Herbal medicine/ja: Difference between revisions

In a 2018 study, FDA identified active [[medication|pharmaceutical additives]] in over 700 of analyzed dietary supplements sold as "herbal", "natural" or "traditional". The undisclosed additives included "unapproved antidepressants and designer steroids", as well as [[prescription drug]]s, such as [[sildenafil]] or [[sibutramine]].

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===Labeling accuracy===

A 2013 study found that one-third of herbal supplements sampled contained no trace of the herb listed on the label. The study found products adulterated with contaminants or [[filler (materials)|fillers]] not listed on the label, including potential allergens such as [[soy]], [[wheat]], or [[black walnut]]. One bottle labeled as [[St. John's wort]] was found to actually contain ''[[Alexandrian senna]]'', a laxative.

Researchers at the [[University of Adelaide]] found in 2014 that almost 20 percent of herbal remedies surveyed were not registered with the [[Therapeutic Goods Administration]], despite this being a condition for their sale. They also found that nearly 60 percent of products surveyed had ingredients that did not match what was on the label. Out of 121 products, only 15 had ingredients that matched their TGA listing and packaging.

In 2015, the [[New York Attorney General]] issued [[cease and desist]] letters to four major U.S. retailers ([[GNC (store)|GNC]], [[Target Corporation|Target]], [[Walgreens]], and [[Walmart]]) who were accused of selling herbal supplements that were mislabeled and potentially dangerous. Twenty-four products were tested by [[DNA barcoding]] as part of the investigation, with all but five containing DNA that did not match the product labels.

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===Practitioners of herbalism===

[[File:Picking of heads of Arnica montana.JPG|thumb|right|A herbalist gathers the flower heads of ''[[Arnica montana]]''.]]

In some countries, formalized training and minimum education standards exist for herbalists, although these are not necessarily uniform within or between countries. In Australia, for example, the self-regulated status of the profession (as of 2009) resulted in variable standards of training, and numerous loosely formed associations setting different educational standards. One 2009 review concluded that regulation of herbalists in Australia was needed to reduce the risk of interaction of herbal medicines with [[prescription drug]]s, to implement clinical guidelines and prescription of herbal products, and to assure self-regulation for protection of public health and safety. In the United Kingdom, the training of herbalists is done by state-funded universities offering Bachelor of Science degrees in herbal medicine. In the United States, according to the American Herbalist Guild, "there is currently no licensing or certification for herbalists in any state that precludes the rights of anyone to use, dispense, or recommend herbs." However, there are U.S. federal restrictions for marketing herbs as cures for medical conditions, or essentially practicing as an unlicensed physician.

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===United States herbalism fraud===

Over the years 2017–21, the [[U.S. Food and Drug Administration]] (FDA) issued [[FDA warning letter|warning letters]] to numerous herbalism companies for illegally marketing products under "conditions that cause them to be drugs under section 201(g)(1) of the Act [21 U.S.C. § 321(g)(1)], because they are intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease and/or intended to affect the structure or any function of the body" when no such evidence existed. During the [[COVID-19 pandemic]], the FDA and U.S. [[Federal Trade Commission]] issued [[FDA warning letter|warnings]] to several hundred American companies for promoting false claims that herbal products could prevent or treat [[Coronavirus disease 2019|COVID-19 disease]].

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===Government regulations===

The [[World Health Organization]] (WHO), the specialized agency of the United Nations (UN) that is concerned with international public health, published ''Quality control methods for medicinal plant materials'' in 1998 to support WHO Member States in establishing quality standards and specifications for herbal materials, within the overall context of quality assurance and control of herbal medicines.

In the [[European Union]] (EU), herbal medicines are regulated under the [[Committee on Herbal Medicinal Products]].

In the United States, herbal remedies are regulated [[dietary supplements]] by the [[Food and Drug Administration (United States)|Food and Drug Administration]] (FDA) under [[good manufacturing practice|current good manufacturing practice]] (cGMP) policy for dietary supplements. Manufacturers of products falling into this category are not required to prove the safety or efficacy of their product so long as they do not make 'medical' claims or imply uses other than as a 'dietary supplement', though the FDA may withdraw a product from sale should it prove harmful.

Some herbs, such as [[cannabis (drug)|cannabis]] and [[coca]], are outright banned in most countries though coca is legal in most of the South American countries where it is grown. The [[Cannabis|''Cannabis'' plant]] is used as an herbal [[medical cannabis|medicine]], and as such is [[legal status of cannabis|legal]] in some parts of the world. Since 2004, the sales of [[Ephedra (medicine)|ephedra]] as a dietary supplement is prohibited in the United States by the FDA, and subject to Schedule III restrictions in the United Kingdom.

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===Scientific criticism===

Herbalism has been criticized as a potential "[[land mine|minefield]]" of unreliable product quality, safety hazards, and potential for misleading health advice. Globally, there are no standards across various herbal products to authenticate their contents, safety or efficacy, and there is generally an absence of high-quality scientific research on product composition or effectiveness for anti-disease activity. Presumed claims of therapeutic benefit from herbal products, without rigorous evidence of efficacy and safety, receive skeptical views by scientists.

Unethical practices by some herbalists and manufacturers, which may include false advertising about health benefits on product labels or literature, and contamination or use of fillers during product preparation, may erode [[consumer confidence]] about services and products.

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==Paraherbalism==

[[File:Cinchona officinalis 001.JPG|thumb|right|An example of a herbal medicine resource: the bark of the [[cinchona]] tree contains [[quinine]], which today is a widely prescribed treatment for [[malaria]]. The unpurified bark is still used by some who can not afford to purchase more expensive antimalarial drugs.]]

'''Paraherbalism''' is the [[Pseudoscience|pseudoscientific]] use of [[extract]]s of plant or animal origin as supposed medicines or health-promoting agents. Phytotherapy differs from plant-derived medicines in standard [[pharmacology]] because it does not isolate and [[Standardization|standardize]] the compounds from a given plant believed to be biologically active. It relies on the false belief that preserving the complexity of substances from a given plant with less processing is safer and potentially more effective, for which there is no evidence either condition applies.

Phytochemical researcher [[Varro Eugene Tyler]] described paraherbalism as "faulty or inferior herbalism based on pseudoscience", using scientific terminology but lacking scientific evidence for safety and efficacy. Tyler listed ten [[fallacy|fallacies]] that distinguished herbalism from paraherbalism, including claims that there is a [[conspiracy theory|conspiracy]] to suppress safe and effective herbs, herbs can not cause harm, that whole herbs are more effective than molecules isolated from the plants, herbs are superior to drugs, the [[doctrine of signatures]] (the belief that the shape of the plant indicates its function) is valid, dilution of substances increases their potency (a doctrine of the pseudoscience of [[homeopathy]]), astrological alignments are significant, animal testing is not appropriate to indicate human effects, [[anecdotal evidence]] is an effective means of proving a substance works and herbs were created by God to cure disease. Tyler suggests that none of these beliefs have any basis in fact.

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==Traditional systems==

{{See also|Traditional medicine}}

[[File:Xi'an traditionnal medecine market (18).JPG|thumb|right|Ready to drink [[Maceration (wine)|macerated]] medicinal liquor with [[goji berry]], [[tokay gecko]], and [[ginseng]], for sale at a traditional medicine market in [[Xi'an]], China.]]

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===Africa===

{{Main|Traditional African medicine}}

Up to 80% of the population in Africa uses traditional medicine as primary health care.

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===Americas===

Native Americans used about 2,500 of the approximately 20,000 plant species that are native to North America.

In [[Andes|Andean]] healing practices, the use of [[Entheogen]]s, in particular the San Pedro cactus (''[[Echinopsis pachanoi]]'') is still a vital component, and has been around for millennia.

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===China===

Some researchers trained in both Western and [[traditional Chinese medicine]] have attempted to deconstruct ancient medical texts in the light of modern science. In 1972, Tu Youyou, a pharmaceutical chemist, extracted the anti-malarial drug [[artemisinin]] from [[sweet wormwood]], a traditional Chinese treatment for intermittent fevers.

===India===

[[File:Herbal medicine platter.jpg|thumb|A platter of herbal medicines at Goa, India]]

In India, [[Ayurvedic medicine]] has quite complex formulas with 30 or more ingredients, including a sizable number of ingredients that have undergone "[[alchemy|alchemical processing]]", chosen to balance [[dosha]]. In Ladakh, Lahul-Spiti, and Tibet, the [[Tibetan Medicine|Tibetan Medical System]] is prevalent, also called the "Amichi Medical System". Over 337 species of [[medicinal plant]]s have been documented by [[C.P. Kala]]. Those are used by Amchis, the practitioners of this medical system. The Indian book, Vedas, mentions treatment of diseases with plants.

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===Indonesia===

[[File:Jamu.jpg|thumb|right|Different types of Indonesian [[jamu]] herbal medicines held in bottles]]

In [[Indonesia]], especially among the [[Javanese people|Javanese]], the [[jamu]] traditional herbal medicine may have originated in the [[Mataram Kingdom]] era, some 1300 years ago. The [[bas-relief]]s on [[Borobudur]] depict the image of people grinding herbs with stone [[mortar and pestle]], a drink seller, an herbalist, and [[masseuse]] treating people. The Madhawapura inscription from [[Majapahit]] period mentioned a specific profession of herbs mixer and combiner (herbalist), called ''Acaraki''. The book from [[Mataram Sultanate|Mataram]] dated from circa 1700 contains 3,000 entries of jamu herbal recipes, while Javanese classical literature [[Serat Centhini]] (1814) describes some jamu herbal concoction recipes.

Though possibly influenced by Indian [[Ayurveda]] systems, the [[List of islands of Indonesia|Indonesia archipelago]] holds numerous indigenous plants not found in India, including plants similar to those in Australia beyond the [[Wallace Line]]. Jamu practices may vary from region to region, and are often not recorded, especially in remote areas of the country. Although primarily herbal, some Jamu materials are acquired from animals, such as [[honey]], [[royal jelly]], milk, and ''[[Ayam Kampung]]'' [[chicken eggs|eggs]].