Herbal supplements come under the gun

Doctors applaud Europe's call for warning labels on St. John's wort, and the Food and Drug Administration moves on kava kava.

By Victoria Stagg Elliott, AMNews staff. March 4, 2002.

The news is enough to make purveyors of kava kava and St. John's wort anxious and depressed, but it's putting some pep in the steps of physicians. The U.S. government and others are increasing their scrutiny of the largely chaotic world of herbal dietary supplements.

The Food and Drug Administration wants to hear from physicians about adverse events among patients related to kava's use.

Elsewhere, Sweden is now requiring warning labels on St. John's wort about the possibility that it causes the birth control pill to fail. Several European countries have banned kava.

Physicians on all sides of the debate about complementary and alternative medicine generally applauded the governments' moves. But many said the steps don't go far enough. Some want more accessible education for both consumers and physicians. Many doctors, however, want much more regulation and, at the very least, more information on supplements' labels to bring them in line with those on pharmaceuticals.

Tim Gorski, MD, points to St. John's wort. In addition to interfering with the birth control pill, the herb is suspected by some of interfering with HIV medicines, transplant drugs and anti-depressants.

The warning label in Sweden "is a great idea, but it doesn't go far enough," said Dr. Gorski, associate clinical professor of obstetrics and gynecology at the University of North Texas Health Science Center in Fort Worth. "St. John's wort is very obviously something that's being taken as a medication ... and the idea that this is a 'supplement to the diet' and should be regulated any differently from Prozac or the rest of them is ridiculous." [...]