Herbal remedies made from plant leaves, bark, berries, flowers, and roots have been used to heal illnesses, diseases, and psychological disorders for centuries. Today, with the ease of the internet, you can self-diagnose, order next day delivery, and even learn how to make your own. Last year three million Britons took herbal remedies to treat everything from fever to joint pain.
But renewed debate about the safety of these remedies was sparked last week following the news of an EU crackdown on herbalists and Chinese medicine practitioners who operate unregulated at present. Under the new law, from 2011 sales of all herbal remedies except for a small number of products for minor ailments will also be banned. Regulators warn that many of us believe that "herbal" is synonymous with "safe", whereas herbal remedies can be deadly"Research we conducted last year found a significant proportion of people believed 'herbal' means 'benign'," says Richard Woodfield, Head of Herbal Policy at the Medicines and Health care products Regulatory Agency (MHRA). "That means people are more liable to self-medicate, and to neglect to inform their doctors, even though there's a risk that the herbal remedy will react with any prescription drugs. They're also more vulnerable to fraudulent, even criminal operators who put products out which are heavily adulterated with dangerous pharmaceuticals."
The actress Sophie Winkleman is reported to have taken aconite, or monkshood, found in some 'herbal Valium' last month to calm her nerves prior to her wedding to Freddie Windsor.
The plant while relatively harmless in licensed homeopathic remedies in which it is rigorously diluted, can be extremely dangerous, in herbal remedies, even lethal.
"If you were to buy aconite root, which is banned from licensed herbal products in the UK, but can still be found in products bought over the internet, and make yourself a herbal tea with it, you'd be dead within five minutes," says Dr Linda Anderson, Pharmaceutical Assessor of the MHRA.
Last year, scientists at Boston University found that a fifth of Ayurvedic medicines – popular traditional Indian herbal remedies – bought over the internet contained dangerous levels of lead, mercury or arsenic, which could cause stomach pains, vomiting or liver problems.
Earlier this year, herbal arthritis remedies came under scrutiny when looked at as part of the Arthritis Research Campaign's (ARC) study of complementary therapies. "Not only did we find that in two-thirds of cases, there was no evidence they actually worked, but one Chinese remedy used to combat rheumatoid arthritis – Thunder god vine – was also reported to be extremely poisonous if not extracted properly," says ARC spokeswoman Jane Tadman.
Menopause remedies also came under fire after a study reported in the Drugs and Therapeutics Bulletin, a journal that reviews medical treatment, found no evidence they actually worked. Gynaecologist Heather Curry of the British Menopause Society says: "Our feeling is that there isn't enough scientific evidence either on effectiveness or safety." A German study last year found the "herbal antidepressant" St Johns wort to be as effective as standard antidepressants such as Prozac.
However, side effects such as dry mouth, dizziness and stomach pains have been widely reported and it interacts strongly with some prescription drugs such as Warfarin and oral contraceptives. And in April, an MHRA investigation into Jia Ji Jian, sometimes marketed as 'herbal Viagra', revealed it contained up to four times the level of pharmaceuticals found in legally prescribed anti-obesity and anti-erectile dysfunction medicinal products, which can cause serious side effects including heart and blood pressure problems. As a herbal remedy it should not contain any pharmaceuticals at all.
"Drug interaction is a big area of concern," says Professor Edzard Ermst, professor of Complementary Medicine at Exeter University. "Herbal medicines may have been around for thousands of years, but the new synthetic drugs haven't and how they interact is still uncharted territory."
The MHRA believes regulating the herbal medicine industry is the best way to limit abuses and ensure consumers are aware of potential dangers. All herbal medicines sold over the counter in the UK should according to the law be licensed. The MHRA assesses them on safety, quality and patient information. By 2011 a new scheme, which is currently being rolled out, will be in place.
"Check for products which have the THR (Traditional Herbal Register) or Product Licence (PL) number on the label," advises Richard Woodfield.
Many herbal practitioners want even further regulation."We want to be registered," says Dee Atkinson, spokesperson for the National Institute of Medical Herbalists and herself a qualified medical herbalist. "Herbs are not harmless, they are drugs, just as pharmaceuticals are drugs and as such they should be prescribed by a qualified, registered practitioner.
"As a rule of thumb, I'd say that for any conditions or problems you'd normally go to a chemist for, you can visit a shop that sells over-the-counter herbal medicines, but anything beyond that you should be seeing a qualified, and we'd like to see registered, professional. Never order anything off the internet unless it's from a UK-based, recognised herbal company."
Richard Woodfield of the MHRA agrees. "Avoid unlicensed herbal remedies, particularly those sold on the internet and steer clear of anything claiming to be "100% safe" or "safe because it's natural". Like any other drugs, herbs can have side effects. Look for the THR or PL standard on the label and consult with your doctor if taking any prescription medicine."
By Tammy Cohen
Published: 7:00AM GMT 02 Nov 2009