Nursing - Herbal products recalled; health risks cited
SPES and PC SPES Recalled
BotanicLab, an herbal product company based in Brea, California, has recalled two of its leading products, SPES and PC SPES, after the California Department of Public Health (CDHS) found the products contaminated with pharmaceutical drugs. PC SPES was found to be contaminated with a form of the anti-coagulant medication coumadin (Warfarin), while SPES was contaminated with the anti-anxiety medication alprazolam (Xanax). Patients were warned to immediately stop using these products and seek medical advice, especially if they were also using any prescription medication.
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The company’s own analysis has shown that SPES was indeed contaminated with alprazolam. A company spokesperson told me that the highest dose found by the California Department of Health was 0.123 in one capsule. If patients took the recommended six capsules per day, they could theoretically ingest a dose of 0.738 milligrams of alprazolam. Alprazolam usually comes in tablets containing 0.25, 0.5 and 1.0 milligrams of the drug. Thus, the daily amount was within the range normally given for the treatment of anxiety.
The highest amount of coumadin found in PC SPES was said to be 0.21 milligrams. The normal dose of coumadin is between 1 and 10 milligrams. Thus, if you took six PC SPES pills you would receive 1.26 milligrams. The company claims, however, that its own tests of PC SPES found not coumadin, but a natural look-alike called coumarin. This is a chemical normally found in many plants, including alfalfa, dong quai and sweet and red clover. Re-testing of PC SPES is underway, but will not affect the recall.
According to the company, the accidental contamination of SPES occurred in China, at a company that supplies the ingredients for the two herbal mixtures. Apparently, these Chinese suppliers also manufacture or handle alprazolam. BotanicLab vigorously denies that there was any intent to adulterate the products either in China or the United States.
No doubt this was a setback for the CAM approach to cancer. PC SPES in particular had begun to break down the barriers between conventional and “alternative” medicine. Now all these gains are imperiled by someone’s gross negligence. This saga illustrates the difficulty of bringing the promise of Traditional Chinese Medicine (TCM) to the US market. It is very difficult to exercise reasonable quality control from such a distance, and the opportunities for errors or worse, abound. This scandal deals a blow to the prestige of herbal medicine in America. Some people will see this as further proof that herbal products need to be under the control of the FDA. But, as obvious as that may seem to some, it would not be a good solution.
FDA’s century-long hostility to herbal medicine is wellknown. We need a sympathetic body of real experts on herbal medicine to oversee the safety and purity of herbal products. That board should look something like the current advisory board of the American Botanical Council. Problems with herbal products should be dealt with in a way that does not damage the integrity of herbal medicine as a whole.
A is for Artichoke
Back in the Fifties, I read a story called “The Heart of the Artichoke.” As a lugubrious teenager, the artichoke seemed like an appropriate metaphor for life: the bitter leaves and “choke” had to be discarded before one could reach and savor the delicious core. The trouble was that, at fifteen, I had no idea what an artichoke was, had never seen or tasted one. Boiled peas were my mother’s idea of an exotic vegetable. Years later, I ate my first artichoke and I was hooked. I put artichokes, fresh, canned, or best of all, marinated, onto and into everything.
The artichoke is technically Cynara scolymus L., a perennial plant in the thistle group of the sunflower family. In its full growth, it covers an area six feet in diameter and reaches a height of three to four feet. The “vegetable” that we eat is actually the unopened bud of a spectacular seven-inch violetblue flower. Artichokes originally hail from North Africa (the name is derived from the Arabic ‘Al-kharshuf’). From North Africa it jumped to the tables of ancient Greece and Rome. Artichokes remain popular in Italy, where they even make an artichoke aperitif, Cynar.
I would eat artichokes even if they had the nutritional value of Mallomars. But, as it turns out, they are very healthful and even show promise as a way of preventing cancer. Artichokes contain silymarin, a flavonoid that has powerful antioxidant activity. Silymarin is widely used in Europe as nutritional support for the liver. Just last month, Japanese scientists found that adding just one part per thousand of silymarin to the diet of mice significantly decreased their incidence of bladder cancers and prevented precancerous growths as well.
For years, Dr. RajeshAgarwal of the University of Colorado School of Pharmacy has also investigated the anticancer properties of artichokes. He has shown that silymarin provides almost complete inhibition of carcinogens on the skin. “Silymarin could be a useful anti-tumor promoting agent in a wide range of tumor promoters,” he wrote. Last September, Mayo Clinic scientists also showed that two substances found in artichokes inhibited the growth of prostate cancer. They didn’t kill cells outright, but arrested their ability to divide and grow.
