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HERBS:THE ROOTS OF MEDICINE
2000 BC - Here, eat this root. Something new on today’s medicine shelves is actually quite old. Ancient, in fact. And like many things, it’s come full circle.
About 15 years ago, however, herbal remedies made an astonishing resurgence and have continued to gain popularity ever since. A number of other non-traditional treatments are in use today, as well. Some of the better-known ones are acupuncture, hypnosis, meditation, therapeutic touch, qi gong, reflexology and the use of mega-doses of vitamins and minerals. All these approaches to healthcare are collectively known as complementary and alternative medicine, or CAM. It is defined by the NIH’s National Center for Complementary and Alternative Medicine (NCCAM) as: those treatments and practices not widely taught in medical schools and not generally used in hospitals. The NCCAM was established in 1992 to study the hundreds of different types of complementary and alternative medicines that originated in countries around the globe. Americans of all ages and socioeconomic backgrounds have wholeheartedly embraced these new-but-old treatments, particularly the use of herbs. It’s estimated that some 15 million adults take herbal medicines and/or mega-doses of vitamins in addition to prescription drugs. Between 1990 and 1998, the prevalence in the use of herbs and other forms of CAM went from 25 to 42 percent, and experts now say that half of the general population, and between 70 to 85 percent of those with HIV/AIDS and cancer, use it in some form. In fact, U.S. consumers spend about $13.8 billion on CAM every year. Why are we so gung-ho to try these unconventional remedies? James S. Gordon, MD, chair of the White House Commission on Complementary and Alternative Medicine Policy, recently spoke at UMDNJ. He says Americans began looking around the world for alternative treatments in the 1970s, because they saw limits to Western medicine. "Our medicine is so potent and sheds so bright a light, that we can easily see where it doesn’t help," Gordon says. "People with chronic, pain-causing diseases who were getting no relief started asking, ‘What else is there?’ and ‘What else is there that I can do?’" Experts at UMDNJ agree. Riva Touger-Decker, PhD, RD, FADA, acting director of the UMDNJ Center for the Study of Alternative and Complementary Medicine, adds that more than ever, people want to participate in their own healthcare, perhaps because of the plethora of information available today. "Patients often go on their own to CAM providers for stress reduction and relaxation therapies," says Touger-Decker, who is also program director of the MS in clinical nutrition at UMDNJ-School of Health Related Professions. "Some people don’t want to deal with the side-effects of prescription drugs; others like the holistic approach that is the basis of many forms of CAM, and usually those providing the therapies are enthusiastic and give patients a great deal of attention and encouragement." Physicians in increasing numbers are becoming more familiar with complementary and alternative treatments. A 1997 survey conducted by the Association of American Medical Colleges found that about 75 percent of the 125 U.S. medical schools were offering some type of instruction in CAM as part of required courses. Research on the efficacy and possible uses of CAM is also ever-increasing. At UMDNJ, many physicians are investigating a host of these therapies. Robert DiPaola, MD, assistant professor of medicine at UMDNJ-Robert Wood Johnson Medical School (RWJMS), for example, is studying the effects of licorice root on laboratory-grown cancer cells. The physician also found that an ancient Chinese remedy comprised of eight herbal extracts, known as PC-SPES, produces an estrogen-like effect that helps keeps prostate cancer at bay. He has identified a number of adverse side effects of PC-SPES as well. David August, MD, director of surgical oncology at The Cancer Institute of New Jersey and an assistant professor of surgery at RWJMS, is studying green tea as a possible preventive of colorectal cancer. So with all this good news, what’s the downside of CAM? Only about 17 percent of those using it tell their physicians. Biological-based CAM – herbs, vitamins, minerals and other chemicals – can interfere and/or interact with medical treatments and in some cases do more harm than good. Take St. John’s wort, for example, one of the most popular herbs sold for the relief of depression. It’s less expensive than its counterparts, Prozac or Zoloft, and can be obtained without a prescription. The herb, however, reduces the effectiveness of several important medications by speeding up activity in a key pathway responsible for their breakdown. This lowers the drugs’ levels in the blood. Two types that are particularly affected are protease inhibitors, used in the treatment of HIV infections, and immunosuppressant drugs, used to prevent organ transplant rejection. Other medications that work through the same pathway and whose effects are decreased by the herb are birth control pills, cholesterol-lowering medications, seizure drugs and blood thinners. The safety of St. John’s wort during pregnancy hasn’t been established, and some users say it causes insomnia, irritability, mild diarrhea and photosensitivity. Ephedra, an herbal stimulant used by millions for bodybuilding and weight loss, has been linked to strokes, heart attacks, seizures and even death. At least 54 deaths and about 1,000 reports of complications from the herb have been reported since the mid-1990s. Some of the other side effects and interactions that herbs can cause are allergic reactions, edema, hypertension and prolonged or enhanced bleeding. (see chart on the following pages). "Natural is not synonymous with safe," says Touger-Decker. "Tobacco and arsenic are all natural, and they’re very dangerous." She explains that herbs are sold in various forms – teas, pills, tinctures, lozenges, syrups and mouthwashes – and each has a different potency. For example, a tincture, which is an herb plus alcohol/water, is stronger than a tea, and an extract is even stronger than a tincture. The particular species of an herb, the length of the season in which it is grown, and the time of year it’s harvested all affect its concentration. Perhaps what is most important for consumers to know is that plants and parts of plants are not defined as drugs. Instead they are considered dietary supplements and undergo the same level of scrutiny as commercially available foods. Herbals don’t undergo the same FDA approval process as pharmaceuticals. In fact, the FDA has no control over safety guidelines that regulate the consistency and purity of herbal compounds. The Dietary Supplement Health and Education Act of 1994, however, does require the herbal industry to follow certain safety standards, but as with the food industry, it’s the manufacturer’s responsibility to make sure its products are safe. Despite the controversy surrounding medicinal herbs, this time around they are here to stay. As more research is done, they will no doubt become an important part of mainstream medicine. Perhaps Paracelsus – a famous 16th century Swiss physician who advocated observation and experiment –best described the role of herbs in medicine when he said: "Poison is in everything and no thing is without poison. It is the dosage that makes it either a poison or a remedy."
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The magazine of the University of Medicine and Dentistry of New Jersey |
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ALOE
ECHINACEA
BLACK
COHOSH 
EPHEDRA
CAPSICUM
(cayenne, hot pepper) 
FEVERFEW
CHAMOMILE
USE: Internally - Chamomile is used as an anti-inflammatory,
anti-spasmodic and smooth muscle relaxant. It is used to relieve
indigestion and other gastrointestinal complaints. Chamomile tea
is also commonly thought of as a mild sedative. Its mild sedative
effect, however, has not been proven. Externally - Chamomile extracts
are useful for treating inflammation of skin and mucous membranes.
GARLIC
GINGER
LICORICE
GINKGO
BILOBA 
ST.
JOHN'S WORT 
GINSENG
VALERIAN
KAVA
KAVA USE: Internally - Kava kava is a relaxant
used to treat fibromyalgia, tension headaches, anxiety and stress.
It is also used to relax skeletal muscles. 
WILD
MEXICAN YAM USE: Internally - An extract has been
shown to lower blood triglycerides and to raise HDL cholesterol.