(31)    Wed 14 May 97 12:20
By: David Bloomberg
To: All
Re: "Natural" Healing Kills
St:
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@EID:38c4 22ae6280
@MSGID: 1:2430/2112 7a13aaf9
 Chaparral Linked to Liver Damage

 May 13, 1997

 NEW YORK (Reuters) - Chaparral, a 'natural' medicine derived from a desert
shrub, has been linked to 18 cases of liver damage, experts say.

 "The use of chaparral may be associated with acute to chronic irreversible
liver damage," according to research led by scientists at the Food and Drug
Administration's (FDA) Center for Food Safety and Applied Nutrition in
Washington, D.C.

 Thirteen of the 18 cases of chaparral-induced illness resulted in
hepatotoxicity, or liver poisoning. Four of those cases developed cirrhosis, a
chronic liver disease, and two patients were so acutely poisoned as to require
life-saving liver transplants.

 Chaparral is a non-prescription, 'natural' remedy derived from the evergreen
shrub of the same name (species name Larrea tridentata), found in the desert
environments of the southwestern United States and Mexico. Sold in tea, capsule
and tablet forms, ingestion of chaparral is thought by some to treat ailments
such as cancer, liver and blood ailments, skin disorders, burns, and obesity.

 While its medical benefits remain unproven, chaparral's potentially dangerous
effects on the liver are all too real, FDA experts say. Those poisoned
experienced "fatigue, abdominal pain... dark urine, light stool, nausea and
diarrhea." Other patients experienced loss of appetite, jaundice, and fever -
symptoms commonly associated with liver poisoning.

 Increased chaparral ingestion seemed to intensify symptoms. In the case of one
patient, "symptoms worsened after she increased her intake of chaparral." And
the FDA researchers believe concurrent use of alcohol and drugs may exacerbate
the already damaging effects of chaparral upon the liver.

 The government experts say too many consumers believe, mistakenly, that if
products "are labeled or regarded as 'natural', they are devoid of adverse
effects." Naturally-derived dietary supplements or medicines may nonetheless
contain dangerous compounds, they say.

 In fact, the FDA is already familiar with one of chaparral's main active
ingredients, nordihydroguaiaretic acid (NDGA). Used as a preservative in foods
over 30 years ago, the agency says NDGA "was removed by the FDA from the
'generally recognized as safe' list in 1968 for use in foods because of the
results of animal toxicity testing."

 Chaparral is not the only health store dietary supplement under FDA scrutiny.
They say "botanicals" such as germander, jin bu huan, groundsel, skullcap,
comfrey, mistletoe, and senna "are also known to be hepatotoxins."

 "Given the growing body of evidence that at least some dietary supplements may
be harmful, we encourage health professionals to inquire routinely about the
use of dietary supplements and other products, (and) to be alert to (their)
potential adverse effects," the FDA experts conclude.

 SOURCE: Archives of Internal Medicine (1997;157:913-919)


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