To Supplement or Not to Supplement

Herbal medicine has been around for thousands of years and has been used successfully for the management of common ailments in many cultures including Asian and African cultures. Specific formulations, cultivated in specific ways, harvested at specific times, compounded in specific ways, made in very small batches as needed are handed down from generation to generation. One might venture to guess that an informal set of regulations may have often guided the manufacture and use of herbal remedies in these cultures as the trade is handed down from master healer to apprentice. A code of honor and a dedication to healing is paramount in these settings. These herbal remedies in these cultures may have stood the test of time for several reasons, the rigor and responsibility associated with the trade, the practice of small batch individual preparation targeted to the patient at hand. It seems a natural leap that large scale commercial mass production of these remedies in a one size fits all formulation are inherently less likely to be as efficacious as a tailored regimen made from intentionally cultivated, specifically harvested preservative free plants. 

The last four to five decades has seen a positive growth in American interest in natural remedies. The concomitant growth in the non-GMO movement appears to have somewhat converged with the growing movement towards natural remedies. It seems the prevalence of chronic medical conditions for which synthetic pharmaceuticals don't seem to have a straightforward answer may also be contributing to this shift in interest

No matter the reason, while I firmly believe the validity of herbal remedy in the management of some chronic disease states, the concern for me as a trained epidemiologist, clinician and public health Internist lie in the ambiguity of the quality and safety of the myriad products marketed as herbal supplements. It is important to keep in mind that while pharmaceuticals are subjected to rigorous testing pre and post-market introduction, there is little structured safety measures in place for herbal supplements. The passage of the DSHEA (Dietary supplement herbal education act) in 1994 basically placed herbal medicines in a category separate from drugs and redefined it as a supplement, therefore allowing manufacturers to market their products to the general public without prior demonstration of quality, safety or efficacy. It is also important to know that manufacturers of herbal supplements are also not required to report post-marketing adverse effects to the FDA. So herein lies the rub! While I am a staunch advocate for holistic approaches to medical care, and a staunch believer in the "less is more" mantra, my philosophy on dietary supplements has always been proceed with extreme caution. Because there are minimal safety measures to protect the consumers in place, it is incumbent on us as consumers to ascertain the credibility, chain of manufacture, constituents, and efficacy of any supplement that you put in your body. Manufacturers of dietary supplements are required to have on their label a statement certifying that the product is not intended for the diagnoses, treatment, cure or prevention of disease but they are not prohibited from making claims about the products such as "promotes circulatory health", "promotes longevity" etc.

The bottom line is, Natural does not always mean safer! Treat your herbal medicines (supplements) the same way you would treat any other medicine, they can be toxic to your organs including liver, the kidney, the heart, the circulation etc. Further many have been shown to contain heavy metals and contaminants including blood thinners. Consult with your physician or primary care provider before you begin taking any medications be it synthetic or herbal.

My mantra and practice philosophy takes into account the entire person, if we keep in mind that no one organ functions independent of the rest of the body, and that the mind, body and spirit are vitally intertwined with form and function, then it becomes clear that effective management of disease conditions will require a treatment of all the facets of the person no matter what sorts of therapy modalities are used, herbal medicines, dietary supplements or synthetic medications. Our lasting interventions come in the form of durable lifestyle changes.

Leave me your thoughts....

Best Regards, 

​Dr H