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Hidden dangers of herbal medication.

Byline: Miriam Stoppard

As a doctor trained to keep patients safe by strictly complying with the recommended dose of medicines, the cavalier use of herbal products scares me.

Precise doses of the active ingredients are frequently unknown.

Even if they are, they're often not present in the product you buy. One survey of ginseng products found widely varying amounts, some even contained none at all.

A further concern of mine is that by definition, herbal products are rarely pure, pure by the standards of all prescription drugs and most over-the-counter drugs.

They can contain many impurities, some of them potentially fatal. In a small survey I did on herbal remedies for babies I found one contained strychnine, which can be fatal to humans.

A recent editorial in the British Medical Journal that drew attention to a particularly nasty herb can still be found in Chinese herbal remedies and freely bought on the internet. It's called aristolochic acid and causes kidney failure and cancer. A Belgian report 20 years ago described nine women with serious, progressive kidney disease. All of them had taken a slimming aid containing herbs from the aristolochic family.

Within five years, the Belgian experts had found 100 more cases, half of them not only had kidney damage but kidney cancers too.

Recently, 300 cases were discovered in Beijing from a single herbal medicine centre. One hundred million Chinese have chronic kidney disease thought to be related to the acid. Nearer to home, an epidemic of kidney disease plus cancer affecting thousands of patients in the Danube basin was laid at the door of aristolochic acid.

Many countries around the world have banned its use but it can still slip though the net when bought by mail order.

The 2004 EU directive on Traditional Herbal Products wisely demanded that all herbal products be registered and approved with demonstrable safety and effectiveness.

However, a recent investigation by our Medicines and Healthcare Products Regulatory Agency showed that it was still contained in herbal products sold here.

A judge in a recent court case about the acid recommended its supply be strictly regulated. The only way that we can safeguard ourselves is for each ingredient to be listed and manufacturers must have data on each to prove safety and effectiveness.

The use of unregulated herbal products is hazardous so don't take them. Stick to regulated medicines where the side effects are known.

Hazardous products can be bought on the internet and
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Title Annotation:Features; Opinion, Column
Publication:The Mirror (London, England)
Date:Jan 7, 2013
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