Imagine your body turning against you just minutes after taking something you thought would help. That's exactly what happened to a Perth woman after taking a popular herbal remedy, highlighting a hidden danger lurking in the world of over-the-counter supplements. Kerry Smith's terrifying experience serves as a stark reminder that even seemingly harmless natural medicines can trigger severe, life-threatening reactions.
On December 30th, Kerry Smith, a resident of Perth, Australia, felt the familiar tickle of a sore throat. Thinking she was coming down with a cold, she reached for ArmaForce, a widely available complementary medicine marketed to boost immunity and alleviate cold and flu symptoms. She had used it before without any problems. But this time was different. Very different.
"Within 10 minutes, I started to feel my palms and my feet start to itch," Ms. Smith recounted to Damian Smith on ABC Radio Perth, painting a vivid picture of the nightmare that was unfolding. "I went back to the bathroom and said to my husband, 'I'm having a reaction, I've taken this [Armaforce]'." The situation deteriorated rapidly. "Then I collapsed on the floor with excruciating stomach cramps, and then shortly after that, I started to have difficulty breathing and my tongue swelled up."
The speed was shocking. "It all happened in the space of about 5 minutes. It was very, very fast and very, very scary." Think about that for a moment: five minutes from feeling a little unwell to fighting for her life.
Thankfully, her husband acted swiftly. He called for an ambulance and administered an EpiPen, an auto-injector containing epinephrine (adrenaline) used to counteract severe allergic reactions. They had EpiPens at home because Ms. Smith had a known allergy to bee stings, although she rarely needed them. "The emergency doctors at the hospital said that if we didn't have the EpiPen on hand, that the outcome could have been much more serious," she revealed. Without it, the consequences could have been devastating.
Upon arriving at the emergency department, Ms. Smith informed the medical staff about the ArmaForce she had taken. The doctors immediately recognized the culprit: Andrographis paniculata, a herbal ingredient in ArmaForce. "They all said, 'Oh, we've had so many presentations of people having a similar reaction'," Ms. Smith stated, clearly surprised. "But I'd never heard of that herb before." And this is the part most people miss: even if you've never heard of it, it doesn't mean it's harmless.
While Andrographis paniculata might be unfamiliar to many, the Therapeutic Goods Administration (TGA), Australia's regulatory body for therapeutic goods, has been monitoring it for years. In fact, the TGA first reviewed the medication back in 2008 "in response to adverse event reports and community concerns about anaphylaxis," the TGA stated. Anaphylaxis is a severe, potentially life-threatening allergic reaction.
Since then, the TGA has issued multiple safety alerts and, in 2019, mandated warning labels on all products containing Andrographis. But here's where it gets controversial... "Despite this requirement for a warning label, adverse event reports to the TGA have continued to increase, with a fatal case of anaphylaxis reported in 2024," the TGA statement said. A fatal case! That's a terrifying statistic.
According to the TGA, "To date, the TGA has received 1,365 adverse event reports for medicines containing Andrographis paniculata, including 859 for ArmaForce products. There have been a total 286 reports of anaphylaxis for medicines containing Andrographis paniculata, including 188 reports involving ArmaForce products." These numbers paint a concerning picture, raising questions about the effectiveness of current warnings and the overall safety of Andrographis supplements.
BioCeuticals, the company that manufactures ArmaForce, issued a statement saying they "empathise with anyone who has experienced a suspected adverse reaction associated with any of our products." They added, "Products containing andrographis may cause allergic reactions in some people, including in rare cases anaphylaxis. All required warnings relating to this risk are included on current product packaging in line with TGA requirements." To further emphasize the risk, "in 2024 BioCeuticals introduced front-of-pack boxed warning labels." But are these warnings enough?
Ms. Smith's experience highlights a crucial problem: warning label comprehension. She said that while she did read the label, she misinterpreted it. She understood it to mean that the warning applied only if she had a prior history of severe allergic reaction to ArmaForce itself, which she didn't, as she had taken it before without problems.
However, the warning actually means that anyone with a history of severe allergic reactions to anything, including bee stings, should avoid the supplement. "When I bought it and I saw the warning, I spoke to the pharmacist and the pharmacist only asked me two questions. They said, 'Have you taken it before? And don't take it for more than two weeks,'" she explained. "I wasn't asked about my allergy history, and it definitely wasn't brought to my attention." This raises serious questions about the role of pharmacists in properly informing consumers about potential risks.
Australasian Society of Clinical Immunology and Allergy president Michael O'Sullivan emphasized that Ms. Smith couldn't have reasonably predicted her reaction. "It really doesn't matter if you've had a reaction to a bee sting or something else before, anyone could be at risk of having a reaction to a medication, including anaphylaxis," Dr. O'Sullivan stated. "It could have just as easily happened to her whether or not she had the bee sting allergy." This underscores the unpredictable nature of allergic reactions and the importance of being aware of potential risks associated with even seemingly benign supplements.
Dr. O'Sullivan characterized Ms. Smith's ordeal as a cautionary tale, demonstrating that over-the-counter complementary medicines can pose the same risks of side effects as prescription drugs. "Herbal supplements and these over-the-counter remedies that a lot of people might not think of carrying the same risk of side effects and reactions as something like taking an antibiotic that your doctor's prescribed," he warned. "But we know that they can have side effects, including allergic reactions, and interfere with other medications or cause other adverse drug reactions." This is a critical point that many consumers overlook.
He also noted the puzzling fact that Andrographis is associated with a disproportionately high number of allergic reactions compared to other herbal remedies. The reason for this remains unclear, and patients need to carefully weigh the potential benefits against the risks. "It's obviously an individual decision and we don't want to overstate the risk – there will be thousands of people who take these medications and these supplements with no problems," he acknowledged.
But ultimately, he suggests seeking evidence-based treatments. "If we had proven effective medications for common viral infections, then we would be recommending them. When you see a GP, you'd be getting prescribed them or recommended to go and buy them, and that evidence just doesn't exist for a lot of these complementary medicines. That's why they're complementary medicines." In other words, they're complementary, not replacements for proven medical treatments.
Fortunately, after spending a night in the hospital, Ms. Smith made a full recovery. But her experience serves as a crucial wake-up call. It forces us to ask: Are we truly aware of the risks associated with herbal remedies and supplements? Are the warning labels clear enough? Should pharmacists be more proactive in screening customers for allergy risks? And perhaps most importantly, are we relying too heavily on unproven remedies instead of seeking evidence-based medical care? What are your thoughts on this? Have you or someone you know had a similar experience with herbal supplements? Share your perspective in the comments below.
