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Herbals: The Good, the Bad, the Ugly

Al Tunnell, Summer Student Intern 2000 and
Doctor of Pharmacy Candidate 2003
Campbell University

For centuries, men and women have turned to a herbal remedy to treat fevers, headache and arthritis. Hippocrates advised women to chew the leaves of this plant to lessen the pain of childbirth. This natural remedy is just as good, if not better, than some prescription medicines. In addition, it is not habit-forming.

So, what is this amazing herbal remedy? It is called willow bark. However, you no longer need to chew the leaves or brew a tea from it to obtain its benefits. A century ago, scientists discovered the chemical in willow bark that causes the pain relief. Today, millions of people buy this pain reliever under its more common name - aspirin.

Aspirin is a purified form of the pain reliever in willow bark. Whether you are taking aspirin or the "natural" willow bark, both remedies must be used with caution. Both can upset your stomach and people with stomach ulcers should be very careful about using them.. The moral to this story is, "Just because herbal medicines are natural doesn't mean they are safe."

In the past few years more and more people have been turning back to herbal remedies as a "natural" alternative to prescription medicines. But as in the case of willow bark, these herbal remedies must be treated with respect.

For example, many busy people are taking a herb called Kava Kava to relieve their stress. This herb has been used for centuries in tribal ceremonies in the South Pacific because of its tranquilizing effects. You might think that if tribes in the South Pacific have used it for thousands of years, then it must be safe. Just like any medicine, Kava Kava can cause side effects--especially when used for a long time. A person could develop shortness of breath, high blood pressure in the vessels of the lungs, or reduced protein levels in the blood. In less severe cases people can have flaking, dry, and discolored skin. Anyone using Kava Kava should not drink alcohol or take any other medicines or herbal remedies that cause sleepiness. Women should not take this herb when pregnant or breastfeeding.

Another popular remedy today is Echinacea, commonly known to garderners as the "purple cone flower." Americans are spending $300 million a year on various echinacea products. It is thought to make a person's immune system stronger and help them fight a cold or flu. Just like willow bark, people must treat this herbal with respect. If you have asthma or hay fever, then you could have an allergic reaction to Echinacea. If you've had a transplant or are taking a steroid, this remedy could make your condition worse. If Echinacea is overused, it could have the opposite effect and weaken your immune system. It can even cause liver damage.

Another problem consumers face is that not all Echinacea products are the same. They may contain different amounts of Echinacea and may have other herbals mixed in. This means that a person taking one brand of Echinacea could have a different reaction than someone taking another brand.

The reason for this is that when manufacturers harvest the plant, they will get bags full of the plant they want, as well as twigs, bark, and other plants that they do not want. Some of that extra material may find its way into the tablets on the shelf. This is why it is difficult to get the same ingredients in every tablet. Every tablet will be slightly different.

Herbal remedy manufacturers claim that sometimes a mixture of chemicals in a herbal remedy is better than having just one ingredient. They argue that it may take several ingredients working together to produce the effect. Unfortunately, there are no studies to prove this one way or the other. Studies are not required by FDA before selling a herbal remedy. Thus, herbal remedies do not have to meet the safety regulations that apply to prescription and nonprescription medications.

If you are considering taking a herbal remedy:

  • Ask your doctor or pharmacist if you have any medical conditions that make it dangerous for you to take a herbal remedy.
  • Ask your pharmacist if it will interact with any other prescription or over-the-counter medicines you are taking. Many herbal remedies can interact with medicines. Some people have even died.
  • Buy it from a reputable source - such as a pharmacy or an established health food store. Be very cautious about "home grown" remedies advertised in magazines or on the Internet.
  • Ask your doctor or pharmacist to explain the side effects and precautions you be aware of when taking the herbal product.

Your doctor and pharmacist want to keep you healthy. They cannot do that without your help. Herbal remedies may be helpful. But until we know more about them, they need to be treated with the same respect as prescription medicines. Just because they are "natural" is no guarantee they are safe. Remember, poison ivy is "natural"too!

© 2000 Consumer Health Information Corporation. All rights reserved.