NATURAL PRODUCTS
Introduction
Natural products have become popular alternatives to
traditional medical therapies, but little is known about these products other that what is
provided on product labels or in advertisements. The information provided on these
pages is meant to enlighten people concerning the use of natural products as alterntives
to traditional medical approaches. This information was compiled from multiple
sources, including the gold standard German Commission E and its literature citations, the
PDR for Herbal Remedies and its literature citations, MEDLINE searches for the latest
literature citations and reports, medical sources of drug interactions, product
advertisements, and the opinions of the author. While every attempt has been made to
ensure the accuracy of this information, there may be errors or omissions. The
reader is advised to consult with their healthcare provider for additional information.
Natural Products
While natural products are generally safe, most have
questionable quality assurance, unknown safe dosing ranges, and unknown drug and food
interactions. Even products that claim to have high quality control and consistent
contents from lot-to-lot or in every capsule or tablet may not be at the most effective
dosing range. In general, combination products should be avoided, because the amount
of each compound in each dose may be inappropriate or one of the compounds may not be safe
for you. The lack of multiple controlled studies with consistent conclusions should
be considered prior to taking any of these products. Even more worrisome is that
some of the supposedly trained people working in stores selling natural products are
misinformed, and there are cases where the wrong natural product has been recommended to
treat a certain complaint. Sometimes with dangerous results.
It is important to remember that a majority of the people
selling natural products are not trained healthcare professionals capable of assessing
your condition and understanding the pharmacology of any prescription or non-prescription
drugs you may also be taking. Another issue is that many healthcare professionals
are unfamiliar with natural products, but many have been attending classes and reading
books and articles on these products. For the most part, these products are safe,
there are exceptions, but anybody taking non-prescription or prescription drugs should
first discuss natural products with their physician or pharmacist. Ask them to
research the matter before answering your questions. There is so much information on
these products that it is difficult, if not impossible, for any one person to remember it
well enough to rattle it off without referring to some form of printed material or drug
interaction publications. However, some questions can easily be answered, without
reaching for the reference books and literature.
A couple of issues of which there is limited information are
the safety of these products in people with kidney or liver disease and the safety of
natural products in pregnancy. It is wise not to use any of these products during
pregnancy, while trying to become pregnant or while nursing, without first discussing
their use with your obstetrician.
Since little information is available concerning the
metabolism and clearance of most of the natural products, people with liver or kidney
disease should use caution when taking any of them. While the active ingredient may
or may not be harmful, the accumulation in the body of the other compounds in the natural
product may be harmful. People with kidney or liver disease may need a lower dose of
these products to prevent toxicity. It is best to discuss their use with the
physician responsible for treating the kidney or liver disease.
Starting at the lowest dose recommended on the label and
titrating up to an effective dose over a couple of weeks or months may be safer than
starting at a higher dose. Adjusting dosages based on variances in age and weight of
the person may be important in the safe and effective use of natural products.
Generally, the elderly require lower dosages, due to an age related decrease in
metabolism, kidney and liver function, and other factors. In any case, the maximum
dose listed on the product's label should normally not be exceeded.
Herbal natural products are not approved for use in
children nor have they been adequately tested in children. They should not be used in
children until they are proven safe and effective.
Standardization is the current buzz word when it comes to
natural products. But standardization in itself has several meanings.
Standardized products list the active component on the label that is being reported as the
standard dose and amount of product in each capsule or tablet. Generally, the label
does not list other compounds from the medicinal plant extract also contained in the
preparation. Depending on the method of extraction, compounds other than the desired
active ingredient may be present in the preparation. For example, using alcohol to
extract a compound from the plant will extract different compounds than using water, oil,
acidic solutions, or basic solutions. Heat may be used during the extraction process
and it alone may destroy some of the components of the extract. Unless all
standardized products of each preparation use the same extraction techniques on the same
parts of the plant, they will contain different amounts of each compound and may have
different physiological actions and adverse reactions. Assuming the product label is
representative of the ingredients contained in the product, at least a standardized
product has a known quantity of one or more active ingredients in each capsule or tablet,
but maybe not all of the active ingredients.
Just because these products are natural does not mean
somebody cannot have an allergic reaction to them or to some of the excipients or binders
within the tablets or capsules. An allergic reaction can be as minor as a mild rash
or itching to as severe as an anaphylactic reaction with hives, low blood pressure, and
severe difficulty breathing requiring immediate medical attention.
Natural products are considered dietary supplements by the
FDA and are not required to undergo the rigorous testing and other controlled studies and
evaluations required by the FDA for prescription and OTC drugs. Natural products may
not be marketed for the treatment, diagnosis, mitigation, cure, or prevention of any
disease, because they are not classified as drugs. In a broad sense, however, they
could be considered unapproved drugs marketed under the guise of dietary supplements.
Since most natural product labels provide little information
about the product, its adverse reactions, and drug interactions, it is best to talk with
your pharmacist or physician prior to taking any of them. Even vitamins taken in
excess can be harmful and can interact with some drugs.
It is up to the consumer to decide whether to try a natural
product or not. Hopefully, the information provided on these pages, when combined
with other reliable information and the advice of qualified trained healthcare
practitioners, who know your current medical and drug history, will empower you to decide
whether natural products are right for you.
For information specific to each product, select from the
list below:
Echinacea
Feverfew
Ginkgo biloba
Ginseng (Panax ginseng)
Glucosamine and Chondroitin
Gymnema sylvestris
Hawthorn
Kava Kava
Ma-Huang (Ephedra sinica)
Rose Hip (Rosa canina)
Saw Palmetto (Serenoa repens)
St. John's Wort (Hypericum perforatum)
Valerian (Valeriana officinalis)
Yohimbe Bark (Pausinystalia yohimbe)
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provided on these pages may not be duplicated or transmitted in any manner without payment
and the express written permission of Solumedia.
Legal Info: Solumedia
is not responsible for errors or omissions. The information provided on the natural
product pages is only a guideline based on current literature and the pharmacological
action of these products. It should not be used as the sole source of information on
these products. Many of the drug interactions listed are not found in current
literature but are based on likely interactions due to the actions of the interacting
drugs. It is recommended that a qualified and licensed healthcare professional be
consulted for additional information. Although the information provided is from
reliable sources, Solumedia has no liability. This information is provided only as a
service.
This page was last updated on 04/29/05. |
