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ane Rogers is a typically exhausted nursing mother of a six-month-old infant. In addition to needing more sleep, she wants to increase her calcium intake Supplements bother her stomach, so she asks an herbalist to recommend an herbal tea instead. "Try this one," he says. "Your baby will sleep better, too."

Back at home, Jane looks at the pamphlet she got from the herbalist. Two of the herbs in the tea, Lobelia and Comfrey are listed, under the title "Herbs of Caution During Pregnancy and Lactation." Both are described as alkaloid-containing plants. Alkaloids are chemicals that have a wide range of drug-like effects. In pregnancy and lactation, states the pamphlet, "it is best to avoid them."

"Then why did they recommend this tea?" she fumes. "I trusted them to give me something safe!"

Why Safety is an Issue

Vitamins, herbs, minerals and supplements are a booming business. Their popularity has soared in the past ten years. They are now the most popular form of complementary and alternative health care used by North Americans. A survey of Canadians in May 2000 found that 2 out of 3 people had used a natural health product (NHP) in the past month. The same year, they spent about $1.8 billion on herbs and supplements. Changing attitudes about health are thought to be responsible for this trend. These include a growing reverence for nature, and a suspicion of anything synthetic or artificial. Marketing for a wide range of personal and health products reinforces these notions.

But natural doesn't always mean safe. And natural health products aren't harmless, just because they come from natural sources. These are some of the reasons why:

• Some NHPs, such as Vitamin A, are toxic if you take too much.
• Natural health products can cause side effects, or allergic reactions.
• Some NHPs may be harmful to people with certain health conditions – such as heart disease, pregnancy and lactation.
• Natural Health Products may also interact with other medications – even non-prescription drugs such as aspirin.

For all these reasons, it's important to talk to your doctor, or an NHP expert first – before you try a natural health product. This is especially important if you have a serious or chronic health condition, or if you are taking any medications. While not all health professionals are well informed about NHPs, any doctor or pharmacist can find out whether a product will interact with your other medications, or cause any negative side effects.

What You Need to Know Before You Buy

"I should have known better," Jane Rogers admits sheepishly about her herbal misadventure. "I ignored the basic questions I should have asked and had answered before I bought that tea."

So, what are those basic questions? Here is a checklist created for the Canadian Health Network's Complementary and Alternative Health Affiliate by Allison McCutcheon, PhD., an ethnobotanist and a Natural Health Products expert. It can be used for any Natural Health Product:

• What is this vitamin/mineral/herb/supplement used for?
• What are the expected effects?
• Are there any known side effects?
• When should it be used, and not be used?
• Do I really need it?
• What dosage is right for me?