Herbal Medicines Must Be Safe Because They’re Natural? So Are Strychnine, Arsenic, and Cyanide.

Health and medicine explained.
Nov. 26 2012 3:36 PM

Natural Does Not Mean Safe

Herbal supplements are unregulated, overhyped, and potentially deadly.

Ephedra and Birthwort.
It took FDA more than 10 years to remove from the market ephedra-containing herbal weight-loss products that had caused hundreds of deaths. Birthwort (right) is another dangerous herbal supplement.

Photographss by Valueline and Istockphoto.

This past October, the office of the inspector general of the Department of Health and Human Services issued two reports underscoring the need for improved oversight of the marketing of dietary supplements and improved surveillance of their effects. The reports add to a mounting body of evidence documenting a serious public-health problem.

Use of dietary and herbal supplements has grown dramatically in recent years in the United States. In 2007, according to the National Center for Complementary and Alternative Medicine, $14.8 billion was spent on nonvitamin, nonmineral, natural products, such as fish oil, glucosamine, and Echinacea—equivalent to approximately one-third of total out-of-pocket spending on prescription drugs. Of that total, $4.4 billion was spent on herbal supplements. Data from the National Health and Nutrition Survey for 2003 to 2006 indicate that one-half of American adults use dietary supplements and 20 percent use a supplement with at least one botanical ingredient.

Many people think that because herbs are natural, and because they are being marketed and sold legally, they must be safe and effective. Furthermore, surveys of the public indicate that most people believe these products are regulated by the U.S. Food and Drug Administration. In fact, both assumptions are mistaken. 

Advertisement

In 1994, Congress passed the Dietary Supplement Health and Education Act, with heavy backing from the dietary supplements industry. By defining herbal supplements and botanicals as dietary supplements, DSHEA exempted them from the more rigorous standards used by the FDA in regulating food, drugs, and medical devices—essentially leaving it up to the industry to regulate itself. This single piece of legislation opened the floodgates to a rapid expansion in the sale of dietary supplements.

Between 1994 and 2008, the number of dietary supplement products on the market increased from 4,000 to 75,000. In the first 10 months of 2008, the FDA received nearly 600 reports of serious adverse events (including hospitalization, disability, and death) from these products and 350 reports of moderate or mild adverse events. However, the FDA believes that these reports are drastically underreported and estimates that the annual number of all adverse events is 50,000.

Two highly-respected physician-scientists, Donald Marcus of Baylor College of Medicine and Arthur Grollman of Stony Brook University, have been drawing attention to the dangers of herbal supplements for more than a decade. In a recent article in the Archives of Internal Medicine, they noted, “Even when the agency [FDA] identifies an unsafe product, it lacks authority to mandate its removal from the market because it must meet the very high legal requirement to demonstrate a ‘significant or unreasonable’ risk. That is why it took FDA more than 10 years to remove from the market ephedra-containing herbal weight-loss products that had caused hundreds of deaths and thousands of adverse events.”

TODAY IN SLATE

War Stories

The Right Target

Why Obama’s airstrikes against ISIS may be more effective than people expect.

The One National Holiday Republicans Hope You Forget

It’s Legal for Obama to Bomb Syria Because He Says It Is

I Stand With Emma Watson on Women’s Rights

Even though I know I’m going to get flak for it.

Should You Recline Your Seat? Two Economists Weigh In.

Doublex

It Is Very, Very Stupid to Compare Hope Solo to Ray Rice

Or, why it is very, very stupid to compare Hope Solo to Ray Rice.

Building a Better Workplace

In Defense of HR

Startups and small businesses shouldn’t skip over a human resources department.

Why Is This Mother in Prison for Helping Her Daughter Get an Abortion?

Use Facebook to Reconnect With Old Friends, Share Photos, and Serve People With Legal Papers

  News & Politics
Foreigners
Sept. 23 2014 6:40 PM Coalition of the Presentable Don’t believe the official version. Meet America’s real allies in the fight against ISIS.
  Business
Moneybox
Sept. 23 2014 2:08 PM Home Depot’s Former Lead Security Engineer Had a Legacy of Sabotage
  Life
Outward
Sept. 23 2014 1:57 PM Would a Second Sarkozy Presidency End Marriage Equality in France?
  Double X
The XX Factor
Sept. 23 2014 2:32 PM Politico Asks: Why Is Gabby Giffords So “Ruthless” on Gun Control?
  Slate Plus
Political Gabfest
Sept. 23 2014 3:04 PM Chicago Gabfest How to get your tickets before anyone else.
  Arts
Brow Beat
Sept. 23 2014 4:45 PM Why Is Autumn the Only Season With Two Names?
  Technology
Future Tense
Sept. 23 2014 5:36 PM This Climate Change Poem Moved World Leaders to Tears Today
  Health & Science
Science
Sept. 23 2014 4:33 PM Who Deserves Those 4 Inches of Airplane Seat Space? An investigation into the economics of reclining.
  Sports
Sports Nut
Sept. 23 2014 7:27 PM You’re Fired, Roger Goodell If the commissioner gets the ax, the NFL would still need a better justice system. What would that look like?