Herbal supplements, also referred to as botanicals, have been used for medicinal purposes for a very long time. This has been despite the little evidence supporting the effectiveness of most of these products (Dasgupta & Hammett-Stabler, 2011). Although herbal supplements are regulated by the Food and Drugs Administration (FDA), they are not classified as drugs or foods but fall under a category referred to as dietary supplements. For the current assignment, I visited two drug stores and recorded information on ten herbal supplements. During the exercise, I noted that herbal supplements have not had adequate scientific scrutiny compared to conventional drugs and as such most don’t have strict regulations governing their sale and consumption. It should be noted that while good manufacturing practices must be followed when producing this type of supplements, approval from the Food and Drug Administration (FDA) is not necessary before these products are taken to the market.
Despite the fact that herbal supplements are not classified as drugs, the FDA monitors the safety of these supplements once they in the market and can take action against any products found unsafe for use. And while this provides for some form of regulation, the FDA does not guarantee the safety of herbal supplements. Considering that some supplements contain active ingredients, it is likely that some of them could pose unexpected risks to consumers.
Another notable aspect about herbal supplements is that some of them are widely popular among consumers despite there being little scientific evidence that shows their effectiveness for any purpose (Villeponteau et al., 2015). For example, ginseng has been purported to have several health benefits such as improved sexual function, increased resistance to stress, and improved normal body functions. However, evidence on the effectiveness of this supplement remains little and insufficient.
Although herbal supplements are associated with a range of side effects, there lacks reliable evidence on most of them. Among the reported adverse effects of herbal supplements include nervousness, hypertension, insomnia, tremor, heart attack, and headaches. According to some studies, approximately 56% of cardiovascular adverse effects cases are reported in persons aged 40 years and below. Due to the health risks posed to younger consumers by some herbal supplements, the FDA proposes a dosage limit on some products. Specifically, the FDA identifies ephedrine as a substance frequently contained in herbal supplements and that can cause heart attacks when used for more than seven days.
Some herbal supplements have also been reported to cause adverse effects when they interact with conventional drugs. Ginkgo Biloba for example has been reported to interact with warfarin and cause hemorrhage (Vaclavik et al., 2014). Hemorrhage is associated with the antiplatelet effects of gingko. An interaction of Ginkgo Biloba and caffeine has also been reported to cause bilateral subdural hematoma. In view of this evidence, patients should be advised to be cautious about any potential interactions between gingko products and conventional drugs.
Another herbal supplement that has adverse effects when it interacts with conventional drugs is St. John’s Wort. According to Anastasi et al. (2011), the purported uses of the supplement include treating anxiety, and seasonal affective disorder, mild to moderate depression. The supplement has, however, been reported to reduce plasma concentrations in the body when it interacts with such drugs as anticoagulants, antiretrovirals, and nevirapine. Another supplement that has been reported to cause adverse effects after interaction with conventional drugs is ginseng. While the supplement has several health benefits, American and Asian types of this supplement have been reported to reduce the effectiveness of warfarin while significantly increasing the hypoglycemic effects of insulin.
Conclusively, since herbal supplements have become increasingly popular among consumers, there is need for physicians to enquire about the use of these products before and when making prescriptions. By regarding the use of herbal supplements as part of the patient’s medication history, physicians can play an important role in reducing cases of adverse effects caused by these products. In order to do so, physicians need to stay updated on current trends in herbal supplements use.
References
Anastasi, J., Chang, M., & Capili, B. (2011). Herbal Supplements: Talking with your Patients. Journal for Nurse Practitioners, 7(1):29-35.
Dasgupta, A., & Hammett-Stabler, C. A. (2011). Herbal supplements: Efficacy, toxicity, interactions with western drugs, and effects on clinical laboratory tests. Hoboken, NJ: John Wiley & Sons.
Vaclavik, L., Krynitsky, A., & Rader, J. (2014). Mass spectrometric analysis of pharmaceutical adulterants in products labeled as botanical dietary supplements or herbal remedies: a review. Analytical And Bioanalytical Chemistry, 406(27), 6767-6790. doi:10.1007/s00216-014-8159-z
Villeponteau, B., Matsagas, K., Nobles, A. C., Rizza, C., Horwitz, M., Benford, G., & Mockett, R. J. (2015). Herbal supplement extends life span under some environmental conditions and boosts stress resistance. PLOS ONE, 10(4), e0119068. doi:10.1371/journal.pone.0119068
