The use of herbs and herbal products has become broadly accepted in our contemporary culture. Consumer surveys consistently find that nearly half of all Canadian/Americans now use herbs in some shape or form, a statistic that is particularly remarkable when we realize that today's herbal products "industry" is just over a quarter century old. In spite of this widespread acceptance of herbal products in individual self-care choices, misconceptions exist as to the regulation, safety and effectiveness of herbal products.


Q. Why should I use herbal products?

The decision to use herbs for their health promoting value is, as with all health decisions, a personal one. There are, however, many good reasons to consider herbal products as complements to your own health care. The best reason, however, may be the fact that herbs and herbal products, with their incredibly wide use throughout time and place, continue to provide real health benefits while maintaining a remarkable safety profile. Readily available natural substances were the first medicines used by humans. Primitive and ancient civilizations as well as contemporary cultures throughout the world have always relied on herbs to provide the benefits that have been observed with their use. In fact, the World Health Organization has estimated that 80% of the world's population continues to use traditional therapies, a major part of which are derived from plants, as their primary health care tools. In our own time and culture, most herbs are available in the form of "herbal supplements." These products are found in the form of teas, tablets, capsules, liquid extracts, and others. We now have ready access to products that bring the herbal traditions from all over the world in a variety of convenient forms. In addition, scientific inquiries continue to develop our knowledge of the benefits of plants, and often validate the observations made over the past centuries.


Q. Are herbs safe?

Plants that enjoy broad culinary and therapeutic usage are generally safe. We can flavor our food with any number of herbs to make a meal more flavorful. We can appreciate a delicious cup of peppermint leaf or ginger root tea, or benefit from the soothing properties of marshmallow root or the bark of slippery elm. We can take an herbal supplement containing dandelion root or saw palmetto berries, or any number of the other herbs. Although allergies and reactions have been recorded for a few herbs that are widely used in foods and supplements, such individual concerns are also seen with many foods, and do not diminish the safety profile of the many herbs that are generally recognized as safe. On the other hand, and as everyone knows, there are any number of plants that are highly toxic, even deadly. Every ten-year-old hiker knows to stay away from poison ivy (Toxicodendron spp.) when walking in the woods. The death sentence imposed on Socrates by an Athenian jury 2400 years ago was carried out with a fatal dose of hemlock (Conium maculatum). The poison curare, a blend of several equatorial rain forest plants (e.g., species of Chondrodendron, Curarea and Strychnos is used by some South American hunter cultures to make their arrows more deadly. Federal law and good common sense, however, prevent the use of any such highly toxic plant in products that are readily available to consumers. The better question then, for today's American consumer, is "Are herbal supplement products safe?"


Q. Are herbal supplement products safe?

Federal law requires that every food product, including herbal supplements, is free of "adulteration" and is not "misbranded." This legal language translates into a requirement that all foods and supplements have a reasonable expectation of safety when offered for sale and when used as directed. So manufacturers of soups, cereals, and supplements all have an obligation to sell only safely made and properly labeled goods, and can find their products subject to seizure should they fail to do so.What that means is that any manufacturer who wants to introduce a new herbal ingredient must first provide HEALTH CANADA with information that shows that the herb will be "reasonably expected to be safe" . There are so few credible reports of unexpected side effects due to herbal products that most experts consider problems with herbal products to be of only minor or occasional concern. Norman Farnsworth, Director of the WHO Collaborating Centre for Traditional Medicine and Research Professor of Pharmacognosy at the University of Chicago at Illinois, is generally considered to be one of the most respected experts on the scientific research of botanical medicines. In a 1993 article written on the subject of herbal safety, Dr. Farnsworth concluded, "...side effects or toxic reactions associated with herbal medicines in any form are rare. In fact, of all classes of substances reported to cause toxicities of sufficient magnitude to be reported in the United States, plants are the least problematic." This is not to say that every herbal ingredient that is sold as an ingredient in a supplement is appropriate for every consumer or in any quantity. Responsible and informed use by consumers is essential to insure that herbal products maintain their established safety profile. Accurate product labeling must provide consumers with all information that is material to the use of the product, and such disclosure is required by Federal law.


Q. Are herbal supplements effective?

Botanicals have remained a primary source of traditional medicine for millennia. They have made contributions over the last centuries to the development of some of the most widely used and effective modern drugs. In the last several decades, there has been a resurgence of research in the clinical efficacy of herbs. The results of such studies often verify that the empirical observations of the past centuries were accurate. For example, recent studies on the effect of valerian have produced results that led researchers to conclude that valerian root can produce "significant improvement in sleep quality" and that valerian root extract can be "recommended for the treatment of patients with mild psychophysiological insomnia". But can a consumer have confidence in the claims made for the products that are available in the market? To begin with, Federal labeling law and regulations for supplements limit allowable claims to those for which a manufacturer "has substantiation that such statement is truthful and not misleading". The manufacturer therefore has a legal burden to assure that the claim that is made for their products has scientific evidence to back it up. Because there is a greater acceptance of herbal therapies by conventional physicians in Europe, a significant body of clinical data supporting the use of herbs has been developed there. More recently, a number of U.S. companies have designed clinical studies for their branded products. It is estimated that there are over 1,000 clinical trials now being undertaken in the U.S. to increase our knowledge about herbs. The National Institutes of Health has even set up a center with a special focus on "alternative" medicine, and is now concentrating much of its resources on the study of herbal products.


Q. How soon can I expect to notice the benefits of an herbal product?

Herbs are rich mixtures of diverse natural compounds. Although the effects of certain herbs will be observed within a short time after consumption, others are more subtle and provide their health promoting benefits gradually. If you have ever used ginger root (Zingiber officinale) or peppermint leaf (Mentha × piperita) tea to promote healthy digestion, you know that you can feel the comforting effects of these herbs almost as you drink the soothing brew. The effect of ephedra (Ephedra spp.) in promoting bronchodilation or better breathing is usually felt within ten or twenty minutes of use. The sense of well-being that results from the use of kava root (Piper methysticum) should manifest in only a short time when using a well manufactured product. Similarly, all of the herbs that contain anthrones, such as rhubarb root (Rheum spp.) or cascara sagrada bark (Frangula purshiana), will produce a laxative effect within a half a day or so. Other herbs are known to produce noticeable benefits only after several days or weeks. For example, improvement in sleep when using an extract of valerian root (Valeriana officinalis) has been shown to be somewhat dependent on continued use. With saw palmetto (Serenoa repens), the berries of which are used to promote the health of the prostate, the full benefits have been shown in one study to be achieved after 12 to 18 months. Other herbs, such as those that are rich in antioxidants, work to improve your health without a noticeable effect. For more information about what to expect from an herbal product (and when to expect it), consult with the product's manufacturer or an herbal health practitioner.