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Herbal remedies

Published by Bupa's health information team, July 2009.

This factsheet is for people who are planning to take herbal remedies, or who would like information about them.

Herbal remedies are made from plants or plant extracts. There are numerous herbal products available that claim to treat the symptoms of a wide range of problems, from depression to colds and flu.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your herbal practitioner's advice.

• About herbal remedies
• Where can I find a herbal practitioner?
• About the treatment
• Is it effective?
• What are the risks?
• Questions and answers
• Related topics
• Further information
• Sources

About herbal remedies

Herbal remedies are made from plant materials that are used to treat disease and maintain good health. They have been used since the beginning of human history. There are different types of therapies that use plants as remedies including:

• Ayurveda, which affects your mind and body together with herbal remedies, yoga, massage, diet and meditation
• Kampo, which uses similar techniques to Chinese medicine and involves the study of herbs to help illness
• traditional Chinese medicine, which works on the same principles as Ayurveda and uses herbs to boost or disperse qi (energy)
• traditional Tibetan medicine, which uses herbal remedies as well as diet changes and therapies such as acupuncture to help illness
• Unani-tibb, which has an emphasis on restoring balance by encouraging healing from within
• western herbal medicine

This factsheet will focus on western herbal medicine.

Herbal remedies (often referred to as herbal medicines) have been used in the UK for centuries. They are used mostly as a complementary treatment (one given alongside conventional treatments).

Many conventional medicines actually originate from a single active ingredient of a plant. For example, the painkiller aspirin comes from the bark of willow trees and digoxin (a medicine used to treat heart failure) comes from the foxglove plant. Scientists often try to separate a single active ingredient of a plant and produce it on a large scale in a laboratory.

This is the opposite of herbal remedies, which may contain dozens of different ingredients. Herbalists believe that all the elements are in balance within a plant and so it's important to keep them together. The different components are made more powerful through the presence of the others.

Examples of specific herbs and the conditions they are used to treat include the following.

• St John's wort is used to treat depression.
• Echinacea may be useful in treating the early stages of a cold in adults.
• Serenoa repens provides mild-to-moderate improvement in symptoms of an enlarged prostate gland (benign prostatic hyperplasia).
• An extract of hawthorn, used in addition to conventional treatments, may be of benefit to people with chronic heart failure.
• Ginger may relieve the sensation of feeling sick and vomiting.
• Melissa officinalis (lemon balm) and Salvia officinalis (sage) may improve mental ability in people with Alzheimer's disease.
• Horse chestnut seed extract has been shown to be effective at treating the symptoms of chronic venous insufficiency.
• Certain herbs including Petasites hybridus (butterbur) may be an effective treatment for hay fever, although more research is needed to confirm this.

There is a range of conventional treatments for the health conditions listed. It's important to be aware that the active ingredients in herbal remedies and conventional medicines can interact so always ask your GP for advice.

Where can I find a herbal practitioner?

You can treat yourself with herbal remedies and there is a huge range available as tablets, capsules, ointments and creams. You can buy these in health food shops, pharmacies and even supermarkets.

For more serious health problems, you may want to see a trained herbal practitioner - or herbalist. There is currently no state registration, but herbal practitioners who are members of the National Institute of Medical Herbalists will have trained for at least three years, are insured and follow the institute's code of conduct. You can search for a herbal practitioner on the National Institute of Medical Herbalists' website.

Some herbal practitioners work alongside doctors and your GP may be able to refer you, but this is likely to be to a private practitioner.

About the treatment

It's important to visit your GP before having herbal remedy treatment, to help diagnose your condition and to ensure that herbal remedies are an appropriate treatment for you.

If you decide to visit a herbal practitioner, you will first have a detailed consultation. The herbal practitioner will ask you questions about your medical history, diet and lifestyle. He or she may also examine you. You can ask any questions you might have.

Your initial consultation will last about an hour. If you have any further appointments, they will be shorter than the first, as your herbal practitioner will already have your background information.

Your herbal practitioner is likely to suggest changes to your lifestyle and diet as well as prescribe herbal remedies. You may be prescribed a remedy that is made up of several different herbs as the herbalist will adapt it to fit your individual needs. The remedy will be individual to you and based on your characteristics. For example, 10 different people being treated for depression would each receive a different mixture.

There are many forms that your remedy may come in, such as syrups, capsules, creams or tinctures (a blend of herbal extracts in an alcohol/water base). It's also possible for remedies to be taken as infusions (teas) and juices.

You may have follow-up appointments every two to three weeks to monitor your progress. However, this will depend on your circumstances.

Is it effective?

The scientific evidence for the claims of herbal remedies is of variable quality. The research is often conflicting and while symptoms of some illnesses improve, the best evidence generally fails to prove that herbal remedies cure illnesses.

There are herbal remedies available that claim to treat almost any common complaint, but there is often limited scientific evidence that these really work. While there is good evidence to show that certain herbal remedies work, for example St John's wort for depression, it's important to realise that prescribing specific herbal mixtures for individual patients' characteristics hasn't been shown to be effective.

What are the risks?

There is no statutory regulation of herbal practitioners at present. However, the UK government is in the process of introducing a system to regulate both herbal remedies and herbal practitioners.

Like any medicine, herbal remedies can have side-effects. There have been reports of fatal poisonous effects with some herbal remedies. For example, kava, which comes from a member of the pepper family and is used in some countries to treat conditions such as anxiety and tension, is suspected to cause severe liver poisoning. Some Chinese herbal remedies have also been shown to cause serious kidney problems.

If you have an adverse reaction to a herbal remedy, there is a system called the Yellow Card Scheme for reporting and recording these to the Medicines and Healthcare products Regulatory Agency (MHRA). You can do this yourself or your GP can do it for you.

Herbal remedies may interact with other medicines. For example, St John's wort can interact with the contraceptive pill, medicines that thin your blood, such as warfarin, and immunosuppressant medicines. If you're taking any medicines, it's important to speak to your GP or pharmacist before taking any herbal remedies. Don't stop taking any prescribed medicine without speaking to your GP first.

If you have certain medical conditions, it's important to seek advice from a herbal practitioner or a doctor before you take herbal remedies. Consult your GP or pharmacist before taking herbal remedies if you have:

• a heart condition
• had or are about to have an operation
• epilepsy
• type 1 diabetes

If you're pregnant or breastfeeding you shouldn't use any herbal medicines as their safety hasn't been established and they could harm both you and your unborn baby.

Herbal remedies have been widely used for many years and may be useful for self-treating minor illnesses. However, natural doesn't mean harmless and it's important not to exceed the recommended doses.

Related topics

• Aromatherapy
• Epilepsy
• Homeopathy
• Type 1 diabetes

Further information

• National Institute of Medical Herbalists
  01392 426022
  www.nimh.org.uk
• Medicines and Healthcare products Regulatory Agency
  020 7084 2000
  www.mhra.gov.uk

Sources

• Report to Ministers from the Department of Health steering group on the statutory regulation of practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional medicine systems practised in the UK. Department of Health, www.dh.gov.uk, 2008
• A potted history of herbal medicine. National Institute of Medical Herbalists. www.nimh.org.uk, accessed 28 January 2009
• Public health risk with herbal medicines: an overview. Medicines and Healthcare products Regulatory Agency. www.mhra.gov.uk, July 2008
• Herbal medicine. National Institute of Medical Herbalists. www.nimh.org.uk, accessed 28 January 2009
• Linde K, Berner MM, Kriston L. St John's wort for major depression. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD000448. DOI: 10.1002/14651858.CD000448.pub3 www.cochrane.org
• Linde K, Barrett B, Bauer R, et al. Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000530. DOI: 10.1002/14651858.CD000530.pub2 www.cochrane.org
• Wilt T, Ishani A, MacDonald R. Serenoa repens for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001423. DOI: 10.1002/14651858.CD001423 www.cochrane.org
• Guo R, Pittler MH, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD005312. DOI: 10.1002/14651858.CD005312.pub2. www.cochrane.org
• Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth 2000; 84(3):367-71
• Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, et al. The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis. Am J Obstet Gynecol 2006; 194(1):95-9
• Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005; 105(4):849-56
• Man SC, Durairajan SSK, Kum WF, et al. Systematic review on the efficacy and safety of herbal medicines for Alzheimer's disease. J Alzheimers Dis 2008; 14(2):209-23.
• Pittler MH, Ernst E. Horse-chestnut for chronic venous insufficiency. Arch Dermatol 1998; 134:1356-60
• Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol 2007; 99(6):483-95
• Guo R, Canter PH, Ernst E. A systematic review of randomised clinical trials of individualised herbal medicine in any indication. Postgrad Med J 2007; 83:633-37
• Find a herbalist. The National Institute of Medical Herbalists. www.nimh.org.uk, accessed 29 January 2009
• What happens during a consultation with a medical herbalist? The National Institute of Medical Herbalists. www.nimh.org.uk, accessed 29 January 2009
• Herbal medicine: for a naturally healthy life. The National Institute of Medical Herbalists. www.nimh.org.uk, accessed 29 January 2009
• Safety of herbal medicinal products. Medicines and Healthcare products Regulatory Agency. www.mhra.gov.uk, 2002
• Krumme B, Endmeir R, Vanhalelen M, et al. Reversible Fanconi syndrome after ingestion of a Chinese herbal 'remedy' containing aristolochic acid. Nephrol Dial Transplant 2001; 16:400-28
• Complementary therapies. National Society for Epilepsy. www.epilepsynse.org.uk, accessed 29 January 2009
• Complementary therapies. Diabetes UK. www.diabetes.org.uk, accessed 29 January 2009
• Pharmacists - the scientists in the high street: herbal remedies. Royal Pharmaceutical Society of Great Britain. www.rpsgb.org, aaccessed 29 January 2009

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for advice from a qualified health professional.

Publication date: July 2009