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Dietary Supplements: A Framework for Evaluating Safety (2005)
Institute of Medicine (IOM)

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. "2 Approaches Used by Others and Existing Safety Frameworks." Dietary Supplements: A Framework for Evaluating Safety. Washington, DC: The National Academies Press, 2005.

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Dietary Supplements: A Framework for Evaluating Safety

development; use during operation of motor vehicles; mutagenicity; teratogenicity; and carcinogenicity.

Next, each section of the monograph is assigned to a writer with expertise in the topic of the section, and the writer is provided with the results of the literature search. Once the sections are drafted, the AHP editor and at least one other expert in the specific field review them. The sections are then incorporated into an initial monograph draft. This draft is then circulated to a peer-review committee of botanists, chemists, herbalists, pharmacists, pharmacologists, pharmacognosists, and physicians (AHP, 2004b). Reviewer comments are incorporated into the draft and the initial authors review and approve their sections. Before it is finalized for publication, the monograph is reviewed by an expert of either the botanical under review or the physiological system that the botanical affects (AHP, 2004b).

American Herbal Products Association

The American Herbal Products Association (AHPA) is a national trade association for the botanical products industry. In response to passage of the Dietary Supplement and Health Education Act (DSHEA), AHPA convened a special subcommittee of its standards committee to address the need for a comprehensive review of safety data for botanical ingredients sold in North America. The committee was made up of natural products scientists and practicing herbalists. According to AHPA, the goal of this committee was to critically evaluate safety and categorize botanicals based on safety. These evaluations are published as The Botanical Safety Handbook (McGuffin et al., 1997).

The committee reviewed over 500 botanicals that were available in the United States, identified primarily by reviewing Herbs of Commerce, another AHPA publication (Foster et al., 1992). After identifying which botanicals to include, AHPA reported that its committee reviewed the available scientific literature for data on human and animal toxicity, traditional use, regulatory status in numerous countries, and current usage of herbs in the United States, China, India, Europe, and Australia. The committee also relied on its own and others’ expertise and clinical experience for the evaluations.

There was no formal weighting of the data used for the evaluations; however, there were some exclusionary criteria. The monographs did not include the following data, conditions, or related products: “… excessive consumption, safety or toxicity concerns based on isolated constituents, toxicity data based solely on intravenous or intraperitoneal administration, traditional Chinese and Ayurvedic contraindications, gastrointestinal disturbances, potential drug interactions, idiosyncratic reactions, allergic reactions, contact dermatitis, well-known toxic plants that are not found in

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69
Front Matter (R1-R20)
Executive Summary (1-18)
1 Introduction and Background (19-42)
2 Approaches Used by Others and Existing Safety Frameworks (43-84)
3 The Framework (85-125)
4 Categories of Scientific Evidence--Human Information and Data (126-155)
5 Categories of Scientific Evidence--Animal Data (156-174)
6 Categories of Scientific Evidence--Information About Related Substances (175-216)
7 Categories of Scientific Evidence--In Vitro Data (217-234)
8 Interactions (235-246)
9 Vulnerable Groups and Prevalance of Use (247-252)
10 Scientific Principles for Integrating and Evaluating the Available Data (253-268)
11 Applying the Framework: Case Studies Using the Prototype Safety Monographs (269-291)
12 Factors Influencing Use of the Safety Framework (292-296)
13 Findings and Recommendations (297-306)
Appendix A: Existing Frameworks or Systems for Evaluating the Safety of Other Substances (307-315)
Appendix B: Scope of Work and Comments to Initial July 2002 Framework (316-321)
Appendix C: Plant Family Information (322-355)
Appendix D: Chaparral: Prototype Monograph Summary (356-362)
Appendix E: Glucosamine: Prototype Monograph Summary (363-366)
Appendix F: Melatonin: Prototype Monograph Summary (367-371)
Appendix G: Chromium Picolinate: Prototype Monograph Summary (372-375)
Appendix H: Saw Palmetto: Prototype Monograph Summary (376-379)
Appendix I: Shark Cartilage: Prototype Monograph Summary (380-384)
Appendix J: Prototype Focused Monograph: Review of Liver-Related Risks for Chaparral (385-449)
Appendix K: Protoype Focused Monograph: Review of Anti-Androgenic Risks of Saw Palmetto Ingestion by Women (450-477)
Appendix L: Acknowledgements (478-480)
Appendix M: Biographical Sketches of Commitee Members (481-488)
Index (489-506)