Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2004; 9: 40
Herbal weight-loss supplements are marketed with claims of effectiveness. However, our earlier systematic review identified only little convincing evidence that any specific herbal dietary supplement is effective for reducing body weight. Thus, even minor adverse events may shift the delicate risk-benefit balance against their use. The aim of this systematic review was to assess all clinical evidence of adverse events associated with herbal dietary supplements for body-weight reduction for which effectiveness data from rigorous clinical trials exist.
We conducted systematic literature searches on Medline, Embase, Amed and the Cochrane Library. Data were also requested from the spontaneous reporting scheme of the WHO. We hand-searched relevant medical journals and our own files. There were no restrictions regarding the language of publication.
The evidence relates to Ephedra sinica, Garcinia cambogia, Paullinia cupana, guar gum, Plantago psyllium, Ilex paraguayensis and Pausinystalia yohimbe. It suggests that some herbal dietary supplements are associated with serious adverse events, including hepatic injury, myocardial infarction and death. For herbal ephedra and ephedrine-containing dietary supplements a 2.2- to 3.6-fold increase in odds of psychiatric, autonomic or gastrointestinal adverse events and heart palpitations was reported. In conclusion, a number of herbal dietary supplements for reducing body weight are associated with serious adverse events.
In the absence of convincing evidence of effectiveness for most herbal weight-loss supplements and in the presence of adverse events that have been associated with their use, any risk-benefit assessment of herbal weight-loss supplements is negative.
