Research Based Herbal Facts Praised, Caution Urged

Herbal Remedy and Supplements

Organic may be great for salads and dairy products, but just because an herbal remedy or supplement is "natural" doesn't mean it is any safer or better than a conventional medication.

Recent reports about the popular supplements kava, St. John's wort and Echinacea highlight cases of liver damage, failure of birth control pills and aggravated symptoms of asthma and allergies. The Food and Drug Administration has just begun an investigation into herbal supplements tainted with the prescription drugs warfarin (trade name Coumadin) and alprazolam (trade name Xanax). Examples like these further underscore the need for research-based information on supplements, credible sources of information and better education of physicians and consumers, according to a Duke University Medical Center researcher.

"Just because something is natural doesn't mean it can't be harmful," says David Kroll, Ph.D., a pharmacologist and consultant to the Duke Center for Integrative Medicine (DCIM). "Many people get caught up in the desire for alternatives to prescription medication because on the surface they appear to be safer than prescription drugs."

However, herbal supplements are not federally regulated like prescription and over-the-counter medications. Because of that, consumers cannot be certain of what they are getting in those bottles of pills, Kroll said.

Kroll is expected to present the latest research-based information on commonly used herbal supplements and their interactions with medications today (Monday) at the 9th annual Duke Palm Beach Forum being held at the Ritz Carlton hotel in Palm Beach. Kroll joins other Duke researchers and clinicians who are addressing topics pertaining to the field of integrative medicine.

A recent report in the Journal of the American Medical Association states that in any given week, most American adults take at least one medication. Of the 2,590 participants in the reported study, 81 percent used at least one prescription drug and 7 percent used five or more medications. Of those taking prescription medication, 16 percent reported taking an herbal supplement at the same time.

"There are dangers in mixing prescription drugs and herbal supplements," says Kroll. "People need to be aware of potential side-effects - especially anyone who is being treated for a chronic medical condition."

Mixing supplements with prescription medication can inhibit the effectiveness of the prescription drugs, lead to toxic effects on the body and cause organ damage or other serious health problems. These possible adverse side effects are why it is so important for patients to share information on supplement use with their doctors, Kroll said.

Any treatment - be it a prescription drug, an over-the-counter drug or even an herbal supplement - that is effective and safely tolerated at a specific dose will be toxic at some greater level of that drug, according to Kroll.

"Many people believe herbal supplements are better because they work synergistically -- meaning that their compounds work together better to effectively treat a specific condition or disease state," he said. "But any of our prescription medications and standard medical treatments -- especially those used in chemotherapy or to control high blood pressure -- work the same way."

Consumers have greater access than ever before to information about medical conditions and treatment options, thanks to resources such as the Internet. However, people are at a disadvantage when they rely solely on supplement labeling and manufacturer promotional materials.

"The single greatest resource for people who want credible herbal information is a health care practitioner who is uniquely trained in both conventional and alternative medicine," says Kroll. "Those people are rare, but the DCIM has been established to train physicians accordingly and to offer a place for patients to turn today for this type of information and medical care."

Kroll is an adjunct associate professor of medicine at Duke University Medical Center and a consultant to the DCIM. He maintains his laboratory at the Research Triangle Institute in Research Triangle Park, N.C. RTI is an independent, non-profit research organization established by Duke University, the University of North Carolina at Chapel Hill and North Carolina State University in 1958.

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PALM BEACH, Fla. - DukeMed News