Phyllis A. Balch, CNC
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 However, any compounding pharmacy can provide custom-made herbal products. To find a compounding pharmacist in your area, call the International Academy of Compounding Pharmacists. (See Appendix B: Resources.)
THE CASE FOR STANDARDIZATION
Herbs are plants. Just as there are very different outcomes of nature and nurture in the characteristics of individual people, there are many differences among individual plants. We all know that there are different kinds of teas and different vintages of wines and that there are low-acid and high-acid kinds of coffee. |
Simon Mills and Kerry Bone
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 The proven benefits of herbal products as alternatives are particularly relevant given the results of a study which found that, in almost half the patients seeking advice for anxiety, panic and phobias, the cause was benzodiazepines or alcohol. One researcher concluded that when symptoms persist following a distressing event, it is often the case that benzodiazepines or alcohol are sustaining them. |
| Adulterated herbal products which contain isolated chemicals added to an inert or herbal matrix and sold as a 'standardized extract'. One example is the addition of caffeine, which is cheap and readily available, to extracts of guarana and kola nut.
The concern that there may be manipulation of the key components of the herb to achieve standardization requires clarification. Apart from the fourth example above, there is little evidence of how and where this might have occurred. |
Michael T. Murray, N.D.
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 In Japan, the figure is thought to be even higher. herbal products are a major business in the United States as well, with an estimated annual sales figure of $1.3 billion dollars for 1992 and climbing.3 However, it is interesting to note that while annual sales of ginseng products in the United States in 1992 were roughly $10 million dollars, over 3 million pounds (roughly $100 million dollars) of American ginseng were exported.4-5
The rebirth of herbal medicine, especially in developed countries, is largely based on the renewed interest of scientific researchers. |
Michael T. Murray, N.D., Joseph E. Pizzorno, N.D.
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 Use ephedra- or tylophora-based herbal products in conjunction with licorice.
7. Use asthma medications as prescribed.
NOTE: In severe cases of asthma, the best treatment is a combined approach, using natural measures to reduce the allergic threshold and prevent acute attacks, along with proper drug treatment of acute attacks.
Diet
Eliminate all food allergens and food additives. If you have multiple food allergies, utilize a four-day rotation diet as effect occurs in one hour and lasts about five hours after administration. |
| Add to this the growing popularity of nutritional supplements and herbal products, and it becomes obvious that there is an emerging trend toward the use of natural medicine. It appears that the concepts and philosophy of naturopathic medicine will persist and be a major part of medicine in the future.
The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet, and in the cause and prevention of disease. |
American Medical Publishing
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| With the above guidelines in mind, here are some more, specific contraindications for a few of the most popular herbal products. Contraindicated means that the substance should not be mixed with another herb, or with a specific prescription drug.
Be advised that herbal and other botanical ingredients of dietary supplements include processed or unprocessed plant parts (bark, leaves, flowers, fruits, and stems), as well as extracts and essential oils. |
Phyllis A. Balch, CNC
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| Moreover, American manufacturers and distributors of herbal products keep current with scientific research in China, Europe, Japan, and especially Germany, places where herbs are part of mainstream medicine.
Another reason the revitalization of herbal medicine has come about is that while modern drugs have achieved a great deal in disease treatment, they also have contributed to ill health. Every modern drug comes with warnings of side effects. A standard textbook for pharmacists even states, "If a drug is stated to have no side effects, then it is strongly suspected it has no central benefit. |
| Clinical studies have shown that various herbal products are effective in treating allergies, asthma, lupus, and rheumatoid arthritis. Herbal medicine also has a unique potential usefulness in balancing the immune system in cases of chronic infection, preventing the immune system from turning on the body and causing destruction.
• Psychosomatic and psychiatric complaints. Chosen in consultation with a health-care provider who can recognize the need for emergency treatment, herbal medicine can be a valuable method of treating psychosomatic and psychiatric complaints. |
| For herbal products for unique individual needs, consult a compounding pharmacy. Compounding pharmacies are local drugstores that prepare custom-made medications of all kinds. Compounding pharmacists are usually "problem-solvers" who can prepare herbs (as well as most prescription medications) to meet specific individual needs that cannot be met by mass production at a factory. A compounding pharmacist can prepare herbs and medications using unique delivery systems, such as lozenges, lollipops, or transdermal gels. |
Linda B. White, M.D.
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 They also tell you how to read the labels of herbal products and how to choose the best product for you.
Once you've become informed about the basics of herbal medicine, you can look up information about your particular condition in three places. "The Remedies at a Glance," a chart beginning on page 48, gives a quick rundown of the drug and herb treatments most often recommended.
The chapters in part 3 provide more specific information about treatments for various conditions, including the potential side efects of each drug, as well as dosage information and safe-use guidelines for each herb. |
Simon Mills and Kerry Bone
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| Dosages of simple herbal products are often determined on the label. They are sometimes at smaller doses than used by a herbal practitioner. Production costs and selling prices effectively discourage heroic dosing and this is in any case inappropriate without trained practitioner supervision.
PHYTOTHERAPY AS A COMPONENT OF OTHER HEALING STRATEGIES
CONVALESCENCE
It is ironic that at the very time that healthcare has to deal with so much chronic and debilitated disease it has abandoned the best strategic approach inherited from tradition. |
Linda B. White, M.D.
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| The point is this: Just like drugs, herbs and herbal products have the potential to do good when used responsibly. But they may cause harm when used carelessly.
In addition to being less potent than drugs, herbs are usually cheaper. As an example, consider the "statin" drugs now widely prescribed to reduce cholesterol. Garlic also reduces cholesterol—not as dramatically, but a lot more economically. If your cholesterol is sky high, a statin-type drug might be the most medically advisable treatment. |
Sharol Tilgner, N.D.
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 Less herb is needed if it is made with high quality raw ingredients.
- herbal products that have been carefully grown and processed retain the energy or vital force of the plants.
• Age of the individual using the product.
- The very young and the elders usually need to take less of an herbal product.
• Weight of the individual using the product
- Doses should always be calculated on the weight of the individual.
• Sensitivity of the individual using the product.
- Everyone has different levels of sensitivity and individuals with the same body weight may need different doses. |
Kathi Keville
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 If you are ambitious enough to make your own herbal products, these basic, generic recipes will guide you. The general uses to which these preparations can be put are discussed earlier in this chapter, where the different types of preparations are explained. To find the recipes suitable to treat a particular condition, look up the specific maladies you wish to treat in the other sections of this book. |
| I first met Bob in the early 1970s at a crafts fair where I was selling herbal products. He said that he had made an herbal salve to heal his son Sierra's diaper rash, and when he told his friends about it, the requests poured in. After his second son, Sage, was born, Bob named his product for the two boys and began selling "Sierra Sage" salve to stores. He later expanded his herb business to include cough syrup for children. Today, he owns a large herb business. |
Janet Zand, LAc, OMD, Allan N. Spreed, MD, CNC, James B. LaValle, RPh, ND
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 The same is true of herbal products and homeopathic remedies. When taking them, particularly in the case of chronic conditions, it is a good idea to choose one that seems to be right for your condition and/or symptoms. Try it for a period of time—say, a week—and see how you feel. Then, if you like, add something else. By proceeding in this fashion, you accomplish two things. First, you will be aware of how each supplement or remedy makes you feel. Second, your body will have time to adjust to each addition.
Unless otherwise indicated, the recommendations in this book are for adults. |
| To be sure you are getting the best and purest product possible, however, we recommend that you use herbal products formulated by reputable manufacturers. The more you use herbs, the more comfortable you will become with this gentle, effective form of health care.
COMMON MEDICINAL HERBS
Any medication, including herbs, can cause an allergic reaction. An allergic reaction can happen with the first exposure or after you have taken the preparation several times. Symptoms of an allergic reaction can include rash, swelling, itching, and/or difficulty breathing. |
| Today, modern techniques are being used to process herbal products. These manufacturing steps are as elaborate as those used to produce manufactured pharmaceutical products—sometimes, in fact, even more elaborate.
Applying the principles of pharmaceutical manufacturing is done for good reason. Over the past forty years, scientists have worked to identify active ingredients and substances termed marker compounds in herbs. |
Simon Mills and Kerry Bone
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| This model predominates among medical doctors, particularly in Europe. herbal products are prescribed in the context of a conventional medical consultation and are viewed as an additional therapeutic option when chemical drugs are inappropriate. Preparations are usually in tablet form and often contain standardized extracts. Adherents to this style of herbal medicine will probably be most interested in the monograph section of this book but will hopefully enjoy learning about the practice of phytotherapy in a wider context. |
Janet Zand, LAc, OMD, Allan N. Spreed, MD, CNC, James B. LaValle, RPh, ND
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| HERBAL TREATMENT
When choosing herbal products, do not select tincture forms. Tinctures contain alcohol, which is strictly off-limits for those with cirrhosis.
¦ Bupleurum and dong quai, a Chinese herbal combination formula, improves digestion and relaxes the nervous system. In Chinese medicine, this formula is used to harmonize the liver and pancreas. Take 1,000 milligrams of a bupleurum and dong quai combination formula two or three times daily for two weeks out of every month (if you are a woman, take it for the two weeks prior to the anticipated onset of your menstrual period). |
Ralph Golan, M.D.
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 During pregnancy, no herbal products should be used unless prescribed by an appropriate health professional.
1. Has bacteriostatic action and suppresses prostaglandin-induced inflammation.
2. Enhances protein digestion and assimilation and decreases bowel transit time.
3. Increases intestinal pH (an alkalinizer) and reduces Candida growth and bacterial overgrowth.
4. Has a tonic effect on the bowel, without being a laxative.
5. |
Simon Mills and Kerry Bone
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| Nevertheless, a shadow was cast over both herbs and indeed on herbal products in general, spurring frequent articles and letters in the leading British journals on the the hidden dangers of herbal use.
It may be easier to publish reports in medical journals on the risks of herbal remedies than it is to prepare a publishable account of their efficacy. In the first case anecdotal evidence is the norm, in the latter case it would be dismissed out of hand. |
Kathi Keville
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| Eventually, you may find yourself preparing your own herbal products and maybe even growing or collecting your own medicinals.
Choose items that best suit the needs of your family. Most of the things you will need can be purchased at a natural food store. Or, if you prefer, you can make your own herbal remedies—just follow the recipes provided in this book. You'll find yourself using salves, compresses, poultices, teas and tinctures (all of which are discussed in detail in chapter 2). Add a few bandages, a pair of tweezers and the usual first-aid paraphernalia, and you'll be all set. |
| According to an investigation of herbal products in the United Kingdom in 1984, very little real skullcap is sold commercially, since this small plant is not easy to grow or harvest on a large scale. Instead, germander is sold as skullcap. This means that germander was probably responsible for two "skullcap" poisonings reported by the Riks Hospital in Norway in 1991. In Wales, four women who took the stress pills Neurelax and Kalms experienced temporary liver damage. |
Christopher Hobbs
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 Kerby, OR 97531 (503) 592-4114 blend of organic Shiitake mushrooms and herbs in powder form
Threshold Enterprises 2 3 Janis Way Scotts Valley, CA 95066 (408) 438-6851
Reishi, Shiitake, Grifola products in powder and liquid for wholesalers for retail orders:
Planetary herbal products Catalog
P.O. Box 7145
Santa Cruz, CA9506f
(408) 464-2003
Western Biologicals Box 283
Alder Grove, B.C. CANADA VOX 1A0 (604) 856-3339
Growing supplies for Shiitake, Oyster, Morels, Maitake, Reishi, etc. |
Jean Carper
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 Tyler, precisely because its government's regulatory system actively encourages natural remedies, making research worthwhile for consumers and doctors and profitable for companies that make and test herbal products. Much of the high-quality testing of natural remedies used in the United States and throughout the world, including St. John's wort (an antidepressant herb), valerian (an antianxiety herb), and echinacea (an antiviral herb), has been conducted in Germany.
In Germany the scientific-regulatory establishment simply has a different attitude toward the possibilities of natural remedies. |
Simon Mills and Kerry Bone
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| Finished herbal products also need to undergo testing before their release. Boxes 5.3 and 5.4 provide examples of possible testing protocols for finished products.
MICROBIAL CONTAMINATION
Since plants come from nature, herbal raw materials carry a microbial burden which needs to be reduced during processing.
The European Pharmacopoeia sets limits for microbial contamination for herbal remedies in Category 4 under Part 1, VIII.15 Microbial Quality of Pharmaceutical Preparations (1995) as follows.
A. |
the Editors of PREVENTION
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 So do similar topical herbal products (those that are applied to the skin) such as ointments, balms, creams, and lotions.
Poultice. Herbal remedies can be pretty darn simple. A poultice is little more than mashed or ground herbs in the form of a soft, semi-liquid, pulplike mass that is usually spread over wounds, bites, or sores and held in place with a bandage or cloth.
Compress. Here's another simple concept that can work. All we're talking about here is a cloth or pad that you press to your skin. |
Linda B. White, M.D.
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| It also releases product safety alerts regarding adulteration—that is, contamination with an unlabeled substance —of herbal products and it publishes an important reference work, the Botanical Safety Handbook.
There's also the Natural Nutritional Foods Association (NNFA), a group of manufacturers and retailers devoted to product quality and truth in packaging and advertising. Among its many activities, the NNFA supports a True Label Program intended to ensure that the products put out by its members actually contain what their labels claim. |
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