Herbal Supplement Information and natural remedies with plants and roots
Feb 24 2014 by
Ray Sahelian, M.D.

Herbal supplement use is widespread in the US adult population, despite the fact that few participants inform their conventional health care providers about their use of dietary over the counter products. The reasons that herbal nutrition supplement use are not mentioned are many, but three that come to mind include:

1. Patients do not expect their doctors to know much more about supplements than they do, particularly if they read a lot about herbs and supplements.

2. Patients may not realize that herbs and supplements can often have a profound influence on their health, medical condition, sleep patterns, energy level, mood, and interaction with other medicines. Hence, they may not think it is appropriate or necessary for them to mention these supplements during an office visit.

J Toxicol. 2014. Cyclosporine and Herbal Supplement Interactions. Cyclosporine (CyA) is a well-known immunosuppressant with a narrow therapeutic window. Its bioavailability is affected by many other traditional drugs and herbal extracts. Cytochrome P-450 isoenzymes CYP3A4 and CYP3A5 and protein P-glycoprotein (P-gp) are involved in CyA bioavailability. Interactions of CyA with herbal extracts are not well known, but, given their increased concomitant use, it is important to know which extracts, many of which are commonly self-prescribed, can affect CyA blood concentrations. Decreased CyA blood concentration has been shown with St John's wort in case reports and, in vivo animal studies, with ginger, liquorice, scutellariae radix, and quercetin. Increased CyA concentration has been reported in patients with grapefruit juice, chamomile, or berberine, and with cannabidiol or resveratrol in animal studies. Effects of Echinacea and Serenoa repens on CyA levels have not been shown consistently, but concomitant use should be avoided.

3. Most doctors do not have enough time to discuss herbal supplements with  their patients within the allotted time needed to satisfy a managed care medical office, or to make a suitable income after office expenses. Talking about supplements takes a lot of time. Insurance companies, and certainly Medical and Medical, are not going to reimburse a doctor adequately enough to justify the extra time. I give no blame. It's a difficult situation to resolve. Only patients who have enough money to pay a private doctor extra for the extended services are able to benefit. And even more difficult is to find a knowledgeable doctor who practices herbal medicine and takes supplements himself or herself to have first hand knowledge. Some patients visit an herbal store for advice. The accuracy of the advice at an herbal store is hit and miss, just like the advice from a traditional medical doctor regarding herbal medicine.

Herbal Remedy
There are countless herbal remedies available. See herbs for a partial list. Herbal treatment does have side effects, sometimes minor, other times very serious. Certain herbs can speed heart rate and cause heart rhythm abnormalities. Many people think that herbal treatment has few side effects, but that is not true. Although herbal treatment has fewer side effects than drug treatment, nevertheless one has to be cautious. Plus, herbal treatment could have unexpected reactions when combined with prescription medicines. Herbal medicine and natural remedies are certainly underused in the United States.

Sometimes combinations or mixes are better than the individual components, the idea of synergism
Pak J Biol Sci. 2013. Synergistic effect of green tea, cinnamon and ginger combination on enhancing postprandial blood glucose. This study was maintained to determine the immediate effect of green tea, cinnamon, ginger and combination of them on postprandial glucose levels. The Glycemic Index (GI) for previous treatments was measured as an indicator for postprandial glucose pattern. Twenty-two healthy volunteers from both genders were enrolled in this study. Mean age was 21.3 years and mean BMI was 24.6 kg m(-2). For each herb and combination treatment, a concentration of 2.5% aqueous tea extract was prepared. The GI of green tea, cinnamon and ginger were 79, 63 and 72 respectively. Herbs combination exerted GI of 60, which was the lowest. Combination of these herbs showed the best lowering effect on postprandial glucose levels as compared with each alone. A potential synergism from the active ingredients of blended herbs was determined.

Herbal supplements that stimulate testosterone
There are several herbal supplements that in animal studies have been thought to stimulate testosterone release. Two such herbs are tribulus terrestris and tongkat ali. It is not clear whether the testosterone stimulation with these herbal supplements is temporary (the body my get exhausted of its testosterone supply) or consistent over days, weeks and months of use. Long term human studies are not available to give us a good understanding.

Herbal tea products and their benefits
There are quite a number of herbal teas that are delicious. Use stevia as a sweetener. Try these various teas: alfalfa, chamomile, cinnamon, earl grey, fennel, ginger, green (contains caffeine), hibiscus, hops (for nighttime), hyssop, lemon balm, licorice (avoid drinking daily since high doses of licorice cause high blood pressure and loss of potassium), milk thistle, mint, nettle, peppermint, rose hips. Many of these herbal teas can be used during pregnancy but it may be best to ask your doctor first.

Herbal weight loss products and Diet Pills
There are several herbs and nutrients that can reduce appetite or cause a thermogenic affect which could help with weight loss. However, whether the herbal weight loss benefits continue with time is difficult to predict due to lack of adequate research. Some companies promote their herbal weight loss products as "herbal phentermine" or "herbal slimming tea" or "herbal life weight loss" "Hydroxycut" "herbal diet tea", etc. and many people buy these herbal products with high hopes. A few people probably do find that these herbal weight loss products are effective for them. For a full discussion, see weight loss herbs.

Herbal extract
Originally herbs were used as a whole plant, but in the last few decades more and more herbal raw material suppliers are providing herbal extract that are concentrated to anywhere from 2 to 100 times or more. In some cases an herbal extract works better, but in other cases the whole herb may be more effective. We received an email question on the topic of herbal extracts.

Herbal Extracts versus the Whole Herb. Which is Healthier?
Q. In terms of herbal supplements, and in particular the ones containing herbal "extracts", I've been wondering whether they are really such a good idea, in that these herbal extracts, as I understand it, contain isolated and concentrated components of plants, these components being what are considered the "active" components. My concerns are:
     1) when these so-called "active" herbal components are isolated and concentrated in this way, are we not possibly excluding other important synergistic components that would normally work with these components in the natural situation, i.e. in the whole herb? , and
     2) when the components are concentrated in this way, is this not now bordering on being like an artificial drug where the active herbal components are present in amounts not normally found in the natural whole herb? Add to that the fact that other components are excluded which otherwise (at least I wonder) maybe would have somehow "balanced" these active components. Is this then safe?
     Basically I've been wondering these things, comparing whole herbs to herbal extracts. Hope your highly knowledgeable staff will enlighten me as usual. Thanks much.
    
     A. This is an excellent question. There is no blanket statement that can be made. Each herb has to be evaluated individually to see whether the whole herb or the extract is preferable. With some herbs, it may be better to take the whole herb, and with others, an herbal extract may be preferable. Sometimes the active ingredients are too minimal within the herb, or they may be toxic or unwanted substances within the herb that need to be removed in order to obtain the active ingredients without toxicity. As a rule, I prefer the whole herb, but I have no problems using extracts when appropriate. Sometimes, in order to elicit a benefit, the active ingredients have to be concentrated in order for therapeutic amount of the active herb to fit in a capsule.
     We have to keep in mind that nature did not produce herbs with the idea that these would be beneficial to human consumption or to treat a human medical condition. Herbs evolved in order to protect themselves from microbes, insects and animals that would eat them or to protect themselves from harsh environmental conditions. It just happens that certain herbs have some beneficial compounds that we find helpful. But this does not mean that every molecule or substances within an herb is beneficial.
     As to whether they are considered a drug when herbal extracts are concentrated, it depends on how one defines a drug. I consider a drug any substance that is not normally found in the body. By this definition most herbs are drugs, whether whole or concentrated, or extracted. However, there are substances within herbs that are useful to the body and are normally found in the body. For instance, goji berry has zeaxanthin, a carotenoid, which is found in the retina and other tissues. Hence, certain components of some herbs are not drugs but supply crucial molecules to the body. One advantage of standardized herbal extracts is that different research labs can compare their results using the exact same herbal extract. One example is ginkgo extract, another is saw palmetto.
     Bottom line: no sweeping statements can be made that apply to all herbs. Each herb and herbal extract needs to be evaluated individually in different dosages for each person who is using them, and also how they interact with other supplements and medicines.  There are too many variables that prevent a simplistic answer. Furthermore, different raw material processing companies may have different ways to make herbal extracts, and one batch from one company may be slightly or significantly different than form another company. Add the fact that soil conditions, temperature, time of harvesting all influence an herb's composition, you can see why no simple answers can be given.

For depression
I would like to thank u for your efforts to bring awareness to herbal medicines it is my belief that this is the direction medicine is heading towards and hopefully more research is done. I have been taking St. John's wort extract for about a year and it has helped me a lot with my anxiety attacks and depression.

Sedative and relaxation effects
My research indicates that at least some of these herbal sedative products (passionflower, skullcap, possibly others) are thought to work because they have constituents that bind to benzodiazepine receptors. If that is the case, then why is it that these herbs would not be just as potentially likely to cause side effects and dependence as benzodiazepine drugs? In other words, what is the difference between an herb that binds to these receptors and a drug that does? I genuinely don't understand this and have not been able to find an answer so thank you for any light you can shed. The reason for my question is that I was on benzos for years, finally broke my dependence after a long and painful process, would like now to try herbal alternatives for my ongoing severe anxiety but don't want to revisit the issues I have put behind me.
    Even though some of these herbal sedatives may have some compounds that influence benzodiazepine receptors, their actions may not be as strong as the medications, plus each herb has dozens or hundreds of chemicals in it and some of the other chemicals may act on other parts of the brain and other receptors thus interfering with the sedative aspects of the chemicals that influence the benzo receptors.

Herbal skin care products
Certain herbs are beneficial to skin health. Some spas use an herbal body wrap. I don't know enough about herbal skin care to comment on the benefits of herbal products for skin care.

Chinese herbal medicine
Chinese herbalists and doctors have used herbal healing knowledge for thousands of years, and there are literally thousands of herbs used in China for practically every illness. I have high respect for Chinese herbal medicine since I have personally used Chinese herbs and many of them are quite potent.

There are many herbal sex stimulants that work including tongkat ali, tribulus terrestris, horny goat weed, muira puama, and catuaba. Each person is different and hence one herbal remedy for libido may work for one person but not for another. See the herbal libido link for some options.

Herbal remedy for menopause
Soy isoflavonoids -- Four-week supplementation with soy isoflavone has beneficial effects on bone metabolism and on serum lipids in perimenopausal women. These effects could have the potential to reduce risks of postmenopausal osteoporosis and of cardiovascular diseases in such women.
Black Cohosh -- A review of randomized, controlled trials found black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Ann Intern Med 2002 Nov 19;137(10):805-13.
Chaste Berry
Red Clover extract
St. John's wort for mood enhancement

I am not aware of an herbal acne remedy that is effective. However, diet does influence acne.

Emails
Q. Is there an herbal energy booster you recommend?
     A. There are quite a number herbal supplements for energy that I like including suma, maca, ginseng, and rhodiola.

Q. Is there an herbal vitamin?
     A. There is no such thing as an herbal vitamin unless you mean an herbal product that also has vitamins in the formula.

Q. In terms of herbal extracts, I've been wondering whetherthey are really such a good idea, in that they, as I understand it, contain isolated and concentrated components of herbs, these components being what are considered the "active" components. My concerns are:
     1) when these so-called "active" herbal components are isolated and concentrated in this way, are we not possibly excluding other important synergistic components that would normally work with these components in the natural situation, i.e. in the whole herb? , and
     2) when the components are concentrated in this way, is this not now bordering on being like an artificial drug where the active herbal components are present in amounts not normally found in the natural whole herb? Add to that the fact that other components are excluded which otherwise (at least I wonder) maybe would have somehow "balanced" these active components. Is this then safe?
     Basically I've been wondering these things, comparing whole herbs to herbal extracts. Hope your highly knowledgeable staff will enlighten me as usual regarding herbal supplements. Thanks much.
     A. This is an excellent question. There is no blanket statement that can be made regarding herbal supplements. Each herb has to be evaluated individually to see whether the whole herb or the extract is preferable. With some herbs, it may be better to take the whole herb, and with others, an herbal extract may be preferable. Sometimes the active ingredients are too minimal within the herb, or they may be toxic or unwanted substances within the herb that need to be removed in order to obtain the active ingredients without toxicity. As a rule, I prefer the whole herb, but I have no problems using extracts when appropriate. Sometimes, in order to elicit a benefit, the active ingredients have to be concentrated for therapeutic amount of the active herb to fit in a capsule.
     We have to keep in mind that nature did not produce herbs with the idea that these would be beneficial to human consumption or to treat a human medical condition. Herbs evolved in order to protect themselves from microbes, insects and animals that would eat them or to protect themselves from harsh environmental conditions. It just happens that certain herbs have some beneficial compounds that we find helpful for us. But this does not mean that every molecule or substances within an herb is beneficial.
     As to whether they are considered a drug when these herbal extracts are concentrated, it depends on how one defines a drug. I consider a drug any substance that is not normally found in the body. By this definition most herbs are drugs, whether whole or concentrated, or extracted. However, there are substances within herbs that are useful to the body and are normally found in the body. For instance, goji berry has zeaxanthin, a carotenoid, which is found in the retina and other tissues. Hence, certain components of some herbs are not drugs.
     Bottom line: no sweeping statements can be made regarding herbal supplements, but each herb and herbal extract needs to be evaluated individually. 

I've took the following herbal powders with the following dosage for about 3 months. I'm am not feeling well and have stomach pains along with new diagnosed hypoglycemia. Is it possible that it is from taking too many herbal supplements? What are your thoughts about what I took along with the amount I took? If this caused a problem, what could it be? My doctors do no really know about herbs. Amla- 1 teaspoon Astragalus Root- 2 teaspoons Barley Grass- 1 tablespoon Burdock Root- 1 teaspoon Eleuthero Root- 1 teaspoon Fo-ti Root- 1 teaspoon Ginkgo Leaf- 1 teaspoon Kava Kava-1 teaspoon Licorice Root-1 teaspoon Maca- 2 teaspoons Milk thistle- 3 teaspoons Mucuna Seed- 1 teaspoon Muira Puama Bark- 1 teaspoon Nettle Root- 1 teaspoon Rhodiola Root- 1 teaspoon Sarsaparilla Root-1 teaspoon Schisandra Berry- 1 teaspoon Suma Root- 2 teaspoons Tribulus- 2 teaspoons Chlorella - 2 teaspoons Spirulina - 1 tablespoon Cacao- 2 teaspons Goji- 1 teaspoon.
   It is easy to overdose on these and I prefer taking a break from all and just choosing one at a time for week to see what their effects are individually before combining them.