A Brief Overview of Liver Toxic Herbs —Alan Franciscus, Editor-in-Chief

Originally Published July 1, 2015

A recent article appeared in Gastroenterology that provided an overview of herbal products. This review will focus on the important issues regarding the lack of standardization, possible contamination, some deceptive claims and a list of the herbs that have the most potential to harm the liver.

In the February 2015 edition of the HCV Advocate Mid-Month Newsletter, I wrote “Herbal Supplement Crackdown.”  The article was about four major chains selling herbal supplements in New York State that contained substances not listed on the package label.  Even more disconcerting was that many of the listed herbs when tested, could not be verified as being the actual labeled herbs. 

Some of the important issues raised in the current study included:

 

Standardization:
There are many factors that affect the potency of herbs such as what season grown, location planted and how much sun the herbs receive, fertilizer (and how much) used and many additional factors. 

For instance, a list of 25 commercial ginseng products from a local health food store was analyzed for ingredients—the ginseng concentrations were different than listed on the label. The difference in the concentrations could be correlated to the standardizations issues listed above.

Contamination and Adulteration:
Herbal products were tested and found to have pesticides and toxins as well as unlabeled drugs in the herbal products.  These types of issues were also found in the herbs analyzed in the New York herbal crackdown. 

Deceptive Marketing:
There have been advertisements that promote the use of herbs stating that some herbal products can help to treat certain conditions and even cure viral infections.  Herbs may provide some relief from particular illnesses and provide supportive care.  However, there never has been a study that has shown that an herb can cure a viral disease such as hepatitis C.  Be careful about these types of claims.

Most Common Liver Toxic Herbs:
The herbs listed below are the most common herbs that have been found to cause liver toxicity, liver injury, possible liver failure and death.  I have listed the common name (bolded), scientific name and the most common ailments the herb is used to treat:

• Black cohosh (Cimicifuga racemose):  menopausal symptoms
• Chaparral (Larrea tridentate): weight loss, rheumatic pain, antibiotic
• Comfrey (Symphyturn officinale): Wound healing
• Germander (Teucrium chamaedrys):  Weight loss
• Greater celandine (Chelidonium majus):  Liver and biliary tract disease
• Green tea extract (Camellia sinensis): General health, weight loss
• Herbalife product line (Multi-ingredient): Mental health and weight loss
• Kava kava (Piper methysticum):  mental health and well-being
• Hydroxycut (multi-ingredient):  Weight loss
• Oxy-Elite Pro (multi-ingredient):  Performance-enhancement,  weight loss
• Saw palmetto (Serenoa repens):  Prostate disease

The good news about herbs is that the New York attorney general and 13 other states are petitioning Congress to investigate the herbal supplement industry.  Additionally, the states are requesting the Food and Drug Administration to provide more oversight to the herbal supplements industry.  Until that time, it is up to the consumer to advocate for themselves, dig deep and to stick to the old warning to consumers—buyer beware.

Resources:

• HCV Advocate Herbal Glossary
• National Center for Complementary and Alternative Medicine
  https://nccih.nih.gov/
• Consumer Labs
  https://www.consumerlab.com/

http://hcvadvocate.org/news/newsLetter/2015/advocate0715.html#1

Updates: Herbal Supplement Crackdown—GNC Reforms, by Alan Franciscus, Editor-in-Chief

In the February 2015 Mid-Monthly Advocate issue, I wrote about the New York State Attorney General’s Office crackdown on four major chains (GNC, Target, Walmart, and Walgreens).  The stores were selling herbal supplements that contained very little of the stated ingredients listed on the labels and that included contaminants.  The testing occurred in the brand named stores throughout New York State.  

Good news—GNC Holding announced that it had restocked some of the herbal supplements to their stores in New York after they reached an agreement with the New York Attorney General and complied and corrected the problems.  Furthermore, GNC agreed that they would adopt testing standards in the 6,000 stores nationwide that would exceed requirements that the Food and Drug Administration requires—this is a first for a major herbal supplement chain in the United States. 
Additionally, GNC committed to the following best practices: 

• Authentication: Within 18 months GNC will implement DNA barcoding to confirm the plant's authenticity.
• Broad Testing for Contaminants:  GNC will test for the eight most common allergens before and after production.
• Consumer transparency:  GNC will prominently display signs in their stores and on their website with relevant information about the herbs and supplements including extracts, chemicals, and solvents used and explain the different processes.  GNC will list all ingredients on its product labels, per existing FDA rules.
• Reporting:  GNC will provide semiannual reports to the Attorney General’s Office, detailing the above information.

In related news, 13 state attorneys have asked the U.S. Congress to investigate the herbal supplement industry based on the NY General’s Office investigation.  The state attorneys are considering giving the Food and Drug Administration (FDA) more oversight over herbal supplements.   However, it has been previously reported that the FDA is considerably underfunded already.  The question of undertaking a massive job of regulating herbal supplements would need a large funding package attached to any herbal regulation bill.   

Comment:  Regarding GNC—this is excellent progress.  However, where are the agreements with Target, Walmart, and Walgreens? Hopefully, the other stores will soon agree to the same terms as GNC.  If you want to know the potential harm of these herbs, check out the original article—it will make you think twice before buying any herbs or supplements unless there is some type of comprehensive oversight.  

Source: http://www.ag.ny.gov/press-release/ag-schneiderman-announces-agreement-gnc-implement-landmark-reforms-herbal-supplements

http://hcvadvocate.org/news/newsLetter/2015/advocate0415_mid.html#3

New York Attorney General Targets Supplements at Major Retailers

The New York State attorney general’s office accused four major retailers on Monday of selling fraudulent and potentially dangerous herbal supplements and demanded that they remove the products from their shelves.

The authorities said they had conducted tests on top-selling store brands of herbal supplements at four national retailers — GNC, Target, Walgreens and Walmart — and found that four out of five of the products did not contain any of the herbs on their labels. The tests showed that pills labeled medicinal herbs often contained little more than cheap fillers like powdered rice, asparagus and houseplants, and in some cases substances that could be dangerous to those with allergies.

The investigation came as a welcome surprise to health experts who have long complained about the quality and safety of dietary supplements, which are exempt from the strict regulatory oversight applied to prescription drugs.

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