Considering treatment options for diseases and disorders can be confusing, especially when debating between herbal supplements and remedies and prescription drugs. When choosing either path, it’s very important to consult professionals in both disciplines in order to make an informed decision.

According to a study by the National Center for Complementary and Alternative Medicine (NCCAM) for the National Institute of Health (NIH), in 2007, Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine, with $14.8 billion of that being nonvitamin, nonmineral, natural products such as fish oil, glucosamine and Echinacea. That expenditure is approximately 1/3 of total out-of-pocket costs for prescription drugs.

Cost-effectiveness is one obvious benefit of using herbal supplements. I consulted with Martina Eberhard, California State licensed Acupuncturist and Herbalist in Traditional Chinese Medicine, to gain some further insight on the use and benefits of herbal supplements and remedies.

Background and Safety

Can herbal remedies be “healthier” and “safer” than prescription drugs? Herbalist Martina Eberhard addressed the question by also providing some background on the evolution of Chinese medicine.

“Chinese medicine evolved over 3,500 years and is still being refined and expanded upon today by incredibly talented practitioners and researchers. It evolved experientially rather than theoretically. It took time for the value and functions and properties of herbs to be discovered and tested. There were no lab rats. People proved or disproved what an herb or a formula of herbs could or could not do. Billions of people have used Chinese medicine,” said Eberhard.

She continued, “Many modern Western hospitals in Asia today have Eastern medicine wings and/or both Western as well as herbal pharmacies under the same roof. China, Taiwan and Korea have clinics that have dispensaries of herbal concoctions. Scientific studies of verification and application of herbs are now prevalent in the West. A search on NLM.NIH.gov showed a total of 524 studies; narrowing this search to Chinese herbal medicine and cancer resulted in 110 articles. Among this research includes documentations on herb-herb and herb-drug interactions.

Which is healthier or safer? That depends. It is hoped that with continued research and maturation of thought, there will grow an essential cooperation between supplement/pharmaceutical industries and practitioners of differing specialties. Modern research continues to define interactions between herbs and pharmaceuticals. But ancient texts in Traditional Chinese Medicine (TCM) had already outlined and detailed herb-herb interactions and contraindications.”

Substance Control

A common concern regarding the use of herbal medicines is that they are not regulated by the Food and Drug Administration (FDA). Supplements are regulated as food.

According to Eberhard, “GMP (Good Manufacturing Practice) is the international standard in regulating pharmaceutical production and distribution and the best herbal companies in the world stamp this all over the packaging of their supplements/formulas/herbal remedies.”

According to spiritrisingherbs.com, “Many U.S. importers of Chinese herbs and herbal products such as Crane, Springwind, NuHerbs, KPC, Kamwo, Mayway, use independent laboratories in the United States to test for hundreds of pesticides as well as testing for sulfur dioxide, aristochic acid, aflatoxin/ochrotion, heavy metals and of course proper species authentication. Herb companies do maintain Certificates of Analysis that specify the results of their testing, as well as where the testing was done (i.e. in China or in the United States) that you can request when you order.”

This doesn’t mean that the herbs will be pesticide-free. According to the article, “To ensure that herbs and products are truly chemical free, they must be certified organic. Certified organic are a bit more expensive than conventionally grown herbs and are becoming easier to find.”

As for FDA regulation, there is also debate as to the validity of the testing and trials performed. A motherearthnews.com article quotes Marcia Angell, M.D., former editor-in-chief of The New England Journal of Medicine:

“Can we believe those trials? After all, that crucial last stage of research and development is usually sponsored by the company that makes the drug, even if the early research was done elsewhere. Is there some way companies can rig clinical trials to make their drugs look better than they are? Unfortunately, the answer is yes. Trials can be rigged in a dozen ways, and it happens all the time,” Angell states in her book “The Truth About the Drug Companies.”

The article adds, “Furthermore, FDA approval committees often include members with ties to pharmaceutical companies. In fact, the 2006 Institute of Medicine’s study recommended that the FDA should “establish a requirement that a substantial majority of the members of each advisory committee be free of significant financial involvement with companies whose interests may be affected by the committee’s deliberations.”

Thus, it can be debated that the FDA is truly the be-all-end-all answer on pharmaceutical safety and control.

Additional Benefits and Common Ailment Treatments

In addition to lower costs, Martina Eberhard notes easier accessibility, widespread availability, reduced risk of side effects and better results for chronic conditions as some of the benefits of herbal medicines/treatment.

She also suggests that prime candidates for herbal consultation would be those conditions that Western medicine has run out of ideas for (meaning all it has to offer is steroids or opioids).  

She said, “Cortisone shots lose effectiveness. People become addicted to morphine for pain. I would add seeking an alternative to anti-depressants or anti-anxiety medications for mild forms of either. People are oft put on antidepressants when in chronic pain. Do yourself a service and consult with an experienced herbalist.”

Eberhard directly addressed herbal practices regarding the very common ailments of arthritis and migraines. She advised, “A common chronic ailment is arthritis. Herbalists will determine what kind of arthritic issue is presented by the patient and then appropriate herbs will be given. In Chinese medicine ailments like arthritis are classified by elements such as heat and cold. Joints can be hot and swollen or cold and crackly. Treatment of either type of arthritis might include dietary changes like adding specific heat clearing or warming herbs, eliminating vegetables from the nightshade family and reducing white sugar consumption.

Five people may seek a remedy for headaches or migraines for example and a skilled herbalist may just have five different remedies based on the specific presentation of symptoms for each person. Meaning, there’s no cookie-cutter treatment which is a good reason for not trying to diagnose yourself.”

Interactions and Warnings

Precautions need to be noted regarding possible adverse reactions, side effects or drug interaction warnings with prescription or over the counter drug and supplement use.

“Most Western MDs don’t have enough information about herb-drug interaction. Pharmacists have marginally more,” said Eberhard.

She noted internationally recognized and respected expert in drug-herb interactions John Chen as a good resource via his website.

Eberhard highlighted the following herb-drug combinations that can pose some of the biggest and well-known adverse reaction risks:

Anti-coagulating drugs: Because Coumadin (Warfarin) interacts with a wide range of herbs, it is best to avoid combining Coumadin with all herbs unless the patient has guidance from an experienced health professional. TCM herbs with the greatest potential for interfering with anti-coagulants includes: Salviae miltiorrhizae (Dan shen), Angelica sinensis (Dang gui), Ligustici chuanxiong (Chuan xiong), Persicae (Tao ren), Carthamus tinctorii (Hong hua), and Hirudo seu whitmania (Shu zhi). Likewise, patients should also monitor their green vegetable intakes when they are on anti-coagulant therapy.

Diuretic drugs: A variety of herbs can increase or decrease this effect.  The most commonly used oriental herbs for their diuretic effects include: Polypori Umbellati (Zhu ling), Semen plantaginis (Che qian zi), and Alismatis orientalis (Ze xie), Akebia trifoliata (Mu Tong).

These are just a couple of examples. Additional risks and interactions can occur and do exist. You can always do a Google search with the herb-medication or supplement medication and add “interaction” or “side effects” and read the returned results (e.g. “Tao Ren and Warfarin side effects”).

Furthermore, it’s of the utmost importance to consult as many professional resources as possible including your physician, pharmacist and a licensed herbalist to discuss your current health issues, any current prescription or non-prescription medications as well as any herbs or supplements you are currently using in relation to any new herbal supplements, formulas or remedies you are considering.

Finding a Licensed Herbalist

Finally, if you’re considering alternative herbal treatment and medicines, Eberhard offers the following advice for finding a good trained and licensed herbalist:

“To recognize a competent herbalist, you’ll notice a properly trained TCM herbalist will almost always insist upon inspecting one’s tongue, feeling the pulse at both wrists, and asking about chief symptoms or complaints. Pulse palpation and tongue inspection are two methods for determining the nature of an individual’s health imbalances that have evolved over a period of several thousand years.

You must interview whomever you call upon. Find out where they went to school, if it’s accredited by Accreditation Commission for Acupuncture and Oriental Medicine, if they’re licensed by the state, and how many years they’ve been in practice. To find an initial list of acupuncturists/herbalists in TCM, you might try www.acufinder.com or www.aaaomonline.org/.”