Many Claims of Herbal Remedies Remain Scientifically Unproven by Gina Shaw When I feel the first signs of a cold coming onóa slight difficulty in swallowing, a sense that my throat is getting just a tiny bit scratchyóI quickly take a couple of capsules of echinacea. If I gulp the herbal remedy in time, Iíve found a full-fledged cold never appears. But if I wait even a few hours after I notice the symptoms, I spend the next week with a set-your-watch-by-them series of complaints: sore throat, sniffles, cough and sneezing. I swear by my echinacea, but can it really prevent or cure a cold? Not necessarily. A number of studies have found that it can shorten the duration of a cold or make the symptoms less severe, but as for stopping a cold in its tracks, the scientific jury is still out. This sums up the problem with herbal remedies. The use of herbal supplements and remedies tripled between 1996 and 1999, according to a study presented in May 2001 at the International Scientific Conference on Complementary, Alternative and Integrative Medicine Research. Despite the enormous popularity of herb al supplements, many of their claims remain largely unproven scientifically. I know several women, for example, with recurrent migraines who couldnít imagine coping without the herb feverfew, but clinical studies of feverfewís migraine-fighting power are a mixed bag at best. Of course, some herbal remedies probably do boast clear and legitimate evidence of their efficacy. Ginkgo biloba, shown to increase cerebral blood flow and relieve vertigo, was found in a 1997 study to improve cognitive functioning in some patients with Alzheimerís disease; further studies are under way. Valerian appears to help with insomnia (although it can cause insomnia and excitability if overused), and black cohosh has demonstrated some effectiveness in treating symptoms of menopause. St. Johnís wort has been used for years to treat depression, and the National Institutes of Healthís (NIH) National Center for Complementary and Alternative Medicine acknowledges that there is some scientific evidence that St. Johnís wort is useful for treating mild to moderate depression, although most studies indicate it canít help those with severe depression. However, a major study in April found no benefits for patients with depression taking the herb when compared to a placebo, fueling more controversy in the ongoing herbal debate. The FDA does not regulate herbal supplements the way it does prescription medications, so itís hard to evaluate the quality of the products and the information youíre getting. Dosages and formulas vary widely by manufacturer, and unlike pharmacists, most health food store clerks, according to an informal survey taken by WebMD in 1999, donít have substantial training in the products theyíre selling. Nor are the labels much help, which have been described as often ìvague, misleading, and confusing,î according to the Mayo Clinic Health Letter. Another concern: Many patients donít tell their doctors when theyíre taking herbal supplements, either because they donít feel they need toóit is ìall natural,î after allóor because they think their doctor might argue with them. However, ìall naturalî does not mean ìrisk free.î Some herbs can interact badly with other herbs and medications or pose risks for people with certain health conditions. Researchers have found that both St. Johnís wort and harmless-sounding garlic supplements can impede the effectiveness of some anti-AIDS drugs. St. Johnís wort has also been found to interfere with anti-rejection drugs given to transplant patients. And some herbal remedies, on their own, can be downright dangerous. The FDA has warned of severe liver injury associated with the supplement kava (also known as kava kava or piper methysticum), which has been touted as a panacea for stress and sleeplessness. And many people continue to take the diet and energy drug ephedra (also known as ma huang) despite its association with strokes, heart attacks and seizures. So how do you know whether that supplement youíre taking is safe for you and has real scientific evidence behind it, or whether youíre spending your money on an unproven fad treatment? A good place to start is with NCCAM, the NIHís Center for Complementary and Alternative Medicine (http://nccam.nih.gov). Its section on making health decisions provides savvy guidelines on evaluating any ìnontraditionalî health option. Among other bits of wisdom, it advises consumers to check out scientific studies associated with the product or treatment (a searchable database is also available on the NCCAM Web site), and to exercise care in evaluating the source of claims about the remedyís effectivenessóin other words, get information from someone who doesnít have a stake in selling you something. No matter what you are taking, always inform your primary health care providers of your herbal supplement regime. Another good source of information if youíre serious about herbals is the Physiciansí Desk Reference for Nutritional Supplements. Edited by Dr. Sheldon Saul Hendler, a clinical professor of medicine at the University of California, San Diego, and editor in chief of the Journal of Medicinal Food, this isnít a tome youíd want to drop on your foot, but itís complete, accurate and authoritative. As for me and my echinaceaówell, NCCAM has just funded a major study of its effectiveness (as well as that of St. Johnís wort) at the University of Iowa to the tune of $6 million over five years. Iíll be staying tuned for the results. Gina Shaw is the medical writer for The Washington Diplomat.