This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (20)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Complementary and Alternative Medicine  • Drug Therapy, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Caveat Emptor

Judith Garrard, PhD; Susan Harms, RPh, MPH, PhD; Lynn E. Eberly, PhD; Amy Matiak, PharmD

Arch Intern Med. 2003;163:2290-2295.

Background  Patients who report use of herbs to their physicians may not be able to accurately describe the ingredients or recommended dosage because the products for the same herb may differ. The purpose of this study was to describe variations in label information of products for each of the 10 most commonly purchased herbs.

Methods  Products for each of 10 herbs were surveyed in a convenience sample of 20 retail stores in a large metropolitan area. Herbs were those with the greatest sales dollars in 1998: echinacea, St John's wort, Ginkgo biloba, garlic, saw palmetto, ginseng, goldenseal, aloe, Siberian ginseng, and valerian.

Results  Each herb had a large range in label ingredients and recommended daily dose (RDD) across available products. Strengths were not directly comparable because of ingredient variability. Among 880 products, 43% were consistent with a benchmark in ingredients and RDD, 20% in ingredients only, and 37% were either not consistent or label information was insufficient. Price per RDD was a significant predictor of consistency with the benchmark, but store type was not.

Conclusions  Persons self-medicating with an herb may be ingesting ingredients substantially different from that recommended by a benchmark, both in quantity and content. Higher price per label RDD was the best predictor of consistency with a benchmark. This study demonstrates that health providers and consumers need to closely examine label ingredients of presumably the same or similar herbal products.

From the Divisions of Health Services Research & Policy (Drs Garrard and Harms) and Biostatistics (Dr Eberly), School of Public Health, and College of Pharmacy (Ms Matiak), University of Minnesota, Minneapolis. The authors have no relevant financial interest in this article.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Application of FDA Adverse Event Report Data to the Surveillance of Dietary Botanical Supplements
Wallace et al.
The Annals of Pharmacotherapy 2008;42:653-660.
ABSTRACT | FULL TEXT  

Herbal remedies for depression and anxiety
Ernst
Adv. Psychiatr. Treat. 2007;13:312-316.
ABSTRACT | FULL TEXT  

Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils
Kemper et al.
NEJM 2007;356:2541-2544.
FULL TEXT  

The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products
Woodward
Hum Exp Toxicol 2005;24:219-233.
ABSTRACT  

Disclosure of Natural Product Use to Primary Care Physicians: A Cross-sectional Survey of Naturopathic Clinic Attendees
Busse et al.
Mayo Clin Proc. 2005;80:616-623.
ABSTRACT  

Phytochemical Assays of Commercial Botanical Dietary Supplements
Krochmal et al.
Evid Based Complement Alternat Med 2004;1:305-313.
ABSTRACT | FULL TEXT  

Possible Interaction Between Sevoflurane and Aloe vera
Lee et al.
The Annals of Pharmacotherapy 2004;38:1651-1654.
ABSTRACT | FULL TEXT