The Gynecologist

Buyer Beware – Suspect Supplements and Hurtful Herbals

February 4, 2011 at 7:26 pm 1 comment

As an obstetrician/gynecologist, one of the things I do is take care of pregnant women.  And, while this blog is dedicated to gynecology, I thought I’d share with you a cautionary tale about my recent care of a woman in her first trimester of pregnancy.

She was asked to try a remedy for morning sickness.  The remedy  is described on its own website as  “a safe, non-addictive, FDA registered natural remedy containing 100% homeopathic ingredients formulated to relieve nausea (morning sickness) during pregnancy.” 

I was asked to look at the product to determine if it was safe for my patient.  At the bottom of a website with abundant testimonials and positive reviews, I found a list of ingredients.  5 of the 7 ingredients were safe and nontoxic.  These were:

• Mentha pip (Mentha piperita– Peppermint oil)
• Ferrum phos (Iron phosphate — a nontoxic iron salt)
• Zingiber (Ginger)
• Nat mur (Natrium muriaticum, also known as sodium chloride, or table salt)
• Sucrose (Sugar)

Two ingredients posed serious potential health risks (regardless of pregnancy status).  These were:  

• Nux Vom (Nux Vomica– derived from the Strychnine tree).  That’s right, I said strychnine.  As in the stuff they use in rat poison and gopher bait.  While very small doses of strychnine cause an increase in bowel motility, which can releive nausea, larger doses can cause neurological toxicity, seizures, and death.
• Nat Phos (Sodium Phosphate — another salt) Oral phosphates were widely used in bowel preparations for colonoscopy. They have been withdrawn in the United States because evidence suggests that sodium phosphate causes serious kidney damage, a condition called phosphate nephropathy. 

I told my patient that I had serious concerns about the safety of the ingredients listed on the website.  I told her that, although the remedy is very unlikely to cause injury in the small amounts in which it is administered (it is sprinkled on foods throughout the day), I could not recommend that she take it when safe alternatives exist. 

And, just to clarify, I am not recommending for or against the use of this (or any other product) on this blog.  I am sharing this anecdote to remind you to share with your healthcare provider ANY vitamins, nutritional supplements, herbal or traditional medicines you desire to take. 

That’s because only a medical professional, who is familiar with your medical history and has an inventory of the other medications you may be taking, is qualified to help you determine whether a particular product is safe for you.  He or she can determine whether the product interferes with other medicines you may be taking .  Your healthcare provider may also have valuable instructions on how to take the product safely (i.e. on an empty stomach, not with grapefruit or acidic juices, etc.)

Vitamins and nutritional supplements are not governed by the same strict set of rules which regulate drugs and medications.  While an herbal remedy, supplement or nutritional product may be registered with the FDA, this should not lead you to believe that a particular product is safe for you (or anybody else).

And, as for morning sickness, my advice to the patient was that peppermint tea, ginger ale, and ginger candies were likely just as effective and by no doubt safer than many of the specialty products marketed to relieve the gastrointestinal suffering of pregnant women. I also recommended small, frequent meals of bland, starchy foods. 

As for over-the-counter treatments, I often recommend vitamin B6, which is safe and non-toxic.  I often recommend this in combination with doxylamine  (found in Unisom), an antihistamine which can alleviate nausea (especially when combined with vitamin B6), although it does cause drowsiness.  

If that’s not enough, I said, call me for a prescription.

Entry filed under: Gynecology. Tags: early pregnancy, first trimester, ginger for morning sickness, gynecology, herbal remedy, herbal remedy for morning sickness, herbal supplement, homeopathy in pregnancy, morning sickness, nausea in pregnancy, peppermint for morning sickness, vomiting in pregnancy.