Natural products. Herbals. Nutraceuticals. Supplements. Different terms for the same thing (homeopathic preparations are a bit different). The term “natural” makes patients feel safe and secure, like they’re doing something good for their health. As a toxicologist, there’s always a scary story to tell. Think of this as food for thought: natural does not automatically mean safe. Opium (natural: from the opium poppy plant); digoxin (natural: from the foxglove plant); cyanide (natural: in many fruit seeds). You get the picture. But to me, patients thinking “natural means safe” is not the biggest issue with natural products. The problem is that it can become the wild, wild west, and patients can be harmed. Snake oil, anyone? When evaluating if you should take a natural product, get curious. What testing is done by the manufacturer? Remember, efficacy and safety testing are not required - the FDA does not consider natural supplements to be drugs, although they can have very real pharmacologic effects. Not to say FDA-approved drugs cannot cause harm, but that is a post for another day.
Here are some things to consider when deciding to take a natural product or if you’re an attorney with a case that in some way involves a natural product. Is the manufacturer making health claims? That’s a no-no for labeling of these products (and relates to cases I’ve been consulted on as an expert witness). The labeling is allowed to state: “supports the immune system” (or any other body system). But the label cannot say “treats COVID-19 infection”. See the difference? After you’ve done some research on the company, checked for quality assurance testing (if any), and made sure the label is compliant, what’s next? Make sure the natural product does not interact with any medications (research this and ask your prescriber or pharmacist) or has the potential to worsen any medical condition. For example, if you have an autoimmune disease, you should not take a natural supplement that revs up your immune system.
Another consideration when it comes to natural products: adulterants: things thrown in the mix but aren’t on the label - they may even be harmful contaminants or actual prescription drugs. What? Viagra is in there? A liver toxic compound? (know what manufacturers you can trust - research, ask questions, consult a naturopathic doctor). Adulterants in such products are another issue where I’ve been consulted as an expert witness. And finally, even if there is a case where harm may, or may not, have been done to a patient due to medications, look at what natural remedies may be in the mix. They may have played a role and that can shed light on the patient’s clinical course. #naturalproducts #naturalmedicine #toxicology #expertwitness #herbalmedicine