How to stay safe with herbal medicines

Pharmaceutical Manager at Bupa UK
07 November 2018

Plant-based (or herbal) medicine has been around for centuries and has even influenced conventional medicine as we know it today. In the early 19th century the first medicine, morphine, was made from opium extracted from the seed pods of the poppy flower. Nowadays, about one in four prescription medicines worldwide are derived from plants.


Herbal medicines

Herbal medicines are complex mixtures of chemicals that may come from any raw or processed part of a plant. They’re often used in combination with other mind-body therapies, such as acupuncture, tai chi or massage to form part of what we call a traditional medicine system. There are many different types with the most well-known of these being Traditional Chinese Medicine (TCM) and Ayurvedic medicine.

Common herbal medicines

Today, herbal medicines are readily available to buy online and in store. Health stores are filled with them and a quick online search returns page upon page of results. Here I outline some of the most common herbal medicines and give a snapshot into the conditions they’ve been proposed to treat. It’s important to note, this doesn’t necessarily mean we have enough evidence that they can treat those problems – as I’ll explain further on in the article. And as I’ll also explain in the sections below, it’s really important to consult with a healthcare provider before starting to take any herbal medicines, to make sure you do so safely.

  1. Garlic

  2. Garlic used as a herbal medicine

    You may be more familiar with using garlic to season your favourite pasta dishes, rather than as a medicine. But over the years, it’s been thought that garlic may be able to treat and prevent numerous different conditions. Everything from the common cold to peripheral artery disease, pre-eclampsia and even colorectal cancer.

    It has also been suggested that garlic could help lower your blood pressure and treat lung infections in people with cystic fibrosis.

  3. Ginger

  4. Ginger as a herbal medicine

    Ginger biscuits, ginger tea – pickled, grated or fried, ginger comes in lots of different shapes and sizes, so to speak. But does it have any health benefits? It’s been suggested that ginger may help with painful periods, feeling and being sick during pregnancy and after surgery, and as aromatherapy to help with pain during labour.

  5. Turmeric

  6. Underground stems (rhizomes) of the turmeric plant

    Turmeric (also known as Indian saffron) is a relative of ginger and grown throughout Asia, in particular India, and also in Central America. It has been used in medicine for a very long time – nearly 4,000 years.

    In modern medicine, it’s been suggested that turmeric might help with the symptoms of arthritis. Scientists have also proposed that turmeric could help to protect people at risk of problems with their heart and circulation.

  7. Ginseng

  8. Roots of the ginseng plant used as a herbal medicine

    Ginseng is one of the most popular herbal medicines in the world. It’s been suggested that it may help people with diabetes to control their blood sugar levels. It’s also thought that it may help to increase energy and motivation, and manage certain symptoms in women going through the menopause.

  9. Milk thistle

  10. Purple flowers of the milk thistle plant, which can be used as a herbal medicine

    The active component of the milk thistle plant is silymarin and has been used in traditional herbal medicine for centuries. It’s thought to be beneficial for liver disease caused, for example, by viruses, drinking too much alcohol or being very overweight.

  11. Feverfew

  12. Feverfew plant used as a herbal medicine

    Feverfew (also known as featherfew or bachelor’s button) is found in both North and South America, and Europe. Today, it’s often used in the hope of preventing and treating symptoms of migraine, but was traditionally used for a range of different problems. From skin conditions like psoriasis, to toothache and asthma – feverfew was used for the lot!

     

  13. St. John’s Wort

  14. St John's Wort and its distinctive yellow flowers

    Today, St. John’s Wort is most commonly known for its use in treating depression.

    It’s important to note that St John’s Wort is a herbal medicine that commonly interacts with conventional medicines. For example, it counteracts the effect of the blood thinning medicine warfarin and so can increase the risk of life threatening blood clots. It can also reduce how effective some types of contraceptives are. The British National Formulary has a page summarising the interactions of St. John’s Wort with other medicines. If you’re considering taking St John’s Wort, discuss this with a healthcare professional first. They can confirm if it’s safe to use with any other medicines you may be taking.

  15. Ginkgo Biloba

  16. Ginkgo biloba plant used as a herbal medicine

    Ginkgo biloba (also known as maidenhair, or ginkgo for short) has been used for many years in TCM to heal various health ailments. It’s thought that it may help with:

    • cognitive impairment (for example, problems with memory and thinking in conditions like dementia)
    • intermittent claudication – a condition where you get temporary periods of pain or cramping in the muscles of your leg during exercise

    It’s also been suggested that it may help to slow progression of the eye condition age-related macular degeneration (AMD).

  17. Saw Palmetto

  18. Saw palmetto is a type of small palm tree, originally from the United States. The extract of the saw palmetto plant, serenoa repens, is thought to help ease problems with passing urine in men who have benign prostatic hyperplasia.

    Saw Palmetto and, in fact, some other herbal products may increase your risk of bleeding during surgery. So, if you’re having surgery, it’s important to tell your doctor or surgeon about any medicines – herbal or conventional – and dietary supplements that you’re taking beforehand.

  19. Aloe Vera

  20. Aloe vera plant used as a herbal medicine

    Substances from aloe vera, the burn plant or, as it’s more majestically known, the lily of the desert are used in many health products today. It’s thought that aloe vera may help with wound healing and be useful in conditions like inflammatory bowel disease (IBD). It’s also thought that it may help people who are developing type 2 diabetes.

Do they work?

What a question – and one that is perhaps too in depth for this article. However, in short, the answer is, “it’s complicated”. Most higher-quality studies show that there isn’t enough good quality or ‘powerful’ evidence to support their use for the various different conditions outlined above. But with lots of people using them for one thing or another, it seems that – for some – the jury is still out.

So the evidence isn’t always there to prove they work, but are they safe?

Safety

Safety is a really important factor to consider when deciding whether or not to take a herbal medicine or product. As with any medicine, it’s important to consider things like whether the benefits of taking the medicine outweigh any risks, and if there are any reasons why you specifically shouldn’t take it. The latter are called contraindications and may include some medical conditions, being pregnant or taking certain medicines. A healthcare professional can discuss any risks or contraindications with you. This can help you to make a well-informed decision before taking a herbal medicine or product.

Talking to a healthcare professional and discussing any risks or contraindications is helpful, but is there any wider regulation?

Regulation

Some herbal medicines are regulated under the European Traditional Herbal Medicinal Products Directive (THMPD). This includes ‘medicines’ used to treat minor health problems like a cold, which you don’t need to go to your doctor for. Herbal medicines that meet EU standards of quality and safety can be given a Traditional Herbal Registration (THR) and be listed on the traditional herbal register. These ‘medicines’ aren’t supported by clinical evidence, but are supported by many years of use and reported anecdotal benefits. As mentioned, they’re also deemed ‘safe’ by EU standards.

Herbal products that don’t claim to treat, ‘cure’ or prevent ailments and those used for general health and wellbeing may however be classified as food supplements. This means they can be produced, sold and marketed without going through the same checks as herbal, let alone, conventional medicines. Although this makes it easier to purchase and use these products, it also means that safety checks are not as strict. So, if you decide to use a herbal medicine or product, it’s very important to understand what exactly it is you’re taking and the potential risks.

Keeping yourself safe

If you decide to use herbal medicines, there are a few things that you can do to keep yourself safe.

  1. Before taking herbal medicines, check to see if they’ll interact with any other medicines you’re taking. They may, for example, affect how well your medicine works or increase the risk of side-effects. Medscape have a drug interactions checker that you could use.
  2. Consider the side-effects. Some herbal medicines or supplements can cause problems such as headaches, tummy pain or dizziness. It’s important to research side-effects thoroughly and talk to your GP or pharmacist about what you can expect. Some herbal medicines can also cause allergic reactions in certain people.
  3. If asked by a healthcare professional about any medicines you’re taking, make sure you remember to tell them about any herbal medicines or supplements too. This is really important if you’re having surgery or in an emergency situation. You should also tell healthcare professionals such as your dentist and optician too.
  4. Know what you’re taking. It can be difficult to navigate the world of herbal medicines, products and supplements. But there are a few key things to look out for.
    • Check to see if your product has a traditional herbal registration (THR). You can identify this on the packaging, or find your product on the traditional herbal register (see our Regulation section above for more information).
    • Be vigilant and use the information on the product packaging to see what exactly it contains and how much. Keep this information to hand in case you need it in future.

  5. And finally, remember to always consult with a healthcare provider, such as a pharmacist or your GP before taking herbal medicines, products or supplements. They’ll be best placed to give you further information and advise if they’re safe for you to use.



Even healthy people become unhealthy sometimes. Health insurance can help you get prompt access to the treatment and support you need to help you get back on the road to recovery. Learn more with our useful guide to understanding health insurance.

Justin Hayde-West
Pharmaceutical Manager at Bupa UK

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