Aplastic Anemia: A Possible Toxic Effect of an Herbal “Colon Cleansing” Preparation

Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages*

“…In one patient, a third rechallenge with cow’s milk did not cause recurrent thrombocytopenia even though thrombocytopenia had apparently recurred with two previous exposures to cow’s milk (39). In the other seven patients, platelet count recovery was incomplete or follow‐up platelet counts were not reported (28, 38, 40–42).…”

“…Six articles described eight patients for whom the reported data suggested that a causal association of five substances with thrombocytopenia was unlikely (Table 6) (28,(38)(39)(40)(41)(42). In one patient, a third rechallenge with cow's milk did not cause recurrent thrombocytopenia even though thrombocytopenia had apparently recurred with two previous exposures to cow's milk (39).…”

“…The challenges with milk appeared to fulfill criterion 4 but the diagnosis was uncertain because of the mother's ITP and the unspecified nature of the milk products Niacin (nicotinic acid, vitamin B3) (41) 51 M (Case 2) developed thrombocytopenia (92 · 10 3 ⁄ lL) and leukopenia (2.1 · 10 3 ⁄ lL) while taking 2.5 g ⁄ d nicotinic acid for about 3 yr. Platelet counts increased after stopping nicotinic acid, but remained low (118 · 10 3 ⁄ lL) 2 months later. Criterion 1 not met Herbal 'Ultimate Colon Cleanse ProgramÔ' (42) 51 F developed thrombocytopenia (24 · 10 3 ⁄ lL), neutropenia (24 · 10 3 ⁄ lL), and anemia (8.5 g ⁄ l) following 30 d of this product which contained 39 different herbal ingredients. Marrow aspirate demonstrated aplasia (<5% cellularity).…”

The physiology of colonic hydrotherapy

“…These are borne out by the complications of hydrotherapy seen in our clinics and practices. Some of the recent complications reported included rectal perforation, aplastic anaemia and disseminated abscesses [9–11].…”