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Why Natural Doesn’t Always Equal Safe
Drug-herb interactions are rising; so are herbal supplement sales
In 2018, a 69-year-old man was admitted to a hospital in China. His complaints included lower limb weakness, unsteady gait, and muscle pain. He was found to have severe rhabdomyolysis, a potentially fatal type of myopathy (neuromuscular disorder) believed to be caused by statin (cholesterol-lowering drug) use. Over the previous decade, the patient had taken 40 mg of simvastatin every day.
For its part, the US Food and Drug Administration (FDA) warned against the use of high-dose simvastatin in 2010, but that’s not the end of this story. The patient was found to be genetically susceptible to statin-induced myopathy (SIM), and environmental factors, such as the addition of new drugs, have been shown to either delay or hasten its onset. Like many others around the world his age (and much younger), the patient regularly ingested a wide array of medications and supplements, including linagliptin (an antidiabetic drug), various vitamins and minerals, coenzyme Q10, and Stevia rebaudiana.
Stevia?
The report cites a recent study, which found that steviol and stevioside[*] have a “weak inhibitory effect” on the activity of an enzyme called CYP3A4, which plays an outsize role in drug metabolism. Linagliptin…
