Statins: How the drug prevents heart attacks and strokes

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Selling herbal supplements has become a lucrative enterprise. Unfortunately, demand has meant unsubstantiated claims sometimes go unchallenged. There is a paucity of reliable evidence to support the use of herbal supplements for improving health outcomes. What’s more, there are instances when taking them can lead to adverse outcomes.

There is certainly a growing body of evidence that points to the pitfalls of taking herbal supplements in conjunction with medicines.

One of the most damning studies is published in the Journal of the American College of Cardiology.

Researchers reviewed the literature pertaining to the mixing of herbal supplements with medicines, namely cardiovascular drugs.

“Despite the paucity of scientific evidence supporting the safety or efficacy of herbal products, their widespread promotion in the popular media and the unsubstantiated health care claims about their efficacy drive consumer demand,” the study researchers wrote in their introduction.

They sought to scrutinise some of these claims by looking at the hard evidence.

A search of the PubMed and Medline databases was performed for the years 1966 to 2008 using the search terms cardiovascular agents, complementary therapies, herb–drug interaction, and cardiovascular disease interactions to identify citations, abstracts, and articles on herbs and cardiovascular disease.

After conducting a deep dive on the literature, researchers concluded that popular herbs and supplements, including St. John’s wort and even garlic and ginger do not mix well with common heart drugs and can also be dangerous for patients taking statins, blood thinners and blood pressure medications.

St. John’s wort raises blood pressure and heart rate, and garlic and ginger increase the risk of bleeding in patients on blood thinners, the researchers said.

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Even grapefruit juice can get you into trouble, increasing the effects of calcium-channel blockers and statins, they said.

“This is not new research, but there is a trend toward more and more use of these compounds, and patients often don’t discuss with their doctors the compounds they are using on their own,” said Doctor Arshad Jahangir, senior author of a paper.

The paper covers more than two dozen herbal products that patients should approach with caution, as well as a list of common drug-herb interactions.

Among the products listed are ginkgo biloba, ginseng and echinacea, as well as some surprises like soy milk and green tea, both of which can decrease the effectiveness of warfarin and even aloe vera and liquorice. 

Doctors need to be more assertive and ask patients about the herbs and supplements they take, and patients need to disclose that information to their providers, Doctor Jahangir said to The New York Times at the time of publication.

For those who take garlic supplements in the belief that it will improve their heart health, he said, “they are very surprised to hear that they may be taking something that could potentially increase the risks of bleeding”.

The evidence is sound enough to have caught the attention of reputable health bodies, such as the Mayo Clinic.

“Herbal products can pose unexpected risks because many supplements contain active ingredients that have strong effects in the body,” warns the health body.

“For example, taking a combination of herbal supplements or using supplements together with prescription drugs could lead to harmful, even life-threatening results.”

The NHS adds that most people do not need to take vitamin supplements and can get all the vitamins and minerals they need by eating a healthy, balanced diet.

“Many people choose to take supplements but taking too much or taking them for too long could be harmful.”

The Department of Health and Social Care recommends certain supplements for some groups of people who are at risk of deficiency.

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