As part of an Institute of Medicine project, my colleagues and I recently reviewed the literature on the effects of Ginkgo on acute mountain sickness, thus we were eager to read the recent article by Chow et al.1 The methods of the study raise some concerns and bring to the fore several recurring issues in research on natural products.2
Botanical products are complex mixtures that originate from biological sources. Such products and their ingredients are invariably “irregular” because their chemical composition depends on factors such as geographical origin, weather, and harvesting practices, while finished products frequently contain multiple botanical ingredients.3 Analytical challenges in botanical quality assurance range from establishing the botanical identity of the material used in the study to measuring the amount of 1 or more desirable or undesirable constituents, such as natural toxins, marker compounds, pesticides, toxic elements, or undeclared synthetic drugs.
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