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Herbal medicine is commonly considered to be safe. However, one herbal medicine banned in Europe and in the United States may still be potentially harming millions of people in parts of Asia. In addition, the medicine may still be appearing in the homes of people in the United States because the Internet makes it easy to buy herbal medicines across country lines.

The substance in question is called aristolochic acid (AA). According to TIME magazine, the acid first gained attention in the early 1990s. A kidney disease epidemic occurred among a group of Belgian women, and the epidemic was traced to the use of the acid at a weight loss clinic.

The acid is found in plants known as birthwort, Dutchman's pipe or scientifically Aristolochic clematitis, and the herbs are used to fight conditions like arthritis, asthma and for weight loss. While the substance has been banned in a number of countries, it is still used quite extensively in India and China, potentially exposing millions of people to fatal diseases like kidney disease and bladder cancer.

The study, published in the Annals of Internal Medicine, is intended to provide diagnostic criteria to an under-recognized illness called aristolochic acid nephropathy, eMax Health reports. The study authors say that they would like physicians to easily have a way to recognize and diagnose the illness. They say that they also want to improve awareness among the public and among physicians in the hopes of finding better epidemiologic, preventative and therapeutic tools. They also hope that more research can be undertaken on the subject.

The study focuses most on its effect in Asia, but Americans are also at risk for the disease. That is because many people have turned to the Internet to buy herbal remedies, particularly for weight loss and other concerns. In the United States, in particular, many people who do so run the risk of poisoning themselves with aristolochic acid, only to be undiagnosed or misdiagnosed by doctors who are unfamiliar with the condition.

Study author Graham Lord urges anyone who uses herbal remedies to familiarize themselves with the ingredients that they are using. Often, they can change with time. If still uncertain, he says to consult with a doctor.