A much-touted recent investigation by the New York State Attorney general’s office claimed national store brand herbal supplements sold at GNC, Target, Walgreens and Walmart in fact did not contain the herbs shown on their labels. Instead they found such things as mustard, wheat, radish and other substances. All four stores were given cease-and-desist letters demanding that they stop selling a number of these supplements.
It was claimed that few of the products investigated were found to contain the herbs on the labels and many may have contained potential allergens that were not identified on the list.
According to the New York Times, the letters stated that “contamination, substitution and falsely labeling herbal products constitute deceptive business practices and, more importantly, present considerable health risks for consumers.”
The American Botanical Council (ABC) quickly issued a rejoinder to the action of the NY AG in a press release “ABC Says New York Attorney General Misused DNA Testing for Herbal Supplements, Should Also Have Used Other Test Methods as Controls.”
As an herbalist I’m well aware that there is and historically has always been a problem of contamination and adulteration of herbs. I’m all for the Attorney General of New York or any other regulatory agency serving as a watchdog and enforcement agency for such matters. I do not hold any great sympathy for the companies that were investigated and found at fault. When it comes to herbs, I’m more in favor of customers purchasing from reputable manufacturers whose specialty is manufacturing and marketing herbal products. Ideally it would be reasonable and much better if such companies had actual herbalists as part of their staff.
The problem with this overzealous and misguided investigation is that the only method for testing they used is a process called DNA barcoding, which identifies individual ingredients through a kind of “genetic fingerprinting.” “DNA” has a ring to it that is particularly appropriate if a prosecuting attorney is seeking the conviction of a serial rapist or sociopath but unfortunately when applied to herbal identification as a ‘stand alone’ method, it is widely regarded in scientific pharmacognosy as unreliable. It’s not clear whether whole herb products were tested, or herbal extracts. It is well known in the industry that DNA testing is not reliable for extracts or preparations involving heat that leave little genetic material intact after processing.
Leading pharmacognocists have pointed out this problem and the obvious absence of controls involved with the procedure. It could have only been ignorance on the part of the New York attorney general Eric T. Schneiderman and his staff, that before publicly condemning these outlets and their products and issuing ‘cease and desist’ orders that industry testing standards be applied. These would be HPLC (high performance liquid chromatography), HTLC (high performance thin layer chromatography) or infrared spectroscopy.
Unfortunately this makes it look more like another smear at an industry that someone doesn’t like rather than a sincere effort at regulation.
The American Botanical Council, an independent organization that along with the herbal industry generally is sympathetic with the Attorney General’s concern regarding deception and adulteration of dietary herbal supplements, takes issue with the obvious oversight regarding more sophisticated methods of testing and evaluating herbs that are available.
The investigators tested 24 products, each claiming to be seven different herbs, echinacea, garlic, ginkgo, ginseng, saw palmetto, St. John’s wort, and valerian. According to the press release, only 21% of the store-brand herbal supplements contained DNA from the plants listed on the products’ labels, with Walmart’s products containing no DNA from a botanical source.
Checking the labels of Walmart’s herbal products, all except echinacea are described as standardized extracts. This only should be cause for any credible investigative agency to employ testing methods other than DNA genetic barcode testing. Wouldn’t it be ironic if instead of being the lowest potency, because they are all standardized extracts they turn out to have the highest potency compared to their rivals, GNC, Target and Walgreens?
Other problems with this sensationalistic smear against the herbal industry which has now wormed its way through myriad media outlets and the Internet is that the individual the Attorney contacted to conduct the DNA genetic barcode study was Prof. James A. Schulte II PhD, of Clarkson University in Potsdam, New York. Dr. Schulte’s background is in evolutionary biology and reptilian zoology and is not recognized as an expert in botany, pharmacognosy, or natural product chemistry.
Another fact for critical relevancy is that the highly respected University of Mississippi’s National Center for Natural Product research issued the following statement:
“The AG’s test results do not comport with other recently published research on herbal dietary supplements. Two recent tests from reputable laboratories on commercial ginkgo extracts have found ginkgo in all or almost all of the samples tested.”
Herbalists welcome fair and unbiased regulations for its industry. I know herbs are not regulated as drugs but as foods or food supplements, but even at that level, the fact that some unscrupulous entrepreneurs decided to exploit ma huang (Ephedra sinica) for instance, as a type of speed for weight loss and recreational use, got shut down. However the upshot of all of this is that one of the most valuable herbs for upper respiratory problems including asthma, emphysema and respiratory allergies is banned from the market place.
Herbalists generally and certainly herbalists who own herb manufacturing companies make a point of promoting quality in the market place. As to the company I have been associated with, Planetary Herbals, the levels of testing and accountability that even a single product must undergo before it is placed on the market is exhaustive to say the least.
The public who relies on herbs and natural supplements for their health needs as well as those of us who involved in the various aspects of producing and marketing them, all have a stake in reasonable, high quality industry standards. While it’s questionable that those seeking herbal supplements would look to purchase the at stores such as Walmart, Walgreens and Target, I’m just happy that they are available to the mass market and if people are looking for higher quality brand names, they should seek out specialty herb stores, herbalists and natural food stores. Nevertheless there are several quality manufacturers who produce decent quality herb products for private labeling.
Speaking with Nutra Ingredients USA, Dr. Pieter Cohen of Harvard, an outspoken critic of the industry, is quoted as saying “If you’d said 10% of the products couldn’t be identified, then I’d have believed that, but 80%? That’s unbelievable.” GNC, a generally high quality national distributor of natural supplements and one least likely to be selling bogus herb products, has taken to using Dr. Cohen’s even while agreeing to comply with the AG’s letter.
Ed Smith, herbalist and founder of Herb Pharm, one of the country’s largest herbal supplements manufacturers, recently stated, “I feel we should definitely condemn the NY AG’s very flawed ‘expose´.’ If he gets away with this then he and/or others will do similar sloppy and misleading work again. We should hold them to the same high level of professionalism that they demand of us.”
With the herb industry reaching an estimated 5.3 billion dollars in 2011 (according to Mark Blumenthal), unlike previous legal battles with regulatory agencies, the industry is showing signs of maturity welcoming appropriate regulatory actions for the good of all but criticizing what in this instance appears to be poor methodology on the part of New York attorney general.
(Added 2/11/15) In the most recent response to the New York attorney general’s cease and desist order GNC, a reputable supplements manufacturer and distributor has rebutted the AG’s accusations:
GNC Holdings has responded to the NY Attorney General’s actions with full and robust responses to every question raised in the cease and desist letter, including original test results and the results of retesting that was performed on the product lots cited in the letter.
"Be it ordained established and enacted by authority of this present parliament, that at all time from henceforth, it shall be lawful to every person being the King’s subject, having knowledge and experience of the nature of Herbs, Roots and Waters… to practise, use and minister in, and to any outward swelling or Disease, any Herbs, Ointments, Baths, Pulters and Emplaisters, according to their Cunning, Experience and Knowledge … without suit, vexation, trouble, penalty or loss of their goods."
-- The Herbalists’ Charter ordained by Henry VIII, 1543
Lesley and I just completed teaching for the annual United Register of Herbal Practitioners (URHP) conference, held at a typically bucolic English countryside conference center in Warwickshire about an hour or so by train south of London. We were gratified to learn that the herbalists in this organization were indeed Planetary herbalists, not confined to a single ethnic herbal tradition. For a dozen years, we used to travel yearly to England to teach Planetary Herbology there, and on this return visit, we met some dear old friends and former students, now respected herbalists in the UK. We could converse easily about Western, Chinese, and Ayurvedic herbs and everyone was able to follow along.
Despite this happy meeting and the invitation for us to teach, the fact is that herbal medicine in the UK is in a state of confusion and repression compared to its present state in the US. I was somewhat dismayed by how things seem to have taken a few steps backward the last 10 or 15 years. The problem seems to have arisen after integration of the UK with the European Union (EU).
Calling around and seeking once familiar herb sources, I found practically no herbal formulas or supplements available to the general public. I learned that one of the mandates of the EU was that herbal formulas and products had to go through a prohibitively expensive licensing process in order to be made available to the public. That means that products sold by such popular companies as Planetary, Source Naturals, Herb Pharm, Kan and GMP (good manufacturing practice) standard Chinese patents are no longer sold, (including ones regularly referred to in our URHP classes). Some flagship Chinese patent formulas are not available even to registered herbalists because they contain substances derived from animal sources (like oyster shell).
Walk-in herb shops in London were rare or virtually non-existent -- stores such as Mayway, Neal's Yard and others have either moved out of the city, shut down or converted to selling mostly trivial potpourri-type items such as herbal bath and toiletry articles.
Ever since the herbalist charter of Henry VIII (a portion of which is quoted above), herbalists throughout the UK have enjoyed a remarkable degree of protection of their right to practice and dispense herbal medicine throughout the UK and all of its present and former territories.
As countries including England faced the prospect of uniting with the newly envisioned European Union (EU), the European Herbal and Traditional Practitioner Association (EHTPA) was set up in 1993 to achieve a secure regulatory basis for herbal practice in the EU. The EHTPA has taken on other important work that would create more uniform standards for their registered herbal practitioners, such as developing standards for practice and accreditation, documenting research as published evidence of the efficacy of herbal medicine, and developing a dispensing code of practice that would ensure the traceability of herbal ingredients.
But where the contention lies is that EHTPA mandated that for the sake of public safety, all herbal formulas and products needed to be licensed along prescribed parameters or they could not be traded on the open market. This applies to all supplements including herbs.
Timelines were set forth for companies to comply. For most, the cost of having even a single product licensed was far too prohibitive, costing several thousands of dollars for each formula or product. Not doing so meant that they forfeited their right to sell their products throughout the EU, including the UK. However, herbalists who are registered would have privileged access and right to dispense unlicensed products to their clients. The problem is that becoming a registered herbalist is a complicated and expensive matter especially since the UK government who proposed and sponsored legislation has been dragging its feet in the final approval process.
What was and continues to be at jeopardy is access to herbs needed to operate an herbal medical practice. On Feb. 16, 2011, the UK government proposed and drafted legislation for statutory regulation of herbal medicine. Strangely, this gave the impression that the UK was more concerned with herbal products rather than the public safety concerns flaunted by the EU generally, and as a result it appeared that the UK was deliberately circumventing EU medicines law. (For more about this issue, see this article.)
URHP Vice President Lloyd Gee writes:
The Herbal Medicine Working Group has been formed to advise the Deputy Chief Medical Officer of Health on the future legislative arrangements for the practice of herbal medicine in the UK. This met twice and there is division within this working group with Association of Master Herbalists (AMH), Association of Naturopathic Practitioners (ANP) and homeopaths generally against statutory regulation (SR).
SR would bring a protected title to herbalists meaning that only properly qualified herbalists could prescribe unlicensed medical herbs which is seen to be important for public safety. This would also mean that naturopaths and homeopaths who are not qualified herbalists would lose their access to dispensing herbs. Schedule 20 herbs (previously schedule 3) have been under threat and several times EHTPA has had to negotiate on the basis that SR will ensure only competent herbalists will be able to use them. With voluntary registration (VR), we are more likely to lose these.
This is where the UK and the EU cross swords. If the UK government’s current legal advice is that SR-registered herbalists would have access to unlicensed herbal products, this would be seen by the EU as the UK deliberately circumventing the directive. The result would be the European Commission imposing hefty fines on the UK government. If that happened, registered UK herbalists would lose access to these products in any case and a big reason for joining an herbal registry would be moot.
As if things were not complex enough, the EHTPA as the umbrella pro-registry organization for the EU, for various reasons would not accredit certain herbal registers. Furthermore, some registers withdrew from the EHTPA because of the delay in getting government support for statutory regulation. Statutory regulation was eventually what the government insisted upon, but not before major herbal suppliers ran out of stock in 2011 and were told that they could not replenish their stores until statutory regulation of herbalists was legally established.
Another factor justifying many herbal organizations' decision to withdraw from the entire process of creating a body of registered herbalists is the required annual fee to support EHTPA activities while the UK government dragged its feet in creating clear legislation. Many withdrew from EHTPA as they felt that they didn't want to pay for something that wasn't going to happen.
To sum up, where things stand at the moment is that English herbalists are awaiting registration approval from a government that seems to be delaying the completion of a process which they first proposed several years ago and have not yet finalized. (This registration of professional clinical herbalists would be equivalent to ‘licensed herbalists’ in the US, if such a thing existed – which it doesn't.)
UK herbalists are stuck in this holding pattern until the government sorts out its own registration process. In the meantime, herbalists not only have limited access to herbal products, but in many instances they also have a difficult time finding sources for them. For now, they are allowed to formulate on the spot for individual clients. This makes aspects of herbal medical practice cumbersome and difficult.
Most herbalists I spoke with would prefer to continue with as little government interference as possible. At best, some of them are willing to forfeit some of their individual freedom of practice to assure the evolution and ongoing practice of herbal medicine especially in the wake of possible EU compliance.
Living in a global community, too often we see how the socio-political concerns and problems of other countries, especially those of Western European nations, eventually become our own.
Present matters in the UK has resulted in discord between herbalists in favor of saving the profession by becoming part of a new herbalists registry and those who staunchly resist any and all government interference with the practice of herbal medicine. Similarly, in the US today and within the ranks of the American Herbalists Guild, there are those who seek to evolve and preserve the profession of medical herbalism by licensing and those who vehemently resist it. Just as in the UK, at times this struggle has engendered fierce hostility between the two sides.
I hope this brief discussion of the complex issues of herbalism in the UK offers some enlightenment and clarification for herbalists in the US, where the pros and cons of licensing in this country are certainly an issue. It is my personal belief that licensing of medical herbalists in the US is a good idea for the safety of the public and to ensure trained herbalists’ access to now restricted herbs such as Ephedra (withdrawn from sale because of opportunistic misuse of the herb as a metabolic stimulant for weight loss). Most herbalists that I know would agree that certain herbs are too dangerous for unrestricted public access. Licensing is a trade-off where certain liberties are exchanged for greater privileges and freedoms.
I also firmly do not want licensing to occur that would in any way prohibit individuals and small community and family groups to not maintain their God-given right to prescribe and use herbs. Where I draw the line is when it comes to setting up a professional medical herbalist practice for pay.
Everything seemed to be going just fine for the few of us herbal pioneers when we freely practiced herbal medicine and prepared our potions in our home kitchens with ideals of bringing the blessing of herbal medicine to people in all walks of life. Funny thing is that we may have succeeded, but now we have to cope with the changing and ever greater responsibilities of more publicly accessible herbs. Now we must prepare our medicines in regulated facilities outfitted with paraphernalia and safeguards mandated by the present GMP codes.
In the same way, if herbal practitioners are to come of age, they face similar demands and must conform to minimum standards of education and practice that will justify the trust that we are asking from the public.
I recommend reading Giovanni Maciocia’s blog of 2010 entitled "Appeal to European Herbal Practitioners"
I think climate change is affecting my garden in Ben Lomond, California (a section of which shown at right). It is situated along a narrow strip in the Santa Cruz Mountains which lie some 2,500 feet above sea level and in close proximity to the San Lorenzo River watershed.
We’ve lived in this same spot where we raised our family for 30 years. For all those years, I indulged my gardening passion. I noticed that while my friends in Santa Cruz mightily contended with gophers in their gardens, the rodents never were a problem for me. Eventually I realized that our high, ground-level water table made an environment inhospitable to gophers.
Then things began to change within the last four or five years: advancing climate change and increased dryness brought the first signs of mole and gopher depredation. It is further added to by the fact that as my neighbors go the route of building wire cages around their fruit trees and planting boxes, it seems that their gopher problem is importing itself into my yard.
But so far, the situation is still manageable. The problem seems to be controlled by the fact that I don’t make it easy for underground critters to set up residence under a pure patch of carrots, corn, broccoli or some other gopher-delectable item. Overplanting too many different things too close seems to be both a virtue as well as a problem with my ‘jungle-styled’ gardening. I tend to have a diversity of vegetables, flowers and what I imagine to be non-delectable herbs growing all together. This happens to be a virtue in terms of controlling a variety of underground pests but not sufficiently thinning to allow for maximum yield and size can also be a problem, which I haven’t yet been able to reconcile with denser, diverse planting.
The second sign of climate change has been the lack of sufficient consecutive sunny, hot growing days. The flavor and sweetness that we enjoy in plants is the taste of sunlight – biochemically transposed into plants. If the weather is inconsistent as it has been (in my opinion because of variable jet stream patterns), the effect on my favorite strawberry patch has been a single modest yield and prolonged dormancy. Tomatoes tend to stay green on the plant too long and when they ripen are less sweet; corn may not ripen at all or yield partially filled ears. The honeysuckle blossoms, which are usually in full bloom by the end of June, have barely opened.
The lack of rainfall has caused a corresponding increase of pollens in the air, making this a particularly bad year for allergies. I’m sure there are many other effects that I haven’t definitively recognized. My small garden nestled in the mountains of Ben Lomond can only join with the ‘non-alleluia’ chorus of humanity around the world, at the mercy of the forces of unrelenting greed to say, "Where is it all leading, when will it ever end?"
Evidently by the sign of things, not anytime soon. With all of this quiet panic in the garden, I read how the US is finding more available oil from fracking and other previously untapped sources. The once lesser populated state of Wyoming is experiencing an oil boom compared to the 1849 Gold Rush in the mountains of California. As in California, this has the potential of wreaking devastation on the pristine nature of the surrounding open-sky plains and rivers.
An article published by Earth Justice says:
Thanks to a drilling boom, air quality on the plains of Wyoming is now worse than the car-choked megalopolis of Los Angeles. In the drilling rig-studded Upper Green River Basin, levels of ozone - the main component of smog - have reached 124 parts per billion - well over the federal safety standard and worse than the worst day in Los Angeles in 2010. There are some bright spots, though: in 2010, the Wyoming Oil & Gas Conservation Commission passed some of the strongest rules in the country requiring oil and gas companies to disclose the secret chemicals they use in fracking – a big step forward for the state and leading the way for reform at the national level.
I have deep misgivings as to what such a disturbance of "The Peace of Wild Things" (referring to the famous poem by Wendell Berry) means to the world, its rivers, plains, forests, plants, creatures, and how what has occurred has already impacted my garden.
A recent article published in the Economist (May 19, 2011) entitled 'Think Yourself Better' claims that all alternative medical treatments are mere placebos designed to bilk the consumer out of an estimated $60 billion per year spent on alternative medicine (based on 2008 estimates).
The article is based on the single opinion of a Dr Edzard Ernst, who retires from his 18-year professorship at Peninsula Medical School in southwest England in May. Described by the author as the world's first professor of complementary medicine, it seems that all Dr. Ernst can say to sum up his findings is that nearly all alternative medicine -- indiscriminately lumping the entire kit and caboodle including acupuncture, herbal medicine, Ayurvedic medicine, homeopathy, crystal healing, reiki, and flower essences -- are mere placebo.
Well thank you Dr. Ernst, and goodbye!
It is a well-known fact that 40 to 60 percent of medical procedures and drugs is claimed to be due to placebo. In light of this, it seems reasonable that one would prefer to 'think him/herself better' with herbs, acupuncture, homeopathy, TCM or Ayurveda that has a long, sound record of safety and efficacy unmatched by invasive medical procedures and drugs that are extremely expensive with a high probability of adverse reactions.
For example, statin drugs taken to lower cholesterol cause a high number of people to develop symptoms of rhabdomyalgia, chronic acute muscle pain caused by a breakdown of muscle fibers. Instead, one might avoid such a horrible side effect by taking the Ayurvedic herb guggul or a garlic supplement. If necessary, red yeast rice lowers cholesterol with no adverse reactions.
Or, perhaps in lieu of an open heart bypass surgery, one might take hawthorn and/or arjuna herb supplement. Many of you might think I've taken things too far with this one. I refer you to an article by Dr. Jonathan Wright published in January 2004, reporting that Dr. Henry McIntosh, a highly respected cardiologist at Baylor University, observing the results of heart bypass surgery over the course of 15 years, said, 'Despite a low operative mortality and rate of graft closure, available data in the literature do not indicate that myocardial infarctions, arrhythmias or congestive heart failure will be prevented, or that life will be prolonged in the vast majority of patients.' Similar opinion is shared by Dr. Howard H. Wayne M.D. of the Non-Invasive Heart Center in San Diego, California, and the same sentiments were reflected in an article in a July, 2008 article in Business Week Magazine entitled 'Is Heart Surgery Worth It?'
Would you rather relieve back pain with acetaminophen, the OTC drug that is known to injure your already beleaguered liver, or with turmeric or willow bark which relieves inflammation and pain with no side effects? You should know that acetaminophen drugs such as Tylenol send 56,000 people to the hospital emergency ward with a reported 458 deaths a year caused by liver failure.
Finally, did you know that correctly prescribed medical treatment and pharmaceutical drugs are the fourth leading cause of death in the U.S., with up to 106,000 deaths a year? The third leading cause is blatant medical malpractice, according to the prestigious Journal of American Medicine Association (JAMA).
I don't want to make this an either-or, bash the medical establishment article, but when a leading magazine publishes such poorly considered schlock, I think we need to speak up for our side -- a side, by the way, that much of the medical profession is slowly coming to validate.
For the remaining unbelievers, following are a number of randomized placebo-controlled, double-blind studies for herbs, acupuncture and homeopathy that Dr. Ernst should have come across during his 18 year spot as professor of complementary medicine '" but as we now know, he didn't.
Chamomile and fennel for infant colic (this is published in a respected and credible journal dedicated to phytotherapy research)
Acupuncture helps with fibromyalgia symptoms '" Mayo clinic:
Acupuncture relieves back pain '" University of Maryland study
Homeopathy research studies:
For numerous other homeopathic research studies go to the National Center for homeopathy: http://bit.ly/lp3SaA
An article published in the UK Independent on Dec. 30, 2010, reports: 'From 1 May 2011, traditional herbal medicinal products must be licensed or prescribed by a registered herbal practitioner to comply with an EU directive passed in 2004.'
The reason given for the directive is a purportedly 'rising concern over adverse effects caused by herbal medicines.' The fact that this reason is given for the regulations reflects not only issues with herb safety but also the herbal community's inability to unilaterally effectively address these concerns. Bickering factions among individual herbalists and herbal organizations have crippled their ability to self-regulate, resulting in regulations imposed by governmental agencies.
While the new law requires registration and licensing of individual herbal products and does not directly regulate the practice of herbal medicine, it will certainly affect herbalists in the EU. In most European countries, herbs are dispensed by medical doctors or individuals licensed in particular healing professions like Traditional Chinese Medicine and so forth. But if one is not a registered herbal practitioner '" for which no registry has yet been created '" one will no longer be able to dispense the hundreds of still-unlicensed herbal products. (For a bit of perspective, here is a World Health Organization listing of how EU countries regulated herbal medicines compiled in 2005.)
Under the new law, the EU has basically succumbed to the dispensing of herbs by medical doctors. However, even with the more extensive training in herbal medicine that German medical doctors evidently receive, it is questionable that they are skilled in the finer aspects of herbal prescribing that is an essential part of the art of traditional herbal systems throughout the world.
What finer aspects are these, you may ask? It's the difference between deciding to prescribe an herb such as willow bark as an alternative to acetaminophen for a headache or choosing to prescribe an herbal compound that addresses both the headache as well as its underlying cause.
Failure to address the underlying cause of disease results in the widespread use and abuse of stronger synthetic alternatives. In fact, as much as 80% of all drugs are either derived from herbs or synthetic compounds found in plants. The reason for the plethora of drug side effects is precisely because of their concentration and the focus being largely directed to muffling symptoms rather than promoting rejuvenation and cure.
Because people have become aware of these undesirable side effects and dangerous risks, they have come to rely on herbs. In fact, the main reason people turn to herbs, supplements and alternative healing methods is because of well-founded fears regarding the adverse reactions to drugs and some medical interventions.
The herbal product regulations in the EU require that companies selling undergo similar licensing requirements as pharmaceutical drugs. Considering that there are literally thousands of medicinal herbs throughout the world with which people have had a long history of safe use, and that there are infinite combinations of herbal formulas that oftentimes make for more effective products, it is both impractical and unrealistic that a company should invest millions of dollars to license each of their herbs and herbal formulas. This is not to mention the inevitable prohibitive ultimate cost to consumers for these products. I agree with the critics of the move to ban herbs in the EU when they say that this is indeed 'disproportionate and discriminatory.'
To restrict the sale of such common herbs as cascara sagrada, an herbal laxative; skullcap, an herbal sedative; and ashwagandha, a whole body tonic that increases health and libido which are only a few of the 100s of herbs that will be banned from sale starting in May shows flagrant disregard to the public's reliance on these and other safe herbal products and discourages people from finding alternatives to the high cost of conventional medical care.
Attitudes similar to the ones that led to the restriction of herbs in the EU, namely that the herbal and nutritional supplement industry is dangerously unregulated, are also present in the United States. Upon closer examination one may discover that the industry in the U.S. is subject to unannounced inspections by the FDA leveling severe fines on herbal companies who fail to follow stringent GMP (Good Manufacturing Practice) guidelines established both by the herbal industry itself along with the FDA. Recognizing the regulatory difficulties involved, the United States enacted what may be one of the most popular legislations in US history, the Dietary Supplement Health and Education Act of 1994 (DSHEA). This established the regulation of herbs and supplements in a separate class from drugs.
But if they don't stand united and agree on a method of self-regulation, U.S. herbalists may find themselves in the same kind of quandary that those in the E.U. face today.
The American Herbalists Guild is the single herbal organization that has come closest to creating standards for professional clinical herbal practice in the United States. For over 20 years it has done much good for the profession, but one of the problems it has consistently encountered is attempting to appeal to and represent all the individual and sometimes quirky styles of herbalism that exist in the U.S. Nevertheless, it has a five-person peer review admissions board whose objective is to screen for and accept only professional applicants who meet the rigorous standards set forth by the AHG for its members.
At the AHG's inception, a number of respected herbalists were granted professional membership based on their prior experience. Recognizing the need for such an organization, most of these herbalists responded to the call, and thus the AHG has grown over the course of its 22 years in existence. Some, however, saw the formation of the AHG as a threat to herbal medicine and an herbalists' "civil war" ensued. The AHG had no intention of limiting the practice of herbal medicine but to establish professional standards of practice for its members and by so doing advance the profession of medical herbalism in America.
Several years ago, foreseeing possible developments restricting herbal medicine as is now occurring in the E.U., some of the members of the AHG tried to create a "Traditional Medicines Category" to protect our access to important medicinal herbs just in case such restrictions would be implemented in the U.S. When this endeavor was met by stiff opposition from "olde garde" herbalists, some members of the AHG felt that the project needed to be abandoned and so it was. Without such a protected category in place these herbs may one day be banned not only from the public but also from practitioners.
In view of the course taken by the E.U. and the highly restrictive climate of these times, herbalists in the United States should really consider this a wake-up call. What can we do to prevent the same from happening to us?
It is difficult at this point to not descend into the typical '˜us against them' polemic but when apparently discriminatory repressive measures are taken against herbal medicines based on a very small number of reported incidents while far greater concerns regarding adverse drug reactions exist worldwide, it is impossible to not refer to the following statistics in order to frame a context for discussion.
An oft-cited statistic comes from a 1995 study based on the United States alone that describes an average 106,000 deaths per year from adverse drug reactions at a cost of $12 billion. Further, when combined with all other iatrogenic causes (caused by drugs and medical treatment) of injuries and deaths, the total rises to 16.4 million people who are affected with costs modestly estimated to be well over $300 billion a year.
In comparison with these statistics, the percentage of deaths and injuries from herbs and natural medicines is minuscule. The Natural Health Federation (NHF) reports that 'There was not even one death caused by a dietary supplement in 2008, according to the most recent information collected by the U.S. National Poison Data System.' This was based on polls of 61 poison centers who provide coast-to-coast data for the U.S. National Poison Data System, which is then reviewed by 29 medical and clinical toxicologists.
While there are no immediate signs that such regulations will extend to the United States, there is reason for concern that with the heightened atmosphere toward increased regulation generally, it could become a concern for those who rely on herbal supplements in the United States.
Therefore I urge that that we stand in solidarity with our European counterparts by signing the petition to stop the European Traditional Herbal Medicinal Products Directive: http://www.gopetition.com/petition/39757.html
To learn more about how to challenge the new law go to:
My friend Don Monkerud recently sent me his periodic political critique which included the following:
'Corporate controlled politicians claim America has 'the greatest healthcare system in the world,' only to reveal their ignorance. The World Health Organization ranked the U.S. 37th among nations in healthcare performance in 2000, although we pay more for less service. Numerous studies reveal that the U.S. is mediocre in treating illness. For example, compared to the G8, the U.S. has the highest infant mortality, the most mothers who die during childbirth, the most lives lost that could have been saved, and the worst in treatment of cancer. The U.N. rates the U.S. even worse: 74th in healthcare performance. And in 2009, the C.I.A. ranked the U.S. 49th in life expectancy in the world.'
Each day we read about phenomenal medical breakthrough research. Doesn't it ever occur to the large numbers who voted the present Conservative regime into dominance in the House that these discoveries are hardly ever available to the majority of average Americans, who are unable to afford health insurance or who have health insurance from companies who can deny coverage for any number of trumped-up reasons?
While Republicans believe in unrestrained capitalism, the wishy-washy Democrats (for whom I nevertheless have more sympathy) have their own considerable deficiencies and weaknesses which have a particular impact on natural health and healing. To wit, their out-of-control protectionism and tendency to play 'big brother' causes them to side with the ill-informed majority against the natural health movement. Do I hear a need for a third, possibly even as many six parties out there (as they apparently have in Canada)?
The choice of either/or in anything is hardly ever a good one, but neither is simply having to choose between the lesser of two evils or, as many do, leave off choosing altogether when neither option offers a decent outcome.
I wish I could end this diatribe with a solution, but frankly I have none to offer. I encourage you to leave your thoughts in the comments section of this post.
I do have a suggestion, however: keep growing and learning about medicinal herbs, self-help and alternative natural healing. Most of us are not likely to find the kind of healing we deserve and need from mainstream medicine.
Almost exactly one year ago today, I published a blog post, 'Who's Afraid of the Big Bad Flu,' about the corporate-made H1N1 fraud.
Now, according to Digital Online, the German news source Der Spiegel published an exhaustive article describing how 30 representatives of Big Pharma met with WHO Director-General Chan and United Nations Secretary General Ban Ki Moon at WHO headquarters for the sole purpose of discussing how to move the H1N1 threat to a phase 6 or pandemic level.
Once upon a time, the term 'pandemic' represented a critical worldwide health threat; somehow it was downgraded to simply mean a world disease.
Hopefully this will awaken more people to the threat of the takeover of the world's economies by multi-national corporations generally, and by Big Pharma in particular.
Few of us can fathom the threat posed by these companies. Having no allegiance to any country and so glutted with wealth, they can shift at will, moving their base from one part of the globe to another. In this way, they are able to benefit from lower operational costs and can bypass national regulations because international regulations, are weaker and more difficult to enforce. While this is true to an alarming extent for all large corporations, it is especially an issue with Big Pharma, whose particular power can hold the people of the world hostage to their mostly 'toxic' wares.
The Der Spiegel exposé, depicting Big Pharma's ability to cloud and influence the judgment of the director of the World Health Organization and of the United Nations for their personal profit, vividly illustrates the power and persuasion unique to that industry. It also makes credible the stories that assert, based on an analysis of the DNA strands of the H1N1 virus showing origin from various parts of the world, that the virus was deliberately created giving this entire hoax an even more Orwellian dimension than most of us are able or willing to embrace.
This Dec. 1, 2009, article at the BBC website entitled "Prince Charles: 'Herbal medicine must be regulated'" points to a potential crisis for the practice of herbal medicine in the UK. Under threat of new European Union (EU) laws scheduled to take effect in April 2011 that would restrict the prescription of manufactured herbal medicines to "statutorily regulated professionals like doctors," the Prince of Wales is urging his government to regulate herbalists, lest they be banned from practice entirely when the new laws take effect. The new laws also stipulate that the only herbal medicines that will be sold over the counter will be ones used to treat 'mild and self-limiting' conditions - basically meaning nothing worse than a cold.
Apart from the fact that this would undoubtedly cause a large legally disenfranchised body of people to seek natural remedies through illegal venues, it also would overturn a 500 year-old Commonwealth law that prohibits governmental legal restriction enabling anyone to treat patients with herbs.
Since 1542, the Commonwealth Charter of Henry VIII has guaranteed herbalists the right to practice freely throughout the Commonwealth. This law is still applied in the UK as well as its former territories worldwide such as Australia and New Zealand. In fact, many think an argument could be made that the U.S.A., as a former British colony, has a legal basis for unregulated and free practice based on the English Herbalists' Charter.
For over 400 years, this has worked pretty well with very few adverse incidents reported, especially compared to those reported about conventional mainstream medicine. Other European countries such as Germany and France have chosen to impose highly restrictive laws limiting the practice of herbal medicine to medical doctors. As a result, there is economic pressure for the UK to declare the Herbalists' Charter antiquated and to get in step with the same restrictions imposed by other European countries. This has met with stiff opposition from a well established tradition that has allowed for the comparatively unrestricted practice of herbal medicine by both lay and professional herbalists.
Aside from the many differences of language, culture and history between closely adjoining countries, the standards for the practice of herbal medicine is yet another obstacle to true union. With obvious financial advantages to globalization in respect to the EU, many of the differences between these financially interdependent countries must be resolved -- and apparently how herbal medicine is practiced and regulated is just another one of those issues. Countries such as the UK with a long history of distinctive customs and traditions encounter difficulties with conformity. For instance, while most European countries have converted their currency to the Euro, the UK still uses the pound sterling as its distinctive "coin of the realm." So far, under the Herbalists' Charter, the UK is similarly seen as 'not fully participatory.'
The upshot of all of this is an ongoing fundamental conflict as to how herbal medicine is practiced, manufactured and sold between the UK and its European Union partners.
One of my former students, John Smith, is now a professional herbalist in the UK who opposes licensure and restrictions of herbalists in that country. In discussion on this issue he recently wrote me the following:
Unfortunately, what has been happening in UK is that it was felt by the powers that be that herbal medicine either had to be regulated or banned entirely -- so herbal bodies agreed to compromise and go for self regulation (i.e. Herbal Registers). (In other words,) we'd get together to exclude non registered or unqualified practitioners and agree on what herbs could and could not be used, etcetera). This was done even though many of us saw such negotiations as a huge compromise but the lesser of two evils. Ten years of time and energy went into this regulation process internal wrangling for power and influence within the herbal and alternative medical community and discussions with the Department of Health and European Union representatives. What is happening at present is that the government has pulled the plug and left herbal medicine back at square one where herbal medical practice could be banned entirely. Prince Charles, a long time proponent of herbal medicine, homeopathy, and alternative medical practice, has chosen the path of supporting the regulated practice of herbal medicine and fights that corner.
Any decision in the EU and UK to restrict herbal medicine to licensed medical doctors would be a purely financial one with no regard for the needs of the people. At the same time it supports an already established free socialized medicine of a particular state-supported brand, administered only by licensed medical doctors.
Preserving the Tradition of Herbal Medicine
Here are three good reasons why herbal medicine should remain as unregulated as possible:
Because of the above stated reasons, both China and India, which have long standing traditions of herbal medicine, are able to recognize professional herbalists without prohibiting the accessibility to herbs and herbal preparations and the popular practice of herbal medicine by all.
It seems either a poor compromise or simply naive for Prince Charles to promote restrictions on herbal medical practice in the UK similar to those now in effect in other European countries. The compromise, which is the financial advantage, is probably more the reason as I can't imagine that someone has not discussed these other matters with him.
Who else stands to gain from herbal regulation and restriction?
Commingled with EU financial considerations to override the UK Commonwealth law and the 1542 Herbalists' Charter is the protection and practice of healing professions. Of course this includes conventional Western medicine but also the practioners of newer recognized alternative medicine professions, such as acupuncturists, herbalists, naturopaths, and Ayurvedic and Chinese healers who have been struggling over recent years with various degrees of success to gain recognition. Despite their roots as popular unregulated healing modalities, each of these, backed by schools standing to benefit from increased enrollment, at least superficially stand to gain in restricting practice to "licensed professionals."
Historically there is nothing new in any of this motivation of protection. Since medieval times, guilds and other organizations have been established specifically for promoting the professional (i.e. financial) interests of its members. There is something gained and something lost from this. What is gained is a standing organization that can share its experience and knowledge with its members and establish a standard of practice. What is lost, of course, is the wider experience that is the result of non-members who may also practice a particular discipline or practice such as herbal medicine.
In order to safeguard its knowledge, these professional organizations developed their own language and jargon that distinguished them from the populace. We encounter this when we try to decipher the diagnostic assessments and prescriptions of medical doctors as well as the metaphorical jargon used by Traditional Chinese Medicine or Ayurvedic doctors.
For example, Latin, a universal language understood by medical legal and scholarly professions across all European countries, was used this way. While at first intended for more widespread understanding and greater definition and clarity, the use of Latin as a professional language of medicine had the same effect as it did when it was used by the Church for 1,500 years where the Bible was only available to be read and interpreted by clergy: to prevent free thought.
The mid-17th century English apothecary-herbalist, Nicholas Culpeper, caused a furor when he published his own translations from the Latin to the English vernacular of various herbal and medical texts of the College of Physicians. He did this so that his fellow countrymen who could not afford expensive doctors would have available to them guides for maintenance of their own health. He published his own herbal, The English Physitian (1652), arguing that "no man deserved to starve to pay an insulting, insolent physician," when he could obtain his herbs from the nearby countryside. Culpeper upheld medicine as a "public asset rather than a commercial secret." Since its first publication over 350 years ago, Culpeper's Complete Herbal has been reprinted as many times as the Bible. He remains a revered iconic figure for English people and herbalists worldwide.
Education, not regulation
Many will still argue that the unrestricted use of herbs and self treatment is dangerous, but the fact remains that statistics of adverse events and deaths from herbal treatments are infinitesimal compared to the estimated 400,000 people who die annually from pharmaceuticals alone, or who are otherwise injured or made sick from conventional medicine and drugs.
It is undoubtedly my personal bias that herbal medicine remain as unregulated and unrestricted as reasonable. In fact, this was my personal path of learning. As part of a counterculture seeking independence from the mainstream in all ways possible, I looked to herbal medicine first as a passionate attraction to nature and plants, and secondly for the possibilities of what it might offer as an alternative to more invasive and Western medical drugs and procedures. It was out of this need that acupuncture and herbal medicine has grown in North America since the late 1960s.
There were no official schools to turn to for an education on this continent, and if there were, I certainly did not have the financial means to afford them. So I made do at first with the scant few books that were available by Jethro Klos and a few others and tried different herbal potions on myself and members of the commune to which I belonged. Despite the limitations of this approach I learned that plants do work and found common weeds such as plantain, comfrey, mullein, goldenseal, and later echinacea to be amazingly effective.
So my career arose out of years of personal trial and effort. I eventually got a leg up when I began to find a few experienced herbalists such Norma Meyers of British Columbia and Dr. John Raymond Christopher of Provo, Utah to study from. This eventually extended to the study of Traditional Chinese Medicine and herbalism in Yunnan, China with some remarkable doctors. Through this path, I think I received a wonderful education. Certainly there were holes because of the sporadic nature of the learning process but I found that I would only learn what I could absorb at the time and gradually my understanding deepened.
To legislate and deprive others from this path of learning to me would seem a shame of the first order. I know today, that there exists a large number of herbalists living in the mountains, forests and countryside who practice with local plants in ways that are not "official" according to accepted standards of clinical Western herbalism, TCM or Ayurveda, and that the contribution of these individuals are just as important as those made by the professionals. I think that there remains a place for both lay herbalists and individuals who might follow a path similar to my own as well as those who may seek a more set curriculum leading to professional licensure.
Recently a friend of mine called to say that she had a terrible bladder infection. Her doctor prescribed an antibiotic, but it had no effect; in fact, the infection worsened. She also said she tried drinking cranberry juice, but that had no effect on the condition either.
Women's bladder infections are one of the most common complaints in the health world, and they probably account for the brisk sales for cranberry (Vaccinium macrocarpon, pictured above) supplements. An article that described 10 randomized controlled trials published by Cochrane Collaboration in January of 2008 concluded that cranberry products may prevent recurrent urinary tract infections in women. I'm sure this helped boost cranberry sales as well as the belief that it can help a woman with a UTI.
I wouldn't disparage the proven value of unsweetened cranberry juice, but I remember the study only seemed to indicate that it prevented recurrent urinary tract infections. By implication, the public and marketers read "cure" and that is an entire different realm to consider.
There are flagrant misrepresentations in the marketplace for the use of herbs and various nutritional supplements, but the public also knows that these things, when used appropriately, can work for situations like my friend's antibiotic-resistant cystitis, when no standard medical procedure or tested natural therapy such as cranberries, do.
(Most studies, even preliminary trials, are expensive. We need to ask ourselves how they were funded, and naturally, this leads us to question who is likely to gain from the study. Given this, I would not be surprised that just as studies of pharmaceutical drugs are funded by the manufacturer, the same could be true, and that studies of the medicinal value of cranberries could be funded by cranberry growers.)
But, as I stated above, cranberry didn't work for my friend, and I bet it doesn't work for a lot of women who've had the same problem. She turned to me and asked what she might do.
I told her about a few other herbs which I know are more powerful for treating bladder infections. I directed her to an uva ursi-based formulation (generally herbal formulas are more effective for more people than are single herbs). Uva ursi (Arctostaphylos uva ursi, pictured at left) is not as strong as pharmaceutical-grade antibiotics and does not cause the same side effects. It works locally, purely with the body fluids, as a urinary antiseptic. It also enhances the liver's powerful role in treating inflammations. These actions, combined with other herbs in the formula, make for a more positive outcome. I also suggested the use of parsley tea which is an old time remedy for urinary tract infections, and cherry stems in the specific treatment of urinary tract infections.
Cherry stems are high in potassium, salts and tannin. Traditionally, when women in Europe were troubled with bladder infections, they would steep a handful of the stems in one or two cups of boiling water and drink the strange-tasting brew. Lesley and I have found that cherry stems work for bladder infections when antibiotics and even most herbs may not.
I think my friend wound up doing a combination of cherry stem tea and the uva ursi formula and within a couple of days her intractable urinary tract infection was gone.
In conclusion, it's good for the herbal consumer to look to the use of herbs as a first line treatment for most diseases. However, it's also important that they learn the value of different herbs and supplements in the event that one may not be enough, that if possible they educate themselves on the wise use of herbs singly and especially in formulations.
To that end I and my wife, Lesley, have published several books on herbal medicine, including the top-selling herb book in the world today, The Way of Herbs, published by Pocket Books, and Lesley's book, Healing with the Herbs of Life, now published by Random House.
It's also obvious there is a need for qualified and skilled professional herbalists. Lesley and I personally make an effort to fulfill this need with the East West Herb Course. It is partially correspondence and partially online, and one can complete it at his or her own pace. Students learn Planetary Herbology, which is a combination of the best global herbal systems from the Western, Ayurvedic and Chinese traditions. Check these and our other herbal products out elsewhere on this site.
Have you noticed the lack of health care in your area? I have, in Santa Cruz.
So many GPs have retired because of the astronomical price of liability insurance they must pay to stay in practice, along with the mounting sheaves of paperwork they are required to maintain -- not to mention the expensive staff they must keep to deal with it.
As if that weren't enough, a further disincentive for these doctors is the difficulty in getting reimbursed from insurance companies and the hoops they must jump through to get even a portion of what they bill. (In our clinic, Lesley and I simply refuse to take insurance. If people want to try to get reimbursed for our services from their insurance companies, they submit the paperwork themselves.)
Insurance companies today dictate what they will or will not cover; the basis of their decision is personal profit. It seems more than a little disingenuous for these companies and others to accuse a proposed hopefully universal health care bill that may do the same.
In either case, people are free to pay for services their plan will not cover or to seek what they believe will be better quality. As it stands, Americans are flocking to other countries such as Thailand or Tahiti, where they know they will get superior health care for a fraction of the cost presently in the United States.
Being so closely involved with American health care for the last 35 years of my career, I have had plenty of opportunities to speak with people, friends and patients from the UK, Canada, France, and Italy who seem quite happy with their health care system and have come to take for granted that this is something that a wealthy country should provide to its citizens.
Recently I had first-hand experience of another nation's universal health care system. Last May, I took a trip to Italy with my grandson. During the first three days in Rome, he was very sick. I decided he should see a medical doctor and I was prepared to be confronted with a large bill comparable to what such a hospital emergency service would cost me in California. I didn't know that Italy had universal health care. When we went to be admitted for examination, few questions were asked. They looked at our passports, that's all. They didn't even question the fact that he wasn't my son and only asked about my relationship to him. It took no longer than six minutes or so to fill out a paper, name, age and complaint before we were put into a cue to be seen.
He was examined by one of the few doctors in the Rome hospital who spoke English. We waited about two or three hours for the results of a blood test. When his condition was deemed not serious, the doctor wrote a prescription for some antibiotics and another drug that would relieve his stomach distress and we simply walked out the door, no further questions asked. Best of all -- we were not charged a single penny! In the United States, such a visit could have cost us anywhere from several hundred dollars to over a thousand. To top it off, my grandson's prescription was filled for under $10!
The way I see it, we've got those who can afford insurance and health care; then we have 46 million Americans who cannot; then we have those who already struggle to pay for health care and are having to deal with rising costs; and finally, the insurance companies, who are more concerned with bottom line profits for their shareholders rather than the needs of their customers. Meanwhile,we are distracted and stalled by the question of whether or not the government has a right to step in.
My question is, if the government doesn't step in at this point, who will?
And following that, what are governments for if not to safeguard the vital interests of its citizens? Let's just assume that none of us know what the best exact plan is. But the fact remains that we need to get in step with all other advanced Western countries and provide universal health care to everyone in America -- and I mean everyone. I don't care if they are citizens or not. The only consideration the hospital had for my grandson when we were in Italy was whether or not he was a member of the human race.
We need to move health care out of profit-driven profession to a true enterprise founded on compassion, for all -- and in case "for all" doesn't say it, let me spell it out: I mean this to include the less fortunate amongst us.
Let's face it: the present dysfunctional health care system wrecks lives! If you are not covered for a medical emergency -- and as it stands, no one knows if they are covered until they have a need -- people have lost everything they have for a single serious health incident. You don't have to go very far from home to know about that.
For example, years ago, my mother was in serious need of health care. She had no insurance. My brother and I both were happy and willing to help but neither of us was prepared to assume the full brunt of the kind of assistance she needed. The problem was that with the present profit-based system, if the government knew we were contributing any financial support, they would cut off their assistance entirely. As a result, we had to go and visit her in a very depressing facility located on the outskirts of San Diego.
My son has been a nurse for decades and enjoys a hefty salary. I'm happy for him, but it doesn't go unnoticed by me that because a few nurses must receive such a generous pay and benefits, the hospitals are understaffed and a patient's single overnight stay could cost from $15,000 to $20,000! It's obscene, the service is usually barely adequate -- ask anyone who has had a medical emergency.
My son recently commented on the paperwork nurses must fill out for every patient. More is added each month. For instance, when he admits a patient, he has to fill out a form for every article the patient has when they are admitted. This is repeated when the patient leaves. Multiply that by 25 or 40 papers for every patient, and you can see why health care givers are mostly standing behind a desk or nursing station when you visit a hospital rather than assisting the large number of patients supposedly under their care!
At present we hope and rely on insurance companies paying for such care, but the reality is, we are all paying for it. The hospitals have to charge so much because they are mandated to not turn anyone away because of lack of funds. "Lack of funds" means that they are entitled to take every penny you have until you really lack funds.
Further, everyone should realize that under a universal health care program, you still have the option to pay for whatever services may not be provided. It's worth paying more taxes to have it; consider it, if you will, a charitable contribution, if necessary. In any case, it would be cheaper than the present single payer system.
Perhaps, like me, you have seen one or more of the many misleading emails that are being circulated around the health care issue. One entitled "Health Care Reform or Government Take Over?" urges the gullible to distrust the government's intentions to reform American health care. (I suggest that any statements that are made pro or con be checked with an impartial web organization such as http://www.politifact.com/. )
When you receive bogus emails like the one mentioned above, consider how powerful the insurance and for-profit medical lobbies are, how they have congresspeople in their pockets, and how willing they are to spend millions on negative propaganda to prevent universal health care from happening in the United States.
My only fear at present is that the final bill will be so compromised that it will not accomplish what it is intended for. Can you even imagine how and why a newly elected president would go head-to-head with the most powerful lobby in the world, staking his reputation on doing what he and most Americans believe is the right thing to do?
President Obama is not writing the bill, he is charging Congress with that task and will sign it after reviewing it. I can assure you that he would not sign a bill that reflected the stupid and unfounded charges represented by many anti-health care emails that are circulating.
These are my own personal arguments for universal health care in this country. I invite you to share your thoughts on this topic in the comments section of this blog.