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Aristolochic acid: Cause for concern?

In spring 2000, the FDA issued an alert to U.S. supplement manufacturers and distributors, stressing the importance of quality checks of herbal ingredients and finished products. The action was prompted by a series of overseas incidents involving Chinese herbal medicines containing aristolochic acids. These constituents, found in plants of the Aristolochiaceae family, were introduced inadvertently to Chinese herbal weight-loss preparations, reportedly causing kidney failure and urinary tract cancer in consumers in France, Spain, Japan, Belgium, Taiwan, and Britain. Inadequate identification of ingredient plants seems to have caused the mix-ups. Apparently, the plant Aristolochia fangchi was mistakenly substituted for Stephania tetranda in the weight-loss pills. Doses higher than 200 grams of Aristolochia fangchi were associated with a higher cancer risk.

While misuse of Aristolochia can have very serious effects, American consumers have little cause for concern. "Aristolochia species, such as Dutchman's pipe, are rarely-if ever-used in the US," pointed out HRF president Rob McCaleb. When identified and administered correctly, small doses of plants containing aristolochic acids are useful in Traditional Chinese Medicine, particularly for respiratory ailments. As always, consumers can protect themselves by purchasing supplements from reputable manufacturers, who easily avoid selling contaminated products by doing adequate quality checks. - Nancy Hoegler, HRF

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