Herbal medicine – most remedies useless

Blue Wode

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In today's news:

Traditional herbal remedies have never been more fashionable: sales have almost doubled in eight years. There's just one problem: science suggests that they don't work.

An estimated 16 million people use them, and surveys suggest that four out of five are satisfied with the results. Sales have almost doubled since 1999 to £191m, fostered by celebrities led by Prince Charles. There are at least 1,000 registered practitioners and an uncountable number who are unregistered. Can so many people be wrong?

The answer is yes, according to two experts who have launched the latest assault on herbal medicine, the practice of treating ailments with either a single "natural" plant, refined and standardised, or a concoction individually tailored to a patient's needs.

Dr Peter Canter and Professor Edzard Ernst from the Peninsula Medical School at the University of Exeter called yesterday for the sale of herbal medicines to be banned unless evidence of their efficacy can be shown. Where there are known risks and no evidence of benefit, there can be no justification for allowing them to remain on to the market, they said.

Read on…

http://news.independent.co.uk/health/article3024732.ece
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The BBC could not even get Peter Canter's name right, and calls him Carter all the way through.

This is a tiny sample and generalisation must be limited. What it does demonstrate is that herbal medicine is not evidence-based, but it doesn't rule out the emergence of evidence in the future. I think it's very unlikely though, simply because the theory and methodology surrounding the practice are mystical and not science based.
 
Edzard Ernst also has an editorial in the same issue, where he draws a distinction between phytotherapy (evidence based), retail herbalism (over the counter stuff), and mystical herbalism. Not available online but I have read it.
 
Ernst: "The gullibility of the public is monstrous."

:)

(True, but it might just antagonise them/us)
 
I should point out that this study does not show that herbal remedies themselves are ineffective, just that individualised herbal medicine has not been shown to be effective.

Ernst and Cantor did not look at single herb extracts or over-the counter type products.
 
In the old days the healers sometimes with a measure of success were able to treat certain diseases with herbal or plant based remedys. To this day certain primitive tribes are treated successfully with local medicines. Not entirely worthless but I'd ratyher go to a real doctor.
 
Hummm-wait a minute-I know they work because I see alot of people in the special store buying all the special foods, additives, and remedies such as ear cleaning candles etc.
If the majority thinks it works, that is good enough for me! I follow my religion with the same logic.
 
If herbal remedies work at all, it's most likely because of the placebo effect. So I say that if someone has tried all avenues of regular medicine to no avail and finds some relief through herbal stuff, then fine. The problem is making sure people turn to regular medicine first rather than to quackery. And making sure the quacks don't charge people too much for their placebos.
 
Professor Yaffle said:
Here's the Guardian article on the same topic (including a few examples of herbs that work and with dangerous side effects):

http://www.guardian.co.uk/medicine/story/0,,2183054,00.html?gusrc=rss&feed=networkfront
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It quotes Ernst as saying
"In my view, self-medication for serious conditions is out of the question," said Professor Ernst. "A depressed patient who takes St John's wort and comes out of depression arguably gathers enough strength to commit suicide, so it is dangerous."
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:rolleyes:
 
Well that is a known risk with all anti depressants. Often the greatest risk period for suicide is when the drug has just started to have an effect. Your mood can still be terribly low, but your motivation levels have increased somewhat making you more likely to take action. Not sure that I necessarily agree with Ernst's point though. Every time I have been prescribed an AD I have been seen once a month to check how things were going, and I don't think that is close enough supervision to reduce that risk.
 
Bethany said:
If herbal remedies work at all, it's most likely because of the placebo effect.
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Not quite. Some (many?) herbs have pharmaceutically active compounds. The problem is identifying those compounds and matching them with the condition to be treated. Short of that, there is probably a placebo effect (or, normal recovery).

I recently asked an academic pharmacognosist if there were any herbs that had been well-studied and shown effective- he only had two examples (offhand). So, you may be right that a lot of "herbal" effects are placebo or wishful thinking; but we still hope to find drugs in natural products.

Bethany said:
So I say that if someone has tried all avenues of regular medicine to no avail and finds some relief through herbal stuff, then fine. The problem is making sure people turn to regular medicine first rather than to quackery. And making sure the quacks don't charge people too much for their placebos.
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Agreed.
 
From the Guardian article I linked to:

What works - and the risks
Kava kava
For anxiety. Banned in Britain because of three deaths and six transplants resulting from liver toxicity
Ginkgo biloba
Leaves of the oldest living tree species - for dementia. Some concern over possible increased risk of brain haemorrhage
Devil's claw
For musculo-skeletal pain, such as backache. May increase stomach acid and should be avoided by people with ulcers
Saw palmetto
For enlarged prostate. Should not be taken with drugs like aspirin or warfarin which increase bleeding, and may interfere with the pill
St John's wort
For depression. Interacts with some conventional drugs, such as immune system suppressants, causing heart transplants to be rejected, and the pill
Valerian
For insomnia. High doses may cause a drug "hangover" effect
Hawthorn
For congestive heart disease. Too serious a condition for self-treatment
Willow bark
For pain relief. Consult doctor if you have asthma or ulcers
Andrographis paniculata
For the common cold. Not available in the UK
Echinacea
North American flower for the common cold. Some people have allergic reactions
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Bethany said:
If herbal remedies work at all, it's most likely because of the placebo effect. So I say that if someone has tried all avenues of regular medicine to no avail and finds some relief through herbal stuff, then fine. The problem is making sure people turn to regular medicine first rather than to quackery. And making sure the quacks don't charge people too much for their placebos.
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Not so. Perhaps you are confusing herbs with homeopathy? Herbs actually do have a physical effect on the body.

As far as I know, medical herbalists are extremely well trained - some are trained in clinical diagnosis. Training does vary though.
 
umm, why would people be taking saw palmetto (prostate enlargement) be taking the pill? or is saw palmetto ONLY effective for prostate enlargement but people take it for something else?
 
Some women use it for PCOS related hirsutism (as it is anti androgenic) - but I don't know if research has shown it is effective for this. The extract I quoted is a little confusing in that respect; the cautions against use aren't necessarily relevant when taking it for the condition it is shown to be effective for, but are relevant when taking it for other conditons.
 
Naughtyhippo said:
umm, why would people be taking saw palmetto (prostate enlargement) be taking the pill? or is saw palmetto ONLY effective for prostate enlargement but people take it for something else?
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If you mean the contraceptive pill, then that is Wild Yam.
 
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