Complementary & Alternative Medicine for Women
Ask the Expert: Commonly Asked Questions & Answers about Complementary & Alternative Medicine
Volume
29
Number 4
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Q.
How safe and effective are herbal remedies and nutritional
supplements? Is there any government oversight?
A. When it comes to herbal remedies and nutritional supplements, it is very much a "buyer beware" market. Unlike prescription or over-the-counter drugs, manufacturers of nutritional supplements and herbal remedies do not have to prove their products are effective. They also do not have to prove their products are safe. The U.S. Food and Drug Administration (FDA) can only take action against a manufacturer if it finds a supplement is unsafe once the product is on the market.
Soon, however, the FDA will
have oversight over manufacturing
processes for supplements to
ensure they are produced in a
quality manner, do not contain
contaminants or impurities and
are accurately labeled. In addition,
by the end of the year, the supplement
industry will be required
to report all serious dietary supplement-
related adverse events to
the FDA, something it hasn't had
to do previously.
—Pamela Peeke, MD
NWHRC Medical Advisor
Assistant Clincial Professor of Medicine
University of Maryland
Baltimore, MD
A. We are only now beginning
to build a record of scientific
evidence for many CAM modalities.
But it is often difficult to
test CAM therapies using the
medical gold standard of a
randomized, double-blind, placebo-
controlled trial. It's hard to
standardize the ingredients being
tested, to come up with adequate
"sham" techniques and to isolate
just one treatment since CAM
therapies are often provided
simultaneously to complement
and balance each other. However,
many of these therapies have
been used for thousands of
years and are much less likely
to cause harm when used as
directed than many prescription
products.
—Victoria Maizes, MD
Executive Director
University of Arizona
Program in Integrative Medicine
Tucson, AZ
A. Yes, there are a number of
nutritional supplements and
herbal remedies a pregnant or
nursing mother may take. The
most common is a well-rounded
prenatal vitamin containing folic
acid and other B vitamins, important
in reducing the risk of neural
tube defects in the fetus, such as
spina bifida. The second thing I
recommend is a mercury-free
source of fish oil to provide DHA,
an omega-3 fatty acid. DHA is
involved in the brain and eye
development of the fetus. While
there are other supplements and
herbs that a pregnant or lactating
woman can safely take, it is
best to work with an experienced
health care provider who
is familiar with herbs and other
supplements and their safety
during this stage of life.
—Barbara Lawson Boston, NP, IBCLC,
Center for Integrative Medicine
Washington, DC
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