The history of modern medicine is grounded in plants. Over thousands of years, medicines have been identified and extracted from botanicals. Some familiar ones include basic aspirin, penicillin, morphine and more.
Most of the world’s population have used or use some type of herbal supplement. The use of herbal medicines, phytonutrients or nutraceuticals is expanding in developed countries, including the UK and the rest of Europe, North America, and Australia.
In the United Kingdom, the European Union, and in Canada, there are various organizations that qualify individuals as credentialed herbalists.
The journal Frontiers in Pharmacology notes that the European Union has established a simplified licensing system to help the public make informed choices about the use of herbal products. They report that all manufactured herbal products either gain a product license of the type needed to manufacture “conventional” products or become registered as a “traditional herbal medicinal product”.
Chris Kilham, founder of MedicineHunter.com, which aims to help consumers learn about safe and effective plant medicines, writes that the difference between a medicine and a poison is often the dose.
“Plants and their derivatives are currently the sources for thousands of drugs worldwide. A small amount of (active) compounds, properly employed in a clinical setting, can benefit health. Too much of (some active) compounds can lead to death. Plant medicines remain indispensable to modern pharmacology and clinical practice. Much of the current drug discovery and development process is plant-based, and new medicines derived from plants are inevitable.”
According to the NIH’s Office on Dietary Supplements, the word “natural” is especially problematic, because many people that word signifies safe and effective, but the safety of a botanical depends on its chemical makeup, how it works in the body, the preparation and the dose. They say, “The action of botanicals range from mild to powerful (potent). A botanical with mild action may have subtle effects. Chamomile and peppermint, both mild botanicals, are usually taken as teas to aid digestion and are generally considered safe for self-administration. Some mild botanicals may have to be taken for weeks or months before their full effects are achieved. For example, valerian may be effective as a sleep aid after 14 days of use but it is rarely effective after just one dose. In contrast a powerful botanical produces a fast result. Kava, as one example, is reported to have an immediate and powerful action affecting anxiety and muscle relaxation.”
As I reported last week, Ecuador’s 2008 constitution guarantees the rights of indigenous populations to their traditional forms of medicine. The BBC.com reports there are 14 ethnic groups in the country, from the coast to the Andes and the Amazon region, and each culture has a different approach to health. Riobamba’s Alternative Andean Hospital is a private institution where Western and Andean medicine are practiced side by side, and where administrators find that indigenous people are more accepting of modern medicine if it is offered alongside their traditional practices.
However, Ecuador does not currently regulate herbal medicines. They are not registered or included on an essential drug list. No post marketing surveillance system exists. In Ecuador, botanicals are sold in special outlets without restriction. And similarly in the U.S. dietary supplements including botanicals are not regulated or examined or tested for efficacy or potency.
Commonly Used Herbals
The following is a brief sampling of popular herbals that may be used safely, what they’re traditionally used for, plus known side effects that need to be respected. The italics are mine and reflect my research.
For more information on any of the herbals I’ve included, please check the references below. For this and all of my columns, I include references from credible sources, including universities and other informational websites: none have a financial stake in marketing the said supplement. The exception for this column is Chris Kilham’s Medicine Hunter, and he markets his own Purity Products brand.
As herbal experts say, plant-based medicine is still medicine. Many natural substances can have harmful effects — especially if they are taken in large quantities or if they interact with other supplements and/or with prescription medicines.
Always use a Drug Interactions Checker (click on Drugs.com) to, as they say, “Know more. Be sure.”
Black cohosh: often used for menopausal disorders including hot flashes and painful menstruation: approved in Germany for these symptoms. Standardized extracts more effective than teas. Not to be used with certain medications that cause liver toxicity such as atorvastatin, acetaminophen (Tylenol), and alcohol. Some research shows that herbal medicines such as black cohosh may interfere with common breast cancer treatments such as radiation and chemotherapy drugs.
Cranberry: often used as a preventative against urinary tract infections, taken as cranberry juice or in the form of concentrated cranberry juice solids. The active ingredient in cranberry (proanthocyanidins) that can keep bacteria from binding to the bladder wall isn’t present in commercial cranberry juice. It is possible that cranberry capsules may have some benefit, but the research is not conclusive. Sweetened cranberry juice cocktail is mostly water and sugar: some brands don’t contain any cranberry juice at all. Prevent UTIs by drinking plenty of water, urinate when you feel the need, wipe front to back, avoid perfumed products and feminine “hygiene” sprays.
Echinacea: a perennial herb native to North America, it is most commonly used in treatment of the common cold and upper respiratory infections, to promote immunity, and externally to promote healing. People with autoimmune diseases, tuberculosis, multiple sclerosis, diabetes, and connective tissue disorders should not use Echinacea. Side effects include insomnia, headache, and jitteriness. May change how the body metabolizes anti-rejection drugs.
St. John’s wort: a plant with yellow flowers commonly used to treat mild to moderate depression, PMS, seasonal affective disorder (SAD): may have anti-inflammatory effects when applied topically (for some skin conditions). Possible interactions with warfarin (a blood thinner), birth control pills, SSRIs (a class of antidepressants), and other drugs. Check with a drug interaction screener and your physician.
Garlic: a member of the allium family (onions, leeks, chives, scallions, shallots), garlic is cultivated all over the world, and has been used for many different healing remedies in countless different cultures. It is one of the best-selling botanical remedies in the U.S. and Europe. Garlic is thought to be antimicrobial, to help lower cholesterol, and reduce clotting. Also used for GI upset to lower high blood pressure: Avoid garlic supplements if you’re allergic to any member of the allum family; interferes with HIV drugs, and discontinue prior to surgery or dental procedures. I cannot find one credible source that recommends powdered supplements, however eating garlic provides micronutrients that can be beneficial as part of a healthy diet.
Ginger: the root or underground stem (rhizome) chewed raw or in tea, used for nausea, indigestion and minor gastric upsets. Morning sickness, thought to be due to hormonal changes in the first 12 weeks of pregnancy, may be eased with ginger lozenges: limit to only 1 g per day for no more than 4 consecutive days: if using processed ginger, buy from a reputable source; since it is thought to slow blood clotting, avoid with other blood-thinning agents.
Ginseng: there are 11 species of slow-growing perennial plants belonging to the Araliaceae family, found in North America and eastern Asia. Asian ginseng has been used for centuries to improve vitality and strengthen immunity, prevent colds and infection: thought to decrease LDL and boost HDL (“bad” and “good” cholesterol”.) May slow blood clotting and decrease effectiveness of warfarin, a blood thinner; not indicated with ACE inhibitors (for high blood pressure). Use of ginseng with caffeine may increase effect of caffeine.
Gingko Biloba: an ancient Chinese medicine with a long history of use for treating blood disorders and memory issues. Also used to improve blood flow, PMS, and macular degeneration. May decrease effectiveness of anti viral drugs, and alter the actions of medications metabolized through the liver: there is a list of more than 500 possible interactions including seizure medications and antidepressants: read more here.
Oil of oregano: oregano is a popular cooking herb, and member of the mint family. Rich in vitamin K and antioxidants, it is thought to have anti-bacterial properties, and has been used to treat some skin conditions, respiratory, GI, and urinary tract disorders: eating the oregano herb offers many nutritional benefits, but concentrated into oil, the active ingredients in oregano can be toxic and must be used in diluted form, individualized to the patient. Consult with a credentialed herbalist to assure a safe dose.
Consult With An Expert
If you decide to use herbal medicines consult with a fully qualified herbal practitioner who is trained to assess which herbal medicines are appropriate for you and who source their herbs and plants reliably. Don’t try to self-medicate especially for a condition such as high blood pressure, or diabetes, or cancer. Delaying conventional treatment can often prove fatal.
Cancer Research UK advises not taking herbal remedies before consulting with your healthcare provider if you have a medical condition, including cancer; are undergoing radiotherapy; are pregnant or breastfeeding; or are due to have surgery in the next few weeks. Certain prescription medications and dietary supplements increase risk for bleeding including fish oil, ginseng, and gingko biloba.
MayoClinic.org reminds us that as we age, we metabolize medications differently, and that goes for herbal supplements too.
Always follow instructions. Don’t exceed recommended dosages or take the herb for longer than recommended.
Keep track of what you take. Take only one supplement at a time to determine if it’s effective. Make a note of what you take — and how much for how long — and how it affects you.
Commercial products may be contaminated. Herbal products from some European countries are highly regulated and standardized. But toxic ingredients like heavy metals and even prescription drugs like amphetamines have been found in dietary supplements manufactured elsewhere, particularly China, India and Mexico.
Check alerts and advisories. The FDA maintains lists of supplements that are under regulatory review or that have been reported to cause adverse effects.
As reported in a 2013 column for TodayinEcuador.com, in 1999 Ecuador’s National Health Department began a process to identify and certify ancestral medicine caregivers, and have certified more than 2,000 men and women. Modern medicine and traditional herbal medicine are not mutually exclusive. There may be value in traditional practice, and there is value in modern medicine. Errors occur in both traditional and modern medicine.
Sometimes it seems that critics of conventional medicine can’t see beyond their own bias, as if all traditional medicine is “good” and all modern medicine is “bad”. As if only conventional medical doctors make mistakes, and alternative practitioners never do.
As a colleague of mine, a registered dietitian with a doctorate in nutritional research said when diagnosed with an aggressive form of blood cancer, “I respect complementary medicine, but, when the “Big C” hits, bring in the big guns.”
After undoing some very challenging treatments, today he is living cancer-free. As his physician said, “If there’s anything positive about your diagnosis, it’s that it happened this year, and not five years ago. Just five years ago, you’d be dead in one year, but today we have been able to target this particular cancer with a powerful new pharmaceutical, and you’re one lucky man, in spite of your diagnosis.”
Modern medicine has led to a radical increase in life expectancy in a very short time. As reported in the Guardian, at the start of the 19th century, we could have expected to live to 40. Today, men live on average to age 75, and women 80 years old. This, in spite of our lifestyles (poor diet and sedentary living) — 80% of heart disease and cancer are caused by preventable causes, namely smoking, overweight and obesity.
In a report from ABC News, among the top 10 health advances that changed the world, vaccines, surgical anesthetic and antisepsis are tops in terms of lives saved. Clean water and sanitation, antibiotics, and antivirals such as penicillin and AZT are lifesavers too.
Organ transplants would not be possible without the development of anti-rejection drugs. And not surprisingly, the birth control pill is singularly revolutionary in creating a social revolution and transforming women and their families’ lives.
Finally, modern medicine is moving forward from a symptoms approach toward a whole-body approach. Genomic medicine is bringing us closer to identifying risk, and targeting medications toward specific individuals and conditions — we can sometimes identify risk for disease before it occurs, and take steps to prevent development.
BBC.com. Ecuador hospital mixes folk and modern medicine. http://www.bbc.com/news/world-latin-america-18483584
Berkeley Wellness. The Power of Garlic. http://www.berkeleywellness.com/supplements/herbal-supplements/article/power-garlic
Christine Dennis, Holistic Herbalist. Herbalist credentials http://www.christinedennis.ca/FAQ.html
Frontiers in Pharmacology. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety.
Integrative and Functional Nutrition Academy. https://www.ifnacademy.com/
Medical News Today. Oregano: Health Benefits, Side Effects. http://www.medicalnewstoday.com/articles/266259.php
Medicine Hunter. About plant medicines. http://www.medicinehunter.com/about-plant-medicines
National Institutes of Health. Botanical Dietary Supplements. https://ods.od.nih.gov/factsheets/BotanicalBackground-HealthProfessional/
Rational Wiki. List of medicinal plants. http://rationalwiki.org/wiki/List_of_medicinal_plants
Science Daily. Healthy Lifestyle Habits May Be Associated With Reduced Risk Of Chronic Disease. https://www.sciencedaily.com/releases/2009/08/090810161906.htm
The Guardian. Medicine will not only make us live longer, but live better. https://www.theguardian.com/zurichfuturology/story/0,,1952688,00.html
Today In Ecuador. Ancestral medicine regains favor in Ecuador. http://www.todayinecuador.com/noticias-ecuador/ancestral-medicine-regains-favor-in-ecuador-580023.html
University of Maryland Medical Center. Complementary and Alternative Medicine Guide. http://umm.edu/health/medical/altmed
Wikipedia. Ginseng. https://en.wikipedia.org/wiki/Ginseng
World Health Organization. Essential Medicines and Health Products Information Portal.
Author’s note: As a registered dietitian, my goal is communicating current scientific and informational advice and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.