Dangerous supplements, 12 supplements to avoid

In this report: Overview; 12 supplements to avoid; Supplement labels; What you can do

May 2004

Twelve supplements you should avoid

The 12 supplement ingredients in this table have been linked to serious adverse events or, in the case of glandular supplements, to strong theoretical risks. They're all readily available on the Web, where our shoppers bought them both individually and in multi-ingredient “combination products.” We think it's wise to avoid all of them. But the strength of that warning varies with the strength of the evidence and the size of the risk. So we've divided the dirty dozen into three categories: definitely hazardous, very likely hazardous, and likely hazardous.

Name (Also known as)	Dangers	Regulatory actions
DEFINITELY HAZARDOUS Documented organ failure and known carcinogenic properties
Aristolochic acid(Aristolochia, birthwort, snakeroot, snakeweed, sangree root, sangrel, serpentary, serpentaria; asarum canadense, wild ginger). Can be an ingredient in Chinese herbal products labeled fang ji, mu tong, ma dou ling, and mu xiang. Can be an unlabeled substitute for other herbs, including akebia, asarum, clematis, cocculus, stephania, and vladimiria species.	Potenthuman carcinogen; kidney failure, sometimes requiring transplant; deaths reported.	FDAwarning to consumers and industry and import alert, in April 2001. Banned in 7 European countries and Egypt, Japan, and Venezuela.
VERY LIKELY HAZARDOUS Banned in other countries, FDA warning, or adverse effects in studies
Comfrey (Symphytumofficinale, ass ear, black root, blackwort, bruisewort, consolidae radix, consound, gum plant, healing herb, knitback, knitbone, salsify, slippery root, symphytum radix, wallwort)	Abnormalliver function or damage, often irreversible; deaths reported.	FDAadvised industry to remove from market in July 2001.
Androstenedione (4-androstene-3, 17-dione, andro, androstene)	Increased cancer risk, decrease in HDL cholesterol.	FDAwarned 23 companies to stop manufacturing, marketing, and distributing in March 2004. Banned by athletic associations.
Chaparral(Larrea divaricata, creosote bush, greasewood, hediondilla, jarilla, larreastat)	Abnormalliver function or damage, often irreversible; deaths reported.	FDAwarning to consumers in December 1992.
Germander(Teucrium chamaedrys, wall germander, wild germander)	Abnormalliver function or damage, often irreversible; deaths reported.	Bannedin France and Germany.
Kava (Pipermethysticum, ava, awa, gea, gi, intoxicating pepper, kao, kavain, kawa-pfeffer, kew, long pepper, malohu, maluk, meruk, milik, rauschpfeffer, sakau, tonga, wurzelstock, yagona, yangona)	Abnormalliver function or damage, occasionally irreversible; deaths reported.	FDAwarning to consumers in March 2002. Banned in Canada, Germany, Singapore, South Africa, and Switzerland.
LIKELY HAZARDOUS Adverse-event reports or theoretical risks
Bitter orange(Citrus aurantium, green orange, kijitsu, neroli oil, Seville orange, shangzhou zhiqiao, sour orange, zhi oiao, zhi xhi)	Highblood pressure; increased risk of heart arrythmias, heart attack, stroke.	None
Organ/glandular extracts(brain/adrenal/pituitary/ placenta/other gland “substance” or “concentrate”)	Theoretical risk of mad cow disease, particularly from brain extracts.	FDAbanned high-risk bovine materials from older cows in foods and supplements in January 2004. (High-risk parts from cows under 30 months still permitted.) Banned in France and Switzerland.
Lobelia(Lobelia inflata, asthma weed, bladderpod, emetic herb, gagroot, lobelie, indian tobacco, pukeweed, vomit wort, wild tobacco)	Breathing difficulty, rapid heartbeat, low blood pressure, diarrhea, dizziness, tremors; possible deaths reported.	Bannedin Bangladesh and Italy.
Pennyroyaloil(Hedeoma pulegioides, lurk-in-the-ditch, mosquito plant, piliolerial, pudding grass, pulegium, run-by-the-ground, squaw balm, squawmint, stinking balm, tickweed)	Liverand kidney failure, nerve damage, convulsions, abdominal tenderness, burning of the throat; deaths reported.	None
Scullcap(Scutellaria lateriflora, blue pimpernel, helmet flower, hoodwort, mad weed, mad-dog herb, mad-dog weed, quaker bonnet, scutelluria, skullcap)	Abnormalliver function or damage.	None
Yohimbe (Pausinystalia yohimbe, johimbi, yohimbehe, yohimbine)	Changein blood pressure, heart arrythmias, respiratory depression, heart attack; deaths reported.	None

According to product labels.
Sources: Natural Medicines Comprehensive Database 2004 and Consumers Union's medical and research consultants.

Diet & Nutrition