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Curbing herbal remedies

A woman goes into a pharmacy in London and asks for over-the-counter emergency contraception, licensed in the UK since 2001. The pharmacist asks several questions about her health including, to her surprise, whether she is taking any herbal preparations. He is acting on the growing concern about harmful interactions between herbal medicines and pharmaceuticals.

The sale of herbal supplements is big business and getting bigger, but rising use has been accompanied by increasing reports of health problems. The Australian government last month suspended the licence of the country’s biggest complementary medicine company, after people taking a popular motion sickness drug suffered hallucinations. Thai officials recently banned the supplement V-1 Immunator because of false claims that it could cure HIV/Aids. Sean Riggins, a young American major league baseball player, died from heatstroke that doctors suspect was linked to ephedra, a herbal weight loss medicine.

Herbal supplements have gained wide acceptance over the past decade and some, if not all, may provide benefit. Evidence supports claims, for instance, that saw palmetto can relieve the symptoms of an enlarged prostate condition and that hawthorn may alleviate mild angina. Gingko shows some effect, in trials, on dementia.

Some experts are sceptical of the move to herbal remedies. “The benefits of herbal medicine rarely show validity in clinical trials, and the harm can be substantial,” says Arthur Grollman of the State University of New York at Stony Brook.

But critics also say herbal treatments pose a serious risk for consumers, particularly in the US where the industry operates under a loose rein compared with Europe (see below). About 30 per cent of Americans, 20 per cent of Britons, and 70 per cent of Germans use them, according to researchers at the University of Exeter. In 2001, Americans spent $4.2bn (£2.6bn) on herb and other plant remedies.

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