Should pharmacist patronize herbs and dietary supplements?

The Philippines Food and Drug Administration (FDA) has issued a stern public warning against the
purchase and consumption of 11 dietary supplements it has pinpointed as 'unlicensed and unsafe'.

https://www.nutraingredients-asia.com/Article/2019/07/02/Urgent-warning-Philippines-FDA-
highlights-unlicensed-and-unsafe-dietary-supplements?
utm_source=copyright&utm_medium=OnSite&utm_campaign=copyright

The Philippines Food and Drug Adminstration (FDA) has issued warnings against 14 unregistered
food products, including beverages, snacks and desserts, advising the public against purchasing
and consuming them.

https://www.foodnavigator-asia.com/Article/2019/07/15/Violative-health-risks-Philippines-FDA-
issues-warnings-against-14-unregistered-food-products?
utm_source=copyright&utm_medium=OnSite&utm_campaign=copyright

http://www.fda.gov.ph/fda-advisory-no-2020-127-public-health-warning-against-the-purchase-
and-consumption-of-the-following-unregistered-food-products-and-food-supplements/

Herbal medicines are not FDA-approved

Just because a medication is made from natural ingredients does not guarantee that it is
safe or effective. “Herbal supplements are not approved by the Food and Drug Administration
(FDA),” says Dr. Roller, “which means that they have not passed any safety, efficacy, or human
clinical trials.” Because these natural medications are not subjected to the same scrutiny as
FDA-approved medications, it is even more important to research potential benefits or side
effects, especially related to certain health issues.
Though the FDA does require that herbal supplements follow good manufacturing
procedures that ensure some level of quality, this in no way ensures that they are safe for
anyone’s use. Any supplement could have potential side effects, and these negative
consequences can increase when taken with other over-the-counter or prescription medications.
Be sure you speak to your doctor or pharmacist about any medications you taking in addition to
the herbal supplement you are considering.

Risks and side effects of dietary supplements

 sellers aren’t required to do research studies in people to prove that a dietary

supplement is safe.
 dietary supplements are mostly self-prescribed with no input from informed
medical sources like doctors, nurses, or pharmacists. 
 There’s a lot of wrong information out there. Even for those who are usually well
informed, it can be hard to find reliable information about the safe use and
potential risks of dietary supplements. 
 Most people who suffer unexpected side effects, illnesses, or drug interactions from
dietary supplements don’t call a poison control center or the supplement manufacturer.

Which vitamins do I need to avoid if I have kidney disease?

  You may need to avoid some vitamins and minerals if you have kidney disease. Some of
these include vitamins A, E and K. These vitamins are more likely to build up in your
body and can cause harm if you have too much.  Over time, they can
cause dizziness, nausea, and even death. 
 You should only take these vitamins if your healthcare professional gives you a
prescription for them. There is also some concern about vitamin C.  Although some
people may need to take a low dose of vitamin C, large doses may cause a buildup of
oxalate in people with kidney disease. Oxalate may stay in the bones and soft tissue,
which can cause pain and other issues over time.

Is it safe to use herbal remedies?

 People with chronic kidney disease and people on dialysis should avoid herbal
remedies and over the counter nutritional supplements. There may be unwanted
interactions with prescribed medicines or other side effects. Always speak to your
healthcare professional or pharmacist before taking any herbal remedies, over-the-
counter medicines, or nutritional supplements.
 If you have a kidney transplant, check with your transplant doctor and kidney dietitian
whether any vitamin or herbal supplements are safe to take.

Problems with Herbal Remedies

While there are many people who have benefitted from herbal remedies, there is no guarantee
that these products or plants will be safe or even effective. Some of the problems with herbal
remedies include lack of regulation, poisoning, no dosing recommendations, and specific,
potentially serious health problems:

No regulation. Herbal supplements and other products are not regulated in the U.S. This
means that claims made by manufacturers regarding safety and efficacy have not been
evaluated and cannot necessarily be trusted. You also cannot rely on adequate quality control
for these products, meaning contamination, purity, and concentration may be issues.

No dosing. Supplements may come with dosing recommendations, but these have also not
been evaluated. There is a real risk with herbals, both from store-brought supplements and
homemade remedies, that you will take too much and suffer from toxic effects.

Poisoning. For people who harvest and use their own herbals, there is a very real risk of
poisoning. You must be very knowledgeable about what you are growing or foraging to avoid
using something that is actually toxic and that could poison you.

Drug interactions. Doctors should always ask their patients what supplements or herbs they
use because dangerous interactions with medications are common. For instance, saw palmetto,
a common herbal used to try to treat prostate cancer magnifies the effects of warfarin, a blood
thinner. This can lead to dangerous bleeding.

https://blog.gardeningknowhow.com/gardening-pros-cons/pros-and-cons-of-herbal-medicine/

https://www.webmd.com/vitamins-and-supplements/ss/slideshow-herbs-supplements-avoid
https://www.agingcare.com/articles/pros-cons-herbal-medications-181656.htm

https://knowridge.com/2018/06/dietary-supplements-pros-and-cons-you-should-know/

An analysis of Food and Drug Administration (FDA) records revealed that, from January
2004 to April 2015, about 1,000 people ages 25 and younger had a health issue linked
to dietary supplements. About 40% of them were categorized as severe problems,
resulting in 166 hospitalizations and 22 deaths.

https://time.com/5602125/dietary-supplements-kids/