| |
1st
appeared 24 May 1999
Study Finds Steroids in Chinese Herbal Creams
Traditional Chinese herbal creams, marketed for skin disorders such as eczema, may contain
potentially harmful concentrations of steroids, according to a study in the May issue of
the Western Journal of Medicine (WJM).
Researchers at King's College Hospital in London found that several of these creams,
obtained from patients at a dermatology clinic, contain a synthetic steroid called
dexamethasone. This steroid was added to the creams and is not a natural substance found
in herbs. Among 11 creams analyzed, eight contained the steroid, unbeknownst to the
patients who were using them. The concentrations of dexamethasone exceeded levels
considered safe for use on the face or on children.
Stephen Bent, a clinical research fellow at UCSF, said that while the sampling in the
study was small, the findings are alarming. Steroid creams may have damaging side effects,
including thinning and scarring of the skin that may be irreversible, he said. For that
reason, steroid creams are rarely used on the face.
In addition, steroids in creams may be absorbed through the skin into the bloodstream and
lead to problems such as osteoporosis, diabetes, muscle wasting, increased susceptibility
to infections and interference with the body's normal hormonal balance, Bent said.
Long-term use of steroids can also lead to a variety of mood disorders including
depression, insomnia and psychosis.
"Steroid creams certainly can be used for eczema, but only when administered by a
doctor who can prescribe doses that are not dangerously high and for limited
periods," said Bent, who wrote a commentary that accompanies the study in WJM.
"Clearly, this dose of steroid can be dangerous for patients, especially if used on
the face or on children, as was the case in this report. The dose of steroids found in
this study would have required a prescription in the United States."
Although creams in the United States weren't analyzed as part of the study, Bent believes
consumers in this country should be cautious until there are adequate regulations of
herbal products. Consumers should insist on information regarding ingredients before
purchasing these treatments, which often come in unlabeled containers, he said.
Earlier studies have indicated that some Chinese herbal creams, without steroids, may
indeed be effective in treating eczema, but more research is needed, he added. "The
practice of adding hidden, active ingredients not only endangers patients, but clouds our
ability to identify herbal treatments that may be beneficial," he said.
In the United States, herbal products are sold as dietary supplements and don't require
approval by the Food and Drug Administration (FDA) before they are marketed or sold in
stores. "There are no standard tests required to document safety," Bent said.
"This is in sharp contrast to the standards for drugs and it is a real problem for
the consumer. There is really no way to be sure that any given herbal product is free from
contaminants or dangerous ingredients."
Bent, a researcher at UCSF's Osher Center for Integrative Medicine, said that a recent
study of 260 Asian patent medicines sold in California herb stores found that 32 percent
contained unlabeled pharmaceuticals or contaminants such as lead, mercury and arsenic.
Asian patent medicines are a specific type of traditional Chinese remedies made of
multiple products including herbs, plants, animal parts and minerals that are mixed into
tablets, pills, liquids or creams and used for a variety of illnesses. The food and drug
branch of the California Department of Health Services collected the samples from retail
herb stores. The samples were analyzed to determine their safety and to educate the public
about their potential dangers.
The herbal product industry in the United States is approaching $4 billion in annual
retail sales and growing at 18 percent a year, Bent said. And in California, there is a
particularly strong presence of traditional Chinese medicine.
"There is a clear need to improve the safety testing of herbal products and other
remedies sold as nutritional supplements in the United States," Bent said. "I
think we will see a move towards federal requirements for documenting the safety of these
products before they are sold."
Links:
UCSF Osher Center for Integrative Medicine
UCSF Stanford Health
Care Purchases Western Journal of Medicine
Source: Laurie Itow, UCSF Stanford
Health Care |
