Descriptive Epidemiology of Herbal and Vitamin Poisonings

An herb is a leafy plant without a woody stem, but herbal preparations include all natural, alternative, and traditional remedies. Twenty-five percent of current, proprietary pharmaceuticals come from plant-herb sources. As a result of the Dietary Supplement and Health Education Act of 1994, the FDA has no authority over regulating herbal and vitamin products, unless they prove to be toxic. 80% of the world's population use herbal products and vitamins daily; most are benign, and offer no health benefit (e.g., vitamin C and Echinacea) or potentially lethal drug interactions (e.g., St. John's wort and SSRIs; garlic, ginkgo, and ginseng, and anticoagulants [ASA, heparin, warfarin]).

The most common herb and vitamin delivery forms include capsules (50+%), tablets (15+%), teas and drinks (10+%).

The most common herb supplement types are single herbs (50+%) and combinations (30+%).

The most popular herb sales in the United States include Echinacea (10%), garlic (10%), goldenseal* (7%), ginseng (6%), Ginkgo (4.5%), and saw palmetto (4.4%). [* Goldenseal is often used illicitly in unsuccessful attempts to disguise urinary marijuana (THC) metabolites.] There are no toxicologic databases on herbal and vitamin toxicity in the United States. In Hong Kong, herbal medicine toxicity accounts for less than 1% of all acute hospital admissions, and Western medicine toxicity and drug-drug interactions account for 4.4% of all acute hospital admissions. Fatalities have resulted from megadoses of the fat-soluble and lipophilic (stored in liver and brain) vitamins A, D, and E; and "therapeutic" (homeopathic) doses of niacin and tryptophan.

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