Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews
The aim of this overview of systematic reviews is to summarise and critically evaluate the evidence from systematic reviews of the adulteration and contamination of herbal medicinal products (HMPs).
Five electronic databases were searched to identify all relevant systematic reviews.
Twenty-six systematic reviews met our inclusion criteria. The most commonly HMPs were adulterated or contaminated with dust, pollens, insects, rodents, parasites, microbes, fungi, mould, toxins, pesticides, toxic heavy metals and/or prescription drugs. The most severe adverse effects caused by these adulterations were agranulocytosis, meningitis, multi-organ failure, perinatal stroke, arsenic, lead or mercury poisoning, malignancies or carcinomas, hepatic encephalopathy, hepatorenal syndrome, nephrotoxicity, rhabdomyolysis, metabolic acidosis, renal or liver failure, cerebral edema, coma, intracerebral haemorrhage, and death. Adulteration and contamination of HMPs were most commonly noted for traditional Indian and Chinese remedies, respectively.
Collectively these data suggest that there are reasons for concerns with regards to the quality of HMPs. Adulteration and contamination of HMPs can cause serious adverse effects. More stringent quality control and its enforcement seem to be necessary to avoid health risks.
KeywordsAdulteration Contamination Herbal medicine Systematic reviews
- 1.Hunt K, Ernst E (2010) Patients’ use of CAM: results from the Health Survey for England 2005. Focus Altern Complement Ther 15(2):101–103Google Scholar
- 2.Vocus/PRWeb (2012) http://www.prweb.com/releases/herbal_supplements/herbal_remedies/prweb9260421.htm. Accessed 9 March 2012
- 3.Ernst E, Pittler MH, Wider B, Boddy K (2006) The desktop guide to complementary and alternative medicine, 2nd edn. Elsevier Mosby, EdinburghGoogle Scholar
- 7.Huang WF, Wen KC, Hsiao ML (1997) Adulteration by synthetic therapeutic substances of traditional chinese medicines in Taiwan. J Clin Pharmacol 37:334–350Google Scholar
- 13.World Health Organisation (2012) WHO guidelines for assessingquality of herbal medicineswith reference to contaminantsand residues. Available at: www.who.int/medicinedocs/index/assoc/s14878e/s14878e.pdf. Accessed 9 March 2012
- 14.Corrigan D (2003) European herbal medicines regulations. Focus Alt Complement Ther 8(2):169–170Google Scholar
- 33.Basch E, Conquer J, Culwell S et al (2012) Green tea (Camellia sinensis) Natural Standard Professional Monograph. Available at: http://www.naturalstandard.com/databases/herbssupplements/all/camellia.asp. Accessed 21 Jan 2012
- 34.Armbruester N, Bryan K, Costa D et al (2012) Cinnamon (Cinnamomum spp.) Natural Standard Professional Monograph, pp 1–70. Available at: http://www.naturalstandard.com/databases/herbssupplements/all/cassia.asp. Accessed 21 Jan 2012
- 35.Ceurvels J, Davis M, Clubb J et al (2012) Blue cohosh (Caulophyllum thalictroides) Natural Standard Professional Monograph. Available at: http://www.naturalstandard.com/databases/herbssupplements/all/caulophyllum.asp. Accessed 21 Jan 2012
- 38.Ernst E (2002) Adverse effects of unconventional therapies in the elderly: a systematic review of the recent literature. J Am Aging Assoc 25:11–20Google Scholar
- 43.World Health Organisation (2005) National policy on traditional medicine and regulation of herbal medicines. World Health Organisation, GenevaGoogle Scholar