How Health Canada Ensures Herb Safety
Just like medications and supplements, herbal medicine is highly regulated in Canada. Health Canada ensures that herbs with even a remote possibility of toxic effects are not available on the market. When you go to the health food store, you can be confident that all the herbal products you see have been thoroughly assessed for safety.
What does this assessment look like? All herbal product manufacturers (including us) must make a strong case to Health Canada by submitting proof of safety and efficacy. This evidence could be from double blind, placebo-controlled clinical trials, just like the ones used to assess supplements and medication. But they can also come from traditional herbal literature – once there have been at least two generations of use. A generation is typically 25 years. By the time a herb has been in use for 50 years, we would have heard about any side effects or safety issues.
Health Canada has published hundreds of herbal monographs, which are like a snapshot of single herb or multi-herb products. Monographs include a summary of the safety evidence and dictate what warning and caution information must be included on the product label. Want to see for yourself? They are all available to the public. Check out this monograph on Milk Thistle.
When we submit a herbal product to Health Canada that they don’t already have a monograph for, its up to us to present a review of the scientific literature. But Health Canada also considers any adverse incident reports they receive.
Take the classic stress resilience herb, Rhodiola. Health Canada received two reports – one on hormone replacement therapy (HRT), and another on oral contraceptives. That’s why all herbal products containing Rhodiola must include warnings related to these on the label. Even if they were isolated incidents, Health Canada simply doesn’t take the risk.
How to Read Plant Medicine Labels
As you can see, Health Canada is very strict about what goes on plant medicine product labels to protect public safety. This label provides you with invaluable information about the herbs’ medicinal benefits, how much to take, known adverse reactions, and when not to take them.
Concepts like cautions and warnings apply to all medicines. But plant medicine labels can look a little different than those of supplements and pharmaceuticals. Let’s take a closer look at the label for St. Francis Herb Farm's Milk Thistle tincture.
Recommended Uses:
By the time you head to the health food store, you probably already know why you want to use a certain herb. Maybe you read an article online or heard about it from a friend or family member.
Because herbs work in a holistic way in the body, you may see more uses than you thought! If you already knew that Milk Thistle can help manage diabetes, you may be pleasantly surprised to learn that it also supports the liver. Make sure that the recommended uses match the reasons why you want to use the herb.
Recommended Dose:
When it comes to how much herbal medicine to take, it’s good to know that most herbs have a wide range of safe dosages. We are very conservative with our doses. This means that the dose you see on the label is on the low end of the scale, making it safe and effective for the widest range of people.
For some of our products we list separate doses for children, teens, and adults. Here, we see one dose for those between 12 and 14 years of age, and a higher dose for those 15 years old and up.
Ingredients:
Our product labels list both medicinal and non-medicinal ingredients. The medicinal ingredient could be a single herb, or multiple herbs.
Non-medicinal ingredients are substances that help make the final herbal product. We use distilled water and certified organic alcohol to extract the powerful plant medicine for all our tinctures. We use cellulose (the branded ingredient is Hypromellose for the vegicap) in our capsules, and some of our products contain whey from cows to help enhance the product. Pay close attention to this section if you have allergies or wish to maintain an animal-free diet.
What about the Quantity Crude Equivalent Ratio of 1:3? This means that one part of dried Milk Thistle seed was used with three parts of water and alcohol to make the final tincture. A ratio of 1:3 means that there is 1 gram (i.e., 1,000 mg) of Milk Thistle herb in every 3 mL of tincture. To put it another way – there is 333 mg of Milk Thistle in 1 mL of tincture.
Cautions and Warnings:
This label section will list medications, supplements, and existing health conditions that require a careful approach. Did you notice that none of these things appear on this label? That means that you can take Milk Thistle with full confidence that it will not interfere with anything else that you are currently taking or impact existing health conditions. And yes – this includes supplements! If you see no supplements listed in this label section (or the contraindications section), you’re good to go.
What is included here, is to consult a health care practitioner if symptoms get worse or persist. The advice to consult a health care practitioner if you’re pregnant doesn’t necessarily mean there is evidence showing that Milk Thistle causes complications in pregnancy. However, almost all products approved by Health Canada contain this warning. In pregnancy, it’s prudent to be extra safe.
Known Adverse Reactions:
Where the evidence indicates any negative side effects for a herb, it will show up in this section. This is more of an FYI of symptoms to look out for once you start taking the herb. For example, some people are sensitive to Milk Thistle. That’s why our label says to stop using it if you have an allergic reaction. To save space on the label, we have put Contraindications, Cautions and Warnings, and Known Adverse Reactions under one heading: Cautions and Warnings.
Contraindications:
This label section is a clear ‘do not take’ warning and should be followed to the letter. For example, the contraindication ‘Do not take if you have bipolar disorder or bipolar spectrum disorder’ appears on all our Rhodiola product labels. While Rhodiola can be used for its mood-elevating properties in depressive states, it can also trigger mania in those who are prone to it, for example, in those with bipolar disorder. Even if very few people experience this effect, it’s vital to have it on the label.
When The Label Says to See a Health Care Practitioner
Now that you understand how to read herbal medicine labels, how will you use the information?
If you don’t see any cautions, warnings or contraindications that apply to you – go for it! Make sure to follow label instructions that indicate how long you can use it safely without the guidance of a health care practitioner. Listen to your body. Watch out for any adverse effects listed on the label. And if you just don’t feel right, then stop taking it. Pay attention to how your mind and body respond, and act accordingly.
What if you do see something on the label that indicates you should see a health care practitioner? If you’re already seeing a practitioner that knows their herbs, you’re all set. But what if your doctor doesn’t have clinical herbal knowledge?
At the end of this article, we provide resources to help you find a herb-savvy Canadian practitioner in your area. But in the meantime – why go to the trouble of finding a new practitioner to use herbal medicine?
The Value of Seeing a Health Care Practitioner Who Knows Their Herbs
There are many different types of health care practitioners who are highly qualified to prescribe herbs, including Naturopathic Doctors, Registered Herbalists, Traditional Chinese Medicine (TCM) practitioners and Ayurvedic Medicine practitioners. All these practitioners can help you use herbal medicine safely alongside medication and supplements. The difference? They each use herbs within their own healing framework.
To learn more, we sat down with Dr. Terry Vanderheyden, ND, RH. Vanderheyden has the distinction of being both a Naturopathic Doctor and a Registered Herbalist. And – he’s our Director of Research and Development, and a Medical Advisor.
Naturopathic Doctors (NDs) in Canada must complete a university undergraduate degree before entering a rigorous, four-year naturopathic medical program. Their training is similar to that of conventional doctors, but takes a more holistic approach to health by recognizing the interconnected nature of the body’s systems, and the strong mind-body connection. But unlike most conventional doctors, they learn how to safely use pharmaceuticals, herbs, and supplements together.
“Tailoring the dose of plant medicine is where a health care practitioner is really important,” explains Vanderheyden. “This is where the art of prescribing comes in. Every individual must be assessed on a case-by-case basis, including differing levels of sensitivity.”
He finds that many of his patients are highly sensitive to the effects of medication. In other words, high doses of herbs are not always needed. Vanderheyden recalls one patient who was plagued with chronic insomnia for years. If he awoke in the night, just a fraction of a drop (1 drop placed in water) of Ashwagandha tincture sent him into a sound sleep. But, without it, he would be wide awake all night long. “It’s a far cry from the label instructions of 80 drops three times a day,” says Vanderheyden. “The beauty of prescribing is trying to individualize.”
Vanderheyden was a Naturopathic Doctor for 22 years before he became a Registered Herbalist. Although his ND education did include herbal therapeutics, he undertook additional training to indicate that he values both the modern and traditional herbal approach.
He encourages people to not be afraid of using herbal medicine for self-treatment. But – there is no replacement for the knowledge of a qualified health care practitioner. “As Herbalists and Naturopathic Doctors, we spend a lifetime learning about herbs,” says Vanderheyden. “Using herbal medicines for self-care is fine if you’re generally healthy. But if you’re seriously ill, it’s not a good idea. You need professional help to guide you.”
Looking for a Canadian health care practitioner that knows their herbs? Use the links below to find a practitioner in your area. Whether you choose to use plant medicine on your own or with a practitioner’s guidance, we’re here to remove the fear factor. Our labels empower you to use herbs on your own, and let you know when seeing a qualified practitioner is best. Are you ready to jump into plant medicine? We’re right here on the journey with you.