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Commonly Used Medicinal Herbs
I especially enjoyed the article by O'Hara1 et al, "A Review of 12 Commonly Used Medicinal Herbs," which concisely and generally accurately discussed 12 commonly used herbal medicines and reviewed a few toxic herbs.
There are 2 areas that deserved further comment in such a review article. (1) Herbs that come from Asian and Latin America countries have a high rate of contamination (30% in 1 study) and generally should be avoided. Contaminants include heavy metals such as lead, mercury, arsenic, phenylbutazone, and cortisone.2-3 (2) The statement by the authors that the adverse effects of ginkgo biloba are similar to placebo may not be accurate. While it appears quite safe considering its extensive use, at least 2 cases of spontaneous hemorrhage in patients using ginkgo biloba have been reported, including 1 spontaneous subdural4 hematoma and 1 spontaneous hyphema.5 Ginkgo biloba has platelet-inhibiting properties. Certainly, patients who are taking anticoagulants or other platelet inhibitors should be aware that they may be at increased risk of bleeding while taking ginkgo biloba.
B. Clair Eliason, MD
Milwaukee, Wis
1. O'Hara M, Kiefer D, Farrell K, Kemper K. A review of 12 commonly used medicinal herbs. Arch Fam Med. 1998;7:523-536.
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2. Olujohungbe A, Fields PA, Sandord AF, Joffbrand AU. Heavy metal intoxication from homeopathic and herbal remedies. Postgrad Med J. 1994;70:764-769.
3. Kao RJ. Adulterants in Asian patent medicines. N Engl J Med. 1998;339:847.
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4. Rowin J, Lewis SL. Spontaneous bilateral subdural hematomas associated with chronic ginkgo biloba ingestion. Neurology. 1996;46:1775-1776.
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5. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med. 1997;336:1108.
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Arch Fam Med. 1999;8:376.
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