False

• The word " natural " means absolutely nothing on a label; the term is not regulated, so anyone can put it on any product. Given this lack of definition, " natural " is hardly comparable with " safe. "
• Many herbs are probably safe for a short time or in low doses. However, overdosing and overuse of any herb can be dangerous. Furthermore, certain herbs can harm people with preexisting diseases or can interact dangerously with conventional medicines.
• Contamination can be a problem even when the herbs themselves may be safe. That contamination can even occur in an herbal product reflects the fact that there is no regulation that assures herbal products have been evaluated for safety, purity or effectiveness before they are sold to the public.

False

Any substance capable of exerting a medicinal effect is also capable of exerting adverse side-effects. Whatever health effect a herbal product has is due the pharmacologic properties of their active ingredients. The amount and type of ingredients in herbal products can vary with differences in soil, growing and harvesting conditions. This often makes it difficult to get a consistent dose. So little is known about herbs that standard dosages for the claimed effect have not been established. Furthermore, quality and potency are not guaranteed when you buy herbal products, because they are not regulated like prescription and over-the-counter medications.

False

Everything you eat has the potential to interact with prescription medications. Herbs, included, can have side effects when combined with some medications. Since many people take herbal products without their physician's knowledge, the potential for dangerous interactions is greatly increased. Herbs can interact with medications in the following ways:

• Delay or reduce the effect of the medication.
• Form a compound with the medication that may make the medication ineffective in the body.
• Enhance the effect of a medication and make it stronger.
• Limit the absorption of certain nutrients.
• Increase the body's need for certain nutrients.
• Cause excessive excretion of certain nutrients.

Physicians and scientists are beginning to learn more about potential drug-herb interactions. Be sure your physician and pharmacist know of all the prescription, over-the-counter, and herbal products you take.

False

Conventional medicines prescribed by a physician are sold in standardized doses, and written information is provided by the drug manufacturer about use, side effects and precautions. The same is true for over-the-counter medications. Because so little is known about the dose, side effects and precautions of herbal products, the information is not provided for these products. So you need to know more about herbal remedies than you would about conventional medicines you may take.

False

There are several important reasons to tell your doctor about any herbal products you may be taking:

• Some people develop adverse reactions to herbal products. If your doctor knows what your are taking, the doctor has a better chance of properly diagnosing and treating the problem earlier.
• The doctor may be able to help prevent problems because he may be able to tell you if an herb you are taking can worsen an existing condition. For example, Echinacea can aggravate rheumatoid arthritis an other immune disorders such as multiple sclerosis, AIDS, or HIV infection.
• The doctor may be able to warn you away from certain herbs that could cause allergic reactions if you have allergies.
• The doctor may be able to tell you if a certain herb can interact with any medications you are taking.

False

Many people believe because a product is sold in pill-form it has been tested for quality, purity, safety and effectiveness. This is not the case with dietary supplements. While prescription and over-the-counter medications are regulated by the FDA, herbal products, and other dietary supplements, escape regulation under the Dietary Supplement Health Education Act of 1994 (DSHEA). There are currently no federal regulations that establish specific criteria for purity, identification and manufacturing procedures for dietary supplements, including herbal products.

True

Any one herb can be sold in a variety of forms including teas, pills, capsules, tinctures and extracts. But not all preparations of the same herb produce the same effects. Different parts of the same plant can also have different effects such as leaves, stems, berries, flowers and roots. To complicated matters further, the potency of herbs can differ depending on growing condition and how the herbs were stored and handled. Some manufacturers are trying to standardize their herbal products, but, because of insufficient research, they often disagree on which ingredients to use and in what doses. Furthermore, because herbal products are not monitored or regulated by any regulatory agency like the FDA, there is no guarantee you get what the label states.

False

As a result of the Dietary Supplement and Health Education Act of 1994, dietary supplements, including herbal products, were removed from the FDA's food additive category, so the burden of proof falls on the FDA to prove lack of safety rather than falling on the supplement manufacturer to prove safety.

False

Fraudulent products often can be identified by the types of claims made in their labeling, advertising and promotional literature. Claims that the product is a secret cure and use such terms as "breakthrough," "magical," "miracle cure," and "new discovery" are some possible indicators of fraud. If the product were a cure for a serious disease, it would probably be widely reported in the media and used by health-care professionals.

False

If consumers find herbal products or other dietary supplements whose labels state or imply that the product can help diagnose, treat, cure, or prevent a disease (for example, "cures cancer" or "treats arthritis"), they should realize that the product is being marketed illegally as a drug and has not been evaluated for safety and effectiveness. Under the Dietary Supplement and Health Education Act and previous food labeling laws, supplement manufacturers are allowed to use "structure-function claims" without FDA authorization. Structure-function claims refer to the supplement's effect on the body's structure or function, including its overall effect on a person's well-being, for example, the label for echinacea may state, "echinacea supports the body's immune system," but it may not say, "echinacea cures colds and flu." They base their claims on their review and interpretation of the scientific literature. Like all label claims, structure-function claims must be true and not misleading. Herbal product labels with structure-function claims must carry the disclaimer, "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease."