Herbal remedies, dietary supplements, and botanical medicines are
part of the growing interest in alternative medicines and therapies
that people are seeking today. When you walk into many large
supermarkets you may see an aisle dedicated to natural medicines.
Spend any time online researching health questions and you will be
bombarded with advertisements for the "next big thing" in
supplements that will claim to cure everything from earaches to
diabetes to cancer.
I am a great believer in the efficacy and safety of natural
products when used properly in a patient's overall regimen. I also
think it's great that more and more people are interested in taking
an active role in their own health plans, but as the old saying
goes, "A little knowledge can be a dangerous thing," especially
when it comes to self-prescribing medicines. Here are three vital
things every consumer should consider about botanicals and dietary
supplements:
1) Just because a plant or herb is natural doesn' t make it safe
for you to take, even if it is sold as an alternative medicine.
2) Not all herbal remedies or natural medicines are created
equal.
3) As always, if the claims about a product sound too good to be
true, they probably are.
Let's consider each of these points in a little more detail. First,
just because a plant or herb is natural doesn't make it safe for
you to take, even if it is sold as an alternative medicine.
Since herbs and plants must be used in strong enough doses to make
them effective in the treatment of many conditions, there can also
be contraindications for the use of them. Contraindications can
occur if the herb is taken over an extended period of time (1- 2
months) or in large doses that could result in side effects. Drug
interactions may also occur when an herb is taken. Combining an
herbal remedy with another drug can be problematic and possibly
dangerous.
The combination of a pharmaceutical drug with an herb may interfere
with the activity of the herb or drug, thus producing a decrease or
increase in the effectiveness of the drug. For example, willow
(salix) is used as an anti-inflammatory and analgesic (pain
reliever) just as aspirin is used in inflammatory conditions such
as arthritis and for headache pain. Willow is also used for fevers.
Like aspirin, willow is contraindicated in conjunction with other
blood thinning agents ( such as coumadin). It is also
contraindicated in patients with bleeding disorders like
hemophilia. It is absolutely essential that you keep your primary
care physician and all others who may prescribe medicines for you (
natural or pharmaceutical) aware of any and all medications you are
taking.
2) Not all herbal remedies or natural medicines are created
equal.
Pharmaceutical drugs are tightly controlled and regulated by the
Food and Drug Administration (FDA) to ensure standardization and
quality in the products. However, herbal remedies and dietary
supplements are classified as "food" by the FDA and therefore are
regulated in a different way. The following is an excerpt from the
web site of the National Center for Alternative and Complementary
Health, a division of the National Institutes of Health:
Currently, the FDA regulates supplements as foods rather than
drugs. In general, the laws about putting foods ( including
supplements) on the market and keeping them on the market are less
strict than the laws for drugs. Specifically:
*Research studies in people to prove a supplement' s safety are not
required before the supplement is marketed, unlike for drugs.
*The manufacturer does not have to prove that the supplement is
effective, unlike for drugs. The manufacturer can say that the
product addresses a nutrient deficiency, supports health, or
reduces the risk of developing a health problem, if that is true.
If the manufacturer does make a claim, it must be followed by the
statement "This statement has not been evaluated by the Food and
Drug Administration. This product is not intended to diagnose,
treat, cure, or prevent any disease."
*The manufacturer does not have to prove supplement quality.
Specifically:
*The FDA does not analyze the content of dietary supplements.
*At this time, supplement manufacturers must meet the requirements
of the FDA's Good Manufacturing Practices (GMPs) for foods. GMPs
describe conditions under which products must be prepared, packed,
and stored. Food GMPs do not always cover all issues of supplement
quality. Some manufacturers voluntarily follow the FDA's GMPs for
drugs, which are stricter.
*Some manufacturers use the term "standardized" to describe efforts
to make their products consistent. However, U.S. law does not
define standardization.
Therefore, the use of this term (or similar terms such as
"verified" or "certified") does not guarantee product quality or
consistency.
(Source: National Center for Complementary and Alternative
Medicine,
http://nccam.nih.gov/health/bottle/)
The bottom line? Some manufacturers produce better products than
others. The herb must be of sufficient potency and meet certain
standards to be truly effective. I like to look at the research
done on the herbs that I prescribe to my patients before
recommending a particular herbal remedy or botanical medicine.
3) As always, if the claims about a product sound too good to be
true, they probably are.
There are a lot of natural products on the market that are being
hyped with some outrageous claims. It is true that I have seen some
pretty amazing results with some botanical medicines, but use
common sense when considering a new product. There is no "cure all"
with herbal remedies. There are more scientific clinical studies
being done every day on herbal products, and I try to stick with
products that have been tested and proven effective. Used with a
complete treatment program, botanicals can be very helpful in
promoting the overall health of a patient.
If you are one of the millions of people who are researching and
considering the use of herbal remedies, I congratulate you for
wanting to take an active role in your own health plan. Be sure to
be an informed consumer, and keep your health care providers
abreast of all the medicines or supplements you may be taking,
natural or otherwise.