Dirty Dozen: twelve supplements to avoid

OB/GYN News, May 15, 2004

Dirty Dozen: Twelve Supplements to Avoid

Name(s)                    Dangers                    Regulatory Actions

DEFINITELY HAZARDOUS: Documented organ failure or known carcinogenic
properties
Aristolochic acid          Potent human carcinogen;   FDA warning to
(Aristolochia, birthwort,  kidney failure, sometimes  consumers and
Snakeroot, snakeweed,      requiring transplant;      industry and
sangree root, sangrel,     deaths reported.           import alert in
serpentary, serpentaria,                              April 2001. Banned
asarum canadense, wild                                in seven European
ginger)                                               countries and
                                                      Egypt, Japan, and
                                                      Venezuela.
VERY LIKELY HAZARDOUS: Banned in other countries, FDA warning, or
adverse effects in studies
Comfrey (Symphytum         Abnormal liver function    FDA advised
officinale, ass ear,       or damage, often           industry to remove
black root, blackwort,     irreversible; deaths       from market in
bruisewort, consolidae     reported.                  July 2001.
radix, consound, gum
plant, healing herb,
knitback, knitbone,
salsify, slippery root,
symphytum radix,
wallwort)
Androstenedione            Increased cancer risk,     FDA warned 23
(4-androstene-3,           decrease in HDL            companies to stop
17-dione, andro,           cholesterol.               manufacturing,
androstene)                                           marketing, and
                                                      distributing in
                                                      March 2004. Banned
                                                      by athletic
                                                      associations.
Chaparral (Larrea          Abnormal liver function    FDA warning to
divaricata, creosote       or damage, often           consumers in
bush, greasewood,          irreversible; deaths       December 1992.
hediondilla, jarilla,      reported.
larreastat)
Germander (Teucrium        Abnormal liver function    Banned in France
chamaedrys, wall           or damage, often           and Germany.
germander, wild            irreversible; deaths
germander)                 reported.
Kava (Piper methysticum,   Abnormal liver function    FDA warning to
ava, awa, gea, gi,         or damage, occasionally    consumers in March
intoxicating pepper, kao,  irreversible; deaths       2002. Banned in
kavain, kawa-pfeffer,      reported.                  Canada, Germany,
kew, long pepper, malohu,                             Singapore, South
maluk, meruk, milik,                                  Africa, and
rauschpfeffer, sakau,                                 Switzerland.
tonga, wurzelstock,
yagona, yangona)
LIKELY HAZARDOUS: Adverse event reports or theoretical risks
Bitter Orange (Citrus      High blood pressure;       None
aurantium, green orange,   increased risk of heart
kijitsu, neroli oil,       arrythmias, heart attack,
Seville orange, shangzhou  stroke.
zhiqiao, sour orange, zhi
oiao, zhi xhi)
Organ/giandular extracts   Theoretical risk of mad    FDA banned high-
(brain/adrenal/pituitary/  cow disease, particularly  risk bovine
placenta/other gland       from brain extracts.       materials from
"substance" or                                        older cows in
"concentrate")                                        foods and
                                                      supplements in
                                                      January 2004.
                                                      (High-risk parts
                                                      from cows under 30
                                                      months still
                                                      permitted.) Banned
                                                      in France and
                                                      Switzerland.
Lobelia (Lobelia inflata,  Breathing difficulty,      Banned in
asthma weed, bladderpod,   rapid heartbeat, low       Bangladesh and
emetic herb, gagroot,      blood pressure, diarrhea,  Italy.
lobelie, indian tobacco,   dizziness, tremors;
pukeweed, vomit wort,      possible deaths reported.
wild tobacco)
Pennyroyal oil (Hedeoma    Liver and kidney failure,  None
pulegioides, lurk-in-the-  nerve damage,
ditch, mosquito plant,     convulsions, abdominal
piliolerial, pudding       tenderness, burning of
grass, pulegium, run-by-   the throat; deaths
the-ground, squaw balm,    reported.
squawmint, stinking balm,
tickweed)
Scullcap (Scutellaria      Abnormal liver function    None
lateriflora, blue          or damage,
pimpernel, helmet flower,
hoodwort, mad weed, mad-
dog herb, mad-dog weed,
quaker bonnet,
scutelluria, skullcap)
Yohimbe (Pausinystalia     Change in blood pressure,  None
yohimbe, johimbi,          heart arrythmias,
yohimbehe, yohimbine)      respiratory depression,
                           heart attack; deaths
                           reported.

Note: Based on data from Natural Medicines Comprehensive Database 2004
and Consumers Union's medical and research consultants.
Source: Consumer Reports, May 2004