During our public health rotation, Tommy Wong, my classmate, and I became aware of how often pharmacists are approached with the question: "Where are your supplements?" And, without hesitation, patients are directed to the supplement aisle while pharmacists continue with their other responsibilities.
Sales of herbal supplements have increased such that approximately 20% of the population are using herbal supplements.1 In fact, 72% of individuals using supplements will continue using them even if they were proven to be ineffective.2 Pharmacists need to be more informed about herbal supplements and provide information to patients about their relative benefits and risks.
Rarely are patients asked why are they considering taking herbal supplements, what other medications they are currently taking, and whether they have health issues that may complicate herbal supplement usage. There is a potential that using herbal supplements can do more harm or than good.1 The 1994 Dietary Supplement Health and Education Act (DSHEA) classifies herbal and botanical products as dietary supplements, and therefore, herbal products are able to be marketed freely3
The problem with this is that the assurance of safety, efficacy, and quality control of these products continues to be suboptimal.3 Herbal preparations may vary among different manufacturers and even from batch to batch within the same manufacturer.1 Information on the labels can be misleading. Prescription medications such as steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), prescription antibiotics, sedatives, and narcotics have been found in these so-called "natural" products.2
This issue is of a particular concern in Chinese communities and where herbal supplements are readily available. U.S. herbal remedies include imported Asianpatented medicines that have been identified to contain unauthorized or toxic ingredients and Rx medications.3
Wong, fluent in reading Chinese, researched herbáis locally in Oakland's Chinatown and found several products with misleading information and containing unauthorized agents. Prescriptiononly ingredients such as erythromycin were available over the counter as eye ointment. Products such as URI Tract Care Formula (Niao Lu Xian Yan Ling) is marketed "to help with inflammation of the urinary tract" in Chinese. However, the English translation only states to "help promote and maintain a healthy urinary system by establishing the body's natural balance. …