Botanical Medicine Health Article

Precautions

Herbal remedies prepared by infusion, decoction, or alcohol tincture from the appropriate plant part, such as the leaf, root, or flower are generally safe when ingested in properly designated therapeutic dosages. However, many herbs have specific contraindications for use when certain medical conditions are present and by pregnant or lactating women. Some herbs are toxic, even deadly, in large amounts, and there is little research on the chronic toxicity that may result from prolonged use. Herbal remedies are sold in the United States as dietary supplements and are not regulated by the Food and Drug Administration (FDA) for content or efficacy. Self-diagnosis and treatment with botanical medicinals may be risky. A consultation with a certified clinical herbalist or naturopathic physician is prudent before undertaking a course of treatment. A 2002 report said that patients often fail to inform their physicians about herbal products they are using, and that patients don't think of them as medicines. Yet many botanical remedies can interact with allopathic medicines and either cancel their effects or cause adverse effects. For example, garlic, ginseng, ginkgo, feverfew, licorice, and other common remedies have anticoagulant properties that can put patients as risk of bleeding during surgery.

Advances in communication technology have made warnings about herbal remedies more important than ever. The Internet includes many sites with unregulated and often unhealthful advice about use of herbal remedies. Many herbalists and allopathic physicians urge patients to use caution when seeking information on herbal treatments on the Internet. One cancer-related study found that only 36% of the web sites found in a search offered information that complied with regulatory guidelines regarding unsubstantiated claims about treatment or cure of disease.

Essential oils should not be taken internally without expert guidance due to the potential for toxicity even in very small amounts. They are not to be used in any form by pregnant or lactating women without competent medical consultation. Essential oil extracts do not contain the full range of phytochemicals present in the whole plant.

Homeopathic remedies are safe because of their extremely dilute nature. These remedies must not be relied upon for treatment of any serious illness or injury. If symptoms persist, other qualified medical help should be sought.

Side effects

Herbs contain numerous phytochemicals formed in the metabolic process of the plant. These chemicals act on the body in different ways; some of these act on the whole body, while some act on a specific organ or system. An herb's effect may be due to a particular chemical in the herb, or it may be due to an interaction among constituents within the plant. Interactions with other herbs, or with pharmacological drugs, is a matter of concern and a growing area of research.

The pure essential oils of aromatic plants, extracted by steam distillation or cold pressing techniques have been used for more than a century in medicines, food, drink, perfumes, detergents, soaps, cosmetics, in various industrial applications, and in aromatherapy. Some compounds found in plant oils can cause sensitization even in very small amounts. Side effects from external application of some essential oils may include mild skin irritation, such as itching and burning; sensitization, which may lead to recurrent mild to severe adverse reactions such as burning and rash each time the essential oil is used; and phototoxicity, a situation in which certain essential oils react with ultraviolet light and cause reactions from mild skin blotching to severe burning any time the skin is exposed to sunlight.

Research & general acceptance

Botanical treatments are generally accepted as part of mainstream medical treatment around the world except in the United States, where herbal remedies are sold as dietary supplements. As of 2003, the branch of the FDA that regulates botanical products under the rubric of dietary supplements is the Center for Food Safety and Applied Nutrition (CFSAN). Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the manufacturer of a botanical preparation is responsible for ensuring that it is safe before marketing it; the FDA is responsible for taking legal action if the product proves to be unsafe after it is marketed. The other government agency that has some oversight over botanical preparations in the United States is the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health, established by an act of Congress in 1998. NCCAM also supports research into botanical products, herbalism, and other alternative therapies that make use of plant-derived products.

In Germany, an expert committee known as the Commission E was established by the government in 1978 to evaluate the safety and efficacy of the 300 herbs and herb combinations sold in that country. No equivalent regulatory commission exists in the United States.

Determining the safety or toxicity of essential oils has primarily been accomplished through animal testing. Human trials of essential oils using volunteers have also been conducted. Some regulation of and guidelines for the use of essential oils, particularly in food, is accomplished by the World Health Organization (WHO), the Council of Europe, and the U.S. Food and Drug Administration (FDA). Two sources of information on the safety of essential oils used in aromatherapy are the Research Institute for Fragrance Materials, and the International Fragrance Research Association. These organizations conduct ongoing research evaluations of essential oils and publish the findings in the journal, Food and Chemicals Toxicity.

Homeopathic remedies have been tested clinically and, in 1997, an international team of researchers reviewed more than one hundred controlled studies and concluded that the collective results of 26 of these controlled studies indicate that homeopathic remedies produce a somewhat greater benefit than a placebo in the treatment of illness.