March 27, 2001

COLLEGE STATION – For as long as human beings have lived on the earth, herbs have been in use – as medicine, as botanicals and as flavorings for foods. And even now, as the 21st century officially dawns, "Americans are spending between $3.5 billion and $5 billion annually on herbal supplements," said Dr. Jenna Anding, assistant professor and Extension nutrition specialist.

Herbs that are touted to be health aids – whether as prevention of some condition or other or as cure – count for a lot of those billions of dollars. Some devotees say because herbs have been used as medications for thousands of years, they must have some value. Other consumers and health professionals are more skeptical. If herbal medications were so wonderful for all those years, they ask, why was life expectancy so much shorter in the past?

In fact, many health care professionals – including Anding herself – are very cautious when it comes to herbal supplements. "Most of the research on herbal medications has been done in Europe, where herbal supplements are regulated more tightly than they are here,"she explained.

In an article on "Herbal Therapy: What a Clinician Needs to Know to Counsel Patients Effectively," Brent A. Bauer, M.D., defines herbs as "a plant or plant part valued for its medicinal, savory or aromatic qualities." Botanicals, he wrote, are "any plant-derived product used for a medicinal or health purpose." (From "Concise Review for Clinicians," the Division of Area General Internal Medicine, Mayo Clinic, 2000 Mayo Foundation for Medical Education and Research)

Sometimes herbs and botanicals are the same thing; sometimes they are not.

But according to information from The Natural Marketplace Trends Report (copyright The Natural Marketing Institute, 2000), the three current top-sellers in the world of herbal remedies are: ginkgo, garlic and Echinacea.

GINKGO

"Generally speaking, ginkgo is often promoted as a means of improving short-term memory – improving concentration and short-term memory," Anding said. "There are some studies that suggest the herb might have some merit – and some (studies) find that it doesn't work."

Perhaps these studies were done differently, used different levels or different strengths of the herb; or the herb was given in different ways for different lengths of time; or the symptoms were monitored differently, she said.

"The jury is still out," Anding said, adding that many studies are still being done.

"One concern is that ginkgo may have some blood-thinning properties," she said. "If one is already taking blood-thinning medication – even aspirin – the ginkgo might thin the blood even more." If someone who has been taking ginkgo is in a serious accident, she said, the bleeding might be difficult to stop.

Anding said the recommendation is to stop taking ginkgo at least two weeks before a scheduled surgery.

GARLIC

Garlic is promoted as a way to reduce blood cholesterol levels, as well as being a possible antioxidant and "it may have some antibacterial properties," Anding said.

But when garlic is taken in high doses (and as Anding points out, "Who knows what a high dose is?"), it may enhance the effectiveness of high blood pressure medication and blood thinning medication. In theory, the use of garlic with insulin or with a drug for hypoglycemia might have an adverse effect on those medications, she said.

Garlic in food is not a problem, Anding said. "Cooking with garlic is fine, although some may get an upset stomach if they eat too much.

"Using a little bit is good; using too much could be harmful."

And, as with other herbs, use of garlic should be discontinued one to two weeks before scheduled surgery.

ECHINACEA

Echinacea is promoted as a method of preventing or treating colds, Anding said. "Some studies say it works; some say it doesn't. There are so many variables it's hard to get a conclusive decision."

Echinacea is also called the purple cone flower, she said, which is part of the daisy family. "If one is allergic to daisies, you may experience a reaction to an Echinacea supplement."

This herb is supposed to prevent colds because it boosts the immune system. But for someone with an autoimmune disease, such as lupus or rheumatoid arthritis, boosting the immune system is the last thing they want.

And its possible benefit might not be all that beneficial. "Some experts say if it's taken for longer than eight weeks, it may reduce the effectiveness of the immune system," Anding said.

Anding's advice is to consult with a doctor or other health care provider before taking any herbal supplements.

Since the FDA (Food and Drug Administration) does not test herbal supplements, these supplements are not scrutinized with the same high standards that more traditional medications are. "Herbs are not tested for purity before going on the market," she said. "Herbs in this country are regulated differently from drugs, although some of them may have drug-like properties."

Anding advised anyone who is thinking of taking any herbal supplement should:

- Talk with a doctor or health care provider, and get into the habit of discussing any and all medications with them, including pharmacists.

- Get an accurate diagnosis before using any herb.

- Learn all about the potential side effects of the herbs considered. Do your homework – get educated and make informed decisions.

- Seek unbiased and scientific-based research for your source of information.

"There are plants that may help and plants that can harm," she said. "Many times the difference between a drug and poison is the dosage."

Anding recommended reading:

Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals, by Varro E. Tyler and James E. Robbers, the Haworth Herbal Press, New York , 1999

Tyler's Honest Herbal, by Steven Foster and Varro E. Tyler, The Haworth Herbal Press, New York, 1999

American Botanical Council Web site: http://www.herbalgram.org/index.html

National Center for Complementary and Alternative Medicine of the National Institutes of Health Web site: http://nccam.nih.gov/