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Introduction
Herbal supplements are a type of dietary supplement
that contain herbs, either singly or in mixtures. An herb (also called a
botanical) is a plant or plant part used for its scent, flavor, and/or
therapeutic properties.
Many herbs have a long history of use and of
claimed health benefits. However, some herbs have caused health problems for
users. This fact sheet contains points you should consider for your safety if
you use, or are thinking about using, herbs for health purposes. It does not
discuss whether herbs work for specific diseases and conditions (for
science-based information on that topic, see "For More
Information").
About Dietary Supplements
Dietary
supplements were defined in a law passed by Congress in 1994. A dietary
supplement must meet all of the following conditions:
· It is a product (other than tobacco) intended to supplement the diet, which contains one or more of the following: vitamins; minerals; herbs or other botanicals; amino acids; or any combination of the above ingredients.
· It is intended to be taken in tablet, capsule, powder, softgel, gelcap or liquid form.
· It is not represented for use as a conventional food or as a sole item of a meal or the diet.
· It is labeled as being a dietary supplement.
It's important to know that just because an herbal supplement is labeled
"natural" does not mean it is safe or without any harmful effects. For example,
the herbs kava and comfrey have been linked to serious liver damage.
Herbal supplements can act in the same way as drugs. Therefore, they can
cause medical problems if not used correctly or if taken in large amounts. In
some cases, people have experienced negative effects even though they followed
the instructions on a supplement label.
Women who are pregnant or nursing
should be especially cautious about using herbal supplements, since these
products can act like drugs. This caution also applies to treating children with
herbal supplements.
It is important to consult your health care provider
before using an herbal supplement, especially if you are taking any medications
(whether prescription or over-the-counter). Some herbal supplements are known to
interact with medications in ways that cause health problems. Even if your
provider does not know about a particular supplement, he can access the latest
medical guidance on its uses, risks and interactions.
If you use herbal
supplements, it is best to do so under the guidance of a medical professional
who has been properly trained in herbal medicine. This is especially important
for herbs that are part of an alternative medical system, such as the
traditional medicines of China, Japan or India.
Alternative medical
systems are built upon complete systems of theory and practice, and have often
evolved apart from and earlier than the conventional medical approach used in
the United States.
In the United States, herbal and other dietary
supplements are regulated by the U.S. Food and Drug Administration (FDA) as
foods. This means that they do not have to meet the same standards as drugs and
over-the-counter medications for proof of safety, effectiveness and what the FDA
calls “Good Manufacturing Practices”.
The active ingredient(s) in many
herbs and herbal supplements are not known. There may be dozens, even hundreds,
of such compounds in an herbal supplement. Scientists are currently working to
identify these ingredients and analyze products, using sophisticated technology.
Identifying the active ingredients in herbs and understanding how herbs affect
the body are important research areas for the National Center for Complementary
and Alternative Medicine.
Published analyses of herbal supplements have
found differences between what's listed on the label and what's in the bottle.
This means that you may be taking less — or more — of the supplement than what
the label indicates. Also, the word "standardized" on a product label is no
guarantee of higher product quality, since in the United States there is no
legal definition of "standardized" (or "certified" or "verified") for
supplements.
Some herbal supplements have been found to be contaminated
with metals, unlabeled prescription drugs, microorganisms or other
substances.
There has been an increase in the number of Web sites that
sell and promote herbal supplements on the Internet. The Federal Government has
taken legal action against a number of company sites because they have been
shown to contain incorrect statements and to be deceptive to consumers. It is
important to know how to evaluate the claims that are made for supplements. Some
sources are listed below.
For More Information
The NCCAM
Clearinghouse provides information on CAM and on NCCAM. Services include fact
sheets, other publications, and searches of Federal databases of scientific and
medical literature. Publications include "Are You Considering Using
Complementary and Alternative Medicine (CAM)?" and "10 Things To Know About
Evaluating Medical Resources on the Web." The Clearinghouse does not provide
medical advice, treatment recommendations or referrals to
practitioners.
U.S. Food and Drug Administration (FDA)
Center
for Food Safety and Applied Nutrition
Web site:
cfsan.fda.gov
Toll-free in the U.S.: (888) 723-3366
Information
includes "Tips for the Savvy Supplement User: Making Informed Decisions and
Evaluating Information" and updated safety information on supplements. If you
have experienced an adverse effect from a supplement, you can report it to the
FDA's MedWatch program, which collects and monitors such information
(1-800-FDA-1088 or fda.gov/medwatch).
Office of Dietary Supplements
(ODS), NIH
Web site: ods.od.nih.gov
E-mail: ods@nih.gov
ODS supports
research and disseminates research results on dietary supplements. It produces
the International Bibliographic Information on Dietary Supplements (IBIDS)
database on the Web, which contains abstracts of peer-reviewed scientific
literature on dietary supplements.
CAM on PubMed
Web site:
nlm.nih.gov/nccam/camonpubmed.html
CAM on PubMed, a database on the Web
developed jointly by NCCAM and the National Library of Medicine, offers
abstracts of articles in scientifically based, peer-reviewed journals on
complementary and alternative medicine. Some abstracts link to the full text of
articles.
The Cochrane Library
Web site:
cochranelibrary/cochrane
The Cochrane Library is a collection of
science-based reviews from the Cochrane Collaboration, an international
nonprofit organization that seeks to provide "up-to-date, accurate information
about the effects of health care." Its authors analyze the results of rigorous
clinical trials (research studies in people) on a given topic and prepare
summaries called systematic reviews. Abstracts (brief summaries) of these
reviews can be read online without charge. You can search by treatment name
(such as the name of an herb) or medical condition. Subscriptions to the full
text are offered at a fee and are carried by some libraries.