Herbal remedies have been in use for thousands of years, but in recent years, their use has been growing in popularity. In India, ayurvedic medicine is commonly associated with medications derived from herbs. Popular herbal preparations in use today range from the ayurvedic ashwagandha to the Chinese ginseng to the Western St. John’s Wort. The inclination towards these or other herbal medicines is frequently related to the impression that “allopathic” medicines come with many side effects, whereas “natural” medicines are safer. Mysterious components of a herbal preparation may also be expected to provide succour in ways that have not yet been evaluated by modern medicine, and sometimes, the multiple ingredients in a herbal formulation may be perceived to be more capable of providing a complete cure.
However, just because a herb is “natural” does not mean it is safe. It is well known that natural products also have pharmacological effects that could result in adverse effects, and sometimes these may be severe. For example, ginseng can cause skin rash, hypertension, nervousness and sleep disturbances. Incidentally, many of our “modern” medicines, e.g., quinine, digitalis, penicillin and morphine, are derived from natural sources, but have been processed for extraction of the active ingredient and to enhance their purity. Such modern medicines must undergo stringent evaluation both before and after marketing. Reassessment is based on a large pool of international data which is constantly updated, on the drug. Often, adverse effects are recognised only after several years of marketing and an offending drug may then be withdrawn from the market.
In contrast, herbs do not undergo a similar review for safety or effectiveness. A problem with herbal preparations is that their potency varies from batch to batch because of the conditions in which the herbs are grown. Standardisation is difficult, because herbal formulations do not simply contain one or more chemical entities in fixed amounts, but rather, contain extracts in which the absolute and relative quantities of the active ingredients can vary from plant to plant. Toxic contaminants such as pesticides, heavy metals, and even prescription drugs have been found in herbal products. In fact, heavy metals are a regular component of traditional remedies and are often added to a formulation to enhance its activity. It should therefore not be surprising if a herbal formulation does not live up to its expectations and on instead, causes adverse effects. Pregnant women need to be particularly careful since the harmful effects of consumed herbs may not be known and some herbs may induce abortion.
An interesting feature is that many herbal products are promoted for diseases which have no known cure, including some serious and life-threatening conditions. Claims by the marketeer, some of which may be based on relatively flimsy evidence, can influence doctors and woo otherwise disheartened patients. However, in a hopeless situation, the patient may have little to lose in trying out a herbal preparation, and in fact, the herb may offer fresh hope. But herbals are not just targeted at the hopeless. Beauty and personal care products also frequently have herbal ingredients, with their advertising emphasizes the “natural goodness” of the ingredients. Do herbs have a special role in beauty products or could it simply have something to do with a belief that good looks must come naturally?
If skepticism is in order, it is because of exaggerated promotional claims and limited information on medicinal activities of the preparations. In any case, “natural” products are not miracle cures nor are they totally free from adverse effects. Looked at in perspective, however, there is no doubt that herbs remain one of our most important sources of new medicines. Over the years, plants have given us some of the best drugs that we have ever had, and surely many more are yet to come. A closer scrutiny of some of our traditional remedies could also throw up some exciting new discoveries. It is believed that the cures for many diseases are available today in the abundant resources of our planet. Most of the approximately 250,000 known plant species are to be found in the rain forests of the world, which are undoubtedly our richest resources. Hundreds of new drugs are thought to be hidden away in these rain forests, waiting to be discovered, if only we know how. Obviously, science has taken us far, but we have miles to go.
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This article was published in Pharma Business 9th June 2000.
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