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Allergy & Asthma Advocate: Winter 2003


 

Risks of herbal medicine
by Clifford W. Bassett, MD, FAAAAI

According to recent data, approximately three-quarters of the world’s population are or have been using herbal supplements. Most individuals use these herbal to enhance their health, as well as to actively treat medical or health symptoms. A recent study found that of a survey of 1,500 eighth-grade students, about 8% were apparently taking herbal supplements.

Several recently published studies described a trend among allergy and asthma sufferers to use herbal supplements to treat their allergic or asthmatic conditions. This is cause for concern, however, as some supplements, such as cayenne and St. Johns Wort may interact with certain medications (e.g. theophylline) used in the treatment of asthma.

While prescription drugs in the United States undergo rigorous evaluation by the Food and Drug Administration (FDA) for safety and efficacy prior to marketing approval, the Dietary Supplement Health and Education Act has exempted manufacturers of herbal supplements from the requirement to prove safety or effectiveness before entering the U.S. marketplace. The FDA can remove from the market any herbal or dietary supplement that it deems unsafe or that makes false claims, however, relatively little is known about the health effects of herbal remedies.

Known risks of herbal supplements
The following medical conditions may increase the risks of side effects of herbal supplements:

  • High blood pressure
  • Blood clotting problems
  • Thyroid disease
  • Enlarged prostate
  • Glaucoma
  • Parkinson’s disease
  • Stroke
  • Heart disease
  • Epilepsy

The following tips may provide some assistance in the use of medicinal herbal remedies:

  • Individuals who may have allergies to various pollens, including weeds and grasses, should be quite cautious in using certain herbal supplements. Use caution in taking herbs when you have seasonal, year-round or food allergies. For example, individuals who are sensitive to ragweed/weed pollens may "cross-react" to compounds such as Echinacea due to their similar plant families. If you are sensitive to sunflower seeds and/or various types of melons, you may also react to Echinacea. Researchers have reportedly identified several dozen cases in which Echinacea has been associated with asthma attacks and/or allergic reactions. Thus, one may use this supplement to fight a cold and wind up with worsening allergy-type symptoms.
  • Observe for any unintended reactions after taking herbal supplements, such as nasal, sinus or respiratory symptoms.
  • Herbs may be "contaminated with various mold spores that can seriously affect allergy patients," according to Marianne Frieri, MD, PhD, FAAAAI, Director of Allergy and Immunology at Nassau County Medical Center, in East Meadow, NY.
  • Never give dietary supplements or herbal remedies to children, especially without consultation with a pediatrician.
  • Patients about to undergo surgery must inform their doctor regarding the use of herbs. Supplements may react with anesthetic agents or other drugs given during surgery, and could cause bleeding or affect post-surgical wound healing.
  • Do not take supplements during pregnancy or while breast-feeding, as they could have effects on your baby. Various supplements may stimulate unwanted uterine contraction.
  • Let your medical provider know which supplement you are using as some may have an interaction with prescription and over the counter medications.
  • The term "natural" does not necessarily mean that it is safe for usage. Remember these herbs may contain weakened or diluted chemicals found in nature or medications.
  • Incorrect labeling, as well as omitting the product’s additives, may lead to unexpected reactions with the use of these supplements.
  • The use of feverfew, garlic, ginger and ginkgo may interact with aspirin and non-steroidal anti-inflammatory medications to cause bleeding.

Be aware of unsubstantiated and false claims of individual herbal supplements. More research and investigation are clearly needed in the evaluation of the effectiveness of herbal remedies, especially in individuals with allergic sensitivities. You may report a possible adverse effect of an herbal supplement to the FDA at www.FDA.gov/medwatch or call them at 1-800-FDA-1088.

Although most of our herbal therapies are not tested for safety or for benefit, many of our current medications are derived from herbs. The National Institutes of Health’s (NIH) National Center for Complementary and Alternative Therapy has been charged with investigating such therapies.

Research has found many more drug interactions and side effects than expected in studies on St. Johns Wort. Research on glucosamine is showing some benefit in retarding the progression of arthritis. A century ago it was discovered that injecting pollen extracts could successfully cure hay fever. Thus, careful scientific evaluation can help us sort out the benefit and harm from traditional therapies.

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