A Troublesome Cup of Tea

A 45-year-old woman presented to the emergency department with nausea and vomiting. Her symptoms had started seven days earlier and steadily worsened. She reported generalized abdominal pain and distention and that her eyes appeared yellow.The patient had no past medical history, took no medications, and said she did not drink or use drugs. Her history showed that she had been drinking an herbal preparation every day for the past five months to ameliorate her heavy menstrual periods.The patient had mild right upper quadrant tenderness but no distention, rebound, or guarding. Her lungs were clear, and her heart rate and rhythm were normal. She had scleral icterus, and her skin was without erythema or jaundice.Her lab results were remarkable for a WBC of 10, creatinine of 1.2 mg/dL, AST of 1020 U/L, ALT of 970 U/L, total bilirubin of 3.5 mg/dL, and INR of 1.2.The herbal and dietary supplement market is worth $180 billion with more than 20 percent of the U.S. population reporting use. The Dietary Supplement Health and Education Act defined dietary supplements in 1994 as a category of food, which placed them under different regulations from those for drugs. Manufacturers of these supplements are not required to test them in clinical trials, and they are considered safe until proven otherwise.Drugs, however, are considered unsafe until proven otherwise, and must have clinical trials supporting their safety. The incidence of severe adverse effects associated with dietary supplement...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs