I’ve always been interested in herbs, even before Simon and Garfunkel sang about Parsley, Sage, Rosemary and Thyme in their evocative song, Scarborough Fair. In 1999, I took a course from Don Ollsin, who created The Herbal Healing Pathway and once owned an herbal dispensary, Self Heal Herbs, in our city. From him, I learned to recognise herbs, appreciate their healing properties, and even make medicine.
All that winter, while taking lessons, and searching fields and forests for healing plants, I dreamed about developing a second career in the field of herbal medicine. But that wasn’t to be. Corporations had just discovered that there was serious money in making and selling herbs. Within a couple of years, pharmacies and grocery stores were selling these products as fast as they could shelve them. The world of herbs, carefully nurtured by teachers like Don, had become commercialized, never to be the same again.
The popularity of herbs
At one time, patients in industrialized countries had complete trust in conventional medicine. During the past 30 years, that faith began to wane, and interest in natural therapies was on an upswing. In 1990 people were spending an estimated 13 billion on alternate therapies and nutritional supplements. By 1997 this had doubled, and expenditure on herbals continued to grow. Today, the industry is worth exponentially more. In 2015, an update was reported in a SciDevNet article:
“Global Sales of Chinese herbal medicine has reached $83 billion, up more than 20 per cent from 2011. The global market for all herbal supplements and remedies could reach $115 billion by 2020, with Europe the largest and the Asia-Pacific the fastest growing markets.”
Currently, herbal preparations are a force in the holistic healing industry. That’s not to say they are accepted. Rather, they are still criticized by health practitioners, and largely ignored by mainstream medical professionals—and there is still the widespread belief that they ‘do not work’.
How pharmaceutical medicine evolved from plants
History tells us otherwise. Until pharmaceutical companies began to formulate various medicines out of chemical compounds, many medicines in common use originated from plants. Physicians and herbalists, for instance, used foxglove to treat disorders such as tuberculosis and edema. Later, in 1988, the connection between foxglove and congestive heart failure was made, and today digoxin, (derived from foxglove) is a popular drug, used to treat atrial fibrillation in thousands of patients. There are other examples, like aspirin, which comes from the white willow tree, and morphine which is derived from the opium poppy.
In fact, nearly a quarter of all modern medicines come from natural sources, many of which were first used in traditional remedies. Of 121 prescription drugs used worldwide for cancer, 90 are derived from plants. Nevertheless, there are still those who decry the use of herbal preparations, say they don’t work, and are only a ruse to bilk people out of their money.
Why do people use herbs?
People are attracted to the use of herbs for a variety of reasons. For one, preparations made from herbs are more affordable. Research, testing, and marketing add to the price of prescription medicines, making their cost prohibitive in some cases. As well, herbs are more easily available. Patients don’t require a prescription to buy them, and some, like ginger and chamomile teas can be made at home.
Unlike many chemical (synthetic) medicines, most herbs are well tolerated by the patient, with typically fewer side effects. Since they are frequently slower acting, and require a longer time to take effect, they may be safer to use over time. Sometimes chronic, less life-threatening complaints respond better to alternative medicines, than to the use of conventional ones. Furthermore, herbal medicines are widely perceived as natural, safe, and not toxic, a belief is not necessarily true.
Are herbs safe?
Although herbs are derived from natural substances, and don’t normally cause an allergic reaction in the body, it is still possible to have adverse reactions from their use. However, research on the safety of herbals as compared to the safety of pharmaceuticals was a real eye opener for me.
Pharmacist Joel Albers, in a comparison between herbal and pharmaceutical reactions, outlines the following findings:
-Deaths from herbals do happen, although to a much lesser extent than with the use of legally prescribed drugs.
– In the US, the FDA received over 2,900 adverse event reports (including 104 deaths) in a study on the use of thousands of herbal supplements.
-Sometimes, interactions between prescribed and herbal drugs can lead to dangerous reactions, although no formal reporting of this issue has been conducted.
-Conversely, adverse reactions to legally prescribed drugs is the fourth leading cause of death in the United States.
-According to the American Medical Association, legally prescribed pharmaceuticals kill approximately 106,000 hospitalized patients annually, are responsible for an estimated 198,000 related annual deaths and necessitate 23% of all hospitalizations.
Why aren’t herbs regulated like other medicine?
In recent years, researchers, some of whom appear to be acting in the interests of large, pharmaceutical corporations, have pressured the holistic community relentlessly.
Reviews like the following, by pathology professor Roger Byard of the University of Adelaide claim that traditional herbal substances are dangerous and “may contain highly toxic chemicals and heavy metals, in addition to naturally occurring organic toxins. These substances” he said, “may cause illness, exacerbate pre-existing ill-health or result in death, particularly if taken in excess or in an unusual manner (e.g., injected rather than ingested).”
Although his mission may have lost steam, others have taken up the cry, determined to level the financial playing field between herbal and pharmaceutical companies.
It is true that herbal medicine is still largely an unproven, inexact science. There are reasons for this. Given the enormous number of different herbs used, to isolate each active ingredient from each herb would be daunting—an immensely time-consuming and expensive exercise for manufacturers.
As well, herbs (botanicals) have multiple active components which act together to result in a greater response in patients. This is an advantage over conventional single-response drugs, but makes it difficult to separate, identify and standardize active components.
Although historically, decades, sometimes centuries, of anecdotal information formed the basis of herbal knowledge, the drive to subject herbals to scientific study is relatively new, and confined to industrialized countries like the US, Canada, Europe, and Australia.
How some countries are addressing this
In some countries, like India, the approach toward traditional herbal medicines is more respectful. Ayurveda, Siddha, and Unani (ASU), are considered safe because of their long history of use, and studies and regulations don’t appear to be necessary.
In the US, as of 2010, herbal preparations, if classified as dietary supplements (under the Dietary Supplement Health and Education Act) are considered safe, and do not need approval from the Food and Drug Administration before they are marketed. This ruling appears to have held to this day.
In Canada, herbal remedies must comply with Natural Health Products Regulations, which says that all natural products require a product license before they can be sold. Thus, detailed information on the medicinal ingredients, source, potency, non-medicinal ingredients, and recommended use are required.
Recently, Canada has adopted a tougher line, with Health Canada planning to dramatically overhaul the process in a bid to regulate herbs and supplemental vitamins under the same rules that apply to drugs, evaluating these products according to the health risks they pose.
The jury is still out on this measure, and to date, I am not aware of any official decision. Ideally, consumers should be given science-based information on dosage, contraindications, and effectiveness. Whether or not herbal medicine and pharmaceutical drugs should be evaluated in the same way is up for debate, and may never be resolved. And in truth, the call for global harmonization of legislation regarding herbal preparations may be pie in the sky.