Town & Gown:
Important Facts to Know
about Herbs and Supplements
Reprinted here in its entirety.

06-13-07

Dr. Tim Roberts, Jacksonville State University associate professor of Family & Consumer Sciences, is an authority on, among other subjects, herbs, supplements and their effects. He recently granted an interview to spread some important information for people who use these items for health reasons.

Q: What are herbs?

Dr. Roberts: Herbs are non-woody plants whose stems are soft and die down after flowering. The active ingredients in herbs may be concentrated in the plant leaves, flowers, stems, seeds and/or roots. For instance, the active ingredients in ginseng (promoted to increase energy) are concentrated in the plant roots. Conversely, the active ingredients in St. John’s wort (promoted to treat mild to moderate depression) are concentrated in the plant’s flowers. Herbs have been used for food, medicinal purposes, and for health promotion for thousands of years around the world, especially in Asia and Europe. Herbs are sold in the form of tablets, capsules, tinctures, extracts, teas, and nutraceuticals (i.e. ginseng candy bars, Echinacea fruit drinks, and ginkgo potato chips).

Q: Who takes herbal supplements and what are the most popular dietary supplements?

Dr. Roberts: Americans spend more than $5 billion annually on herbal supplements. By 2010, sales of herbal supplements will likely exceed $25 billion annually. It is estimated that 17 per cent to 30 per cent of Americans take some form of an herbal supplement daily. Limited studies indicate that well-educated, middle-aged to older women are most likely to take herbal supplements. Popular supplements among women are glucosamine, chondroitin, ginkgo biloba, St. John’s wort, and black cohosh. Men are more likely to take garlic pills, ginseng, and saw palmetto. Appears individuals take herbal/botanical products because they may be dissatisfied with conventional treatment and therapies, desire for personal control of one’s own health, and/or influence from the media.

Q: What are the potential benefits of selected herbal supplements?

Dr. Roberts: There are many herbal supplements available to consumers in the marketplace. Although well-controlled scientific studies are limited, some herbals appear to exhibit health benefits in the treatment of certain health conditions and disease. For instance:

• St. John’s Wort — Several studies in Europe indicate St. John’s wort to be affective in the treatment of mild to moderate depression. In Germany, St. John’s wort is prescribed for treatment of anxiety, depression, and sleep disorders. St. John’s wort has been described as “nature’s prozac.” It should be used under doctor’s supervision. St. John’s wort has not been found to be effective for the treatment of major depression of moderate severity.

• Ginkgo Biloba — Preliminary studies indicate ginkgo biloba may slow the progression of Alzheimer’s disease and provide modest improvement among patients suffering from dementia. Ginkgo biloba may enhance blood flow to the brain. This should also be used under doctor’s supervision.

• Garlic — Studies indicate fresh garlic to be effective in lowering total blood cholesterol and LDL-cholesterol. A well-controlled study reported garlic supplementation of 300 mg 3x/d with meals for a 12-week period to lower total blood cholesterol by about 11.5 per cent and LDL-cholesterol by about 14 per cent. Incorporation of garlic in the diet may be useful as part of a treatment regiment for individuals suffering with hyperlipidemia.

• Echinacea — Echinacea exhibits antiviral, antibiotic properties and may be useful in the treatment of respiratory infections. Several trials indicate Echinacea shortens the duration of symptoms associated with the common cold or other mild respiratory infections when administered in the early stages.

Q: What are some of the potential side effects and risks associated with selected herbal supplements?

Dr. Roberts:

• St. John’s Wort — Possible side effects include dry mouth, dizziness, minor gastrointestinal upset, and photosensitivity. St. John’s wort should never be combined with other antidepressant drugs, such as Prozac, and MAO inhibitors.

• Ginkgo Biloba — Possible side effects include indigestion, headache, and allergic skin reactions. Ginkgo biloba exhibits anticoagulant properties and should never be combined with blood thinners such as coumadin.

• Garlic — Excessive intake may cause GI upset (i.e. heartburn and flatulence). Garlic exhibits anticoagulant properties and should never be combined with blood thinners such as coumadin.

• Echinacea — Individuals with autoimmune disorders like multiple sclerosis and rheumatoid arthritis and those who are HIV positive should avoid Echinacea. Never combine Echinacea with immunosuppressants - corticosteroids and cyclosporine.

Q: What are some of the selected herbs to avoid?

Dr. Roberts:

• Ephredra (Ma Huang) — Stimulant promoted as a weight loss supplement. Ephredra may cause a significant rise in blood pressure, increase risk of stroke, and/or cardiac infraction.

• Kava — Sedative, anxiety, insomnia, restlessness. Long-term use of kava could damage the liver and should never be used with alcohol or antidepressants.

• Comfrey — Cuts, bruises, and ulcers. Alkaloids in comfrey are associated with increased risk of liver disease.

• Germander — Digestive disorders and fever. Germander has stimulating properties and could cause heart problems.

Q: Explain the regulation of herbal supplements.

Dr. Roberts: The Dietary Supplement Health Education Act of 1994 restricts the Food and Drug Administration regulatory powers over dietary supplements including herbs/botanicals. Therefore, dietary supplement manufacturers are not required to prove the safety and efficacy of their products as long as they do not make a claim their product affects a disease. DSHEA allows dietary supplements to be marketed without prior approval from FDA. Supplement manufacturers can make a structural or functional claim on their products based on scientific evidence (i.e. supports the immune system; promotes urinary tract health; maintains cardiovascular function, etc.). However, the supplement manufacturer cannot make a statement that their product will “prevent,” “treat,” “diagnose,” “mitigate,” or “cure” a disease. A supplement is presumed to be safe until the FDA receives documented reports of adverse reactions. FDA can intervene and have a supplement pulled from the market if evidence exists that the product can cause harm to the public.

Q: Can you give us some tips concerning herbal medications?

Dr. Roberts:

• Educate yourself about the medical research supporting the product’s claims;

• Discuss your herbal medication use with your physician or pharmacist;

• Do not exceed recommended maximum dose (do not mega dose) and do not use for prolonged periods;

• Know benefits, risks, and potential side effects;

• Know potential drug interactions and never use herbal supplements when pregnant or nursing;

• Do not use for serious illnesses;

• Know the supplement source — the more controlled and standardized the better.

For more information, contact Dr. Roberts at 782-587 or wtroberts@jsu.edu.

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