About one in ten infants are given unregulated and potentially unsafe herbal products or teas by their moms. Continue reading
In general, we believe that alternative medicine is inappropriate for children. Why? The potential risks are too high. Continue reading
Long-time readers know of my fondness for ConsumerLab.com. Their independent testing of natural medications (herbs, vitamins, and supplements) guides my teaching and my prescribing. Now, a review by ConsumerLab.com finds 45% of ginseng products don’t provide the full amount of the ingredient indicated on the label, or worse, are contaminated.
ConsumerLab.com is now reporting that five out of eleven of the most popular ginseng supplements in the U.S. were selected for testing and contained less ginseng than expected from their labels or were contaminated with lead and/or pesticides.
Problems with the quality of ginseng supplements have been reported by ConsumerLab.com since 2000. Ginseng is a popular herb with U.S. sales last year of $83 million according to Nutrition Business Journal.
“Consumers need to be wary of the quality of ginseng supplements” said Tod Cooperman, MD, President of ConsumerLab.com.
“People should also recognize that there is enormous variation in the amount of ginsenosides — key ginseng compounds — in marketed supplements. We found most products to provide approximately 10 to 40 mg of ginsenosides per day, but some yielded much higher amounts, including one that delivered a whopping 304 mg. We are not aware of human studies with the higher amounts. The effects might certainly differ from one product to another.”
Ginseng has often been promoted for increasing vitality. While there is not much clinical evidence to support an energy boosting effect, studies indicate that that certain preparations may help prevent colds and flus or keep blood sugar levels down in people with diabetes. A range of other uses have been suggested but lack strong evidence.
The new Product Review of Ginseng Supplements provides test results for fifteen supplements – eleven selected by ConsumerLab.com and four tested at the request of their manufacturers/distributors that passed the same testing through CL’s Voluntary Certification Program.
Also listed are two products similar to one that passed testing but sold under different brand names.
Brands included are Action Labs, Bluebonnet, Good Neighbor Pharmacy, Imperial (GINCO), Nature Made, Nature’s Bounty, Nature’s Plus, NSI (Vitacost), Pharmanex, Puritan’s Pride, Solgar, Spring Valley (Walmart), TruNature, Vitamin Shoppe, Vitamin World, and Whole Foods.
ConsumerLab.com is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. The company is privately held and based in Westchester, New York.
Of importance, it has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.
The folks at Natural Standard recently sent out a notice of a significant review in the cardiology literature on the potential interactions between herbs and heart medications. A news release on the study can be found here. This new analysis suggests that herbal supplements, such as Ginkgo biloba and garlic, may cause dangerous interactions when combined with heart medications.
Some examples of herbs and their adverse effect on heart disease management include:
- St. John’s wort, which is typically used to treat depression, anxiety and sleep disorders among other problems, reduces the effectiveness of medications contributing to recurrences of arrhythmia, high blood pressure or increase in blood cholesterol levels and risk for future heart problems.
- Ginkgo biloba, which is supposedly used to improve circulation or sharpen the mind, increases bleeding risk in those taking warfarin or aspirin.
- Garlic, which supposedly helps boost the immune system and is commonly used for its cholesterol and blood pressure lowering properties, can also increase the risk of bleeding among those taking warfarin.
The authors searched PubMed and Medline databases for articles about herbs and heart disease that were published in 1966-2008. They identified nearly 30 herbal products that could cause harmful effects and should not be taken with heart medications, including those that lower blood pressure, prevent blood clots, regulate cholesterol and stabilize heart rhythms.
Bleeding was among the most common interactions that were reported. The authors found that alfalfa, angelica (dong quai), bilberry, fenugreek, garlic, ginger, ginkgo and khella may increase the risk of bleeding when taken with anticoagulants like warfarin (Coumadin®). The researchers also identified herbs (such as capsicum, ginseng, licorice, St. John’s wort and yohimbine) that may increase blood pressure.
Grapefruit juice may also cause dangerous interactions. The fruit inhibits an important enzyme that helps break down drugs. As a result, grapefruit may increase the amount of medication in the body to toxic levels.
According to the researchers, grapefruit juice may increase the effects of cholesterol-lowering drugs (statins), blood pressure-lowering drugs (calcium-channel blockers) and cyclosporine (a drug that reduces the risk of transplant rejection).
“There is a clear need for better public and physician understanding of herbal products through health education, early detection and management of herbal toxicities, scientific scrutiny of their use, and research on their safety and effectiveness,” the authors concluded in the Journal of the American College of Cardiology.
“These herbs have been used for centuries—well before today’s cardiovascular medications—and while they may have beneficial effects these need to be studied scientifically to better define their usefulness and, more importantly, identify their potential for harm when taken with medications that have proven benefit for patients with cardiovascular diseases,” said Dr. Jahangir, one of the authors of the study.
“Patients, physicians, pharmacists and other healthcare providers need to know about the potential harm these herbs can have.”
In addition to greater public education about the risks of using herbal products, patients and clinicians need to actively discuss the use of over-the-counter medications, supplements and herbal products in addition to prescription medications.
Dr. Jahanigir also urges the scientific community to commit to conducting studies to test manufacturers’ claims and study the impact of these compounds on heart disease management. He reports no conflict of interest.
Obviously, like conventional drugs, herbs and supplements may cause side effects and interact with other therapies and you should never take natural medications (herbs, vitamins, and supplements) with prescription or even OTC drugs without checking with your physician or pharmacist.
You can read more herbs and natural medicines in my book, Alternative Medicine: The Christian Handbook:
Two products failed to properly list the part of the milk thistle plant used — a FDA requirement. Among the remaining supplements, only one contained the expected amount of silymarin compounds, which are believed to be the active constituents of milk thistle.
Studies suggest silymarin may be helpful in type 2 diabetes and, possibly, certain liver conditions.
While most products claimed that their milk thistle extracts were standardized to 80% silymarin, ConsumerLab.com found actual amounts to range from 47% to 67%.
Sales of milk thistle in the U.S. have climbed for several years, reaching $95 million in 2008 according to the latest figures from Nutrition Business Journal.
ConsumerLab.com’s Vice President for Research, Dr. William Obermeyer, a former scientist with the U.S. Food and Drug Administration (FDA), suggested supplement makers may be relying on non-specific tests, such as UV spectrophotometric analysis, that can falsely inflate a product’s silymarin content by counting other compounds that are not silymarin.
In contrast, ConsumerLab.com used a highly specific HPLC method to test the products.
Some ingredient suppliers offer both a higher priced and a lower priced milk thistle extract. The higher cost product is certified with the HPLC test, while the lower cost product is certified with the non-specific UV test.
The FDA does not set standards for the quality or testing of herbal supplements, so manufacturers may choose either form of milk thistle. Consumers normally have no way of knowing which form they purchase.
An abstract of the Product Review of Milk Thistle Supplements can be found here, however, the full review, including the full results, reviews, and comparisons of ten supplements selected by ConsumerLab.com is only available by subscription.
The Review provides information on how to choose and use these supplements. Brands included in report are 1Fast400, Enzymatic Therapy, Finest Natural, Jarrow Formulas, Natural Factors, Nature’s Plus, Nutrilite, Pharmex, Smart Basics (Vitacost.com), and Whole Foods.
ConsumerLab.com is one of my favorite web sites for evidence-based information on natural medications (herbs, vitamins, and supplements) and a leading provider of consumer information and independent evaluations of products that affect health and nutrition.
Reviews of other popular types of supplements are available from www.consumerlab.com. Subscription to ConsumerLab.com is available online here. The company is privately held and based in Westchester, New York. It has no ownership from, or interest in, companies that manufacture, distribute, or sell consumer products.
You may also enjoy these blogs:
- Trustworthy consumer websites for NATURAL MEDICATION information (herbs, vitamins, and supplements)
- Physician calls for increased FDA regulation of dietary supplements
- Herbal remedies need real regulation
- The Ten Commandments of Preventive Medicine – Part 8 – Alternative Medicine
- Study Links Herbal Medicines to Lead Poisoning. How can you find safe herbs?
Here are the most popular blogs, based upon blogs that you’ve read, over the first three months of 2009. The most popular blog was “Is It a Cold or Sinus Infection? How to Tell the Difference” and the second most popular blog was “Faith-Based Health and Healing – Part 1 – What does the Bible say about health?” The latter blog is a twelve-part series. I hope you’ll look up any of these you missed the first go round.
More Information: Continue reading