Herbs / Vitamins / Drugs / Supplements

Herbs - Are they Safe and Effective?

I have undertaken a course of study to become a certified herbalist. The course work is fascinating and the information extremely valuable. I have so many interesting items to share, but I'd like to start with issues of safety.

If you listen to the news media, you would think that herbs are all poisonous and dangerous. However, the actual statistics reveal a far different picture.

Category 1989
Antidepressants 140 1315 135 1187
Analgesics 126 705 118 663
Heart Drugs 70 286 65 246
Stimulants & Street Drugs 64 276 101 295
Fumes, gasses, vapors 46 129 39 128
Household cleaners 24 173 19 168
Pesticides 12 111 12 113
Plants, all 1* 32 1* 21

*One death was reported for each of the 2 years covered by this report. The cause of death and the plants involved are unknown. Statistics on plant toxicity from American Assn of Poison Control Centers

Further, compare these numbers to the statistics regarding death and injury for hospital admissions from the American Family Physician (Holland E.G., et al., AFR 1997; 56(7):1781-1788). The authors point out that an estimated one million patients per year are injured while in the hospital, and approximately 180,000 of these people will die because of those injuries. They also stated that drug-related morbidity (serious injury) and mortality (death) are common and are estimated to cost more than $136 billion a year.

In view of this data and given the relative toxicity of herbs, which are clearly safer than household cleaners we all use on a daily basis, why all the emphasis on herbal dangers? To fully comprehend the situation, I need to explain the concept of risk/benefit ratio. The words “risk/benefit ratio” present a very scientific, quantitative evaluation, do they not? Yet, the truth is, an actual calculation is never actually performed. The evaluation is subjective, based upon the belief in the idea that the drug or procedure is life-saving; therefore, a greater degree of risk is acceptable in that context.

However, herbs are regarded as useless for therapy; and, therefore, any degree of risk is unacceptable. In part, this viewpoint is based upon ignorance of the actual efficacy of herbal remedies, but much of it is simple prejudice. American healthcare is dominated by pharmaceutical companies. Anything not originating with the drug companies is automatically suspect. (This discussion does not begin to include the financial interests involved in media reporting; I would need a book to even begin that topic!)

There are, however, some genuine concerns regarding herbal safety. Perhaps the largest problem is that you can't be sure what is contained in the herbal remedy. This is an issue of ethics, and as such deserves close attention. For example, skullcap has been implicated as being liver toxic. However, it is common practice in the herbal industry to substitute germander (a much cheaper herb) for skullcap - without acknowledging the substitution. The label states that the product contains skullcap. Unfortunately, germander is extremely liver toxic. Tests on skullcap products implicated in liver damage indicate the presence of germander. Another common substitution is Aristolachia, a common and inexpensive herb, in a number of oriental herbal products. It is substituted for several more expensive therapeutic herbs. Unfortunately, Aristolachia causes severe kidney damage, including renal failure and malignancy of the urinary tract.

Another issue arises with oriental patent medicines that can be obtained in health food stores. Many of them have been removed from the marketplace because they contain pharmaceuticals, which are not listed on the label. In one study, 23.7% of these patent medicines were contaminated. (Ko RJ, Clinical Toxicology, 1999; 37(6):697-708.

What is the message? Be certain of your source of herbs to guarantee that no adulteration has occurred. In our office, we are switching all our herbal remedies to either the Medi-Herb or Metagenics line, because both of these companies conduct extensive raw material testing to assure potency and purity.

There are more issues concerning efficacy which I will cover in next month's letter. Also, I will report on a wonderful NON-ESTROGENIC herb for menopausal symptoms, as well as a wonderful combination formula for fibromyalgia and auto-immune disease. It's practically magic! I can't tell you how much relief I have found using it. So, watch your mailbox for more details.

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