Every culture on Earth has used plants to cure disease, ease pain, and heal the ills and discomforts of the human body. Herbal medicine undoubtedly predates written history. We can assume that at the same time that human beings were learning which plants were good to eat and which were poison, they also were discovering which plants could heal them. People first started to keep records of herbal medicine some 5,000 to 7,000 years ago in China and Mesopotamia. Much later, in a.d. 78, a Greek physician named Discorides described some 700 healing plants in a comprehensive work called De Materia Medica. For several centuries afterward, this was the foundation text for practitioners of herbal medicine throughout Europe.
The New World added new pages to the growing book of herbal cures. When Europeans stepped ashore in North America, they found Native Americans who had a flourishing apothecary that drew on healing plants of the forests and prairies. As white settlers pushed farther into the interior, many turned to Native American plants and herbal practices when they needed frontier treatments for illness and infection.
Native American herbs were still used by North American doctors throughout the nineteenth century and well into the twentieth. Entrepreneurial pharmacists drew on Native American lore when they started marketing patent medicines. They would grind up some of the traditional ingredients and include them in cures for a wide range of ailments.
Today, the search continues for plants with healing properties. Ethno-botanists, who study how herbs are used in other cultures, continue to bring back new plants for study from places as remote as the South American rain forests. Even drug companies have gotten into the act, hoping through exploration and experimentation to discover sources of new chemicals for the development of possible drugs.
In other words, herbal healing is nothing new.
What Is an Herb?
Simply put, a healing herb is a plant, so the range of potential sources of medicines is just as diverse as the plant kingdom. Herbs range from the towering, rock-hard lapacho tree of the Brazilian rain forests, which has an inner bark that helps cure fungal infections, to the lowly, common feverfew, a weed found in roadside ditches that does a remarkable job of preventing migraine headaches.
Discovering that a plant or part of a plant has healing properties is only part of the challenge, however. Anyone who prescribes or uses herbs would also like to know how these plants can deliver the most healing benefit to our bodies. During the several millennia that humans have known about herbal healing, practitioners have used herbs in a wide range of forms, from teas and tinctures to poultices and compresses—and today, as supplements.
When medicines are derived from healing herbs, they’re called phytomedicines, botanicals, or herbal supplements. The terms are interchangeable, and all mean medicines derived solely from plant material. Today, these botanicals are widely distributed. Many are available in drugstores, health food stores, grocery stores, and even department stores. Others may be provided by naturopathic doctors, Chinese doctors, or practitioners of alternative medicine who use herbs as important elements in their healing regimens.
In parts 2 and 3 of this book, you’ll find details about what these herbal supplements can do for you, the most effective ways to use them for particular health conditions, and specific cautions that you’ll want to observe. Before you turn there, though, it’s helpful to know something about herbal supplements in general and why some are considered far more effective than others.
Isolating Medicinal Properties
Many of the medicines that we consider pharmaceuticals actually come from plant sources. It was in the early 1800s that scientists first began to isolate and extract healing compounds from plants. Poppies yielded morphine, the narcotic that can help to dispel pain but can also be addictive. From willow bark comes aspirin, perhaps the most universal of all pain relievers. Quinine, widely used to prevent and control malaria, comes from a plant species called cinchona. A wildflower, foxglove, yields digitalis, which is used as a medication for a wide range of heart problems. Taxol, an extract from the bark of the yew tree, is now being used as an anti-cancer drug.
Concentrating an active ingredient that’s derived from a plant—or synthesizing that chemical in the lab—has its advantages. Drugs allow doctors to deliver a powerful dose of medicine that’s intended to cure a specific ailment. The concentrated active ingredient delivers a well-aimed punch.
When ingredients are intensely concentrated in a small package, however, taking large doses can have unwanted effects. "Whenever you use an isolated ingredient, you’re increasing the likelihood of side effects," says Eran Ben-Arye, M.D., a researcher at the natural medicine research unit at Hadassah University Hospital in Jerusalem. "That’s one reason that you might want to try an herb," he says. "Herbs are not so concentrated and are almost always milder on your system."
Another reason is that you may not need the powerful punch of a pharmaceutical. A case in point: The herb St. John’s wort can be very effective against mild depression and has some advantages over antidepressant medications. On the other hand, just because St. John’s wort appears to be a very good treatment for mild depression doesn’t mean that anyone with severe depression should ignore a doctor’s prescription and take St. John’s wort as a substitute.
"If you have a moderate to severe problem with depression, you probably should be taking one of the antidepressant drugs," says Dr. Ben-Arye. "If it’s mild, St. John’s wort may be all you need."
Making a Comeback
Botanical medicines are making a comeback in America. Before the 1940s, many doctors were still prescribing phytomedicines for health problems, but that all changed with the advent of antibiotics during World War II. Considered "wonder drugs" because of their remarkable ability to fight bacterial infections, antibiotics spawned a whole new generation of pharmaceuticals specifically targeted to mow down bacteria. Plant-based medicines quickly fell out of favor.
"People were looking for magic bullets," says Steven Dentali, Ph.D., a natural products chemist with Dentali Associates in Troutdale, Oregon, and a member of the advisory board of the American Botanical Council. "When we adopted these new medicines, we left behind herbs and a way of healing that had served many people well for a long time. Herbs just weren’t in vogue anymore."
| Choosing an Herbal Supplement They’re sold under many brands, with a wide range of information on their labels. So what should you look for when you’re choosing an herbal supplement? Here are some tips. Buy the standardized extract. If you can find the supplement you want in the form of a standardized extract, it’s your best assurance that the product contains a measured amount of a particular ingredient that’s thought to be the active ingredient in the herb. “A standardized extract gives you some guarantee that what’s supposed to be in the product is probably in there. It’s a good quality marker,” says Alison Lee, M.D., a pain-management specialist and medical director of Barefoot Doctors, an alternative medicine practice in Ann Arbor, Michigan. Remember, though, that a standardized extract contains many other beneficial substances besides the “primary” ingredient listed on the label. Check the botanical name. Look for the genus and species names on the product label to make sure you’re getting the right herb. (You’ll find the correct Latin names of recommended herbs in the “Supplement Snapshots” in part 2.) That’s important because a common name can sometimes refer to two or three different herbs. Ginseng, for instance, is a common name, but each of three bottles of ginseng might contain a different species of the herb, and each species has different properties. Stick with single herbs. Beware of herbal combinations and formulas, says Andrew Weil, M.D., clinical professor of internal medicine and director of the program in integrative medicine of the University of Arizona College of Medicine in Tucson, and author of Eight Weeks to Optimum Health. Herbal medication formulas take a shotgun approach, says Dr. Weil. They may expose you to more medication than you need, which makes side effects more likely. Check expiration dates. Herbal products age rapidly with light and heat. Buy the freshest supplements you can find, says Steven Dentali, Ph.D., a natural products chemist at Dentali Associates, in Troutdale Oregon, and a member of the advisory board of the American Botanical Council. Keep it cool. Herbs generally stay potent longer if they’re kept cool, says Dr. Dentali. Store them in the refrigerator. Buy from the big guys. Large companies like Nature’s Way, the Eclectic Institute, and Enzymatic Therapy have established reputations for quality control, says Dr. Weil. Without federal regulation of herbal products, you have to rely on the manufacturer for quality control. |
This was true only in the United States, however. In Europe, healing herbs continued to be recommended, prescribed, and used by mainstream medical doctors. European private companies, sometimes with government support, extended their research into plant-based medicine. In central Asia and China, where herbal traditions date back thousands of years, it was virtually unthinkable for plant medicines to be neglected as they had been in the United States. In these Asian countries, scientific methods of investigation continue side by side with traditional medicine. Hospitals and research institutions frequently analyze and find scientific evidence to support the use of many herbal cures, Dr. Dentali says.
As was almost inevitable, researchers and doctors in the United States are now looking more closely at phytomedicines, says William Page-Echols, D.O., an assistant clinical professor of family medicine who teaches alternative medicine at the Michigan State University College of Osteopathic Medicine in East Lansing. People hear about herbal alternatives, and naturally they ask their doctors whether these herbs are effective.
People want medicines that are less invasive, easier on their systems, and readily available. They’re learning that herbs offer another way of healing, a way to help the body help itself, says Dr. Page-Echols.
Saw palmetto, for example, is said to help shrink an enlarged prostate. "I have patients who come in and ask me about saw palmetto," says Dr. Page-Echols. "They’ve heard about it in the media or from other men who have the same problem."
Also, people who have had less-than-satisfactory experiences with conventional medications are likely to consider an herbal alternative. If you have insomnia, for instance, an M.D. might immediately prescribe a pharmaceutical sleeping pill. As many people have discovered, a sleeping pill is less than magic. While it may put you to sleep at night, you may find that you wake up the next morning feeling hung-over and spaced-out.
| Food, Spirit, and Magic Native Americans introduced several important phytomedicines to Western medicine, including cinchona, sarsaparilla, coca, black cohosh, sassafras, witch hazel, capsicum, goldenseal, and echinacea. When Europeans first encountered the healing traditions of Native Americans, their perception was shaped by an entrenched attitude toward healing medicines. To the Europeans, herbs were medicines that you took when you were sick—and that was all. To Native Americans, herbs represented not only food and medicine but also spirit and magic, says David Winston, a professional member of the American Herbalists Guild and a practicing herbalist in Washington, New Jersey. “North American Indians saw plants as living beings,” says Winston. “They were used with great respect. Plants had life and power.” Religious and mystical overtones pervaded Indian herbal traditions. While the average Native American probably knew 100 to 200 useful plants, a medicine man or shaman might be learned in using some 800 plants, says Winston. “Sometimes, there was a certain allure or quality associated with Native American medicine,” says Winston. Frontier physicians who practiced native medicine often advertised themselves as Indian doctors. Hucksters of patent medicines boasted that their elixirs contained Indian herbs with wondrous healing properties. In fact, the Pharmacopoeia of the United States of America, first published in 1820, contained more than 200 indigenous drugs. Most of these were the herbs originally used by Native Americans. |
In the search for alternatives, you might turn to kava kava or valerian, the phytomedicines used for insomnia. Many people who have used these botanicals report that they relieve anxiety or take the nervous edge off enough to allow an easier transition to sleep and an awakening free of the typical side effects of pharmaceuticals. "A gentle herbal remedy may be much better," says Woodson Merrell, M.D., a specialist in alternative and complementary medicine and assistant clinical professor of medicine at the Columbia University College of Physicians and Surgeons in New York City.
There’s another appeal as well. "Herbs fit in with self-healing and prevention," says Dr. Merrell. "That’s one reason that you’re seeing them out in the marketplace in such quantity."
A Regulatory Purgatory
Currently, herbal medicines sold in the United States are in limbo between regulation and free-market distribution. Since they are classified as dietary supplements, not drugs, they can be purchased without a prescription.
This policy raises doubts in the minds of many health practitioners. In Europe, where phytomedicines are common, people are accustomed to having herbs prescribed by doctors. In the United States, however, you can just walk into a health food store and buy them in quantity. Why should there be such a discrepancy in the way they’re distributed?
"Just because they are readily available or advertised as so-called natural products does not mean that they are completely safe and free of side effects," warns Dr. Ben-Arye. "You really should treat herbs like drugs. They shouldn’t be used indiscriminately or taken for fun."
The quality of the products is another concern. The U.S. government does not hold supplement manufacturers to the same standards as drug companies. The potency and quality of herbal products vary greatly. You can’t always be sure you’re getting the real thing. "Many of the products are overpriced and ineffective. Also, there’s a great deal of promotion about health benefits by these companies that is pure baloney," says Andrew Weil, M.D., clinical professor of internal medicine and director of the program in integrative medicine of the University of Arizona College of Medicine in Tucson, and author of Eight Weeks to Optimum Health.
By law, manufacturers of herbal supplements aren’t allowed to make specific health claims for their products, Dr. Weil says. They can instead make general statements about an herb’s effect on the body’s structure and function. Thus, a supplement label will not say "prevents atherosclerosis" or "relieves arthritis." Instead, the label is likely to say that it is "good for circulation" or "good for joint health."
Despite these limitations, there’s a rich tradition and a long history of anecdotal evidence as well as a growing body of scientific references to support the use of herbs for overall, general good health and for specific health problems. Just because the landscape is confusing doesn’t mean that you should ignore what you can find. It does mean, however, that if you’re going to use herbs, it will help to have the guidance of a book like this one. Or you may want to go a step further as well and consult a health practitioner who has experience with herbal medicines.
If you do consult an experienced practitioner, you have a number of choices. One alternative is to find a certified herbalist who is a member of the American Herbalists Guild. Or you might want to see a naturopathic doctor, who will integrate the use of herbs with other healing techniques. A doctor of oriental medicine will also prescribe herbs. Some chiropractors and some physicians—both M.D.’s and D.O.’s—have taken the time to learn about phytomedicines. In addition, you may find some pharmacists who are quite knowledgeable.
Unfortunately, it’s impossible to say which practitioners are fully qualified to prescribe herbal medicines. Just as there are no set standards for botanicals, we have no government or professional organizations that oversee the standards of practitioners.
Word-of-mouth recommendations and professional reputation are important. In gathering the information on herbal supplements that you find in this book, we turned to herbalists and practitioners who are recommended by their peers or who have made significant contributions to the research on the subject. In addition, we have asked the opinions of many medical doctors and well-qualified naturopathic doctors who observe practical results in their daily practices. As you read about herbal supplements in parts 2 and 3, you’ll find dosages and cautions that have been recommended by these experts. You’ll also learn how to take these supplements for maximum effect and discover how other supplements can boost or reinforce their healing power.
Thinking about Herbs
Whether you visit an herbal practitioner or choose to self-medicate, there are two ways to consider herbal supplements.
One view is that botanicals are simply substitutes for drugs. If you have a tension headache, for instance, you want instant relief, so you reach for an over-the-counter pharmaceutical like aspirin, ibuprofen, or acetaminophen. If these are no longer effective or have undesirable side effects, you might consider taking an herbal supplement instead. In a case like that, you’re really looking for a one-to-one substitute—an herb to relieve a symptom instead of a drug to relieve a symptom.
| Look to Germany In Germany, people seeking herbal medicine have access to nearly 700 plant-based remedies, and the cost of many of them is covered by health insurance. In fact, some 70 percent of German physicians routinely prescribe phytomedicines. Drugstores carry them, and pharmacists are knowledgeable about their many uses. Germany has undertaken the most comprehensive science-based investigation of herbs of any Western country. In 1978, the German government established Commission E to evaluate herbal medicines and write a series of monographs, or scholarly works, on them. A team of physicians, toxicologists, pharmacologists, and other specialists set about to produce the most comprehensive study ever attempted. The commission’s series of monographs covers some 400 herbs. For each herbal medicine, Commission E sets certain guidelines for dosage and uses. Unlike the Food and Drug Administration in the United States, which uses a requirement of “absolute certainty” before licensing a drug, Commission E uses a criterion of “reasonable certainty” to determine if an herb is effective. To arrive at its conclusions, the commission took scientific studies into account, but it also considered historical use, anecdotal evidence, and information from field studies as well as other sources. |
Looking for quick, targeted relief is a mindset of Western medicine. The model is allopathic, which simply means trying to substitute a new, benign condition (no headache) for a condition that’s causing a lot of discomfort (oh, that aching head). In the allopathic model of medicine, when you have a symptom or a disease, you expect to find some treatment that will produce a different effect and relieve whatever ails you as soon as possible.
Sometimes, the treatment addresses the underlying cause. If so, that treatment might get rid of the pain or discomfort and also keep it from coming back again. But what happens if you just treat the symptom without eliminating the cause? A tension headache is a good example of that. Aspirin or ibuprofen might beat the pain and help you get through the rest of the day, but it does nothing to prevent the headache from recurring a day or a week later.
Herbalists and naturopathic doctors tend to distrust the allopathic model for just that reason. Why not address what’s causing those headaches, they ask, on the chance that they can be prevented in the future? Symptoms are important clues to an underlying imbalance. A skilled herbalist can use herbs to treat hormone imbalances, stress, or allergies that cause a headache, not just provide anti-inflammatories that subdue the immediate pain. Yes, herbs can be used for particular problems, but they also provide nourishment for the whole body.
"Herbs can help the body achieve a healthier condition so it can better protect and heal itself," says Jennifer Brett, N.D., a naturopathic doctor at the Wilton Naturopathic Center in Stratford, Connecticut. "It’s really a nutritive or positive cure viewpoint."
The second view of using herbs is a more holistic model, as opposed to the allopathic model, meaning that the body is viewed as a whole rather than a set of isolated parts. Instead of seeing a headache as an isolated problem that begins somewhere above your shoulders, a holistic practitioner wonders what’s happening all over. Is digestion a contributing factor? Mood? Lifestyle factors? Posture? In the view of the holistic practitioner, if we understand how other body factors contribute to the problem, we can better address the causes.
In many cultures, it’s not unusual to consume different healing herbs at different times of the year to keep the whole body healthier and prevent disease. When winter comes on, the Chinese often add astragalus to their soups and stews as a way to boost their immune systems and fight off seasonal colds and flu. People living on the Indian subcontinent use red pepper, curry, and garlic on their food all year round, not just as spices but also as medicines to aid digestion, improve liver health, or lower cholesterol, Dr. Brett says.
Balms and Cures
Of course, herbs wouldn’t be your first choice if you had an acute-care situation, such as a heart attack, pneumonia, or a broken leg. In these cases, it’s best to get yourself to the hospital, says Dr. Brett.
Herbal supplements are well-suited for preventing illness, building up the body’s defenses, and easing the symptoms of long-term conditions such as heart disease, diabetes, migraines, and asthma. They can also make a big difference if you have elusive problems like insomnia, anxiety, depression, or lack of energy, she adds.
Unlike synthetic drugs designed to cure specific ills, herbs tend to have a wide range of applications. In fact, the very terms drug and medicine are inappropriate descriptions of what they actually do. Many herbalists use other terms, such as tonic and adaptogen. Tonic herbs restore, nourish, and support individual organs or the entire body. Adaptogens help restore balance in the body, particularly helping it to adapt to stress, be it physical, environmental, or emotional.
An adaptogen can make adjustments on the plus or the minus side. Let’s say you’re feeling run-down and sluggish—or just the opposite: stressed-out and wired. Although the symptoms seem totally different, the cause may be the same—adrenal glands that are not working optimally, says Dr. Brett. Maybe your adrenal glands are overactive, producing more hormones than they should, or perhaps they’re not producing enough. Either way, an adaptogen might help.
By taking an adaptogenic herb that supports adrenal health, you can restore the balance of the adrenals and normalize function, says Dr. Brett. "An adaptogen really shunts in wherever it is needed. It just helps your body do what it should be doing."
Subtle Healing
In most instances, you’ll find the work of herbs to be subtle and gentle, says Dr. Dentali. Sometimes, you really need to pay attention to notice whether they’re working. Also, if they’re causing a side effect, that might not be readily apparent.
Feverfew, for example, has been very successful in limiting migraines, but it may take weeks before the herb has an effect. If you start taking it, your headaches may ease so gradually that it may seem as if the herb has nothing to do with the relief you’re getting. The cause-and-effect relationship isn’t entirely clear.
"If you are going to self-medicate, you really need to pay attention, even take notes on your condition. That way, you can better tell if the herb is working," says Dr. Dentali.
| From Plant to Shelf Making herbal supplements these days is a far cry from the traditional hunter-gatherer methods of yore. As with any complex manufacturing operation, supplement makers require a steady stream of raw materials, and there are many checkpoints for quality control throughout the process. When you step inside the doors of Herbalist and Alchemist, an herbal medicine manufacturer in Washington, New Jersey, the complexity of the operation is immediately apparent. In the factory, which employs 13 people, technicians make herbal tinctures in a processing room that’s the picture of scrupulous hygiene. People wear gowns, goggles, hair and beard nets, and rubber gloves. Some have respirators. In an area that resembles a very neat, well-organized chemistry lab, there are checklists and formulas, glass beakers, electronic scales, and a computer that assigns lot numbers and expiration dates to bottled products. Herbs come from a wide range of sources. Nearby herb farms in New Jersey supply plants that are native to the region. Kava kava is imported from Hawaii. Botanical brokers on the West Coast link small farmers and organic growers to this hub of manufacturing activity in New Jersey. Other brokers represent the people who gather plants from fields and forests in the Carolinas. All the herbs used by Herbalist and Alchemist are grown organically and gathered responsibly, according to Beth Lambert, the company’s chief executive officer. Once delivered to the facility, the herb is ground, measured, and placed in five-gallon glass jars with a solution of ethanol and distilled water. The solution, called a menstruum, extracts the healing chemical compounds from the plant material. Most plants soak in the menstruum for about two weeks. A technician then strains and presses out the plant material. What’s left behind is tincture, a colored liquid with a strange but earthy odor of alcohol and plants. Depending on the herb, the manufacturing process can be more complicated. Herbs may be cooked or percolated in the menstruum. Plants are sometimes shredded when wet. Processing times can be shortened or extended. Sometimes, several tinctures are mixed together in herbal combinations developed by David Winston, the company’s founder. The company makes only tinctures, even though the end product may be higher-priced than other popular forms of the herb. “We only make tinctures because we believe that once the active ingredients are extracted by the menstruum, the medicines are more easily assimilated into the body,” Lambert says. Despite the high-tech trappings, the sampling and selection of ingredients is a subjective process based upon the instincts and experience of the people who scan the raw material and maintain quality control. The key people in that selection process are Winston and Betzy Bancroft, both herbalists who are professional members of the American Herbalists Guild. “We do our own grinding,” says Bancroft. “We want our herbs as whole as possible because they stay fresher longer that way.” She and Winston subject every shipment to a detailed examination. It’s the first hurdle that the product must pass before it can be approved by the two certified herbalists. They use sight, smell, taste, and feel to evaluate whether the raw materials pass muster. If a shipment of ginger arrives, Winston will taste it to make sure the plant meets his criteria for gingerols, the active ingredients that give ginger its pungent taste. As for the rest of the process, the strict hygiene and quality-control practices are self-imposed rather than required by law, according to Lambert. She thinks that these careful processes will someday be required of everyone. The labeling of their products also follows strict guidelines. “We can trace a bottle of our tincture at a health food store right back to the herb supplier,” she says. Begun in 1982, the company sells most products wholesale to medical doctors, naturopathic doctors, homeopaths, herbalists, chiropractors, and health food stores. |
Stanley W. Beyrle, N.D., a naturopathic doctor at the Kansas Clinic of Traditional Medicine in Wichita, says that after 18 years of practicing herbal medicine, he tends to prescribe much lower dosages than he once did. "A little bit can be enough. What you’re looking to do is nudge the body in one direction or another so it can take care of itself," he says. "You don’t want to overdo it."
Timing is also a factor. There are really very few herbs that you should be taking long-term unless it’s to address a chronic condition, says Alison Lee, M.D., a pain-management specialist and medical director of Barefoot Doct
