Before revision: Examples of herbs that may have long-term adverse effects include ginseng, the endangered herb goldenseal, milk thistle, senna (against which herbalists generally advise and rarely use) , aloe vera juice, buckthorn bark and berry, cascara sagrada bark, saw palmetto, valerian, kava (which is banned in the European Union), St. John's wort, khat, betel nut, the restricted herb ephedra, and guarana.
After revision: Examples of herbs that may have long-term adverse effects include ginseng, the endangered herb goldenseal, milk thistle, senna , aloe vera juice, buckthorn bark and berry, cascara sagrada bark, saw palmetto, valerian, kava (which is banned in the European Union), St. John's wort, khat, betel nut, the restricted herb ephedra, and guarana.