I hear it often repeated that supplement safety can't be trusted because they are not regulated. Doctors often tell their patients to rely on prescription medication instead. Yet prescription medications cause an estimated 100,000 deaths and 2.2 million adverse reactions each year.1 Reported supplement related deaths account for a dozen or so.

Many herbs have stood the test of time for safety and effectiveness. Compared to using prescriptions, herbal supplements are much safer. In fact, many people using herbal medicines only turned to them after suffering adverse side effects from pharmaceutical drugs.

What patients need is better information on how to use both safely. Today we'll look at the real safety problems and I'll tell you my favorite herbs and their appropriate safe use.

* Primum Non Nocere - First, Do No Harm *

Some drugs create problems worse than the disease. I often see a drug prescribed to combat the side effects of another drug. In addition to annual deaths, nearly 5% of all hospital admissions--more than 1 million per year--are the result of drug side effects.2
When the FDA approves a new drug, tests last from six months to 2 years. Yet a drug's safety remains uncertain until it has been on the market for many years. A JAMA study tracked the new warnings and recalls of drugs after they became available. They found that about one out five new prescription drugs had a serious side effect that had not been found in the pre-approval testing. 3
Another study led by the New England Journal of Medicine found that drug side effects plague one in four patients. Among the side effects 39 % were preventable and 13 % were serious such as internal bleeding and low blood pressure. Patients were given the wrong drug 45 % of the time; prescribed the wrong dosage 10 % of the time; and told to take a drug too often 10 % of the time.4
Drug sales are incredibly profitable with a single top-selling drug generating billions of dollars. The profit motive is tremendous. Drug companies spend millions to convince doctors to prescribe their drugs. These reasons compound the safety problems of these potentially lethal tools.

* The Contrasting Record of Supplements *

Unlike synthetic drugs, herbs are naturally occurring. They are generally weaker but much safer. Unlike drugs, there are no routine hospital admissions or thousands of deaths. They have relatively uncommon problems that usually occur in the very ill or with inappropriate use. But like medications, herbs can produce adverse effects if you take:
• The wrong dosage
• An incorrect supplement for your condition
• In combination with an already dangerous drug
There are a few supplements that I do not recommend for the following safety concerns:

• Ephedrine – It has been linked to cardiac death.
• Condroitin – There is a suspicion it may increase risk of prostate cancer.
• Kava – Like alcohol, it is toxic to your liver if taken in excess.
• St. John's Wort - Like some antibiotics, it can cause light sensitivity.
• Ginseng - It is a mild stimulant. It should be used in strict moderation if you have an irregular heart beat.

There are far more herbs that are reported dangerous that actually have very good safety records. Here are some of my favorites:
• Aloe Vera: for minor wounds, especially burns
• Black Cohosh: for PMS, menstrual cramps and menopausal symptoms
• Chamomile: aids as a tranquilizer, helps stress, anxiety
• Cranberry: prevents urinary tract infections
• Garlic: works like an antibiotic, helps prevent heart disease & reduces cholesterol
• Ginger: prevents motion sickness, morning sickness
• Lavender: a sleep and digestive aid, effective in relaxation
• Milk Thistle: promotes liver health
• Peppermint: settles upset stomachs, helps IBS sufferers
• Saw Palmetto: relieves symptoms of an enlarged prostate
• Tea Tree: works like an antiseptic, kills bacteria, fungi
• Tumeric: eases arthritis symptoms
• Valerian: induces sleep, relaxation
• White Willow: herbal aspirin

Al Sears, MD

1. Schardt, David. “Are Your Supplements Safe?” Nutrition Action Healthletter, Nov. 2003, Vol. 30, No. 9: 3-7
2. “Prescription for Disaster.” Better Nutrition, Aug. 2003
3. Napoli, Maryann. “Many Prescription Drugs Have Unexpected Harmful Effects.” Healthfacts, May 2002
4. “Prescription for Disaster.” Better Nutrition, Aug. 2003