Safety of Alternative Medicines

Q:  There are more and more alternative medications on the market now. I’m interested in natural treatments, but have started to read more negative information on some of them. How can I know for sure that what is sold over-the-counter is safe and that it will not have any long term consequences?

A:  Before answering your question, let me first ask you one. In the absence of a medical illness or a documented deficiency, why are you considering taking anything at all? For the vast majority of Americans, eating a balanced diet provides all the necessary nutrients one needs with the exception of calcium supplementation and perhaps the need for a multivitamin. The substances are sold as being “natural” which can sometimes diminish the sense of possible harm they can cause. They can also be quite expensive and as they are not covered by most forms of insurance – a drain on one’s finances. Most have not been the subject of the same kinds of scrutiny that prescription medications must satisfy before being approved by the FDA.

Three natural substances have recently been the subjects of more extensive research. Two were found to be ineffective, and one the cause of irreversible damage and possibly death.

Black cohosh is known to have estrogenic effects and as a result has been sold as an alternative to premarin for the treatment of the symptoms of menopause as well as the prevention of osteoporosis. Although women may feel it helps with their symptoms, its effect on the prevention of osteoporosis were clinically insignificant.

St. John’s Wort is sold to treat depression. A recent study found it an ineffective medication for this condition. Despite the fact that both of these are relatively harmless, the down side is that they don’t work as advertised and as a consequence, the conditions that they are supposed to treat may actually get worse.

The third substance is aristocholic acid, a component of some natural weight loss compounds. Aristocholic acid has been found to cause irreversible kidney damage and in some, a form of cancer of the kidneys. How tragic to be ingesting a chemical purchased over the counter to find out too late that it is anything but healthy.

This is not to say that all alternative medications are harmful. What it does imply is that many have been inadequately studied and their potential benefit or harm will remain unknown until they are subjected to the same scrutiny as non-natural medications. The temptation associated with these medications is that they offer a simple solution to complex problems with the implication that they offer some kind of shortcut that is often very expensive.

Please be very careful and at the least, read the labels and check with a textbook on natural treatments at the library if you have questions. At least let your doctor know through a phone call that you are taking something new so it can be noted on your medical record.

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