Adverse effects of plant food supplements and botanical preparations: a systematic review with critical evaluation of causality

Abstract

AIMSThe objective of this review was to collect available data on the following: (i) adverse effects observed in humans from the intake of plant food supplements or botanical preparations; (ii) the misidentification of poisonous plants; and (iii) interactions between plant food supplements/botanicals and conventional drugs or nutrients. METHODSPubMed/MEDLINE and Embase were searched from database inception to June 2014, using the terms 'adverse effect/s', 'poisoning/s', 'plant food supplement/s', 'misidentification/s' and 'interaction/s' in combination with the relevant plant name. All papers were critically evaluated according to the World Health Organization Guidelines for causality assessment. RESULTSData were obtained for 66 plants that are common ingredients of plant food supplements; of the 492 papers selected, 402 (81.7%) dealt with adverse effects directly associated with the botanical and 89 (18.1%) concerned interactions with conventional drugs. Only one case was associated with misidentification. Adverse effects were reported for 39 of the 66 botanical substances searched. Of the total references, 86.6% were associated with 14 plants, including Glycine max/soybean (19.3%), Glycyrrhiza glabra/liquorice (12.2%), Camellia sinensis/green tea ( 8.7%) and Ginkgo biloba/gingko (8.5%). CONCLUSIONSConsidering the length of time examined and the number of plants included in the review, it is remarkable that: (i) the adverse effects due to botanical ingredients were relatively infrequent, if assessed for causality; and (ii) the number of severe clinical reactions was very limited, but some fatal cases have been described. Data presented in this review were assessed for quality in order to make the results maximally useful for clinicians in identifying or excluding deleterious effects of botanicals.

Knowledge, Attitudes, and Practices Towards Herbs and Herbal Products Among Health Sciences Students of a University in Uae

“…They are also able to potentially interact with other medications and decrease their efficacy, like St. John's wort speeding the breakdown of drugs like antidepressants and birth control pills 17 . Side effects of herbal preparations can also vary from hypersensitivity, as seen sometimes with soybeans, to hypertension and hypokalemia, as seen with liquorice 18 .…”

Watch it grow: Esophageal impaction with chia seeds

“…[7,8,[13][14][15][16] Up until now, there have been no studies or analyses documenting adverse harms from chia seeds, specifically with obstruction as described above. [17][18][19] When added to liquid at room temperature (see Figure 3), dry chia seeds immediately begin to form a hydrogel gum capsule absorbing up to 27 times their weight in water, [6] which exhibits a non-Newtonian fluid behavior. [11] The seed has two fundamental characteristics which increase its ability to hold onto water.…”

Complementary and alternative medicine therapies for the anesthesiologist and pain practitioner: a narrative review

“…The induction of hepatic enzymes is involved in some of the most serious adverse events related to nutraceuticals. 44,45 Patients' use of herbal medications can have twofold significance during the perioperative period. First, these supplements are most often used to treat an underlying condition or as prevention.…”