Yesterday, I received a bulk email ad advertising a book about Chinese herbal medicine in pets.One of the introductory statements said that Chinese medicine is "becoming more popular as people realize the powerful yet gentle ways of TCM healing." On the same day, I received a Morbidity and Mortality Weekly Reports article entitled "Hepatitis temporally associated with an herbal supplement containing artemisinin."

Also known as qinghaosu, artemisinins are a class of compounds (drugs) that are used for the treatment of malaria. They are the active constituents of the herb Artemisia annua (sweet wormwood). Herbal supplements containing these compounds are marketed for "general health maintenance" (whatever that means), treatment of parasites and treatment of cancer.

In the MMWR case report, the CDC was notified about a person who developed hepatitis while taking an herbal supplement containing artemisinin. The person was prescribed the supplement by a naturopathic practitioner who attributed the patient’s chronic abdominal pain to a parasitic infection. Six weeks of treatment was prescribed but 1 week into treatment, signs of hepatitis developed. No other causes of hepatitis were identified, and it resolved after the person stopped taking the supplement. That doesn’t prove the supplement was the cause, but it is suspicious.

The supplement was tested and it had the amount of artemisinin that the label claimed. Artemisinin is generally considered a safe treatment for malaria, however the prescribed dose was much higher than the dose that is conventionally used for malaria treatment. It’s unclear whether the liver damage occurred because of the dose, interactions with other compounds in the supplement, or an unusual reaction in this patient.

It’s important to remember that herbal therapies are drugs. The fact that they are still in their natural state does not necessarily mean they are safer. In fact, there can be increased risks because of inconsistency in potency, dose and the presence of other compounds. With conventional drugs, extensive testing is done before they are released, to reduce the risk of them making people sick. With alternative therapies, the opposite occurs. There is no mandated pre-release testing so harmful products are only identified after they make a lot of people or animals sick.

A drug is a drug, whether it comes in a pill, liquid or leaf form.