Alan FranciscusA 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 "Herbal Supplement Crackdown,"  I wrote 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:

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.

HCV Advocate Herbal Glossary
National Center for Complementary and Alternative Medicine 

This article is reprinted from the July, 2015 HCV Advocate. Copyright 2015 with permission from the HCV Advocate and Alan Franciscus.