>Scientists Rip Herbal Remedies
> Fatal health problems tied to lack of
> regulation
>
> Kenneth Howe, Chronicle Staff Writer
>
> Friday,
>January 21, 2000
>
>
>
> Regional -- Alarmed by widespread reports of
> serious health problems -- some leading to death --
> associated with herbal remedies, a group of Bay
> Area doctors and nutrition experts is calling for new
> oversight of the nation's burgeoning $12 billion
> dietary supplement industry.
>
> Hundreds of medical emergencies have been linked
> to a host of herbal supplements that can be bought
> without prescription, even though few scientific
> studies have been conducted to assess their safety
> and dietary value.
>
> Unlike pharmaceutical drugs, which are subject to
> rigorous testing supervised by the Food and Drug
> Administration, dietary supplements are largely
> exempt from clinical scrutiny by a 1994 law.
>
> ``People are dying, and something has to be done,''
> said pharmacist Frederick Mayer, a member of the
> ad hoc Dietary Supplement Safety Committee, an
> informal group established after FDA hearings on
> dietary supplements in Oakland last year.
>
> Mayer is concerned about people such as Tammy
> Hooper, a 38-year- old Louisiana woman who
> suffered a seizure and permanent heart damage after
> drinking a popular herbal tea. The tea contained
> high levels of senna, a strong laxative that can rob
> the body of electrolytes and put consumers at risk
> for cardiac arrhythmias.
>
> ``I went to the health food store because I wanted a
> mild laxative that didn't have any drugs in it,'' said
> Hopper. ``Now, I've got a defibrillator in my chest
> and I'm taking drugs every day to stay alive.''
>
> Others have not been so lucky.
>
> More than 180 deaths have been linked to dietary
> supplements in the past few years, according to an
> FDA tracking system that lists voluntarily reported
> incidents only.
>
> Mayer and his organization, which is composed of
> doctors, nutritionists, toxicologists, pharmacists and
> public health experts, is concerned about a broad
> range of vitamins, minerals, herbs, botanicals, amino
> acids and hormones that are legally classified as
> dietary supplements.
>
> These products have been linked to severe medical
> problems ranging from psychotic episodes to kidney
> damage, heart attacks and strokes, some fatal.
>
> Three out of every 10 Americans take some type of
> botanical or herbal medicine and may be at risk,
> Mayer said.
>
> ``People assume that many of these products are
> safe because they are natural,'' said Joyce Lashof,
> former dean of the School of Public Health at the
> University of California at Berkeley and also a
> member of the ad hoc Dietary Supplements Safety
> Committee. ``But many of them have never been
> seriously tested for efficacy or toxicity.''
>
> Lashof and other medical experts acknowledge that
> some herbal remedies may have health benefits.
> Preliminary studies of St. John's wort, for example,
> suggest that the herb may be effective in treating
> mild forms of depression.
>
> But scientists are concerned that a number of herbal
> remedies are intrinsically dangerous, while others
> may be harmful when used with other drugs.
>
> Lashof and other scientists are particularly
> concerned about so- called ``bad boy botanicals,'' a
> broad group that includes ephedra, chaparral and a
> concoction known as dieter's tea.
>
> Ephedra is an ancient Chinese herb that can act as a
> powerful stimulant, particularly when combined with
> caffeine-rich herbal ingredients, such as guarana.
> Also known as ma huang, ephedra is used in many
> weight reduction products, such as Easy Trim and
> Diet Max, and ``herbal highs'' like those sold under
> the brand names Ripped Fuel and Quick Shot. The
> active ingredient, ephedrine, has been linked to
> heart attacks and strokes.
>
> In Detroit a 47-year-old woman was taken to the
> emergency room. Doctors were mystified. Her
> body's muscle tissue was deteriorating, and she was
> dying. A toxicologist eventually found that she had
> been taking ephedra to lose weight. She eventually
> recovered after she stopped taking the herb.
>
> The nation's second-largest drugstore chain, CVS
> Corp., said yesterday that it would begin asking
> customers to tell their pharmacists what herbal
> supplements they take in order to avoid harmful side
> effects.
>
> The drugstores will enter the information into a
> computer and cross-check the supplements with the
> prescribed drugs to avert possible damaging
> interactions.
>
> Other natural products have been inadvertently
> ``spiked'' with harmful or toxic ingredients. Some
> calcium supplements, for example, have been found
> to contain levels of lead that exceed those allowed
> under California law.
>
> And for a wide array of other herbal products --
> from echinacea and ginseng to melatonin and zinc --
> the claimed health benefits are unproven.
>
> ``How these products interact and what their
> long-term adverse consequences may be are
> completely unknown,'' said Sheldon Margen,
> professor emeritus at the School of Public Heath at
> UC Berkeley.
>
> Consumers routinely assume that the medications
> they take and the food they ingest have been
> scrupulously studied by the FDA. But that is not
> true of natural or herbal products.
>
> In 1994, the dietary supplements industry pushed
> the little-noticed Dietary Supplement Health and
> Education Act through Congress. The bill essentially
> exempts dietary supplements -- vitamins, minerals,
> herbs and botanicals -- from FDA oversight as long
> as they claim only to ``affect the structure or
> functions of the body'' rather than cure disease.
>
> Earlier this month, the FDA ruled that such
> symptoms as memory loss or morning sickness
> were not diseases but rather natural conditions.
> Thus, makers of herbal supplements can market
> products to treat these conditions without proving
> they are either safe or effective.
>
> The dietary supplement industry argues that the law
> brings greater freedom of choice to consumers.
>
> ``The bottom line is that there is a current regulatory
> system in place in the United States that allows us
> all to make the best and safest self- care decisions
> possible,'' said a spokeswoman for the Consumer
> Healthcare Products Association, which represents
> more than 80 manufacturers of over-the-counter
> dietary supplements.
>
> ©2000 San Francisco Chronicle Page A1
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