I don’t suppose that many readers of this blog believe all things natural to be entirely safe, but the general public seems to be hard-wired victims of this myth: Mother Nature is benign, and herbal remedies must be harmless!
There are, of course, several reasons why supposedly “natural” herbal treatments can be unsafe. Plants extracts can be toxic, they might interact with prescribed drugs or they can be contaminated or adulterated.
The latter two terms describe similar but not identical phenomena: contamination means the accidental addition of substances which should not be present in an herbal remedy; and adulteration signifies the deliberate addition of ingredients. If the substances in question are not pharmacologically inert, their presence in herbal remedies can cause adverse effects.
Both contamination and adulteration break laws and regulations; both are therefore illegal. Sadly, this does not mean that such things do not happen.
We have recently published an overview of the existing knowledge in this area. For this purpose, we summarised the evidence from 26 previously published reviews. Our findings were interesting but far from reassuring: the most commonly found contaminants were dust, pollen, insects, rodents, parasites, microbes, fungi, mould, pesticides, and heavy metals. The adulterants invariably were prescription drugs such as steroids, anti-diabetic medications etc.
These substances were implicated in a wide range of serious adverse effects in the unfortunate patients who took the remedies in question: agranulocytosis, meningitis, multi-organ failure, stroke, arsenic poisoning, mercury poisoning, lead poisoning, caner, encephalopathy, hepato-renal syndrome, kidney damage, rhabdomyolosis, metabolic acidosis, renal failure, liver failure, cerebral oedema, coma, and intra-cerebral bleeding. Several patients did not survive.
To avoid such disasters, consumers need to know which types of herbal remedies are most frequently implicated; our review showed that these were foremost Chinese and Indian remedies. While herbal medicines from the US or Europe ought to comply with certain rules and regulations regarding their quality and safety, Chinese and Indian herbal mixtures frequently enter our countries illegally or are bought from dubious sources, for instance, over the Internet. It is this type of herbal remedy that we should be concerned about.
We have to ask whether the risks outweigh the proven benefits of Chinese or Indian herbal mixtures. The short answer to this question is NO. There is very little compelling evidence to suggest that these treatments are efficacious. In the absence of proven benefit, even small or rare risks weigh heavily.
If the risk-benefit profile for any medical intervention fails to be positive, there can only be one reasonable conclusion regarding the use of this therapy – and that is: DON’T DO IT!
14 Responses to Contamination and adulteration of herbal remedies
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Dr. Ernst, I believe if you reconsider the question you posed in the next to the last paragraph you will want to rephrase it or answer it with yes.
Thank you for all your work
Walter Turner
Contamination can have multiple cause but adulteration? I don’t believe that adulteration of herbal products with prescription medicines can be anything other than a deliberate criminal act by manufacturers. The MHRA, FDA and other regulatory body websites do contain large numbers of warnings about “herbal viagra” products that are adulterated with prescription medicines intended for the treatment of impotence. Yet a cursory search of the internet reveals that many of the products are still for sale on the internet from UK vendors. Arguably, “safety warnings” without enforcement merely draws the attention of a certain type of consumer to the products rather than warning them off.
It is understandable that the likes of the MHRA simply do not have the resources to police this sort of thing.
Cosyns JP and others published in the 1990 that chinese herbal teas used by woman for slimming was contaminated with aritolochia acid a strong carcinogen of the kidney. Many woman were nephrectomiced and were then on dialysis.
This incident is now known as Belgian nephropaty.
But still now TCM preparations may contain aristolochia acid. AND TCM practitioners in the EU claim that they have no problem with a carcinogen such as aristolochia acid- they can handle the risk? How? Prophylactic nephrectomy?
Better not to use any of such preparations.
And what about powdered human flesh (http://www.dailymail.co.uk/news/article-2140702/South-Korea-customs-officials-thousands-pills-filled-powdered-human-baby-flesh.html) in alternative Chinese remedies?
And what about tiger bones and other protected animals in alternative Chinese remedies?
In Sacramento, an acupuncturist was sold the wrong Chinese herb for a tea meant to help her arthritis. She wound up in a coma and, when she woke up, her hands and legs were partially paralyzed.
Sometimes herbal remedies may do because problem but they have also a positive side also. Contamination and adulteration this can be happen because of malfunction of herbs and this is what happens in some unknowing peoples…
not sure what you mean.
more evidence here: http://www.abc.net.au/news/2015-12-10/traditional-chinese-medicines-dangerous-chemical-contaminants/7015534
Yes i agree with you. But in this modern world with full involvement of latest technologies ,i think it is not possible.