Herbal Remedies Notes

Herbal remedies and alternative medicine are therapies outside traditional Western medicine.
In the past decade, herbal medicine has become a major alternative medical treatment in the U.S.
Herbal medicines are naturally occurring compounds in biological organisms; they are classified as foods rather than drugs by the FDA.
The herbal industry is an $18$ billion dollar per year industry ( $9.6$ B in 2019).
Dietary supplements contain secondary components that can have powerful physiological effects on the body, but sometimes they are marketed without rigorous scientific study.

The 1994 Dietary Supplement Health Education Act (DSHEA) includes vitamins, minerals, and herbs.
Dietary supplements are NOT subject to clinical studies for safety, effectiveness, side effects, etc.
Although some herbal remedies show great potential, some may interact with prescription or other drugs.
Be careful and never take any plant compound unless you know it is safe!
ALWAYS TALK TO YOUR DOCTOR FIRST!

St. John’s wort (Hypericum perforatum) is used for treating mild depression, but its effectiveness has been questioned.
- It may lift spirits by raising the level of serotonin.
- One drawback is that it may induce photosensitivity in some individuals and may react adversely with other medications.

Ginkgo (Ginkgo biloba) leaves have been used for centuries in China to treat asthma and bronchitis.
- Now it is studied as a brain tonic and may halt the progression of Alzheimer’s disease.
- There is no conclusive scientific evidence.
- However, if taken with aspirin, it may induce internal bleeding.

Saw palmetto (Serenoa repens) has cherries with a substance that may help some patients suffering from BPE (Benign Prostate Enlargement).
- Again, results may not be consistent.
Echinacea is a top-selling herbal remedy.
- It MAY help stimulate the body’s immune system.
- It MAY help prevent cold and flu.
- Research shows it works for some people, but not others.

Garlic - may help reduce cholesterol levels and blood pressure
Ginseng - may not be effective in improving physical performance or as a brain tonic, according to studies
Grape seed extract - used for cardiovascular disease
Green tea - may treat some cancers and lower cholesterol, but weight loss data is mixed

Bilberry fruit – possibly effective for problems in the retina or high blood pressure
Aloe – possibly effective against skin psoriasis and to relieve constipation
Kava root – possibly effective to reduce anxiety, but may be very harmful to the liver!
Most research is not conclusive, or there is insufficient evidence for effectiveness regarding many herbal products.

Ephedra species is a gymnosperm native to China, used for medicinal purposes as a decongestant against asthma and bronchitis.
Active compound: ephedrine.
It is a CNS stimulant, bronchial dilator, and increases blood pressure, with effects similar to adrenaline.

It was used as a dietary supplement found in performance-enhancing and weight loss products.
Has been found to have adverse effects:
- hypertension
- palpitations
- irregular heart beats
- dizziness
- headache
- stroke
- seizures
- heart attacks

The FDA has issued warnings against its use and is now considered a dangerous drug.
The FDA banned ephedra on April 12, 2004!
Ephedrine products have been linked to 155 deaths and 1300 cases of harmful effects after overdoses (Baltimore Orioles pitcher Steve Bechler).
So be careful!

Initially, Bechler’s death was thought to have been from heatstroke, but it turned out to be more than that.
According to The Baltimore Sun, a medical examiner later ruled that the death was caused, in part, by an over-the-counter diet supplement Bechler was taking to lose weight.
His death eventually led to the ban of products containing ephedra, a stimulant once common in diet pills.

The DSHEA act in 1994: herbal dietary supplements are not subject to clinical tests by the FDA to determine their safety!
The herbal supplement industry is an $18,000,000,000$ ( $18$ Billion!) a year in the US.
People need to consult with their doctors first!
CBS News report on herbal supplements: https://www.youtube.com/watch?v=z4tLyM8N-f4

Many studies on herbals are inconclusive or plain wrong. Also important: who paid for the study?
Some did not include a placebo.
Placebo: a simulated treatment to make a patient think they are taking a medicine (like a sugar pill, masked as a medicine).
Labels are often very vague or confusing.
- “May help in the relief of… ”
- “energizing”
- “invigorating”
Does “all natural” meal safe?
“Preliminary clinical trials show… ” What do they mean by “preliminary”? 5 people?

Double-blind study: When two groups of patients are administered a treatment (one of them is a control), but neither one knows they are being given the actual treatment (sometimes not even the researchers know) – in order to prevent pre-judgement of participants, that may skew the results.
Placebo effect: a beneficial effect in a patient, following a treatment, that comes from the patient’s expectations of the treatment, rather than the treatment itself.

Neither participants nor doctors/researchers know who is receiving the treatment or the placebo!
A third, independent party analyzes results.

Placebos won't lower your cholesterol or shrink a tumor. Instead, placebos work on symptoms modulated by the brain, like the perception of pain.
"Placebos may make you feel better, but they will not cure you," says Prof. Ted Kaptchuk from Harvard University. "They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea."
How placebos work is still not quite understood, but it involves a complex neurobiological reaction that includes everything from increases in feel-good neurotransmitters, like endorphins and dopamine, to greater activity in certain brain regions linked to moods, emotional reactions, and self-awareness. All of it can have therapeutic benefit. (From: Harvard Health Publishing, Harvard Medical School, May 2017)

Always tell your doctor before taking any herbal dietary supplement, as it may react adversely with other medications – or just be dangerous to your health.
Look up reliable sources (like MedlinePlus or the NIH) for trustworthy information on the effectiveness of the product.
If in doubt, avoid taking it! Always play it safe, don’t risk your health.