Clinical Implications of Herbal Supplements in Conventional Medical Practice: A US Perspective

Abstract

Herbal supplements are common complementary and alternative medicine (CAM) approaches with an everincreasing use trend in the last two decades among the US population. Self-medication with herbal supplements which are promoted for general well-being, weight loss, immunity, and memory boost, and mental and physical health claims are very prevalent. There is a misperception that herbal supplements are harmless as they are prepared from natural sources. Unlike conventional drugs, the US Food and Drug Administration (FDA) does not regulate herbal supplements for premarketing purity and potency. Hence, there is a growing concern for health risks due to misbranded toxic ingredients, contaminants, adulterants, and herb-drug interactions (HDI) with co-administered drugs. The spectrum of pharmacological and toxicological effects of herbal supplements includes deranged lab results, allergic reactions, genotoxicity, carcinogenicity, teratogenicity, organ damage, and even fatality contributing to sizable emergency visits and hospitalizations in the US. The use of herbal supplements should be carefully monitored in high-risk groups such as pediatric and geriatric populations, pregnant women, breastfeeding mothers, immunocompromised patients, and surgical candidates. The deleterious health effects of herbal supplements are loosely addressed in conventional medical practice in part due to the limited knowledge of practitioners. This comprehensive narrative review aims to explore the clinical implications of herbal supplements in order to fill the knowledge gaps by summarizing scientific publications. It also highlights the pivotal roles physicians can play in minimizing the health risks of herbal supplements by encouraging patients to disclose usage through a non-judgmental approach, employing HDI screening tools, and reporting adverse reactions to FDA. Formal training of physicians, a standardized pharmacovigilance system, stricter regulation of the herbal industry, and more scientific studies are keys to establishing herbal safety and efficacy in clinical practice.

The Threat of Weight-Loss Over the Counter Supplements: A Case of Camellia Sinensis Autoimmune Hepatitis

“…HDS is considered the most widely used complementary and alternative medicine, with an increasing trend over the last two decades [ 16 ]. Their use around the world is partially related to their perception of them as a safety measure to treat and prevent various diseases [ 17 ]. Its regulation is not dependent on the Food and Drug Administration (FDA); in fact, it does not require pre-marketing approval like conventional medications [ 18 ].…”

“…The diagnosis of HDS-induced liver injury is challenging because there are no specific markers, and most of them are not FDA-approved, so their side effects are underreported [ 17 ]. Therefore, high suspicion is needed since the presentation can vary from transient elevation of liver function tests to fulminant hepatic failure resulting in death or liver transplantation [ 21 ].…”

Green Alternatives as Antimicrobial Agents in Mitigating Periodontal Diseases: A Narrative Review

“…Natural medicine is used widely, irrespective of geographical and demographic differences. However, the encouraging outcomes of most herbal supplements in contemporary treatment are few, conflicting, or inconsistent [ 577 ]. Instead, there is more evidence that herbal supplements may have potentially harmful effects, leading to public health concerns [ 578 ].…”

“…Herbal products could also be unsafely promoted due to inadequate quality controls, labeling, and patient education. A regulatory flaw exists regarding herbal products, as premarketing approval is not required by the Food and Drug Administration [ 326 ], unlike the situation for conventional pharmaceuticals such as prescription and OTC treatments [ 577 ]. Regulatory authorities must establish appropriate measures to protect public health, as safety remains a significant concern with traditional remedies.…”

Cannabidiol Attenuates Doxorubicin-Related Cardiac Disorders Using Modulation of IL6R Signifying Trail in Adult Male Sprague Dawley Rats

“…The use of herbal supplements for selfmedication with promises of general health, weight loss, immunity, memory improvement, and other bene ts is fairly common. There is a misconception that because herbal supplements are made from natural sources, they are safe (Hassen et al 2022).…”