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5 Pro Tips for Buying Herbal Medicine

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Something about herbal medicines seems unthreatening. After all, they're made from plants. Some of your favorite foods come from plants. How bad could they be for you, really?

As it turns out, pretty bad. A new study in the New England Journal of Medicine found that adverse effects caused by these supplements and other nutritional pills (like amino acid supplements) are responsible for more than 23,000 visits to the ER per year. The main problems seemed to be with herbal remedies meant to deliver more energy or weight loss perks causing irregular heartbeat or chest pain, says the study's author, Andrew Geller, M.D.

Other recent research presented at the conference CleanUp 2015 found that herbal and Ayurvedic medicines contain heavy metals, including arsenic, cadmium, and mercury. That's a problem, since long-term exposure to these to these toxins has been shown to cause problems like organ damage and even cancer.

"There are regulations concerning dietary supplements in the U.S.," says Tod Cooperman, M.D., president of ConsumerLab.com. "But they're rather loose. Anyone can sell a supplement; there's very little oversight." Because of that, it's hard to know exactly what's inside them, and how those ingredients will affect your body or interact with other drugs you might be taking.

That said, not all plant-based supplements will send you to the ER. We asked Cooperman how to choose a safer supplement.

Avoid "Proprietary Blends"
If you see this phrase on the ingredient list, steer clear. "Often, proprietary blends are just a laundry list of herbal ingredients, but they don't tell you the actual amounts of the herbs," says Cooperman. "That's really the complete opposite of how you should be buying supplements. Ideally, you know the ingredient and the dose you want before you go out and buy a product." In other words, proprietary blends are often a sneaky way for manufacturers to hide the fact that their product is mostly filler, with very little active ingredient.

Look for Third-Party Approval
There are three major companies that conduct third-party testing of supplements: Cooperman's ConsumerLab.com, the U.S. Pharmacopeial Convention (USP), and the NSF. All three let products that pass their quality tests display their seals or logos on their labeling, so stick to bottles that have these safety hallmarks.

Think Big
Cooperman means store size. Buy supplements at major chains, and do it in person, he suggests. "There's more scrutiny in bigger stores, compared to a regional gas station or even online," he says. Earlier last year, for example, New York State's attorney general's office tested herbal supplements at GNC, Walmart, Walgreens, and Target. Unfortunately, they found that several of the pills were mostly cheap fillers. But major retailers like these can be held accountable in a way small shops can't. Case in point: Shortly after the initial investigation, GNC announced that they were tightening their quality control practices with supplements.

Watch Out for These Claims
Be extra cautious around herbal supplements that claim to boost energy levels or help you lose weight. These tend to contain ingredients, like caffeine or bitter orange, that have been shown to create heart palpitations and other issues, says Cooperman.

Talk to Your Doctor
Obvious—but too many people skip this step. Ask your doctor (or ask the healthcare app that's like Yelp) about any new supplements you plan on taking, especially if you're on other meds. Even plant-derived pills can interact with other drugs, and can be dangerous if you're pregnant.

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