It is very important that people do not self-diagnose any health conditions. Any medication herbal or otherwise should be taken under the supervision of a knowledgeable and qualified practitioner.

Herbal medicines can be mistakenly thought to be completely safe because they are 'natural' products. This is not always correct. Herbal medicines may produce negative effects that can range from mild to severe, including:.

Like other prescription medications, herbal medicine should always be prescribed by a qualified and registered practitioner. Contact the professional association for your chosen therapy and ask for a list of members in your area. This may include:.

During the first visit with your practitioner, ask about their training and qualifications. Be very cautious about any practitioner who advises you to abandon your conventional medical treatment. Herbal medications and supplements may interact in harmful ways with over-the-counter or prescription medicines you are taking.

Taking herbal supplements may increase or decrease the effectiveness of other drugs you are taking or may increase the risk of negative side effects. If you are considering taking herbal medicines, it is always a good idea to talk to your doctor about possible side effects and interactions with other medications you are taking.

Not all herbal medicines that are sold are safe. Always purchase from a source that stocks products from a reputable manufacturer or supplier, such as health food stores, supermarkets, pharmacies or from a reputable practitioner. Be careful about purchasing herbal medicines over the internet.

Unregulated herbal medicines from overseas may not be manufactured to the same quality and standard as regulated medicines. In some cases, products purchased online have been found to have dangerous levels of lead , mercury or arsenic, which can cause serious health problems. Herbal medicines made in Australia are subject to regulations.

Consult with your pharmacist about the safety and effectiveness of the herbal medicine or supplements you are thinking of buying. If you are considering taking herbal medicine, it is recommended that you:.

This page has been produced in consultation with and approved by:. Acupuncture is part of traditional Chinese medicine and consists of inserting fine needles into specific points on the skin.

The Alexander technique stresses that movement should be economical and needs only the minimum amount of energy and effort. The different smells and chemical constituents of aromatherapy oils can produce different emotional and physiological reactions.

Ayurveda is an ancient healing system from India that uses a range of techniques to treat illness and encourage wellbeing.

Bowen is a holistic remedial body technique that works on the soft connective tissue fascia of the body.

Bowen therapy can be used to treat musculoskeletal or related neurological problems including acute sports injuries and chronic or organic conditions.

It is gentle and relaxing and does not use forceful manipulation. Content on this website is provided for information purposes only.

Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website.

All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances.

The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Skip to main content. Complementary and alternative care. Home Complementary and alternative care. Herbal medicine. Actions for this page Listen Print.

Summary Read the full fact sheet. On this page. What is herbal medicine? Active ingredients and herbal medicine Medicinal uses for specific herbs Do not self-diagnose ailments Special considerations for herbal medicine Where to get help. Active ingredients and herbal medicine Herbal medicines contain active ingredients.

Medicinal uses for specific herbs Herbal medicine aims to return the body to a state of natural balance so that it can heal itself. Some herbs that are commonly used in herbal medicine, and their traditional uses, include: Echinacea — to stimulate the immune system and aid the body in fighting infection.

Used to treat ailments such as boils , fever and herpes. Dong quai dang gui — used for gynaecological complaints such as premenstrual tension , menopause symptoms and period pain.

Some studies indicate that dong quai can lower blood pressure. With this continued trend, products from plants and natural sources such as fungi and marine microorganisms or analogs inspired by them have contributed greatly to the commercial drug preparations today. Examples include antibiotics e.

Between and , 13 drugs derived from natural products were approved in the United States. Average life expectancy at birth has increased from around 41 years in the early s to approaching 80 years in many developed countries. Consequently, the percentage of elderly people 65 years and above in our populations is increasing.

The graying of our populations brings an increasing burden of chronic age-related disease and dependency. Aging is associated with a progressive decline in physiological function and an increased risk of pathological changes leading to cancer, cardiovascular disease, dementia, diabetes, osteoporosis, and so on.

Lifestyle factors such as nutrition or exercise play an important role in determining the quality and duration of healthy life and in the treatment of chronic diseases Bozzetti ; Benzie and Wachtel-Galor , It is most likely that there is no one cause of aging, and different theories of aging have been suggested over the years.

Genetic factors are undoubtedly important, but among all the metabolic theories of aging, the oxidative stress theory is the most generally supported theory Harman ; Beckman and Ames This theory postulates that aging is caused by accumulation of irreversible, oxidation-induced damage oxidative stress resulting from the interaction of reactive oxygen species with the DNA, lipid, and protein components of cells.

However, even if the aging process itself is found to be unrelated to oxidative stress, highly prevalent chronic age-related diseases all have increased oxidative stress Holmes, Bernstein, and Bernstein ; Beckman and Ames ; Finkel and Holbrook ; Rajah et al.

Antioxidants in herbs may contribute at least part of their reputed therapeutic effects Balsano and Alisi ; Tang and Halliwell Given the market value, potential toxicity and increasing consumer demand, particularly in the sick and elderly members of our populations, regulation of production and marketing of herbal supplements and medicines require attention.

In , the U. gov , last access: November 5, , and the European Scientific Cooperative on Phytotherapy ESCOP was founded in with the aim of advancing the scientific status and harmonization of phytomedicines at the European level www.

com , last access: November 5, This led to an increase in investment in the evaluation of herbal medicines. While this scale of investment is low compared to the total research and development expenses of the pharmaceutical industry, it nevertheless reflects genuine public, industry, and governmental interest in this area Li and Vederas With tremendous expansion in the interest in and use of traditional medicines worldwide, two main areas of concern arise that bring major challenges.

These are international diversity and national policies regarding the regulation of the production and use of herbs and other complementary medicines and their quality, safety, and scientific evidence in relation to health claims WHO ; Sahoo et al.

The diversity among countries with the long history and holistic approach of herbal medicines makes evaluating and regulating them very challenging.

In addition, there are a great number of different herbs used. Legislative criteria to establish traditionally used herbal medicines as part of approved health care therapies faces several difficulties. In a survey conducted across countries, WHO reported the following issues regarding herbal medicines: lack of research data, appropriate mechanisms for control of herbal medicines, education and training, expertise within the national health authorities and control agency, information sharing, safety monitoring, and methods to evaluate their safety and efficacy.

The support needed from different countries includes information sharing on regulatory issues, workshops on herbal medicines safety monitoring, general guidelines on research and evaluation of herbal medicines, provision of databases, herbal medicine regulation workshops, and international meetings.

National policies are the basis for defining the role of traditional medicines in national health care programs, ensuring that the necessary regulatory and legal mechanisms are established for promoting and maintaining good practice, assuring the authenticity, safety, and efficacy of traditional medicines and therapies, and providing equitable access to health care resources and their resource information WHO Another fundamental requirement is harmonization of the market for herbal medicines for industry, health professionals, and consumers Mahady Herbal medicines are generally sold as food supplements, but a common regulatory framework does not exist in different countries.

As a result, information on clinical indications for their use, efficacy, and safety are influenced by the traditional experience available in each place. A brief outline of the legislation in United States, Canada, and Europe is given in this section, and could be used to guide the legal aspects of the herbal medicine industry in other countries.

In the United States, under the Dietary Supplement Health and Education Act DSHEA of , any herb, botanical and natural concentrate, metabolite and constituent of extract, is classified as a dietary supplement.

Dietary supplements do not need approval from the Food and Drug Administration FDA before they are marketed FDA Under DSHEA, herbal medicines, which are classified as dietary supplements, are presumed safe, and the FDA does not have the authority to require them to be approved for safety and efficacy before they enter the market, which is the case for drugs.

This means that the manufacturer of the herbal medicine is responsible for determining that the dietary supplements manufactured or distributed are indeed safe and that any representations or claims made about them are sustained by adequate evidence to show that they are not false or misleading.

Regarding contamination, the FDA has not issued any regulations addressing safe or unsafe levels of contaminants in dietary supplements but has set certain advisory levels in other foods FDA ; Gao A product being sold as an herbal supplement dietary supplement in the United States cannot suggest on its label or in any of its packaging that it can diagnose, treat, prevent, or cure a specific disease or condition without specific approval from the FDA.

A claim also cannot suggest an effect on an abnormal condition associated with a natural state or process, such as aging FDA ; Gao In Canada, herbal remedies must comply with the Natural Health Products Regulations Health Canada According to these regulations, all natural products require a product license before they can be sold in Canada.

In order to be granted a license, detailed information on the medicinal ingredients, source, potency, nonmedicinal ingredients, and recommended use needs to be furnished.

Once a product has been granted a license, it will bear the license number and follow standard labeling requirements to ensure that consumers can make informed choices.

A site license is also needed for those who manufacture, pack, label, and import herbal medicines. In addition, GMPs must be employed to ensure product safety and quality. This requires that appropriate standards and practices regarding the manufacture, storage, handling, and distribution of natural health products be met.

The GMPs are designed to be outcome based, ensuring safe and high-quality products, while giving the flexibility to implement quality control systems appropriate to the product line and business.

Product license holders are required to monitor all adverse reactions associated with their product and report serious adverse reactions to the Canadian Department of Health. The directive establishes that herbal medicines released on the market need authorization by the national regulatory authorities of each European country and that these products must have a recognized level of safety and efficacy Calapai The registration of herbal medicinal products needs sufficient evidence for the medicinal use of the product throughout a period of at least 30 years in the European Union EU , at least 15 years within the EU, and 15 years elsewhere for products from outside the EU.

With regard to the manufacturing of these products and their quality, products must fulfill the same requirements as applications for a marketing authorization.

Information is based on the availability of modern science—based public monographs in the European Pharmacopeia and their equivalents developed by the pharmaceutical industry. The standards put forward allow not only to define the quality of products but also to eliminate harmful compounds, adulteration, and contamination.

Within the EU, a number of committees were set up to attempt and standardize the information and guidelines related to herbal medicines. A variety of materials has been produced, such as monographs on herbs and preparations, guidelines on good agricultural and collection practice for starting materials of herbal origin, and guidelines on the standardization of applications and setting up pragmatic approaches for identification and quantitative determination of herbal preparations and their complex compositions Routledge ; Vlietinck, Pieters, and Apers Herbal medicine has been commonly used over the years for treatment and prevention of diseases and health promotion as well as for enhancement of the span and quality of life.

However, there is a lack of a systematic approach to assess their safety and effectiveness. The holistic approach to health care makes herbal medicine very attractive to many people, but it also makes scientific evaluation very challenging because so many factors must be taken into account.

Herbal medicines are in widespread use and although many believe herbal medicines are safe, they are often used in combination and are drawn from plant sources with their own variability in species, growing conditions, and biologically active constituents.

Herbal extracts may be contaminated, adulterated, and may contain toxic compounds. The quality control of herbal medicines has a direct impact on their safety and efficacy Ernst, Schmidt, and Wider ; Ribnicky et al. But, there is little data on the composition and quality of most herbal medicines not only due to lack of adequate policies or government requirements but also due to a lack of adequate or accepted research methodology for evaluating traditional medicines WHO ; Kantor In addition, there is very little research on whole herbal mixtures because the drug approval process does not accommodate undifferentiated mixtures of natural chemicals.

To isolate each active ingredient from each herb would be immensely time-consuming at a high cost, making it not cost-effective for manufacturers Richter Another problem is that despite the popularity of botanical dietary and herbal supplements, some herbal products on the market are likely to be of low quality and suspect efficacy, even if the herb has been shown to have an effect in controlled studies using high-quality product.

There is a belief that herbs, as natural products, are inherently safe without side effects and that efficacy can be obtained over a wide range of doses.

A major hypothetical advantage of botanicals over conventional single-component drugs is the presence of multiple active compounds that together can provide a potentiating effect that may not be achievable by any single compound.

This advantage presents a unique challenge for the separation and identification of active constituents. Compounds that are identified by activity-guided fractionation must be tested in appropriate animal models to confirm in vivo activity.

Ideally, the composition of the total botanical extract must be standardized and free of any potential hazards, and plants should be grown specifically for the production of botanical extracts under controlled conditions and originate from a characterized and uniform genetic source with a taxonomic record of the genus, species, and cultivar or other additional identifiers.

Records should be maintained for the source of the seed, locations and conditions of cultivation, and exposure to possible chemical treatments such as pesticides. Because the environment can significantly affect phytochemical profiles and the efficacy of the botanical end product, botanical extracts can vary from year to year and may be significantly affected by temperature, drought, or flood as well as by geographic location.

Therefore, biochemical profiling must be used to ensure that a consistent material is used to produce a botanical. The concentration step can also be challenging, and the process to concentrate active compounds to a sufficient level can negatively affect their solubility and bioavailability.

Therefore, improving efficacy by increasing concentration can be counterproductive, and the use of solubilizers and bioenhancers needs to be considered just as for drugs Ribnicky et al. However, there are major challenges to achieving this.

Although in theory botanicals should be well characterized and herbal supplements should be produced to the same quality standards as drugs, the situation in practice is very different from that of a pure drug.

Herbs contain multiple compounds, many of which may not be identified and often there is no identifier component, and chemical fingerprinting is in its early stages and is lacking for virtually all herbs see Chapter This makes standardization of botanicals difficult, although some can be produced to contain a standardized amount of a key component or class of components, such as ginsenosides for ginseng products or anthocyanins for bilberry products see Chapter 4 on bilberry and Chapter 8 on ginseng in this volume.

However, even when such key compounds have been identified and a standard content is agreed or suggested, there is no guarantee that individual commercial products will contain this.

Another interesting point to consider is that herbal materials for commercial products are collected from wild plant populations and cultivated medicinal plants.

The expanding herbal product market could drive overharvesting of plants and threaten biodiversity. Poorly managed collection and cultivation practices could lead to the extinction of endangered plant species and the destruction of natural resources. It has been suggested that 15, of 50,—70, medicinal plant species are threatened with extinction Brower The efforts of the Botanic Gardens Conservation International are central to the preservation of both plant populations and knowledge on how to prepare and use herbs for medicinal purposes Brower ; Li and Vederas Research needs in the field of herbal medicines are huge, but are balanced by the potential health benefits and the enormous size of the market.

Research into the quality, safety, molecular effects, and clinical efficacy of the numerous herbs in common usage is needed. Newly emerging scientific techniques and approaches, many of which are mentioned in this book, provide the required testing platform for this. Genomic testing and chemical fingerprinting techniques using hyphenated testing platforms are now available for definitive authentication and quality control of herbal products.

They should be regulated to be used to safeguard consumers, but questions of efficacy will remain unless and until adequate amounts of scientific evidence accumulate from experimental and controlled human trials Giordano, Engebretson, and Garcia ; Evans ; Tilburt and Kaptchuk Evidence for the potential protective effects of selected herbs is generally based on experiments demonstrating a biological activity in a relevant in vitro bioassay or experiments using animal models.

In some cases, this is supported by both epidemiological studies and a limited number of intervention experiments in humans WHO In general, international research on traditional herbal medicines should be subject to the same ethical requirements as all research related to human subjects, with the information shared between different countries.

This should include collaborative partnership, social value, scientific validity, fair subject selection, favorable risk-benefit ratio, independent review, informed consent, and respect for the subjects Giordano, Engebretson, and Garcia ; Tilburt and Kaptchuk However, the logistics, time, and cost of performing large, controlled human studies on the clinical effectiveness of an herb are prohibitive, especially if the focus is on health promotion.

Therefore, there is an urgent need to develop new biomarkers that more clearly relate to health and disease outcomes. Predictor biomarkers and subtle but detectable signs of early cellular change that are mapped to the onset of specific diseases are needed.

Research is needed also to meet the challenges of identifying the active compounds in the plants, and there should be research-based evidence on whether whole herbs or extracted compounds are better. The issue of herb—herb and herb—drug interactions is also an important one that requires increased awareness and study, as polypharmacy and polyherbacy are common Canter and Ernst ; Qato et al.

The use of new technologies, such as nanotechnology and novel emulsification methods, in the formulation of herbal products, will likely affect bioavailability and the efficacy of herbal components, and this also needs study. Smart screening methods and metabolic engineering offer exciting technologies for new natural product drug discovery.

Advances in rapid genetic sequencing, coupled with manipulation of biosynthetic pathways, may provide a vast resource for the future discovery of pharmaceutical agents Li and Vederas This can lead to reinvestigation of some agents that failed earlier trials and can be restudied and redesigned using new technologies to determine whether they can be modified for better efficacy and fewer side effects.

For example, maytansine isolated in the early s from the Ethiopian plant Maytenus serrata , looked promising in preclinical testing but was dropped in the early s from further study when it did not translate into efficacy in clinical trials; later, scientists isolated related compounds, ansamitocins, from a microbial source.

A derivative of maytansine, DM1, has been conjugated with a monoclonal antibody and is now in trials for prostate cancer Brower Plants, herbs, and ethnobotanicals have been used since the early days of humankind and are still used throughout the world for health promotion and treatment of disease.

Still, herbs, rather than drugs, are often used in health care. For some, herbal medicine is their preferred method of treatment. For others, herbs are used as adjunct therapy to conventional pharmaceuticals.

However, in many developing societies, traditional medicine of which herbal medicine is a core part is the only system of health care available or affordable. Regardless of the reason, those using herbal medicines should be assured that the products they are buying are safe and contain what they are supposed to, whether this is a particular herb or a particular amount of a specific herbal component.

Consumers should also be given science-based information on dosage, contraindications, and efficacy. To achieve this, global harmonization of legislation is needed to guide the responsible production and marketing of herbal medicines. If sufficient scientific evidence of benefit is available for an herb, then such legislation should allow for this to be used appropriately to promote the use of that herb so that these benefits can be realized for the promotion of public health and the treatment of disease.

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Show details Benzie IFF, Wachtel-Galor S, editors. Search term. Chapter 1 Herbal Medicine An Introduction to Its History, Usage, Regulation, Current Trends, and Research Needs.

I nternational D iversity and N ational P olicies The diversity among countries with the long history and holistic approach of herbal medicines makes evaluating and regulating them very challenging. Q uality , S afety , and S cientific E vidence Herbal medicine has been commonly used over the years for treatment and prevention of diseases and health promotion as well as for enhancement of the span and quality of life.

RESEARCH NEEDS Research needs in the field of herbal medicines are huge, but are balanced by the potential health benefits and the enormous size of the market. Antioxidant effects of natural bioactive compounds. Curr Pharm Des. Barnes P. M, Bloom B, Nahin R. Complementary and alternative medicine use among adults and children: United States, CDC National Health Statistics Report pdf access date: 5 Nov.

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