Angry Toxicologist

A study this month ($) in Pharmacoepidemiology and Drug Safety (just rolls off the tongue doesn't it?), looked at poison control data during 2001 for two herbal supplements: St. John's wort and Echinacea.

There were 356 contacts for SJW and 406 contacts for Echinacea. That's not what interests me; we know the compounds are bioactive and have toxicities associated with their use (See here for the adverse effects seen from these contacts). SJW is even implicated in suicidal and aggressive thoughts (Nanayakkara et al. 2004. Ned Tijdschr Geneeskd. 149; 1347-1349) and interferes with many prescription drugs, many times limiting the amount of active drug that your body is exposed to. What interests me here is that the percentage of young people experiencing adverse effects was lower than the adults (For Echinacea: 3.4 vs 28.9%; For SJW 14.4 vs 46.4%). Possibilities: 1) Since children's exposures were largely accidental, they took very little compared to the intentional adult exposure. 2) Children who ingest any supplement are more likely to be reported whether they have symptoms or not while adults are more likely to reported only if they take too much or experience adverse effects. 3) Children are less sensitive to Echinacea and SJW (not likely base on current evidence).

It would be useful to run this down to get some firm numbers on adverse reactions of children to herbal supplements (especially those which contain a lot of caffeine like guarana). The poison control center data is well known to underestimate exposure and toxicity due to severe underreporting (even for poisonings leading to death). Additionally, only contacts which Echinacea and SJW were the only associated products were included to keep the analysis clean. The bigger point, however, is that poison control centers get contacts every year (by the numbers, at least a couple a week) about harmful effects of children or adults taking Echinacea or SJW.

So, I know it's legal and natural* but it's not safe; that goes double if you've got kids in the house. Oh, and shouldn't GNC et al. put their snake oil into child safe bottles? Not that they really care about anyone's health anyway, but it's nice to dream.

*I don't consider it natural as it's extracted and processed. It's like saying digoxin is natural becuase of foxglove; or gasoline because of crude oil.