Introduction:

Natural medicine or Alternative Medicine or the field of Naturopathy with their widespread health food stores that have filled up the shelves of pharmacies as well is based on the propaganda that medications are chemicals and unsafe and their own products natural and safe. The field of naturopathy and the natural or herbal medicines that have dominated the health products market and sell more than prescription medicines, is solely based on the notion that the prescribed medications are chemicals and theirs are not. The irony is that everything is chemical, the oxygen in the air that we breath (O2), the water that we drink (H2O), and all the food that we eat, and so on.

In fact the prescribed medications that are nowadays synthesized in pharmaceutical factories have been originally made out of plants, e.g. Digoxin for heart attacks, Atropine for pupillary dilatation and else, Codeine for pain relief, L-Dopa for treatment of Parkinson’s, Aspirin, Quinidine an anti-arrhythmic, Reserpine a hypotensive, Theophylline a diuretic, and Yohimbine an aphrodisiac among so many others. Investing and profiting from the popular lack of sufficient knowledge and also the mass suggestibility, the field of alternative medicine has gone so far that simple food items such as garlic, cranberry and fish oils have nowadays been packaged in capsules, tablets and sold to consumers (1-2).

Although the science of Medicine originated from the herbs and plants, it was not until the modern era that the real based evidence medicine as we know it developed a competitor as “alternative medicine” to promote the use of natural medicine and other forms of healings. This alternative medicine or “naturopathy” from the start by the Bavarian priest Sebastian Kneipp in late 19^th century to Benedict Lust, the founder of naturopathy in US, started their propaganda against evidence-based or real medicine and medications, including vaccinations even in children and against killing infections such as small pox or chicken pox. Although naturopathy or alternative medicine cover an extensive area and different treatment modalities, e.g. acupuncture, aromatherapy, massage therapy, Chinese medicine, homeopathy, herbology, reflexology, Reiki and chiropractic, the focus here will be on the promotion of the use of natural or herbal medicines, vitamins, minerals and supplements that have become a huge profit making business and available everywhere even on the shelves of pharmacies and grocery stores (3).

 The efficacy and safety of herbal medicines:

In argument against the core of natural or herbal medicine that they are natural and safe while prescription medicines are not, there are numerous studies across the globe demonstrating evidence to the contrary. It is well known even to the lay people that one could get poisoned by food, consuming plants or even coming in touch with them. Mushroom poisoning and contact dermatitis by poison ivy are the two very common examples that almost everyone is aware of. A total of 216 medicinal plants belonging to 77 families in North and Central America and Caribbean have been reported as toxic. These herbal medicines and alike that have been promoted and used for different illnesses such as rheumatism, wound healing, flu, headache, dysentery, gastritis, constipation, diarrhea, body pains, cancer, antiseptic, digestive, diuretic, fever, infections, menopause, dysmenorrhea, postpartum, diabetes, asthma, anemia, inflammation, muscle relaxant, hair loss, seizures, hypertension, anxiety, depression, psychosis, weight loss or simply to purify body and the blood, have been reported to cause many side-effects and toxicities (4).

The list of these untoward effects and toxicities like the claimed positive effects are numerous, e.g. nephrotoxicity (toxicity of kidneys), hepatotoxicity ((toxicity of liver), dermatitis, hypertension, nausea, vomiting, diarrhea, muscle paralysis, cardiotoxicity (toxicity of heart), gastritis, even being carcinogenic, sleepiness, muscle paralysis, respiratory failure, neurotoxicity (toxicity of nerves and central nervous system), causing abortions, hallucinations (hearing voices or seeing visions), edema (swelling), hemorrhage, blurred vision, vertigo, stupor, confusion, being narcotic and addictive among others (5-16).

Other than the above gross and obvious toxicities, the herbal medicines could caused molecular and cellular toxicities (cytotoxicity), even mutagenicity and genotoxicity (causing gene mutations and toxicities). Some herbal medicines could also cause toxicities during pregnancy and reproduction and cause abortions. These facts are only the tip of the iceberg of the possible side-effects and toxicities of the herbal medicines as most people do not report to their physicians and refer to emergency rooms of hospitals when intoxicated. Moreover there are untoward interactions of the herbal or natural medicines with the prescription medications that again many patients do not report to their physicians or pharmacies when use these products in addition to their prescribed medications (17-20).

 The case of naturopathy or homeopathy and their broad advertisements in media, specially in social media, TV, and many journals are beyond control. Nowadays to skip the drug agency controls, many of these products are offered in the common food products such as drinks, teas and even candies and other snacks. Moreover the health benefits of certain herbs, vegetables, plants and food as simple as garlic or fish oil have been exaggerated and they have been produced and released into tablets, capsules and sold in the market at a much higher prices, instead of promoting these basic food items in meals. These propagandas have been at the cost of advertising against the consumption of some food health promoting foods that nowadays are missing from many people’s diet such as dairy products, eggs, lipids, red meat and fruits (21-22).

 Moreover there are interactions between the prescribed medications and the herbal medicines that are often ignored by the patients, never questioned by the health food stores who are not experts in such area of medicine and skipped from the inquiries by physicians. Since many consumers of naturopathic and herbal medicines are already on prescribed medications and probably of middle to old age, the risk of interactions with their prescribed medicines and also the possibility of side-effects, specially on their liver and kidneys that could be already somewhat compromised is multifold (23-25). The side-effects and untoward drug-drug interactions are not just limited to the uncommon herbal medicines, but with very common ones found in every drug stores. These include but not limited to the common herbal medicines such as Gingko Biloba, Echinacea, Kava Kava, Ginseng, etc. (26-40). Some examples of the toxic effects of the common herbal medicines are hepatotoxicity of Gingko, muscular paralysis, manic and psychosis-induction, anaphylactic reaction, shock, and cardiac toxicities of Ginseng (26-40).             

  What about Vitamins: Are they good?

Vitamins that are essential micronutrients and needed for the different vital functions of the organism such as humans are supplemented in foods and are needed in minute amounts. Therefore if the individual’s intake of essential foods, specially fruits and vegetables are sufficient, the person would not need to take extra supplement of vitamins. A list of different essential vitamins, their functions and food source is as follow:

1-Vitamin A: is a fat soluble vitamin and is essential in vision and skin health and is available from animal meat specially fish, liver, dairy products, vegetables and fruits such as carrots, orange, pumpkin, squash and spinach.

2-Vitamin B1: or Thiamine is water soluble and is essential for many vital functions of the body such as cardiovascular, nervous systems and vision and is available in the pork meat, oatmeal, brown rice, vegetables, potatoes, liver and eggs.

3-Vitamin B2: or Riboflavin is water soluble and is an important co-factor for many enzymes and other vitamins in the body and important for the cornea of the eyes and mucosa of the mouth. It is available in dairy products, bananas, green beans and asparagus.

4-Vitamin B3: or Niacin is water soluble and is essential for a healthy skin, digestive nervous systems and is available in meat, specially fish, eggs, vegetables, mushrooms and nuts.

5-Vitamin B5: or Pantothenic acid is water soluble and is essential for synthesis of co-enzyme A, and also for metabolism of fat, proteins and carbohydrates. It is available in meat, broccoli, and avocados.

6-Vitamin B6: or Pyridoxine is water soluble and is essential in red blood cells, metabolic and nervous systems and is available in meat, vegetables, nuts and bananas.

7-Vitamin B7: or Biotin is water soluble and is essential in the skin health and GI system and in utilization of fat, proteins and carbohydrates. It is available in raw egg yolk, liver, peanuts, and leafy green vegetables.     

8-Vitamin B9: Folic acid or Folate is water soluble and is essential in red blood cells and in the fetal development and is available in leafy vegetables, past, bread, cereal and liver.

9-Vitamin B12: or Cyanocobalamine is water soluble and is essential in red blood cells and other cells and is available in meat, poultry, fish, eggs and milk.

10-Vitamin C: or Ascorbic acid is water soluble and is essential for repair of tissues and enzymatic production of certain neurotransmitters and is available in many fruits specially the citrus group, vegetables and liver.

11-Vitamin D: or Cholecalciferol (D3) and Ergocalciferol (D2) is fat soluble and essential in calcium synthesis, hence the solidarity of the skeletal system. It is biologically inactive in diet and needs the UV light from sun exposure to become active in the body through synthesis in the skin. It is synthesized from cholesterol and is available in lichen, eggs, liver, sardines, and some mushrooms such as shiitake.

12-Vitamin E: or Tocopherols is fat soluble essential for enzymatic liver functions and is available in many fruits and vegetables, nuts, seeds and seed oils.

13-Vitamin K: or Phylloquinone/Menaquinones is fat soluble and is essential for blood coagulation and is available in leafy green vegetables such as spinach, egg yolks and liver (41-46).

 All the vitamins as mentioned above are needed in small amounts in micro and a few milligrams that mostly are available in the usual foods, if not avoided or restricted seriously. Taking supplementary extra vitamin pills could be non-beneficial or at worse lead to hypervitaminosis and serious problems as follow:

Hypervitaminosis A: Abnormal softening of the bones with pain and/or swelling; Blurred vision; changes in consciousness; decrease appetite; dizziness; double vision; drowsiness; headache; hypercalcemia; cerebral edema and increased intracranial pressure; liver damage; irritability; nausea; skin and hair changes; cracking at the corners of the mouth; hair loss; higher sensitivity to sunlight; oily skin and hair; premature epiphyseal closure and slowed growth; skin peeling and itching; spontaneous fracture; yellow discoloration of the skin and vomiting (47-53).

Hypervitaminosis B1 (Thiamine): Drowsiness and muscle relaxation (54).

Hypervitaminosis B3 (Niacin): Liver damage (54).

Hypervitaminosis B5 (Panthothenic acid): Diarrhea; nausea and heartburn (54).

Hypervitaminosis B6 (Pyridoxine): Nerve damage, impairment of proprioception (54).

Hypervitaminosis B9 (Folate, Folic acid): may mask symptoms of Vitamin B 12 deficiency (54).

Hypervitaminosis D: Dehydration; vomiting, diarrhea; decreased appetite; irritability; constipation; fatigue; muscle weakness, metastatic calcification of the soft tissues (55-58).

Hypervitaminosis E: Possible increased incidence of congestive heart failure (59).

Hypervitaminosis K: Decreased anticoagulation effect of warfarin (60).

 Minerals and other supplements:

Minerals such as calcium, potassium, sodium, phosphorous, iron, zinc, magnesium, and iodine among others that are again available in sufficient required amount in foods, but have been commercialized and sold in pills on every pharmacy and grocery stores’ shelves. Excessive and unnecessary intake of some of these minerals could cause the following health problems:

Hypercalcemia: Excessive intake of calcium or vitamin D could cause excess of calcium in the blood and other parts of the body and lead to calcification of soft tissues, loss of elasticity of vascular walls, formation of calcium plaques in the vessel walls, and disruption of blood flow, plaque rapture, thrombosis, increased risk of myocardial infarction and other cardiovascular and cerebrovascular events, and kidney stones among others (61).

Hyperkalemia: High serum level of potassium may cause life-threatening cardiac arrhythmias, muscle weakness or paralysis (62).

Hypernatremia: High blood level of sodium that could happen by high intake of table salt that is sodium chloride would cause increase thirst, weakness, nausea, loss of appetite, hypertension, confusion, muscle twitching, and cerebral hemorrhage (63).

Hyperphosphatemia: Phosphorous that is needed in tiny amount in any living organism for the formation and function of DNA & RNA could be very toxic in more than needed dose and cause nerve damages. It is mostly occurs in the cases of renal failure and diabetic ketoacidosis, but rarely could happen due to high dietary supplement intake or by inhalation through the use of fertilizers and pesticides that contain phosphorous (64).  

Zinc Toxicity: High level of zinc in the body could lower the serum iron level, and also could cause nausea, vomiting, cramps and diarrhea.

Hypermagnesemia: High serum level of magnesium could cause weakness, confusion, lower breathing rate, reflexes, blood reflexes and even cardiac arrest.

 Conclusion:

Natural medicine despite its commercialization and propaganda by their producing companies and misconceptions of the lay people are chemicals and are not devoid of side- and toxic-effects. Their use basically and in majority have not been tested scientifically and medically in controlled studies as prescription medications are and there are no safeguard and insurance and assurance if they do not work and causing untoward even life-threatening consequences. Therefore the consumers take the natural or herbal medicine purely at their own risk. Even the vitamins and minerals that are vital for the function of the body organs and cells, when taken as supplement and in excess could lead to untoward and even toxic effects as somewhat detailed in this paper. In brief the health of people should not be a subject of profit making and regulatory agencies need to step in and regulate the naturopathy and their products that are not controlled and act like the wild wild west.    

Dr. Mostafa Showraki, MD, FRCPC,  Lecturer, School of Medicine, University of Toronto, Author: ADHD: Revisited Book, Adhdrevisited.com/medicinerevisited.com      

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