Herbs as Medical Intervention
Lyn W. Freeman
Herbal medicines are the fastest growing category of alternative therapies in the United States. Yet, there are challenging issues to be considered when using herbal phytomedicines. What are the benefits of a particular herb? Has an herbal product been controlled for quality? Are there side effects? Will a particular herb cross-react with a patient's prescription medication? What do the clinically controlled trials reveal about an herb's efficacy and its side effects? This chapter will answer these questions for 10 popular herbs sold in the United States today. Most importantly, this chapter assists the reader in the development of an herbal "thinking style" so that critical information can be sought concerning any herbal product the reader must evaluate. Can herbal medications be beneficial? Yes. Are there also risks and quality issues that must be addressed? Absolutely. This chapter delineates the informational categories necessary for evaluating the benefits and risks of herbal products.
Plants used for medicinal purposes, rather than for food, are referred to as "herbs" or "medicinal herbs." Physical evidence of the use of herbal remedies dates back approximately 60,000 years, and more than one fourth of prescription medicines have been developed from herbs.
For centuries, it was believed that each herbal plant was a gift from God and contained a "sign," intended to give humankind dues as to the herb's healing effects. This belief was referred to as the "doctrine of signatures." Today, herbals are still used for their healing abilities, and herbal phytomedicine is the fastest growing alternative therapy in the United States.
Germany has been the premier world leader in developing a mechanism designed to ensure herbal safety and efficacy. Herbs, in Germany, are reviewed and approved in the some manner as drugs. The creation of the German Commission ∊ expert panel resulted in the development of monographs, which provide the most accurate data in the world today on the safety and efficacy of herbals.
In the United States, the Food and Drug Administration (FDA) evaluates the safety and efficacy of new drugs based on data supplied by the drug manufacturer. The process of demonstrating new drug safety and efficacy takes approximately 15 years and costs an estimated $500 million. Since herbal remedies cannot be patented, research companies in the United States are unlikely to invest the time and money necessary to meet FDA requirements. This means that the quality of herbal products in the United States is not as controlled as it is in Europe.
In this chapter, 10 popular herbs are discussed in detail: bilberry, cranberry, echinacea, feverfew, Ginkgo biloba, goldenseal, kava kava, milk thistle, saw palmetto, and St. John's wort. The categories of information provided on these herbs include description and history; pharmacology and action; recommended key uses; and dosage, toxicity, and side effects. These informational categories should be evaluated when considering the use of any herbal as medical intervention.