Health Tips

Malaysia is blessed with rich biodiversity; among them are flora that possess high medicinal value. Herbal medicine usage is becoming increasingly popular among Malaysians, as they often view herbal medicines as ‘more natural’ and therefore ‘less harmful’ than modern medicine. (which is not true, as we shall discuss below)

With such high demand for herbal medicine there comes many suppliers who would like to share this lucrative economic pie. They sell various herbal medicinal products to customers without regarding the safety, efficacy and quality of such products. This is especially dangerous when our current regulations on herbal medicines are inadequate. 

Here we list out 5 dangerous health effects associated with herbal medications. You are encouraged to consult a healthcare provider before taking any herbal medications, especially if you have any medical condition.

1. Cushing’s syndrome 

E.g. Any traditional medicine products which are adulterated by dexamethasone

Malaysia has long struggled with traditional medicine products adulterated with substances which are not supposed to be present in such products, such as dexamethasone. Dexamethasone is a controlled medicine; it has powerful anti-inflammatory properties and was recently made famous by its use in patients with severe COVID-19. 

Image credit: https://www.bbc.com/news/health-53077879

Although a useful drug when used appropriately by healthcare professionals, it has a wide array of side effects and should not be used lightly. Unfortunately, many unscrupulous sellers added dexamethasone into their traditional medicine practice to boost its anti-inflammatory effects, which eventually subjects its users to many side effects such as Cushing’s syndrome. People suffering from Cushing’s syndrome may have a round face (‘moon face’), high blood pressure, hallucinations, diabetes and central obesity (marked by a big belly).

Image credit to https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/symptoms-causes/syc-20351310

We wrote an article on adulterated cosmetic products previously, check it out here.

2. Damage your heart (cardiotoxicity)

E.g. Ephedra sinica (马黄, ma-huang)

Image credit to: © Steven Foster at https://www.nccih.nih.gov/health/ephedra

Traditionally, the dried stems of ephedra are commonly used to treat asthma, coughs, fever, problems with urination and alleviate swelling. However, the Food and Drug Administration (FDA) in the United States has banned ephedra-containing products in 2004 due to mounting scientific evidence and the receipt of more than 18,000 adverse-event reports. 

Among many other negative health effects, scientists have found the most prominent adverse effects of ephedra are cardiovascular-related: high blood pressure, heart attack, stroke, myocarditis and irregular heart rhythm that can be deadly. Ephedra is still found in herbal remedies in various parts of the world but are not allowed to be used in traditional medicines registered in Malaysia.

3. Damage your liver (hepatotoxicity)

E.g. Black cohosh 

Black cohosh is well-known for its ability to relieve menopausal complaints and painful menstruation (dysmenorrhea). While black cohosh is generally safe when used under supervision of a healthcare professional, there have been reports on individuals who used black cohosh suffered from liver failure.  Some scientists concluded that black cohosh may not be inherently toxic, and the liver failure may be caused by an unexplained immunological reaction towards black cohosh; or due to poor quality control over products containing black cohosh.

4. Mouth ulceration 

E.g. feverfew (Tanacetum parthenium)

Feverfew has been used traditionally to treat migraine as well as arthritis. In general, feverfew is well-tolerated by many people. However, feverfew can cause ulcers in the mouth, which manifests as widespread inflammation of the oral mucosa of tongue, lip swelling and even loss of taste. There are many scientific reports on feverfew may cause skin inflammation (dermatitis) as well. 

In rare instances, after using feverfew for a long time and stopping it abruptly, you may experience what is known as the ‘post-feverfew syndrome’, which involves anxiety, headaches, insomnia and joint pains. 

5. Damage your kidney

E.g. Various Chinese herbs

Image credit to http://temperate.theferns.info/plant/Aristolochia+contorta

Many Chinese herbs contain chemical compounds that may damage the kidney. The main culprit from such herbs are aristolochic acids and alkaloid compounds. Aristolochic acids are a group of chemical compounds which may cause cancer and damage the kidney. They are mainly derived from the birthwort family of plants (Aristolochia contorta Bunge北马兜铃, Aristolochia manshuriensis Kom 关木通/木通马兜铃, Clematis Chinensis Osbeck威灵仙, and Aristolochia cathcartii Hook管兰香). As a result, individuals who suffer from such damage may experience acute kidney injury, kidney stones and severe anemia. 

Use herbal medications safely

This article is an non-exhaustive list of the possible adverse effects herb medicines may cause. This is not to say that you should not use any herbal medications, but use it wisely and under the supervision of a healthcare professional. It is important that you do not buy any traditional herbal products from an unregistered seller. 

Check if the product is registered on NPRA website. 

If a product has been reported to be adulterated, it will be recorded in this portal.

Use herbal medications wisely so that it positively contributes to better health and not the other way around. 

Written by

Ms Joyce Toh