Saturday, December 2, 2006

Making sense of herbal remedies - ultimate herbalism guide

Herbal medicine uses plant medicines, in many forms, to promote good health and to treat ill health. This booklet offers an introduction to Western herbal medicine, gives information about basic self-help and describes some of the herbs you can use. It also tells you how to find a herbal practitioner and offers sources of further help.

Why do people choose herbal medicine?

People try herbal remedies for all sorts of reasons: because they hear from others that it has worked, because they feel it's natural and believe it's likely to have fewer side effects, or because they prefer its holistic approach. People also like the idea of having more control over their own treatment. Others turn to herbal remedies because conventional medicine has let them down, or because they want to relieve the side effects caused by the prescription medication they need to take.

The popularity of herbal medicines is clear now that herbs are much more widely available over the counter. Also on the increase is the number of qualified practitioners and those choosing plant medicines, in their many forms.

Herbal medicines can be used to treat health problems that are short-lived (acute) or firmly established (chronic), as part of a holistic approach to health. In other words, when looking at the person as a whole, and working out whether there are underlying medical, emotional or lifestyle factors that may be having some influence on the outbreak of symptoms.

How is it best to use herbs?

It's important to recognise, first of all, that herbs don't have a specific and limited purpose, in the way that conventional medicines do. Each person should have their individual needs identified, so that herbs prescribed specially for him or her, at the time, can address these.

For example, not only are there different types of depression, but they can also vary in intensity. A person may go through a depression that is altogether different from their experience of depression on a previous occasion. It may also involve a whole range of physical symptoms – lethargy, stomach problems (constipation and diarrhoea) and headaches, to name just a few – that are individual to that person.

A herbalist will take into consideration the whole picture of someone’s symptoms, and use an individually tailored combination of plants to address those symtoms and to restore health. Combining two or more herbs can enhance the individual effects of each one. This is known as synergism. Herbs for the nervous system fall into a number of categories. They can be used to strengthen a system, to relax or sedate a system, or to stimulate it.

How should I take herbal remedies?

At home, the easiest way is to make a tea or 'infusion', by leaving the plant material in boiling water for 5–10 minutes, before straining and drinking it. Herbal remedies come in many other forms, however. They can be bought over the counter as:

  • fresh herbs (such as, garlic cloves or peppermint leaves)
  • capsules or tablets (powdered herbs)
  • extracts (a concentrated form that comes as liquid tinctures, solid pills or capsules)
  • tea
  • in foods
  • as essential oils (for external use)
  • as creams and ointments (for applying to the skin).

The potency and quality of all of these vary widely. The herbs need additives to make them into extracts, which come in a range of strengths. Tinctures are more readily absorbed and solid extracts (pills or capsules) are the most concentrated and perhaps the best value.

Some products are (or contain) 'standardised extract'. This means that the manufacturer guarantees that the product contains a certain amount of a particular ingredient, so that you know how much (by weight) of that ingredient is in each day's dose. Different manufacturers produce remedies in different strengths and to different qualities. Prices will vary, and may not necessarily reflect the quality of the product.

Herbalists themselves prefer to use herbs in their natural state, or as close to it as possible, with nothing added and nothing taken away. They prefer this 'full spectrum' to standardised extracts

because they feel that preparations with added or boosted components influence the effectiveness and safety of plants, for no good reason.

How do I shop for them?

Remedies are now available in health food shops, chemists and supermarkets, and directly from herbalists. (Some can even be bought via mail order.) Supplements can be useful, but it’s always better to get an individual prescription rather than just guessing which herbs to use.

Herbal remedies aren't covered by a standard licensing procedure (although some do have product licences). They are either classed as food supplements, or come under section 12 of the Medicines Act, which makes them exempt from licensing. They don't have to undergo the same testing procedures as pharmaceutical drugs.

When buying herbs,

Choose remedies carefully – do a bit of research before you buy anything, and compare manufacturers as well as different forms of the herb. Don't choose on the basis of price alone.

  1. Buy your herbs from a reputable supplier to ensure high quality.
  2. Check the expiry date.
  3. Choose single herbs, not combinations. (Remember that herbs act synergistically. See page 5.)
  4. Check the recommended dosage – different manufacturers have different recommendations.
  5. Always read and follow the instructions on the label, carefully.
  6. Don’t overuse products. With all herbs, if you are self-prescribing, follow the instructions on the product, or the recommendations of a qualified herbalist. Start with the minimum dosage recommended.
  7. Be aware of any side effects you experience. If you feel a herb does not suit you, stop taking it and seek advice from a qualified herbalist.
  8. Many of the herbs available are user-friendly and have clear instructions. If you are self-prescribing but are unsure what to buy, contact a herbalist for advice.

Do herbs have side effects?

A herb, like any other chemical compound, may have side effects. Being 'natural' doesn't make something automatically safe. But, on the whole, the side effects seem to be much milder and more infrequent than for pharmaceutical drugs. Most of the herbs that may have side effects in high doses aren’t readily available to buy over the counter. Where problems have been reported, this seems to have been caused by very poor-quality products or by extreme misuse.

Sometimes, people do take the wrong remedy for the wrong reason – mistakenly believing, perhaps, that taking a higher dose will make it work better. Not only might they do themselves harm, they also miss out on the real benefits of the remedy. That's why it's vital to know what you're taking and why you're taking it.

Is it safe to treat my family or myself using herbs?

Most people can safely treat themselves for problems that are normally fairly short-lived, but for any long-standing condition, or one that doesn't go away, you should consult a qualified herbalist, and make sure that another form of treatment isn't also necessary. With self-diagnosis, it's important to know if and when to consult a doctor.

If your child is under five or has a tendency to allergies, seek help from a qualified practitioner. Otherwise, using herbs for children is relatively straightforward, with chamomile perhaps being the mainstay of the first-aid cabinet. When giving children herbs, mix them in yogurt with a little honey or dilute fruit juice, to help them.

For safe and accurate treatment, follow these guidelines:

  1. Don't overuse products. Use the minimum dosage for all herbs, if you are self-prescribing.
  2. Be aware of any side effects you experience. If a herb doesn’t suit you, stop using it.
  3. The more severe the problem, the more cautious you should be about self-treatment, as a general rule.
  4. Don't use herbal remedies if you are trying to have a baby, or if you are already pregnant or breastfeeding, without first consulting a qualified herbalist or your GP.
  5. Never use herbs for babies or small children without seeking professional advice.
  6. Don't take herbs alongside other prescribed drugs without consulting a qualified herbalist, because some herbs may strengthen the effects of drugs or make others less effective. With consultation, it may be possible to reduce your conventional medication.
  7. Don't make the mistake of switching from your existing pharmaceutical drug to a herbal remedy without consultation. Herbs are medicines that work in complex and subtle ways and won't always have exactly the same effect.
  8. If you have long-standing health problems, see a herbalist who can work with you in a holistic and effective way to treat the underlying causes and achieve the best outcome.
  9. If you have a short-lived condition and the symptoms aren’t getting better within a few days, get professional advice.

In what way can a herbalist help me?

Herbalists see people of all ages, who are trying to cope with short or long-term problems. People often ask for help when they haven’t been able to find relief from long-standing problems, or when they are taking prescription drugs, which have unwelcome side effects. Often, herbal remedies can help reduce these. Medical herbalists also see many children with common and ongoing conditions, such as eczema, asthma and problems sleeping or with digestion.

Herbalists treat symptoms affecting many systems of the body. Frequently, people have a batch of symptoms that can all be addressed by a trained practitioner. The same person could have a problem with their kidneys (recurrent cystitis), digestive system (irritable bowel syndrome or diverticulitis), heart and circulation (high blood-pressure), gynaecological problems (period pains or menopausal problems), nervous system (insomnia or nerve pain) and joints (arthritis).

What happens during a consultation?

Herbalists want to tackle the underlying causes of ill-health, as well as to relieve the symptoms that brought you to see them in the first place. So, a first consultation will take between an hour and an hour-and-a-half. It will cover, in detail, aspects of your medical, dietary, and emotional history and lifestyle, as well as getting a good account of your current state of health. He or she may do a physical examination, if that's necessary, and will usually check your blood pressure. This is especially useful if you haven’t been to see your GP for a long time. It's also important for a herbalist to decide whether you should see your doctor, or whether a different system of health-care could be helpful.

Herbalists don't dispense standard remedies for symptoms. Following a consultation, a herbalist may prescribe herbs for a period of two to three weeks. After this time, the prescription will be reviewed, depending on what the outcome has been.

Remedies can take time to work or may work quickly, depending on the symptom and health picture. A qualified herbalist will give you an indication of timescales in which to expect changes and improvements to your symptoms, and how this will be evaluated.

How do I find a good herbalist?

To be confident about someone treating you, you should check whether they are qualified members of a recognised, professional body, and find out details of their training and experience. For instance, members of the National Institute of Medical Herbalists (established in 1864) have undergone a rigorous, four-year training, including subjects such as Western medical sciences, pharmacy, nutrition, the therapeutic actions of plants, and therapeutics. They have a strict code of ethics and full professional insurance. The letter MNIMH or FNIMH after the name indicate that someone is a member of the Institute.

Most herbalists have a sliding scale of fees, which they can apply according to whether you are working or on a reduced income.

Unfortunately, not everyone can afford herbal medicine. Many GPs are open to the idea of herbal remedies (some are even practising herbalists themselves). Although they have general guidelines for referring patients to complementary practitioners, they don't have standard criteria for doing so. In some areas, herbalists work within GP practice settings, alongside other health professionals who may work with complementary or conventional medicine.

Which herbs are used for mental and emotional health?

Practitioners approaching mental or emotional problems frequently choose from a class of herbs that includes those known as the nervous trophorestoratives. In other words, these are herbs that

feed and nourish a system. Herbs usually have a primary action, but may also have additional influences. It's therefore important to use herbs that synergise, or enhance each other's activities. Such herbs may include St John's wort, lemon balm, damiana, passionflower, hops, valerian and kava kava.

Herbalists need to take care that the herbs they use do not over-stimulate an individual. In the short-term, the herbalist may use additional prescriptions of regular doses of herbs throughout the day to regulate sleep or alleviate panic attacks, for instance.

This will go on until the main prescription begins to make an impact. The time-scale will depend on the choice of treatment and individual needs.

Scientific research on the herbs St John's wort, kava kava and valerian has confirmed good results in treating, variously, depression, anxiety, insomnia, and memory problems. It has also provided much more information about side effects that might be associated with them. (See opposite for detailed information on individual herbs.)

There are other herbs traditionally used for emotional problems:

passionflower, reishi and hops, for anxiety and stress sage, hyperzine and peony, for memory problems chamomile, lemon balm and passionflower, for sleep.

Recently, there’s been greater focus and interest in treating problems relating to sexual function. Here, herbs are seen as a safe option when compared to the medications frequently prescribed. Self-help is probably of limited value however, because problems of this kind can have so many origins. It’s best to speak to a qualified practitioner about this, if possible.

St John's wort has been successful as a safe treatment for many people who have mild or moderate depression. But this has fuelled a mistaken idea that a particular herb can 'fix' a particular problem, and that all people need do is go and buy a bottle. This contradicts the core principles of herbal medicine, and creates false expectations. It's important to remember that what works for one person may not work for another, in just the same way that someone may try several conventional antidepressants before finding one that works.

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