I read with interest the letter by Feingold1 about a case of hypokalemia induced by herbal tea. Herbs have been used as both medicines and foods since the beginning of human civilization. Herbal medicines have made many important contributions to modern pharmacology, including ephedrine from Ephedra sinica (Ma Huang), digoxin from Digitalis purpurea (foxglove), aspirin from Salix alba (willowbark), and reserpine from Rauwolfia serpentina (snakeroot), to name just a few.2 In recent years, the herbal market in the United States has experienced unprecedented growth; one third of the nation's adults used herbal remedies,3 and over two thirds of patients did not reveal their herbal use to their physicians.3 Hence, not only is the potential for drug-herb interaction unmonitored, but the concomitant use of drugs and herbs may not even be acknowledged.4
Cheng TO. Herbal Interactions With Cardiac Drugs. Arch Intern Med. 2000;160(6):870–871. doi:
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