What about bitter melon?

DANGEROUS SUPPLEMENTS: INCOMPETENT RESEARCH. INTENTIONAL DECEPTION?

By William A. Courson, BVS (Ayur), D.Ayur., C.H., CHIS 

A recent article appearing on the Yahoo Health website (http://health.yahoo.net/articles/nutrition/dangerous-supplements) captioned "Dangerous Supplements"  and dated August 3, 2010 contains some serious misstatements of fact and omits pertinent information needed by readers in making informed health choices. In some instances the omissions are of so critical a nature as to amount to intentional deception, and I feel these need to be addressed publicly.

The feature, attributed to the publication Consumer Reports, states that "we [presumably, Consumer Reports] have identified a dozen supplement ingredients that we think consumers should avoid because of health risks, including cardiovascular, liver, and kidney problems. We found products with those ingredients readily available in stores and online." These, labeled by the authors as "the Dirty Dozen" include aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe.

It is on one of these, namely comfrey, that I wish to focus my attention - but the unimaginably shoddy research design, sloppy methodology and rationally unjustifiable conclusions stand as stark testimonials to the kind and quality of "scientific investigation" brought to bear when the therapeutic efficacy of plant medicines is questioned in an obvious but unspoken comparison to that of commercially manufactured pharmaceutical agents.

Due to low level concentrations of a group of substances known as pyrrolizidine alkaloids (PA's) in the leaves and roots of Symphytum officinale, some authorities no longer recommend using comfrey internally. These alkaloids are reported to have caused liver damage when consumed over a long period of time. Have the dangers of internal use been exaggerated out of proportion with the truth? Are such claims in any fashion accurate? And what was the methodology used to gather data to support them?

In recent years there has been much public controversy and professional discussion about the extreme dangers of comfrey. Some governments among them Canada) have actually made it illegal to sell this long used herb. The question is, is comfrey truly a dangerous plant that should be legally banned from human use? After all, this is an herb that has been used for thousands of years, by widely separated enclaves of users, for similar or identical purposes.

It emerges that the pyrrolizidine alkaloids in comfrey, (fresh roots contain about ten times the quantity of PAs than do fresh young leaves) if isolated, concentrated and injected into newborn rats over a protracted period have indeed been linked to liver damage and also liver cancer. The "study" isolated and concentrated the PA's in comfrey and injected them multiple times interperitoneally to 2-week-old rats over a period of seven (7) weeks, after which liver damage was observed. The quantities injected are estimated to have been about 5,700 times - proportionally - the average dose in humans. It was thus concluded that Comfrey (and any other plants) which contain unsaturated pyrrolizidine alkaloids, will cause liver damage in humans. In another "study," rats were fed comfrey in a quantity comprising 33% of their diet for a period of 480-600 days.

What's wrong with the foregoing picture?

This kind of research is not only methodologically flawed and irrelevant but totally meaningless and counterproductive when we compare it with how comfrey is actually used as a therapeutic agent by humans.

It is common knowledge that any substance, if taken in great enough quantities, will have a deleterious effect. The amount of PAs that were injected into each newborn rat in that 7-week period was the equivalent of a rat the size of an adult human being ingesting of over 5,700 comfrey leaves.

Isolating and concentrating virtually any phytochemical substance and unnaturally injecting it in high dosages into infant mammals for a protracted period is going to predictably cause some damage. The physiological effects on a human moderately using a whole plant medicine such as comfrey will be as different as surgery from a shotgun wound. Whole plants used in rational dosages by people cannot be compared with such artificially contrived excesses. Britain's National Institute of Medical Herbalists has gone on record to state that, "No man, woman, or child has been recorded as suffering toxic effects from taking recommended doses of Comfrey leaf... as medicine."

In a landmark study published in Science, cancer authority Bruce Ames, Ph.D., chairman of the Biochemistry Department at the University of California at Berkeley, attempted to estimate the average person's lifetime cancer risk from exposure to hundreds of man-made and naturally occuring carcinogens. Dr. Ames estimated that one cup of Comfrey tea posed:

About the same cancer risk as one peanut butter sandwich, which contains traces of the natural carcinogen aflatoxin.

About one-third the risk of eating one raw mushroom, which contains traces of the natural carcinogen hydrazine.

About half the risk of one diet soda containing saccharin.

And about one-hundredth the risk of a glass of wine, which contains the natural carcinogen ethyl alcohol.

I believe that these studies debunking the therapeutic efficacy of herbs and highlighting their supposed dangers - and there have been many of them, which one reads about constantly in the popular press - and that have been conducted by putatively reputable scientists at prestigious institutes and universities have been deceptive, riddled with omissions and filled with exaggeration and "post-hoc" conclusion-drawing.

I question now whether they have also been intentionally misleading.

It seems worth noting that in one recent calendar year, there were a reported 164 deaths and serious adverse events resulting from the use of Aleve (Naproxyn), including gastrointestinal hemorrhage, suicide, hepatic necrosis, encephalitis and renal failure (among others). Deaths due to the use of aspirin (acetylsalicylic acid) in that same year totalled 7,600.

Further, Acetaminophen use is the number one cause of acute liver failure (ALF) in the United States accounting for 50% of all cases of ALF and carry a 30% mortality. Nevertheless, acetaminophen is a highly successful product with sales easily exceeding a billion dollars annually. A narcotic containing acetaminophen preparation is the number one generic drug sold in the United States.

How many deaths and adverse effects can be laid at comfrey's doorstep for a similar period? Or at the doorsteps of the other eleven herbs about which we are cautioned in Consumer Reports' article?

The question of intentional misinformation suggests itself to the reasonable inquirer.

DANGEROUS SUPPLEMENTS: INCOMPETENT RESEARCH. INTENTIONAL DECEPTION?

By William A. Courson, BVS (Ayur), D.Ayur., C.H., CHIS 

A recent article appearing on the Yahoo Health website (http://health.yahoo.net/articles/nutrition/dangerous-supplements) captioned "Dangerous Supplements"  and dated August 3, 2010 contains some serious misstatements of fact and omits pertinent information needed by readers in making informed health choices. In some instances the omissions are of so critical a nature as to amount to intentional deception, and I feel these need to be addressed publicly.

The feature, attributed to the publication Consumer Reports, states that "we [presumably, Consumer Reports] have identified a dozen supplement ingredients that we think consumers should avoid because of health risks, including cardiovascular, liver, and kidney problems. We found products with those ingredients readily available in stores and online." These, labeled by the authors as "the Dirty Dozen" include aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe.

It is on one of these, namely comfrey, that I wish to focus my attention - but the unimaginably shoddy research design, sloppy methodology and rationally unjustifiable conclusions stand as stark testimonials to the kind and quality of "scientific investigation" brought to bear when the therapeutic efficacy of plant medicines is questioned in an obvious but unspoken comparison to that of commercially manufactured pharmaceutical agents.

Due to low level concentrations of a group of substances known as pyrrolizidine alkaloids (PA's) in the leaves and roots of Symphytum officinale, some authorities no longer recommend using comfrey internally. These alkaloids are reported to have caused liver damage when consumed over a long period of time. Have the dangers of internal use been exaggerated out of proportion with the truth? Are such claims in any fashion accurate? And what was the methodology used to gather data to support them?

In recent years there has been much public controversy and professional discussion about the extreme dangers of comfrey. Some governments among them Canada) have actually made it illegal to sell this long used herb. The question is, is comfrey truly a dangerous plant that should be legally banned from human use? After all, this is an herb that has been used for thousands of years, by widely separated enclaves of users, for similar or identical purposes.

It emerges that the pyrrolizidine alkaloids in comfrey, (fresh roots contain about ten times the quantity of PAs than do fresh young leaves) if isolated, concentrated and injected into newborn rats over a protracted period have indeed been linked to liver damage and also liver cancer. The "study" isolated and concentrated the PA's in comfrey and injected them multiple times interperitoneally to 2-week-old rats over a period of seven (7) weeks, after which liver damage was observed. The quantities injected are estimated to have been about 5,700 times - proportionally - the average dose in humans. It was thus concluded that Comfrey (and any other plants) which contain unsaturated pyrrolizidine alkaloids, will cause liver damage in humans. In another "study," rats were fed comfrey in a quantity comprising 33% of their diet for a period of 480-600 days.

What's wrong with the foregoing picture?

This kind of research is not only methodologically flawed and irrelevant but totally meaningless and counterproductive when we compare it with how comfrey is actually used as a therapeutic agent by humans.

It is common knowledge that any substance, if taken in great enough quantities, will have a deleterious effect. The amount of PAs that were injected into each newborn rat in that 7-week period was the equivalent of a rat the size of an adult human being ingesting of over 5,700 comfrey leaves.

Isolating and concentrating virtually any phytochemical substance and unnaturally injecting it in high dosages into infant mammals for a protracted period is going to predictably cause some damage. The physiological effects on a human moderately using a whole plant medicine such as comfrey will be as different as surgery from a shotgun wound. Whole plants used in rational dosages by people cannot be compared with such artificially contrived excesses. Britain's National Institute of Medical Herbalists has gone on record to state that, "No man, woman, or child has been recorded as suffering toxic effects from taking recommended doses of Comfrey leaf... as medicine."

In a landmark study published in Science, cancer authority Bruce Ames, Ph.D., chairman of the Biochemistry Department at the University of California at Berkeley, attempted to estimate the average person's lifetime cancer risk from exposure to hundreds of man-made and naturally occuring carcinogens. Dr. Ames estimated that one cup of Comfrey tea posed:

*About the same cancer risk as one peanut butter sandwich, which contains traces of the natural carcinogen aflatoxin.

*About one-third the risk of eating one raw mushroom, which contains traces of the natural carcinogen hydrazine.

*About half the risk of one diet soda containing saccharin.

*And about one-hundredth the risk of a glass of wine, which contains the natural carcinogen ethyl alcohol.

I believe that these studies debunking the therapeutic efficacy of herbs and highlighting their supposed dangers - and there have been many of them, which one reads about constantly in the popular press - and that have been conducted by putatively reputable scientists at prestigious institutes and universities have been deceptive, riddled with omissions and filled with exaggeration and "post-hoc" conclusion-drawing.

I question now whether they have also been intentionally misleading.

It seems worth noting that in one recent calendar year, there were a reported 164 deaths and serious adverse events resulting from the use of Aleve (Naproxyn), including gastrointestinal hemorrhage, suicide, hepatic necrosis, encephalitis and renal failure (among others). Deaths due to the use of aspirin (acetylsalicylic acid) in that same year totalled 7,600.

Further, Acetaminophen use is the number one cause of acute liver failure (ALF) in the United States accounting for 50% of all cases of ALF and carry a 30% mortality. Nevertheless, acetaminophen is a highly successful product with sales easily exceeding a billion dollars annually. A narcotic containing acetaminophen preparation is the number one generic drug sold in the United States.

How many deaths and adverse effects can be laid at comfrey's doorstep for a similar period? Or at the doorsteps of the other eleven herbs about which we are cautioned in Consumer Reports' article?