Kristina Fiore, staff writer for MedPage Today, released an article on Sept. 22, 2015 titled Some Yohimbe Supplements Stronger than Labeled, with a subheading Pharmaceutical-grade yohimbine, used for sexual dysfunction, is passing for a botanical supplement. The article documented the concern expressed by Pieter Cohen MD of the Cambridge Health Alliance in Massachusetts that the yohimbe supplements did not have alkaloids that normally occur in the plant extracts. Their study found that the purity in about 40% of the 49 samples exceeded expectations for a yohimbe extract.
Dr. Cohen expressed the opinion that these yohimbe products should be treated as drugs, not supplements, because of their purity. Yohimbine is an active ingredient in the extract that is used to treat ED.
If you have yohimbine that’s highly refined to higher-than-prescription doses, you’re selling a drug. You shouldn’t be able to make a pharmaceutical drug — even if it is found in a plant — and put it in supplements and sell it over-the-counter.
Yohimbe is derived from a west African evergreen tree, and has been traditionally used to increase libido and treat erectile dysfunction (ED). The National Institute of Health (NIH) provides a thorough discussion of yohimbe and the active ingredient yohimbine. The pharmaceutical product is yohimbine hydrochloride, and is also sold to treat ED. A thorough description of the testing done by Cohen MD, et. al. is available. It was a very precise study. The study does not provide identification of the specific supplements that were tested.
As consumers increasingly turn to traditional alternative herbs and supplements because of risks associated with pharmaceutical drugs, these conflicts of supplements versus drugs are going to occur more frequently. Medical marijuana faces similar complaints when it is used to replace anti-seizure drugs on young children, with the pharmaceutical product being shown to be less effective and with significantly more adverse side-effects when compared to the medical marijuana solution.
Ayurvedic medicine has been successfully used for over 5,000 years in India and across the Far East. Oriental medicine from China, Korea and Japan has been used for over 3,000 years. Claims by pharmaceutical companies that there are no data to support the efficacy and safety of these traditional medicines is deceptive and false. The proof comes from actual cures to serious diseases using the alternative approaches for thousands of years.
The multiple phase testing data provided by pharmaceutical manufacturers to evaluate drugs is not available for supplements, herbs and extracts. Pharmaceutical companies do not spend money to verify safer and cheaper solutions than their expensive drugs. There will continue to be increased lobbying by the pharmaceutical manufacturers’ associations to restrict the availability of herbs and supplements, and to force testing on herbs and supplements that have been successfully used for thousands of years.
Be aware that there should be serious considerations of the impact of these herbs and supplements, however. While generally having fewer side effects and rarer fatal interactions as those of pharmaceutical drugs, herbs and supplements should be taken with care. The NIH tract on yohimbe includes cautions about potential issues, and these should be consulted before ingesting any yohimbe extract. The tract includes the standard disavowal of supplements.
- It is not known whether yohimbe is effective for any health condition because clinical trials have not been conducted on the bark or its extract.
Side Effects and Cautions from the NIH for yohimbe
- Yohimbe has been associated with high blood pressure, increased heart rate, headache, anxiety, dizziness, nausea, vomiting, tremors, and sleeplessness. Yohimbe can be dangerous if taken in large doses or for long periods of time.
- People should not combine yohimbe with monoamine oxidase (MAO) inhibitors as effects may be additive. Yohimbe should be used with caution when taken with medicines for high blood pressure, tricyclic antidepressants, or phenothiazines (a group of medicines used mostly for mental health conditions such as schizophrenia).
- People with kidney problems and people with psychiatric conditions should not use yohimbe.
- Women who are pregnant or breastfeeding should not take yohimbe.
- Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
The use of herbs, supplements, essential oils, homeopathic remedies and Oriental medicine extracts provide alternative solutions to pharmaceutical drugs. Their safety and effectiveness have thousands of years of experience, but buying a bottle of any of these products and taking them without supervision is risky if careful research is not done. There is no substitute for diet, exercise, management of stress, and attention to the body’s signs of distress to maintain good health. Using alternative supplements and other natural products can provide a safer and less expensive solution to a medical issue, but it is recommended that a qualified alternative provider is consulted.