Bring Herbal Remedies Into Doctor Dialogue, Experts Caution
Bring Herbal Remedies Into Doctor Dialogue, Experts Caution
Use of herbal teas should be considered in diagnosing liver problems
By Nancy A. Melville
MONDAY, Feb. 18 (HealthScoutNews) -- Herbal remedies may seem like
safe alternatives to conventional medicines, but experts say recent
cases of liver toxicity underscore the need for caution when taking
In one such instance, a 40-year-old woman from Brooklyn, N.Y., was
diagnosed with liver toxicity that was traced to the consumption of
Chinese rice tea.
According to Dr. T.C. Chauhan, who treated the woman, she had
apparently been drinking just a few cups of the tea each day because
she believed the tea helped control her diabetes.
The woman was from Sri Lanka, where some believe Chinese rice tea
strengthens the pancreas, and hence lessens the diabetes risk,
according to Chauhan, a gastroenterology fellow at the Brooklyn
Chauhan says the tea was targeted because the woman had no other
liver problems, and the symptoms disappeared after she stopped
drinking the tea.
While Chinese rice tea isn't known to be a toxin, Chauhan says it
can, like so many other herbal remedies, have a toxic effect for any
number of reasons.
"The active ingredients contained in many herbal remedies aren't
standardized, so it could be that some people, like this woman, may
find themselves with stronger concentrations that can be harmful," he
In another case related to herbal tea, doctors from the Wyckoff
Heights Medical Center, also in Brooklyn, reported that a patient
suffered the toxic effects of lead consumption after consuming an
herbal tea that had actually been contaminated with lead.
The patient is estimated to have inadvertently consumed more than
three grams of lead, say the doctors. After being diagnosed and
treated, the patient recovered.
In addition, in the third, more stark case, doctors with Cook County
Hospital in Chicago reported that a 45-year-old woman experienced
liver failure after consuming almost 30 different herbal remedies
over several months.
The woman had been reluctant to admit she was using the alternative
therapies, but after she was diagnosed, she successfully underwent a
Doctors say the case illustrates the problem of patients hiding
information that might be crucial in diagnosing a serious problem.
"Because patients are not aware of the potential danger of these
alternative therapies, they may be reluctant to admit to their use,"
Chauhan says his patient also withheld information on her use of
herbal remedies until symptoms became serious.
"Until she was hospitalized for jaundice and other signs of
hepatotoxicity, our patient denied her use of herbs and
over-the-counter remedies," he says.
But Robert Bonakdar, a family physician and clinical and research
fellow in integrative medicine at the Scripps Center for Integrative
Medicine in La Jolla, Calif., says patients bear only part of the
Doctors must also be more assertive in inquiring about patient use of
alternative remedies, he says.
"It's really a two-pronged problem, because a lot of doctors don't
even ask if their patients are taking herbal medicines. I've seen
statistics that say between 60 and 80 percent don't ask their
patients," he says.
In addition, it's not always because doctors aren't concerned about
potential problems. In fact, Bonakdar says, it's those concerns that
actually may prevent them from inquiring in some cases.
"For one thing, doctors have legal considerations to think about,"
Bonakdar adds. "If they don't know enough about a supplement a
patient is taking and problems do arise, they may fear being liable
in some way."
Another factor can be ego, he adds.
"Some doctors may fear that if they ask about herbal remedies and are
told a patient is taking something they haven't heard of, they look
like an idiot for not knowing, so they just won't even ask," he says.
Whatever the reasons, by not asking patients about herbal remedies,
doctors compound patients' notions that it's not all that important.
"Patients may think that if the doctor asks about things like
medicines, exercise and smoking, but not about supplements, then it
must not be that important. And that's a complete misconception,"
The possible role of herbal remedies or alternative therapies should
be especially considered in patients showing up at doctor's offices
with symptoms of liver problems, Chauhan says.
"Problems from misuse of herbal remedies are often seen in the liver
because the liver is sort of their first pass," he says. "Once taken,
the medicine changes to chemically different components, which have
an effect on the body and can affect liver cells down the road."
Experts say some of the most popular herbal remedies - - garlic, for
instance - - are generally harmless and indeed, potentially
beneficial, in acceptable doses.
But problems can arise from other herbal remedies even if consumers
think they are taking correct doses because, since such supplements
aren't regulated, there is no oversight of levels of active
ingredients a product contains, explains Bonakdar.
"Tests on selected herbal remedies have shown everything from
products containing far less or even no amounts of the active
ingredient advertised, to others containing several times more of the
ingredient than is described on the label, which can be especially
dangerous," he says.
One company that does performs such tests recently found that only
about half of products that claimed to contain the sleep-inducing
herb Valerian had the amounts indicated on their labels, and four out
of the 17 contained no detectable levels of the ingredient.
The U.S. Food and Drug Administration (FDA) reports that sales of
herbal and botanical products totaled $3 billion in 1999. The figures
represented a 20 percent increase from 1995, constituting the highest
increase of all dietary supplement products.
Some of the highest selling herbal products include garlic, ginseng,
ginkgo biloba and echinacea.
What To Do
Visit the National Institute of Health's National Center for
Complementary and Alternative Medicine for more information on what's
considered safe and what's not.
In addition, visit the FDA's site on Dietary Supplements for more
The FDA also offers extensive information on Illnesses and Injuries
Associated With the Use of Selected Dietary Supplements.
These links are paid for by individual sponsors. They are carefully
reviewed by our editors to assure validity and consumer interest.
For information on clinical trials being conducted on a variety of
diseases and conditions,please go to Acurian.
SOURCES: Interviews with T.C. Chauhan, M.D., fellow, gastroenterology
and hepatology, Brooklyn Hospital Center, Brooklyn, N.Y.; Robert
Bonakdar, M.D., family physician, and clinical and research fellow,
integrative medicine, Scripps Center for Integrative Medicine, La
Jolla, Calif.; American Academy of Gastroenterology press release
Copyright � 2002 ScoutNews, LLC. All rights reserved.
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