AHP releases White Mulberry Leaf Assessment Report

AHPA is sharing with its members the following press release and White Mulberry Leaf Assessment Report released today by the American Herbal Pharmacopoeia (AHP). This report assesses the purported association of white mulberry leaf (Morus alba) with the tragic death of Lori McClintock. AHPA – among other experts in the herbal products and dietary supplements industries – has questioned the conclusion that Mrs. McClintock's death was related to white mulberry due to the herb's long history of safe use in addition to the lack of information supporting such conclusion. AHPA is grateful to AHP for preparing and distributing this report.

September 23, 2022

AHP releases 65-page assessment report on white mulberry leaf. The report is an assessment of an article presented in Kaiser Health News on August 24, 2022 regarding the death of a California woman whose cause of death was reported by a local coroner to be due to ingestion of white mulberry leaf. 

On August 24, 2022, Kaiser Health News published an online article entitled Congressman's Wife Died After Taking Herbal Remedy Marketed for Diabetes and Weight Loss.

We first express our heartfelt sorrow to the family of the deceased and apologize that we felt the need to address the facts of this sad event of someone so close and so dear to you.

The “herbal remedy” presumably taken was white mulberry leaf, a botanical with a long and safe history of use throughout Asia and is also used in Greek cuisine. The official cause of this death was listed as “dehydration due to gastroenteritis…that was caused by adverse effects of white mulberry leaf ingestion.” This determination was apparently made without any formal review of causality and presumably because a leaf fragment was found in the stomach of the deceased. When such tragic events occur, it is contingent among all involved to be as conscientious as possible in determining their determinations, both to help prevent similar future events and to bring an accurate reporting of what happened to the family. According to AHP president and herbalist Roy Upton who compiled the report:

“Because adverse effects, especially fatalities, related to botanicals are so rare, I always pay special attention when they are reported. When I read about this I took particular interest as I drank copious amounts of white mulberry leaf tea when I had COVID early in 2020. I knew of an acupuncturist/herbalist friend who had given eight pounds of it to his mother-in-law for a chronic cough she had and she has been taking it for months. Just a month ago, I sent a pound of it to my sister who also had a chronic cough from COVID and my partner started drinking it for a cough she had just a few weeks ago. I needed to know right away if there was any reality that called into question the safety of mulberry leaf.”

All aspects of the use of mulberry as a food, supplement, and medicine were reviewed. AHP reached out to experts in traditional Chinese medicine, botanists, medical doctors, pharmacologists, and toxicologists and reviewed as much of the national and international pharmacovigilance data that was accessible. AHP also communicated with herbal experts in Mainland China, Hong Kong, Taiwan, United Kingdom, and the US. The consensus, with no equivocation among all experts, is that there is no way to know for certain that the fragment was white mulberry, and if it was, the combined historical and current use of white mulberry as a food and supplement, together with formal clinical trials and toxicological reviews, gives no indication that white mulberry leaf has any action that would have caused or contributed to this sad event.

The most glaring deficiency on the part of the coroner in assessing causation is that there is no indication a formal assessment for determining causality was employed. Nationally and internationally varying processes are used. The presence of a substance is not sufficient to assert causality. A second challenge is that the leaf fragment found was fairly small and according to some expert botanists and plant specialists extremely difficult to identify with certainty.

The article also took this event as an opportunity to disparage the supplement industry and as was stated the “risks of the vast, booming market of dietary supplements and herbal remedies.” AHP reached out to the writer who was largely unaware of supplements overall and came to her conclusion based on numerous health professionals and others she had spoken to in her investigation. Because of this, AHP also took the opportunity to address the frequently repeated myth of an underregulated industry. Subsequent to the original Kaiser article, the writer, after having spoken with those well-informed about herbs and supplements, released a follow-up article similarly calling into question how the coroner made the determination that the leaf fragment somehow caused or contributed to the death. She received no response from the coroner's office. She additionally presented opinions of other experts who affirmed the safety of mulberry leaf and expressed doubt that based on everything known about mulberry leaf that it could have any contributory role.

Following is the link to the full AHP report which also includes a four-page executive summary.

AHP Monographs and Therapeutic Compendiums are regarded as among the most comprehensive and practically valuable of herbal publications and has set a new bar for herbal medicine reviews. 

Roy Upton




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