Previously undocumented adverse effects and drug interactions continue to be reported in association with herbal products. For example, although St. John's wort has been used for many years worldwide, its ability to induce theophylline metabolism was just recently recognized. Kiefer and Barrett are not comfortable with my statement that herbs are not natural to the human body. Just because the chemicals in herbs are manufactured by plants, it does not make them safer than chemicals manufactured in the laboratory. Patients have the right to know this.
Patients also have the right to know exactly what is in the products that they purchase.
Kiefer and Barrett ask if there is documentation for the statement concerning pollen contamination. I do not have documentation for this because this information was added later by the editors. However, the warning does not state that this has occurred, only that it might occur. I appreciate the additional information provided by Drs. Cheng and Bullock regarding oleander and danshen, and caution readers that my article is not meant to be a comprehensive, all-inclusive review of all of the adverse effects and interactions that have been reported with herbal remedies.