What you need to know when deciding whether herbal remedies will work for you
http://www.irishtimes.com/newspaper/health/2011/1025/1224306439300.html
DOES IT WORK? BACKGROUND For the past three and a
half years, the evidence for different herbs and supplements has been
examined here. This will be the last of this series, although a book of
the columns will be published mid-2012 by Glasnevin Publishing. In this
final column, I’d like to leave you with some general guidance about
herbal remedies.
People have been using herbal remedies for
thousands of years, but this doesn’t necessarily mean they are all
useful. Some are effective for specific conditions, others are
poisonous, and still others will do little more than waste your money.
For example, St John’s wort has good evidence to support its
effectiveness for mild depression, while Aristolochia species have
caused the deaths of hundreds of people. Meanwhile, new herbs appear on
the market all the time with little or no evidence to guide people.
The
complexity here is reflected in the number of products available. One
report in the US a few years ago found that 1,400 different species of
herbs were available in more than 30,000 different products.
Many
products contain several herbs. A market analysis published earlier in
2011 found that multi-herb products dominate this market and are
predicted to “race ahead” of single-herb remedies. This makes it even
more difficult to determine if a product works or is good value for
money. Products may contain several herbs with similar reputations,
but it becomes difficult to know if enough of any of them is present in
these mixtures to have an effect. The potential for interactions, both
good and bad, also arises.
For this reason, products with a single
herb offer the best chance of getting a clearer understanding of their
evidence. Uncovering that evidence can then be a challenge. As with many
topics, the internet provides much information – some of it good, and
some of it bad.
Discernment is vital when searching the internet,
especially for health information. Be critical. If a website recommends a
herb and is also selling it (as three-quarters of the sites are), be
wary. If a website claims a herbal remedy will cure everything, surf
away. If it sounds too good to be true, it probably is too good to be
true.
To help when searching the web for health information,
various accreditations are available. Websites agree to abide by a code
of conduct and in return can display a certification logo. One is the
Health On the Net (HON) Foundation, a not-for-profit organisation based
in Switzerland. In general, websites with such logos should be
trustworthy (but check out what the logo really means).
The best
type of evidence for the effectiveness and safety of herbs, supplements
or medicines are controlled clinical trials. These are increasingly
available for herbal remedies and published in peer-reviewed journals.
However, these are not written for popular consumption, and often
provide so much detail that even busy professionals don’t have time to
examine them. For this reason, systematic reviews are conducted to
summarise the available research. These are designed to remove as much
bias as possible from the conclusions.
One of the best sources of
systematic reviews is the Cochrane Library, available at TheCochrane
Library.com. This is produced by independent professionals and available
both in great detail and in plain language summaries. Reviews of
several dozen herbs are available, and more are added each month.
PROBLEMATIC ASPECTS
The
impression is often given that natural is safe. Hemlock, the death cap
mushroom (Amanita phalloides) and deadly nightshade (Atropa belladonna),
should be enough to remind us that nature can be dangerous. Consuming
enough capsaicin from chilli peppers will kill you. Many herbs have
adverse effects, and unfortunately some herbal remedies (especially
those bought over the internet) can be impure. Batches of “herbal
viagra” in particular have been found to be contaminated with
pharmaceuticals.
Herbal remedies can be a way to avoid expensive
medicines. For short-term conditions, these may be an option. But for
serious conditions, or if symptoms persist, it is important not to avoid
medical attention. Self-diagnosis has its limitations.
RECOMMENDATIONS
Although
thousands of herbs are used, only a few dozen have received extensive
research. Many have not been studied in controlled trials and trying
them is, at best, guesswork. For others, a few studies may be available.
Be
wary of general claims about products being “scientifically proven”
unless specific references are given to that evidence. Also, ask your
doctor or pharmacist about herbs or supplements you are using or
considering. They should have access to the growing number of
professional databases addressing herbal remedies (such as
NaturalDatabase.com). It is also important that they know about all the
herbs, supplements and medicines you are taking as some of them can
interact with one another.
If a herb works, it does so because it
contains chemicals that affect our bodies. In that way, they are
naturally occurring drugs that should be taken with due caution.
Dónal
O’Mathúna has a PhD in pharmacy, researching herbal remedies, and an MA
in bioethics, and is a senior lecturer in the School of Nursing Human
Sciences, DCU. His
Irish Times columns will be published mid-2012 by Glasnevin Publishing.
Series concluded
My Thoughts
Yesterday I got bitten by some bug. I went picking some star fruit and found myself itching all over. I needed immediate cure, an alternative medicine. I tried every alternative medicine I can get hold of. And then I remembered vinegar- the alternative medicine for a lot of things, including bites.
Well, I smelled kind of awful. But the itching did stop. The rashes are still reddish, but not as uncomfortable as it was the first time.
I don't think vinegar is considered herbal. But I'm convinced it is an alternative medicine.