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Herbal remedies—more hype than help?

Most of us would never dream of sampling a friend’s prescription medication. Yet millions of women have no qualms when it comes to dosing themselves with billions of dollars worth of equally potent—and unprescribed—pills and potions.

We’re talking about herbs, of course, and our growing (no pun intended) fascination with leaves, roots and flowers to treat everything from eyestrain to infertility. In fact, herbal remedies have become so popular that one study estimates that more than a third of us have sampled at least one and that 60 million Americans rely on them regularly.

So it came as quite a surprise when a study found that one of the most popular herbal cures, echinacea, an extract from the purple coneflower, was no better at preventing colds than a placebo. Suddenly many enthusiasts found themselves wondering whether they were paying for hype instead of help. But The Archives of Family Medicine, which published the report, was only confirming what the scientific community has been saying about the safety and effectiveness of herbal remedies since the boom began in the mid-’90s: Most claims are, at best, unproven and unfounded, and, at worst, actually fraudulent and downright dangerous.

Scientific studies lacking

Despite their long history (potions and poultices made from plants were first prescribed by prehistoric medicine men) and widespread use (four billion people, about 80 percent of the world’s population, still rely on herbs as their primary medical treatment), there is scant scientific evidence that most herbal cures really work. The reason? No one has bothered to find out.

Ordinarily, drug research and development, an extremely expensive process, is funded by large pharmaceutical companies in the hopes of eventually making a profit. But, unlike drugs, most herbal supplements can’t be patented. Consequently, most companies are reluctant to spend the time and money it takes to test them. And, without testing, there’s no way of knowing whether an herb is beneficial, which of its many ingredients is likely to produce benefits or even what constitutes an effective dosage.

Empty promises?

Unlike prescription or over-the-counter medications, herbal supplements are only loosely regulated by the U.S. Food and Drug Administration (FDA). Consequently, manufacturers can make any health claims they choose—“slows aging,” “boosts immunity,” “improves memory”—without any proof whatsoever, as long as their products don’t promise to cure or prevent specific diseases. Also, because the government doesn’t require uniform standards within the industry, the amount and type of herbal ingredients in any given product may vary from one manufacturer to another—or even from one bottle to the next, since the potency of herbs can change dramatically depending on how and where they’re grown.

Hidden dangers

If it were just money that was being wasted, all of this would be disturbing enough. But many people, reassured by the claims that herbal remedies are “all natural,” forget that herbs contain potent chemicals. And, just like their over-the-counter and prescription cousins, herbs can be dangerous. Some, like ephedra, a weight-loss aid linked to the deaths of at least 15 people before the FDA banned its sale, are downright lethal. Others may be harmless in one form, like chaparral, a shrub that grows in the Southwest, but toxic in another (used safely in herbal teas by Native Americans, chaparral in tablet form causes hepatitis). There’s also the possibility that an herb with no known harmful side effects could prove hazardous when combined with other drugs. Take kava, for instance. Touted as a cure for anxiety, kava, when used with the tranquilizer alprazolam, sold under the brand name Xanax, could result in a coma.

Unfortunately, even the most conscientious consumer may have problems sorting all this out. Reading up on herbs helps, but even that doesn’t guarantee safety: Comfrey, whose toxicity has been well documented, is still listed in popular herbal books as a treatment for ulcers, diarrhea and colitis. And since most herbs have so many different names, it’s doubtful that even people who are aware of comfrey’s dangers would recognize it under any of its other listings, such as symphytum or consormol.

On the other hand, there’s no denying that herbs can be beneficial: Almost 25 percent of modern drugs, including aspirin, contain at least one active ingredient derived from plants—and are safe if used with caution. Many believe that herbs are a panacea, while others believe they have no value.

Until we uncover the truth, however, a safer and surer route to well-being, according to most experts, is still in the greens you find at your local grocery.