Herbal Medicines Use: Remedies or Risks
Article Sidebar
Abstract Views | PDF/EPUB Downloads
0
/ 0
Main Article Content
Abstract
Background: There is an increasing use of herbal products and herbal medicines globally with the belief that herbal medicines are always 'safe' and carry no risk because they are from natural sources. However, there are concerns regarding medicinal plants and their ability to produce adverse effects. The World Health Organization (WHO) directive encourages developing countries to supplement their health programmes with traditional herbal preparations provided they are proven to be non-toxic
Objectives: Some plants and their constituents have been shown to be potentially toxic. In this paper, we review data looking at the benefits and risks of herbal medicines use.
Results: Literature search shows the huge role herbs play in health and wellness as some conventional medicines were originally derived from natural sources. For example, Digitalis, a cardiac glycoside was derived from the foxglove plant (Digitalis purpurea L.); the anticancer drug Vincristine was derived from periwinkle (Cantharnthus rosues Linn. G. Donn); the antidiarrhoeal and narcotic analgesic drugs Codeine, Morphine and paregoric were derived from the opium poppy (Papaver somniferum L.); the antimalarial drugs Quinine and Artemisinin were, respectively, derived from Cinchona pubescens Vahl and Artemisia annua L.Despite the profound therapeutic benefits possessed by medicinal plants, some of them have been found to be toxic to specific organs, mutagenic or teratogenic. Current study revealed that Azadirachta indica, Morinda lucida, and Enantia chlorantha possessed mutagenic potentials in modified Ames assays, while Alstonia boonei induced testicular and kidney damage.
Conclusion: Herbal medicines have significant benefits in health and wellness, but must be cautiously used due to their potentials for toxicity. Overall, the integration of herbal medicine into national healthcare scheme may enhance safe use of herbal remedies via appropriate research, regulation and rational use of herbal medicine.
Downloads
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
How to Cite
Share
References
1. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, and Kessler RC (1998). Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA 280(18): 1569-1575.
2. Hughes EF, Jacobs BP, Berman BM (2005). Complementary and Alternative Medicine: Current Medical Diagnosis and Treatment. Edited by Tierney LM, McPhee SJ and Papadakis MA, pp. 1696-1719.
3. Chizzola R, Michitsch H and Franz C (2003). Monitoring of metallic micronutrients and heavy metals in herbs, spices and medicinal plants from Austria. Eur. Food Res. Technol. 216(5): 407-411.
4. Ehrlich SD (2013). Herbal medicine (University of Maryland Medical Center). Available from: https://www.umm.edu/health/medical/altmed/treatment/herbal-medicine. [Accessed: 30-Nov-2017].
5. Farnsworth N, Akerele O, Bingel A, Soejarta D and Eno Z (1985). Medicinal plants in therapy. Bulletin of the World Health Organization 63: 965-81.
6. WHO (1985). The WHO traditional medicine programme: policy and implementation. Int. Tradit. Med. Newsl., 1: 1-5.
7. WHO (2004). WHO Guidelines on Safety Monitoring of Herbal Medicines in Pharmacovigilance Systems [Online]. Available: http://apps.who.int/medicinedocs/en/d/Js7148e/. [Accessed: 30-Nov-2017].
8. Hollman A (1985). Plants and cardiac glycosides. Heart 54(3): 258-261.
9. Arcamone F, Cassinelli G and Casazza AM (1980). New antitumor drugs from plants. Journal of Ethnopharmacology 2(2): 149-160.
10. Elhardallo SB (2011). Cytotoxicity and Biological Activity of Selected Sudanese Medicinal Plants. Research Journal of Medicinal Plants 5: 201-229.
11. Raskin I (1992). Role of Salicylic Acid in Plants. Annual Review of Plant Biology 43(1): 439-463.
12. Rain Tree Nutrition (2001). Tropical plant database: Database for Quinine (Cinchona officinalis).
13. Covello PS. Making artemisinin. Phytochemistry 69(17): 2881-2885.
14. WHO (2005). National Policy on Traditional Medicine and Regulation of Herbal Medicines - Report of a WHO Global Survey [Online]. Available: http://apps.who.int/medicinedocs/en/d/Js7916e/. [Accessed: 30-Nov-2017].
15. WHO (2014). WHO Traditional, Complementary and Integrative Medicine. Geneva.
16. Amole AOO, Yemitan O and Oshikoya K (2009). Anticonvulsant activity of Rauvolfia Vomitoria (Afzel). African Journal of Pharmacy and Pharmacology 3(2): 319-322.
17. Ilori M, Sheteolu AO, Omonigbehin EA and Adeneye AA (1996). Antidiarrhoeal activities of Ocimum gratissimum (Lamiaceae). J. Diarrhoeal Diseases Research 14(4): 283-285.
18. Oyelami OA, Agbakwuru EA, Adeyemi LA and Adedeji GB (2005). The effectiveness of grapefruit (Citrus paradisi) seeds in treating urinary tract infections. Journal of Alternative and Complementary Medicine (New York, NY) 11(2): 369-371.
19. Okeniyi JOA, Ogunlesi TA, Oyelami OA and Adeyemi LA (2007). Effectiveness of dried Carica papaya seeds against human intestinal parasitosis: a pilot study. Journal of Medicinal Food 10(1): 194-196.
20. Adegbehingbe OO, Adesanya SA, Idowu TO, Okimi, Oyelami OA and Iwalewa EO (2008). Clinical effects of Garcinia kola in knee osteoarthritis. Journal of Orthopaedic Surgery 3: 34.
21. Oyelami OA, Onayemi A, Oyedeji OA and Adeyemi LA (2009). Preliminary study of effectiveness of Aloe vera in scabies treatment. Phytotherapy Research 23(10): 1482-1484.
22. Gadano AB, Gurni AA and Carballo MA (2006). Argentine folk medicine: genotoxic effects of Chenopodiaceae family. Journal of Ethnopharmacology 103(2): 246-251.
23. Akintonwa A, Awodele O, Afolayan G and Coker HAB (2009). Mutagenic screening of some commonly used medicinal plants in Nigeria. Journal of Ethnopharmacology 125(3): 461-470.
24. Awodele O, Osunkalu VO, Akinde OR, Teixeira da Silva JA, Okunowo WO, Odogwu EC, Akintonwa A (2010). Modulatory roles of antioxidants against the aqueous stem bark extract of Alstonia boonei (Apocynaceae)-induced nephrotoxicity and testicular damage. International Journal of Biomedical and Pharmaceutical Sciences 4(2): 76-80.
25. Jayasuriya DC (1990). A review of legislation concerning medicinal plants. Unpublished Report.
26. Heide L (1991). Traditionelle Arzneipflanzen in der Gesundheitsversorgung der dritten Welt-Möglichkeiten und Grenzen. Zeitschrift für Phytotherapie 12: 1-8.
27. Niggemann B and Grüber C (2003). Side-effects of complementary and alternative medicine. Allergy 58(8): 707-716.
28. Abt AB, Oh JY, Huntington RA and Burkhart KK (1995). Chinese herbal medicine induced acute renal failure. Archives of Internal Medicine 155(2): 211-212.
29. Lee CT, Wu MS, Lu K and Hsu KT (1999). Renal tubular acidosis, hypokalemic paralysis, rhabdomyolysis and acute renal failure - A rare presentation of Chinese herbal nephropathy. Ren. Fail. 21(2): 227-230.
30. Šubat-Dežulović M, Slavić I, Rožmanić V, Peršić M, Medjimurec B and Šukanec-Špoljar M (2002). Drug-induced acute tubulointerstitial nephritis: a case with elevated urinary cadmium. Pediatric Nephrology 17(5): 382-385.
31. Luyckx VA, Ballantine R, Claeys M, Cuyckens F, Van den Heuvel H, Cimanga RK, Vlietinck AJ, De Broe ME, Katz IJ (2002). Herbal remedy-associated acute renal failure secondary to Cape aloes. American Journal of Kidney Diseases 39(3): e13-1.
32. Au TC (2006). Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Hong Kong Medical Journal 12(5): 394-397.
33. Lin CC and Chen JC (2002). Medicinal herb Erycibe henri Prain ('Ting Kung Teng') resulting in acute cholinergic syndrome. Journal of Toxicology: Clinical Toxicology 40(2): 185-187.
34. Nadir A, Agrawal S, King PD and Marshall JB (1996). Acute hepatitis associated with the use of a Chinese herbal product, ma-huang. The American Journal of Gastroenterology 91(7): 1436-1438.
35. Tyler VE and Foster S (1999). The Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. New York; London: Haworth Herbal Press.
36. Borum ML (2001). Fulminant exacerbation of autoimmune hepatitis after the use of ma huang. The American Journal of Gastroenterology 96(5): 1654.
37. Escher M, Desmeules J, Giostra E and Mentha G (2001). Hepatitis associated with Kava, a herbal remedy for anxiety. BMJ 322(7279): 139.
38. Webb AN, Hardikar W, Cranswick NE and Somers GR (2005). Probable herbal medication induced fulminant hepatic failure. J. Paediatr. Child Health 41(9-10): 530-531.
39. Hsu LM, Huang YS, Tsay SH, Chang FY and Lee SD (2006). Acute hepatitis induced by Chinese hepatoprotective herb, xiao-chai-hu-tang. Journal of the Chinese Medical Association 69(2): 86-88.
40. Rowin J and Lewis SL (1996). Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology 46(6): 1775-1776.
41. Granger AS (2001). Ginkgo biloba precipitating epileptic seizures. Age and Ageing 30(6): 523-525.
42. Benjamin J, Muir T, Briggs K and Pentland B (2001). A case of cerebral haemorrhage-can Ginkgo biloba be implicated? Postgraduate Medical Journal 77(904): 112-113.
43. Chan TYK (2002). Herbal medicine causing likely strychnine poisoning. Human and Experimental Toxicology 21(8): 467-468.
44. Vahid B (2007). Severe complications of herbal medicines. Critical Care and Shock 10: 4-10.
45. Bannerman RH, Burton J, Chen WC (1983). Traditional medicine and health care coverage: a reader for health administrators and practitioners.
46. Kassaye KD, Amberbir A, Getachew B and Mussema Y (2006). A historical overview of traditional medicine practices and policy in Ethiopia. Ethiopian Journal of Health Development 20(2): 127-134.
47. Agbaje EO and Babatunde EO (2005). A KAP study of the attitude and practice of traditional medicine in a contemporary Nigerian community. Central African Journal of Medicine 51(5-6): 58-62.
48. Awodele O, Agbaje EO, Ogunkeye FA, Kolapo AG and Awodele DF (2011). Towards integrating traditional medicine (TM) into National Health Care Scheme (NHCS): Assessment of TM practitioners' disposition in Lagos, Nigeria. Journal of Herbal Medicine 1(3): 90-94.
49. Abel C and Busia K (2005). An exploratory ethnobotanical study of the practice of herbal medicine by the Akan peoples of Ghana. Alternative Medicine Review - A Journal of Clinical Therapeutics 10(2): 112-122.
50. Tabi MM, Powell M and Hodnicki D (2006). Use of traditional healers and modern medicine in Ghana. International Nursing Review 53(1): 52-58.
51. Amira OC and Okubadejo NU (2007). Frequency of complementary and alternative medicine utilization in hypertensive patients attending an urban tertiary care centre in Nigeria. BMC Complementary and Alternative Medicine 7: 30.
52. Osamor PE and Owumi BE (2010). Complementary and alternative medicine in the management of hypertension in an urban Nigerian community. BMC Complementary and Alternative Medicine 10: 36.
53. Fakeye TO, Adisa R and Musa IE (2009). Attitude and use of herbal medicines among pregnant women in Nigeria. BMC Complementary and Alternative Medicine 9: 53.
54. Awodele O, Agbaje EO, Abiola OO, Awodele DF and Dolapo DC (2012). Doctors' attitudes towards the use of herbal medicine in Lagos, Nigeria. Journal of Herbal Medicine 1(2): 16-22.
55. Owen DK, Lewith G and Stephens CR (2001). Can doctors respond to patients' increasing interest in complementary and alternative medicine? BMJ 322(7279): 154-158.
56. Zollman C and Vickers A (1999). Complementary medicine and the doctor. BMJ 319(7224): 1558-1561.
57. Akinboro A and Bakare AA (2007). Cytotoxic and genotoxic effects of aqueous extracts of five medicinal plants on Allium cepa Linn. Journal of Ethnopharmacology 112(3): 470-475.
58. Eilert U (1978). Antibiotic principles of seeds of Moringa oleifera. West Indian Medical Journal 38(235): 1013-1016.
59. Eilert U, Wolters B and Nahrstedt A (1981). The antibiotic principle of seeds of Moringa oleifera and Moringa stenopetala. Planta Medica 42: 55-61.
60. Ezeamuzie IC, Ambakederemo AW, Shode FO, Ekwebelem SC (1996). Antiinflammatory effects of Moringa oleifera root extract. International Journal of Pharmacognosy 34(3): 207-212.
61. Ferreira R, Napoleão TH, Santos AF, Sá RA, Carneiro-da-Cunha MG, Morais MM, Silva-Lucca RA, Oliva ML, Coelho LC, Paiva PM (2011). Coagulant and antibacterial activities of the water-soluble seed lectin from Moringa oleifera. Letters in Applied Microbiology 53(2): 186-192.
62. Sreelatha S, Jeyachitra A, Padma PR (2011). Antiproliferation and induction of apoptosis by Moringa oleifera leaf extract on human cancer cells. Food and Chemical Toxicology 49(6): 1270-1275.
63. Awodele O, Oreagba IA, Odoma S, da Silva JA, Osunkalu VO (2012). Toxicological evaluation of the aqueous leaf extract of Moringa oleifera Lam. (Moringaceae). Journal of Ethnopharmacology 139(2): 330-336.
64. Cajuday LA and Pocsidio GL (2010). Effects of Moringa oleifera Lam. (Moringaceae) on the reproduction of male mice (Mus musculus). Journal of Medicinal Plants Research 4(12): 1115-1121.
65. D'souza J and Kulkarni AR (1993). Comparative studies on nutritive values of tender foliage of seedlings and mature plants of Moringa oleifera Lam. Journal of Economic and Taxonomic Botany 17(2): 479-485.
66. Anwar F and Bhanger MI (2003). Analytical characterization of Moringa oleifera seed oil grown in temperate regions of Pakistan. Journal of Agricultural and Food Chemistry 51(22): 6558-6563.
67. Anwar F, Ashraf M and Bhanger MI (2005). Interprovenance variation in the composition of Moringa oleifera oilseeds from Pakistan. Journal of the American Oil Chemists' Society 82(1): 45-51.
68. Siddhuraju P and Becker K (2003). Antioxidant properties of various solvent extracts of total phenolic constituents from three different agroclimatic origins of drumstick tree (Moringa oleifera Lam.) leaves. Journal of Agricultural and Food Chemistry 51(8): 2144-2155.
69. Posmontier B (2011). The medicinal qualities of Moringa oleifera. Holistic Nursing Practice 25(2): 80-87.
70. Ajasa AMO, Bello MO, Ibrahim AO, Ogunwande IA and Olawore NO (2004). Heavy trace metals and macronutrients status in herbal plants of Nigeria. Food Chemistry 85(1): 67-71.
71. Ang HH and Lee KL (2006). Contamination of mercury in tongkat Ali hitam herbal preparations. Food and Chemical Toxicology 44(8): 1245-1250.
72. Arzani A, Zeinali H and Razmjo K (2007). Iron and magnesium concentrations of mint accessions (Mentha spp.). Plant Physiol. Biochem. PPB 45(5): 323-329.
73. Mubeen H, Naeem I, Taskeen A and Saddiqe Z (2009). Investigations of heavy metals in commercial spices brands. New York Science Journal 2(5): 20-26.
74. Khan SA, Khan L, Hussain I, Marwat KB and Akhtar N (2008). Profile of heavy metals in selected medicinal plants. Pakistan Journal of Weed Science Research 14: 101-110.
75. Awodele O, Popoola TD, Amadi KC, Coker HAB and Akintonwa A (2013). Traditional medicinal plants in Nigeria-Remedies or risks. Journal of Ethnopharmacology 150(2): 614-618.
76. Moura AC, Silva EL, Fraga MC, Wanderley AG, Afiatpour P and Maia MB (2005). Anti-inflammatory and chronic toxicity study of the leaves of Ageratum conyzoides L. in rats. Phytomedicine 12(1-2): 138-142.
77. Oluyemi KA, Okwuonu UC, Baxter DG and Oyesola T (2007). Toxic Effects of Methanolic Extract of Aspilia africana Leaf on the Estrous Cycle and Uterine Tissues of Wistar Rats. International Journal of Morphology 25(3): 609-614.
78. Odugbemi T (2006). Outlines and Pictures of Medicinal Plants from Nigeria [1st ed.]. Lagos: University of Lagos Press.
79. Prasad MNV (2001). Bioremediation potential of amaranthaceae. In Phytoremediation, Wetlands, and Sediments. Leeson A, Foote EA, Banks MK and Magar VS (Eds.). Columbus: Proceedings of the Sixth International In Situ & On-Site Bioremediation Symposium, Battelle Press.
80. Stables NLT (1997). Descriptive Flora of Puerto Rico and Adjacent Islands [Online]. Available: https://www.nhbs.com/descriptive-flora-of-puerto-rico-and-adjacent-islands-volume-5-book. [Accessed: 30-Nov-2017].
81. Adewole SO and Ojewole JAO (2008). Protective Effects of Annona muricata Linn. (Annonaceae) Leaf Aqueous Extract on Serum Lipid Profiles and Oxidative Stress in Hepatocytes of Streptozotocin-Treated Diabetic Rats. African Journal of Traditional, Complementary and Alternative Medicines 6(1): 30-41.
82. Oberlies NH, Jones JL, Corbett TH, Fotopoulos SS and McLaughlin JL (1995). Tumor cell growth inhibition by several Annonaceous acetogenins in an in vitro disk diffusion assay. Cancer Letters 96(1): 55-62.
83. Tormo JR, Royo I, Gallardo T, Zafra-Polo MC, Hernández P, Cortes D and Peláez F (2003). In vitro antitumor structure-activity relationships of threo/trans/threo mono-tetrahydrofuranic acetogenins: correlations with their inhibition of mitochondrial complex I. Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics 14(3): 147-154.
84. Vasquez MR (1990). Useful Plants of Amazonian Peru, Second Draft Filed with USDA's National Agricultural Library. FL, USA: CRC Press Inc.
85. Takahashi JA, Pereira CR, Pimenta LPS, Boaventura MAD and Silva LGFE (2006). Antibacterial activity of eight Brazilian annonaceae plants. Natural Product Research 20(1): 21-26.
86. Baskar R, Rajeswari V and Kumar TS (2007). In vitro antioxidant studies in leaves of Annona species. Indian Journal of Experimental Biology 45(5): 480-485.
87. Awodele O, Ishola IO, Ikumawoyi VO, Akindele AJ and Akintonwa A (2014). Toxicological evaluation of the lyophilized fruit juice extract of Annona muricata Linn. (Annonaceae) in rodents. Journal of Basic and Clinical Physiology and Pharmacology 25(4): 411-421.
88. Kale OE and Awodele O (2016). Safety evaluation of Bon-santé cleanser® polyherbal in male Wistar rats. BMC Complementary and Alternative Medicine 16(1): 188.
89. Sahoo N, Manchikanti P and Dey S (2010). Herbal drugs: standards and regulation. Fitoterapia 81(6): 462-471.
90. WHO (2002). The Importance of Pharmacovigilance - Safety Monitoring of Medicinal Products.
91. Bigoniya P (2009). Pharmacovigilance of herbal medicines: current status and future strategies. Pharmacological Reviews 7: 77-88.
92. De Smet PA (1995). Health risks of herbal remedies. Drug Safety 13(2): 81-93.
93. Furnharm A (1996). Why do people choose and use complementary therapies? Ernst E (Ed.), Editorial Oxford: Butterworth-Heinemann.
94. De Smet PAGM (1997). Adverse effect of herbal remedies. Adverse Drug Reaction Bulletin 183: 695.
95. Talalay P and Talalay P (2001). The importance of using scientific principles in the development of medicinal agents from plants. Academic Medicine 76(3): 238-247.