Herb Safety · natural doesn't mean safe

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Milk Thistle
The two ends of herbal safety: in LiverTox, the US database on drug-induced liver injury, milk thistle's likelihood of causing liver injury is rated E (unlikely), while Polygonum multiflorum (he shou wu) is rated A (a well-established cause), with about one in ten clinically apparent cases fatal or needing an urgent liver transplant. Being natural makes something neither safe nor dangerous by itself.

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Why natural doesn't mean safe

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Natural and safe have never been the same thing.

This story is not saying herbs do not work. Quite the opposite. Artemisinin comes from sweet wormwood, and it won Tu Youyou the 2015 Nobel Prize in Physiology or Medicine; aspirin started out as willow bark; digoxin comes from foxglove. There is real medicine in herbs.

But precisely because they do real pharmacology, they can also do real toxicology. A molecule that can change something inside you can change the wrong thing. Where there is a drug effect, there is a toxic effect: that holds for pharmaceuticals, and it holds word for word for herbs. An herb in the body is acting as a drug, and none of the three layers of dose, purity and regulation becomes safe just because it is a plant.

One thing to remember first: while taking any herb, if your skin or the whites of your eyes turn yellow, your urine turns as dark as strong tea, or you have persistent tiredness, nausea or pain in the upper right abdomen, stop the herb and see a doctor right away to have your liver function checked (the chapter How to use herbs more safely covers this).

Educational content, not medical advice — consult a clinician.

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Herb Safety · natural doesn't mean safe

Story

Connected to · 1

contrast · 1

Milk Thistle
The two ends of herbal safety: in LiverTox, the US database on drug-induced liver injury, milk thistle's likelihood of causing liver injury is rated E (unlikely), while Polygonum multiflorum (he shou wu) is rated A (a well-established cause), with about one in ten clinically apparent cases fatal or needing an urgent liver transplant. Being natural makes something neither safe nor dangerous by itself.

Read full story

Stop 1/6

Why natural doesn't mean safe

EVIDENCEGUIDE 1 · REVIEW 2 · COHORT 1

READ THE ORIGINAL

Natural and safe have never been the same thing.

This story is not saying herbs do not work. Quite the opposite. Artemisinin comes from sweet wormwood, and it won Tu Youyou the 2015 Nobel Prize in Physiology or Medicine; aspirin started out as willow bark; digoxin comes from foxglove. There is real medicine in herbs.

But precisely because they do real pharmacology, they can also do real toxicology. A molecule that can change something inside you can change the wrong thing. Where there is a drug effect, there is a toxic effect: that holds for pharmaceuticals, and it holds word for word for herbs. An herb in the body is acting as a drug, and none of the three layers of dose, purity and regulation becomes safe just because it is a plant.

One thing to remember first: while taking any herb, if your skin or the whites of your eyes turn yellow, your urine turns as dark as strong tea, or you have persistent tiredness, nausea or pain in the upper right abdomen, stop the herb and see a doctor right away to have your liver function checked (the chapter How to use herbs more safely covers this).

Educational content, not medical advice — consult a clinician.