The Internet has revealed the broad, vast world of herbal medicine, or botanicals, to most everyone. Webpages abound with information on substances that may or may not be harmful or even effective therapies. Because herbal medicines are often less expensive and don't always require a prescription, you might consider self-medicating. But just like treatment with conventional Western, or allopathic, medicine, using herbals requires knowledge of complex systems. In the case of botanicals, those systems are found in both the plant world and the human body. There are a variety of health care practitioners and healers who are qualified to prescribe herbal medications.
Not So New
Herbal medicine has been around for thousands of years, far longer than allopathic drugs, many of which are based on herbals. The National Center for Complementary and Alternative Medicine says that by the Middle Ages, thousands of botanicals had been analyzed to the extent possible at the time and classified according to their medicinal effects. Chemical analysis began in the early 19th century, and scientists started the process of making medicines from plants' active ingredients. Herbal medicine has long been a standard part of medical care in many parts of the world, including Europe, and has started to grow in popularity in the United States, partly because of the rising cost of pharmaceuticals and the increasing number of uninsured patients.
Defining "Official"
Physicians who prescribe herbal medicines concur that virtually any substance can be used medicinally. Chris Axelrad, L. Ac., FABORM, Clinical Director of Axelrad Clinic, explains, "To an herbalist, all herbs are 'official' medicines." He clarifies that the Food and Drug Administration does not regulate herbal medicines, but does regulate their labeling. Since 1994, the U.S. Dietary Supplement Health and Education Act has classified herbal supplements as dietary supplements. While this means botanicals can be sold without first being tested for safety and effectiveness, they still must be manufactured according to good practices. If you're wondering whether there are herbal medicines that absolutely must be prescribed by a physician, Dr. Janet McKenzie says the answer is "tricky, because legal requirements will vary by region and jurisdiction." There are some, like digitalis -- derived from the plant called fox glove -- that are only accessible to patients with a prescription because of their inherent dangers if used incorrectly. Dr. McKenzie says, in her opinion, others should be prescribed, including herbs that, like digitalis, have strong cardiovascular activity, such as hawthorn and oleander. She adds to her "prescription-only" list herbs known to have a high likelihood for interacting with other medications, including other herbs, "because they alter the metabolism of these substances by liver enzymes." St. John's wort is an example.
Authorities
Some other countries have more authoritative control over the manufacture and prescribing of herbal medicines. In Germany, for example, the German Commission E is made up of medical experts who research herbs to determine their safety and effectiveness. The United States has no similar system for making sure practitioners of herbal medicine are credentialed or licensed. Some states, for example, provide licensing for naturopathic physicians, or N.D.s, while many others do not recognize the license. Still, N.D.s and their colleagues who similarly practice unconventional medicine -- like traditional Chinese medicine physicians -- are allowed to provide limited services even in those states where they are unlicensed. Nearly all of the professional healing practices have stepped in where the American government has not and created groups that help ensure patients seeking alternative health care can access legitimate and trained practitioners. Examples of these groups include the American Herbalists Guild, the American Association of Naturopathic Physicians, and the National Certification Commission for Acupuncture and Oriental Medicine.
Uses
Any ailment is potentially treatable with herbal medicine. The issue, Axelrad says, is "rapidity of effect and safety as compared to drugs." For acute, serious, life-threatening infection or immune system reaction -- for example, severe allergic reaction -- herbs can work, but antibiotics and antihistamines are better to use. For long-term, chronic ailments, herbs often out-perform their pharmaceutical counterparts because they are gentler and have fewer long-term side effects. Allergies to the plant substances or similar plants would be a contraindication. Certain herbs do carry contraindications for conditions, such as pregnancy and hypertension, so it is important to consult with an experienced herbalist if you intend to use herbal medicine for long-term therapy or while pregnant.
Professional Guidance Necessary
Because there are few, if any, restrictions by the American government, patients must rely on the professionals who practice herbal medicine to act in their best interests. To take matters into your own hands and self-medicate can be risky, unless you're willing to devote the same amount of time to learning that the practitioners have. Naturopathic physician Janet McKenzie of Ontario cautions that not all herbs are safe, and some that are safe can become toxic in certain preparations or dosages. "Generally, the herbs you're accustomed to using in cooking, either as a food itself or for flavor, are safe to experiment with medicinally. In contrast, some herbal remedies -- such as foxglove for example -- can be toxic at even a small dose. Herbs with a low threshold for toxicity are best prescribed by a certified herbalist or naturopathic doctor."
References
- Chris Axelrad, L. Ac., FABORM; Clinical Director, Axelrad Clinic; Houston
- Janet McKenzie, BSN, MBA, ND; Naturopathic Physician, Perfect Balance Natural Health Care; Hamilton, Ontario
- National Center for Complementary and Alternative Medicine : What Is Complementary and Alternative Medicine?
- University of Maryland Medical Center: Herbal medicine
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