Herbal supplements are products that contain herbs or other plant materials and are taken as an addition to a person's normal diet. People usually take herbal supplements to try to achieve some sort of health goal, such as losing weight, building muscle, or improving memory. Dietary supplements may come in pills, tablets, capsules, powders, liquids, and extracts. Herbal supplements are part of a larger category of products called dietary supplements. Dietary supplements are used for the same reasons as herbal supplements but may contain different materials. These materials could include vitamins, minerals, amino acids , or enzymes .
Herbal supplements are becoming more popular around the world but particularly in the United States. The number of Americans using herbal supplements tripled between 1996 and 1999. In 2001 Americans spent over $4 billion on herbal supplements. These supplements are considered to be food, not drugs, by the federal government. The government does not regulate the use of supplements in the same way that it regulates over-the-counter and prescription medicines. This means that these supplements do not have to be proven safe or effective before going on sale.
Researchers are studying a variety of herbal supplements to find out how they affect the body and if they are safe to use. Although there are very few studies on the safety of herbal supplements, some supplements have been linked to an increase in sickness and death among their users.
Commonly Used Herbal Supplements
In 2001 the best-selling herbal supplements in the United States were garlic, ginko biloba, echinacea, ephedra, kava, ginseng, senna, and St. John's wort. Other popular dietary supplements include SAMe, creatine, and androstenedione.
St. John's wort and SAMe are used to treat mild depression, anxiety, and sleeplessness. The herb St. John's wort contains chemical compounds that can be extracted and put into pills, capsules, or tea. SAMe, usually taken as a pill, is the artificial version of a chemical made by the body's cells. The herb kava (sometimes known as kava kava) is another supplement used to treat stress and anxiety.
Echinacea, also known as purple cone flower, is used to prevent colds and flu. It contains compounds that may strengthen the body's immune system . Echinacea is sold in pills, teas, liquids, and powders. Ginseng, another herb that affects the immune system, is also used to treat colds and flu. Some people take ginseng to boost their energy levels and reduce stress.
Other commonly used herbs include ephedra, senna, and ginkgo biloba. Ephedra, or ma huang, is an herb used to speed up the body's fat-burning process and to increase energy. The compound extracted from ephedra is called ephedrine. Forms of ephedrine are also used in cold and allergy medicines. Senna is another herb used to promote weight loss. Its leaves are a natural laxative, and senna is often found in drinks labeled "dieter's tea" or "slimming tea." Ginkgo biloba comes from the leaves of the ginkgo biloba tree. It is used to improve blood flow to the brain and to improve memory. Ginkgo is often used along with ginseng to increase overall energy and alertness.
Creatine is an amino acid dietary supplement, used to help build muscle and to provide short bursts of high energy. Creatine is especially popular with young athletes, who drink powdered creatine mixed into shakes or other liquids as part of their training. Creatine experienced a surge of popularity in 1998, when baseball player Mark McGwire of the St. Louis Cardinals admitted taking the supplement during his record home-run season. McGwire also used a hormone called androstenedione, commonly known as andro. Although androstenedione is classified as a dietary supplement, some researchers think that it should be classified as a steroid .
The most common supplements used by teenagers include those used to treat depression, encourage weight loss, and increase energy and strength. St. John's wort, ephedra, and creatine and andro are among the most popular supplements used by people in this age group.
The Potential Health Risks Associated with Herbal Supplements
Potential health risks related to supplements come from incorrect doses and incomplete information about how supplements might affect different types of people. Unlike over-the-counter and prescription drugs, there is no recommended dosage for specific supplements. Different brands of an herbal supplement may contain different amounts of the active herbal compounds, or other harmful ingredients. A 1998 study found that nearly one-third of 260 herbal supplements imported from Asia either contained drugs not listed on the label, or lead, mercury, or arsenic.
As more people take herbal supplements, the number of negative health effects associated with some supplements has increased. For instance, reports of health problems related to ephedra use have increased sharply. In 2000 the Food and Drug Administration released a study that linked ephedra use to 134 cases of health complaints, ranging from chest pain and sleeplessness to stroke, addiction, and death.
The rise in supplement users has uncovered another potential health risk: the interaction of supplements with other drugs. For instance, studies in 1996 and 2000 showed that St. John's wort may interact with drugs used to treat HIV infection and prevent the body from rejecting transplanted organs. St. John's wort may also interact with other, prescribed drugs for depression, such as Prozac or Zoloft, and birth control pills.
The Potential for Herbal Supplement Abuse
Herbal supplements, like drugs, may be abused. Supplement abuse usually happens when users take massive doses of the supplement or combine supplement use with other substances such as alcohol.
Ephedra may act as a powerful stimulant (like an amphetamine) when combined with caffeine, as is often the case in weight-loss products. Some researchers believe this combination has the potential to be addictive, especially if users take massive doses of each. Other stimulants such as ginseng can be candidates for abuse as well.
People with eating disorders, such as anorexia nervosa or bulimia nervosa , sometimes abuse supplements like ephedra and senna. In these cases, users abuse the supplements to carry out other behaviors associated with eating disorders, such as starvation, bingeing, and purging.
Some people combine supplement use with drinking, hoping that the supplements will either allow them to drink more or drink without the side effects such as a hangover. One such combination includes energy supplement drinks such as Red Bull, which contains amino acids and caffeine, and alcohol. This pair is especially popular with young binge drinkers who want to remain alert while drinking or who want to drink for a longer period of time.
Treating Drug Abuse with Herbal Supplements
Some doctors are trying to treat illicit drug abuse with the help of herbal supplements. The Center for Addiction and Alternative Medicine Research in Minnesota is one of the leaders in this effort. Among other projects, its scientists study whether particular Chinese herbal mixes can be used to treat alcohol abuse and smoking.
One recent study suggested that herbal supplements might have an opposite effect on teenagers, acting as a gateway to try substances such as tobacco, alcohol, and illicit drugs. The 1999 study of 2,000 high school students in New York State found that almost 29 percent of students said they used herbal products to either feel or perform better in activities such as sports. These same students were also much more likely to be using other drugs as well, the researchers found.