Warnings: The chronic use of anthraquinone laxatives or their indiscriminate use in teas sold to help reduce weight has created many problems that have led to warnings from the FDA. In 1995 the FDA’s Food Advisory Committee recommended that herbal products carry a statement to warn the public.
They suggested labeling products with an abbreviated version of the following: “NOTICE (OR WARNING); Contains herbs (insert whatever the herbs are) that can act as stimulant laxatives. Prolonged steeping time can increase the risk and adverse laxative effects including, nausea, vomiting, abdominal cramps and diarrhea. Chronic use of laxatives can impair colon function. Use of laxatives may be hazardous in the presence of abdominal pain, nausea, vomiting or rectal bleeding. Laxative-induced diarrhea does not significantly reduce absorption of food calories. Acute or chronic diarrhea may result in serious injury or death.”8
Taking a cue from the FDA, the American Herbal Product Association (in July 1995) and the California Department of Health Services Food and Drug Branch (in November 1996) issued similar warnings for products that contained Aloe (Aloe ferox and related species), buckthorn bark and berry (Rhamnus catharticus and related species), cascara sagrada bark (Rhamnus purshiana), Chinese rhubarb root (Rheum palmatum), and senna leaf and pod (Cassia angustifolia and related species). The aloe gel, which contains minimal quantities of anthraquinone derivatives, is excluded from the list. The American Herbal Products Association warning reads, “NOTICE: Do not use this product if you have abdominal pain or diarrhea. Consult a health care provider prior to use if you are pregnant or nursing a baby. Discontinue use in the event of diarrhea or watery stools. Do not exceed recommended dose. Not for long-term use.”8
The California Department of Health Services Food and Drug Branch (FDB) warning must include the essence of the following, “NOTICE: This product contains (name the substance[s] and common name if different). Read and follow directions carefully. Do not use if you have or develop diarrhea, loose stools or abdominal pain. Consult your physician if you have frequent diarrhea. If you are pregnant, nursing, taking medication or have a medical condition, consult your physician before using this product.” The FDB notice in January 1997 reported 67 illnesses in first-time and regular users of the “dieter’s teas” and up to 10 deaths in regular consumers.9
Although there is a correlation between the use of anthraquinone containing products and serious illness or death, there is no conclusive evidence that these products have been the main cause of such problems.
It has been known for a long time that frequent use of these products do cause electrolyte imbalance and hypokalemia leading to life-threatening cardiac arrhythmia’s and death. Those suffering from bulimia, anorexia or nutrient deficiencies are particularly prone to the harmful effects of these laxatives.8, 9