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Expert Q&A

	By Michael D Benson, MD Attending Physician, Highland Park Hospital, IL

Are herbs safe to take to help with infertility? I have been off the pill for about 1 year. But I have only been trying to conceive for about 3 months. I have been charting BBT and according to this my doctor says I'm not ovulating. I have been seeing a herbologist who is trying to help me naturally before taking Clomid -- like the doctor wants. She assures me the herbs are safe -- even if I got pregnant on them, they would be safe for the baby. Can you give me your input on herbs? Thank you."

The question is a broad one since it pertains to the diet additives "herb," in general. There are several issues that arise in considering the safety and benefits of health food additives for pregnant women and people in general.

1. The manufacturers make assertions of benefits on the basis of testimonials. These diet additives NEVER undergo the same type of scientific testing required of medications -- yet the health food industry is able to claim that these are valid alternatives to medications.

2. If herbs actually had the biological effects claimed by their manufacturers, one would expect that they would have undesired side effects, just like medications.

3. The amount of biologically active agent from pill to pill or among different manufacturers may vary considerably since the manufacture of these products is much less regulated.

4. In many cases, herbal products have more than one biologically active agent.

5. The assumption that because something is an herb or a mineral that it is non-toxic is not correct:
   1. Vitamin E is known to be fatal in high doses and is a suspected teratogen in lesser doses in pregnant women.

   2. Chromium, a popular "mineral" supplement is actually a heavy metal (in the same chemical class of compounds as lead) that is extremely poisonous in any (but the most microscopic) dose. It is amazing to me that the health food industry would ascribe any benefits at all to chromium supplements.

   3. St. John's Wort is actually an MAO inhibitor that can have a variety of dangerous drug interactions -- including the potential for dangerous effects in people undergoing anesthesia.

Regarding pregnancy specifically, few if any herbs have been studied in terms of fetal safety -- particularly in the doses commonly seen in diet supplements. Even if these agents occur "naturally" it does not follow that something that is safe in tiny amounts is also safe in much larger amounts. Given the fact that neither the claimed benefits nor the safety of these agents has been carefully studied, the most basic answer to your question is that pregnant women should probably avoid taking herbal supplements -- particularly in large quantities. Of course, there may be more information on specific supplements. When in doubt, ask your doctor.

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