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Herbal Medicine: Does it Work?
 

Interested in trying herbal medicines? You’re not alone! The popularity of herbal medicine is steadily increasing in the United States. Recent surveys showed that about half of American adults have used herbal supplements within the last year. Many of them can testify to the beneficial effects of herbal medicines. The reasons for using the herbal remedies include: ineffectiveness of their current medical treatment, high cost of healthcare and prescription drugs, and unwanted side effects of prescription drugs. Spurred by public demand, in 1998 the US Congress approved the formation of the National Center for Complementary and Alternative Medicine (NCCAM) to explore the value of herbal medicines.

In contrast to the enthusiasm of the general public, the medical community still regards herbal medicine with some skepticism. Likewise, herbal medicines are not classified as drugs in the United States, nor are they categorized as drugs by the FDA. Herbal medicines are not rigorously tested by scientific studies for their health benefits like conventional drugs. Herbal medicines are not produced to the same quality standards as conventional drugs for lot-to-lot consistency. The side effects of herbal medicines are often not quite clear, so users may feel concerned about the safety of herbal medicine. Ironically, while clinical studies demonstrated the efficacy of a given herbal remedy are often met with doubts from the medical community, any report on potential negative side effects of herbal remedies are readily accepted.

The question to skeptics of herbal medicine is that if herbal medicine could have harmful physiological effects, then why couldn’t they have positive effects as well? After all, no matter what the effect is, it all works by the natural molecules contained in the herbal medicine on the body’s physiology.

To the surprise of some people, natural molecules comprise a major part of modern medicine. As recently as the last two decades (1981-2002), 49% the 877 New Chemical Entities drugs approved by FDA, were natural products or derived from natural products.1 Not to mention that prior to that drugs were predominantly developed from natural products.

Herbal medicines have been an important source of natural product drugs, and the root of modern pharmacology and drug development. Take Digoxin as an example.2 Digoxin is a modern drug used for congestive heart failure. It’s a natural molecule occurring in the herb foxglove. Foxglove was originally used in folk herbal remedies consisting of a dozen of herbs. Over 200 years ago foxglove was found to be the active ingredient in these herbal remedies. By 1906, several different preparations of foxglove were included in US pharmacopeia. No standard was in place at that time. Then standard assays were developed to monitor the bioactivity of foxglove preparations. Eventually, Digoxin was identified, and became a standard chemical drug.

While modern drugs were largely developed from the herbal medicines in the Western world, traditional Oriental medicines -- namely Chinese medicine -- remain mostly unexplored by modern drug discovery. Traditional Chinese medicine (TCM) consists of thousands of Chinese herbs and even a larger number of herbal formulas combining several different Chinese herbs. TCM also includes a unique system of theories that directs the proper use of Chinese herbs. Chinese people have relied solely on TCM for thousands of years for their health, much the same as Western herbal medicine did for the Europeans before modern medicine was born from it.

So far only one modern drug has been successfully developed from Chinese herbs and won the world’s acclaim.3 The drug is Artemisinin (Qinghaosu) from the Chinese herb Qing Hao. Qing Hao has been used in traditional Chinese medicine for many centuries to treat malaria. Artemisinin was purified from Qing Hao and further demonstrated by Chinese scientists to be superior to the standard antimalarial Quinine treatment.4,5 Artemisinin also represents a novel class of chemical structure and forms the basis for synthesizing new drugs. Artemisinin and its derivatives are playing a major role in fighting rampant malaria in the third world. The adaptation of Qing Hao to combat malaria is traditional Chinese medicine’s huge contribution to world health.

One may ask why, with thousands of Chinese medicines, only Artemisinin has been discovered. For one reason, the drug discovery abilities in Chinese academics and pharmaceutical labs are still in their infancy. While a large number of effective Chinese remedies are being used, it remains a huge challenge to develop modern drugs from them. It is my belief that many drugs will be eventually developed from Chinese herbs just like Artemisinin. It will likely take decades of work by scientists from around the world to investigate each Chinese remedy. Until that happens, for those whose needs are not met by the current healthcare system, I would recommend trying Chinese herbal medicine.

References
  • 1. Koehn FE, Carter GT. The evolving role of natural products in drug discovery. Nat Rev Drug Discov. 2005 Mar;4(3):206-20.
  • 2. Goldman P. Herbal medicines today and the roots of modern pharmacology. Ann Intern Med. 2001 Oct 16;135(8 Pt 1):594-600.
  • 3. Engel LW, Straus SE. Development of therapeutics: opportunities within complementary and alternative medicine. Nat Rev Drug Discov. 2002 Mar;1(3):229-37.
  • 4. Klayman DL. Qinghaosu (artemisinin): an antimalarial drug from China. Science. 1985 May 31;228(4703):1049-55.
  • 5. Jiang JB, Li GQ, Guo XB, Kong YC, Arnold K. Antimalarial activity of mefloquine and qinghaosu. Lancet. 1982 Aug 7;2(8293):285-8.