Side Effects of taking herbs, vitamins, minerals, natural supplements, herbal medicines by Ray Sahelian, M.D.
June 16 2014

I am quite cautious when new medicines are introduced because it is not uncommon that unforeseen side effects could come up after a medicine is marketed to the public and hundreds of thousands of patients start using it for many months or years. Most of the time, studies with new drugs are done for a maximum of a few months, yet doctors prescribe these new drugs to patients for years and decades at a time.

Advice and recommendation
When starting a new medication or dietary supplement, begin with a low amount in order to prevent reactions that are unpleasant.

Side effects of herbs and herbal medications
What is the worst side effects that herbs can have?
   I would say heart rhythm disturbances are the most serious side effects from certain herbs such as ephedra.

Clin Med. 2013. Adverse effects of herbal medicines: an overview of systematic reviews. Peninsula Medical School, Veysey Building, Exeter, Devon. This overview of systematic reviews (SRs) aims to evaluate critically the evidence regarding the adverse effects of herbal medicines (HMs). Five electronic databases were searched to identify all relevant SRs, with 50 SRs of 50 different HMs meeting our inclusion criteria. Most had only minor weaknesses in methods. Serious adverse effects were noted only for four HMs: Herbae pulvis standardisatus, Larrea tridentate, Piper methysticum and Cassia senna. The most severe adverse effects were liver or kidney damage, colon perforation, carcinoma, coma and death. Moderately severe adverse effects were noted for 15 HMs: Pelargonium sidoides, Perna canaliculus, Aloe vera, Mentha piperita, Medicago sativa, Cimicifuga racemosa, Caulophyllum thalictroides, Serenoa repens, Taraxacum officinale, Camellia sinensis, Commifora mukul, Hoodia gordonii, Viscum album, Trifolium pratense and Stevia rebaudiana. Minor adverse effects were noted for 31 HMs: Thymus vulgaris, Lavandula angustifolia Miller, Boswellia serrata, Calendula officinalis, Harpagophytum procumbens, Panax ginseng, Vitex agnus-castus, Crataegus spp., Cinnamomum spp., Petasites hybridus, Agave americana, Hypericum perforatum, Echinacea spp., Silybum marianum, Capsicum spp., Genus phyllanthus, Ginkgo biloba, Valeriana officinalis, Hippocastanaceae, Melissa officinalis, Trigonella foenum-graecum, Lagerstroemia speciosa, Cnicus benedictus, Salvia hispanica, Vaccinium myrtillus, Mentha spicata, Rosmarinus officinalis, Crocus sativus, Gymnema sylvestre, Morinda citrifolia and Curcuma longa. Most of the HMs evaluated in SRs were associated with only moderately severe or minor adverse effects.

Int J Clin Pract. 2012. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. The use of herbs and dietary supplements (HDS) alone or concomitantly with medications can potentially increase the risk of adverse events experienced by the patients. This review aims to evaluate the documented HDS-drug interactions and contraindications. A structured literature review was conducted on PubMed, EMBASE, Cochrane Library, tertiary literature and Internet. While 85 primary literatures, six books and two web sites were reviewed for a total of 1,491 unique pairs of HDS-drug interactions, 213 HDS entities and 509 medications were involved. HDS products containing St. John's Wort, magnesium, calcium, iron, ginkgo had the greatest number of documented interactions with medications. Warfarin, insulin, aspirin, digoxin, and ticlopidine had the greatest number of reported interactions with HDS. Medications affecting the central nervous system or cardiovascular system had more documented interactions with HDS. Of the 882 HDS-drug interactions being described its mechanism and severity, 42.3% were due to altered pharmacokinetics and 240 were described as major interactions. Of the 152 identified HDS contraindications, the most frequent involved gastrointestinal (16.4%), neurological (14.5%), and renal/genitourinary diseases (12.5%). Flaxseed, echinacea, and yohimbe had the largest number of documented contraindications. Although HDS-drug interactions and contraindications primarily concerned a relatively small subset of commonly used medications and HDS entities, this review provides the summary to identify patients, HDS products, and medications that are more susceptible to HDS-drug interactions and contraindications. The findings would facilitate the health-care professionals to communicate these documented interactions and contraindications to their patients and/or caregivers thereby preventing serious adverse events and improving desired therapeutic outcomes.

Nutritional supplements
Many popular dietary supplements contain ingredients that may cause cancer, heart problems, liver or kidney damage, but U.S. stores sell them anyway and Americans spend millions on them, according to Consumer Reports, August 2010. The organization pointed to 12 supplement ingredients in particular that it said could be dangerous: aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe. Potential dangers include liver and kidney damage, heart rhythm disorders and unhealthy blood pressure levels.

Doctors should be more aware of side effects of prescription drugs
When patients feel they might be having an adverse drug effect, doctors will very often dismiss their concerns. In a survey of 650 patients, taking cholesterol-lowering drugs called statins, who reported having side effects to the drugs, many said their physicians denied that the drugs could be connected to their symptoms. Physician reaction to a potential side effect is crucial because the muscle problems can progress to a rare but potentially fatal condition called rhabdomyolysis if the drug isn't discontinued. Drug Safety, 2007.

Sleeping pills
Side effects of sleeping pills can include memory loss, daytime sleepiness, and increased risk of falls, which are especially risky for older patients.

The best-known side effects of statins, which include widely prescribed drugs such as Lipitor and Zocor, are liver damage and muscle problems, although statins can also cause changes in memory, concentration and mood.

Patented products, formulas
November 12, 2013
USPlabs LLC is recalling certain OxyElite Pro dietary supplements linked to liver illnesses in Hawaii and a number of other states, according to the FDA. One person has died, another received a liver transplant, and others are awaiting liver transplants in connection with the supplements, which are used for weight loss.The recalled products include certain OxyElite Pro Super Thermo capsules, OxyElite Pro Ultra-Intense Thermo capsules and OxyElite Pro Super Thermo Powder.The FDA sent a warning letter to USPlabs last month telling the company they must stop distributing OxyElite Pro and another dietary supplement, VERSA-1.The supplements contain the ingredient aegeline.

Acne treatment side effects
The Food and Drug Administration said in June 2014 problems have been reported with gels, face washes, pads and other products that contain two ingredients: benzoyl peroxide or salicylic acid. But the agency says it's unclear whether those ingredients trigger the reactions or whether some other combination of ingredients is to blame.The over-the-counter treatments are sold as Proactiv, Neutrogena, MaxClarity, Oxy, Aveeno and other brands. For now the agency wants consumers to stop using the products immediately if they experience allergic reactions such as tightness of the throat, breathing problems, lightheadedness or swelling of the eyes, face or lips.