Herbal Remedies Reviewed

The evidence suggests that many people are satisfied with alternative treatments of chronic conditions. A study from Harvard researchers published in 2001 in the Annals of Internal Medicine showed that almost half of the people who had tried some type of complementary or alternative medicine were still using it 11 to 20 years later.

Not So Safe

There are, however, a number of concerns about the use of herbal medicine. "Of all the complementary and alternative medicines, herbal medicine has, I think, the most potential but also the most risk to patients," says Kennedy. "There's this impression that herbs are safe and natural. But they can interact with other drugs and other herbal products and cause serious health consequences." Unfortunately, most people and even many physicians are not aware of the potential dangers.

Photo courtesy of Jen Schripsema St John's Wort: This herbal supplement can interfere with the effectiveness of birth control pills and prescription blood-thinners.

For example, St. John's Wort can decrease the effectiveness of birth control pills. Feverfew, garlic, ginkgo, ginseng, and ginger all thin the blood; using any of these herbs in combination with prescription blood-thinners can lead to uncontrolled bleeding. Ginseng alters blood glucose levels and should never be used by people with diabetes.

The perceived safety of herbal supplements leads many people to use them without supervision. Only 5% of those taking herbs were doing so under the care of an alternative medicine provider. Additionally, two-thirds of people using herbal supplements did not tell their physician.

Herbal medicine use may also reveal fundamental problems with access to healthcare. Kennedy is currently involved in research that shows that St. John's Wort use is higher in people without insurance or a primary care physician. "They are self-treating with cheap, unregulated alternatives because they can't afford to pay for prescription medications and psychiatry visits," says Kennedy.

The U.S. Food and Drug Administration (FDA) classifies herbal supplements as a food, not a drug. They are, therefore, not subject to the same testing, manufacturing, and labeling standards as prescription and traditional over-the-counter drugs. "There is no enforcement using current regulation," says Kennedy. "When you've got for-profit companies selling these products and treating them as benign dietary supplements instead of drugs, that's potentially a problem."

Companies may mislabel, misidentify, or adulterate the products they sell. A study published in May 2006 in the Journal of Agricultural and Food Chemistry underscored the extent of this problem. Researchers from Columbia University and the City University of New York tested 11 commercially available brands of black cohosh, used to treat symptoms of menopause, and found that three of those products contained no black cohosh at all.