People were using herbs to treat medical problems long before modern drugs arrived on the scene, but only in the last few years have these "natural" remedies come back into vogue. One in three Americans now use them routinely to promote good health or cure illnesses. Herbal medicines come in many forms: The flowers, fruit, leaves, seeds, stems, bark, and roots of plants are available raw and whole, brewed into teas, dried and pulverized into powders, dissolved in liquid tinctures, or processed into salves, capsules, or pills. Medicinal herbs are most commonly used for minor complaints like aches and pains, stomach and digestive problems, premenstrual symptoms and menstrual cramps, colds, skin ailments, and difficulties in sleeping. And, more and more, they are being used to treat serious or potentially serious health conditions like depression, Alzheimer's disease, prostate swelling and even cancer.

Not necessarily. Natural does not mean safe. Any substance with the power to heal also has the power to harm. Herbs can be just as potent -- and toxic -- as conventional drugs (pharmaceuticals). In fact, more than a quarter of all pharmaceutical drugs on the market today originally came from plants. Ma huang or ephedra, was the original source of the active ingredient in the decongestant Sudafed. Ephedra can sharply increase blood pressure and heart rate, which may be dangerous if you have high blood pressure (hypertension). In April 2004, after years of reports of heart attacks, high blood pressure, and strokes associated with ephedra, the U.S. Health and Human Services announced a ban on the supplement.

Foxglove, the herb from which the heart drug Lanoxin (Digoxin) was derived, varies widely in potency. Taking a little more than the therapeutic dose can be toxic. And since even standardized herbal products are inconsistent, it's hard to know exactly how strong a dose you're getting.

The problem is that the Food and Drug Administration classifies herbs as dietary supplements rather than drugs. Under existing dietary supplement laws, herb manufacturers aren't required to prove that their products are safe or effective. As a result, no one is sure about the risks or benefits of most herbal products. Some are known health hazards; the widely available herb sassafras contains a cancer-causing compound called safrole that was banned for food use in the U.S. decades ago. Other herbs, such as comfrey and chaparral, have been reported to cause liver damage.

Product labels aren't allowed to make any claims concerning the treatment of disease; they can only refer vaguely to an herb's ability to enhance well-being or maintain healthy function. So, for example, although several human studies have found that taking feverfew may help prevent migraines, you'd never know it from looking at a feverfew product label. Keep in mind, too, that herb manufacturers aren't required to provide information about risks, side effects, or potential drug interactions. Besides that, just like conventional drugs herbs can affect each person differently, depending on age, weight, sex, and genetic makeup. They can also interact in unpredictable ways with other herbs, foods, and conventional drugs. Always tell your doctor, pharmacist and herbalist about any medicines or herbs you're already taking before you add something new. And if you're pregnant, don't take any herbs without consulting your obstetrician. No one knows how most herbs might affect the health of your fetus, and some are known to increase the risk of miscarriage.

To find out what you should watch out for or how effective an herb is in treating a particular ailment, you'll need to look beyond the product label. Ask your doctor or pharmacist or a trained herbalist. Some alternative practitioners, such as naturopaths, and some, but not all, acupuncturists, are trained in herbal medicine.

If you decide to go it alone, you'll need to educate yourself. One reliable source of information is the book Tyler's Herbs of Choice (Haworth Press, 1998) by Varro Tyler, an expert on herbal medicine. Many health professionals rely on The Natural Medicines Comprehensive Database, http://www.naturaldatabase.com .

It isn't easy. An herb's potency can vary a great deal, depending on the conditions under which it's grown, when it was picked, the part of the plant that's used, and the way it's processed. Herbal companies have tried to solve this problem by boiling herbs down into concentrated extracts that contain a specified percentage of a marker compound. But since there are no manufacturing standards for herbs in this country, it's impossible to know whether a product really provides what the label says it does. Surveys have found that capsules of St. John's wort extract contained anywhere from one-quarter to twice the labeled dose of the marker compound, hypericin. And herbs that are rare or expensive to harvest, such as goldenseal (Hydrastis canadensis) and ginseng (Panax ginseng), are often adulterated with more common plants. In a recent survey of ginseng products, 60 percent were watered down and contained little or no ginseng.

Your best bet is to ask your pharmacist, naturopath or herbalist to recommend a reliable manufacturer. Large companies that have been in business for many years tend to make high-quality products. Dried herbs, even in tea or powdered capsules, can deteriorate and lose their potency. Generally, the most potent products are extracts and tinctures because they are concentrated.

-- Kate Lee is a former associate editor at Consumer Health Interactive and researcher at Time Inc. Health. She is currently a senior editor at BabyCenter.

Further Resources

American Association of Naturopathic Physicians

(206) 298-0126

American Association of Oriental Medicine

(610) 266-1433

References

First published March 3, 1999
Last updated January 23, 2008
Copyright © 1999 Consumer Health Interactive

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