"Some people think herbs can replace prescription drugs," said Teri Gabel, PharmD, BCPP, a drug therapy consultants. "Herbs are more subtle, more for mild to moderate kinds of conditions and can be helpful for health maintenance and disease prevention. They can be great additions to lifestyle change and diet and exercise."
What exactly is considered an herb? St. John's Wort, valerian, passion flower, and even chamomile tea are herbs – plant-based substances. Supplements are vitamins, minerals, amino acids, and substances like glucosamine (which is made from seashells or can be synthetic).
Herbs and supplements are not a quick fix for what ails you. These substances are best used as part of the mind-body-spirit process and also can, with caution, be used in combination with prescription medications, according to Dr. Gabel.
Let's use cholesterol lowering as an example. For someone with mildly high cholesterol, Dr. Gabel might recommend an herb or supplement such as red yeast rice and garlic, in addition to monitoring fats and cholesterol in the diet and adding daily exercise.
"If you truly want to lower your cholesterol, herbs can help – but not if you continue to eat red meat every night and sit on the couch and eat donuts!" she said. She recommends lifestyle changes in combination with herbs to reach your health goals. This approach, she said, is preferable over merely taking a prescription drug to lower cholesterol and not making a commitment to a healthy lifestyle.
Many people stand in the drugstore aisles, look at the array of herbs, vitamins, and supplements and simply don't know which to buy. They think they should take something – "for insurance." But often they don't know why they are taking an herb or vitamin at all. Nor do they know if what they take is working.
Here are some guidelines Dr. Gabel suggests if you're thinking about taking herbs, vitamins, and other dietary supplements:
- Ask yourself why you are taking an herb or supplement. "You should not treat something unless it has been diagnosed by your doctor," said Dr. Gabel. "Find out what your ache or pain is first. Don't treat something you think you have." Your doctor can play another role in your herbal use by ordering lab tests to measure progress. Work with your doctor to interpret your lab results.
- Determine the best dose. You can read the label to determine how much to take, but the listed dose for most products is based on a 170-pound man. Dr. Gabel said you might refigure the dosing and lower it if you weigh 120 pounds or increase it if you weigh 200 pounds. Herbs, just like prescription drugs, can alter your lab numbers. So know your current cholesterol levels, blood glucose, or whatever you are monitoring, and start taking the lowest dose that may be effective. Then monitor your lab numbers again in 2 to 4 months to check progress.
"Establish your baseline and compare it to your progress," Dr. Gabel said. "Then you will know if an herb is working for you or not." Many people stop using herbals too quickly if they don't see results. Other ways to measure progress, depending on what you're taking and why, would be to see if , for example, you have better range of motion or better pain control when taking herbs for arthritis.
- Monitor drug interactions. Work with your doctor and pharmacist to monitor any interactions between your herbs and other drugs you take or side effects from the herb itself. "Just assume you will have a drug interaction," said Dr. Gabel. Evaluate together what you are taking. "If you're going to put it in your mouth, know why you are taking it and what you can find out about it," she said. Most herbs are going to thin your blood, for example. Some contain natural vitamin-K-like products and can interfere with other prescription medications. Your doctor needs to know everything you take for just this reason.
- Consider the cost. Herbs and other dietary supplements are often not much cheaper than prescription medications. You can find good products at major drug stores and drug departments. Sometimes store brands are just as effective and less expensive than name brands.
- Beware of schemes and scams. Challenge advertised claims unless you have verified proof from another source about a product's usefulness. Don't trust the "scientific claims" on a Web site that is trying to sell you something. Know who is selling you a product. Do your research before you buy. Dr. Gabel recommends these websites: the Food and Drug Administration and the National Center for Complementary and Alternative Medicine.
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