Botanical Medicine: A Clinician's Perspective

Consumers generally perceive herbal remedies as safe and most use without consultation from a health care provider. Clinicians, on the other hand, often cite safety concerns regarding quality (i.e., adulteration, contamination) and the potential for herb-drug interactions. This concern may be justified. A large national survey reported that 72% of people using herbal remedies were also taking prescription drugs and 84% were using over-the-counter medications. The issue of adulteration and contamination is also a legitimate concern and complicated by the fact that finished products adulterated with pharmaceuticals can be very hard to detect using traditional laboratory analysis. Coupled with the tremendous variation in dose/serving size in the marketplace, product recommendations can be very tricky. This is further complicated by the fact that the vast majority of physicians are not adequately trained to counsel patients on the responsible use of herbal medicine. There is an urgent need for clinicians, pharmacists, medical journal editors, and supplement manufacturers to work together to improve the quality and delivery of, as well as education about, herbal products commonly used by the American population.