Herbal medicine
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Herbal medicine

An herb is a plant or plant part used for its scent, flavor or therapeutic properties. Herbal medicine products are dietary supplements that people take to improve their health. Many herbs have been used for a long time for claimed health benefits. They are sold as tablets, capsules, powders, teas, extracts and fresh or dried plants. However, some can cause health problems, some are not effective and some may interact with other drugs you are taking.

History of herbal medicine
Plants had been used for medicinal purposes long before recorded history. For example, ancient Chinese and Egyptian papyrus writings describe medicinal plant uses. Indigenous cultures (such as African and Native American) used herbs in their healing rituals, while others developed traditional medical systems (such as Ayurveda and Traditional Chinese Medicine) in which herbal therapies were used systematically.

Recently, the World Health Organization estimated that 80% of people worldwide rely on herbal medicines for some aspect of their primary health care. In the last 20 years in the United States, increasing public dissatisfaction with the cost of prescription medications, combined with an interest in returning to natural or organic remedies, has led to an increase in the use of herbal medicines. In Germany, roughly 600 - 700 plant-based medicines are available and are prescribed by approximately 70% of German physicians.

Why do herbs work?
For most herbs, the specific ingredient that causes a therapeutic effect is not known. Whole herbs contain many ingredients, and it is likely that they work together to produce the desired medicinal effect. Many factors determine how effective an herb will be. For example, the type of environment (climate, bugs, soil quality) in which a plant grew will affect its components, as will how and when it was harvested and processed.

Using herbs
The use of herbal supplements for medicinal purposes has increased dramatically over the past 30 years. Herbal supplements are classified as dietary supplements by the U.S. Dietary Supplement Health and Education Act (DSHEA) of 1994. The FDA defines a dietary supplement as "...any product taken by mouth that contains a so-called 'dietary ingredient' and its label clearly states that it is a dietary supplement." Per the provisions of DSHEA, herbal supplements -- unlike pharmaceutical drugs -- can be marketed without undergoing testing to prove their safety and efficacy. However, herbal supplements must be manufactured according to good manufacturing practices.

The most commonly used herbal supplements in the U.S. include echinacea (Echinacea purpurea and related species), St. John's wort (Hypericum perforatum), ginkgo (Ginkgo biloba), garlic (Allium sativum), saw palmetto (Serenoa repens), ginseng (Panax ginseng, or Asian ginseng; and Panax quinquefolius, or American ginseng), goldenseal (Hydrastis canadensis), valerian (Valeriana officinalis), kava (Piper methysticum), chamomile (Matricaria recutita), feverfew (Tanacetum parthenium), ginger (Zingiber officinale), evening primrose (Oenothera biennis), and milk thistle (Silybum marianum ).

Several herbs are often used together to enhance effectiveness and synergistic actions and to reduce toxicity. Health care providers must take many things into account when recommending herbs. For example, the species and variety of the plant, the plant's habitat, how it was stored and processed, and whether or not there are contaminants (including heavy metals and pesticides).

What is herbal medicine good for?
Herbal medicine treats many conditions, such as asthma, eczema, premenstrual syndrome, rheumatoid arthritis, migraine, menopausal symptoms, chronic fatigue, and irritable bowel syndrome, among others. Herbal supplements are best taken under the guidance of a trained health care provider. Be sure to consult with your doctor or pharmacist before self-treating. Some common herbs and their uses are discussed below.

bullet Ginkgo (Ginkgo biloba), particularly a standardized extract known as EGb 761, appears to produce improvements in awareness, judgment, and social function in people with Alzheimer's disease and dementia. Randomized controlled studies assessing the use of ginkgo supplements for Alzheimer's disease in individuals older than 65 years have produced positive results.
bullet Kava kava (Piper methysticum) has become popular as a treatment for anxiety, but recent reports have traced liver damage to enough people who have used kava that the U.S. Food and Drug Administration (FDA) issued a warning regarding its use, while other countries, such as Germany, France, and Canada, have taken kava off the market. However, there is no definitive proof that kava alone is responsible for liver damage in humans. Kava has been used traditionally for thousands of years.
bullet Saw palmetto (Serenoa repens) is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia (BPH). The evidence suggests that saw palmetto provides mild-to-moderate improvement in urinary symptoms and flow measures. Saw palmetto produces similar improvement in urinary symptoms and flow compared to finasteride (Proscar), a pharmaceutical drug used in BPH, and is associated with fewer adverse treatment events.
bullet St. John's wort (Hypericum perforatum) is well known for its antidepressant effects. The clinical efficacy of some standardized St. John's wort standardized extracts in the treatment of mild and moderate depression has been demonstrated in about 40 controlled clinical trials.
bullet Valerian (Valeriana officinalis) has had a long tradition as a sleep-inducing agent, with the added benefit of producing no hangover feeling the next day.
bullet Echinacea preparations (from Echinacea purpurea and other Echinacea species) may improve the body's natural immunity. Echinacea is one of the most commonly used herbal products, but controversy exists about its benefit in the prevention and treatment of the common cold. A meta-analysis of 14 clinical studies evaluating the effect of echinacea on the incidence and duration of the common cold found that echinacea supplements decreased the odds of developing the common cold by 58% and the duration of a cold by 1.4 days.

Standardized herbal supplements are the best way to ensure proper dosages and effects similar to human clinical trials. Ask your doctor or pharmacist about which herbal supplements are the best choice for your health concerns.

Side effects
Used correctly, many herbs are considered safer than conventional medications, but because they are unregulated, herbal products are often mislabeled and may contain undeclared additives. Some herbs are associated with allergic reactions or interact with conventional drugs. Self-prescribing herbal products will increase your risk, so it is important to consult your doctor or pharmacist before taking herbal medicines. Some examples of adverse reactions from certain popular herbs are described below.

bullet St. John's wort causes sensitivity to the sun's ultraviolet rays, and may cause an allergic reaction, stomach upset, fatigue, and restlessness. Clinical studies report that St. John's wort also interferes with the effectiveness of many drugs, including warfarin, birth control pills, certain asthma drugs, and many other medications. In addition, St. John's wort should not be taken with prescribed anti-depressant medication. The FDA has issued a public health advisory concerning many of these interactions.
bullet Kava kava has been linked to liver toxicity. Kava has been taken off the market in several countries because of the liver toxicity, although the causes remain controversial.
bullet Valerian may cause over-sedation, and in some people it may even have the unexpected effect of over-stimulating instead of sedating.
bullet Bleeding time may be altered with the use of garlic, ginkgo, feverfew, and ginger, among others.
bullet Evening primrose (Oenothera biennis) may increase the risk of seizures in patients taking drug known to lower seizure threshold, such as anticonvulsants.
bullet Some herbal supplements, especially those imported from Asian countries, may contain high levels of heavy metals, including lead, mercury, and cadmium. It is important to purchase herbal supplements from reputable manufacturers to ensure quality. Talk to your health care provider for more information.

Who is using herbal medicine?
Nearly one-third of Americans use herbs. Be sure to consult your doctor before trying any herbal products.

See the Natural Herbs Guide for more information.

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