The following excerpt is reprinted from Brown's book, Herbal Prescriptions for Better Health (Prima Publishing, 1996).
Q: Do herbs really work?
A: Eighty percent of the world's population can't be wrong. That's the estimated number of people worldwide who use herbal medicines to stay well. In many countries herbs are used primarily as folk medicines, but developed countries such as Germany, France, China and Japan have successfully incorporated herbal medicine into their health care systems. Why? Because they work.
These countries have created a model for the effective use of herbal medicine. Thanks to their efforts, we need no longer refer to herbal medicine as "folk medicine." Folklore gave us clues to the medical use of herbs, but the modern research conducted in these countries has provided us with scientific support for their use in modern medical systems.
Q: Where do herbs fit in my health care program?
A: Herbal medicines are usually more gentle in their action than commonly prescribed drugs. They may take longer to act and often work to support or influence balance in a body system, instead of doing its job for it. This makes them ideal for prevention of illness.
For many individuals, they also offer means of recovery from illness. Again, the nudge is usually gentle and based on support rather than on overwhelming your body's own ability to get well.
Herbal medicines are also a wonderful way to address many chronic conditions that are not responding to drug therapy. Examples include eczema, rheumatoid arthritis, premenstrual syndrome and benign enlargement of the prostate. Once improvement occurs, the herbal prescription generally is a safer alternative for continued treatment.
Remember, the best way to decide how herbs fit into your health care program is to find a health care professional trained in herbal medicine to act as your guide.
Q: If herbs are so effective, why don't doctors regularly recommend them in the United States?
A: The bottom line is that medical doctors in the United States don't receive any training in herbal medicine. Naturopathic medicine represents one way in which herbal medicines might be successfully integrated into a medical system. We also have a very strong role model in the health care systems of France and Germany, where doctors and pharmacists receive training in herbal medicine. Herbal medicines are a core part of their treatment options.
In the next decade, we're going to see huge growth in educational opportunities for health care professionals in herbal medicine. Paired with the introduction of herbal medicines with a strong history of research and clinical use, I expect herbs to be welcomed back into our health care system.
Q: Why aren't herbs labeled as to what they do and what conditions they treat?
A: Until the end of 1994, herbs were regulated like foods by the Food and Drug Administration (FDA). This regulation disallowed health claims of any kind, including which actions an herb has in the body or which condition it might be used to treat. The result: a consumer wanting to buy an herbal medicine often knew less about its actions than he or she did about a potato's.
The passage of the Dietary Supplement and Health Education Act (DSHEA) in late 1994 is starting to reverse this trend. Consumers will now begin seeing labels that explain how an herb influences different actions in the body. But the labels still can't tell you anything about treating specific conditions with an herb.
The law also offers greater access to "third-party" literature; that is, unbiased reviews of research that shed light on which conditions respond best to herbal medicine.
Q: Can herbs be taken with prescription or over-the-counter drugs?
A: The answer is usually yes. Many herbal medicines will support body systems during drug therapy. A classic example is the use of echinacea during and after antibiotic therapy to keep the immune system functioning optimally.
Herbs can also reduce the side effects of some drugs. For example, milk-thistle extract can help keep the liver functioning normally when a person is taking antidepressant or anticonvulsive drugs.
There are exceptions. I wouldn't recommend using St.-John's-wort while taking a prescription antidepressant. Also, it wouldn't make sense to take saw palmetto while taking a prescription drug for benign prostate enlargement. These are examples of herbal alternatives to drug therapy.
Herbs are typically not aggressive enough for use in the treatment of many acute or emergency situations. Notable are bacterial infections, which are best treated with antibiotics.
Q: Can herbs act as substitutes for prescription or over-the-counter drugs?
A: Well, we've already mentioned St.-John's-wort and saw palmetto. Even these two herbal alternatives, however, are best thought of as treatments for milder forms of the conditions they address. Other examples include vitex for premenstrual syndrome and infertility, valerian for insomnia, kava for mild anxiety and hawthorn for early- stage congestive heart failure.
Medical care in this country stands to improve dramatically if we could start phasing herbal prescriptions into the early treatment of many conditions before they become more serious. We could save precious health care dollars by slowing the progression of conditions that ultimately require expensive medical interventions.
Q: I've heard that because herbs are from plants, they're basically safe. Do I have to worry about any side effects?
A: Most herbs have few side effects. These are usually mild and affect a small minority of people. Some people may be allergic to an herb or one of its constituents.
If you take an herbal product and have a bad reaction, contact your doctor first. Notify herb companies, also. This feedback provides them with important information about their products. Like the drug industry, herb companies should track side effects of their products.
The adage that herbs are safe just because they are from plants is a dangerous one. Herbal laxatives such as senna, aloe and cascara should be used with the caution afforded any drug. When consumed in large amounts on a regular basis, licorice root products can cause high blood pressure and water retention. Comfrey root may cause damage to the liver when consumed in large amounts.
While the scare tactics employed by government agencies to make herbs look dangerous are usually overblown, use the same caution with herbs that you would with any medication. Most of the serious side effects I've been called about over the past five years have stemmed from overuse or misuse of an herbal medicine. Use herbs sensibly and you'll usually avoid trouble. If you're not sure, seek the help of qualified professionals.
Q: When I begin taking an herb, how do I know what dosage to use and how long to take the product?
A: Like most drugs, herbs affect people in different ways. When taking a product for the first time, you may want to start with a low dose and work up over time to the desired dose. It may take some experimentation before you determine how long to take a product. A qualified health care professional or herbalist can help guide you.
Note: Seek professional help when deciding on the proper dosage for your child.
Q: Are herbal medicines addictive?
A: The commercial herb industry is not allowed to sell herbal supplements that are addictive. Obviously, many addictive drugs come from the plant kingdom (e.g., opium, heroin and cocaine) but fortunately they aren't sold in your friendly health food store or natural health section of your pharmacy.
One trend that makes me very uneasy is the growing use of herbs high in caffeine for weight loss and energy. Caffeine certainly rates as a mild addiction and has the down side of making people edgy. With time, it also runs down your adrenal function. Products promising "escalation" or "acceleration" belong on espresso stands and not in health food stores.
Q: Do herbs contain steroids or hormones?
A: This is a widely held misconception. Some herbs (e.g., black cohosh and ginseng) contain compounds that may act like hormones, albeit weakly. Others (e.g., wild yam) contain some of the chemical precursors of a hormone. However, they do not have the strength of actual hormones such as estrogen or progesterone.
Some herbs actually support glands that produce hormones and steroids. These products will often work on the endocrine system, which includes the thyroid, adrenal glands and reproductive organs. Examples include vitex, eleuthero- coccus (Siberian ginseng) and licorice.
Q: What do the designations "organically grown" or "wild-crafted" mean?
A: An herbal product that bears the designation "organically grown" means that no chemical pesticides, herbicides, fertilizers or irradiation were used to produce, grow or preserve the plant. Most herb companies strive to buy organically grown herbs whenever possible.
"Wild-crafted" usually means that the herb is not grown in a controlled setting, such as a farm. Wild-crafted herbs are usually picked in the wild by an experienced herbalist. While this is often romantically perceived as being the best way to harvest herbs, it is fraught with potential problems. The first problem is the environmental impact. If every herb company depended on wild-crafting, our natural supply of such plants would be so greatly diminished that many herbs would face possible extinction.
The second problem is consistency in wild-crafted herbs. Different growing conditions can significantly change the concentration of medically active constituents.
Large herb companies in the United States and Europe rely primarily on herbs that have been grown under controlled situations. This means less impact on our wild plants as well as better quality control. Many U.S., European and Asian herb companies have developed plant strains and optimal growing conditions that guarantee a higher plant yield and greater concentration of important medical constituents in the herbs.
Q: When I decide to buy an herbal medicine, how do I know which one is best?
A: Products from companies that have formed liaisons with European, Asian and Indian companies that produce high-quality and well-researched products should be at the top of your list. These companies are attempting to bring you the best available form of the herb. Liaisons of this sort also give you greater assurance that the herbal preparation matches the form used in research and clinical settings.
Q: Are there standards that companies in the herb industry must follow?
A: The herb industry has its own trade organization, known as the American Herbal Products Association (AHPA). Membership in the organization is voluntary. Companies that belong to AHPA work together to set standards of quality for the growing, harvesting, storage and manufacturing of herbal products.
Another trade organization of interest is the National Nutritional Foods Association (NNFA). It has a "Tru-Label" program that assures accuracy in label claims. Many herb companies participate in this program.
Q: Which companies produce the best products?
A: Your first criterion should be quality control. A quality herb company buys the best raw materials and maintains the strictest quality assurance in its manufacturing methods. This includes testing raw materials for adulterants, heavy metals, pesticides and bacteria. Assaying for levels of active constituents, when applicable, is also important. A quality herb company will continue to test for contaminants and bacteria during manufacturing. Lastly, its labels and packaging will accurately depict the contents of the product and its shelf life. This includes the content of the herb(s) in the product as well as any fillers and excipients. For example: if it's a liquid product, what is the concentration of alcohol or glycerin?
Next, look for companies that are committed to education. Companies that hire employees who are trained in herbal medicine are more likely to offer accurate information. Their labels will be based on research and clinical information instead of hype. These companies spend a great deal of money educating the people from whom you buy herbs in the retail store. This is an important link to you, the consumer. Educated retailers help ensure that you receive accurate and reliable information.
Last, some personal biases. I believe that a quality herb company commits a portion of its resources to research. We desperately need to do more clinical research on herbal medicine in the United States. Such research will influence, perhaps critically, how herbs will be integrated into the U.S. health care system.
A quality company committed to excellence in its products should also have a global perspective. This means support for commercial growing of native herbs in their countries of origin. This creates financial opportunities for many countries. Also, supporting programs that work to save natural habitats for plants is critical. Without a healthy environment, we can hardly expect a healthy future for herbal medicine.
Donald J. Brown, N.D., practices in Seattle and is a faculty member of Bastyr University of Natural Health Sciences. Brown is the founder of Natural Products Research Consultants (NPRC), which is dedicated to furthering education and research on natural medicine. REFERENCE
1. Davis, B. "A New World Class Herb for A.K.
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