To Your Health:

Herbs – Should You Be Using Them?

By Nancy DiMarco, Ph.D.

Americans spent $17 billion in 2001 on dietary and herbal supplements, and an estimated 124 million Americans are using amino acids, enzymes, herbs, minerals and vitamins to treat a smorgasbord of ills, pains, sleeplessness, lose weight, increase sex drive or improve memory.

The question that I frequently get asked is: "Should I be using _____?"

Not since the early 1900s have so many people purchased so many products without much sound science to back up the product's claims, according to a study by the Food and Drug Administration. The FDA has documented close to 3,000 adverse events from people using ephedra, gingko, St. John’s Wort, ginseng, to name but a few. Of those 3,000 events, 104 were deaths. The FDA also estimates that for every adverse event, at least 100 more go unreported.

This is not to say that herbal products aren’t effective, but rather that many manufacturers today pay very little attention to either safety or efficacy and may be more motivated by making a buck than wanting to alleviate medical problems.
Over the next few columns, I will focus on a few of the most popular herbal supplements and examine the claims, facts and concerns about these interesting plants. This time, I’d like to focus attention on Echinacea and valerian.

Of all herbs on the market, valerian is the fastest selling product in the U.S. Valerian is an effective and reliable sedative and sleep aid.

It is effective in conditions of anxiety, insomnia and nervous irritability. Unlike prescription or over-the-counter sleep and anxiety medication, it is not habit-forming nor does it produce a hang-over-like side effect. Almost every herbal sleep remedy contains valerian. It targets the same neurotransmitter in the central nervous system as those drugs prescribed by physicians.

ConsumerLab.com notes that if you purchase valerian, it should contain the rhizomes (roots) that are associated with valerenic acid, the "marker compound" for valerian. While there is more than one species of valerian, some of the products manufactured from plants other than valeriana officinalis have been found to contain didrovaltrate, a toxic compound.

In Canada, England, France, Switzerland, and several other countries, valerian has been approved as a sedative. Even though we do not have definitive clinical studies to support its effectiveness, anecdotal evidence is convincing even hard core researchers to try it.

So why the concern?

The biggest concern is lack of rigorous control over the manufacturing of dietary and herbal supplements. Of 17 popular, over-the-counter valerian products tested by ConsumerLab.com, four of them had no marker compound and four others had half of the claimed content.

In other words, almost half of the tested products failed. This troubling fact should make consumers even more wary of dietary and herbal supplements.

Valerian also can have side effects, including blurred vision, headaches, heart palpitations, nausea, and in some people excitedness and restlessness. The U.S. Pharmacopeial Convention advises — since long-term studies of valerian’s safety and efficacy have not been completed — that people should not take it for more than two weeks at a time. The amount considered to be safe by the Physician’s Desk Reference for Herbal Medicines is 2-3 grams, three times a day, but not while taking any other form of sleep-inducing product, alcohol or while driving.

Echinacea, also called Purple Coneflower and native to the U.S., was the most widely used medicinal plant of the Central Plains Indians. The leaf and root are mildly antibacterial, antiviral and used for healing wounds. German research has confirmed, in numerous clinical studies, the usefulness of Echinacea purpurea in strengthening the body's immune system as well as for prevention and natural treatment of colds and flu.

However, in a recent study published in the Annals of Internal Medicine, researchers determined that Echinacea had no effect on the length or severity of cold symptoms of 148 university students participating in a double blind, placebo-controlled study (the gold standard for clinical trials).

Phenols, the marker compounds present in Echinacea, are thought to ward off the common cold by stimulating the immune system, particularly those cells responsible for destroying harmful bacteria and preventing viruses from reproducing.

In Germany, Echinacea is an approved product to treat colds, flu and upper respiratory tract infections. However, in Germany, the herbal market is highly controlled and many herbs need a prescription from a physician to be used.
When ConsumerLab.com tested 25 Echinacea products available in the U.S., five were disqualified for having less than the advertised active ingredient or for having bacterial contamination three times the limit set by the World Health Organization, six were disqualified for improper labeling, leaving just over half of the products with a passing score.

Echinacea use should start at the onset of symptoms, not be used for longer than two weeks and not be used by persons who have autoimmune disorders such as rheumatoid arthritis or by people allergic to members of the asteraceae family (daisy), according to published usage recommendations. The recommended dose of the extract is 300 mg, three times a day.

It is becoming increasingly important for consumers to do their homework when it comes to health products because you don’t always get what you pay for. In the long run, good nutrition from real food and moderate exercise are really hard to beat.

Dr. Nancy DiMarco is a research professor in the Department of Nutrition and Food Sciences, the nutrition coordinator for the Institute for Women's Health and coordinator of the master's program in Exercise and Sports Nutrition at Texas Woman's University. She can be reached at ndimarco@twu.edu.

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