Are herbs safe to use? – The ephedra story
Health and Human Services Secretary Tommy Thompson announced recently that the FDA will be banning the sale of the herb ephedra. This notorious herb has been in the headlines for several years now. Stories of death caused by the use and abuse of diet and energy enhancement products using ephedra show up quite frequently. I’m sure we all read about Minnesota Viking player Corey Stringer dying after a difficult workout and that his death was associated with the use of an ephedra containing weight control product. Several states and some other countries have already banned the sale of ephedra. So it seems that it was a good time for the FDA to get on the bandwagon. Certainly it is politically expedient to be involved in this movement. After all, the Bush administration wants to be sure they are in the forefront of any effort to protect the health of all those voters.
First of all, I think a great misconception should be cleared up. The real problem with the soon to be banned diet and energy products is not ephedra. Ephedra sinica, the scientific, Latinized name for the herb ephedra, is an herb that contains small quantities of the drug ephedrine. It also contains small quantities of the drug pseudoephedrine, better known by its brand name Sudafed. I’m sure many of you have taken pseudoephedrine products for cold and flu symptoms. All of the offending diet or energy products contain “ephedra extract” or “ma huang extract” (the Chinese name for ephedra. This extract is essentially purified ephedrine, which is a strong stimulant that can increase heart rate, blood pressure, anxiety and sleeplessness. These effects are usually considered to be a potential problem, if not downright dangerous, in certain susceptible individuals, such as people with heart conditions, high blood pressure, glaucoma and, ironically, those whom are overweight. The great misconception is that people are really not taking an herb, but a drug that is extracted from an herb. The herb ephedra contains hundreds of other chemicals besides ephedrine and pseudoephedrine. One of these chemicals is known to slow down the absorption of ephedrine so that an individual will not get the high blood levels of the drug that can cause these ill effects.
Many other drugs that we use every day are extracted from herbs but are not called by their herbal name. Digoxin is one of the top ten most prescribed drugs, used for heart ailments, but it is not called purple foxglove, which is the herb it comes from. Codeine and morphine are not called poppy or poppy extract. The drug tamoxifen, used to treat breast cancer, is not called American yew because it is only one chemical that occurs in this common tree. Many people use Ben Gay or Icy Hot or one of many topical pain relief products that contain the drug methyl salicylate, but they don’t know that this drug is extracted from the herb wintergreen.
The reason I make this point is because the whole ephedra issue puts the use of herbs in a bad light. It gives fuel to individuals and groups who decry the use of herbs as dangerous. What better example is there but that of the dangerous herb ephedra! Let’s call a drug a drug and an herb an herb. This confusion is most definitely the fault of the companies that are selling these admittedly dangerous products to a public that believes because it is herbal it must be safe. In fact true herbal products are very safe.
According to the information gathered by acclaimed researcher and scientist James Duke, PhD, the statistics on deaths caused by herbs compared with other causes are quite revealing:
- Herbs: 1 in 1 million
- Supplements: 1 in 1 million
- Non-steroidal anti-inflammatories (such as ibuprofen, acetaminophen, Aleve, etc.): 1 in 10,000
- Hospital surgery: 1 in 10,000
- Improper use of drugs: 1 in 2,000
- Angiogram: 1 in 1,000
- Alcohol: 1 in 500
- Cigarettes: 1 in 500
- Hospital caused infections: 1 in 80
- Bypass surgery: 1 in 20
As can be seen from the above comparisons, the use of herbs in general is very safe, but certainly not without need for caution when deciding to use herbs while taking prescription or non-prescription drugs. I was taught in pharmacy school that one must always weigh the risks against the benefit of drug therapies. Checking the chart it's easy to see that there is much more risk in taking drugs than there is in taking herbs.