Irresponsible Herb Information
Answered by: Conrad Richter
Question from: Judith Forst
Posted on: August 21, 1998

I recently purchased an herbal formula for various women’s hormonal symptoms that contains the following: black cohosh, baybery, cats claw, wood betony, capsicium, uva ursi, parsley, and raspberry. I looked up the various herbs in one of my books, and learned that uva ursi should not be taken for more than 7 - 10 days. I wrote the manufacturer and they said that it was up to me to check with my health care professional. I think this is an irresponsible answer, given that there seem to be potential problems that a consumer should know about. Also I learned from my research that several of the ingredients, bayberry, uva ursi, raspberry, and black cohosh, should not be taken during pregnancy. There was no warning about this on the supplement. I want to take this product for hot flashes. Do you think it is safe to take it for this condition, and for how long? Thank you for your input.

This gets at one of the thorniest issues in the herb industry. Without defending or castigating the manufacturer in this case, I will comment on what I think is the problem.

It is true that herbs have potent effects. There are serious issues concerning side effects, contraindications, interactions, and dosages with many herbs and herbal products. The problem is that the manufacturer and the retailer are severely limited in what they can say about their products by the laws that govern the sale of medicines. This is especially true in Canada where we are located, and it is true in other countries too.

In Canada, for instance, manufacturers have complained for years that they cannot, under current law, say *anything* about contraindications beyond a few limited statements sanctioned under the DIN (Drug Identification Number) program administered by Health Canada’s Health Protection Branch. And for the many herbs and herbal remedies that cannot be sold as "drugs", and which must be sold as "foods", absolutely nothing can be said about side effects, contraindications, etc.

In the United States, the situation is a little better under the rules of the 1994 Dietary Supplement and Health Education Act, but there are still severe legal implications if a manufacturer or retailer goes too far with such information. In no way do manufacturers have the same leeway that drug companies have to provide such essential information about their products.

The unfortunate squeeze on the herb industry comes from the emerging litigation climate surrounding herbs, where manufacturers and retailers are being sued for failing to provide adequate warnings on their products. But as much as they want to provide such information, they cannot; or that there are no clear ground rules for doing so.

There is no question that the industry has had to take a careful stance on this issue. By necessity, herbs are sold under a "buyer beware" philosophy, and where possible, consumers are directed to consult their health care provider for advice. The rules imposed by government, for the most part, do not apply to the doctor-patient relationship and doctors and other health care providers can more freely provide such information to their patients. But even here there are indications that health practitioners are at risk of civil litigation if things go wrong, as a recent case in the United States illustrates (see Richters HerbLetter, July 1998).

The question is further complicated by the fact that herbs often have very complicated effects on the body, and the body has a very complex range of responses to herbs. One of the strengths of herbs is that they rarely act like the "silver bullets" of the drug materia medica. It is often an advantage that herbs can have moderating effects -- lowering when too high and raising when too low -- or other equally complex effects, but it is also difficult to unilaterally say that a herb has a certain effect in every situation. It can be very confusing when herbs such as black cohosh can have a sedative effect on the nervous system while stimulating the cardiac system and moderating the hormonal balance in women, and if taken in large doses cause poisoning.

What is the answer? The laws need to be changed to allow manufacturers and retailers more leeway to explain the correct use of their products and to provide adequate warnings. Until, then consumers have to rely on their own research, as you have done, and on the advice of their health care practitioner.

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