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What About Herbal And Nutritional Supplements?

A Word of Caution

By David A. Peters, MFT


You have seen them on television, and in all the news magazines.  Advertisements are everywhere for herbal supplements to give you energy, boost your sex drive, lift your spirits, and improve your concentration.  Periodically in my practice a client will express an interest in using an herbal supplement in place of a more traditional prescription psychotropic medication.  Many assume that because it's "natural" that is safe to use.  They may have heard claims from advertisements or friends that the supplement is a miracle cure.   But do they work?  And are they safe?  How can you be sure?  Here are some facts you should know before you take an herbal supplement.

As of this writing, there is no governmental agency that oversees the manufacture or ensures the safety of herbal supplements.  The result is, no one is making sure that each pill has what it claims to have in it, and nothing more.  Thank your representative in the US Congress for this!   Independent research has found that up to one third of herbal supplements sold don't have the claimed amounts of the active agent in them.  For all you know they are just corn starch!  Recent investigations revealed that in some brands, arsenic and other toxins have been found - particularly in some imported from China.  The brand name you choose does make a difference. Some nutrition stores have specialists on staff who know which brands are more trustworthy.  Your doctor may also know.  In my experience, and in consultation with psychiatrists, I have come to trust Nature's Way, Enzymatic Therapy, and Centrum brands.  But there is no guarantee until the government sets standards for manufacture.  

Keep in mind that any chemical agent that is potent enough to have a benefit is also potent enough to have a side effect.  Don't assume that because it is "natural" that it is safe.  Some of the herbals do have side effects, and they are difficult to predict with so little research available.  Below are just a few examples of complications with herbs.  You can do your own research on most any herbal product at Consumer Lab, and at the WebMD.

St. John's Wort (commonly used for depression) - The herb could be deadly if taken in combination with an "MAO inhibitor" such as Nardil or Parnate.  For those taking medications for HIV, the herb has been shown to interfere with medications such as Crixivan.  For organ transplant patients, the herb could inhibit the action of Neoral, a drug used to keep transplant patients from rejecting new organs.  St. John's Wort may also reduce the effectiveness of some contraceptives for women. 

Kava Kava (commonly used for anxiety) - High doses of the herb have been associated with hepatitis.  As a relaxing agent, it may increase the effects of alcohol or barbiturates.  If over-used along with a medication such as Xanax, it could result in a coma.  As it can intoxicate at higher doses, caution should be used while driving.

Ginkgo Biloba (commonly used to increase concentration) - When used in combination with blood thinners or aspirin, the herb could increase the risk of intracranial bleeding.  

Golden Seal (commonly used to cleans the blood stream) - In extended use the herb may cause nervous excitement, hallucinations, or delirium. 

Always inform your primary care physician about any herbal supplements you are using, especially before surgery.  If you are in therapy, always inform your therapist of any use of herbal supplements.  Never give an herbal supplement to a child without a pediatrician's approval.  And keep in mind, your therapist can take no responsibility or assume liability for adverse reactions to herbals you use. 

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