Are Herbs Good Medicine?
By Bob Calandra
The study, published last month in The Journal of the American Medical Association, tested 200 people suffering from serious depression. At the end of the eight-week trial, doctors concluded that St. John's wort was basically useless in helping them.
But, counter proponents of herbal remedies, no one ever said the mood-boosting herb would be of benefit to people with deep depression.
"Nobody is out there making claims that St. John's wort is for people with major or severe depression," says Mark Blumenthal, founder and executive director of the American Botanical Council (ABC), a nonprofit research and education organization based in Austin, Texas. "You can't take the results of that study and extrapolate it to people with mild to moderate depression."
And you would be wrong if you did, according to the results of several earlier studies that found the herbal product to be effective in people milder forms of depression.
Confused by such seemingly conflicting reports, consumers aren't sure what to do. In the case of St. John's wort they've apparently decided to back off for a while. In just the past year, sales of the herb have fallen by almost half.
Mainstream Medicine Taking Note
And it's not just St. John's wort that's hurting. Overall sales of herbal remedies declined last year, according to the ABC. The organization cites negative media coverage over the past two years as being behind the 15% decline in sales.
Still, herbal remedies are wildly popular. Americans spent $591 million out of pocket for herbal remedies in 2000, ABC reports. And the number of people using complementary therapies -- including herbal medicine, massage, megavitamins, folk remedies, and homeopathy -- jumped from 33% in 1990 to more than 42% in 1997, according to the NIH's National Center for Complementary and Alternative Medicine (NCCAM).
What's more important is that mainstream medicine is beginning to take the industry seriously. For instance, according to NCCAM, 75 out of 117 American medical schools now offer courses in alternative remedies.
Courses in herbal medicine didn't exist when Michael Cirigliano, MD, was in medical school. But over the past nine years Cirigliano, assistant professor at the University of Pennsylvania School of Medicine and a specialist in internal medicine, has become an expert on the subject and lectures on the topic at least once a week.
"The main reason I got interested was that my patients were taking herbal supplements and I had to know what they were taking," Cirigliano says. "The government is pumping millions of dollars into studying complementary medicine to see if it does or doesn't work. There is a lot of interest in research and a lot of people doing research."
NCCAM, the agency directing that research, was created by Congress in 1998 specifically to explore and support work in alternative and complementary medicine. In its short lifetime NCCAM's budget has jumped from $2 million in 1998 to more than $68 million last year. Much of that money is given out in grants and to research centers across the country studying the efficacy of complementary and alternative medical treatments.
Keep Your Doctor in the Loop
But many physicians still question if herbals have any real role in medicine.
"It depends on whom you talk to," Cirigliano says. "There are plenty of physicians who feel there is a role and plenty who feel it's baloney. In my opinion that is unfortunate. The healing process is not just what is written in The New England Journal of Medicine, despite what some people think."
Cirigliano is quick to add that there are limits to the role herbal remedies can play. St. John's wort, he says, is a perfect example.
"For mild depression, a fair number of studies show it works," Cirigliano says. "But the study also shows that there is no role for herbals in serious illness."
Cirigliano recommends that patients get a medical diagnosis of their ailment and talk to their doctor before taking any herbal remedies.
"If it's a serious condition there probably is not a role for an herbal remedy," he says. "You should never take herbals if you are pregnant or lactating. You shouldn't really take them without supervision if you are very young or very old. And you should never mix herbals with pharmaceuticals without supervision. Don't use them in higher doses than recommended, and don't take them for long periods of time unsupervised by a knowledgeable healthcare provider."
Still, some herbal treatments have shown some medical possibilities. Here are some of the most promising:
Bob Calandra is a freelance writer whose work has appeared in several magazines including People and Life. He lives in Glenside, Pa.
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