Last week, it was reported that two people in San Francisco were admitted to intensive care after taking Chinese herbal medicine. This incident is likely to raise questions about the safety of Chinese herbal medicine. But are they more dangerous than drugs prescribed by doctors or sold over the counter without a prescription?
Herbal medicine is generally believed to be safe, with research suggesting that at least a third of people use herbal medicine in some countries, such as the UK.
To better understand the relative risks involved, it is helpful to put herbal medicine and pharmaceuticals into context. It is generally accepted that medicines cause side effects. However, as part of the licensing requirements, a risk-benefit analysis is performed to determine whether the benefits outweigh the potential harms. In other words, is the potential harm caused by the drug acceptable? If so, the drug has been approved for sale ( product license) may be granted.
Without a doubt, pharmaceuticals kill people. It is estimated that pharmaceuticals cause approximately 100,000 deaths each year in the United States. However, for certain conditions there may be no substitute for drug therapy, and certain drugs may help prolong life, such as those used to treat diabetes, heart disease, and cancer.
In contrast, herbal medicine is considered by many to be a safer alternative and is preferred by many people for treating non-life-threatening conditions. There is also some evidence to support the idea that herbal medicines are safer for mild illnesses. For example, drugs used to treat mild to moderate pain, such as paracetamol and aspirin, are known to cause rare but serious side effects such as stomach bleeding. On the other hand, herbal equivalents such as devil’s claw are reported to have a lower risk of side effects.
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difficult comparison
Adverse events associated with herbal medicines are reported much less frequently than those associated with pharmaceuticals. For example, in the UK, between 2006 and 2008, there were only 284 such reports on herbal medicines, compared to 26,129 reports on pharmaceuticals in a similar two-year period.
The reasons for this large difference are complex and suggest that adverse events of herbal medicines are either unrecognized or underreported. We would also expect the numbers for pharmaceuticals to be higher, as far more medicines are consumed than herbal medicines. However, this large difference suggests that adverse events are much more common with pharmaceuticals than with herbal medicines.
When herbal medicines cause serious side effects, they are often caused by low-quality products, products containing newly discovered botanical ingredients, or products contaminated with foreign substances such as pharmaceuticals.
For the general public, purchasing regulated herbal products provides some assurance that the medicine is safe and of acceptable quality. For example, in the UK traditional herbal remedies are manufactured to high standards, listing known side effects and, importantly, warning patients about possible interactions with medicines, which is another cause of side effects. An information leaflet is included.
For example, St. John’s wort, a herbal medicine used to treat mild depression, is known to have side effects when taken with fluoxetine (Prozac). Manufacturers of these products also have a legal obligation to monitor and report side effects to regulatory authorities.
voluntary restraints
Another way to avoid side effects is to visit a qualified herbalist, especially when dealing with symptoms that are not always suitable for self-treatment with over-the-counter medications. The training and regulation of herbalists varies widely from country to country, and without government regulation of herbalists, it is difficult for the public to assess who is legitimate.
However, self-regulation by professional associations does exist and is in effect in many countries, including the United States, Canada, the United Kingdom, and Australia. This regulation helps ensure that practitioners are properly educated and safe.
Herbal medicines are relatively safe compared to pharmaceuticals, as long as they are regulated products or prescribed by herbal medicine practitioners registered with the appropriate governing body. However, to avoid the occurrence of further serious side effects, consumers need to be better informed about the risks of obtaining herbs from unregulated sources.
