The Usual Supplements - not so safe if you’re expecting

Healthy women often rely on dietary supplements to fill in the gaps when diet and exercise run out of control. Pregnancy warps the picture though, making some natural remedies look as risky as an episode of Extreme Makeover. Even dietitians, physicians and naturopaths can’t seem to agree. And when prominent herbalists disagree over the effects an herb has — which happens even with common ones like garlic — it proves that supplementing safely is a hard concept to pin down.

While women have taken herbal remedies for thousands of years, it’s a relatively new idea in western culture. If you're tempted to try a more natural approach to your supplement regime, do your homework first. Natural doesn't always mean safe, and some herbs like sassafras, goldenseal and pennyroyal can seriously harm a developing baby. Herbal teas appeal to moms-to-be because they’re often caffeine-free. But the temperature of the water, the amount of tea leaves, and the length of time the brew steeps can make each cup vary dramatically in potency. Also, there is not enough researched information to consider them all safe, says Dr. Amos Grunebaum, OB/GYN, director of Clinical Maternal-Fetal Medicine at New York Presbyterian Hospital and Medical Director of WebMD. Citrus peel, ginger, lemon balm, orange peel and rose hip are known to be safe though. Red raspberry and ginger teas are also excellent and accepted cures for morning sickness. One issue all sides do agree on is that the current American regulatory situation fails consumers completely.

“Herbal products are considered dietary supplements and are not regulated by the FDA,” says Dr. Grunebaum. “Manufacturers are not required to demonstrate the safety and effectiveness of their products before they reach the market and, as a result, the composition may vary greatly from one batch to another.”

As well, "raw" herbs — plants, leaves, roots, stems, and grasses — aren’t regulated at all. Levels of active ingredients, varying quality, or strains grown in different regions under all sorts of conditions are anyone’s guess. In addition to problems with regulations, scientists don't fully understand all herbal actions, and problems can arise if herbs are taken in combination with prescription drugs. Their combined effects can increase chances for harmful reactions by 30 percent or adversely alter the absorption time of prescription medications.

It comes down to consumers relying on herb manufacturers for answers — a risky proposition at best. Much of what’s out there is contradictory, misleading and inaccurate — with little hope of finding the downsides clearly described. And if you think growing your own herbs will solve the problem, you’re in for another shock.

“Herbs grown in urban gardens could contain potentially hazardous amounts of lead from deteriorated paint, past use of lead-containing gasoline and industrial pollution,” Dr. Grunebaum says.

Ultimately, it’s up to consumers educate themselves. Herbal supplements can counter, eliminate, or destroy the desired effects of prescription medications. Many of us don't ask about drug and herbal interactions, and according to surveys, seven out of 10 doctors don't tell patients about the risks of drugs prescribed. Pharmacists can help clear up confusion about herbal and traditional drug interactions. If you’re not sure, ask! Call 1-877-2MYMEDS (1-877-269-6337).

Natural Disasters

The following are four herbs known to be dangerous to a developing baby. Remember that culinary herbs used in small amounts are considered harmless before, during and after pregnancy. • Goldenseal: Usually paired with echinacea to ease cold and flu symptoms, it’s also a laxative, an antiseptic, it relieves irritation from hemorrhoids, and helps prevent (and eliminate) gum disease, canker sores and cracked lips.

This herb raises blood pressure, says Dr. Earl Mindell, registered pharmacist and author of The Vitamin Bible. “If the mother has a history of high blood pressure or her pressure increases during pregnancy, this herb is contraindicated.”

• Ginseng: An ancient Chinese herb, it can normalize blood sugar levels, boost sagging libidos, and even prolong life. It’s famous for revving up sinking energy levels and staving off fatigue, but some Japanese scientists are looking into its anti-cancer properties and tranquilizing effects. It’s a recipe for trouble during pregnancy though. “High doses may make you jittery if taken too close to bedtime, and headaches and elevated blood pressure could occur,” Dr. Mindell says. “Pregnant women should not take ginseng.”

• St. John’s Wort: Believed to have infinite healing powers, St. John’s Wort is used to treat a number of symptoms — urinary infections, cuts, burns, cystitis, sprains, bruises, rheumatism and tumors, and even depression. It’s currently being studied for anticancer properties and as a possible cure to AIDS. But be careful. St. John’s Wort interferes with anti-depressant medications such as Zoloft and Prozac, by increasing their effects to dangerous levels. In 1977, the FDA listed the herb as unsafe, and in 1992 stated that it had not been proven safe and effective as claimed.

• Chromium: This natural element (not herb) found in the soil finds its way into our foods every day. Chromium helps us breakdown sugar into useable energy, which makes it a preferred choice for dieters. “It burns fat, and increases muscle mass, reduces cholesterol and triglycerides and prevents insulin resistance,” Dr. Mindell says.

Because American soil contains low levels of this element, over-exposure isn’t usually a problem. In large quantities, though, it can become toxic, and (in rare cases) can cause cancer — usually 20-30 years after over-exposure. Use during pregnancy is a no-brainer — stay away from it.