The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety

Frontiers in Neurology

Volumn 4 JAN, Issue , 2014, Pages

  Ekor, Martins ^a  

^a UNIVERSITY OF CAPE COAST   (Ghana)

Author keywords

Adverse reactions; Challenges; Herbal medicines; Monitoring safety; Public health

Indexed keywords

ACONITUM EXTRACT; ARISTOLOCHIA FANGCHI EXTRACT; EPHEDRA SINICA EXTRACT; GARLIC EXTRACT; GINKGO BILOBA EXTRACT; HYPERICUM PERFORATUM EXTRACT; KAVA EXTRACT; LIVER ENZYME; PLANT EXTRACT; TUSSILAGO FARFARA EXTRACT; UNCLASSIFIED DRUG;

ACONITE; ACONITUM CARMICHAELII; ACONITUM KUSNEZOFFII; ALLERGIC REACTION; ALLERGY; BRADYCARDIA; BURNING SENSATION; CARDIOTOXICITY; CARDIOVASCULAR DISEASE; CENTRAL NERVOUS SYSTEM DISEASE; CONCENTRATION LOSS; CONSTIPATION; DERMATITIS; DIARRHEA; DIPLOPIA; DIZZINESS; DRUG CARCINOGENICITY; DRUG EFFICACY; DRUG INTOXICATION; DRUG MONITORING; DRUG QUALITY; DRUG SAFETY; DRY SKIN; DYSPNEA; ELEVATED BLOOD PRESSURE; ENZYME BLOOD LEVEL; EPISTAXIS; EXCITATION; EYE REDNESS; FATIGUE; FIBROSING ALVEOLITIS; GASTROINTESTINAL SYMPTOM; GENOTOXICITY; HEADACHE; HEART PALPITATION; HEART VENTRICLE FIBRILLATION; HEART VENTRICLE TACHYCARDIA; HEPATITIS; HERBAL MEDICINE; HUMAN; HYPERESTHESIA; HYPERHIDROSIS; HYPERVENTILATION; HYPOKALEMIA; HYPOMANIA; HYPOTENSION; INSOMNIA; INTRAOCULAR HEMORRHAGE; KIDNEY FAILURE; LIVER CIRRHOSIS; LIVER FAILURE; LIVER INJURY; LIVER TOXICITY; LIVER VENOOCCLUSIVE DISEASE; MASTALGIA; MYDRIASIS; NAUSEA; NEPHROTOXICITY; NERVOUSNESS; NEUROTOXICITY; NONHUMAN; PARESTHESIA; PHOTOPHOBIA; PHOTOSENSITIVITY; QUALITY CONTROL; RESTLESSNESS; REVIEW; SELF MEDICATION; SKIN DISCOLORATION; SPINAL HEMATOMA; STEVENS JOHNSON SYNDROME; SUBARACHNOID HEMORRHAGE; SUBDURAL HEMATOMA; TRANSITIONAL BLINDNESS; TREMOR; UNSPECIFIED SIDE EFFECT; VAGINA BLEEDING; VOMITING; XEROSTOMIA;

EID: 84893445474     PISSN: None     EISSN: 16642295     Source Type: Journal    
DOI: 10.3389/fphar.2013.00177     Document Type: Review

References (121)

1. Abbot, N. C., and Ernst, E. (1997). Patients' opinions about complimentary medicine. Forsch. Komplementarmed. 4, 164-168. doi: 10.1159/000210318.
2. Almeida, J. C., and Grimsley, E. W. (1996). Coma from the health store: interaction between kava and alprazolam. Ann. Intern. Med. 125, 940-941. doi: 10.7326/0003-4819-125-11-199612010-00023.
3. Anquez-Traxler, C. (2011). The legal and regulatory framework of herbal medicinal products in the European Union: a focus on the traditional herbal medicines category. Drug Inf. J. 45, 15-23. doi: 10.1177/009286151104500102.
4. Astin, J. (1998). Why patients use alternative medicines: results of national study. J. Am. Med. Assoc. 279, 1548-1553. doi: 10.1001/jama.279.19.1548.
5. Auerbach, B. J., Reynolds, S. J., Lamorde, M., Merry, C., Kukunda-Byobona, C., Ocama, P., et al. (2012). Traditional herbal medicine use associated with liver fibrosis in rural Rakai, Uganda. PLoS ONE 7:e41737. doi: 10.1371/journal.pone.0041737.
6. Baldwin, C. A., Anderson, L. A., and Phillipson, J. D. (1986). What pharmacists should know about Ginseng. Pharm. J. 237, 583-586.
7. Bandaranayake, W. M. (2006). "Quality control, screening, toxicity, and regulation of herbal drugs," in Modern Phytomedicine. Turning Medicinal Plants into Drugs, eds I. Ahmad, F. Aqil, and M. Owais (Weinheim: Wiley-VCHGmbH & Co. KGaA), 25-57. doi: 10.1002/9783527609987.ch2.
8. Bennett, D. A. Jr., Phun, L., Polk, J. F., Voglino, S. A., Zlotnik, V., and Raffa, R. B. (1998). Neuropharmacology of St. John's wort (Hypericum). Ann. Pharmacother. 32, 1201-1208. doi: 10.1345/aph.18026.
9. Bensky, D., Clavey, S., and Stoger, E. (2004). Chinese Herbal Medicine: Materia Medica, 3rd edn. Seattle, WA: Eastland Press.
10. Blumenthal, M., Brusse, W. R., Goldberg, A., Gruenwald, J., Hall, T., Riggins, C. W., et al. (1998). The Complete German Commission E Monographs. Therapeutic Guide to Herbal Medicines. Austin, TX: The American Botanical Council.
11. Bodeker, C., Bodeker, G., Ong, C. K., Grundy, C. K., Burford, G., and Shein, K. (2005). WHO Global Atlas of Traditional, Complementary and Alternative Medicine. Geneva, Switzerland: World Health Organization.
12. Boozer, C. N., Daly, P. A., Homel, P., Solomon, J. L., Blanchard, D., Nasser, J. A., et al. (2002). Herbal Ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int. J. Obes. Relat. Metab. Disord. 26, 593-604. doi: 10.1038/sj.ijo.0802023.
13. Boullata, J. I., and Nace, A. M. (2000). Safety issues with herbal medicine. Pharmacotherapy 20, 257-269. doi: 10.1592/phco.20.4.257.34886.
14. Braun, L. A., Tiralongo, E., Wilkinson, J. M., Spitzer, O., Bailey, M., Poole, S., et al. (2010). Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice. BMC Complement. Altern. Med. 10:38. doi: 10.1186/1472-6882-10-38.
15. Brevort, P. (1998). The booming us botanical market: a new overview. Herbal. Gram. 44, 33-48.
16. Calapai, G. (2008). European legislation on herbal medicines: a look into the future. Drug Saf. 31, 428-431. doi: 10.2165/00002018-200831050-00009.
17. Chan, T. Y. (2002). Incidence of herb-induced aconitine poisoning in Hong Kong: impact of publicity measures to promote awareness among the herbalists and the public. Drug Saf. 25, 823-828. doi: 10.2165/00002018-200225110-00006.
18. Chan, T. Y. (2009). Aconite poisoning presenting as hypotension and bradycardia. Hum. Exp. Toxicol. 28, 795-797. doi: 10.1177/0960327109353056.
19. Chan, T. Y., and Critchley, J. A. (1994). The spectrum of poisonings in Hong Kong: an overview. Vet. Hum. Toxicol. 36, 135-137.
20. Chau, W., Ross, R., Li, J. Y., Yong, T. Y., Klebe, S., and Barbara, J. A. (2011). Nephropathy associated with use of a Chinese herbal product containing aristolochic acid. Med. J. Aust. 194, 367-368.
21. Chen, C. H., Dickman, K. G., Moriya, M., Zavadil, J., Sidorenko, V. S., Edwards, K. L., et al. (2012). Aristolochic acid-associated urothelial cancer in Taiwan. Proc. Natl. Acad. Sci. U.S.A. 109, 8241-8246. doi: 10.1073/pnas.1119920109.
22. Chen, W. L., Tsai, T. H., Yang, C. C., and Kuo, T. B. (2010). Acute effects of Ephedra on autonomic nervous modulation in healthy young adults. Clin. Pharmacol. Ther. 88, 39-44. doi: 10.1038/clpt.2010.66.
23. Chinese Pharmacopoeia Commission. (2010). Pharmacopoeia of the People's Republic of China (English edition). Beijing, China: China Medical Science Press.
24. Chong, S. K. F., and Oberholzer, V. G. (1988). Ginseng: is there a use in clinical medicine? Postgrad. Med. J. 64, 841-846. doi: 10.1136/pgmj.64.757.841.
25. Committee on the Use of Complementary, and Alternative Medicine by the American Public, Board on Health Promotion, and Disease Prevention, Institute of Medicine. (2005). Complementary and Alternative Medicine in the United States. Washington, DC: The National Academies Press.
26. Cosyns, J. P., Jadoul, M., Squifflet, J. P., De Plaen, J. F., Ferluga, D., and van Ypersele de Strihou, C. (1994). Chinese herbs nephropathy: a clue to Balkan endemic nephropathy? Kidney Int. 45, 1680-1688. doi: 10.1038/ki.1994.220.
27. Cosyns, J. P., Jadoul, M., Squifflet, J. P., Wese, F. X., and van Ypersele de Strihou, C. (1999). Urothelial lesions in Chinese-herb nephropathy. Am. J. Kidney Dis. 33, 1011-1017. doi: 10.1016/S0272-6386(99)70136-8.
28. Damsch, S., Eichenbaum, G., Looszova, A., Lammens, L., Feyen, B., Van den Bulck, K., et al. (2011a). Unexpected nasal changes in rats related to reflux after gavage dosing. Toxicol. Pathol. 39, 337-347. doi: 10.1177/0192623310388430.
29. Damsch, S., Eichenbaum, G., Tonelli, A., Lammens, L., Van den Bulck, K., Feyen, B., et al. (2011b). Gavage-related reflux in rats: identification, pathogenesis, and toxicological implications (review). Toxicol. Pathol. 39, 348-360. doi: 10.1177/0192623310388431.
30. Dega, H., Laporte, J. L., Francès, C., Herson, S., and Chosidow, O. (1996). Ginseng as a cause for Stevens-Johnson syndrome? Lancet 347, 1344. doi: 10.1016/S0140-6736(96)91001-6.
31. Dhesi, P., Ng, R., Shehata, M. M., and Shah, P. K. (2010). Ventricular tachycardia after ingestion of ayurveda herbal antidiarrheal medication containing Aconitum. Arch. Int. Med. 170, 303-305. doi: 10.1001/archinternmed.2009.518.
32. Dunnick, J. K., and Nyska, A. (2013). The toxicity and pathology of selected dietary herbal medicines. Toxicol. Pathol. 41, 374-386. doi: 10.1177/0192623312466451.
33. Edgar, J. A., Colegate, S. M., Boppre, M., and Molyneux, R. J. (2011). Pyrrolizidine alkaloids in food: a spectrum of potential health consequences. Food Addit. Contam. Part A Chem. Anal. Control Expo. Risk Assess. 28, 308-324. doi: 10.1080/19440049.2010.547520.
34. Ekor, M., Osonuga, O. A., Odewabi, A. O., Bakre, A. G., and Oritogun, K. S. (2010). Toxicity evaluation of Yoyo 'cleanser' bitters and fields Swedish bitters herbal preparations following sub-chronic administration in rats. Am. J. Pharmacol. Toxicol. 5, 159-166. doi: 10.3844/ajptsp.2010.159.166.
35. European Union Herbal Medicines Directive. (2004). Directive 2004/24/EC of the European Parliament and of the Council of 31 March 2004 amending, as regards traditional herbal medicinal products, Directive 2001/83/EC on the Community code relating to medicinal products for human use. Off. J. Eur. Union 47, 85-90.
36. Ernst, E. (2002). Toxic heavy metals and undeclared drugs in Asian herbal medicines. Trends Pharmacol. Sci. 23, 136-139. doi: 10.1016/S0165-6147(00)01972-6.
37. Fang, Z. Z., Zhang, Y. Y., Wang, X. L., Cao, Y. F., Huo, H., and Yang, L. (2011). Bioactivation of herbal constituents: simple alerts in the complex system. Expert Opin. Drug Metab. Toxicol. 7, 1-19. doi: 10.1517/17425255.2011.586335.
38. Farah, M. H., Edwards, I. R., Lindquist, M., Leon, C., and Shaw, D. (2000). International monitoring of adverse health effects associated with herbal medicines. Pharmacoepidemiol. Drug Saf. 9, 105-112. doi: 10.1002/(SICI)1099-1557(200003/04)9:2<105::AID-PDS486>3.0.CO;2-2.
39. Foster, D. F., Phillips, R. S., Hamel, M. B., and Eisenberg, D. M. (2000). Alternative medicine use in older Americans. J. Am. Geriatr. Soc. 48, 1560-1565.
40. Fujita, Y., Terui, K., Fujita, M., Kakizaki, A., Sato, N., Oikawa, K., et al. (2007). Five cases of aconite poisoning: toxicokinetics of aconitines. J. Anal. Toxicol. 31, 132-137. doi: 10.1093/jat/31.3.132.
41. Hackman, R. M., Havel, P. J., Schwartz, H. J., Rutledge, J. C., Watnik, M. R., Noceti, E. M., et al. (2006). Multinutrient supplement containing Ephedra and caffeine causes weight loss and improves metabolic risk factors in obese women: a randomized controlled trial. Int. J. Obes. 30, 1545-1556. doi: 10.1038/sj.ijo.0803283.
42. Hallas, J., Bjerrum, L., Stovring, H., and Andersen, M. (2008). Use of a prescribed ephedrine/caffeine combination and the risk of serious cardiovascular events: a registry-based case-crossover study. Am. J. Epidemiol. 168, 966-973. doi: 10.1093/aje/kwn191.
43. Haller, C. A., Jacob, P., and Benowitz, N. L. (2005). Short-term metabolic and hemodynamic effects of Ephedra and guarana combinations. Clin. Pharmacol. Ther. 77, 560-571. doi: 10.1016/j.clpt.2005.01.023.
44. Hashimoto, K., Higuchi, M., Makino, B., Sakakibara, I., Kubo, M., Komatsu, Y., et al. (1999). Quantitative analysis of aristolochic acids, toxic compounds, contained in some medicinal plants. J. Ethnopharmacol. 64, 185-189. doi: 10.1016/S0378-8741(98)00123-8.
45. He, B. C., Gao, J. L., Luo, X., Luo, J., Shen, J., Wang, L., et al. (2011). Ginsenoside Rg3 inhibits colorectal tumor growth through the down-regulation of Wnt/ss-catenin signaling. Int. J. Oncol. 38, 437-445. doi: 10.3892/ijo.2010.858.
46. Hong, Y. T., Fu, L. S., Chung, L. H., Hung, S. C., Huang, Y. T., and Chi, C. S. (2006). Fanconi's syndrome, interstitial fibrosis and renal failure by aristolochic acid in Chinese herbs. Pediatr. Nephrol. 21, 577-579. doi: 10.1007/s00467-006-0017-6.
47. Huxtable, R. J. (1990). The harmful potential of herbal and other plant products. Drug Saf. 5, 126-136. doi: 10.2165/00002018-199000051-00020.
48. Hwang, Y. H., Kim, T., Cho, W. K., Yang, H. J., Kwak, D. H., Ha, H., et al. (2012). In vitro and in vivo genotoxicity assessment of Aristolochia manshuriensis Kom. Evid.-based Complement. Alternat. Med. 2012, 412736. doi: 10.1155/2012/412736.
49. John, T. A., Okoli, C. C., and Ekor, M. (1997). Some phytochemical, safety, antimicrobial and haematological studies of super b and seven keys to power blood purifier herbal tonics. Nig. J. Med. Res. 1, 37-43.
50. Kasilo, O. M. J., and Trapsida, J. M. (2011). Decade of African traditional medicine, 2001-2010. Afr. Health Mon. (Special Issue) 14, 25-31.
51. Kessler, D. A. (2000). Cancer and herbs. N. Engl. J. Med. 342, 1742-1743. doi: 10.1056/NEJM200006083422309.
52. Kim, E. J. Y., Chen, Y., Huang, J. Q., Li, K. M., Razmovski-Naumovski, V., Poon, J., et al. (2013). Evidence-based toxicity evaluation and scheduling of Chinese herbal medicines. J. Ethnopharmacol. 146, 40-61. doi: 10.1016/j.jep.2012.12.027.
53. Kim, H. J., Park, J. M., Kim, J. A., and Ko, B. P. (2008). Effect of herbal Ephedra sinica and Evodia rutaecarpa on body composition and resting metabolic rate: a randomized, double-blind clinical trial in Korean premenopausal women. J. Acupunct. Meridian Stud. 1, 128-138. doi: 10.1016/S2005-2901(09)60033-9.
54. Kim, J. W., Jung, S. Y., Kwon, Y. H., Lee, J. H., Lee, Y. M., Lee, B. Y., et al. (2012). Ginsenoside Rg3 attenuates tumor angiogenesis via inhibiting bioactivities of endothelial progenitor cells. Cancer Biol. Ther. 13, 504-515. doi: 10.4161/cbt.19599.
55. Kohara, A., Suzuki, T., Honma, M., Ohwada, T., and Hayashi, M. (2002). Mutagenicity of aristolochic acid in the Lambda/lacZ transgenic mouse (MutaTMMouse). Mutat. Res. 515, 63-72. doi: 10.1016/S1383-5718(01)00350-3.
56. Kong, J. M., Goh, N. K., Chia, L. S., and Chia, T. F. (2003). Recent advances in traditional plant drugs and orchids. Acta Pharm. Sin. 24, 7-21.
57. Lai, M. N., Wang, S. M., Chen, P. C., Chen, Y. Y., and Wang, J. D. (2010). Population-based case-control study of Chinese herbal products containing aristolochic acid and urinary tract cancer risk. J. Natl. Cancer Inst. 102, 179-186. doi: 10.1093/jnci/djp467.
58. Lee, T. Y., Wu, M. L., Deng, J. F., and Hwang, D. F. (2002). High-performance liquid chromatographic determination for aristolochic acid in medicinal plants and slimming products. J. Chromatogr. B Analyt. Technol. Biomed. Life Sci. 766, 169-174. doi: 10.1016/S0378-4347(01)00416-9.
59. Li, P. C., Lam, E., Roos, W. P., Zdzienicka, M. Z., Kaina, B., and Efferth, T. (2008). Artesunate derived from traditional Chinese medicine induces DNA damage and repair. Cancer Res. 68, 4347-4351. doi: 10.1158/0008-5472.CAN-07-2970.
60. Lin, C. C., Phua, D. H., Deng, J. F., and Yang, C. C. (2011). Aconitine intoxication mimicking acute myocardial infarction. Hum. Exp. Toxicol. 30, 782-785. doi: 10.1177/0960327110385960.
61. Liu, Q., Zhuo, L., Liu, L., Zhu, S., Sunnassee, A., Liang, M., et al. (2011). Seven cases of fatal aconite poisoning: forensic experience in China. Forensic Sci. Int. 212, e5-e9. doi: 10.1016/j.forsciint.2011.05.009.
62. Lord, G. M., Tagore, R., Cook, T., Gower, P., and Pusey, C. D. (1999). Nephropathy caused by Chinese herbs in the UK. Lancet 354, 481-482. doi: 10.1016/S0140-6736(99)03380-2.
63. Moawad, F. J., Hartzell, J. D., Biega, T. J., and Lettieri, C. J. (2006). Transient blindness due to posterior reversible encephalopathy syndrome following Ephedra overdose. South Med. J. 99, 511-514. doi: 10.1097/01.smj.0000215739.90211.3b.
64. Mukherjee, P. W. (2002). Quality Control of Herbal Drugs: An Approach to Evaluation of Botanicals. New Delhi, India: Business Horizons Publishers.
65. Nag, S. A., Qin, J. J., Wang, W., Wang, M. H., Wang, H., and Zhang, R. (2012). Ginsenosides as anticancer agents: in vitro and in vivo activities, structure-activity relationships, and molecular mechanisms of action. Front. Pharmacol. 3:25. doi: 10.3389/fphar.2012.00025.
66. National Toxicology Program. (2012). NTP toxicology and carcinogenesis studies of Ginkgo biloba extract (CAS No. 90045-35-6) in F344/N rats and B6C3F1 mice (Feed Studies). Natl. Toxicol. Prog. Tech. Rep. Ser. 578, 1-224.
67. National Institute of Health (NIH) Office of Dietary Supplements. (2011). Kava. Available at: http://ods.od.nih.gov/Health_Information/kava.aspx. [accessed August 2013].
68. Nissen, N. (2010). Practitioners of Western herbal medicine and their practice in the UK: beginning to sketch the profession. Complement. Ther. Clin. Pract. 16, 181-186. doi: 10.1016/j.ctcp.2010.06.001.
69. Nortier, J. L., Martinez, M. C., Schmeiser, H. H., Arlt, V. M., Bieler, C. A., Petein, M., et al. (2000). Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N. Engl. J. Med. 342, 1686-1692. doi: 10.1056/NEJM200006083422301.
70. Pal, S. K., and Shukla, Y. (2003). Herbal medicine: current status and the future. Asian J. Cancer Prev. 4, 281-288.
71. Parle, M., and Bansal, N. (2006). Herbal medicines: are they safe? Nat. Prod. Rad. 5, 6-14.
72. Raynor, D. K., Dickinson, R., Knapp, P., Long, A. F., and Nicolson, D. J. (2011). Buyer beware? Does the information provided with herbal products available over the counter enable safe use? BMC Med. 9:94. doi: 10.1186/1741-7015-9-94.
73. Reed, C. J. (1993). Drug metabolism in the nasal cavity: relevance to toxicology. Drug Metab. Rev. 25, 173-205. doi: 10.3109/03602539308993975.
74. Reginster, F., Jadoul, M., and van Ypersele de Strihou, C. (1997). Chinese herbs nephropathy presentation, natural history and fate after transplantation. Nephrol. Dial. Transplant. 12, 81-86. doi: 10.1093/ndt/12.1.81.
75. Rey, J. M., and Walter, G. (1998). Hypericum perforatum (St John's wort) in depression: pest or blessing? Med. J. Aust. 169, 583-586.
76. Rietjens, I. M., Martena, M. J., Boersma, M. G., Spiegelenberg, W., and Alink, G. M. (2005). Molecular mechanisms of toxicity of important food-borne phytotoxins. Mol. Nutr. Food Res. 49, 131-158. doi: 10.1002/mnfr.200400078.
77. Roberts, J. E., and Tyler, V. E. (1997). Tyler's Herbs of Choice. The Therapeutic Use of Phytomedicinals. New York: The Haworth Press.
78. Rodrigues, E., and Barnes, J. (2013). Pharmacovigilance of herbal medicines: the potential contributions of ethnobotanical and ethnopharmacological studies. Drug Saf. 36, 1-12. doi: 10.1007/s40264-012-0005-7.
79. Rose, K. D., Croissant, P. D., Parliament, C. F., and Levin, M. B. (1990). Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: a case report. Neurosurgery 26, 880-882. doi: 10.1227/00006123-199005000-00026.
80. Rosenblatt, M., and Mindel, J. (1997). Spontaneous hyphema associated with ingestion of Ginkgo biloba extract [letter]. N. Engl. J. Med. 336, 1108. doi: 10.1056/NEJM199704103361518.
81. Routledge, P. A. (2008). The European Herbal Medicines directive: could it have saved the lives of Romeo and Juliet? Drug Saf. 31, 416-418. doi: 10.2165/00002018-200831050-00006.
82. Rowin, J., and Lewis, S. L. (1996). Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology 46, 1775-1776. doi: 10.1212/WNL.46.6.1775.
83. Schmeiser, H. H., Bieler, C. A., Wiessler, M., van Ypersele de Strihou, C., and Cosyns, J. P. (1996). Detection of DNA adducts formed by aristolochic acid in renal tissue from patients with Chinese herbs nephropathy. Cancer Res. 56, 2025-2028.
84. Schneck, C. (1998). St. John's wort and hypomania. J. Clin. Psychiatry 59, 689. doi: 10.4088/JCP.v59n1208d.
85. Schoepfer, A. M., Engel, A., Fattinger, K., Marbet, U. A., Criblez, D., Reichen, J., et al. (2007). Herbal does not mean innocuous: ten cases of severe hepatotoxicity associated with dietary supplements from Herbalife products. J. Hepatol. 47, 521-526. doi: 10.1016/j.jhep.2007.06.014.
86. Sells, D. M., Brix, A. E., Nyska, A., Jokinen, M. P., Orzech, D. P., and Walker, N. J. (2007). Respiratory tract lesions in non-inhalation studies. Toxicol. Pathol. 35, 170-177. doi: 10.1080/01926230601059969.
87. Sidorenko, V. S., Yeo, J. E., Bonala, R. R., Johnson, F., Scharer, O. D., and Grollman, A. P. (2012). Lack of recognition by global-genome nucleotide excision repair accounts for the high mutagenicity and persistence of aristolactam-DNA adducts. Nucleic Acids Res. 40, 2494-2505. doi: 10.1093/nar/gkr1095.
88. Skoulidis, F., Alexander, G. J., and Davies, S. E. (2005). Ma Huang associated acute liver failure requiring liver transplantation. Eur. J. Gastroenterol. Hepatol. 17, 581-584. doi: 10.1097/00042737-200505000-00017.
89. Sparreboom, A., Cox, M. C., Acharya, M. R., and Figg, W. D. (2004). Herbal remedies in the United States: potential adverse interactions with anticancer agents. J. Clin. Oncol. 22, 2489-2503. doi: 10.1200/JCO.2004.08.182.
90. Stengel, B., and Jones, E. (1998). End-stage renal insufficiency associated with Chinese herbal consumption in France. Nephrologie 19, 15-20.
91. Studdert, D., Eisenberg, D., Miller, F., Curto, D., Kaptchuk, T., and Brennan, T. (1998). Medical malpractice implications of alternative medicine. J. Am. Med. Assoc. 280, 1610-1615. doi: 10.1001/jama.280.18.1610.
92. Tai, Y. T., But, P. P., Young, K., and Lau, C. P. (1992). Cardiotoxicity after accidental herb-induced aconite poisoning. Lancet 340, 1254-1256. doi: 10.1016/0140-6736(92)92951-B.
93. Tanaka, A., Nishida, R., Sawai, K., Nagae, T., Shinkai, S., Ishikawa, M., et al. (1997a). Traditional remedy induced Chinese herbs nephropathy showing rapid deterioration of renal function. Nihon Jinzo Gakkai Shi 39, 794-797.
94. Tanaka, A., Shinkai, S., Kasuno, K., Maeda, K., Murata, M., Seta, K., et al. (1997b). Chinese herbs nephropathy in the Kansai area: a warning report. Nihon Jinzo Gakkai Shi 39, 438-440.
95. U.S. Food and Drug Administration. (2002). Kava-Containing Dietary Supplements May Be Associated with Severe Liver Injury. Available at: http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm085482.htm [accessed August 2013].
96. U.S. Food and Drug Administration. (2011). Regulatory Framework of DSHEA of 1994. Available at: http://www.fda.gov/NewsEvents/Testimony/ucm115163.htm [accessed August 2013].
97. U.S. Food and Drug Administration. (2012). Dietary Supplement Health and Education Act of 1994. Available at: http://www.fda.gov/RegulatoryInformation/Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/ucm148003.htm [accessed August 2013].
98. UNESCO. (2013). Report of the International Bioethics Committee on Traditional Medicine Systems and their ethical implications. SHS/EGC/IBC-19/12/3 Rev. Paris, 8 February.
99. Vale, S. (1998). Subarachnoid haemorrhage associated with Ginkgo biloba [letter]. Lancet 352, 36. doi: 10.1016/S0140-6736(05)79516-7.
100. van Ypersele de Strihou, C. (1995). An EDTA registry for the year 2000? Nephrol. Dial. Transplant. 10, 432-433.
101. Vanhaelen, M., Vanhaelen-Fastre, R., But, P., and Vanherweghem, J. L. (1994). Identification of aristolochic acid in Chinese herbs. Lancet 343, 174. doi: 10.1016/S0140-6736(94)90964-4.
102. Vanherweghem, J. L., and Degaute, J. P. (1998). The policy of admission to the education in medicine and dentistry in the French-speaking community of Belgium. Acta Clin. Belg. 53, 2-3.
103. Vanherweghem, J. L., Tielemans, C., Abramowicz, D., Depierreux, M., Vanhaelen-Fastre, R., Vanhaelen, M., et al. (1993). Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Lancet 341, 387-391. doi: 10.1016/0140-6736(93)92984-2.
104. Varlibas, F., Delipoyraz, I., Yuksel, G., Filiz, G., Tireli, H., and Gecim, N. O. (2009). Neurotoxicity following chronic intravenous use of "Russian cocktail". Clin. Toxicol. 47, 157-160. doi: 10.1080/15563650802010388.
105. Verduin, M. L., and Labbate, L. A. (2002). Psychosis and delirium following metabolife use. Psychopharmacol. Bull. 36, 42-45.
106. WHO. (2002a). WHO Monographs on Selected Medicinal Plants, Vol. 2. Geneva, Switzerland: World Health Organization.
107. WHO. (2002b). Traditional Medicine Strategy (2002-2005). WHO/EDM/TRM/2002.1. Geneva, Switzerland: World Health Organization.
108. WHO. (2003). WHO Guidelines on Good Agricultural and Collection Practices (GACP) for Medicinal Plants. Geneva, Switzerland: World Health Organization.
109. WHO. (2004). WHO Guidelines on Safety Monitoring of Herbal Medicines in Pharmacovigilance Systems. Geneva, Switzerland: World Health Organization.
110. WHO. (2005a). "WHO global atlas of traditional, complementary and alternative medicine," in Map Volume, eds C. K. Ong, G. Bodeker, C. Grundy, G. Burford, and K. Shein (Geneva, Switzerland: World Health Organization).
111. WHO. (2005b). National Policy on Traditional Medicine and Regulation of Herbal Medicines. Report of a World Health Organization Global Survey. Geneva, Switzerland: WHO.
112. Wong, A. H. C., Smith, M., and Boon, H. S. (1998). Herbal remedies in psychiatric practice. Arch. Gen. Psychiatry 55, 1033-1044. doi: 10.1001/archpsyc.55.11.1033.
113. Xu, T. X., Liang, X. L., and Lu, Z. (2005). Prevention and management of Aconitum poisoning. Henan Trad. Chin. Med. 25, 65.
114. Yang, H. Y., Wang, J. D., Lo, T. C., and Chen, P. C. (2009). Increased mortality risk for cancers of the kidney and other urinary organs among Chinese herbalists. J. Epidemiol. 19, 17-23. doi: 10.2188/jea.JE20080035.
115. Yang, S. S., Chu, P., Lin, Y. F., Chen, A., and Lin, S. H. (2002). Aristolochic acid-induced Fanconi's syndrome and nephropathy presenting as hypokalemic paralysis. Am. J. Kidney Dis. 39, E14. doi: 10.1053/ajkd.2002.31425.
116. Zeil, H. (1999). Complementary alternative medicine boon or boondoggle. Skeptic 7, 86-90.
117. Zhang, L., Yan, J., Liu, X., Ye, Z., Yang, X., Meyboom, R., et al. (2012). Pharmacovigilance practice and risk control of traditional Chinese medicine drugs in China: current status and future perspective. J. Ethnopharmacol. 140, 519-525. doi: 10.1016/j.jep.2012.01.058.
118. Zhang, Y., Huang, F., Wu, D., and Zhang, M. (2008). Hepatotoxicity of Flos Farfarae and the contained alkaloid to mice. Lishizhen Med. Mater. Med. Res. 19, 1810-1811.
119. Zhang, Z. J., Ye, F., Wiseman, N., Mitchell, C., and Lun, S. H. (1999). On Cold Damage Paradigm Publications. Brookline, MA: Paradigm.
120. Zhou, J., Ouedraogo, M., Qu, F., and Duez, P. (2013). Potential genotoxicity of traditional Chinese medicinal plants and phytochemicals: an overview. Phytother. Res. doi: 10.1002/ptr.4942 [Epub ahead of print].
121. Zhou, S., Koh, H. L., Gao, Y., Gong, Z. Y., and Lee, E. J. (2004). Herbal bioactivation: the good, the bad and the ugly. Life Sci. 74, 935-968. doi: 10.1016/j.lfs.2003.09.035.