The herb dilemma

by Jody Larson

I saw this headline in a recent magazine advertisement: "If your antacid medicine is so good, why do you still get indigestion?"
Why indeed? That's the heart of the matter..the futility of taking substances for symptom relief alone.
The sufferer pictured in the ad, a man in business attire, might want to consider changing his eating habits and lessening the stress in his life. But that's not where the ad is leading, of course. The advertiser's point is that he needs a new, better, stronger antacid medicine to "fight" his acid stomach.
Herbal medicine has historically taken a different approach, being based originally on the model of nourishing and supporting, rather than fighting illness and relieving symptoms. But many people expect herbal remedies to work the same way as the fast-fast-relief pills. Although some herbs can give quick relief from some conditions, many others need to be taken regularly, frequently, and over a period of time.
How did the general cultural attitude toward medicines, herbal or otherwise, become focused on battling symptoms and illness, rather than nurturing and tonifying the whole person? The answer has to do with historical healing philosophies. (The accompanying box summarizes three of them.) Conventional medicine is currently dominated by the Scientific View, which makes disease and death our enemy and which values purified, refined chemicals as medicines.
"Party line" conventional medicine also regards herbal preparations as, paradoxically, either ineffective or dangerous. But how different are herbal remedies and drugs? Can herbs be as good or better?
The fact is, prior to the middle of this century, most drugs came from herbal sources, and many still do. In this article I describe three health conditions that illustrate similarities and differences of herbs and drugs as well as general guides for proper use.
Ephedra and the Stuffy Nose
Ephedra sinica, sometimes known as Mormon Tea, is commonly found in the western United States; Ephedra equisetina, also known as Ma Huang, is a well-known Chinese herb. Both plants are used for their decongestant properties.
Many different species of the plant Ephedra occur throughout the world. Evidently a lot of confusion exists about the species names of this plant. 'Mormon tea,' a common name for the North American plants, is applied to both Ephedra viridis and Ephedra nevadensis (Wats.). These may simply be different names for one plant. In addition, Ephedra trifurca is used for a flower essence made by an Arizona company, and Ephedra fragilis (joint fir) is also a native species. I found the name 'Ma Huang' applied to Ephedra sinica or sinensis, Ephedra equisetina (Bunge), and Ephedra vulgaris (Rich.). Again, these may or may not be different names for a single plant. There are 40 species of Ephedra worldwide What's an herb user to do? Check the source of the plants. Ephedra that's wildcrafted in the Southwest is probably not Ma Huang, no matter what name is on the label. Ephedra species produce two chemical compounds that are named after the plant: ephedrine and pseudoephedrine. These compounds are identical, except for the orientation of one part of the molecule. Similar as they are, ephedrine and pseudoephedrine have slightly different actions in the human body. Ephedrine is more a bronchial dilator, and so in its refined form it's found in some asthma medications. Pseudoephedrine is more a nasal decongestant, and in its refined form is widely used in cold remedies. In fact, you can hardly find a nasal decongestant product on the market that does not contain pseudoephedrine. (Sudafed takes its name from this compound.)
But ephedrine and pseudoephedrine have other effects. I've noticed that after a couple of days taking pseudoephedrine, whether in Sudafed, Nyquil, or SinuStop, my nose stays stuffed up anyway -- known as a rebound effect -- and I can't get to sleep. Both these compounds are also stimulants, especially ephedrine (more of which is produced by Ma Huang). As with any stimulant, overuse can even be dangerous.
During a recent cold, a friend of mine ran out of SinuStop late one night. Fortunately there was some Ephedra sinica herb in the house, and she drank a cup of tea made from roughly a tablespoon of dried herb in a coffee mug's worth of water. Not only did her nose stay clear all night (as compared with four hours taking SinuStop), but she had no trouble sleeping.
Can it be that taking both ephedrine and pseudoephedrine together, as is the case when using the whole herb, has a better effect than taking either purified substance alone? My friend's experience suggests that it does. What's more, the Ephedra plant produces many other compounds besides the two that scientists have identified as "active ingredients" and learned to synthesize. It may be that those other compounds have a moderating effect. Certainly one test doesn't "prove" anything, but my friend has subsequently bought more Ephedra sinica herb to have on hand.
Digitalis and Heart Disease
Digitalis species, commonly known as foxgloves, produce several compounds that regulate heart rate and strengthen heart contractions: digoxin, digitoxin, deslanoside, ouabain and gitalin. The "discovery" by conventional medicine of the effects of Digitalis has been of major benefit for those with too-rapid heartbeat and congestive heart failure. All these compounds have similar chemical structures--they might represent different stages in a metabolic process. All are also active in the human body, but some act quickly and others more slowly.
Digoxin and digitoxin are the compounds commonly extracted, purified, and made into prescription drugs. Digoxin and digitoxin have similar effects, but digitoxin is preferred because its effects continue for days rather than hours.
Could this be another case where use of the whole plant in an herbal preparation could be as good or better than the purified drug? Here's what one medical reference book, AMA Drug Evaluations (5th Ed., 1984), has to say:
"Digitalis leaf has approximately the same onset, peak effect, duration of action, and rate of metabolism as digitoxin. However, purer, more standardized preparations are preferred. "
By whom are they preferred...and why? (See the accompanying box on standardization.)
Dandelion and Water Retention
Lasix is a brand name for the chemical furosemide, a widely prescribed diuretic. Fluid buildup is often a problem in congestive heart failure, and use of diuretics, which increase kidney output, has been shown to be as effective a treatment as use of Digitalis compounds.
One of the drawbacks of furosemide therapy, however, is the loss of sodium and potassium along with excess water. The loss of potassium in particular can aggravate cardiovascular problems.
Well, that's easy to solve, though the doctor prescribing Lasix simply adds a prescription for potassium supplements. After all, what's another pill? Taraxicum officinale is the botanical name for the common dandelion. It's well known for its nourishing and tonic properties, both as a food and an herbal preparation. It's also an effective diuretic.
What's more, dandelion is also one of the best natural sources of potassium. Herbalist David Hoffman, author of The Holistic Herbal (Element Books, Longmead, U.K., 1988), says, " [Dandelion] thus makes an ideally balanced diuretic that may be used safely wherever such an action is needed, including in cases of water retention due to heart problems. " (Emphasis his.)
The Proper Uses of Herbs
The preceding three examples have shown cases where use of an herbal preparation may produce the same or even more beneficial results than the purified chemicals extracted from plants or synthesized. Herbs can be used for symptom relief, such as for nasal congestion, and also for longer term therapy, such as for heart problems and water retention. But other herbal remedies require a course of treatment to have an effect. Their action nourishes, stimulates, or helps the body to rebuild over time.
Echinacea is currently a very popular herb. Its primary use is as an immune system stimulant, and it's said to be effective against both bacterial and viral infections. You can find Echinacea included in a number of herbal compound remedies, and you often hear people say they start taking it at the first sign of flu or cold symptoms. But many health practitioners believe that the time to build up the immune system is before the onset of infection. If you've already caught the flu, Echinacea will still work, but your immune system may already be weakened. Further stimulation could simply be an additional stress on your body.
The general advice on use of Echinacea (and advice on this herb varies from one source to another) is to use it three times a day for no fewer than ten to twelve days. (It may be taken longer, but should not be taken continuously--take a few weeks' break after a few weeks' use.) If you begin prior to the cold and flu season, you're less likely to catch a cold to begin with. This is not a quick fix, and it requires preplanning and sticking with the regimen. "But wait!" someone might object, "If you don't get the flu, how do you know it's because you took Echinacea? Maybe you wouldn't have gotten it anyway. And besides, what if you took Echinacea and then got the flu. Does that mean it doesn't work? " Well, I could ask the same questions about flu shots.
With any course of prevention, you're playing the odds. Some people who get flu shots this year will get the flu anyway, and the odds on this are well known. I can't quote you the odds on use of Echinacea, but the point is, statistics don't guarantee what will happen in your case, whether you're using herbs or drugs, or nothing at all for that matter. Proper use of herbs depends on the herb you're using and what you're using it for, just as with prescription or over-the-counter drugs. Plenty of information is available through books, holistic health stores, and local herbalists. The ultimate test is, Does it work for you?

Jody Larson is managing editor of Many Hands. She has a masters degree in environmental studies and an ongoing interest in healing practices.

About Standardization?
We assume that for conventional drugs, standard dosages have been established, and they have. But often, depending on the substance, a wide range of values can constitute an acceptable dose.
Consider aspirin. Most of us assume that the standard dose is what we read on the label: Each adult-sized aspirin tablet contains 325 mg. of acetylsalicylic acid, and we are to take one to two tablets every four hours.
In Mexico, however, the standard adult-sized aspirin tablet contains 500 mg., and the instructions are two tablets every six hours. The manufacturer? Bayer. Imagine this company is making different dosages of aspirin depending on what country they're being sold in. Are Mexicans really different from Americans in this regard? Is it all those terrible tequila hangovers? Who knows. The point is, in Mexico people routinely take the equivalent of three U.S. aspirin per dose.
Lately many people are calling for some kind of standardization of commercial herbs and herbal remedies. This idea isn't necessarily bad, because herbs vary in potency depending on the time of year gathered and the length of storage before use or processing, as well as on other factors such as health of soil, region of the country, and methods.
The questions we should ask, though, are: Who wants them standardized, and why? Who will establish the standards, and how? Who will do the testing, and what kinds of tests will be used? Will larger companies profit, while smaller companies are forced out of business by compliance costs? And finally, are these just numbers for the sake of numbers?
With or without standardization, the best bet for consumers is to purchase from sources known to be reliable. Most herbal companies will provide information on how plant material is grown or gathered, processed, and prepared. If you can't get this information, you might want to consider another source.