Part 2:

How soon can I expect to notice the benefits of an herbal product?

Herbs are rich mixtures of diverse natural compounds. Although the effects of certain herbs will be observed within a short time after consumption, others are more subtle and provide their health promoting benefits gradually. If you have ever used ginger root (Zingiber officinale) or peppermint leaf (Mentha x piperita) tea to promote healthy digestion, you know that you can feel the comforting effects of these herbs almost as you drink the soothing brew. The sense of well-being that results from the use of kava root (Piper methysticum)should manifest in only a short time when using a well manufactured product. Similarly, all of the herbs that contain anthrones — such as rhubarb root (Rheum spp.) or cascara sagrada bark (Frangula purshiana) — will produce a laxative effect within a half a day or so.

Other herbs are known to produce noticeable benefits only after several days or weeks. For example, improvement in sleep when using an extract of valerian root has been shown to be somewhat dependent on continued use.(13) With saw palmetto (Serenoa repens), the berries of which are used to promote the health of the prostate, the full benefits have been shown in one study to be achieved after 12 to 18 months.(15) Other herbs, such as those that are rich in antioxidants, work to improve your health without a noticeable effect. For more information about what to expect from an herbal product (and when to expect it), consult with the product’s manufacturer or an herbal health practitioner. You can find a regional list of herbalists the American Herbalists Guild’s professional member referral list at http://www.americanherbalistsguild.com/, or your local acupuncturist at the American Association of Oriental Medicine http://www.aaom.org.

How do I know how much to use?

Two different parts of the Federal laws that govern dietary supplements present manufacturers with guidelines for providing quantitative recommendations on the package of their products. First, all supplement manufacturers are responsible for assuring that their products do not present significant or unreasonable risks under conditions of use recommended in labeling or under ordinary conditions of use. In addition, all dietary supplements, including herbal supplements, are required by Federal regulation to identify the “serving size.” A general recommendation then, with regard to how much of an herbal product to use: the amount recommended on the label. The idea that “more is better” is no more relevant for an herbal supplement than for any other food that, while it might be delicious, refreshing or nutritive in moderation, becomes unhealthful when consumed in excess. It may also be useful to speak with a qualified herbal expert. A regional list of herbalists is maintained on the American Herbalists Guild’s professional member referral list at http://www.americanherbalistsguild.com/. Similarly, a local acupuncturist may be found at the American Association of Oriental Medicine at http://www.aaom.org and naturopathic physicians can be located through the American Association of Naturopathic Physicians at http://naturopathic.org.

How are herbal supplements regulated?

All supplements, including herbs, vitamins, minerals, etc., must conform to Federal regulations that control their manufacture, labeling, and advertising. In order to sell an herbal supplement, a manufacturer must meet many different Federal (and sometimes state) regulations, and must also adhere to state and local health and business regulations. Since supplements are legally classified as a specifically defined type of food, all supplements are required to be manufactured to the same high standards that are required of all foods. These mandated good manufacturing practices establish basic guidelines to assure that supplements are manufactured under sanitary conditions that result in properly identified products that are not contaminated or adulterated, and that are fit for consumption. Any supplement that does not conform to these basic guidelines is subject to regulatory action by FDA. In addition, all supplement products are required by law to provide certain information about their formulation.

Like foods, supplements must provide consumers with nutritional information. Unlike foods, supplements must state the quantity of each of the contained ingredients, or of the “proprietary blends” that make up a product. All herbal products are required to identify the parts used of each of the plant ingredients, and to label them with their commonly accepted names. One of the areas of the most detailed Federal regulation of supplements is in the area of product claims, whether on product labels or in advertising. The Food and Drug Administration specifies exactly what kind of claims are allowed, and prohibits the use of any statement that would brand the product as a drug. Herbal supplements are not allowed to make statements regarding prevention, cure, mitigation or treatment of diseases. Instead, their claims are limited to statements that are legally defined as “statements of nutritional support” or “structure/function statements.”

Unfortunately, some uninformed writers have published statements that infer that the entire supplement industry is unregulated. Although this unfortunate “fact” has been broadly reported, it is absolutely false.

What about interactions with drugs?

Humans have been learning about the diverse effects of ingesting plants throughout our evolution. We have, by trial and error, found both good and bad effects that are related to specific plants, some of which we use as food, and others that are used for therapeutic purposes. The introduction of synthetic and highly purified drugs is an extremely modern development. As researchers observe the interactions that drugs have with common foods and herbs, surprises continue to surface. For example, less than 10 years ago it was found that drinking grapefruit juice increases the serum drug concentration when patients take certain drugs. This effect, which can last for up to 24 hours after consumption, is now thought to inhibit specific enzymatic activities responsible for breaking down the drugs.( Similarly, both avocado and leafy vegetables that are high in vitamin K can diminish the effectiveness of blood-thinning drugs. These concerns are not widely known by the public, but now that medical professionals are aware of these effects, they can routinely monitor their patients to assure effective treatment.

Similar information has surfaced about some of the herbs that we use. For example, we now know that the use of an extract of St. John’s wort (Hypericum perforatum) may cause certain prescription medications to be eliminated more quickly leading one researcher to caution that, “As with grapefruit juice, a food product, physicians should also be aware of potential drug-herb interactions.” In response to this new information, the American Herbal Products Association has recommended that products containing St. John’s wort be labeled to suggest that the advice of your prescribing physician be requested if you are taking any prescription drugs. Speculation on the exact mechanism of St. John’s wort has led to reports that the use of this herb might affect oral contraceptives, leading to ineffectiveness and unwanted pregnancies. To date, there have been no reports of any such actual occurrence. Nevertheless, women taking oral contraceptives such as ethinyl estradiol and desogestrel should be aware that, if you experience break-through bleeding, you might experience a reduction in protection against pregnancy.

As can be seen by the above examples, the effect of a drug can be either increased or decreased in the presence of other factors in the diet, including herbal use. Although it is likely that most such factors have little or no influence on drug metabolism, continued research will add to our knowledge of such interactions and responsible food and supplement manufacturers will be expected to inform their customers of any new findings. There is now an ongoing interest in other drugs that are suspected of interacting with certain specific herbs, with most contemporary emphasis on the use of herbs with blood-thinning drugs such as warfarin. Although the current concerns are either conceptual or based on isolated and inconclusive reports, it is advisable to inform your prescribing physician or pharmacist that you are using herbs when undergoing any drug therapy. As close monitoring of the effect of warfarin is an established standard of medical practice, this additional information will assist your physician in maintaining good supervision of your drug levels. In order to understand the potential for an herbal product to interact with prescription drugs, it may also be useful to consult with a qualified herbal expert. You can find a regional list of herbalists the American Herbalists Guild’s professional member referral list at http://www.americanherbalistsguild.com/, or your local acupuncturist at the American Association of Oriental Medicine http://www.aaom.org. A similar database of naturopathic physicians is maintained by the American Assoc. of Naturopathic Physicians at http://naturopathic.org.

How can I choose the herbal product that is right for me?

Single herb or combination product? Capsule, tablet, extract or tea? Which brand? Standardized or not? Sometimes it seems that there are just too many choices!! Some of these choices are ultimately matters of personal choice. The issue of product form is one example — are you attracted to the rich history of herbal extracts and decoctions? …or do you have trouble swallowing tablets and capsules? Then you may want to try a liquid extract or tea product. On the other hand, if you can’t bear the taste of valerian or echinacea, or if you like the convenience of non-liquid forms, you might choose a tablet or capsule. Similarly, there are separate values attached to both single herb products and to herbal formulas. You might appreciate the experience and knowledge that many manufacturers have brought to designing combination products, with a goal toward attaining a higher synergy for the intended use. Multi-ingredient formulas have been the standard in Asian and Indian herbal traditions for centuries. Then again, you might prefer the simplicity of taking only one herb at a time, an approach that has more historical acceptance in the West.

Finally, if you have purchased a product that works for you and that provides the promised benefits, stick with it, whether it’s a tablet, tincture or tea, whether a single herb or a complex formulation of several herbs. And remember — a brand that is remarkably less expensive than other products with the same or similar ingredients is not always the best bargain.

We hope that this 2 part series shining the light on all nature medicinal herbal remedies was helpful to you, and shed more light on an ever growing industry. We encourage people to stay illuminated, all natural & healthy!