Herbal Remedies Examined

The doctors were astonished: The 47-year-old Detroit woman's muscle tissue was rapidly dying. She soon needed a feeding tube and ventilation as she lost the ability to swallow or breathe. Yet doctors couldn't find any disease.

The only clue: She ultimately revealed she had a sack full of herbal products. She first used a few as diet aids, but then when she began feeling ill, she desperately bought some 20 different herbs in her search for a cure-all.

Enter toxicologist Susan Smolinske, a sort of medical detective at Detroit's poison control center. She tested the patient's grab-bag of self-treatments and found a suspect: ma huang, a Chinese herb also known as ephedra. It often is used for weight loss, but Smolinske says it has been blamed for 15 other cases of muscle destruction.

"She didn't realize the herbs were the cause of her problem, and compounded it" by taking more, explained Smolinske. The woman eventually recovered.

Then there was the young woman who walked into Smolinske's office covered head-to-toe in an amazing rash. Itchy pustules even coated the soles of her feet. She had just switched from her regular multivitamin to one with added ginkgo. Smolinske's diagnosis: Every so often, ginkgo can be contaminated with a poison ivy-like substance.

Navigating the myriad alternative therapies and dietary supplements on store shelves is a challenge. So the Journal of the American Medical Women's Association dedicated its fall issue to checking out the science behind the products.

The result is the proverbial good-and-bad news: The researchers found some glimmers of hope, saying a few herbs in particular need study as possible anti-cancer and gynecologic therapies.

But they also found far too little scientific research on popular remedies, and they urged doctors to take better care of women by talking honestly about what they use.

Studies suggest 40 percent of patients don't tell doctors they use alternative therapies.

Some supplements are proven helpful. Folic acid and calcium are highly recommended for many women, for example.

While the supplements industry insists problems are rare, some products are considered risky, especially if taken with other medications. Many herbalists, for example, advise people on blood-thinners to avoid ginkgo and ginseng.

Other remedies simply haven't been studied for safety.

"Mainstream medicine doesn't have all the answers," stressed Judith Jacobson, a Columbia University epidemiologist who has enrolled 80 breast cancer survivors in a new study to see if an herb called black cohosh eases hot flashes. Breast cancer survivors usually avoid the hot-flash medication estrogen.

But there are big differences between test-tube, animal and human research.

"People without medical training ... find that something worked in mice and they get very excited about it," Jacobson cautioned. "'Are you a man or a mouse?'or 'a woman or a mouse' is a good quesion."

It's an especially important question for women, who experts say use alternative products far more often than men.

"There are many herbs with therapeutic potential, but I think you need to be smart with... them," Smolinske said.

In addition to checking the American Medical Women's Association's journal review, she offered the following tips:

• Check the product label. Although supplements are largely unregulated, the U.S. Pharmacopeia has developed standards for some, and those bottles should mention "USP."
• The American Botanical Council publishes "HerbalGram," which Smolinske called a "pretty unbiased" source.
• Ask your doctor about possible drug-supplement interactions.

Written by Lauran Neergaard