Where Did That Herb Come From — The Things I Check

"Aren't herbs from China? Are the pesticides and heavy metals alright?"

To be honest, I welcome this question. Because it is a question you absolutely should ask.

Asking what is in what you eat is not impolite. And if there is a place that cannot answer this question clearly, I tell people to worry more about that place.

In the past there really were problems

This misunderstanding did not arise out of nothing.

In the past there was a period when herbs were simply processed and sold without quality inspection. In those days residual pesticides and heavy metals were detected and became a major social issue, and distrust of herbal medicine as a whole took root here.

This is true. I do not brush it aside with "that's an old story, so forget it." That distrust had grounds.

What changed is that because of that problem, the system changed.

This is how herbs are managed now

Herbs used in medical institutions must be standardized products. You cannot just bring in and use anything from anywhere.

There is a certification system called hGMP. It requires the entire production process to be managed to national standards — the facilities that make the herbs, the process of purchasing raw materials, manufacturing and quality inspection, and shipping. Only what is produced according to set standards and specifications, by a company that has received this certification, becomes a standardized product.

In that process it goes through testing for harmful substances, including heavy metals and residual pesticides. A record remains of where a given herb came from and which tests it passed.

That is, the herbs prescribed at a clinic now are inspected pharmaceuticals. They are managed under a different system.

It is not that domestic is safe and imported is dangerous

Because there is a lot of misunderstanding on this point, let me address it.

The country of origin does not determine safety. Whether it passed inspection determines it.

Even if it is domestic, if it was not inspected, its contents are not verified. Even if it is imported, if it is a standardized product, it has passed the standards. I do not say "it's domestic, so rest easy." That phrase guarantees nothing.

Of course, depending on the herb, there are cases where one grown domestically is of better quality. But that is a matter of that herb's characteristics, not of the country of origin. I look at each herb by that standard.

So what I actually worry about

More than the herbs inside the inspection system, I worry far more about the things outside the system.

• Herbs you buy and decoct yourself at a market or online
• Pills or powders of unknown origin given by an acquaintance, or bought while traveling
• Things arbitrarily mixed together as being "good for the body"
• Imported health supplements with no ingredient labeling

For these there is no inspection. There is no way to verify what went in or how much, and even if a problem arises there is no way to trace it.

In fact, most accidents happen through these routes. And yet when an accident happens, it is the name "herbal medicine" that takes the blame. I find this unfair, but at the same time I think it is a part that a Korean medicine doctor must speak about more clearly.

And inspection is not all-powerful either

Here I will go one step further.

Passing inspection means harmful substances are below the standard; it does not mean this medicine is safe for you.

Even clean licorice can be a burden for someone with high blood pressure or weak kidneys. This is a matter unrelated to inspection. (A Medicine's Benefit and Its Side Effect Come From the Same Place)

So safety has two layers.

First, is the herb itself clean — this the system looks after.
Second, is this medicine right for this person — this I look after.

The second one the system does not do for you. That is why, before prescribing, I always check the medications you take and your existing conditions. (Same Diagnosis, Why Is Each Person Treated Differently)

You may ask

For a patient to ask like this is not rude at all.

• "Is this herb a standardized product?"
• "Is it alright to take with my blood pressure medication?"
• "Does this prescription contain licorice?"

A Korean medicine doctor should be able to answer these questions. If it is a place that dodges the answer or says "just trust me," I tell people to think again.

When you should go to a hospital first

• If you take a medicine of unknown origin and swell, have abnormal urine, or your skin or eyes turn yellow — stop taking it immediately and seek care. If possible, bring the medicine you were taking. What you took is decisive for diagnosis.
• If you already have liver or kidney disease — you must consult your attending doctor before starting any medicine.

Finally

To the question "Are herbs safe?", I do not answer only "yes."

What is being used, where it came from, which tests it passed, and whether it is right for this person — only when one can speak this far does it become an answer.

Doubt is not a bad thing. I work more safely with patients who doubt.