Herbal? Natural? Sure. Safe? Maybe Not

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In the last couple of years, any aura of unmitigated health surrounding the herbal supplement industry has been torn to shreds. Consumers have been forced to confront their unrealistic expectations for "natural" cures: We want herbs to be as effective as medicine, but we want to use them without caution. Thursday, the new issue of the New England Journal of Medicine produced another herbal horror story. Aristolochia fangchi, a Chinese extract used primarily for weight loss, may now be linked to both systemic kidney failure and urinary tract cancers. The herb's contribution to kidney deterioration is well documented; after the supplement was given to a sizable group of Belgian clinic patients from 1990 to 1992, nearly 100 were diagnosed with kidney disease or complete failure. Now, members of that same group have developed urinary tract cancer, and scientists suspect the herb may be responsible.

The report, which has set off alarms among patrons of herbal supply stores across the country, is vague on some counts: It does not reveal the number of patients who received the herbs, and fails to rule out other potentially cancer-causing factors in the patients' lives. But that ambiguity, says TIME medical contributor Dr. Ian Smith, shouldn't cloud our perception of the lesson in all this. "Even though we're uncertain of all the details of the study, we do know without a doubt that we must not use any products not cleared by extensive scientific research," says Smith. And plenty of people seem to agree with that analysis. Since 1994, the Food and Drug Administration has been largely paralyzed by congressional legislation curbing the agency's power to regulate "natural" supplements. But now American researchers, many of whom tend to harbor more emphatic misgivings about herbal supplements than their European counterparts, are urging Congress to backtrack and enhance the agency's controls over herbs. In the meantime, the FDA is gearing up to ban the importation of any substance containing Aristolochia, an uncharacteristically decisive move scheduled to take effect within the month.