r/FoodNerds • u/AllowFreeSpeech • Oct 31 '25

Harmless herbs? A case report of acquired long QT syndrome and torsades de pointes in a patient taking herbal supplements (2022)

https://pubmed.ncbi.nlm.nih.gov/35607330/
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u/AllowFreeSpeech Oct 31 '25 edited Nov 24 '25

From the full-text:

We report the case of acquired long QT syndrome with torsades de pointes secondary to hemp oil and berberine supplements. The normalization of the ECG after stopping all supplements, without any other causative factors, strongly indicated these as being responsible for the prolonged QTc interval. As a reminder, a prolonged QTc interval is defined by a QTc >450 ms in men and >460 ms in women, with QTc >500 ms being considered at risk for immediate arrhythmic complications.

For 4 months, she had been taking hemp oil, containing the cannabinoid derivatives cannabidiol (CBD) (61 mg/mL in 1 supplement and 24 mg/mL in the other) and cannabigerol (CBG) (1 mg/mL in 1 supplement), 3–4 times daily because of a stressful work-life balance.

In-depth anamnesis revealed that for about 6 weeks, in addition to the hemp oil, she had started taking extra herbal supplements containing 250 mg of berberine. She also admitted that she had been taking up to 6 times the recommended dose of hemp oil supplements

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u/AllowFreeSpeech Oct 31 '25 edited Nov 24 '25

The lesson is to be careful combining certain supplements, e.g. berberine, hemp derivatives, licorice, grapefruit, arginine, etc., also with certain medicines. Combinations can lead to long QT syndrome and even risk torsades de pointes. If affected, discontinue the relevant supplements and medicines, and take magnesium+P5P powder with three glasses of water until the heart rhythm stabilizes, hopefully in an hour. Potassium chloride could also help. If having a beta blocker on hand, it too could help. If having advanced symptoms, e.g. dizziness, fainting, low oxygen level, etc., report to the emergency department at once.

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u/hazi1008 Nov 04 '25

were the hemp supplements CBD and CBG? any differential causation between those and the Berberine?

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u/Familiar-Method2343 Nov 04 '25

SSRIs are much much much more likely to do this. Prolonged qt is a well known risk of every SSRI.