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11 Toxic and dangerous herbs

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Effects of Herbal Supplements on Clinical Laboratory Test Results
This chapter is in the book Effects of Herbal Supplements on Clinical Laboratory Test Results
11 Toxic and dangerous herbs11.1 IntroductionAdverse drug reactions are a major cause of hospitalization and death in the USA. It is estimated that an average of 2.2 million people are hospitalized annually and approxi-mately 100,000 die from adverse drug reactions (1). People turn to herbal supplements to avoid adverse drug reactions. Although many herbal supplements are fairly safe, certain herbal supplements are very toxic and may cause serious adverse reactions and even death. Dennehy et al. studied dietary-supplement-related adverse events reported to the California Poison Control System during April 2002 to September 2002 and found that most patients who experienced adverse effects from dietary supplements took ephedra-containing herbal products. The symptoms most frequently reported were increased heart rate, agitation, nausea and vomiting (2). Wang et al. reported a case of a 34-year-old female who died after using a herbal medicine powder containing Strychnos nux- vomicaseeds. The authors identifi ed strychnine and brucine in blood and gastric content samples from the woman. Death was attributed to use of a strychnine-containing herbal supplement (3). A 41-year-old Chinese man died from renal failure because he consumed a herbal preparation called Den Quing Wu Lin Wan that contained Guan Mu Tong as the main ingredient. Guan Mu Tong is prepared from the plant Aristolochia manshuriensis, which contains aristolochic acid, a known nephrotoxic compound. Microscopic examination of renal tissue revealed severe degeneration, necrosis and desquamation of renal tubular epithelial cells, the presence of protein casts and a widened edematous interstitium with interstitial fi brosis (4). There are many other case reports in the literature showing the dangers of using certain herbal supplements.11.2 Herbal supplements that may cause deathDeath may occur after ingestion of a very toxic herbal supplement or tea. A number of such reports deal with Chinese medicines such as Chan Su, aconite-containing herbal products, and products contaminated with aristolochic acid. However, death has also occurred after drinking of oleander tea or taking a kava supplement or other herbal products such as germander and chaparral. The Chinese weight loss product ma- huang, which contains ephedra alkaloids, is also very dangerous and may cause death. Herbal supplements that may cause fatality are listed in Tab. 11.1.11.2.1Ephedra (ma-huang) Ephedra is a small perennial shrub with thin stems that rarely grows over 1 ft (0.3 m). Some of the better-known species include Ephedra sinica and Ephedra equisetina (collectively called ma-huang) from China. Ephedrine is the predominant active compound found

11 Toxic and dangerous herbs11.1 IntroductionAdverse drug reactions are a major cause of hospitalization and death in the USA. It is estimated that an average of 2.2 million people are hospitalized annually and approxi-mately 100,000 die from adverse drug reactions (1). People turn to herbal supplements to avoid adverse drug reactions. Although many herbal supplements are fairly safe, certain herbal supplements are very toxic and may cause serious adverse reactions and even death. Dennehy et al. studied dietary-supplement-related adverse events reported to the California Poison Control System during April 2002 to September 2002 and found that most patients who experienced adverse effects from dietary supplements took ephedra-containing herbal products. The symptoms most frequently reported were increased heart rate, agitation, nausea and vomiting (2). Wang et al. reported a case of a 34-year-old female who died after using a herbal medicine powder containing Strychnos nux- vomicaseeds. The authors identifi ed strychnine and brucine in blood and gastric content samples from the woman. Death was attributed to use of a strychnine-containing herbal supplement (3). A 41-year-old Chinese man died from renal failure because he consumed a herbal preparation called Den Quing Wu Lin Wan that contained Guan Mu Tong as the main ingredient. Guan Mu Tong is prepared from the plant Aristolochia manshuriensis, which contains aristolochic acid, a known nephrotoxic compound. Microscopic examination of renal tissue revealed severe degeneration, necrosis and desquamation of renal tubular epithelial cells, the presence of protein casts and a widened edematous interstitium with interstitial fi brosis (4). There are many other case reports in the literature showing the dangers of using certain herbal supplements.11.2 Herbal supplements that may cause deathDeath may occur after ingestion of a very toxic herbal supplement or tea. A number of such reports deal with Chinese medicines such as Chan Su, aconite-containing herbal products, and products contaminated with aristolochic acid. However, death has also occurred after drinking of oleander tea or taking a kava supplement or other herbal products such as germander and chaparral. The Chinese weight loss product ma- huang, which contains ephedra alkaloids, is also very dangerous and may cause death. Herbal supplements that may cause fatality are listed in Tab. 11.1.11.2.1Ephedra (ma-huang) Ephedra is a small perennial shrub with thin stems that rarely grows over 1 ft (0.3 m). Some of the better-known species include Ephedra sinica and Ephedra equisetina (collectively called ma-huang) from China. Ephedrine is the predominant active compound found

Chapters in this book

  1. Frontmatter I
  2. Preface VII
  3. Contents IX
  4. 1 Commonly used herbal supplements 1
  5. 2 Abnormal liver function tests due to use of herbal supplements 19
  6. 3 Kelp and thyroid panel tests 29
  7. 4 Interferences in digoxin immunoassays by various herbal supplements 37
  8. 5 Interaction of St. John’s wort with various drugs 45
  9. 6 Herbs to avoid with warfarin therapy 59
  10. 7 Interaction of ginseng, ginkgo, garlic and ginger supplements with various drugs 67
  11. 8 Interactions between fruit juices and drugs: clinical impact 75
  12. 9 Heavy metal toxicity due to use of Oriental and Ayurvedic medicines 83
  13. 10 Contamination of herbal supplements with Western drugs 95
  14. 11 Toxic and dangerous herbs 103
  15. Appendix 115
  16. Index 119
  17. Color plates 123
Readers are also interested in:
https://doi.org/10.1515/9783110245622.103

Chapters in this book

  1. Frontmatter I
  2. Preface VII
  3. Contents IX
  4. 1 Commonly used herbal supplements 1
  5. 2 Abnormal liver function tests due to use of herbal supplements 19
  6. 3 Kelp and thyroid panel tests 29
  7. 4 Interferences in digoxin immunoassays by various herbal supplements 37
  8. 5 Interaction of St. John’s wort with various drugs 45
  9. 6 Herbs to avoid with warfarin therapy 59
  10. 7 Interaction of ginseng, ginkgo, garlic and ginger supplements with various drugs 67
  11. 8 Interactions between fruit juices and drugs: clinical impact 75
  12. 9 Heavy metal toxicity due to use of Oriental and Ayurvedic medicines 83
  13. 10 Contamination of herbal supplements with Western drugs 95
  14. 11 Toxic and dangerous herbs 103
  15. Appendix 115
  16. Index 119
  17. Color plates 123
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