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Table 1 - T h e efficacy of herbal medicines

Each herb is followed by the conditions it supposedly treats and a rating.


The ratings reflect the amount and quality of evidence supporting the efficacy of each herb. Those herbs given a poor rating should be avoided, as
there is no good reason to believe that they are effective. Even those herbs
given moderate and strong ratings are not necessarily advisable for patients
- the reasons for caution are explained in the next section of this chapter.
It is worth noting that for many diseases and conditions, including cancer,
diabetes, weight loss, multiple sclerosis, osteoporosis, asthma, hangover and
hepatitis, there are no effective herbal remedies.

Aloe vera (Aloe barbadensis): herpes, psoriasis, wound healing,


skin injuries.

Poor

Andrographis (Andmgraphis paniculata): common cold.

Medium

Artichoke (Cynara scolymus): high cholesterol, dyspepsia.

Poor

Bilberry (Vaccinium myrtillus): eye conditions, varicose veins,


phlebitis, menstrual pain.

Poor

Black cohosh (Actaea racemosa): menopause, cold, menstrual


and other gynaecological problems.

Medium

Chamomile (Chamomilla recuita): a 'cure all' - e.g. dyspepsia,


irritable bowel syndrome, insomnia.

Poor

Cranberry (Vaccinium macrocarpon): prevention of infections


in the urinary-tract.

Medium

Devil's claw (Hapargophytum procumbens): musculoskeletal pain. Good


Echinacea (E. angustifolia, pallida, or purpurea): treatment and
prevention of common cold.

Good

Evening primrose (Oenothera biennis): eczema, menopausal


problems, PMS, asthma, psoriasis; a 'cure all'.

Poor

Feverfew (Tanacetum parthenium):

Medium

migraine prevention.

Garlic (Allium sativum): high cholesterol.

Good

Ginger (Zingiber officinalis): nausea.

Medium

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Ginkgo (Ginkgo biloba): dementia, poor circulation in the leg.

Good

Ginseng, Asian {Panax ginseng): impotence, cancer, diabetes;


a 'cure all'.

Poor

Ginseng, Siberian (Eleutherococcus senticosus): enhancement


of performance, herpes.

Poor

Grape seed (Vitis vinifera): prevention of cancer and


cardiovascular disease.

Medium

Hawthorn (Crataegus spp.): congestive heart failure.

Good

Hops (Humulus lupulus): insomnia.

Poor

Horse chestnut (Aesculus hippocastanum): varicose veins.

Good

Kava (Piper methysticum): anxiety.

Good

Lavender (Lavendula angustifolia): insomnia, anxiety.

Poor

Ma huang (Ephedra sinica): weight loss.

Good

Milk thistle (Silybum marianum): hepatitis and liver disease


caused by alcohol.

Medium

Mistletoe (Viscum album): cancer.

Poor

Nettle (Urtica dioica): benign prostate hyperplasia.

Medium

Passion flower (Passiflora incarnata): insomnia, anxiety.

Poor

Peppermint (Mentha xpiperita): irritable bowel syndrome, dyspepsia.

Medium

Red clover (Trifolium pratense): menopausal symptoms.

Good

St John's wort (Hypericum perforatum): mild to moderate


depressive states.

Good

Saw palmetto (Serenoa serrulata): benign prostate hyperplasia.

Medium

Tea tree (Melaleuca alternifolia): fungal infections.

Medium

Thyme (Thymus vulgaris): bronchitis.

Poor

Valerian (Valeriana officinalis): insomnia.

Medium

Willow (Salix alba): pain.

Medium

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Table 2 - T h e r i s k s of herbal m e d i c i n e s
This table relates to all the herbs in Table 1. Unlike conventional pharmaceuticals, herbal remedies have not been properly tested or monitored for safety,
so it is impossible to assess their risks fully. Because of the lack of proper
safety testing, some of the risks below are based on just one or two case
reports. It is also important to note that many herbs can trigger allergic reactions.
We have not included these in the table as there is insufficient space.
Aloe vera as a juice can cause diarrhoea, damage to the kidneys or electrolyte depletion. It can also interact with antidiabetic and heart medication.
The gel is applied externally and is not known to cause adverse effects.
Andrographis interacts with some synthetic drugs, including antidiabetics
and anticoagulants. It also might cause unwanted abortion.
Artichoke is not known to have adverse effects apart from flatulence.
Bilberry may cause blood sugar levels to drop dangerously or enhance
antidiabetic medications. It can also interact with anticoagulants.
Black cohosh has been associated with about 70 cases of liver damage. It
might also interact with heart medications.
Chamomile might interact with anticoagulants.
Cranberry has been associated with a rare case of thrombocyctopenia, a
condition characterized by a low platelet count, resulting in bleeding.
Devil's claw has been linked to interactions with drugs such as anticoagulants
and heart medications. It has also been associated with unwanted abortion.
Echinacea has been linked with asthma and rare conditions such as
erythema nodosum.
Evening primrose could trigger an epileptic fit and might interact with
drugs lowering blood pressure or heart medications.
Feverfew might interact with anticoagulants; can cause mouth to swell.
Garlic might cause blood sugar levels to drop. It can also exaggerate the
effects of anticoagulants, and might interact with other drugs.
Ginger may cause bleeding and may interact with blood pressure drugs.

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Ginkgo may cause bleeding or enhance anticoagulants; also linked with


epileptic seizures and Stevens-Johnson syndrome.
Ginseng, both Asian and Siberian, might interact with anticoagulants and
other drugs. Asian ginseng is also linked with insomnia, headache, diarrhoea, hypertension, mania and cardiovascular and endrocrine disorders.
Grape seed might interact with anticoagulants.
Hawthorn can amplify the effects of blood pressure and heart medications.
Hops might interact with contraceptive pill.
Horse chestnut could interact with anticoagulants and antidiabetic drugs.
Kava associated with skin problems and 80 cases of liver damage.
Lavender has caused nausea, vomiting, headache and chills. In rare cases, it
might cause hormonal side-effects such as swelling of the breast tissue.
Ma huang contains ephedrine, which stimulates the nervous and cardiovascular systems and can cause hypertension, myocardial infarction and stroke.
Milk thistle has been associated with colic, diarrhoea, vomiting and fainting.
It also interacts with antidiabetic and anti-viral drugs.
Mistletoe might interact with anticoagulants and other drugs.
Nettle has been associated with a rare condition called Reye's syndrome and
it might interact with drugs for lowering blood pressure.
Passion flower may affect brain activity and EEG tests.
Peppermint might interact with blood pressure and heart disease drugs.
Red clover has been associated with bleeding and may interact with anticoagulants, the contraceptive pill and other drugs.
St John's wort and its risks are discussed on pages 206-207.
Saw palmetto might affect blood platelets, which may cause bleeding.
Tea tree might cause swelling of breast tissue in rare cases.
Thyme can cause nausea, vomiting, diarrhoea, headache and other problems.
Valerian has been associated with isolated reports of liver damage.
Willow has been linked with isolated reports of liver damage and bleeding.

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