Hazards of Herbal Therapeutics

Herbal therapies have a therapeutic effect and are acceptable interventions for diseases and symptoms. However, the lack of standards in manufacturing and lack of oversight by regulatory agencies exposes patients to potential hazards.

Pharmaceuticals approved for distribution in the Untied States have undergone rigorous testing that identifies the purity and concentration of the active ingredient that delivers the therapeutic effect. This also identifies the toxic levels that can cause serious and potentially lethal toxic effects. In addition, testing also identifies the effect a pharmaceutical has when combined with other prescribed or OTC medications.

Herbal therapies lack this testing for a number of reasons. These include the expense of these tests and the lack of regulation. Anyone can sell herbal therapy without having to receive approval from a governmental agency or from the medical community.

A major concern is the effect herbal therapy has on the patient who is also taking prescribed medications. Medication interaction is always a risk. A prescriber should always ask what medication the patient is taking and review the patient's chart before prescribing another medication.

For example, a patient who takes cascara—a laxative for constipation—and senna—also a laxative—along with Digoxin—which is used to treat an irregular heart rhythm—can develop a toxicity. Likewise, taking juniper—a diuretic that causes increased urination—and dandelion—also a diuretic—along with

Lithium, which is a commonly prescribed psychiatric medication, elevates the therapeutic effect of Lithium and can result in a toxic level.

Another hazard is the route in which herbal therapy is administered. For example, comfrey is used as an ointment to relieve swelling that is associated with abrasions and sprains. However, internal use can cause liver damage. Some comfrey therapies are designed for internal use. One such use is treating a cough using comfrey as an expectorant.

The herbal dietary supplement ephedra, commonly known as ma huang, is used as an energy boost and for losing weight. Ephedrine and pseudoephedrine are components of ephedra that have a stimulant and bronchodilation effect. However, ephedra has an adverse effect of palpitations—which can result in stroke.

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