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June 12, 2000 -- Americans are turning more and more often to herbal remedies as a natural alternative to drugs. But before you head off to the health food store for that bottle of St. John's wort or kava kava, you should know that natural does not necessarily mean safer. In fact, evidence is mounting that some of the most popular herbs can have serious side effects.
Now, a team of researchers has collected all the information available -- from clinical trial results to FDA warnings to individual physician's reports -- on several of the most widely used herbs, and created a set of guidelines that doctors and patients can use to protect themselves. Their complete report appears in the Spring issue of the Journal of Neuropsychiatry and Clinical Neuroscience.
"The bottom line is that these herbal medications are purported to be harmless, but that's an incorrect myth. [Reports about individuals] and letters to the editors in various medical journals have documented that these are in fact not harmless," says lead author W. Curt LaFrance Jr., MD, who is with the departments of neurology and psychiatry at Brown University School of Medicine in Providence, R.I.
St. John's wort, for example, which can indeed be useful in mild or moderate depression, has now been implicated in heart transplant rejection. Apparently, LaFrance explains, the herb can render anti-rejection drugs ineffective. Kava kava, which has been shown to successfully relieve insomnia and anxiety, can also cause patients on various psychiatric drugs like Valium and Librium to become severely disoriented. And the list of side effects and drug interactions continues to grow.
Unlike prescription drugs, which are closely regulated by the FDA, herbal products are considered food and are not required to undergo rigorous animal and human testing before being placed on the market. It is entirely up to the consumer to seek out information before deciding to take an herbal product, but most consumers are not doing the research. And they're not talking to their doctors, either, LaFrance tells WebMD.
Although doctors should be making every effort to learn exactly which drugs -- chemical or herbal -- their patients are taking, patients must do their part as well, says LaFrance. People worry that their doctor will scoff at their use of an alternative medicine, he says, so they put themselves at unnecessary risk by not mentioning it.
"I think there is potential for these herbal medications, so I wouldn't throw the baby out with the bath water," says LaFrance. "But it needs to be cautiously monitored." Herbs may come from a garden rather than a laboratory, but they "are bioactive substances with the potential to do good and the potential to harm," he says. "The bottom line is that they should be regulated."