The Handbook of Clinically Tested Herbal Remedies is an excellent reference source on herbal medicines. Writing in the International Society for Complementary Medicine Research Newsletter (go here and click the volume 2 number 4 issue), the reviewer states that editor Marilyn Barrett and her contributors, “take a rigorous look at both the nature of the herbal evidence base, and how it [the evidence base] is and should be generated.”
The reviewer’s main concern is the importance placed on “identifying the active components of individual herbs.” The reviewer’s position is that “The focus on researching individual herbs is — an essential piece of the herbal puzzle, but — it should take its place alongside a more pragmatic investigation of complex, ideally individuated, herbal formulae, which is the “stuff” of professional herbal practice.”
With respect, I believe that in the long run this view is flawed and will relegate herbal medicines to second-class status. Identifying the active ingredient is the essential step in establishing standards. You can’t seriously expect to achieve benefit in the absence of standards for product content. And to date, published analyses of some herbal preparations show great disparities in the concentrations of the active ingredient. This site has reported on some of these discrepancies here, here, here, and here.
Identifying the active ingredient(s) is even more important if the reviewer is correct about the relationship between components. But at least let’s start by profiling and documenting the actions of the main ingredient and then move on to relationships and relative concentrations among ingredients.
Historically, compounds of botanical origin have contributed greatly to healthcare. Some of the best known and most valuable drugs (eg, aspirin, digitalis, quinine) are of botanical origin. Let’s not sell herbals short by relaxing our standards for chemicals used for health purposes.
John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.