Abstract
Herbal
medicines are products originating from herbs which may have some ingredients with
health benefits. During recent years, there
has been a dramatic increase in the use of herbal products as an alternative
medicinal treatment around the world.
The efficacy and safety of using herbal medicinal products have been discussed
for a long time. The safety of herbal
medicine is a complex issue interrelated to a variety of factors including methods
of production, public perception, and attitudes with regards to the products, and
the nature of the plants. There are many herbal medicines with the potential for
toxicity and problems with contamination.
Furthermore, some herbal medicines may have particular side effects. Another issue is that herbal medicine lacks a comprehensive,
scientific universal standard.
Therefore,
regulation of herbal medicine is required to assure consistency between studies
and to develop the efficacy and safety of herbal drugs.
Introduction
Herbal medicines have been used
for thousands of years. In the last few decades, there has been significant growth in using herbal medicines, particularly in developed
countries like Australia. This report highlights different aspects of herbal
medicine including definition, the extent of use, safety and efficacy as well
as the potential side effects and adverse reactions.
Description
of Herbal Medicine
Herbal medicines are products originating
from herb materials which may have health benefits. According to the World
Health Organization (2000), ‘herbal materials include leaves, flowers, fruit,
seed, stems, wood, bark, roots, and rhizomes’. Any of these given herb materials contain multiple ingredients which can be extracted in different forms like, fresh
juices, gums, fixed oils, essential oils, resins, and dry powders. The preparation of herbal medicine varies in
different parts of the world. The production process may include steaming,
roasting, stir baking with honey, alcoholic beverages or other materials, (WHO,
2000).
The Extent of Use
of Herbal Medicine
The herbal medicine includes a
significant proportion of alternative medicinal treatments around the world. As
Chan (2003) mentions ‘around 70–8o percent of the world populations rely on
non-conventional medicine mainly of herbal sources.’ Despite scientific improvements in
conventional medicine and recent innovations in the sector of health services, data
indicates a remarkable growth in using herbal medicine in developed countries. ‘Nearly 1 in 5 adults in the United States report
taking an herbal product’ (Bent, 2008). In other developed countries, the extent
of use of herbal medicine is also quite high.
As Shaw (1998), states that ‘In 1994 the European herbal medicine market
was worth over £1.8 billion at retail selling prices.’
Efficacy of
Herbal Medicine
The efficacy of herbal medicinal
products has been debated for quite a long time. Scientifically, the efficacy
of any herbal remedy requires an evidence-based examination. Scientific
examination of several herbal medicines and suggest that the following herbal
medicines might have efficiency on specific health problems. Woolf (2003), states
that the effectiveness of these three herbal medicines is scientifically approved
in these particular treatments: Tea Tree Oil may be useful to remedying fungal
skin disorders, Artemisia seems to be associated with chloroquine in the treatment
of a specific kind of malaria, and St John’s Wort may help to treat mild
depression in adults. Furthermore, according to Myers and Cheras (2004), garlic may reduce blood
concentration; however, it may affect other conventional medicines like
paracetamol and chlorpropamide. Although the efficacy of some herbal medicine has
been examined, the effectiveness of other herbal medicine remains unverified,
inadequately observed or not even examined at all.
Safety of
Herbal Medicine
The safety of herbal medicine is a
complex issue interrelated to different factors including public perception and
the nature of plants. As Firenzuoli & Gori (2007) state, some herbal
medicines have a foundation in magical or religious beliefs. Furthermore, according
to Calixto (2000), most people think herbals are safe because they are natural
substances. However, there are un-scientific perceptions and cultural
superstitions with regards to using of herbal medicine, but the major circumstances
by which the safety of herbal medicines could be affected include, but not
limited to toxic hazards, side effects due to interaction with prescription medicine;
lack of regulation of herbal medicine; and contamination, adulteration, and overdose
usage.
· Toxic
Side Effects
There are many herbal medicines
with the potential for toxicity. The degree of toxicity may vary in different
herbal medicines. Furthermore, the toxic contaminants can originate from environmental
situations as well as the periods and processes of preparation, storage and carriage,
(Chan, 2003). Even though some toxic
herbals have been identified, many remain hazardous. As Calixto (2000), has noted ‘since 1978,
more than 4000 herbal medicines have been … marked out because of important
toxic effects and risks for human use.’
· Side
Effects due to Interaction with Prescription Drug
There are particular side effects
for some kind of herbal medicine. ‘Although herbs are often perceived as
“natural” and therefore safe, many different side effects have been reported
owing to active ingredients, contaminants, or interactions with drugs’ (Bent,
2008). According to Ekor (2014), the ordinary side effects associated with Kava vary from headache
and dizziness to gastrointestinal discomfort and redness of the eyes. Even though, side effects may be inherent in some
herbal medicine, when taken with prescription drugs there may be serious side
effects. In addition, due to the non-prescription
availability of herbal medicine, the potential risks of interaction with other
drugs, is quite difficult to be documented. Myers and Cheras (2004) state that patients
often do not advise their doctors that they are using herbal products and when
combined with prescription medicines the effect can be serious.
· Regulation
of Herbal Medicine
Regulation
of herbal medicine is required to assure consistency between studies and to ensure
the efficacy and safety of herbal drugs. Regulation of herbal medicine differs
based on regions and countries in the world. ‘Several regulatory models for herbal
medicines currently exist (Calixto, 2000). In many countries including the
United States herbal medicines are sold as a dietary supplement and there is
no regulation, while in some other countries like the UK, drug regulations are
applicable to some specific kind of herbals products. Global harmonization is essential to assure the efficacy and safety of herbal
medicine, which will
be achieved through well-controlled and randomized
clinical trials and regulation processes (Calixto, 2000).
· Contaminated
and Adulteration
Herbal medicine can be contaminated
in a variety of ways. Primarily contamination accrues during the preparation of
herbal medicine, though, contamination can happen in the periods of storage (Shaw,
1998). The intentional accumulation of
extra ingredients with herbal medicine is called adulteration, in which a safe
herb may be substituted with a wrong constituent. Contamination and adulteration are
potential factors for either study interference in research or serious health
effects for patients. Furthermore, there are herbal products which are deliberately
manipulated with the purpose of boosting its efficacy. This herbal process is
called adulteration. ‘Adulteration complicates adverse reaction monitoring
since the wrong plant may be investigated, and documented effects may be
associated with the wrong herb, (Shaw, 1998).
· Toxicity
by heavy metals
Toxicity can be caused by a higher concentration of heavy metals. According to Singh, et al (2011) “Prolonged
exposure to heavy metals such as cadmium, copper, lead, nickel, and zinc can
cause deleterious health effects in humans. Molecular understanding of plant
metal accumulation has numerous biotechnological implications also, the long
term effects of which might not be yet known.”
Conclusion
There has been a long history of
using herbal medicine, yet, the efficacy and safety of many herbal medicines
remain experimental. Even though, a variety of side effects, either intrinsic
or extrinsic have been observed, herbal medicine seems to be beneficial for
health. Therefore, further research to assess the the efficacy and safety of
herbal product is required.
Recommendations
·
Governments and related
institutions should launch a strategic work plan to ensure local regulation of
herbal medicine leading to global and international standardization.
·
Related institutions along with
governments should work to raise public awareness regarding the risks and side
effects of natural retrieved drugs particularly herbal medicine. This requires
a cumulative public awareness campaign, targeting the misperceptions of using
herbal medicine, emphasizing neither every natural substance is safe nor every
cultural attitude is accurate.
·
Manufacturers should feature the major
side effects on every individual herbal medicine packaging.
·
Further studies and research need
to be done aiming not only to find the positive aspects but also investigate
side effects of herbal medicine. In
order to conduct further research studies, government should raise funding in
this field.
Acknowledgment
The writer gratefully acknowledges the support provided by the writing
teacher, Jenny Parry during the course of preparation of this report.
Reference
List
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regulation. Journal of General Internal
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Calixto, J. B. (2000).
Efficacy, safety, quality control, marketing and regulatory guidelines for
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Brazilian Journal of Medical and Biological
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Chan, K. (2003).
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Ekor, M. (2014) The growing use of herbal medicines:
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Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1296770/pdf/jrsocmed00024-0008.pdf
Woolf, A, D. (2003) Herbal remedies and children: Do they work? are they harmful? the American Academy of Pediatrics. 112:240. Retrieved from: http://pediatrics.aappublications.org/content/112/Supplement_1/240.full.html#ref-list-1
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