Herb use roundup

Here is a quick review of some information that can shed light on who is using herbal and complementary medicines today. My comments at the end.

• Alternative Therapies (vol 13, number 2, March/April 2007) produced two interesting studies on herb use. In the first, a survey was conducted amongst over 30,000 adults asking about the use of a limited number of herbs and supplements (29 of 35 were herbal). During the last year, about 20% of respondents reported using one of the products. Factors associated with use were: age 45 to 64; being uninsured; being female; living in the West; using prescription and OTC medicines; having education beyond high school; and being of non-Hispanic ethnicity. The most common herbs: Echinacea, ginseng, ginkgo, garlic - most often used for head and chest colds, followed by muscoloskeletal complaints, and GI tract issues. Crucially, over half of respondents did not inform their primary care doctors about the use of herbs. Cost of conventional treatment was often cited as a factor leading to herb use.
• The second study in Alternative Therapies followed over 800 people coming through outpatient clinics in San Jose, California. The population here was about 45% Hispanic, but of those who used herbs, 52% were Hispanic - suggesting a contradiction to the above study. Herb use was assessed for potential interaction with conventional treatment, and where the potential existed, case history was reviewed to see if any adverse events had actually occurred. The conclusions: about 15% of those surveyed used herbal medicines. Adverse interactions were deemed possible in 40% of those users. These theoretical interactions included potentiation of hypoglycemic medicines; potentiation of anticoagulant medications; interaction with the metabolism of statin and other drugs through effects on liver metabolism; effects on blood pressure; and effects on clotting time. Actual adverse events were only observed in 7% of total herb users, and the severity of these events was generally rated as mild.
• The Australian and New Zealand Journal of Obstetrics and Gynaecology released a report showing that women who pursue fertility treatments are much more likely than average to be using complementary and herbal therapies (as recommended by naturopathic doctors and/or herbalists). In this case, the authors of the prospective study also found that such use of non-traditional therapies is rarely reported to the "conventional" doctor.

Not all of this is new information for herbalists. What comes out loud and clear to me are two main things: first, many people aren't talking to their doctors about herbs and supplements they are taking. While the first study listed above does go into why this may be, the main reason in my opinion is the attitude that conventional medicine has put forth over the last 60+ years, especially in the United States. Pushing "unscientific" medicine away has led not only to the greatest health care crisis our country has ever seen, it has also kept care providers in the dark about what the public is doing to address the holes in the modern healthcare machine.
The second striking fact is that, generally speaking, herbs have very few adverse events associated with them, and that these are most likely linked to the concomitant use of prescription medicines. This, at first, is reassuring - but when we factor in the knowledge that doctors aren't really getting the full picture before they prescribe powerful drugs, I feel a bit less calm.
My recommendations: doctors need to ask more questions. Herbalists need to speak up more, and try to help doctors understand everything their patients are doing. We are living in a world where "modern medicine" is not the only treatment modality! I'm not sure everyone involved in health care, let alone clients and patients, has a clear grasp of this fact. The future lies in an integrative approach, and while this holds great promise, it requires clear communication.