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Herbal medicines, is 'natural' always a good choice?

by Capt. Jeff Vaughan
Hospital Pharmacy Element Chief

The herbal medication industry is a multi-billion dollar business in the United States. The cost of herbal products may range from a few dollars to hundreds of dollars. However, herbal remedies are usually not covered by health care insurance.

Several factors have influenced the explosion of herbal supplements in the healthcare market: herbal medications are considered by many as "natural" and therefore better. But herbal medications can have potent effects just like prescription drugs.

So why the sudden demand for herbal medications? A common belief is that symptoms/complaints most often perceived as untreated by medical doctors (fatigue, headache, insomnia or anxiety) can be alleviated by herbals.

Here are a few herbal medications that are commonly used by patients and some facts that you may not be aware of:

Ephedra

Other Names: Ma-Huang or Ephedra sinica.
Uses: weight loss, cardiovascular stimulant and bronchodialator.
Side Effects: increases blood pressure and heart rate.
In April 2004, the FDA issued a ban on products containing ephedrine because of evidence linking the drug to significant adverse health effects, including heart attack and stroke.

Saw Palmetto

Other Names: Sabal Serrulata or Serenoa repens.
Uses: Benign Prostatic Hyperplasia, Sexual Dysfunction and Prostatitis.
Interactions: concurrent use with Finesteride ( Proscar ) or other medications used to treat BPH. Currently, there is ongoing study by the National Institute of Health, examining 3000 males investigating Saw Palmetto's effectiveness in controlling BPH.

Gingko Biloba

Uses: improving memory.
Potential Interactions: May cause increased levels of blood-thinning medications. Also may increase prescription anti-depressant levels in the blood. It may affect insulin levels, so diabetics should be especially cautious.

Garlic

Uses: lowering cholesterol.
Because garlic is broken down by certain enzymes in the liver, excessively large amounts of it may possibly interfere with the use of prescription drugs that are processed by the same enzymes. Some of these drugs are: allergy drugs such as Allegra, antifungal drugs such as Itraconazole and Ketoconazole or cholesterol-lowering drugs such as Zocor.

Another important thing to consider when selecting an herbal medication, is that manufacturers of dietary supplements do not have to demonstrate efficacy of their products. Dietary supplements are not required to be standardized in the United States. The presence of the word "standardized" on a supplement label does not necessarily indicate product quality. Often times the consumer pays for claims that are unrealistic and could potentially be detrimental to their health.

Many of the herbal teas that claim to prevent disease often fall short of these claims and are based on weak evidence.

Before taking any herbal medication, here are some helpful guidelines to consider:

Herbal medications are considered over-the-counter drugs. While most people who use herbal medications do not consider them to be drugs there is a very real risk of drug interactions from the use of herbals. To reduce the risk of complications and or side effects, patients should always tell their health care providers about all medications, both prescription and herbal they are taking. Also, health care providers should be sure to ask patients for that same information.

The purity of herbal medications are neither regulated nor guaranteed. Information you should look for on the label that may be indicative of a safer product include:

Product is produced in the United States, it has an identification number, a USP/NF label, the manufacturers name and address, and the batch and lot number.

Remember that natural does not equal safe. Many prescription drugs are or were derived from plants, such as Coumadin (anticoagulant) and Digitoxin.

The effectiveness of many herbal medications has not been demonstrated. Herbal medications rely on "testimonials" for reports of effectiveness rather than going through the expensive process of clinical trials.

Seek medical attention for any serious medical problem. People with serious medical conditions may be delaying more effective treatments and using herbal remedies that have not been proven to be effective.

There are several herbal remedies that have shown some effectiveness for some medical conditions, but the best way to stay safe and healthy is through education. Before you take any herbal medications do your homework first, find information about it from reliable sources.

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