Herbal supplements used to be thought of as leftovers of the hippie culture. Long a staple of natural-food stores, herbal supplements can now be seen in supermarkets, drugstores, books, magazines, newspapers and on television–like wildflowers and grass proliferating everywhere after an El Nino spell.
More than ever, it’s crucial that one do thorough homework before trying these products, experts say.
“There’s heightened interest because the supplements are `natural’ and they just seem like an attractive way to relieve a variety of symptoms and are not prescription-based,” said Dr. Ralph Cygan, vice president of primary-care services at the University of California at Irvine Medical Center and clinical professor of medicine at the university. Cygan says patients are asking about St. John’s wort, echinacea and ginkgo biloba.
“People feel better about taking them because they come from natural sources,” he said, “but there’s little good sound scientific research in the U.S. that tells us about their safety and efficacy. There are an increasing number of studies being done to look at the efficacy of these things. Patients and physicians should approach these things with a healthy skepticism and at the same time, with an open mind.”
Cygan says the growth of immigrant communities that have centuries-old traditions of herbal medicine, especially the Chinese, contribute to a greater awareness about herbal supplements. He cites acupuncture as one Chinese practice that has found acceptance in the world of Western medicine.
Gary Dylewksi, who practices osteopathic medicine in Orange, Calif., says more than half of his clients ask about herbal supplements.
“They range from people who are used to taking modern pharmaceutical medicine, are used to the research backing that and are wondering whether the herbal supplements are as good as drugs to people who are afraid of pharmaceutical (drugs) and their side effects and want to find a safer alternative,” Dylewski said. “People in the middle have done both. They are part of the alternative-medicine movement, they’ve educated themselves on the subject and go to Mother’s and Health Emporium.”
The great interest in herbal supplements has driven people to specialists such as natural-food stores for information and wider selection.
Sales of herbal supplements in 1997 were nearly $1.9 billion, up 18 percent from 1996, according to Packaged Facts, a market research firm. The company’s study estimates that sales will hit nearly $4.2 billion by 2002.
A 1997 Prevention magazine survey shows that 32 percent of adult Americans frequently use herbal medicines.
The growth is faster than the Food and Drug Administration can keep pace.
The FDA’s concern is efficacy and safety: At minimum, the supplements may not be effective. At the worst, people might consume them in harmful quantities or some ingredients may be hazardous to health.
The problem is that there’s a serious lack of scientific research in the United States to support the health benefits these herbs claim. There’s little U.S. research to show they don’t.
That’s changing gradually.
Studies are trickling into the American medical industry. In October, the Journal of the American Medical Association published a report indicating that ginkgo biloba can be of significant benefit in treating dementia associated with Alzheimer’s disease.
Institutions such as Harvard, Stanford and Columbia Universities have begun to include herbal medicine in their research programs. For most herbal-medicine proponents, verifiable scientific evidence that some herbs do work comes from Europe, particularly Germany, which they say has among the highest standards in herbal medicine. Germany’s Commission E, the equivalent of the FDA, regulates medicinal herbs as drugs and requires proof of their safety and efficacy.
Although the FDA won’t classify herbal supplements as drugs the agency recently amended its Dietary Supplement Health and Education Act to make ingredient listing more uniform and user-friendly. The guidelines will be enforced beginning March 23, but manufacturers are urged to comply as soon as possible.
