Are Herbal Supplements Safe? -- Arthur Presser, PharmD, DHPH
WebMD Live Events TranscriptEvent Date: Wednesday, June 2, 2004
Millions of people take herbal supplements because they want to ingest
something safe and healthy. But just because something is natural, is it safer
than a synthetic drug? And exactly who is looking over the manufacturers'
shoulders on your behalf? Supplement expert Arthur Presser, PharmD, DHPh,
joined us on June 2, 2004, with some answers.
If you have questions about your health, you should consult your
personal physician. This event is meant for informational purposes
Welcome to WebMD Live, Dr. Presser. How are herbal supplements regulated in the
U.S.? Are they given the same level of scrutiny as prescription drugs?
No, of course not. Prescription drugs have the highest level of scrutiny
because they're literally chemical poisons that we're using for their positive
benefits against their negative benefits. They're used to treat diseases and
conditions that must be diagnosed and monitored by physicians. The next level
down would be over-the-counter drugs that are on the market for conditions that
are self-diagnosable and self-limiting.
Herbs are considered dietary supplements, and basically part of the food
chain. Prescription drugs, to come to market, must undergo hundreds of millions
of dollars of clinical testing to prove their efficacy and measure their
toxicity. Herbs are nature's medicines that have sometimes 5,000 years of
historical use for many conditions. Only in recent times have universities and
private industry taken these traditional uses and run clinical studies to
determine how they might be working or have worked in the past and predict what
they might be useful for in the future. However, they are still dietary
supplements, and really are subject to claims that are just associated with
structure and function of the human body.
You have to understand that there is a very strong political aspect to
herbal medicine. Between 25% and 50% of pharmaceutical drugs on the market
today are derived directly from, or from a model of, a plant chemical. This
plant chemical cannot be used directly as it comes from nature because it
cannot be patented and protected financially, so the chemical must be altered
into a new entity, an analog, and then tested for efficacy and toxicity. If
this new chemical works and isn't too poisonous, it is entered into the
hundreds of millions of dollars of testing to bring a new drug to market.
The herbs in themselves, as whole herbs, are generally much milder,
generally not toxic, take longer to work, and are much more complicated than
pharmaceutical drugs. Pharmaceuticals are monostructures; that is they contain
one single chemical. Herbs can contain hundreds and hundreds of chemicals, each
doing something different in the bodies, oftentimes offsetting toxicities; that
is if there is a chemical that might raise blood pressure there may be a
secondary chemical that offsets chemical A's ability to act in this manner.