The Everything Guide to Herbal Remedies (33 page)

Some herbs are standardized for a certain level of an active compound, meaning they’ve been processed in a way that isolates and measures the key constituent or constituents—something that makes it a whole lot easier for consumers to know what they’re buying. However, the issue of standardization is fairly controversial.

Medicinal herbs that are sold in Europe are typically standardized to contain a certain amount of the constituent responsible for their therapeutic effect, also known as the
active ingredient
or
marker.
Thus, milk thistle
(Silybum marianum)
is standardized for
Silymarin,
the compound that seems to be behind its medicinal effects.

Standardization makes sense for several reasons. From a quality-control standpoint, it allows manufacturers to ensure consistency of their products from batch to batch. It also guarantees that the product contains a therapeutic dose of the medicinal ingredients that made you want to buy it in the first place.

Ideally, the compounds that are used for standardization would be the ones that are responsible for the herb’s beneficial effects. In this way, every time you bought an herb in 250 mg capsules, you’d know exactly how many milligrams of the active ingredient you were getting and what effects you could expect.

But in the majority of cases, the exact compounds that are producing the effect is unknown, meaning you can’t know which ones to pick for standardization. In many cases, we also don’t always know what other compounds, or
cofactors,
must be present in order for the active constituent to do its job.

Consider Saint John’s wort
(Hypericum perforatum),
one of the most popular and well-researched herbs around. Scientists continue to debate over which of the plant’s many chemical constituents (there are about sixty) is or are responsible for its medicinal effects. A few years back, everyone seemed to agree that it’s the
hypericin,
and commercial products standardized for hypericin started appearing. Then researchers began to wonder if another chemical,
hyperforin,
was the real active ingredient. As of this printing, the jury is still out.

What’s more, the practice of standardization itself isn’t exactly standardized. Different U.S. manufacturers standardize for different amounts of marker compounds and use different methods of testing.

Meanwhile, many herbalists and natural health practitioners advocate using extracts of the whole herb (or the whole herb part, such as the root) instead of any isolated components. These are called
crude
extracts. Aside from the question of picking the right ingredient to isolate, they argue that this is the best strategy because herbs have been used for centuries as intact organisms, not individual chemicals, and there’s evidence that the various constituents in herbs work together synergistically.

Unfortunately, this isn’t an ideal solution, either. Because there can be such disparity among crops of plants, there can be enormous variation among their crude extracts—meaning some batches may have higher levels of active constituents than others.

Right now, the best approach seems to be using standardized crude extracts wherever possible. This means you’re getting the whole herb and all of its components but are ensured of getting a therapeutic dose of the active ingredient (or at least the ingredient that seems to be the active one). For more on buying herbal preparations, see
Chapter 18
.

If you have specific health issues, including chronic conditions like diabetes or cardiovascular disease, you should use extra care when taking herbal remedies. If you’re taking medicines as part of a long-term treatment plan, be sure to get your doctor’s approval before using herbs. Some can amplify the effects of medicines and interfere with cytochrome P450 (CYP), an enzyme that’s critical to drug metabolism.

While herbs have been used for centuries to help manage chronic diseases and conditions, you shouldn’t treat yourself. If you have any of the following health concerns, talk with your doctor before using herbal products:

• Blood clotting problems

• Cancer

• Cardiovascular disease (including heart disease and/or hypertension)

• Clinical depression or another psychiatric condition

• Diabetes

• Enlarged prostate

• Epilepsy

• Eye diseases, such as glaucoma

• Immune system problems

• Liver disease

• Parkinson’s disease

• Thyroid disease

If you’re scheduled to have surgery, be sure to talk with your doctor about any herbs you’re taking. In most cases, she will tell you to stop taking them a few weeks before your operation.

Several herbs, including ginkgo
(Ginkgo biloba)
and turmeric
(Curcuma longa),
can cause problems during surgery by interfering with the anesthesia or increasing the risk of bleeding.

Many prescription and OTC drugs can interact with herbal products. Herbs can affect the way your body processes a pharmaceutical agent—and vice versa. For example, Saint John’s wort
(Hypericum perforatum)
can affect the absorption of certain drugs, increasing the amount that’s absorbed in some cases and reducing it in others (meaning you’re not getting enough of the drug to treat the condition it’s supposed to be treating).

You should talk with your doctor before combining herbs and any pharmaceuticals, but be especially careful if you’re taking any of these:

• Antidepressants, antianxiety drugs, or any other psychotropic medications

• Antiseizure drugs

• Anticoagulant/antiplatelet drugs (also known as blood thinners)

• Antihypertensives

• Heart medicines, such as beta blockers or nitrates

• Cancer drugs

• Diabetes medicines

Pregnant women, young children, and seniors all have special concerns—and should take extra care with herbal medicines.

Some herbs are safe for pregnant and breastfeeding women, while others are known to causes problems. Pregnant and breastfeeding women should not take:

• Black cohosh
(Actaea racemosa, Cimicifuga racemosa)

• Dong quai
(Angelica sinensis)

• Feverfew
(Tanacetum parthenium)

• Goldenseal
(Hydrastis canadensis)

• Juniper
(Juniperus communis)

• Red clover
(Trifolium pratense)

• Kava
(Piper methysticum)

• Sage
(Salvia officinalis, S. lavandulaefolia)

• Saint John’s wort
(Hypericum perforatum)

• Vitex
(Vitex agnus-castus)

Pregnant women also should avoid caffeine-containing herbs, such as coffee
(Coffea arabica),
guarana
(Paullinia cupana),
mate
(Ilex paraguariensis),
and tea
(Camellia sinensis).

Pregnant women can take these herbs, worry free:

• Ginger (Zingiber officinale)

• Peppermint (Mentha x piperita)

• Psyllium (Plantago ovata, P. psyllium)

In addition, aloe
(Aloe vera),
cayenne
(Capsicum annuum, C. frutescens),
gotu kola
(Centella asiatica),
and witch hazel
(Hamamelis virginiana)
can be used topically—and safely—during pregnancy.

Generally speaking, you should stick to herbs with relatively gentle actions when treating children. Don’t treat babies or kids with herbs that work as stimulants, stimulant laxatives, strong sedatives, or phytoestrogens. Don’t give the following herbs to a baby or young child:

• Black cohosh
(Actaea racemosa,Cimicifuga racemosa)

• Guarana
(Paullinia cupana)

• Red clover
(Trifolium pratense)

Many herbs have a long history of being safe for children. They include:

• American ginseng
(Panax quinquefolius)

• Echinacea
(Echinacea purpurea)

• Flax
(Linum usitatissimum)

• Ginger
(Zingiber officinale)

• Lemon balm
(Melissa officinalis)

• Licorice
(Glycyrrhiza glabra)

• Passionflower
(Passiflora incarnata)

• Peppermint
(Mentha x piperita)

• Psyllium
(Plantago ovata, P. psyllium)

• Slippery elm
(Ulmus rubra)

In addition, the following herbs are safe for children when applied topically:

• Calendula
(Calendula officinalis)

• Lavender
(Lavandula angustifolia)

• Rice bran
(Oryza sativa)

• Garlic
(Allium sativum)

• Goldenseal
(Hydrastis canadensis)

Many seniors will find that they can use lower doses of many medications—and herbs—as their bodies often process drugs differently than younger people’s bodies do. Talk to your doctor to determine the best dosage.

Many of the prescription and OTC drugs used by seniors can interact with herbs. For example, anticoagulant/antiplatelet drugs—also known as blood thinners—can interact with several herbs, including Asian ginseng
(Panax ginseng),
dong quai
(Angelica sinensis),
feverfew
(Tanacetum parthenium),
garlic
(Allium sativum),
and ginkgo
(Ginkgo biloba).

And the cardiac drug digoxin (Lanoxin, Digitek), also known as digitalis, can interact with several popular herbs, including hawthorn
(Crataegus monogyna, C. oxyacantha)
and Saint John’s wort
(Hypericum perforatum).
To be safe, talk with your doctor before using any herbal preparations.