HERBAL REMEDIES - Plants with the power to heal

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This article came up as a link to related matters in current report. It's got some valuable information and, despite its age, is worth a read.

ISSUE 1397 Tuesday 23 March 1999

Plants with the power to heal

Herbal remedies are growing in popularity - but what of their side-effects? Edzard Ernst calls for further tests

ANYONE who is about to invest their savings might like to consider putting them into herbs. A worldwide boom in medical herbalism is in full swing. Between 1990 and 1997, the use of plant-based medicines increased in America by a staggering 380 per cent. No equally reliable figures exist for Britain, but the trend is similar.

However, while patients are voting with their wallets, British doctors remain utterly unimpressed: they tend to rate herbalism as the least effective of all major complementary therapies. Yet phytomedicine, the scientific offspring of traditional herbalism, is in fact firmly rooted in science.

Phytomedicine is the pharmacological investigation of plant extracts, and the carrying out of clinical trials to test efficacy and evaluate safety. In contrast, traditional herbalism is still somewhat committed to non-validated methods of diagnosis and individualised treatments whose efficacy is untested.

Phytomedical research has been going on for decades, mostly on the European continent. But it has largely remained unnoticed in Britain and America. It has generated a wealth of knowledge, with the result that many herbal remedies have been officially licensed in Europe. In Germany and France they are used in much the same way as conventional synthetic drugs - so much so that, in these countries, few experts would view phytotherapy as "alternative" or complementary medicine.

Well-researched phytomedicines include ginkgo biloba (for circulatory disorders and dementia), garlic (for lowering the risk of heart disease) and St John's wort (for mild forms of depression). In Germany, prescriptions for St John's wort outnumber those handed out for Prozac. Other, less well-known, phytomedicines include palmetto, kava and horse chestnut.

Since the early 1700s, American Indians have used the berries from saw palmetto for infections of the bladder and to treat male genital disorders. More recently, saw palmetto was discovered to be effective as a treatment for benign prostatic enlargement, a problem that affects many older men and typically leads to problems when passing urine.

Several trials have been initiated, with good results. In November 1998, a review of 18 randomised controlled trials was published in the Journal of the American Medical Association. It concluded that saw palmetto was significantly better than placebo, and as effective as conventional medication, in relieving the symptoms of benign prostatic hyperplasia. However, scientists are still trying to understand how the herb works.

Kava roots are traditionally used in the South Seas for recreational purposes. In the West, the shrub has become so popular for its relaxing effects that it is now cultivated on a large scale and prices have risen. Commercially available extracts have been tested for their potential to relieve anxiety.

Recent trials at my own department at Exeter University have shown that kava is more effective than placebo, and is probably equally effective as conventional tranquillisers in relieving the symptoms of anxiety. Again, how exactly this works is still not fully understood.

The seeds of horse chestnut have historically been used to treat venous problems that particularly affect many middle-aged women (varicous veins, for instance). It is popular in Germany, but not well known in Britain. A recent review of all 13 randomised controlled trials, again carried out by my department, concluded that horse chestnut seed extracts are more effective than placebo, and equally effective as various mainstream treatments when it comes to alleviating symptoms.

Even so, cynics argue that it there is little point in using herbs that we don't fully understand, especially while there are neat synthetic compounds around that are much easier to control. These critics are ignoring, however, the possibility that a more widespread use of herbs could mean reduced side-effects for patients, and lower costs to the health service.

Let's deal with side-effects first. While it is naive to assume that "natural" automatically means "safe" - most plants can cause allergies, and some can damage the liver or kidney - some herbs are blissfully devoid of side-effects. None of the above-mentioned herbal remedies, for instance, is associated with serious or frequent side-effects.

Very little research exists showing whether herbal remedies might interact with conventional drugs when taken simultaneously. However, some rather worrying case reports suggest that they do interact, and with serious results. The example of a man who took kava together with a conventional tranquilliser was recently cited in a leading American medical journal. The man fell into a coma and had to be admitted to hospital where, luckily, he made a speedy recovery. As a general rule, women who are pregnant or breastfeeding should not take herbal treatments.

It is obvious that the quality of a herbal remedy matters. Being natural products their quality can vary, much as that of a good wine can. One harvest might be optimal, the next could turn out to be dismal. As with wine, the best way to ensure consistently high quality is to use a reputable producer.

Most herbal remedies in Britain are not marketed as medicinal products but as food supplements, which means that the quality of the product is not as rigorously controlled. Asian herbal mixtures, for instance, have often been found to be contaminated.

A quarter of all Chinese remedies collected for the purpose of one study contained contaminants that would have harmed the user. Recently, Chinese herbal creams on sale in London were found to contain high concentrations of corticosteroids that were not declared on the packaging, and were therefore illegal. In Belgium, a Chinese slimming remedy was found to contain toxic ingredients, when 30 people died after taking it.

In view of these potential dangers, it is understandable that the Medicines Control Agency has little choice but to try to regulate the area of herbal medicines more rigorously. However, too many regulatory demands on the (usually small) manufacturers would force them out of business, and the customer might lose valued options for medical treatment.

But what about costs? Some herbs are expensive, others relatively cheap; a few can be found in the garden. Saw palmetto, kava and horse chestnut are all commercially available and, if used on a daily basis, cost about the same as conventional drugs. The difference, of course, is that herbal remedies are not normally available on the NHS so people usually incur out of pocket expenses.

So what is the way ahead? What can the consumer expect to happen?

I believe that the best chance lies in applying the rules of science. Traditional herbalists need to demonstrate beyond reasonable doubt that their approach to diagnosing disease, and individualising herbal mixtures to the intrinsic characteristics of the patient, is safe, effective and efficient. In other words, we need proper clinical trials.

As the herbal boom reaches new heights, the major drug companies are beginning to show some real (and certainly not unselfish) interest. We must make sure that they take more heed of the concerns of patients than of investors.

Prof Edzard Ernst is the director of the Department of Complementary Medicine at the University of Exeter. Phytomedicine is the subject of a one-day discussion meeting at The Novartis Foundation, London, on March 22. Telephone 0171-636 9456 for more information.

How to be sure of the cure

Always discuss your decision to take herbal medicines with your doctor.

Buy remedies from a reputable producer; your pharmacist should be able to advise on this.

Don't buy products if the ingredients and dosages are not listed on the packaging.

If the condition does not improve or gets worse, stop taking the herbal remedy immediately and see your doctor.

Be aware that herbal medicines can cause side-effects: if you experience any, discontinue the remedy and see your doctor.

If you are pregnant or breastfeeding, don't take herbal remedies unless you have been specifically advised to do so by a healthcare professional.

If you are also taking prescribed drugs, be aware that herbal treatments might interact with these medications. Discuss this with your doctor or pharmacist.

Be aware that many Asian herbal mixtures have been shown to be adulterated.

Avoid taking the following herbs unless specifically advised: aconite, broom, chaparral, comphrey germaner, liquorice, pennyroyal.

Ten top treatments

Aloe vera: For various (mostly skin) conditions

Echinacea: To boost the immune system

Evening primrose: To relieve the symptoms of pre-menstrual syndrome

Garlic: For prevention of heart disease

Ginkgo biloba: For circulatory disorders

Ginseng: A general tonic, boosts energy

Kava: To relieve anxiety

Saw palmetto: To treat benign prostate enlargement

St John's wort: Relieves mild depression

Valerian: Aids good sleep

-- Anonymous, June 14, 2001

Answers

ET

ISSUE 1387 Saturday 13 March 1999

Take a bunch of weeds twice daily

Make room for some medicine in your borders, says Charles Lyte. It's amazing what a bit of ribwort can do

HEIN ZEYLSTRA loves weeds. Founder of the College of Phytotherapy (better known as herbalism) in East Sussex, he fights a constant battle against the gardener's use of hoe and herbicide.

In his study filled with plants and books, he enthuses about the benefits to be harvested from dandelions, plantains - bane of the perfect lawn - meadowsweet and marigolds.

Zeylstra moved from Holland to Sussex 34 years ago, leaving his farm near Arnhem to set up as a dairyman producing organic milk. It was a brave move. Only madmen farmed organically in those days, he says. But the risk paid off. Hotels and health-food shops in Tunbridge Wells soon ordered his pints and demand grew steadily.

In his spare time he studied medicinal herbs, building on his previous experience as a dispenser for a Dutch herbalist. Having completed a course at the National Institute of Medical Herbalists, he went on to become the Institute's general secretary, and then head of its department of education.

In 1982 he launched his own school, which was originally based in Tunbridge Wells and is now at Bodle Street Green.

"We have 450 students on the four-year correspondence course and 40 full-time students at the school," says Zeylstra.

In the grounds there are demonstration plots, showing how to cultivate and harvest the herbs. Zeylstra says that there are "an enormous number of herbs that can be grown in the garden and used safely". Many have been used for centuries.

The earliest medicines were probably brewed by ancient hunter-gatherers. Later the medieval doctrine of signatures argued that plants which resembled a malady or part of the body might hold a cure. The nodular roots of pilewort (celandine) is one example.

More successful than this is willow bark (salix), which is an essential component of aspirin. According to the theory, since the willow thrives in marshes and bogs, home to the mosquitoes which carry malaria, willow would provide the antidote to fever. And so it was.

If you have a less than perfect lawn, you have a herbal chemist's store at your feet. The leaves of the dandelion (Taraxacum officinale) are, according to Hein Zeylstra, "the best diuretic. The roots are a fine tonic for the liver."

Lawn perfectionists spend hours trying to eliminate ribwort (Plantago lanceolata), the leaves of which are "excellent" for treating persistent colds, respiratory problems and catarrh.

Camomile (Chamaemelum nobile), known in Germany as "mother of the gut", is supposed to help ailments such as gastritis, colitis, stomach ulcers and disorders of the alimentary tract, as well as a being a sedative for irritable bowel syndrome.

Marigolds are not only popular for decorating salads but are used by Zeylstra as an "antiseptic" and for treating fungal diseases such as athlete's foot, viruses, acne and burns. Use only the fully open flowers fresh as an infusion or dry as a tea.

To make a herb tea, or "tisane", infuse an ounce of your chosen herb in half a pint of boiling water. Ensure that no steam (containing essential oils) escapes by leaving the brew in a Thermos flask for 10 to 15 minutes. The ideal time to take herbal drinks is at bedtime.

Some people are of course allergic to certain plants, so always try a little to see if there is a bad reaction. If so, leave it alone or consult a herbalist. Feverfew (Tanacetum parthenium), for example, is good for headaches but can cause mouth blisters.

The cone flower (Echinacea purpurea) has become popular for herbaceous borders and is thought to stimulate the immune system. It is being used in research for the treatment of HIV and cancer. Chop up the top growth when it is flowering, store for a few days in the refrigerator and use in an infusion to treat recurrent 'flu or when you feel a cold coming on.

St John's Wort (Hypericum perforatum) has been a magical plant since pagan times. It can be turned into a soothing oil for treating shingles and earache by packing the flowers into a jar, covering with sunflower, almond or olive oil and leaving on a windowsill until the liquid turns blood red (about six weeks).

Yarrow (Achillea millefolium) has filigree fine leaves and flat heads of white flowers that are sometimes tinged with pink. Made into a tea, it is good for high blood pressure, menstrual problems and even common colds. Betony (Betonica officinalis) tea is uplifting and meadowsweet (Filipendula ulmaria), which has a delicate scent and will thrive in shady places as well as sunshine, eases arthritis.

Grown with culinary herbs, medicinal herbs look attractive and the majority do not like being fussed over, or fed with manure or fertiliser. Ordinary garden soil will do. If some of these so-called weeds try to take over, simply pull out those you do not want, and prevent the others from running to seed.

Whether they are medicinal or culinary herbs, the harvesting rule is simple. Choose a good sunny day and cut them when any dew or rain has evaporated. Dry in loose bundles in a cool room in front of an open window, taking care not to leave them in direct sunshine.

-- Anonymous, June 14, 2001


I have been busy harvesting hearbs since april, and right now have a rack of flower tops and a rack of "greens", my gardens are looking like jungles again!

-- Anonymous, June 14, 2001

Cranberries May Ward Off Variety of Diseases Monday, June 4, 2001 Home Edition ID: 0010046516 Health Section Byline: Amanda Ursell 336 words That cranberries can promote health of the urinary tract and ward off infection is no longer in doubt. But one of the researchers who worked out how is now hedging her bets that this small, red berry holds other bug-beating promise.

LA Times members only can retrieve full article. I thought maybe someone had read this???

-- Anonymous, June 16, 2001


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