Potentially Harmful Traditional Chinese Medicinal Products (Human)

[Guest guest]

Hi Damian & Al,

 

Damian wrote re: Potentially Harmful Traditional Chinese Medicinal Products

(Human):

 

> Dear Phil, ... it may be of interest to you that the IMB yesterday

> posted a product-specific warning about the above on it's website. 

> The URL is:http://tinyurl.com/2jxlye   Regards, Damian

 

Damian, many thanks for the alert. The danger of undesirably high levels of

aristolochic acid (AA) in herbal formulas has been discussed on several

TCM lists in recent years. However, I am posting this to some Lists now.

 

The four products on the IMB recall order were:

 

(1) Xiegan Wan / Pian (called XIE GAN WAN TABLETS, but probably

Longdan Xiegan Wan / Tang / Pian) - Ekong International (UK) Ltd.

 

This formula should contain Longdancao, Chaihu, Zhizi, Danggui,

Shengdihuang, CHUANmutong, Cheqianzi, Zexie and Gancao. It is a safe

product IF authentic herbs, properly processed, are used. However, some

companies add GUANmutong instead of the safer forms of Mutong.

 

If one MUST use Mutong, use a low-AA variety, like CHUANmutong /

Huaitong / Baimutong (Caulis Akebiae / Clematidis).

 

Apart from Longdan Xiegan Wan / Tang / Pian, other formulas also contain

Mutong, like Xinyi San, Xiaofeng San, Bazheng San, Danggui Sini Tang,

Daochi San, etc;

 

AVOID all formulas w GUANmutong (Caulis Aristolochiae)!

 

(2) Baitouweng Wan / Pian (called BAI TOU WENG WAN TABLETS -

Lanzhou Taibao Pharmaceutical Factory, China.

 

A problem is that this formula is not a standard recipe. One company uses

Baitouweng + a high dose of Aiye (Mugwort, which can be dangerous by oral

route); another company uses Baitouweng, Huangbai, Huanglian & Qinpi -

all safe herbs if properly processed before inclusion).

 

I cannot see how the AA got into that formula UNLESS there were

undeclared ingredients containing it.

 

(3) Chuanxiong Chatiao Wan / Pian (called CHUAN XIONG CHA TIAO

WAN TABLETS) - Lanzhou Taibao Pharmaceutical Factory (Lanzhou

Minshan Pharmaceutical Factory), China.

 

The traditional formula contained Bohe, Chuanxiong, Baizhi, Qianghuo,

XIXIN, Fangfeng, Jingjie & Gancao, taken with Green Tea (Qingcha /

Lucha).

 

However, as XIXIN can have high AA levels, some companies substitute

Xiangfu for it (at the same dose as Baizhu). The formula banned by IMB

may have had XIXIN in it.

 

(4) Xiaoqinglong Wan / Pian (called XIAO QIN LONG WAN TABLETS) -

Lanzhou Taibao Pharmaceutical Factory (Lanzhou Minshan Pharmaceutical

Factory), China.

 

The traditional formula contained BANXIA, Mahuang, Baishao / Shaoyao,

Gancao / Zhigancao, Guizhi, Wuweizi, Ganjiang & XIXIN.

 

All those herbs are safe, except XIXIN (and possibly BANXIA, if not

processed correctly).

 

In summary, the main sources of AA in TCM formulas are: GUANmutong

(Caulis Aristolochiae), GUANGfangji (Rx Aristolochiae Fangchi) & XIXIN (Hb

Asari).

 

The IMB is correct to ban medicinals with high AA levels. Of the 4 banned

formulas, the AA may have come from GUANmutong (in formula #1), XIXIN

(in formulas #3 & 4), or UNDECLARED ingredients (such as the latter two,

or GUANGfangji) in formula #2.

 

PS: If not processed properly before inclusion, BANXIA (Rz Pinelliae), as in

formula #4, can be toxic (though not as a source of AA).

 

Best regards,

 

1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0);

VOIP Number: +353-1482-7068;

Tel: (M): +353-(0)

 

 

 

" Man who says it can't be done should not interrupt woman doing it " -

Chinese Proverb

 

 

 

[Guest guest]

Hi Damian & Al,

 

Damian wrote re: Potentially Harmful Traditional Chinese Medicinal Products

(Human):

 

> Dear Phil, ... it may be of interest to you that the IMB yesterday

> posted a product-specific warning about the above on it's website. 

> The URL is:http://tinyurl.com/2jxlye   Regards, Damian

 

Damian, many thanks for the alert. The danger of undesirably high levels of

aristolochic acid (AA) in herbal formulas has been discussed on several

TCM lists in recent years. However, I am posting this to some Lists now.

 

The four products on the IMB recall order were:

 

(1) Xiegan Wan / Pian (called XIE GAN WAN TABLETS, but probably

Longdan Xiegan Wan / Tang / Pian) - Ekong International (UK) Ltd.

 

This formula should contain Longdancao, Chaihu, Zhizi, Danggui,

Shengdihuang, CHUANmutong, Cheqianzi, Zexie and Gancao. It is a safe

product IF authentic herbs, properly processed, are used. However, some

companies add GUANmutong instead of the safer forms of Mutong.

 

If one MUST use Mutong, use a low-AA variety, like CHUANmutong /

Huaitong / Baimutong (Caulis Akebiae / Clematidis).

 

Apart from Longdan Xiegan Wan / Tang / Pian, other formulas also contain

Mutong, like Xinyi San, Xiaofeng San, Bazheng San, Danggui Sini Tang,

Daochi San, etc;

 

AVOID all formulas w GUANmutong (Caulis Aristolochiae)!

 

(2) Baitouweng Wan / Pian (called BAI TOU WENG WAN TABLETS -

Lanzhou Taibao Pharmaceutical Factory, China.

 

A problem is that this formula is not a standard recipe. One company uses

Baitouweng + a high dose of Aiye (Mugwort, which can be dangerous by oral

route); another company uses Baitouweng, Huangbai, Huanglian & Qinpi -

all safe herbs if properly processed before inclusion).

 

I cannot see how the AA got into that formula UNLESS there were

undeclared ingredients containing it.

 

(3) Chuanxiong Chatiao Wan / Pian (called CHUAN XIONG CHA TIAO

WAN TABLETS) - Lanzhou Taibao Pharmaceutical Factory (Lanzhou

Minshan Pharmaceutical Factory), China.

 

The traditional formula contained Bohe, Chuanxiong, Baizhi, Qianghuo,

XIXIN, Fangfeng, Jingjie & Gancao, taken with Green Tea (Qingcha /

Lucha).

 

However, as XIXIN can have high AA levels, some companies substitute

Xiangfu for it (at the same dose as Baizhu). The formula banned by IMB

may have had XIXIN in it.

 

(4) Xiaoqinglong Wan / Pian (called XIAO QIN LONG WAN TABLETS) -

Lanzhou Taibao Pharmaceutical Factory (Lanzhou Minshan Pharmaceutical

Factory), China.

 

The traditional formula contained BANXIA, Mahuang, Baishao / Shaoyao,

Gancao / Zhigancao, Guizhi, Wuweizi, Ganjiang & XIXIN.

 

All those herbs are safe, except XIXIN (and possibly BANXIA, if not

processed correctly).

 

In summary, the main sources of AA in TCM formulas are: GUANmutong

(Caulis Aristolochiae), GUANGfangji (Rx Aristolochiae Fangchi) & XIXIN (Hb

Asari).

 

The IMB is correct to ban medicinals with high AA levels. Of the 4 banned

formulas, the AA may have come from GUANmutong (in formula #1), XIXIN

(in formulas #3 & 4), or UNDECLARED ingredients (such as the latter two,

or GUANGfangji) in formula #2.

 

PS: If not processed properly before inclusion, BANXIA (Rz Pinelliae), as in

formula #4, can be toxic (though not as a source of AA).

 

Best regards,

 

1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0);

VOIP Number: +353-1482-7068;

Tel: (M): +353-(0)

 

 

 

" Man who says it can't be done should not interrupt woman doing it " -

Chinese Proverb

 

 

 

[Guest guest]

I think we should not be so willing to buy into government regulations

against Chinese herbs. I know that there is a greater tendency to do this in

the UK, perhaps in Ireland. I also see many of many of my American

colleagues who fall into this tendency perhaps in an attempt to just get

along. Regulatory agencies are notorius for having banning herbs that may

have none or little toxicity. They make errors in their pronouncements in an

antempt to err on the safe side which is too often against herbal medicine.

 

Remember, the poison is in the dose and anything at an inappropriate dose

can prove toxic. Mugwort is a time tested herb with 1000's of years of safe

usage. Asarum has very little AA's and also has a long history of safe use

both In North America and in China -- again it is a matter of dosage. I

fielded this to Roy Upton who is director of the American Herbal

Pharmacopiea and his reply was " ANy botanical with high amounts of

sesquiterpenes has the potential for toxicity as they seem to have a greater

degree of allergenicity than others, are photosensitizers, and can be hard

on kidneys and liver. One point worth noting; the note said to use a low AA

variety of mu tong. Neither clematis nor akebia contain any AA. We have

conclusively shown this with extensive HPLC-MS work. "

 

I don't think even in China a pharmacy like Lanzhou could stay in business

if they were poisoning people with their many preparations.

 

I think there is far too much Chinese herb bashing going on in the Western

world.

 

Michael Tierra

 

_____

 

 

On Behalf Of

Friday, November 09, 2007 9:14 PM

vBMA; traditional_Chinese_Medicine

Cc: ; eVHMA

Re: Potentially Harmful Traditional Chinese Medicinal

Products (Human)

 

 

 

Hi Damian & Al,

 

Damian wrote re: Potentially Harmful Traditional Chinese Medicinal Products

(Human):

 

> Dear Phil, ... it may be of interest to you that the IMB yesterday

> posted a product-specific warning about the above on it's website.

> The URL is:http://tinyurl. <http://tinyurl.com/2jxlye> com/2jxlye

Regards, Damian

 

Damian, many thanks for the alert. The danger of undesirably high levels of

aristolochic acid (AA) in herbal formulas has been discussed on several

TCM lists in recent years. However, I am posting this to some Lists now.

 

The four products on the IMB recall order were:

 

(1) Xiegan Wan / Pian (called XIE GAN WAN TABLETS, but probably

Longdan Xiegan Wan / Tang / Pian) - Ekong International (UK) Ltd.

 

This formula should contain Longdancao, Chaihu, Zhizi, Danggui,

Shengdihuang, CHUANmutong, Cheqianzi, Zexie and Gancao. It is a safe

product IF authentic herbs, properly processed, are used. However, some

companies add GUANmutong instead of the safer forms of Mutong.

 

If one MUST use Mutong, use a low-AA variety, like CHUANmutong /

Huaitong / Baimutong (Caulis Akebiae / Clematidis).

 

Apart from Longdan Xiegan Wan / Tang / Pian, other formulas also contain

Mutong, like Xinyi San, Xiaofeng San, Bazheng San, Danggui Sini Tang,

Daochi San, etc;

 

AVOID all formulas w GUANmutong (Caulis Aristolochiae)!

 

(2) Baitouweng Wan / Pian (called BAI TOU WENG WAN TABLETS -

Lanzhou Taibao Pharmaceutical Factory, China.

 

A problem is that this formula is not a standard recipe. One company uses

Baitouweng + a high dose of Aiye (Mugwort, which can be dangerous by oral

route); another company uses Baitouweng, Huangbai, Huanglian & Qinpi -

all safe herbs if properly processed before inclusion).

 

I cannot see how the AA got into that formula UNLESS there were

undeclared ingredients containing it.

 

(3) Chuanxiong Chatiao Wan / Pian (called CHUAN XIONG CHA TIAO

WAN TABLETS) - Lanzhou Taibao Pharmaceutical Factory (Lanzhou

Minshan Pharmaceutical Factory), China.

 

The traditional formula contained Bohe, Chuanxiong, Baizhi, Qianghuo,

XIXIN, Fangfeng, Jingjie & Gancao, taken with Green Tea (Qingcha /

Lucha).

 

However, as XIXIN can have high AA levels, some companies substitute

Xiangfu for it (at the same dose as Baizhu). The formula banned by IMB

may have had XIXIN in it.

 

(4) Xiaoqinglong Wan / Pian (called XIAO QIN LONG WAN TABLETS) -

Lanzhou Taibao Pharmaceutical Factory (Lanzhou Minshan Pharmaceutical

Factory), China.

 

The traditional formula contained BANXIA, Mahuang, Baishao / Shaoyao,

Gancao / Zhigancao, Guizhi, Wuweizi, Ganjiang & XIXIN.

 

All those herbs are safe, except XIXIN (and possibly BANXIA, if not

processed correctly).

 

In summary, the main sources of AA in TCM formulas are: GUANmutong

(Caulis Aristolochiae), GUANGfangji (Rx Aristolochiae Fangchi) & XIXIN (Hb

Asari).

 

The IMB is correct to ban medicinals with high AA levels. Of the 4 banned

formulas, the AA may have come from GUANmutong (in formula #1), XIXIN

(in formulas #3 & 4), or UNDECLARED ingredients (such as the latter two,

or GUANGfangji) in formula #2.

 

PS: If not processed properly before inclusion, BANXIA (Rz Pinelliae), as in

 

formula #4, can be toxic (though not as a source of AA).

 

Best regards,

 

1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0);

VOIP Number: +353-1482-7068;

Tel: (M): +353-(0)

http://homepage. <>

eircom.net/~progers/vaplinks.htm

http://homepage. <>

eircom.net/~progers/tecnotes.htm

 

" Man who says it can't be done should not interrupt woman doing it " -

Chinese Proverb