January 2005 · Vol. 17, No. 1How to judge an herbal remedy
How do you determine usefulness? It’s a matter of efficacy, safety, quality, and cost.
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Fast Track
Do not prescribe or recommend herbal remedies without proven efficacy
Peppermint oil eases irritable bowel, according to 8 trials
St. John’s wort reduces plasma levels of several conventional drugs
1 of 5 Ayurvedic herbal products may contain potentially toxic levels of lead, mercury, or arsenic
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Edzard
Ernst,
MD, PhDLang Chair in Complementary
Medicine Peninsula Medical School
Universities of Exeter and Plymouth, Exeter, UK
How many of your patients take herbal preparations? More than you think, thanks to the proliferation of products. Between 1990 and 1997, the US population increased its use of herbal medicines by 380%, and total out-of-pocket expenditures in 1997 were $5.1 billion (TABLE 1).1,2
Safety issues surrounding herbal medicine are complex: possible toxicity of herbal constituents, presence of contaminants or adulterants, and potential interactions between herbs and prescription drugs. In addition, the preparations are often poor in quality. One reason: They are inadequately regulated, a problem many experts hope to change. Cost evaluations of herbal medicines are not available.
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