Consider this clinical scenario: an elderly patient with strong risk factors for heart disease takes a daily aspirin as a preventive measure. Lately, she has become a little forgetful and begins taking Ginkgo biloba because she read in a magazine that the herbal supplement can improve cognition. Several months later she falls on a loose piece of carpeting. Fortunately, she does not fracture her hip. But a protruding carpet nail leaves her with a deep gash in her arm. On the way to the emergency department, paramedics have difficulty controlling her bleeding, and she is at risk for substantial blood loss.
Voelker R. Cardiac Patients’ Herbal Supplement Use Deserves More Careful Investigation. JAMA. 2010;303(9):824. doi:10.1001/jama.2010.219