Understanding Herbal Remedies

ESSENTIAL HERB SAFETY TIPS

While herbal remedies generally have far fewer and far milder side effects than pharmaceuticals, they may still cause problems if used improperly. Here's how to take herbs safely.

1. Become well informed. Read up on herbs before you use them. This book is a good place to start. Don't follow a friend's advice about dosage (unless that friend is a practitioner with years of clinical experience). Get your information from a reliable source that includes safety warnings.

2. Start with a low dose. Herb dosages are typically presented as ranges; for example, 1 to 2 teaspoons of herb per '/, litre of just-boiled water, steeped for 10 to 20 minutes and taken two or three times a day. Begin at the low end of the recommended range - with 1 teaspoon steeped 10 minutes twice a day. If a low dose does not provide sufficient relief, gradually move towards the top of the recommended range. If you still do not experience noticeable benefit, consult a herbalist, a naturopath or your doctor.

0. If you buy commercial preparations (teas, tinctures, pills, capsules, combination products, and so on), follow the directions on the label. These preparations may vary in strength; some are concentrated. If the to the public. Pharmaceutical companies spend millions of pounds to prove that their drugs are safe when taken as directed (although sometimes hazardous side effects are discovered only after a drug has been approved). They also have to prove that their drugs actually work for each disorder for which they're prescribed.

Herbs that are not sold as medicines do not face the same costly regulatory hurdles, so manufacturers can get their products to market more quickly and more cheaply. Some experts are concerned that this lack of regulation puts the public at risk of wasting money on worthless products - or worse, experiencing serious side effects. That's why it's so important to find out which herbs are effective and safe - perhaps by referring to a book like this one - before starting a herbal regimen.

Finally, some herbs are what herbalists call tonics. Rather than treating specific conditions, as drugs are designed to do, tonics exert a gentle health-promoting effect on the whole body over time. The best label and this book disagree, follow the manufacturer's dosage recommendations,

0. If you experience any unusual symptoms within eight hours of taking a herbal preparation, discontinue use. Everyone reacts to herbs differently. If you're unusually sensitive, you may experience side effects and allergic reactions even at low doses.

1. Do not give herbal remedies to children younger than 2 year old without

the approval of the child's doctor.

0. If you are over the age of 65, stick with dosages at the low end of the

recommended ranges. Sensitivity to drugs and the medicinal compounds in herbs increases with age. So does the risk of side effects.

0. If you are pregnant or breastfeeding, or if you have a long-term illness and/or are taking any medication, do not take medicinal. herbs without consulting your doctor.

1. If you consult a herbal practitioner, follow that person's instructions, and promptly report any unusual `symptoms to them or to your doctor.

 

 

THERE'S A LOT OF confusion on the subject of herbal medicine.While it's wonderful to have so many herbal products available in chemists and health food stores, it's frustrating not to have easy access to information that will help you make the right choices. Which herb is best, say, for a sinus infection? Should you buy a capsule or a liquid? Do standardised extracts offer more for your money? Can you take a herb if you're also taking antibiotics? Can you take a herb if you're on blood pressure medication?

That's a lot of questions. Before you can answer any of them, you need to know for certain what condition or symptom you're trying to treat.

WHATS WRONG - AND WHY IT MATTERS

Sometimes you can diagnose your own symptoms. For example, you can certainly tell when your stomach is upset - and often you'll also know why. It's fine, in such instances, to treat yourself with peppermint or camomile or fennel tea.

However, if such digestive upsets occur frequently, they could well be caused by something other than food that disagrees with you. They could be a sign of a serious condition. In such cases some herbs can be exactly the wrong things to take. After all, peppermint is one of the safest, most widely used herbs, but people with heartburn or oesophageal reflux disease should avoid it because it relaxes the valve between the stomach and oesophagus, actually worsening symptoms.

If your symptdms are serious, recur or persist, see your doctor or health-care practitioner. If you don't know what's causing a minor symptom, it can't hurt to consult your doctor for an accurate diagnosis. If you have already been diagnosed and are under a doctors care, or if you're taking over-the-counter or prescription drugs for any chronic health problem, you must consult your doctor before adding any herbs to your treatment regimen. Some herbs interact with drugs in dangerous ways. Do not discontinue routine medication and substitute herbs without your doctor's consent and supervision.

In many ways herbal treatment is still self-treatment, because many people don't have access to a herbal expert. Doctors, whether or not they know natural remedies, do know disease; it's what they see day in and day out. Enlist their help in determining what you have, then go about researching the best way to heal it. Many medical doctors are becoming better informed about the effectiveness and safety of medicinal herbs, nutritional supplements, dietary changes and other natural therapies.

TYPES OF HERBS

Herbalists have developed a set of categories to describe what herbs do. While you won't see these terms very often in this book, they tend to crop up in health publications, advertisements and manufacturers' litreature as well as on herb product labels. These categories are sometimes called action-types.

Many herbs fit into more than one category because they have more than one specific effect on the body. For example, ginkgo enhances circulation in the microscopic blood vessels of the body, including those in the eyes and the brain. It's also a potent antioxidant, meaning that it cleans up free radicals, a type of cellular waste product that attacks body tissues.

It's helpful to understand a few of these action-type categories in choosing a herbal remedy.

Specifics and Tonics

These two broad terms refer to whether a herb targets a particular symptom or enhances the health and efficient operation of a whole organ or body system. Valerian, for example, is a specific for insomnia. Chemical compounds in the herb are sedating and promote sleep. Astragalus, on the other hand, is a tonic. When repeated illness or stress weakens the immune system, astragalus slowly rebuilds immune strength.

Specifics are taken for brief periods or only when symptoms are present. Tonics, on the other hand, are taken long term, sometimes with short breaks. Some herbs have several uses; they may function as a specific for one symptom and have a tonic use as well.

 

The 'Anti's

The prefix 'anti' means 'against'. Herbs that fall into this category are used to combat whatever follows the prefix. So antiviral herbs fight viruses, antifungals fight fungi, and so on. A few of the 'anti' action­types bear further explanation.

Antispasmodics relieve spasms or cramps in muscles, whether

it's the skeletal muscles that hurt when they're cramped or the smooth muscles that encircle the airways and intestines. Some antispasmodic herbs that act on smooth muscles can help ease coughs or diarrhoea.

Antioxidants inhibit oxidation. These herbs contain certain compounds that help prevent a particular set of chemical reactions implicated in diseases such as arthritis and macular degeneration. These chemical reactions are called oxidation reactions. They're set off by free radicals, unstable molecules that grab electrons from stable ones. Free radicals are neutralised by antioxidants, which can give up their electrons without becoming unstable themselves.

Anti-inflammatories counteract or suppress the body's production of chemicals that inflame tissues, such as histamine. In an inflammatory response, whether it's caused by a bee sting or hay fever, small blood vessels dilate and leak fluid into the surrounding tissue. What you experience is swelling - of a stung foot or your airways.

Other Action-Types

Adaptogens are a particular type of tonic. They enhance the body's ability to deal with stress, strengthening the disease-fighting immune system and the hormone-producing endocrine system, which includes the adrenal glands. The adrenal glands are important because they're responsible for releasing hormones in response to stressful situations. When you experience a lot of stress, these glands can become overworked. Adaptogens help repair the adrenal and other glands of the endocrine system and help them work together with the immune system.

Bitters are bitter-tasting herbs, such as dandelion and gentian, that stimulate the stomach's production of digestive fluids. These digestive fluids help your body absorb nutrients from the food you eat. Bitters are often a component of a nutritional healing plan.

Carminatives help dispel wind from the intestines, relieving the cramps that often accompany such wind.

Demulcents soothe inflamed mucous membranes or digestive tissues. These herbs contain mucilage, sticky or slippery substances that coat body tissues and help protect them from irritation.

Expectorants help the body expel mucus from the respiratory tract. They do this either by stimulating bronchial secretions that thin the mucus, or by making the mucus itself less sticky.

CHOOSING A HERB FORM

Unless you have a trained herbalist whom you trust and depend on for advice orr your doctor is knowledgeable about herbal medicine, you'll have to educate yourself about which herbs to take, how much and how often. Part Ill of this book discusses which herbs may be appropriate for specific conditions. Here we'll discuss the various forms in which herbs are available, how to choose among them and how to read a herb or dietary supplement label.

Not only are hundreds of different herbs available in the marketplace, they come in many different forms. Understanding the different preparations and how they're made will help you decide which one is best for you.

Capsules

Eighty per cent of all herbal supplements are sold'in capsule form. They're not necessarily better than other forms. They are, however, convenient, palatable and portable. Some are made from gelatine, while others are made from vegetable sources.

Capsules do have some disadvantages. They contain dried, ground herbs, and when herbs are in that fine form they can lose their potency more quickly. If you're taking whole herb capsules, not a concentrated extract, you may have to take quite a few capsules to get enough of the herb.

If you choose capsules, it's important to buy them from a reputable manufacturer, for the bottle to be safety sealed and for the label to contain a future expiration date.

Fresh versus Dry

If you garden or harvest wild herbs (which you shouldn't do unless you're certain of your ability to identify a particular species), then you have ready access to fresh herbs. Some herbs just taste better fresh; others are more effective that way, whether the herb is cut from your garden, grown in commercial farm fields or plucked from a wild hillside (a practice known as wild-harvesting).

Fresh herbs are wonderful to add to foods, make into teas, or mash up and apply topically to a minor skin irritation such as an insect bite (plantain) or a minor sunburn (aloe vera). But, for most people, dried herbs are more convenient to use and, if they haven't outlived their shelf life, they're effective. You can check the freshness of some dried herbs by their scent. If they have a smell when fresh, they should still retain some of that smell when dried.

Teas, Infusions and Decoctions

Teas are the most familiar, most traditional herbal preparation. To make them, you buy dried plant material - leaves, flowers, bark, roots, seeds or berries. Then you add hot water, which extracts some of the plant material's active components.

Some herbs lend themselves very well to this process. Peppermint, camomile and sage are examples of herbs the aerial, or above-ground, parts of which readily release their volatile oils in near-boiling water. Herbalists call this process infusing and the product it yields an infusion.

Barks, roots, seeds and berries tend to require a little more heat and time to release their medicinal compounds. They usually need to be simmered on low heat for 10 to 30 minutes. Herbalists call this process decocting and the product it yields a decoction.

MEDICINAL TEA TECHNIQUES

Medicinal teas are simple to prepare. What's more, they can be used in several ways. Teas can be drunk from a cup, poured into a bath, or used as a compress for rashes, minor burns and mild sprains.

Medicinal teas are made by either steeping or simmering. To steep a herb, you soak it in water that has been brought just to a rolling boil, then removed from the heat. Use a timer; the few minutes necessary for soaking a regular tea bag are not quite enough time for medicinal teas.

To simmer a herb, on the other hand, you need to leave it on the heat, with the mixture of herbs and water gently but barely boiling.

What do you do if your tea contains both types of plant parts?

You can simmer the tough parts, strain the liquid, reheat it to boiling, remove it from the heat and then steep the more fragile herbs in the hot liquid. If you're using finely chopped roots, bark or berries, you can probably just steep the tea for a longer time - say, 10 to 20 minutes. Follow the tea recipes in Part III (or the manufacturer's instructions on the tea you've purchased).

Of course, one of the most familiar ways to buy tea is in tea bags. These prefilled and premeasured bags make tea a simple and portable remedy. Generally speaking, however, the dried herbs in tea bags have been chopped finer, which means the herbs lose their freshness more quickly. So if you're buying tea bags, make sure the manufacturer has a reputation for freshness, store them away from heat and light, and throw away unused bags after a year has passed.

Tinctures and Glycerites

Sometimes herbs (either fresh or dried) are soaked in a liquid other than water to release the medicinal compounds. For tinctures, that liquid is alcohol; glycerites use glycerin.

With some herbs, the chemicals that do the healing work don't extract well into certain liquids. Alcohol is able to extract more chemical components from more plants than glycerin, so we recommend using tinctures if you're able to consume alcohol.

Standardised Extracts

The concentration of medicinal compounds in herbs varies a great deal from one kind of plant to another. For instance, a teaspoon of dried peppermint leaves is powerful enough to make a tea that's very effective in calming an upset stomach. A tea made from a teaspoon of ginkgo leaves, however, would have no value at all in restoring your memory, one of the benefits that is usually associated with this herb. It takes many, many kilograms of ginkgo leaves to make a single effective dose, and the doses must be repeated regularly over a period of time.

So how do you know if the ginkgo product you're thinking about buying is concentrated enough to do any good? You can check to see whether or not it's standardised. For ginkgo, standardisation means that a product contains approximately 24 per cent flavone glycosides, a compound found in the herb. (In some standardised herbal products the compound that's measured is not one of the herb's 'active ingredients', but for various reasons - for example, ease of measuring or uniqueness

HERBS COMMONLY SOLD AS STANDARDISED EXTRACTS

The chart below lists several widely used herbs and the compounds to which they're usually standardised. As research on herbs continues, you may see

products standardised to different compounds.

Bilberry _ 25% anthocyanocides

Garlic 5.4 milligrams of allicin per dose

Ginkgo biloba 24% ginkgo flavone glycosides

Grapeseed 95% proanthocyanidins

Hawthorn 19% oligomeric procyanidins

Kava-kava 29% kavalactones

Liquorice 2% glycyrrhizin

Milk thistle 70% silymarin

Saw palmetto 95% free fatty acids -

St John's wort 0.3-0.5% hypericin

to that particular herb - the compound has been designated as a marker of that product's potency.)

Most herbs that are standardised don't require the extreme concentration that ginkgo does, and, in fact, may be standardised for other reasons. Perhaps a single compound has been isolated for research, and the manufacturer wants to be sure the amount that was found to be effective on actual patients is found in the product.

Does this mean that standardised

products are superior to others that are not standardised? Not necessarily, although standardisation does give some assurance of potency and benefit. Standardised products are available as capsules, tablets, and liquids.

Those people who advocate whole-herb preparations argue that there are many, many compounds in any given herb, and that these compounds act synergistically to provide the maximum benefit to the user. Those who favour standardised preparations contend that, without a rigorous process of concentrating and measuring one or more compounds in the product, you don't really know what you're getting. Both sides are correct.

For example, most St John's wort products are standardised to contain a certain amount of hypericin, one of the compounds that researchers believe is responsible for the plant's ability to ease mild and moderate depression. At the time of this writing, however, new research suggests that another of the herb's compounds, hyperforin, might have therapeutic effects. It's possible that right now new studies of St John's wort are identifying other compounds with health benefits.

'Herbs Commonly Sold as Standardised Extracts' lists other often-used herbs that are usually standardised, the component that is identified for standardisation and the amount of that component you'll find in most products.

 

SINGLE HERB, OR FORMULA?

A century ago preparations of single herbs were called `simples', and the skill of making them 'simpling'. These days you can still get simples. You can also choose from a host of products that combine several herbs to treat specific conditions such as colds or premenstrual syndrome (PMS). (You'll see these products referred to as formulas or as combination products.) There's a place for both simples and herbal formulas.

If you're sure of what's causing your illness, it's relatively minor, and you have no allergies or sensitivities to herbs, you may wish to purchase a formula product. Read its label carefully, however, and check the quantities of the herbs to make sure you're getting enough of the ones that you need the most.

Formula products have their drawbacks. They may or may not contain an adequate amount of the most important, or most well-researched, herb for your condition. They may also contain herbs that you don't want to take or that are not well researched.

What's more, it's often hard to tell the difference between the various formulas. The only solid advice is to buy a brand you know you can trust, and make sure you check the product's expiration date. If it doesn't have one, don't buy it.

On the other hand, formula products can be a very convenient way to take herbs. Just as whole herbs offer you chemical compounds that work together, not in isolation, formula products may offer benefits that come from combinations of herbs. They can also be a lot cheaper than buying several different bottles of capsules!

Single herbs, however, offer you greater control. You decide how much of each herb you're going to take; if you do wind up with a reaction or sensitivity to one of them, you simply discontinue using it. If you buy from a reputable manufacturer, you're sure of what's in those capsules or that bottle of liquid extract.

Infused and Essential Oils

These two similar-sounding forms of herbs are actually very different. Infused oils are oils in which herbs have been steeped, usually for several weeks, over low heat or at room temperature. They are most often used topically for skin irritations (calendula oil) and muscle aches (arnica oil and/or St John's wort oil). They're also easy to make yourself.

Essential oils, on the other hand, are chemical concentrations of a plant's volatile, or easily evaporated, oils. Most often produced by distillation, essential oils are very, very strong and in most cases should not be used on the skin in their undiluted form. The great majority of them should not be taken internally. Some are even toxic.

The use of essential oils in healing is known as aromatherapy, whether or not they smell good! Some of the best-known essential oils are tea tree oil, which doesn't smell pretty but is a potent antifungal, and lavender oil, which smells wonderful and also heals burns.

Other Forms of Herbs

Sprays. A relatively new form of herbal supplement, a spray is a liquid that is taken under the tongue. The active ingredients enter the bloodstream quickly, by-passing the gastrointestinal tract where they might be damaged by stomach acids. Sprays are useful for people who have difficulty swallowing tablets or capsules.

Tablets. A carefully controlled quantity of finely milled herbal material is compressed into the chosen shape and given a thin coating. One type of coating, called an enteric coating, is formulated in such a way that it doesn't dissolve until the tablet reaches the small intestine, where the active ingredient can be absorbed without being affected by stomach acids. Some tablets are made to dissolve under the tongue, where absorption of the active ingredient into the bloodstream is rapid.

COMMON HERB/DRUG INTERACTIONS

This list isn't exhaustive, but it provides some examples of how certain herbs can alter the activity of certain drugs.

Herb	Effect
Bromelain	Increases risk of bleeding when taken with blood thinners
Echinacea	May counteract immuno suppressive drugs
Ephedra	May worsen the side effects of other stimulants (including caffeine)
Garlic	May increase the effects of blood thinners
Ginkgo	May increase the effects of blood thinners
Ginseng	May worsen the side effects of stimulants
Hawthorn	May increase the action of some heart medicines and decrease their side effects
High-tannin herbs such asblack or green tea, whiteoak bark, bearberry, witchhazel, black walnut huskand raspberry leaves	Reduce the absorption of most drugs
High-berberine herbs such as goldenseal, Oregon grape root and barberry	Counteract short-acting blood thinners
High-fibre herbs such as fennel seed, psyllium husk, marshmallow root, Icelandic moss, apple pectin, flaxseed, aloe gel and slippery elm	May delay the absorption of most drugs taken at the same time
Liquorice	May worsen the effects of drugs that cause potassium loss
Siberian ginseng	Increases the effects of antibiotics
St John's wort	May increase the effects of narcotics and some antidepressants
Valerian	Increases the effects of sedatives

Is there an expiration date on the product, and is it in the future? If there's no expiration date, you're taking your chances on whether the product is still effective.

Is there a batch number on the product in case you want to ask the manufacturer about it? Does the manufacturer provide an address, telephone number or web site address so you can get more information?

HOW MUCH TO TAKE

When trying a new herbal remedy, start out with the lowest recommended dose - from this book, a doctor or trained herbal practitioner, or the product label - and monitor your response carefully. If you have any unpleasant side effects such as rashes, dizziness, nausea or headaches, stop taking the herb immediately.

Dosage advice includes how long you should take a herb. As with drugs, there are some herbs that may do harm if taken for more than a specific number of weeks. Others take several months to produce benefits; still others can be taken long-term with no ill effects.

Some people have allergic reactions to certain plant foods or airborne plant substances. Since herbs are both plants and food, and since herbal supplements may be very concentrated, it's not unheard of for allergic reactions to occur. There are some commonsense predictors. If you're allergic to ragweed, for example, you will want to be cautious about using camomile, which is in the same plant family as ragweed.

It is also known that some herbs can interact in negative ways with certain foods, pharmaceutical drugs, caffeine or alcohol. If you're using any of these substances, be careful about taking a herb that could cause a critical interaction. Always check for cautions on the labels of herbal products you buy. Even if you're using fresh herbs, do your homework.

Herbal supplement manufacturers tend to be very careful and conservative in making dosage recommendations. It's wise to follow label instructions, especially at first, unless they are contradicted by your health practitioner or another information source that you trust. One thing product labels won't tell you, though, is that most herbal supplements are formulated for the needs of a 68-kilo (10%-stone) man.