Herbal medicine

What is herbal medicine?

Herbal medicine - also known as botanical medicine, phytotherapy or phytomedicine - involves using a plant or part of a plant for healing purposes. The herbal part of a remedy may come from the leaf, flower, stem, seed, root, fruit or bark of the plant and it may be used to treat wounds and a range of other conditions.

History of herbal medicine

Herbal medicine is considered to be the most ancient form of healing. Herbs have been used in most traditional cultures and have had a major influence on many systems of medicine, including traditional Chinese medicine, Ayurvedic (Indian) medicine, Native American and Indigenous Australian medicine and also conventional medicine.

Written records of Roman, Egyptian, Persian and Hebrew cultures show that herbs were used to treat practically every known illness. The history of herbal medicine is actually part of the history of medicine itself and herbal knowledge came to Europe from the Middle East during the crusades. Many prescription medicines used today were originally derived from trees, shrubs or herbs.

Herbal medicine is used worldwide

Today there are many types of herbal medicine, which have been developed by different cultures around the world. In Australia, the most common types are traditional Chinese, Ayurvedic, Indigenous and Western (European) herbal medicine. The different types of herbal medicine all have in common that they use medicinal plants, but they vary in which plants they use, how they prepare and apply them and the philosophies behind their approaches to treatment.

Although herbal medicine is classed as 'alternative' or 'complementary' in most Western countries, it remains the only form of medicine widely available to much of the world’s population.

Plants: an untapped healing resource

There are an estimated 400,000 plants known today, but only a fraction of these have been studied or used medicinally. Many researchers believe that there are plants as yet unrecognised for their healing powers. Pharmaceutical companies and others are actively investigating the potential of plants to provide new antibiotics and other medicines.

How does herbal medicine work?

Herbs contain a large number of naturally occurring chemicals (constituents) that have some type of biological activity. Herbs work in a similar fashion to many pharmaceutical preparations. In fact, some pharmaceutical medicines are still obtained from plants. For example, the malaria medicine quinine is extracted from the bark of the cinchona tree, and the pain medicine morphine is produced from the opium poppy.

Western herbalists, however, believe that herbs should be used in their complete form to ensure the balance of constituents contained in the plant is utilised. They consider that herbal remedies are of most benefit when used to treat chronic, ongoing conditions. There are generally no quick-fix herbal treatments.

Herbalists also believe that herbs can be very effective in the treatment of many conditions, but without the unwanted side effects that are often seen in conventional pharmaceutical treatments. Nevertheless, it should be realised that herbs can be very potent and, if used incorrectly, can cause serious adverse effects.

Also some herbs can affect how your body responds to prescription and over-the-counter medicines, either decreasing or increasing the effects of these medicines. For example, St John’s wort can interfere with birth control pills, and gingko biloba can increase your risk of bleeding with anticoagulant (blood-thinning) medicines.

Consult a herbalist

You should always consult a fully trained herbalist before using herbal remedies. Herbalists are trained to know how to mix remedies for specific conditions and symptoms and how much should be taken and for how long. They also aim to treat the person as a whole, using whole plant medicines to stimulate the body’s own healing abilities. Herbs are chosen to suit each person as well as to treat their disease or condition.

Types of herbal remedies

Herbal remedies come in a variety of forms and may be applied internally or externally.

Herbal remedies that are taken internally include:

  • liquid herb extracts;
  • teas;
  • powders; and
  • capsules and tablets.

Herbal remedies that are applied externally include:

  • baths
  • compresses;
  • douches;
  • poultices and plasters;
  • oils;
  • ointments;
  • salves; and
  • wraps.

Uses of herbal medicine

Herbal medicine offers treatments for virtually every ailment affecting any body system. Common conditions seen by herbalists include:

  • skin problems such as psoriasis, acne and eczema;
  • digestive problems such as peptic ulcer, colitis, irritable bowel syndrome and indigestion and heartburn;
  • heart and circulatory conditions such as angina, high blood pressure, varicose veins and ulcers; and
  • gynaecological disorders such as premenstrual syndrome and menopausal problems.

Other conditions herbalists treat include:

  • arthritis;
  • insomnia;
  • stress and nervous related conditions;
  • headaches and migraine;
  • upper respiratory tract infections;
  • colds and flu; and
  • allergic responses such as hay fever and asthma.

Note that when you see a herbalist you should always tell them what conventional medicines you are taking. You should also tell your doctor if you are planning to start a course of herbal medicine. You should never stop taking your conventional medicines in favour of herbs unless your doctor knows and approves.

Regulation of herbal medicines

Medicinal products containing herbs are regulated in Australia by the Therapeutic Goods Administration. If the ingredients are deemed to be higher risk, whether because of their toxicity, likely length of use, side effects, interactions or other feature, the medicine will have to be a "registered" medicine with the designation 'AUST R' on the label. If it is deemed low risk, the product can be labelled a "listed medicine" with the label designation 'AUST L'.

The indications and claims made for listed medicines are not investigated or evaluated before the medicines are marketed, but the manufacturers are required to hold evidence to support any claims they make.

On the other hand, registered complementary medicines are assessed individually for quality, safety and efficacy.

While the TGA can regulate herbal medicines sold over the counter in Australia, it is difficult for it to control plant material or imported herbal medicines such as those bought over the Internet. There are examples of imported 'herbal' medicines for weight loss and other conditions that on analysis have been found to contain pharmaceuticals, some of which have been discontinued because of safety concerns, or which could have dangerous effects or interactions with other medicines in some people.

The TGA publishes safety alerts/advisories on its website about medicines of concern and advises consumers to exercise extreme caution in buying medicines over the Internet, as they may not meet the same standards as medicines approved in Australia and can contain unauthorised and potentially harmful ingredients.

Regulation of herbal medicine practitioners

At the time of review, any person in Australia, trained or not, can legally start practising as a herbalist or naturopath. Concerned parties within these professions are working towards establishing a national register of trained naturopaths and herbalists to offer the public greater protection and improve health outcomes. The Government is also working on creating a single registration system for healthcare professionals that may include herbal medicine dispensers, herbalists and naturopaths.

References

1. National Herbalists Association of Australia. What is herbal medicine? http://www.nhaa.org.au/ (accessed Dec 2010).
2. Chopra AS. Ayurveda. In: Selin H, Shapiro H, Editors. Medicine across cultures: history and practice of medicine in non-Western cultures. Dordrecht, Netherlands: Kluwer Academic Publishers; 2003: 75-83.
3. National Center for Complementary and Alternative Medicine, National Institutes of Health (US). Herbs at a glance. A quick guide to herbal supplements (revised Jun 2010). Bethesda, MD: US Department of Health and Human Services. http://nccam.nih.gov/health/herbsataglance.htm (accessed Nov 2010).
4. Hawkins B. Plants for life: Medicinal plant conservation and botanic gardens. Richmond, UK: Botanic Gardens Conservation International; 2008. http://www.bgci.org/files/Worldwide/Publications/PDFs/medicinal.pdf (accessed Dec 2010).
5. Botanic Gardens Conservation International. Plant species numbers. http://www.bgci.org/ourwork/1521/ (accessed Dec 2010).
6. National Institute of Medical Herbalists (UK). How herbalists use medicinal herbs. http://www.nimh.org.uk/about-medical-herbalists/what-medical-herbalists-do/Who-and-What-does-a-Medical-Herbalist-treat (accessed Dec 2010).
7. Casey MG, Adams J, Sibbritt D. An examination of the prescription and dispensing of medicines by Western herbal therapists: a national survey in Australia. Complement Therap Med 2007; 15: 13-20. http://www.complementarytherapiesinmedicine.com/article/PIIS0965229905001457/abstract (accessed Dec 2010).
8. Vickers A, Zollman C. ABC of complementary medicine: herbal medicine. BMJ 1999; 319: 1050-3. http://www.ncbi.nlm.nih.gov/sites/ppmc/articles/PMC1116847/ (accessed Dec 2010).
9. Australian Government Department of Health and Ageing, Therapeutic Goods Administration. The regulation of complementary medicines in Australia - an overview (Apr 2006). http://www.tga.gov.au/cm/cmreg-aust.htm (accessed Jan 2011).
10. National Herbalists Association of Australia. Herbalists support national register (22 Oct 2010). http://www.nhaa.org.au/index.php?option=com_content&view=article&id=419:herbalists-support-national-register&catid=73:media&Itemid=265 (accessed Jan 2011).
11. National Herbalists Association of Australia. Registration and regulation of herbalists and naturopaths in Australia. http://www.nhaa.org.au/index.php?option=com_content&view=article&id=285&Itemid=355 (accessed Jan 2011).
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