Let’s start with a story from Dr. Kevin Pho, an internal medicine physician:
I once diagnosed a patient with high cholesterol, and prescribed him a medicine commonly known as a Statin. When I saw him months later for follow-up, he admitted that he didn’t fill the prescription. “I took red yeast rice capsules instead,” he said. When I asked him why, he told me that he was wary of Statins’ long list of side effects and felt taking a “natural,” over-the-counter cholesterol-fighting supplement was safer.
The moral of the story
Herbal drugs constitute a major share of all the officially recognised systems of health in India viz. Ayurveda, Yoga, Unani, Siddha, Homeopathy and Naturopathy, except Allopathy. More than 70% of India’s 1.2 billion population still use these non-allopathic systems of medicine.
It’s a fact that certain herbs have real medicinal value. After all, many commonly used prescription drugs have their origins in naturally occurring substances. Therefore, the question to ask is “why is the medical profession not embracing the use of herbal supplements?” The answer is based upon various issues that immediately surface such as efficacy, side effects, potency and quality assurance.
When it comes to herbal supplements, doctors generally inform patients that most have little evidence to suggest that they actually work, but leave the ultimate decision of whether to take them to patients. But given the results of recent studies, many doctors are beginning to wonder if patients are better off avoiding these supplements altogether.
While smaller studies have previously suggested that herbal supplements are often not what they seem, an October 2013 study from BMC Medicine used DNA analysis to provide the most definitive evidence to date. Researchers looked at 44 randomly selected supplements, and found that one-third had no trace of the plant advertised on the label. The problems are widespread and quality control for many companies, whether through ignorance, incompetence or dishonesty, is unacceptable.
But this goes beyond false advertising. Herbal supplements can cause real health damage. Some pills use fillers that are made up of rice, or worse, black walnut, which can severely affect those with nut allergies, while others contain unlabeled toxic ingredients. Many also interact with prescription drugs, like garlic which can increase the effect of blood thinners and cause life-threatening bleeding.
Despite the data, many patients feel that supplements are safe, sometimes even preferring them to prescription drugs. This reflects the mindset of the majority of people who falsely believe that herbal pills have to be approved by their country’s central medical authority before being sold. Patients also may not be aware that up to 70% of herbal drug producers violated manufacturing guidelines designed to prevent adulteration of their pills. Of course, prescription medications have the potential of uncommon, and in rare cases, serious, side effects, but these drugs are regulated so at least we know what’s inside them, and if what’s inside them works. That’s certainly far more than we can say about the vast majority of herbal supplements patients take today.