Supplemental side effects from OTC herbs and pills

Sean Henahan Health and Science University. Dr Fraunfelder conducted a review of reported cases of ocular side effects associated with over- the-counter herbal medicine and dietary supplements. He reviewed the literature and collated cases of adverse ocular side effects reported to the WHO, the FDA and the National Registry of Drug-Induced Ocular Side Effects. The review revealed a wide range of ocular side effects, most of which were associated with higher doses. Popular remedies with serious ocular side effects He found that eight products in particular were associated with reports of clinically significant Frederick W Fraunfelder ocular side effects.These were ginkgo biloba, Echinacea purpurea, Courtesy of Frederick W Frauenfelder MD HERBAL products and vitamin Oral consumption of the carotenoid canthaxanthine can lead to deposits of the chemical on the retina, resulting in reduced vision detectable chamomile, liquorice, through visual field testing and electroretinography. pills can have a variety of canthaxanthine, datura, niacin and supplemental ocular side effects vitamin A. ranging from dry eye to retinal "A large segment of the Dr Fraunfelder found reports of datura are also used to treat eye Education Act (DSHEA). The haemorrhage and transient vision population uses herbal medicines severe conjunctivitis when inflammation as well as asthma, relatively lax oversight by the FDA loss, according to Frederick W and dietary supplements, many chamomile was used topically in bronchitis, influenza and coughs. under DSHEA can lead to Fraunfelder MD. times without the treating and around the eyes. Dr Fraunfelder’s survey uncovered unwanted and sometimes "Herbal medicines and physician's knowledge," noted Dr Liquorice is another mainstay several instances of mydriasis, dangerous ocular and systemic nutritional supplements are being Fraunfelder, who also is director on the complementary medicine following use of this substance side effects as well as significant used without strong evidence of of the National Registry of Drug- shelf. It is used to treat upper and recommends caution in interactions with prescription efficacy or safety. Ocular side Induced Ocular Side Effects. respiratory tract infections, ulcers, patient predisposed to narrow drugs.The World Health effects from these products are The herbal product ginkgo appendicitis and constipation. angle glaucoma. Organisation published guidelines often undiagnosed and biloba is one of the best sellers on Native Americans reportedly use Niacin is another product that on the use of herbal medicines in the alternative medicine shelf, liquorice to treat inflammatory most would not normally suspect 2004, including recommendations used to treat everything from eye diseases. Dr Fraunfelder of causing problems. However, it on cultivating, collecting, “Physicians must tinnitus to asthma and tonsillitis. discovered potentially serious caused some of the most severe classification, quality control, Dr Fraunfelder’s review found two ocular side effects reported with ocular reactions of all the storage, labelling and distribution. remain vigilant in cases of hemorrhaging in the what is normally considered an products reviewed. It is a clinically He cautioned that many herbal anterior chamber of the eye as innocuous product, in the form of proven cholesterol-lowering medicines interact with recognising well as reports of retinal transient vision loss. The effects agent. Off-label uses include prescription medicines.Therefore haemorrhages in patients taking following ingestion of large doses everything from schizophrenia and it behoves the treating physician adverse ocular this product. He warned that were similar to the symptoms of diabetes to sexual dysfunction and to inquire what alternative ginkgo biloba inhibits platelet ocular migraine without headache. migraine headaches. Potential products a patient might be side effects and aggregation and should be used Ocular adverse effects can also ocular side effects of niacin taking. with caution by patients taking result from taking canthaxanthine, include decreased vision, cystoid inquiring whether aspirin. a carotenoid used in cosmetics, as macular oedema, dry eyes, Dr Fraunfelder’s review appeared in the Echinacea purpurea is another a food colouring and to produce discoloration of the eyelids, eyelid October 2004 issue of the American Journal of Ophthalmology. a patient is using popular herbal remedy. It is used an artificial suntan when taken oedema and loss of eyebrows and orally. Canthaxanthine eyelashes.The ocular side effects to treat colds, coughs, fevers, as Frederick W Fraunfelder MD alternative well as urinary tract infections, consumption leads to deposits of appear to be dose related, usually [email protected] burns and influenza. He found the chemical in the retina.The occurring with dosages greater therapies," cases of eye irritation and deposits are absorbed over time, than 3.5 grams daily. conjunctivitis associated with but can take years to disappear. ingestion of echinacea. Visual changes from this Lax oversight unreported. Physicians must Chamomile, a popular panacea, nutritional supplement are related Dr Fraunfelder notes that dietary remain vigilant in recognising is used to treat eye disease as well to retinal abnormalities detected supplements are not regulated by adverse ocular side effects and as insomnia, indigestion, migraine with visual field testing and the FDA’s Food Drug and inquiring whether a patient is headaches, bronchitis, fevers, electroretinography. Cosmetic act but instead, using alternative therapies," said colds, inflammation and burns. Datura, also known as Jimson depending upon the products Dr Fraunfelder, assistant professor While there seems to be little Weed is used as a psychoactive disease treatment claims, the of ophthalmology at Oregon harm in drinking chamomile tea, stimulant.The dried leaves of Dietary Supplement and Health

EuroTimes April 2005