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People frequently
want to use "natural" or "herbal" medicines. Many believe that any
"natural" or "herbal" medicine must be better or safer than other
medicines. This belief needs closer examination.
First
of all, I think that most people would agree that the most important
and pertinent questions to ask are:
1) Has this "natural", "herbal", or whatever form of medicine, been
tested adequately in clinical trials?
2) What are the proven benefits related to my medical conditions?
3) What are the known potential side effects? And how likely is
it that such side effects might occur? (Bear in mind that one can
say that a medicine has no known side effects just because no adequate
studies have been done or the medicine has not been closely scrutinized.)
4) Considering the benefits and risks (and the chances that such
benefits or risks could occur), do I, the patient, want to take
this medicine?
Secondly,
we need to remember that nature is neutral, neither good nor bad,
neither benevolent nor malevolent towards us humans. Just think
of some of the "natural" things that we'd rather not be exposed
to: leprosy, poison ivy, arsenic, jimson weed … The most toxic substances
come from nature. All infectious diseases, and in fact, all diseases
are "natural." Indeed, it is "unnatural" to have no diseases or
illnesses at all. Nature does not exist to serve us - it just exists.
(Actually, we are destroying nature every day, and, come to think
of it, if "Mother Nature" has a conscious mind, she has many reasons
to be quite malevolent towards us humans, considering what we are
doing to her.) We need to treat nature with a lot more respect.
We need to "use" nature wisely.
Any medicine, "natural", "herbal", or otherwise, needs to be studied
adequately before we can tell if it is actually effective or safe,
or what side effects it might have. Again, remember that one can
claim that a medicine has no known side effects just because one
has not done studies to evaluate the medicine closely and systematically.
Thirdly,
just what is "natural" anyway? Take ginkgo biloba for example. Is
it natural when it is harvested from the wild? Is it "natural"
when it is cultivated? Is it "natural" after it has been extracted
through solvents, filtered, dried, preserved, mixed with binders,
or encapsulated?
Does ginkgo biloba have known adverse effects in some people? The
answer is yes. Have people died from taking gingko biloba? The answer
is also yes. Does that mean that no one should take ginkgo biloba
or eat gingko nuts? The answer is no. Hey, ginkgo nut and rice soup
is delicious. Don't take that away from me.
Take another example - ginseng. Ginseng from the snow mountains
of Korea, ginseng from China, ginseng from Japan, and ginseng from
the milder climate of the Appalachians. Which one is the "real"
ginseng? Which one is the "natural" ginseng? If one could benefit
from eating Korean ginseng (and let us assume that the benefit has
been proven beyond the shadow of a doubt), would one benefit from
taking ginseng pills after the ginseng has been extracted, filtered,
dried, preserved, mixed with binders, and encapsulated? And would
one benefit if the pills were made from Appalachian ginseng?
Have people suffered adverse effects after eating ginseng or taking
ginseng pills? Sure, you bet. Should ginseng be banned? Heck, no.
I love ginseng and chicken soup. Don't take that away from me. However,
for soup, the ginseng should be a special type since ginseng taste
varies greatly (Did you know that?). The chicken should be young,
small, and preferably "free-range" with a more "natural" mild and
gamy taste, and not one of the thousands-in-a-coop-raised-to-optimum-size
chickens. Hmmm, let me see, which one is the "natural" chicken?
Maybe I should go into the woods to hunt some wild chicken.
The
bottom line is to know and weigh the benefits and risks (frequently
the benefits and risks are simply not known) and not to assume that
just because something is labeled "natural," it is effective, safe,
or beneficial.
Don't be blindsided by the prevalent mass media advertisements produced
by the major pharmaceutical companies hawking their patent drugs.
By the same token, in fact, by more tokens (how I love to twist
the English language, just like advertisements do), don't be blindsided
by those equally glitzy "herbal" and "natural" drug advertisements
and those testimonials, articles, books, and journals which are
simply advertisements-in-disguise. These ads that constantly bombard
our eyes and ears from every known media source are produced by
the multi-billion dollar "herbal" and "natural" medicine industry.
At least the major pharmaceutical companies are much more tightly
regulated by the FDA. The "herbal" and "natural" medicine industry
is the wild, wild, west.
© Chun-Kwok Wong, M.D.
Clinical Assistant Professor of Medicine
University of Texas Health Sciences Center at San Antonio
Faculty, Section of Endocrinology,
Regional Academic Health Center
November 2002
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