Ask About Herbal Remedies

OB/GYN News, Dec 15, 1999 by Mike Bykowski

Before you prescribe any new drug, ask patients what herbal therapies they use.

"We've been operating on a 'don't ask, don't tell' policy," Dr. Rossanne Philen said at a workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Md. "We have to get out of that mind-set" to reduce the incidence of adverse drug reactions, she said.

Alone and in combination with prescribed drugs, a wide variety of dietary supplements--including azarcon, greta, pay-loo-ah, chaparral, jin bu huan, ephedrine, and many others--have been linked to severe illness, exacerbation of disease, liver damage, and even death, said Dr. Philen of the Centers for Disease Control and Prevention.

"We're seeing extraordinary interactions between traditional medical herbs and pharmacy drugs," concurred Andrew L. Rubman, N.D., of the University of Bridgeport in Southbury, Conn.

The first presentation of side effects from dietary supplement use tends to be nonspecific--a variety of constitutional effects, fever, nausea. By the time jaundice and other more specific symptoms develop, it's often too late and the patient will require a liver transplant, he warned.

Cases of suspected toxicity due to dietary supplements can be reported to the Food and Drug Administration's Medwatch program at 800-FDA-1088 or to the Centers for Disease Control and Prevention at 770-488-7350.