Herbal products are widely used throughout the world. For marketing authorisation, regulatory bodies in certain countries may require that herbal products meet acceptable standards of quality, safety and efficacy. In general, the use of herbal products does not pose a significant risk to human health. However, with the widespread and increasing use of traditional medicines (TM) and complementary and alternative medicine (CAM), there are safety concerns which need to be addressed. This was highlighted in the WHO Traditional Medicine Strategy 2002-2005 report:
- The use of TM/CAM is increasing rapidly in developing countries. In many parts of the world, policy makers, health professionals and the public are wrestling with questions about the safety, quality, availability, preservation and further development of this type of health care.
- Although many TM/CAM therapies have many promising potential, and are increasingly used, many of them are untested and their use are not monitored. As a result, knowledge of their potential side effects is limited. This makes identification of the safest and most effective therapies and promotion of their rational use more difficult. If TM/CAM is to be promoted as a source of healthcare, efforts must be made to promote its rationale use, and identification of the safest and most effective therapies will be crucial.
The notion that herbal products are ‘natural’ and thus safe is quite misleading. Herbs contain chemical compounds in different proportions and mixtures, thus their ability to interact with other chemicals present in allopathic drugs and also with the chemicals present in other herbs need to be investigated and documented. There is also a need to investigate interactions that may occur in people with certain disease states (chronic diseases, for example, hypertension, diabetes, ulcer, asthma) or certain conditions, for example; pregnancy, lactation/breast feeding, the peri-operative stage, and certain age groups, for example; geriatrics and pediatrics, may be predisposed to the adverse effects of herbs used. These interactions have been reported for certain herbs and need to be documented and further investigated.
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