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Patients, Beware: All-Natural Products May Not Be All-Safe

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By RAO MUSUNURU

For The Tampa Tribune

Published: October 5, 2008

My wife of 33 years reminds me almost on a daily basis of all the things I do not do. I am not referring to the responsibilities involving housework, shopping, temple visits or social life. I'm talking about her advice about my health: how I do not drink enough water, how I do not take enough antioxidants, how I find excuses not to go to yoga classes, how I do not eat enough organic stuff, etc. Never mind that I went through rigorous medical training for 13 years and have been practicing medicine for another 27 years and have received national awards for preaching prevention. She has all the answers for all my problems - tiredness, aches and pains, allergies and losing hair. I can imagine the pressures other people must be under from friends, families, claims and commercials to lead a "natural, safe and organic life."
Complementary and alternative medicine has a definite and important role in the prevention and treatment of many diseases when utilized appropriately and is being gradually integrated into mainstream allopathic medicine. It is especially attractive for patients suffering from chronic diseases, because of the frustration from inadequate relief from symptoms in spite of multiple prescription medications. The prohibitive cost of prescription medications, marked up by the pharmaceuticals motivated by the profits, does not help.

Use of "over-the-counter natural products" constitutes one of the common forms of complementary and alternative medicine. Patients tend to take them without informing their physicians for fear of offending their respected doctor or because of the patient's unwillingness to stop. Other reasons could be either the physician is not making the extra effort to seek out this information from the patients or that patients simply are not seeing any need to bother their physicians about their consumption of natural and, thus, safe products. Patients who cannot afford to buy prescription medications many times manage to find money to buy and take several of these "natural" products.

It is a common misconception that all the "natural" products sold in the stores or on the Internet are safe and healthful. All-natural may not be all-safe. For example, compounds such as nicotine, opium, lead, mercury and arsenic are natural but definitely not safe. Many of the natural products sold for health benefits are not strictly controlled by the government agencies such as the Food and Drug Administration. Different brands of the same compound manufactured by different companies are not calibrated to the same dose or strength. They usually do not undergo rigorous clinical trials to assess their efficacy, and more importantly, their safety.

There may not be adequate quality control to safeguard against contaminants. Many times their advertisements are not screened for accountability or accuracy, and their claims may not be substantiated. The companies that manufacture health or natural supplements can be driven by the same greed as the pharmaceuticals manufacturing the prescription medications.

Some of these "natural" compounds have similar chemicals as their prescription counterparts - for example, the natural red yeast rice and the prescription statin drug for control of elevated cholesterol. Patients most of the time do not inform their physicians about the use of these competing, complementary, maybe even contradicting chemicals, as they are "natural." So, the patients are not monitored for the total dosage, side effects (for example, affecting the liver or kidneys) and interactions with other medications (for example, patients taking blood thinners such as Coumadin). Those side effects may ultimately lead to unintended, serious, life-threatening consequences.

Weight control products are among the commonly marketed natural compounds. Unless a person has one of the rare specific medical conditions contributing to obesity, being overweight is simply the result of excess calorie intake in relation to energy expenditure. The body stores excess calories as fat whether consumed in the form of carbohydrates, fats or protein. Healthy lifestyle changes, such as controlled eating and a regular exercise regimen, should be the main strategy for weight control.

Also, there is no end to the marketing of "anti-aging" products. Aging is a normal and natural process of human development. One has to count his or her blessings for the good fortune of aging, as the only definitive anti-aging intervention is death, which obviously is not desirable. The goal should be "propositive aging" with healthy lifestyle changes, concentrating on the prevention of all the known risk factors that promote the ill effects of aging.

A lot of medications come from nature, but they need to be purified and calibrated. Sometimes they need to be synthesized to produce large quantities and even altered to enhance the desired effect and to reduce the side effects. You can get your own body to produce natural chemicals, some useful and some harmful. For example, a regular exercise program produces good chemicals that are conducive to good health. Physical and mental stress produce chemicals that are destructive and detrimental. Being overweight produces harmful chemicals causing inflammation, for example, heart attacks and some cancers, for example, breast cancer. Fat around the belly is like a chemical factory and is particularly harmful.

Too much of a good thing is not necessarily good, especially in pharmacotherapy. Mega-quantities of even natural vitamins and supplements may not be doing any good other than producing expensive urine, and some may even harm the body organs, such as the liver and kidneys, that are trying to get rid of them.

Consult with your physicians before taking any of the natural products or remedies, including herbal supplements, to evaluate their necessity, efficacy and safety, including the interactions. Even physicians may not have or cannot find adequate information about some of these products. Buyer beware!

The natural adverse effects of some of these natural remedies may involve more than your checkbook. The secret to success is finding the right balance, naturally!

The writer is a cardiologist practicing at Regional Medical Center Bayonet Point in Hudson. He is a current member of Advisory Council for National Heart, Lung and Blood Institute (NHLBI) at the National Institutes of Health.

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