Possibilities and Limits of Phytotherapy
Herbal medicine today finds itself caught between tradition and innovation. In addition to herbal medicines, which are ‘only’ based on traditional use, a number of licensed herbal medicines have become established that are the result of modern research into medicinal plants. Although herbal medicines have established their place in self-medication, many consumers would also like doctors to prescribe them.
Consumer surveys repeatedly show an increasing demand for natural medicines, especially herbal medicines. Over the last 30 years, the number of people using natural medicines has risen constantly.
These increases can be found in both men and women, all age groups and all social classes. Although herbal medicines are widely used in self-medication, many people believe it is ‘important’ or ‘very important’ for doctors to understand and be able to prescribe natural remedies. This highlights the fact that, for many people, herbal medicinal products have become almost indispensible.
Phytotherapy and ‘conventional medicine’
Herbal medicine was and is still often associated with the ‘alternative therapy scene’, and for as long as phytotherapy (i.e. the use of medicinal plants on sick people) is not a subject in the training of doctors or pharmacists, it will have to overcome a whole host of obstacles before being accepted by the medical profession.
However, many doctors have already recognised that rather than being an alternative to conventional medicine, phytotherapy is part of modern, scientifically oriented medicine and an important element of therapy.
This is because, with their broad pharmacological and therapeutic effect, herbal medicines fill therapeutic gaps when treating certain conditions, increasing the therapeutic choices for preventing and treating acute and chronic illnesses.
They also offer a good risk-benefit balance, with good efficacy and are generally safe and well-tolerated. The main areas of use are in illnesses with mild to moderate severity. Herbal medicines are also being increasingly used in the care of the elderly.
Good results are being seen when strengthening the body's immunity, with colds, respiratory diseases, exhaustion, nervousness, sleep problems, skin diseases, mild to moderate depression, cardio-vascular diseases, rheumatic pain, circulatory problems in the brain, vein problems, gastrointestinal problems, dry eyes, arthritis, menopausal symptoms, bladder inflammation and benign prostate hyperplasia, to name but a few.
As a complementary therapy that strengthens the immune defence system and supports a patient's self-healing powers, herbal medicines can also be useful as a supplementary measure for serious illnesses such as cancer.
Therapeutic objectives within herbal medicine
"Phytotherapy has met treatment objectives, . . . . . which were neglected in other areas of medicine (e.g. holistic approaches, self-healing powers, self-regulation possibilities, prevention, 'mild' effect, 'natural' interventions, self-competence in treatment). Such approaches are currently highly topical among patients, and also among many doctors."
Quote from: Saller/Reichling/Hellenbrecht ”Phytotherapie. Klinische, pharmakologische und pharmazeutische Grundlagen“, Haug Verlag, Heidelberg 1995
Judgements and prejudices
While some people refer to the active substances contained in plants as ‘wonder weapons’, others rail against the ‘flowers’ and ‘green stuff’ with the simplistic hypothesis that even plants are capable of killing.
The sham alternative of (good) nature versus (bad) chemistry as portrayed so often and so eloquently in the media frequently then culminates in the following assertion, which is as cynical as it is incorrect: "If there are no sideeffects, there can be no effect, either."
Blanket and undifferentiated assertions that herbal medicines at most have a dubious benefit in terms of their effect are just as incorrect as the claim that everything herbal is always ‘gentle’ and totally without risk during use. Herbal medicines can also have side effects, although these are rarely serious if the products are used with due and proper care.
When using herbal medicines, savvy consumers should always note the following points:
- Herbal remedies are medicines. Although they rarely trigger side effects, they can (like any medicine) produce undesired effects and interactions with other remedies in individual cases. Read the pack leaflet carefully, and note the points listed under ‘contraindications’.
- Generally, herbal medicines can be taken for long periods of time. However, there are also some medicinal plants which are only suitable for short-term use. For example, if used over time, high doses of juniper berries can damage the kidneys, and peppermint can in certain circumstances relax the sphincter between the stomach and the oesophagus, thus triggering indigestion. If you plan to use a herbal medicine over a long period of time, get advice from your healthfood store, naturopath, pharmacist or doctor.
- Even herbal medicines are not always ideal for pregnant women. During pregnancy, do not take any preparations without asking advice from your doctor or a pharmacist.
- Before an operation, you should inform your doctor if you are taking natural medicines (eg. Garlic, St. John's Wort, Baldrian or Valerian),
- There are no products within herbal medicine that are effective against a wide range of indications (from aids to cancer and headaches to preventing miscarriages). If you encounter such claims, you should treat them with caution and scepticism. Contact your healthfood store, pharmacies, chemists, consumer protection organisations, consumer advice centres, health authorities or other independent experts for advice.
- The plants you use should not have been treated with herbicides or pesticides, should not be contaminated with heavy metals and should not even have been contaminated with synthetic medicines (which in particular was and still can be the case for ‘plant preparations’ sold over the Internet from Asian countries). For your own safety, it is better to use plant preparations whose starting products come from controlled organic or biological cultivation.
- Look out for the term ‘standardised’. It guarantees a consistent effect. For fresh herbal medicines from A.Vogel, standardisation means standardising quality at all stages of production, from self-grown seeds to the finished tincture or tablet.
- As well as causing the plants to lose essential oils, the drying process also produces changes in the overall structure of an extract and this can have a negative impact on the levels of active substances present, as well as stability. With his patients, Alfred Vogel observed better, broader and deeper effects from extracts produced from fresh plants compared to those from dried plants.
- Last but not least, the reputation of the manufacturer represents a certain guarantee of quality. Serious producers provide consumers, store staff, therapists and doctors with information and, if available, the results of scientific studies.
• Ingrid Zehnder-Rawer