Pseudoscientific Interventions for Gut Health to Avoid in Natural Medicine

A recent review article urged integrative practitioners to avoid certain natural medicine approaches to gastrointestinal health and detoxification, citing a lack of scientific backing and potential adverse effects.

The paper, published in Integrative Medicine: A Clinician’s Journal, was authored by Cristina Paul, MS, scientific consultant for Designs for Health in Palm Coast, Florida, and David Brady, ND, CCN, DACBN, IFMCP, FACN, chief medical officer for Designs for Health. In it, Paul and Brady discuss concerns of toxicity and mucosal damage due to the long-term use of aggressive laxative herbs as well as the harmful effects of treatments involving fulvic acids and/or humic acids.

“After 30 years in practice, academia, and industry in the professions of clinical nutrition, natural, integrative and functional medicine I have seen many of the same pseudoscientific parlor tricks come and go, usually re-appearing and repeating themselves multiple times," said Brady in a statement. "One of the most popular ones is the use of toxic cathartic herbs that cause damage and sloughing of the intestinal lining in order to eradicate fictional parasites that supposedly 'all people have' yet can’t be identified by even the most sensitive modern laboratory analysis. Another is the use of dubious and potentially harmful chelating agents to promote 'detoxification'."

In the paper, Brady explained that aggressive use of cathartic herbs was popularized most recently in response to panic around hypothetical disease-causing parasites called “rope worms” promoted by two unsubstantiated articles by authors with credentials not related to gastroenterology or helminthic sciences. Word about these so-called parasites was further spread by various social media posts and videos sharing people’s experiences with the parasites along with non-scientific interventions and explanations for them. 

Soon, nutritional supplement companies and even healthcare providers were encouraging patients to use damaging protocols like aggressive laxative regimens to expel these rope-like tissues. Patients were instructed to take laxative herbs continuously or in multiple cycles, which according to Brady and Paul, can lead to serious adverse effects. In the paper, the authors listed each of these herbs and their side effects, which included:

• Cascara (Cascara sagrata). Brady and Paul said long-term use of Cascara can irritate the colon, speeding up peristalsis and leading to cramps, diarrhea, and weight loss. In addition, there have been reports of mild to severe liver injuries caused by the herb after a few days or months of use.
• Senna (Senna alexandrina). According to the authors, hepatotoxicity and genotoxicity have been observed when Senna is abused. In addition, they advised patients with kidney disorders and those taking antiarrhythmic, cardiotonic drugs and medicinal products inducing QT-prolongation and digoxin to avoid Senna as it may potentiate their effects and toxicity.
• Rhubarb (Rheum rhubarbarum) extracts. The paper explained that there have been reports of liver toxicity after long-term use of rhubarb extracts, most likely due to compounds in the supplement, such as tannins and hydrolyzed tannins. The authors wrote that these compounds may cause hepatocyte necrosis, which refers to the death of cells in the liver. 

“These protocols are not supported by science-based microbial assessments of stool or any helminthis taxonomy and may result in altered gut barrier integrity and intestinal hyperpermeability,” the authors wrote.

In addition, the paper expressed concern about using humic acids (HAs) and fulvic acids (FAs) for heavy metal detoxification. Multiple studies have indicated that while the acids may have benefits like anti-inflammatory, anti-allergic, anti-microbial, and anti-function actions, supplementing with FAs and HAs also has potentially damaging effects. According to the authors, these side effects include increased inflammation and oxidative stress and reduced thyroid function or laxative effect. Research also suggests FAs and HAs may deplete nutritionally essential minerals, leading to adverse consequences like anemia, DNA fragmentation, and osteoarthrosis. 

In the paper's conclusion, Paul and Brady warned practitioners to be cautious of products containing FAs and HAs, writing “many dubious detox protocols intended for the removal of heavy metals or mold spores employ the use of ingredients that contain FAs and/or HAs without standardization and clear characterization of their sources. There are no long-term clinical trials to affirm the safety and efficacy of FAs/HAs with specific doses and duration of use.” 

As a natural medicine doctor, Brady said he views the use psuedoscientific interventions mention in the paper with extreme frustration.

"These are precisely the kinds of things that needs to stop for our medicine to be taken seriously," he said. "While laymen may be excused for falling for this type of hype, the healthcare providers [who use these interventions] need to re-evaluate their discernment over these approaches when they are proposed to them, and the companies that are out there shamelessly promoting them for profit should be embarrassed and called to task for doing so.”