Efficacy of herbs

imagesThe use of herbal medicine began in ancient China at the time of Xia dynasty and in India during the Vedic period. In US, adults use herbal products with gross sales surpassing $5 billion annually. It is estimated that at least 20% of adult Americans taking prescription medications also use herbal products, megavitamins, or both. It should be noted that many individuals did not receive any advice from CAM practitioners. They frequently made the choice on their own, just by perusing products on a shelf at the local nutrition store (Herbal medicine; 2012)

Herbs is believed to be safer and better than standard medical practice because they are natural or are based on a religious, philosophical or a strongly felt concept of wellness and health. Treatments with herbal medicine concentrate on re-establishing or reinforcing natural healing processes and wellness. Among various herbal products, garlic, ginkgo, ginseng, and ginger have been favored in the US (Herbal products; 2011).

Unknown-2Garlic; Historically, garlic (Allium sativum) has been used for colds, sore throats, intestinal disorders, rheumatism, and coughs as well as a diuretic. Garlic is reported to be the third most popular herbal supplement in US, with sales exceeding $19 million per year. Fresh garlic and garlic in dietary supplement form may have different physiological effects and properties, with both forms purported to have anti-bacterial and cholesterol-lowering properties.

images-22Ginkgo; Ginkgo (Ginkgo biloba) is among the top ten best-selling herbs in US, with sales exceeding $17 million per year. Ginkgo is frequently used as an anti-oxidant, circulatory stimulant, and for intermittent claudication, tinnitus, vertigo, enhancement of memory and brain power, and for sexual dysfunction. Ginkgo acts as a free radical scavenger, and that it affects platelet activating factor inhibition, both of which have beneficial effects on vasculature.

Because of its strong anti-oxidant qualities, ginkgo may have great use in treating Alzheimer’s disease. Those patients with multi-infarct dementia and Alzheimer’s disease had improvement, or at least no worsening in their socialization and cognitive skills. However, it seems less possibility of a preventive effect in healthy persons. In volunteers above 74 years with normal cognition or mild cognitive impairment at study entry, ginkgo (240 mg/day) for a median of 6 years did not reduce the incidence rate of dementia and Alzheimer.

UnknownGinseng; Ginseng (Panax ginseng) is a perennial herb found in Korea and China. It has been used in eastern Asian herbal remedies for thousands of years as a stimulant and aphrodisiac and is presently marketed in US and many other countries to increase alertness and energy. Ginseng was used in ancient times for long life, vigor, and strength. It is recognized for its adaptogenic qualities. Globally, sales of ginseng exceeded $ 1.5 billion in 2008.

Unknown-1Ginger; Ginger is the rhizome of the plant Zingeber officinale. Ginger is one of the classic examples of an herb used for not only culinary preparations but also for unique therapeutic significance owing to its anti-oxidant, anti-microbial, and anti-inflammatory potential. It has been used to alleviate nausea. The recommended daily dose of ginger is 1 g daily. Amounts exceeding 4 g may cause stomach discomfort and nausea. Ginger has also been reported to lower cholesterol levels and to have blood-thinning properties.

Interaction between herbs and drugs; Almost 60% of patients fail to disclose alternative therapy use (including herbals) to their physicians. Moreover, images-1physicians used to focus attention on potential toxicities, even though identification of toxicity from herbal preparations is often difficult, because patients generally self medicate with these and may withhold this information.

As the use of complementary medicine grows, it is likely that concurrent use of herbs with drugs may mimic, magnify, or oppose the effect of drugs leading to herb-drug interactions. Health-care practitioners should caution patients against mixing herbs and pharmaceutical drugs. However, there is very little information published on herb-herb or herb-drug interactions as compared to the use of herbs.

Common herbal medicines that interact with drugs include St John’s wort, ginkgo, ginger, ginseng, and garlic. The common drugs that interact with herbal medicines include warfarin, midazolam, digoxin, amitriptyline, indinavir, cyclosporine, tacrolimus and irinotecan. Herbal medicines may interact with drugs at the intestine, liver, kidneys, and targets of action (Hermann et al. 2012).

 

Adverse effects; Despite increasing popularity, communication about the use of herbs Unknown-2between physicians and patients is limited: most physicians know little about herbs and patients avoid discussing CAM because they fear being received with indifference. Up to 15 million users may be at risk for potential adverse interactions between these alternative products or their prescriptions (Herbs side effect;  2012).

Unlike conventional medicines, herbal remedies are not regulated by governmental agencies such as FDA. The Dietary and Supplement Health and Education Act of 1994 classified herbal remedies as dietary supplements, which rendered them exempt from the safety and efficacy regulations required of prescription and over-the-counter medications.

Some herbs could adversely affect coagulation when taken alone or in combination with anti-platelet medications. Herbs could alter hemostasis by a variety of mechanisms, such as reducing platelet aggregation or inhibiting arachidonic acid, a cellular signaling messenger and inflammatory intermediate. Moderate to severe adverse events, such as spinal epidural hematoma, spontaneous intracerebral hemorrhage, retrobulbar hemorrhage, subarachnoid hemorrhage, spontaneous hyphema, and postoperative bleeding, have occasionally been anecdotally associated with consumption of herbs (Herbs; 2012)