Evaluating Herbal Information
"The truth is more important than the facts. "
- Frank Lloyd Wright -
FLASH - In 2006 a wave of dishonesty in the media and scientific community has risen to unprecented proportions - read this article that exposes some of the more serious betrayals of public trust
Information on herbs is now voluminous. Some days I get ten e-mails trying to sell me herbal products, a phone call or two from salespersons, and a few pounds of catalogs. Unless your are cross- trained in science, traditional medicine, and advertising psychology, it is very difficult to clearly judge every piece of information you come across. Information comes to us from diverse sources: magazine articles, books, friends, TV advertising, internet advertising, physicians, health care practitioners and health food store employees. Current herbal information available to consumers ranges from the most precise and accurate articles to outright falsehoods and deceptions. I am going to share my understanding of the ins and outs of this information with the hope that it will afford you some protection against misconceptions and common errors. We will look at:
• Evidence-based medicine
• Dishonesty in media
• Pricing issues
• Combination products
• Naming and substitution issues
Before we explore all these issues, I want to again mention the good guys. There are many herbal companies and health food stores that distribute promotional information that accurately describes the nature, quality and expected actions of their products. They employ well-trained sales representatives who can answer questions clearly and responsibly. There are many books and Internet sites that distribute reliable information. Throughout the website you will find links to many of the ones I have personally evaluated.
I shop at Harvest Market, a local health food store in Delaware, run by a wonderful guy named Bob. When I go to the store, the first thing I notice is that Bob gets most all of his products from high quality sources. Bob keeps a copy of the Botanical Safety Handbook on the shelf and a good variety of magazines and articles on hand. Most impressive to me was an incident that occurred one day when I saw several copies of a best-selling herbal cancer treatment book I strongly believed was misleading to the general public. When I voiced my concerns to Bob, he promptly took all six books off his shelf as we spoke. His action was a manifestation of his genuine concern and care for his clients. There are a lot of good guys in the natural foods and herbal medicine world. "Good" doesn't just mean good-hearted. To me, it means good-hearted, well-read and endowed with critical thinking skills.
Don't Be Duped
A few years ago I took a defensive driving course. I liked to think I was a pretty good driver and therefore had little to fear on the road, so I was taking the course merely to save money on my car insurance premiums. In the first class my instructor said, "When you turn on your engine, imagine you will be driving through a pit of snakes...and if you are not afraid of snakes, you should be." I would recommend heeding this same advice any time you initially encounter anyone or anything, human or electronic, that sells herbs and vitamins.
While noting again that there are many honest and skilled salespeople in the herbal marketplace, dishonest or overzealous retailers are not in short supply. Ever since Madison Avenue realized "Thar's gold in them thar holistic hills," there has been a deluge of herbal marketing messages from TV, radio, magazines, catalogs, Internet sites, books, billboards, audio tapes and videos. If you are suffering from illness, the natural desire to get better places you at increased risk for believing magical accounts of the healing powers of herbs.
Do not underestimate the persuasive powers of a determined salesperson. I remember a particular patient to whom I had explained for over an hour her detailed medical requirements. I provided extensive documentation and clear explanations for my entire course of recommended action, which involved over $75 worth of rare and uniquely useful herbs. I was confident my suggestions would help her, though I expected it to take several months.
She never returned for her second visit, and when I called her she confessed tearfully that a multi-level marketing salesperson had convinced her I was a thief who was only trying to "get my hands on her money and string her along." He claimed that his single product would absolutely solve her problem within a few weeks. I may have been a better herbalist, but he was obviously a better salesman. She returned six months later, no improvement of course, and I was able to improve her skin condition in a few months.
In order to protect your health and your wallet from predatory salespeople, you must have a nose for fantastic claims, as well as the ability to recognize appeals to your desire to escape and avoid pain. Many of these fantastic pitches claim to be backed up by scientific research.
In the next sections, you can read two fictional marketing appeals I have constructed from real ads I have in my files. Sadly enough, if I ran these "ads" I'd probably sell a lot of juice. By the way, if you think I am exaggerating, one of the real ads I am parodying claims that by diluting their juice with different amounts of water, it will cure different parts of your body. The water dilution changes its cosmic vibrations. If you dilute it 2:1 it will cure your skin, and if you dilute it 3:1 it will cure your bowels, and so on...
The most common problem with scientific claims in herbal medicine is the use of valid but perhaps minor or insufficient scientific evidence. Based upon the great success of German herbal marketing with products like Ginkgo, it became clear that providing scientific evidence was a great marketing tool. Unfortunately, giving an herb to a lab rat and consequently seeing diminished redness in his nostril membranes does not a new sinus medicine make. This point is made clearly in the many websites developed since the British book Evidence Based Medicine first appeared
In an article appearing in the Journal of the American Medical Association entitled "Technology Follies: The Uncritical Acceptance of Medical Innovation," the authors argue that many physicians are untrained in the need for critical reading of the scientific literature, and lack necessary skills to practice evidence-based medicine. If physicians have problems in this area, we should take note of the probability of our own shortcomings. In his book, Evidence-Based Medicine: How to practice and teach EBM, author David Sackett and his colleagues argue for the need for clinicians to spend time reading and sorting out good quality evidence applicable to their patients. As a result of this movement, clinical practice guidelines, quality and value of health services, and science-based decision making protocols are finding their way into every part of the health care sector.
While the general consumer can't always take such a systematic approach to herbal medicine, there are a few simple guidelines that can help you to sort out the scientific information you will encounter in the marketplace.
• Don't believe everything you read in books, including this one. When you encounter a piece of medical information concerning an issue relevant to you, such as an herb you might want to try, you need to evaluate the information critically. If, for instance, a friend tells you about an herb for "arthritis," you might ask to read the original article from which he or she got the information. If the article quotes a scientific study, you might want to go to the original study and evaluate its validity and relevance for yourself. Some studies are poorly done. For example, in one study on the safety of Prozac in nursing mothers, this was "measured" by ASKING THE MOTHERS if their babies' behavior changed.
• If you have Internet access, you can easily look up studies about different herbs or illnesses using the wonderful and massive PubMed databases provided by the United States government. This source provides easy-to-access information of high quality.
• Anecdotal accounts have great appeal, but they do not qualify as scientific proof. Do not expect scientists to be swayed by this type of evidence. These accounts are valuable, and I will give many from my personal experience in this book, but you need to know that, at best, they point to the need to pursue futher study. Anecdotes, especially expert clinical observation, are the first step in discovering new truths. In this sense, they are of great value.
• Medical studies are ranked by certain criteria. Randomized, placebo-controlled, double blind clinical studies are the gold standard and should therefore rank higher in your estimation. These studies eliminate many sources of error. Even better is meta-analysis, a statistical process that takes a large number of studies and combines their results to assess the validity of the theory being tested. Ten studies on echinacea, for example, might be ranked according to their quality. A few are thrown out for not meeting quality-control restrictions, and the results for the rest are tabulated.
• In addition to the quality of the study design, there is also the fact that studies done on living human beings are far superior to studies done on animals. In vivo means the study was performed on living creatures, while in vitro means it was performed in an artificial environment, like a test tube. You should know these terms. Although providing valuable information, studies done in test tubes are the least clinically relevant and most likely to mislead. For example, it is much easier to shrink a tumor in a test tube than in a human being. Human studies, on the other hand, are limited by the fact that certain variables, such as diet or external environment, are much harder to control.
• If a study is well done, then it makes sense to accept and use its findings only if they are clinically relevant to you. You can ask yourself the question, "Does this study have a direct bearing on my health problem?" For example, a study that shows that a particular herb "strengthens the immune system" is not nearly as useful as one that shows that a particular herb has helped real people with your condition in a clinical setting.
• Scientific studies are not the only evidence used in herbal thinking. Traditional teachings, those that have persisted over several generations of dedicated herbalists, are accepted as a form of reliable information.
The next section shows what happens when new media and sometimes even journal sources do not follow these simple rules.
Dishonesty About Vitamins, Herbs and Nutrients in the Media
Starting in the late 1980's a media trend appeared which was generally very favorable to and supportive of herbal medicine. Of course, there have always been debunkers who question the usefulness of natural medicines, but in most cases their obvious biases do not affect public opinion. The general public has been solidly and steadily moving toward acceptance of natural products as a very important part of health care. In recent years, however, there has been a trend of "warning" articles about herbal medicines. While we all want to hear valid warnings, it is very confusing if the media does not use good judgment.
Perhaps the funniest "warning" was the one published in the March 1999 edition of the journal Fertility and Sterility. It was the basis of news reports that St. John's Wort (Hypericum perforatum), echinacea (Echinacea species) and ginkgo leaf (Ginkgo biloba) might have a negative impact on human fertility. Researchers from the Loma Linda University School of Medicine in California reported that directly dosing human sperm with large amounts of these herbs in the test tube caused the sperm to lose its ability to penetrate hamster eggs. The lead author of the study, Richard R. Ondrizek, M.D. was upset and "flabbergasted" that his research was being used in the media to promote the idea that these herbs could cause infertility in humans (Ondrizek 1999), prompting me to write a humerous response.
Herbalist Robyn Kline, AHG, instructor at the Sweetgrass School of Herbalism, has been vigilant in exposing the strategies used by dishonest critics, and she sent me the following synopsis of her investigations. By the way, Robyn publishes "Robyn's Recommended Reading," which is a great way to keep up on the best literature in the field of herbal medicine. Take a look at the resource guide in section four for a comprehensive list of Robyn's suggestions.
Following are some examples of the less-than-truthful tactics that have been used by critics of herbal medicine.
• Convince the public that an adverse effect of an herb was discovered through credible research. A study published in Fertility and Sterility suggested that echinacea and St. John's wort cause sterility and mutation of cells. This study cannot support this conclusion (Ondrizek 1999).
• Base claims of toxicity on single constituents while ignoring the whole herb. Carotoxin is toxic to lab rats. It is found in minute amounts in garden carrots. This does not prove that garden carrots are therefore dangerous. People don't ingest purified active constituents. People ingest teas, tablets, and liquid extracts made from whole plants (Crosby 1967).
• Focus on the uncommon use of the poisonous part of an herb instead of the gentler, more commonly used part of the herb. Many critics ignore the gentle parts of an herb completely and instead focus on the uncommon use of the more potentially poisonous parts of the herb. This is like saying potatoes are dangerous because the leaves are poisonous.
• Use a rare herb which is not usually found in herbal products to prove that herbs in general pose a danger to the public. In fact, many critics use examples of poisonous plants not even found in herbal products. They warn against using uzara root, which contains cardiac glycosides but is rarely used in herbal medicine today (Miller, 1998).
• Use examples of overdose or misuse of an herb instead of appropriate properly prescribed dosage to imply that the herb poses a health danger. Ephedra has been used safely for centuries in China to treat asthma. But companies here in the U.S. began to add the alkaloids to weight-loss products, causing serious problems (Cupp, 1999).
• Present flawed or incomplete scientific research as conclusive evidence. One study showed that echinacea wasn't effective for treating or shortening colds. What the report didn't reveal was that the researchers studied ridiculously low doses.
• Ignore any literature that does not come out of Western scientific research, even though there might be an overwhelming amount of evidence from traditional and ethnobotanical literature. This happens all the time.
• Use one case of an adverse reaction to imply that such reactions are commonplace. Critics constantly warn that chamomile flower can cause anaphylactic shock, though this only occurs in one out of millions of doses (Jensen-Jarolim 1998).
• Demand that herbal medicine must meet standards that have never been applied to Western medicine. Critics of herbal products claim that they have not been proven efficacious or safe using the objective, scientific methods of placebo-controlled double-blind studies and rigorous testing. Yet such critics conveniently ignore the fact that some 85 percent of everyday medical treatments have never been scientifically validated. For example, each year 700,000 children have tubes inserted into their ears to treat otitis media. However, statistics show that this procedure is often ineffective (Chan 1989).
• Use hypothetical interactions of an herb with a drug to alarm clinicians when no such interactions have been reported. Examples: 1) Skeptics warn against the use of ginseng root with estrogen or corticosteroids. 2) They also purport that dangerous licorice root-digoxin interactions exist. However, there are no in vitro, in vivo or clinical reports to support these warnings, just theoretical claims (Miller 1998).
• Blame an innocent herb by association with a blemished herb. One case of hepatotoxicity caused by a product containing echinacea and scullcap led to an incorrect deduction that echinacea causes hepatotoxicity. However, it is possible that the scullcap (Scutellaria laterifolia) had been adulterated with germander (Teucrium chamaedrys), an herb known to be toxic to the liver.
• Use alternative products which are not herbs as examples of toxicity. A product called Kyushin is a Chinese medicine rarely seen in the West containing dried toad venom, and has been shown to be toxic. Kyushin is not an herb, so its dangers should not reflect on herbal medicines (Miller 1999).
• Overstate hypothetical adverse reactions for an herb because it is used to treat a condition for which dangerous Western drugs are typically prescribed. Hawthorn used alone has shown absolutely no dangerous effects on the heart or vascular tissue. There are no clinical reports of hawthorn interacting with any cardiac medicine. Hawthorn is assumed to work like a cardiac drug, so potentiation is only a theoretical concern (Upton, 1999).
• Blame an herb for adverse effects commonly associated with administration of a concurrently taken medication. Evening primrose and borage oils have been blamed for epileptic episodes in patients undergoing treatment with phenothiazines. While there is no evidence to support the claim that these oils are responsible, there is scientific research showing that phenothiazines can cause epileptic episodes.
Robyn found evidence of these tactics while reading articles in such respected and prestigious publications as the New England Journal of Medicine, the Journal of the American Medical Association, The New York Times, and Archives of Internal Medicine. You can see another obvious example in the 2005 attacks on vitamin E.
The problems outlined above can be solved if all of us insist that only good quality science and scientific reporting be used to evaluate herbal medicines. On August 4, 1999, the Associated Press reported that the U.S. Congress had reiterated its commitment to this practice when it announced that the FDA had used sloppy science to justify some of its proposed rules for the use of ephedrine.
As I mentioned earlier, most journalists attempt to write honest evaluations of their understanding of herbal safety issues while some do not in specific instances. However, I have seen magazine and newspaper articles appearing in early 2000 through the end of 2004 that defy all sense of propriety. When you mix moderate amounts of accurate information with large amounts of innuendo, speculation and discredited information you take away the public's ability to judge and replace it with fear. Honesty means discussing individual issues in detail as they arise, and using only the best available information. In one of these "articles", they took every available negative issue with herbal medicine, mixed it together with the worst possible slant. It seemed as if anyone dared to take an herb, they were in danger of being immediately poisoned or blinded. Fortunately, I knew the truth behind each of the thirty or so negative points brought up in this article, and now so do you, since just about each and every one has been discussed in this section
First, Bring a Calculator
1. Product 1 contains 120 capsules of milk thistle extract, 150 mg (80% flavonoids), and costs $13.50
2. Product 2 contains 90 capsules of milk thistle extract, 200 mg (80% flavonoids), and costs $12.50
Q & A. Which is the better Deal?
We need to calculate how much each product costs per gram:
Product 1: 120 capsules x 150 mg = 18,000 mg for $13.50
If we divide by 1000, we see that this product costs $13.50 for 18 grams, or 75 cents per gram.
Product 2: 90 capsules x 200 mg = 18,000 mg for $12.50
If we divide by 1000, we see that this product costs $12.50 for 18 grams, or 69.5 cents per gram, so it is the better deal
This is the basic calculation method for determining the true cost of an herbal product. However, in Product 1, the 150 mg of milk thistle extract was packaged in a capsule containing 350 mg of an inexpensive filler herb. In other words, there may have been 500 mg of total herb in each capsule as stated on the label, but only 150 mg of it was milk thistle. You must read the labels carefully to make accurate calculations.
I have a catalog that offers all my herbs and vitamins at very low prices, significantly lower than the costs in the health food store. Can I trust the company?
Perhaps. We are now in a revolution where low-cost Internet and catalog shopping are taking significant market share from the health food stores. Because of mass buying and lower infrastructure costs, they can offer things at lower cost, and often with great convenience. However, there are several pitfalls. The first thing you should know is that there is wide disparity in the costs of different herbs, so it is worth your while to carry a calculator to do as the above example suggests.
Think of it like this. Imagine you are buying a car. Imagine further that you cannot see the car you are buying, because a huge capsule covers it. You must depend on the information on the outer label. This puts you at a huge disadvantage over the retailer, who knows what went into the capsule before it was sealed. A $25,000 car capsule containing a new Mercedes would be a bargain, while a $6,000 car capsule containing a used bicycle would be a rip-off.
For example, I'm looking at a catalog right now. Let's assume the catalog offers only good quality products. First of all, two common herbs, ginkgo leaf and echinacea, are offered at very good prices. However, the prices for other herbs in this particular catalog are not nearly as good. This is known as a loss leader. The items with which consumers are familiar are offered at a low cost in the hopes of gaining your trust, so you will assume that everything else is fairly priced as well, which may not be true.
To really identify good prices you need to do a little comparison-shopping. Read the labels carefully to make sure the products contain the same herbs in the same form. Then use a calculator to compare. For a detailed example, see the example provided at the beginning of this section
Labeling is supposed to be controlled by the government, and ideally, it just means that the herbs listed on the label match what the laboratory has determined to be inside. If the label says 200 mg of dandelion root per capsule, then each capsule contains 200 mg of dandelion root, right? Maybe so, but labels can be literally true but still misleading. Just because the product contains a total weight of an herb, it doesn't tell you anything about the source, form and level of concentration.
How do I know I am really getting what is says on the label?
Starting in the spring of the year 2000, the FDA will require all labels to list the full contents of a product, providing common and scientific (Latin) names, the parts used, the form used and the potency. This important step will help end a lot of confusion. You will still have to read labels carefully, paying special attention to the contraindications and cautions statements that tell you obvious reasons why you should not use a particular product. Also, don't forget to check the expiration date--this is a common oversight. Bottles without expiration dates are suspect.
In spite of the positive changes mentioned above, product labeling is currently a hot issue in the herbal medicine industry. Even with the new labeling laws, manufacturers have found many ways to fool consumers into buying their products.
Some typical tricks follow...
• "Three tablets contain." I love this one. The "three tablets contain" is listed in small print so that people who are not used to reading eight-point type do not even notice the notation and end up believing each capsule or tablet contains a larger quantity of the active ingredient than it really does.
• A product is formulated with a concentration of the active ingredient at a level much lower than what is recommended. I had a patient come to me complaining that her $8 bottle of ginkgo leaf was not working, and that I had cheated her because I had tried to sell her the same thing for $18. Upon closer inspection, I discovered that her $8 preparation contained a 5:1 ginkgo leaf dry concentrate, while mine had the typical recommended 50:1 concentrate.Essentially, her $8 bottle really cost $80. The label on the product was telling the truth, but the manufacturer probably knew that many consumers would not know the difference between that little 5:1 (if they even noticed it) and the standard 50:1. In these cases, the manufacturer is only concerned with selling the product, without regard for whether it will actually benefit consumers. After all, who cares of a few elderly people don't get enough oxygen to their brains? Worse, many will never try this product again, when it could be of great benefit.
• A product is promoted for its ability to increase energy when it contains herbal forms of caffeine. Improved energy levels may result from taking herbs like black tea (Camellia sinensis) or guarana (Paullinia cupana), but people should be told that the herbs contain caffeine. Other herbs like this include yerba mate (Ilex paraquariensis) oolong tea, green tea, and cola (Cola nitida, Cola acuminata). Not that the energy from caffeine is bad, just that energy derives solely from caffeine is not the true energy that comes from tonic nutritive herbs like Siberian Eleuthero root bark (Eleutherococcus senticosus).
• A low-quality component is combined with a better one in the same product. Sometimes manufacturers will mix a small amount of a standardized ingredient with crude herb. The label might read "milk thistle, 500 mg, standardized to contain 80% flavonoids." In small print on the label you see that the product is a mixture of 80 mg of standardized herb and 420 mg of herb that is not standardized, possibly making the product weaker and less effective.
Names, Dosing and Other Problems
Problems with Dosing
Each herb requires proper dosing, which is listed on the label. There would be few problems if companies would just put the standard effective adult dose on the label of a product, and provide enough pills in the package to last for two weeks to a month. The problem is simple--consumers like low prices, and manufacturers like high returns. It is a well-known fact in the mass market that as product prices go beyond about $9 per bottle, items become more difficult to sell. So even if manufacturers indicate on the label that each pill contains a low (read: ineffective) dose, people will still buy the seemingly low-cost product. If consumers were aware of the dose required for effect, they might find themselves finishing off a bottle every three or four days. The manufacturers are justified in one sense, in that they could argue (and in court must argue) that they are selling nutritional supplements, not medicines, and so are not required to put effective dose levels for treating diseases on their labels.
The doses listed on many herbal product labels are far below what is needed to obtain a therapeutic effect, especially in acute cases. I found general agreement in China, India and Nepal with regard to dosage levels. In China, you would usually leave the herb doctor's office with about 100-200 grams of dried plants, which would be a three-day supply. You would need to go home and brew it into tea, using 1/3 of the batch to make two or three cups of dark intense tea. Whew! Then you would have to drink it. In Nepal it was about the same, but they used concentrated powders, and you would take 1-2 teaspoons of powder (about 3-6 grams) straight, or make a tea with it.
Consider that if you get plain herbs in powder form, each cup of tea would require 10-20 grams, which translates into 20-40 500-mg pills. Tinctures face the same problem. Echinacea seem quite inexpensive at $9 per 1-oz bottle, until you start taking 1 teaspoon every two hours, and use up a bottle in a day-and-a-half. Standardized herbs like ginkgo leaf and saw palmetto berries are less vulnerable to this problem, though I often need to double the dosages to get results. Many times herbal treatments fail because the dose is too low.
Another aspect of herbal medicine difficult for the novice to explore concerns using combination products, otherwise known as formulas. Without being a professional, it is next to impossible to determine if a group of herbs in a formula designed to support the prostate or the kidneys will be good for you. Some of these formulations are well thought out, while others simply mix everything "good for the pancreas," no matter how far this stretches credulity. Good companies hire well-paid experts to formulate their products.
Often these are marketed using names like "Livr-Pure" or "Hepato-Magic." I suggest that people look up the individual ingredients one by one, or try to find literature explaining the history and scientific or traditional basis behind the formulation. Beware of formulas which use the word "secret," or which "were handed down from an ancient Indian formula revealed in a trance to the company president's dead uncle."
Organic, Synergistic, Balanced, Natural and Best
Labels often contain lots of words that are full of sound and fury, yet signify next to nothing. If something is "synergistic," it should mean that the parts work together and create something stronger than if we simply totaled the effects of each piece. For example, adding an herb that aids digestion to one that is hard to digest would increase the medical activity of the second. Unfortunately, words like "synergistic" are generally used without discrimination or definition. The uses of "balanced" and "best" also have no agreed-upon meaning. "Natural" sometimes describes a product derived from natural sources as opposed to synthetic, but I have seen it used to describe white sugar. Nonetheless, consumers are attracted to herbs that are "the highest quality best-selling synergistically balanced and completely natural formula you can buy today."
Polypharmacy Vs Good Formula Writing
The random mixing together of herbs was dubbed polypharmacy by the Eclectic physicians of the last century, and they looked down on it as an ill-conceived practice. Well-constructed herbal formulas are put together to match the needs of the patient, and should be based upon a solid system of differential diagnosis or scientific reasoning. Each herb in the formula should have a stated and specific purpose. For example, putting six diuretics into a formula for the kidneys is not the correct way to treat a kidney infection. Some of the diuretics may be mild, while others, such as uva-ursi leaf (Arctostaphylos uva-ursi) may be irritating and therefore contraindicated. A good formula in this case might contain two non-irritating diuretics, along with one or two herbs that reduce inflammation, one that soothes the ureters, and one that stimulates the immune system.
To make a formula for a general purpose or particular organ instead of a specific condition is certainly allowable, and can work well, as long as you are aware of the drawbacks. Formulas that are designed for the liver, for example, have to recognize that hepatitis is a different liver problem than elevated cholesterol or cirrhosis, distinctions that may escape the layperson. Herbs that are beneficial for one liver condition might be harmful or ineffective for another. This does not mean, however, that there aren't a few very safe liver herbs that can be used without much worry.
When Nai-shing first came to this country, she examined a group of TCM formulas I had been using. By reading the ingredients, she immediately knew what the formula was, and what it treated. It seems the company I was working with had copied a core group of traditional formulas known by every well-trained TCM doctor. Upon examination, Nai-shing said that the company had also done a good job with the literature provided along with the formulas, which I found reassuring.
Good medicine making and new formula construction still exist. Well-trained herbalists, physicians, nutritionists and biochemists are creating new combination products all the time. As new information comes to light, new formulas are constructed.
This gives us three basic groups of formulas: those that were formulated at random with little thought; those that have been handed down through an herbal tradition; those that were formulated by a knowledgeable herbalist or physician in modern times.
Consumers without the specialized knowledge of an expert like Nai-shing or myself cannot distinguish among these groups. I would humbly suggest that such information, giving the name of the formulator or the text in which the formula first appeared, should appear on the label. If such information does appear on the label there is a good chance that you are getting a superior product.
By the way, today we have a new form of polypharmacy, which occurs when people wander from pharmacy to pharmacy picking up every new wonder herb until their countertop is full of herbs. This is actually more of a disease than a mere habit. In the advanced stages, you run out of counter space and lose all memory of what the herbs you bought three months ago are supposed to do.
The Name Game
There are many ambiguities in herbal naming systems. There is a single international body of botanists responsible for establishing the Latin names of herbs in the world. Latin names are always italicized and are the best way to identify herbs. Common names vary from place to place, and a Latin-named herb can have various common names. A single well-known name may refer to several related or even unrelated plants. Each country has its own common names in its own language. This leaves plenty of room for mistakes and trickery. Some examples:
Substituting one plant for another. Because the Chinese herb Ma huang (Ephedra sinica) got a bad rap and was removed from the market after people died from diet products containing the chemical ephedrine, many diet pills became suspect. Ephedrine is a stimulant that can be dangerous for some people. Finding out that the Ayurvedic plant Bala (Sida cordifolia) also contains ephedrine alkaloid (though less), manufacturers substituted it for the ephedra. Now consumers who for medical reasons should avoid taking the ephedrine alkaloid might be fooled into taking something that can endanger their health. The label may be "honest," but the intent is not.
Hiding ingredients by using little-known common names. Perhaps I want to make a laxative formula using aloe leaf (Aloe vera). I don't want anyone to know, because they might copy my formula, so I use a little-known common name, like "socotrine aloes," or even a foreign name like "kumari." The average consumer would never figure out what plant it really is. This creates lots of confusion for both patients and doctors if a problem develops. I've got one here I still can't figure out -- rain deity bark. Contact me if you know what it is.
Associating your product with a more popular one. Wild red desert "ginseng" was sold for a time before people realized it was not ginseng root at all. It came from a different plant family, and had no relationship whatsoever to ginseng. The same trick was used to promote Siberian ginseng root bark, although this plant does share some tonic actions with real Chinese or American ginseng root.
Using made-up names. In an attempt to get around legal restrictions on claiming disease benefits for particular herbs, sometimes manufacturers will actually make up new names. I saw a French product that contained an herb I could not identify by common name. The Latin name given was something like Turina anticarcinoma. In another case, an attempt to promote the supposed sexual potency-enhancing properties of the Ayurvedic herb gokshura fruit (Tribulus terrestris), some manufacturers changed the Latin name to Tribulus erectus. This is almost a real herb. There is an herb called Trillium erectum. Unfortunately it is used to treat female problems and to induce vomiting. Its common name is "stinking benjamin."
More On Substitution
When performed by growers in the wild, substitution can cause major problems with safety (more on this in chapters four and five). Most often, however, the problem is not one of safety, but of effectiveness. In ancient times, herbalists studying and working in one part of a country sometimes could not find a particular plant when they moved to another region. They may have gotten around this problem by substituting another plant with similar qualities or similar appearance. This is not a major problem if both herbs are effective and the herbalists in each region know how to use them.
Other substitutions can mean bigger problems for consumers. For example, Dang gui root (Takg Kuai / Angelica sinensis) is sold all over America as a "women's" herb. Although this herb is used for many female problems, its traditional Chinese use as a warming, blood-nourishing herb for both men and women has been put in the background in favor of the modern and sometimes correct and sometimes incorrect use as a treatment for menopausal hot flashes.
This problem is compounded by the fact that in 1957, a lot of European Dang gui root (Levisticum officinale) was planted in China to meet demand. This process began in the area around Beijing and then spread to the rest of the country, in large measure supplanting authentic dang gui. The reasons were financial. The European variety was larger, yielding more plant per acre. In 1983 the Chinese government stopped this process. It is still assumed that the European dang gui may enter the market at times. To make matters even more complicated, the Chinese name dang gui is also spelled "tang kuai" and "dong quai" on many bottles.
Here is joke article I wrote ridiculing internet hype on herbal medicines. Because I was criticized for "misleading people" when actual orders came in, I was forced to write this disclaimer.
NOTE TO THE DENSE:
THE ARTICLE BELOW IS A JOKE - DO NO ORDER THIS PRODUCT OR YOUR BRAIN WILL BE TELEPATHICALLY FRIED BY VENUSIANS.
Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice -
Dead Volcanos Don't Fib
By Taoist Priest Alan Tillotson, nominated for World Presidency in 1997
I would like to share with you a remarkable new discovery I made last week. (Before I begin, I want to assure you that, as a Taoist priest, I am forbidden to lie.) I have been working underground in the health care field for over 20 years, so I have had plenty of time to fill out and mail in coupons, and last month I won a free trip for two to a tropical island. I brought my dog Elmer. While wandering around ancient volcanoes, Elmer began to yip excitedly, so I followed him to the top of a small dead volcano which appeared by the lack of discarded Coca Cola cans to have been forgotten since the dawn of time. Elmer had been trained by me to eat a diet of pure health food since birth (my leftovers), and I knew that yip meant some sort of health product must be close. But I wasn't prepared to find what I did - Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice.
At first I didn't know what I had found. As I peered into the void, all I could see was what looked like an oil slick surounded by tiny little trees. The trees were magnificent, like those Japanese things - you know, the little trees that look like big trees. I used my cellular phone to call my friend Professor Albert Schatz, PhD, spiritual healer and soil scientist, who quickly deduced that the volcanic soil, perhaps the oldest soil on earth, had strange magnetic qualities that it got from being originally at the center of the Earth, and someone had dropped some Nino seeds into the volcano, which sprouted and absorbed the magnetic colloidal minerals from the volcanic ash, which then produced the tiny trees with their blue, green, yellow fruits. (Nino is an ancient beverage drink used by Islanders to induce visions, dye their hair, and stop diarrhea.)
He could not deduce the effect of the fruit, however, without trying some. Elmer, however, had already eaten several thousand of the fruits (which are really tiny), so when I returned to my hotel, I watched anxiously. All that seemed to happen at first was that Elmer stopped defecating or urinating, and his musculature changed almost overnight. Originally a weenie dog, he now resembled a german shepherd. Elmer is actually a girl dog, but I didn't know that until his first heat, after I had named him, so I wasn't surprised when all the male dogs in the area began to gather around the hotel lobby.
To make a long story short, we discovered that Elmer was now exuding a super strong pheromone - you know, that smell that insects and people give off when they are in rut - that made him irresistible. Dogs came from all over the island. It was like a riot. Some people believed that this had something to do with the two whales that beached that afternoon, but I am a bit of a skeptic. I need real proof before I'll believe anything.
Months of research at my apartment back home brought out the real truth. Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice enters the colon, and the suspended particles magnetically attach themselves to the colon membrane. There, their unique colloidal blue, green, yellow structure causes them to absorb all sorts of food, juice, vitamins, minerals, trace minerals, fat, carbohydrates, proteins, anthraquinones, glycosides, and cosmic vibrations, and transform them into pure energy. This is why Elmer stopped defecating. The juice also transmutes all negative energy, including industrial filth, air pollution and even sugar, into its sub-atomic state, where is is hydolized and hydrogenated into amino acid carbon chains which reform into energized spring water particles which your cells can absorb without producting waste products. This is why you stop peeing too. The research is continuing, and we expect more to be added to this e-mail and spread around as people transform themselves with the product.
Our group, the World Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice Marketing Association, has entered into an exclusive contract with the Native People around the volcano, who had heard about the success of their relatives in the casino business. They are now growing them at the secret volcano site. To live forever (no one who has used the product has yet died), send me your credit card number, and your first shipment of juice, in thimble sized containers, taken one thimbleful each day, will arrive shortly. For an extra $100 per month, you can send your own Super Blue, Green, Yellow Magnetic Volcanic Colloidal Nino Juice story and your bank account number. We will bulk e-mail your story along with ordering instructions to millions of people over the internet for you each month. We will then deduct the cost of the juice from your credit card, and then ship the juice out for you, and then electronically deposit the money we receive back into your bank account, minus a small service fee. You don't have to do anything, and your bank account will grow pyramidically, so, in addition to being eternal, (no one who has used the juice has yet died), you will be rich.
And don't forget about the pheromones you women will be exuding. At first we thought men were denied this benefit, but we later found that Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice increases testosterone by 492%, and the combination of that with the new muscles and increased bank account creates a similar effect on the opposite sex.
Yours in Health,
Alan & Elmer
Warning: This product is not intended to treat any disease, and should not be used during pregnancy or ovulation unless under a metaphysical doctor's supervision. The above statements have not been evaluated by the FDA.
Address all orders to:
Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice
Chinese Hong Kong Discount Industrial Surplus Warehouse, Canoga Park, Ill. 696969
1. "In the Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice Zone cookbook." only $19.95.
2. "Anal Retention Enema of Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice for the Elderly and Infirm." (Pamphlet) $4.95.
3. "The Tuna Flavored Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice Science Diet," by Elmer Canine Fido. $7.95.
4. Free with your order - "Grandma's Super Blue, Green, Yellow Magnetic Volcanic Colloidal Anti-Carcinomic Nino Juice Jello Recipes."
To all the people who wrote me asking the right to distribute the Nino juice satire, I at first hesitated, but Elmer can now control me telepathically, and he swayed my vote.
Anyone can copy, change, add, delete or do anything else they want with this joke. Help yourselves.