Use of Mutong and Fangji in Taiwan

[Guest guest]

Phil,

 

It is important to note that for quite some time the Mu Tong and Fang Ji used in

Taiwan were species that contain Aristolochic acid. Namely, Guang Fang Ji and

Guan Mu Tong. While both these herbs have been sold in the US in the past, it is

rare to find them nowadays as bulk herbs. Taiwan companies are now well aware of

the issue and hopefully their products only contain Han Fang Ji and Chuan Mu

Tong both of which contain no aristolochic acid. Note that the database used in

this study was from 1997-2002. During that time the use of the aristolochic acid

containing herbs was still allowed in Taiwan. Now they are banned.

 

Andy Ellis

 

 

 

Chinese Medicine , " "

< wrote:

>

> Hi All,

>

> CUMULATIVE dose of Mutong or Fangji >60g increased the statistical

> risk of KI failure in Taiwan:

>

> Lai MN, Lai JN, Chen PC, Hsieh SC, Hu FC, Wang JD. Risks of kidney

> failure associated with consumption of herbal products containing

> Mutong or Fangchi: a population-based case-control study.

> Am J Kidney Dis. 2010 Mar;55(3):507-18. Epub 2010 Feb 8.

> Institute of Occupational Medicine and Industrial Hygiene, College of

> Public Health, National Taiwan University, Taipei, Taiwan.

> BACKGROUND: Taiwan has a remarkably high incidence of end-stage renal

> disease (ESRD). The objective of this study is to determine the

> association between prescribed herbal products containing

> aristolochic acid and ESRD. STUDY DESIGN: Population-based case-

> control study. SETTING & PARTICIPANTS: All new ESRD cases in Taiwan

> and a simple random sample (200,000 people) drawn from the national

> health insurance reimbursement database in 1997-2002. PREDICTOR: Age;

> sex; hypertension; diabetes; cumulative doses of nonsteroidal anti-

> inflammatory drugs, acetaminophen, and adulterated herbal supplements

> potentially containing aristolochic acid before the development of

> chronic kidney disease; and indications for prescribing such herbs,

> including chronic hepatitis, chronic urinary tract infection, chronic

> neuralgia, or chronic musculoskeletal diseases. OUTCOMES &

> MEASUREMENTS: Occurrence of ESRD through construction of multiple

> logistic regression models. RESULTS: There were 36,620 new ESRD cases

> from 1998 through 2002. After exclusion of cases with chronic kidney

> disease diagnosed before July 1, 1997, there were 25,843 new cases of

> ESRD and 184,851 controls in the final analysis. Women, older age,

> hypertension, and diabetes were significantly associated with

> increased risks of the development of ESRD. After adjustment for

> known risk factors, cumulative doses >60 g of Mutong (OR, 1.47 [95%

> CI, 1.01-2.14] for 61-100 g; OR, 5.82 [95% CI, 3.89-8.71] for >200 g)

> or Fangchi (OR, 1.60 [95% CI, 1.20-2.14] for 61-100 g; OR, 1.94 [95%

> CI, 1.29-2.92] for >200 g) were associated with increased risk of the

> development of ESRD with a dose-response relationship. This

> relationship persisted when analyses were limited to participants who

> consumed <500 pills of nonsteroidal anti-inflammatory drugs and those

> without diabetes. LIMITATIONS: No measurement of renal function, no

> contact with patients, over-the-counter sales were not recorded, and

> potential underestimation of exposure dose for cases and ORs.

> CONCLUSIONS: Consumption of >60 g of Mutong or Fangchi from herbal

> supplements was associated with an increased risk of developing

> kidney failure. Copyright 2010 National Kidney Foundation, Inc.

> Published by Elsevier Inc. All rights reserved. PMID: 20116155

> [PubMed - indexed for MEDLINE]

>

> Best regards,

>

>

[Guest guest]

There is awareness of the issue in China, too. When I was in the DAOM program, a

visiting nephrology specialist said that he saw many kidney failure patients who

has been taking aristolochic acid-containing herbs.

 

- Bill

 

 

 

Chinese Medicine , " taipeiandy001 "

<liren001 wrote:

>

> Phil,

>

> It is important to note that for quite some time the Mu Tong and Fang Ji used

in Taiwan were species that contain Aristolochic acid. Namely, Guang Fang Ji and

Guan Mu Tong. While both these herbs have been sold in the US in the past, it is

rare to find them nowadays as bulk herbs. Taiwan companies are now well aware of

the issue and hopefully their products only contain Han Fang Ji and Chuan Mu

Tong both of which contain no aristolochic acid. Note that the database used in

this study was from 1997-2002. During that time the use of the aristolochic acid

containing herbs was still allowed in Taiwan. Now they are banned.

>

> Andy Ellis

>

>