| Product purity is questionable; there is potential for misidentification and contamination with: |
| - Pesticides |
| - Herbicides |
| - Pharmaceuticals |
| - Heavy metals |
| - Excipients such as alcohol |
| Particularly for products imported from developing countries. |
| Reliability of products is uncertain; there is great variability in concentration of active ingredients within plants used, growing conditions, processing, and storage. |
| Effectiveness of active ingredients in children often not studied. |
| Safety and toxicity for short-term use in children is often unknown. |
| Safety and toxicity for chronic use in children is often unknown. |
| Unknown interactions with other medications and treatments. |
| Unknown metabolism in children with renal, hepatic, and other disorders. |
| Cost of products is not necessarily related to quality, purity, or concentration of active ingredients. |
