Don't Bogart That Wort, My Friend

We know that nature's way may be the best way. The catch is we don't know enough about nature, itself. The ultimate natural remedy for depression or mania or memory enhancement is probably sitting on the bottom of a rain forest someplace, or in the belly of some sea creature that even the fish don't know about. In the meantime, alarming numbers of people are experimenting on themselves with what's out there, often without telling their doctors, an astounding 60 percent, according to a Mayo Clinic study.

Since 1994, when new laws went into effect virtually removing supplements from FDA control, supplement sales have grown by nearly 80 percent, from $8.8 billion to a projected $15.7 billion for 2000. No doubt, some of these substances represent the right choice for many, but the idea of freely available weeds or roots or bulbs in pill form is disconcerting to many medical practitioners, who fear that as many as 15 million Americans may be at risk for potential herb-drug interactions.

Moreover, there might not be as much "nature" in "natural" as suppliers would like you to believe. In a major investigative piece, The Washington Post found that increasing numbers of Americans are falling seriously ill or even dying after taking dietary supplements that promise everything from extra energy to sounder sleep.

Among its findings:

• Dangerous contaminants and poor quality control in supplement ingredients. California investigators in 1998 found that nearly one-third of 260 imported Asian herbals were either spiked with drugs not listed on the label or contained lead, arsenic or mercury. Last month, state officials discovered five Chinese herbals that contained powerful diabetes drugs.

• Poison control centers in various states are reporting adverse reactions to a broad range of supplements. Pittsburgh documented 198 incidents involving herbal supplements in the 15 months ending last March, with ginseng and St. John's wort the most frequently mentioned substances. In Georgia, ephedra and melatonin, a sleep aid, led the list in 1999.

• In Long Island, a mother gave her 18-month-old baby a teaspoon of eucalyptus oil last year after a store clerk told her it was good for a fever. The child suffered permanent neurological damage and almost died.

• The FDA's monitoring system implicated dietary supplements in 2,621 adverse events between 1993 and 1998, with 184 of them resulting in death. The American Association of Poison Control Centers received 6,914 reports on supplements in 1998 alone, including 1,369 cases involving treatment in a health care facility.

To survey some of nature's most popular offerings:

ST JOHN'S WORT

Some 27 European studies have more than demonstrated its

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