Herbal remedies, dietary supplements, and botanical medicines are part of the growing interest in alternative medicines and therapies that people are seeking today. When you walk into many large supermarkets you may see an aisle dedicated to natural medicines. Spend any time online researching health questions and you will be bombarded with advertisements for the "next big thing" in supplements that will claim to cure everything from earaches to diabetes to cancer.

I am a great believer in the efficacy and safety of natural products when used properly in a patient's overall regimen. I also think it's great that more and more people are interested in taking an active role in their own health plans, but as the old saying goes, "A little knowledge can be a dangerous thing," especially when it comes to self-prescribing medicines. Here are three vital things every consumer should consider about botanicals and dietary supplements:

1) Just because a plant or herb is natural doesn' t make it safe for you to take, even if it is sold as an alternative medicine.

2) Not all herbal remedies or natural medicines are created equal.

3) As always, if the claims about a product sound too good to be true, they probably are.

Let's consider each of these points in a little more detail. First, just because a plant or herb is natural doesn't make it safe for you to take, even if it is sold as an alternative medicine.

Since herbs and plants must be used in strong enough doses to make them effective in the treatment of many conditions, there can also be contraindications for the use of them. Contraindications can occur if the herb is taken over an extended period of time (1- 2 months) or in large doses that could result in side effects. Drug interactions may also occur when an herb is taken. Combining an herbal remedy with another drug can be problematic and possibly dangerous.

The combination of a pharmaceutical drug with an herb may interfere with the activity of the herb or drug, thus producing a decrease or increase in the effectiveness of the drug. For example, willow (salix) is used as an anti-inflammatory and analgesic (pain reliever) just as aspirin is used in inflammatory conditions such as arthritis and for headache pain. Willow is also used for fevers. Like aspirin, willow is contraindicated in conjunction with other blood thinning agents ( such as coumadin). It is also contraindicated in patients with bleeding disorders like hemophilia. It is absolutely essential that you keep your primary care physician and all others who may prescribe medicines for you ( natural or pharmaceutical) aware of any and all medications you are taking.

2) Not all herbal remedies or natural medicines are created equal.

Pharmaceutical drugs are tightly controlled and regulated by the Food and Drug Administration (FDA) to ensure standardization and quality in the products. However, herbal remedies and dietary supplements are classified as "food" by the FDA and therefore are regulated in a different way. The following is an excerpt from the web site of the National Center for Alternative and Complementary Health, a division of the National Institutes of Health:

Currently, the FDA regulates supplements as foods rather than drugs. In general, the laws about putting foods ( including supplements) on the market and keeping them on the market are less strict than the laws for drugs. Specifically:

*Research studies in people to prove a supplement' s safety are not required before the supplement is marketed, unlike for drugs.

*The manufacturer does not have to prove that the supplement is effective, unlike for drugs. The manufacturer can say that the product addresses a nutrient deficiency, supports health, or reduces the risk of developing a health problem, if that is true. If the manufacturer does make a claim, it must be followed by the statement "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease."

*The manufacturer does not have to prove supplement quality.

Specifically:

*The FDA does not analyze the content of dietary supplements.

*At this time, supplement manufacturers must meet the requirements of the FDA's Good Manufacturing Practices (GMPs) for foods. GMPs describe conditions under which products must be prepared, packed, and stored. Food GMPs do not always cover all issues of supplement quality. Some manufacturers voluntarily follow the FDA's GMPs for drugs, which are stricter.

*Some manufacturers use the term "standardized" to describe efforts to make their products consistent. However, U.S. law does not define standardization.

Therefore, the use of this term (or similar terms such as "verified" or "certified") does not guarantee product quality or consistency.

(Source: National Center for Complementary and Alternative Medicine, http://nccam.nih.gov/health/bottle/ )

The bottom line? Some manufacturers produce better products than others. The herb must be of sufficient potency and meet certain standards to be truly effective. I like to look at the research done on the herbs that I prescribe to my patients before recommending a particular herbal remedy or botanical medicine.

3) As always, if the claims about a product sound too good to be true, they probably are.

There are a lot of natural products on the market that are being hyped with some outrageous claims. It is true that I have seen some pretty amazing results with some botanical medicines, but use common sense when considering a new product. There is no "cure all" with herbal remedies. There are more scientific clinical studies being done every day on herbal products, and I try to stick with products that have been tested and proven effective. Used with a complete treatment program, botanicals can be very helpful in promoting the overall health of a patient.

If you are one of the millions of people who are researching and considering the use of herbal remedies, I congratulate you for wanting to take an active role in your own health plan. Be sure to be an informed consumer, and keep your health care providers abreast of all the medicines or supplements you may be taking, natural or otherwise.




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