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You In Mind Blog - Herbal Supplements: Use With Caution

You In Mind Blog – Herbal Supplements: Use With Caution

Herbal Supplements: Use With Caution

By Elizabeth M. Felder, MD

Herbal, or “natural,” supplements and vitamins have been gaining popularity in recent years and seem to have benefits for some. In children, it’s not uncommon for complementary approaches to be used for anxiety or stress, autism, attention-deficit hyperactivity disorder (ADHD) and insomnia or trouble sleeping.

However, there are potential dangers in relying on these products to ease symptoms of medical diseases or disorders. It is important for parents to realize that supplements are something like a medication, and so you can get drug-herb interactions. They also have side effects, which can sometimes be dangerous.

Herbal supplements and vitamins are over-the-counter products and are regulated under the Dietary Supplement Health and Education Act of 1994 (DSHEA) – not the Food and Drug Administration. These products can enter the market without any testing for efficacy, and companies do not have to provide proof of a product’s safety, only a “reasonable assurance.”

They do not have to be manufactured according to any standards, although reputable manufacturers support standards. It’s basically up to the company that manufactures the product to make sure it is not contaminated and that the ingredients are basically consistent.

There’s no need, whatsoever, for the company to make sure it works.

Dietary supplements include vitamins, minerals and herbal remedies. Fish oil/omega-3 fatty acid supplements, melatonin, probiotics/prebiotics, essential oils and echinacea are some of the more common products used for children. Two popular herbal remedies that are considered unsafe for children include licorice and ephedra. Licorice lacks evidence backing its effectiveness. Ephedra, or ma huang, is an appetite suppressant and decongestant. It can cause heart palpitations, heart attacks and death.

Melatonin is an example of an herbal supplement that has been scientifically studied and found to be truly effective for sleep in ADHD and autism. It is now considered a mainstream therapy, but patients can develop a tolerance to it.

Essential oils are currently being studied and have recently been linked to liver damage and gynecomastia. Additionally, omega fatty acids are said to reduce tics in children with Tourette’s. However, they can cause belching, nosebleeds, nausea, loose stools and at higher doses, decreased blood coagulation or blood “thinning.” The jury is still out regarding their effectiveness for hyperactivity and improved concentration.

Other products available online but deemed unsafe for children: aconite (also known as bushi), belladonna, blue cohosh, borage, broom, calamus, chaparral, coltsfoot, comfrey, germander, life root, lobelia, pennyroyal, poke root, sassafras, skullcap, tansy ragwort and wormwood.

Companies that make supplements do not need FDA approval for packaging or marketing claims. Because of this, substantial variations exist in the quality and quantity of biological ingredients. Risks from lower standards and lax regulations can include contamination, inadequate packaging information and unknown toxicities and interactions.

One voluntary quality indicator used by manufacturers is the United States Pharmacopeia Dietary Supplement Verification Program, identified by a USP “dietary supplement verified” logo. The website ConsumerLab.com also provides an “approved quality” logo, tests samples voluntarily sent by manufacturers, and rates the quality of different brands. Look for this logo if you are planning to use supplements and always tell your doctor.

Adverse reactions should be reported to the Food and Drug Administration’s MedWatch at 800-FDA-1088 (fax: 800-FDA-0178) and to Poison Control at 800-222-1222.


(Information for this article was obtained from Contemporary Pediatrics, Sleep Medicine Reviews, the Journal of Autism and Developmental Disorders, and Medscape.)

At Connections, we serve as a regional resource center providing medical, educational, and speech/language evaluation services for children and teenagers. Following diagnosis, we work with you and your child to determine the best course of treatment and therapy for them. If you would like to schedule an appointment, please call us at 601-261-5159.

Information on this page should be utilized as a guide, not medical advice. If you feel you need to speak with someone regarding behavioral therapy or counseling, please contact Connections to make an appointment.