely drank a good amount of a concentrated essential oil that is never ever used internally.   herbs are super safe.


harumph


rapier1
rapier1

I love it when people say herbal medications are just fine and don't need to be regulated. What they overlook is that tobacco - proven to be a cancer causing killer was once an herbal medication. Many other plants can also prove to cause injury or death - and that includes a number of plants used in herbal medicine. Oleander, rhubarb, castor, jasmine and so forth , when used as an herbal remedy, all depend on the preparer being honest (so as to not adulterate the product) and careful (so as to avoid contamination and maintain sub-lethal concentrations). I would never argue that medicine hasn't benefited greatly from herbals and plants - aspirin, digitalis, penicillin, quinine, and more all find their roots in herbal/folk remedies. However, having a standardized method of preparation with highly regulated quality controls is a huge win for the public. If herbals could maintain the same level of consistency and proof of efficacy that would really be helpful.

RandyLeJeune
RandyLeJeune

You want people to stop taking risks with herbal medicines? That's easy . . . make traditional medicines and doctors affordable so average people can afford them.

DavidChirantanSerlin
DavidChirantanSerlin

For all of you that say that some herbal remedy cured you of disease X, as the folks down under would say. "Good on You!"  I would never question that you got better.  What we don't know and you don't know is whether it was some compound in the herb extract, or if it was your own brain fixing the problem.  I worked in Food and drug research most of my career. I ran a study once in 500 people who complained of "frequent" colds and were recruited by doctors in various clinics. They were given either vitamin C tablets or milk sugar tablets in numbered bottles labeled "Experimental Cold Prevention Medication." The group as a whole -based on their self reporting of previous winters, were expected to have between four and five colds a winter. After two winters the study was stopped and the case report forms decoded. The vitamin C group had a cold frequency of 0.97 meaning many patients had no colds at all for two years. The dummy "placebo" tablets had a cold frequency of 0.95, meaning that there was no difference between vitamin C and an inactive tablet. Both were spectacularly successful. Convince your brain that what you are taking is good for you and in nearly all cases you *will* get better. Convince your brain that what you are taking will not help, and you will probably not do well.   The human mind can cure any disease that it wants to. The trick is convincing it to do that. The "placebo effect" accounts for anywhere from 65 to 90% of the efficacy of many drugs. So getting 3/4 of the curative effect of a pharmaceutical medicine with an inexpensive herb (providing it is really safe) is not a bad thing.

loridenise7
loridenise7

They want to control everything! I get so sick and tired of people wanting to tell others what to do. My life, My body. If we all go around scared of what might happen every time we turn around then we have not even lived. Should we put on a life vest just in case a sudden flood comes?! Live your life! Life is about living, learning, growing. 

DavidMaret
DavidMaret

I have used herbal medicine for years and it has healled me of all kinds of health issues inculding cancer. Do not let the medical BS drive you away from what is good for you. If it was not good for you then mother earth would not of grown it. Yes some folk will have reactions, but look at the meds of today, the side effets are worse then the issue.

stewymichelle
stewymichelle

Funny how herbal remedies are constantly attacked by the mainstream media, yet they never have a thing to say about all the health risks posed by drugs prescribed everyday. Drug companies are behind this research no doubt.

samk112
samk112

Alex, don't pay attention to the trolls, it's a good article. Go Northwestern!

Cheers

deanobambino64
deanobambino64

Flouride in the water isn't a problem. Radiation from Japan in our food is not a problem. Barium and aluminum being sprayed on our communities from planes is not a problem.....but health supplements and plant based remedies are?  You can fool the sheeple, but you cannot fool us all.

OMdoc
OMdoc

Alexandra, what kind of journalism do you do exactly?  The kind that informs the public?  Nope.  The kind that scares the public?  There we go.  

1. Out of the 400 or so herbs in the Chinese medical pharmacopia, only about five contain even trace amounts of aristalochic acid.  And, as you might know if you actually did know anything about herbology, you could eat a pound of the stuff before it would even show up on a blood test.  Obviously, in the practice of herbal Chinese medicine, we do not prescribe them as concentrated dangerous compounds.  That's what happens when idiot doctors prescribe medicines which are outside of their scope of practice.  In other words, don't blame the herbs.  Blame the idiot doctors.  Of course, if you concentrate something, it has harmful potential.  Then it's a drug.  Then it should be regulated.  Duh.  

2. Please refine your title statement that "One western allopathic weight loss clinic prescribing an untested compound for an off label side effect" poses health risk.  You are referring to only one compound, contained in a few herbs.  That's not all of "herbal medicine".  That's a light year away from real journalism.  Thanks for the two steps back.  We love having to make our case again and again over the objections of doctors who are afraid of what they might accidentally do with our herbs.  We also love having to explain to our patients how you in the press have your heads up your asses.

Thank you so much for the help in informing the public about our fantastic medicine.  *cough.

Oriental Medicine Practitioner

DavidChirantanSerlin
DavidChirantanSerlin

It is interesting how uneducated pop culture people think "herbal" and "natural" also  means safe.  "So Dr. Socrates, have a cup of this Hemlock herb Tea. Don't worry sir, it's organic and all natural...."  Or, "Don't worry about those so-called poison arrows the natives are shooting at us, that is just an all-natural organic herb paste that is on them. Can't hurt you...." As pointed out by AngelaDaum it is a return to the Snake Oil of long ago. At least the identity, purity, and possible harmful effects of  pharmaceuticals are documented and reviewed. Are they perfect? Of course not. But at least you know what you are getting and what it may do to you rather than living in this naive fantasy world that if its natural it is safe. Poison Oak is an herb. Rattlesnake and Black Widow spider venom are all natural and organic as well. 


bmcdonald227
bmcdonald227

Give me a break -- Herbal medications are fine...You need to go after the pharmaceutical companys and Pharmacies that sell medicines. I see medications advertised on tv that says:  Could cause fatal death, kidney failure, heart failure,skin rash, excessive bleeding, etc. -- the worst.  I can't believe people would even buy these medicines advertised on tv.... don't they hear the side effects.  Its worst than the problem they are curing.  I will take herbal medicines over pharmaceuticals anytime!!!!!

AngelaDaum
AngelaDaum

Sad thing is Snake Oil sales pitches catch peoples ears because the pharma industry is out of control and people can't afford it sometimes. Some folks feel they don't have a choice - sad as that seems.

rxlawdude
rxlawdude

The current state of no regulation of herbals in the US is an embarrassment.  We have returned to "Snake Oil" sales pitches, with companies appearing and disappearing as their false claims are revealed.  It's a game of whack-a-mole.  Do you want to trust your life to businesses like that?

If it seems too good to be true, it's probably not true. 

irving_tx
irving_tx

"Pharmaceutical Medicines Pose Health Risk to Millions Worldwide" - would this be a wrong title for an article?

The human race has come millions of years without the need for Pfizer, Merck, Glaxo or whatever... How come no one, says anything about the damage mainstream drugs are causing to people? You guys should carry one article per day for the rest of the time, to be able to do tell a small share of that damage. But then...

Read more: http://healthland.time.com/2013/03/20/herbal-medicines-pose-health-risk-to-millions-in-asia/#ixzz2O6erUu2A