Potential adverse reactions from complementary and alternative medicine (CAM) and dietary supplement (DS) in North America

Background:  Complementary and alternative medicine (CAM) and dietary supplement (DS) being natural products, are usually considered harmless.  Potential adverse reactions in four preparations are presented.

Method:  Visits were made to Chinese herbal shops and health food stores in Vancouver, Canada, and New York, USA.  The ingredients of some CAM and DS were carefully examined.

Results:  Four preparations, two from Vancouver (1,2) and two from New York (3,4) were noted to have potential adverse reactions.

1. ARTHO-ACE "pill for pain relief" with a label stating "This product is made from [ten] selected natural herbal [sic] and contains no toxin [sic] & chemicals." Does it mean it may contain heavy metal or pharmaceutical product?

2. RAPIDCUTS "a rapid fat burning catalyst", to take 1 pack BID, with ingredients in each pack including (i) Magnolia bark extract (known to contain turbocurarine) and (ii) caffeine 298mg (less than 400mg of caffeine per day from all sources, recommended by Health Canada).

3. CHINA TUNG SHUEH PILLS "pill for blood thinning", containing "Radix Salvine Miltiorrhizae [sic]" with potential herb-drug interaction with warfarin.

4. FU ZI LI ZHONG WAN "nausea extract for gastric bloating", containing prepared aconite root (Aconitum carmichaeli) with potential adverse cardiac side effect. 

Conclusions:  There are potential adverse reactions in CAM and DS purchased in Chinese herbal shops and health food stores in North America.  Physicians should inquire the use of CAM and DS by patients.  There should be higher standard in regulation in CAM and DS in North America.