M.D.s and Herbalists

When people learn I am an herbalist, they often share their frustration and dismay that their “regular doctor” does not sanction the inclusion of herbs and supplements in their diet and health care. Discouraging comments or disagreeable advice from their very important primary healthcare providers perplexes many people. Doctors’ responses range from “I don’t know anything about it” to “Where is the data? It has not been clinically proven.”

OK, fair enough. Doctors are reluctant to offer anything that has not been clinically proven because it is a risk. Should anything go wrong—side effects, allergic reaction or negative results from the inadvisable mixing of herbs and pharmaceuticals—they could get sued.

Curious about just exactly what data physicians require to recommend herbs and supplements and also what new information they look to for positive assurance, I attended the conference, “Natural Supplements: An Evidence-Based Update,” sponsored by the Scripps Center for Integrative Medicine in San Diego. The lineup of 27 speakers from around the country and Canada was impressive, with all but two being MDs or PhDs. The topics were indeed mostly about supplements, but some presentations included herbs, and there were workshops on medicinal spices; one on coffee, chocolate and tea brought herbs to the fore.

Mary Hardy, MD, reported on her review of herb and supplement clinical trials, listing significant results: Increased intake of Vitamin D improves bone health; folic acid was proven to improve cognitive function over a three-year period. Black cohosh is associated with reduced incidence of breast cancer. Red yeast rice has applications for coronary heart disease and diabetes and it lowered cholesterol. Genistein, an active agent from soy, benefits heart and bone health. Essential oil of lavender did not promote gynecomastia (breast growth in boys). Gargling with tea catechins reduced the risk of flu in elders. Smooth Move® tea was effective for constipation. Taking cranberry for four months significantly reduced the incidence of urinary tract infections in women who had been prone to have at least six per year. Hardy suggested that broader acceptance and use of herbs in healthcare would probably come with the introduction of “simples”—preparations using a single herb. Perhaps some day hospitals will offer chamomile tea for poor digestion and warming, or arnica oil might be used topically to relieve arthritis pain.

Mark Blumenthal, founder and executive director of the American Botanical Council and editor and publisher of HerbalGram magazine, was the voice of herbalism in his presentation, “The Role of the Herbalist: A Global Perspective and Future Trends.” He pointed out that herbs often offer a gentler, safer approach to medicine that may be more in line with the patient’s philosophy. He predicted wider consumer acceptance and demand as more research verifies the benefits of herbs.

A final presenter was Tierona Low Dog, who was an herbalist before she became an MD. She directs the education program in integrative medicine and clinical assistant professor in the Department of Medicine at the University of Arizona School of Medicine. Hearing her talk in the realms of more familiar territory about the sensual, physical and therapeutic qualities of herbs and even explaining how to prepare them put me at ease. Noting that abdominal fat and insulin resistance can contribute to polycystic ovary disease, she listed the herbs cinnamon, fenugreek and bitter melon to inhibit the condition, including directions for how to prepare the melon and a description of how real cinnamon can be identified (“The bark rolls in the same direction and is very breakable”). She went on to talk about the benefits and applications of licorice, peony, chaste tree berry and sawpalmetto for hirsutism (hair growth). She proclaimed, “I do not worship at the feet of evidence-based medicine!” It was all I could do not to jump up and yell “Bravo!”

The busiest vendor booth sold fish oil capsules, the substance most frequently mentioned in presentations. Turmeric was another hot seller, recommended to reduce inflammation which many professionals now regard as the root of almost all disease.

To many at this conference, this was breaking news; I have heard this same information at herb conferences for 15 years.

Many clinical studies of herbs validate what herbalists already know. Besides showing whether a therapy works, clinical trials often explain its physiological mechanism. The documentation presents the information in a format that physicians can assimilate into their medical knowledge.

On the plane ride home, I browsed through a peer-reviewed journal, Journal of Alternative Therapies, that had been distributed for free at the conference. The Brief Report inside was on the use of nettle stings for pain by Les Alford, MSc. The author researched the age-old use of gently slapping skin with nettle leaves to relieve pain after a patient reported he had gotten significant relief of lower back pain by doing so. Alford investigated a study of such therapy that had shown similar, positive results. At the end of the article, he rhetorically asks “Is it time to add nettle leaf sting to heat and ice as home physical therapies for short-term pain relief?” I say, “why not?”

One glaring omission— the report never mentions that only fresh nettle triggers the pain-relieving action. Confusion and doubt about an herb’s healing potential can develop when essential details are not included about its proper use. This is precisely where I see the role of the herbalist as a necessary affiliate of any integrative health-care team. Herbalists base much of their practice on old healing wisdom handed down to become home remedies and practical therapies. Attending the conference did not assuage my perplexity at the disconnect between botanical medicine and the widely accepted practice of western medicine, but a quote in Krista Tippett’s book, Speaking of Faith, offered me an interesting insight. Substituting the contrast between western medicine and herbalism for that between science and religion in the following quote describes my view of this quandary.

“Beyond our culture’s entrenched debates, a parallel universe of dialogue is unfolding.... It’s not so much true that science [medicine] and religion [herbalism] reach different answers on the same questions, which is how our cultural debate has defined the rift between them. Far more often, they simply ask different kinds of questions altogether, and the responses they generate together illuminate human life more completely than either could do alone.”

This article was previously published in Catalyst Magazine and has been reprinted with permission.