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Last Updated: Thursday, 4 October 2007, 09:09 GMT 10:09 UK
Hocus pocus or reliable remedy?
By Clare Murphy
Health reporter, BBC News

The UK's most eminent expert in complementary medicine says high street herbal remedies are either useless or dangerous, while a study suggests the "tailored" preparations concocted by herbal practitioners are a waste of money.

St John's Wort
St John's Wort: good for depression but not with prescription drugs

But are we really wrong to have fallen in love with the humble herb?

It is said we've never had it so good: living longer thanks to the leaps and bounds made by medical science.

And how do we express our thanks?

According to the critics, by turning our backs on the mainstream and dabbling in the occult - or at the very least the unproven: spending millions of pounds each year on herbal formulas for conditions ranging from an itchy patch of skin to terminal disease.

"I used to say if it made my patients feel better then it was ok by me," says Professor Michael Baum, a professor emeritus of surgery.

"But increasingly I feel one has to speak out against it - because there's no knowing where this hocus pocus will end up."

Really that bad?

As far as Professor Baum is concerned, if a treatment is subjected to scientific rigours and found to be efficacious then it should be integrated into mainstream medicine and put in the hands of doctors - at which point the label "alternative" ceases to apply.

And there are indeed herbs which have passed these tests - although only about a dozen of the many hundreds on offer.

Some members of the medical community don't like herbal medicine because they are used to playing God and worry that it may encroach upon their territory
Dr Lakshman Karalliede
Toxicologist

Gingko for instance is known to be effective in treating dementia, Valerian insomnia and Devil's Claw musculoskeletal pain.

But that does not mean they should be bought freely over the counter, argues Professor Edzard Ernst, the first professor of complementary medicine in the UK and a believer in the power of herbal treatments.

"The ones that work tend to be for serious conditions," he says, "and self medication for these is really not advised."

One of the principal problems is interaction with existing prescription drugs. Herbal remedies are known to interfere with all sorts of medication - from common anti-coagulants to anti-HIV drugs.

At the extreme end of the spectrum, a transplant patient who has taken St John's Wort while low in the aftermath may find it seriously affects his body's ability to accept a new organ and his chances of survival.

Referring on

But because doctors in the UK are seen as notoriously uninterested in herbal therapies - unlike their colleagues in Germany where herbs form part of frontline care - they may be unlikely to ask their patient if they are taking any remedies.

"And for his part the patient may not confide because he is afraid of being sneered at," says Dr Lakshman Karalliedde, who has just published a book promoting the safer use of herbal medicines and looking at potential herb-drug interactions to help GPs prescribe.

Brought up in Sri Lanka amid ancient Ayurvedic Medicine traditions, Dr Karalliedde was trained in Western medicine and worked for many years in toxicology at Guy's and St Thomas's hospital in London.

"Of course a lot of herbal medicine is nonsense," he says. "But some of it isn't.

"What we really need is proper research to establish both the benefits and the risks: some members of the medical community don't like herbal medicine because they are used to playing God and worry that it may encroach upon their territory."

But despite the fears that the proponents of herbal medicine are luring patients away from their doctors, one practitioner suggests quite the opposite is true.

"I've been doing this more than 20 years, and if anything people seem to have a much better relationship with their doctor these days," says Alison Denham, a fellow of the National Institute of Medical Herbalists. "The numbers seeking this kind of help really aren't increasing.

"And I'm the first to say, 'have you seen your doctor?'"



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