Adverse effects of herbal or dietary supplements in G6PD deficiency: a systematic review

• Published in: British journal of clinical pharmacology 2017-01, Vol.83 (1), p.172-179
• Main Authors: Lee, Shaun Wen Huey, Lai, Nai Ming, Chaiyakunapruk, Nathorn, Chong, David Weng Kwai
• Format: Article
• Language: English
• Subjects: Dietary Supplements - adverse effects; Drug-Related Side Effects and Adverse Reactions - epidemiology; Drug-Related Side Effects and Adverse Reactions - etiology; Glucosephosphate Dehydrogenase Deficiency - blood; glucose‐6‐phosphate dehydrogenase; Hemolysis - drug effects; herbal medicine; Humans; Plant Preparations - adverse effects; Review‐themed Issue; safety; systematic review
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/bcp.12976

Aim Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is a common genetic disorder, affecting nearly 400 million individuals worldwide. Whilst it is known that a number of drugs, foods and chemicals can trigger haemolysis in G6PD deficient individuals, the association between herbal and dietary supplements and haemolysis is less clear. The objective of this study was to evaluate the association between herbal or dietary supplements and adverse events in G6PD deficient individuals. Methods We searched 14 electronic databases from their inception until November 2015 for articles describing the use of herbal or dietary supplements in G6PD deficient individuals. Additional publications were identified from manually searching textbooks, conference s and the grey literature. All study designs were included as long as they contained clinical information. These gathered findings were summarized narratively. Results Thirty‐two publications met inclusion criteria. These reported on 10 herbal and dietary supplements. Overall evidence linking haemolysis to a herbal/dietary supplement was only found for henna. No evidence of harm was observed for vitamin C, vitamin E, vitamin K, Gingko biloba and α‐lipoic acid. Conclusions The review showed that there was insufficient evidence to contravene the use of most herbal or dietary products at therapeutic doses in G6PD deficient subjects.