MAGICAL MYSTERY CURES?

The antidepressant drug of choice in Germany is not Prozac. It is an
extract of a yellow wild flower, St John's wort, or 'hypericum
perforatum'. German doctors write about three million prescriptions
for the flower extract every year, which outsells Prozac by more than
10 to one. Happy consumers praise its power to relieve depression,
anxiety and sleep disorders without side effects.

In France and Finland, pycnogenol (pronounced "pik-nod-ja-nol") is
the miracle plant cure to take if you are suffering from circulation
problems. An extract of grape seed, it is also believed to be a
powerful anti-oxidant, mopping up potentially toxic and reactive
chemicals in the body. Another herbal remedy gingko biloba, could well
be the next lifestyle drug after Viagra. Derived from the ornamental
gingko tree, the miracle medicine is said to enhance memory.

Western consumers are reared on the traditional medical concept of the
"silver bullet" cure: one pill to solve one problem. However, as
disillusionment with conventional medicine grows, western consumers
are turning to phyto (plant) medicines, or botanicals. It is estimated
that more than a third of Americans regularly use herbal remedies. In
Europe, Germany leads the way, with 62 per cent of its citizens
placing their trust in complementary medicine. According to the
American Herb Association, in 1996 Germans spent $2.3 billion on
herbal medicines, the Americans $3.6bn and the British S146 million.

But the speed at which these miracle cures are being incorporated into
western medicine cabinets should be sounding alarm bells. There is a
knowledge gap in the efficacy and safety of herbal remedies. St John's
wort may be as good as Prozac in treating depression for some patients
but consumers need questions answered. How much should you take to get
the best effect? Can taking too much damage your health?

The vacuum in which governments and legislators are operating was made
clear by the vitamin B6 debacle in Britain last month. Britain's food
advisory committee recommended that doses of greater than 50mg of
vitamin B6 would be available only on prescription, because of
concerns over long-term safety at higher doses. The agriculture select
committee then publicly ridiculed the proposed set of guidelines,
saying that they were based on flawed medical data. Vitamin B6 is
taken by women as a treatment for premenstrual tension.

What the spat revealed is the dearth of data on vitamins and food
supplements, which include herbal remedies. Consumers need information
on which to base choices. The pace of acceptance of complementary
medicines into the western way of life means it is essential that
guidelines or advice, based on the best scientific knowledge, are made
available now.

The answer may lie in Germany, where herbal products are used by the
majority of the population and are regularly prescribed by doctors.
Germany's Commission E, a division of the Bundesgesundheitsant, the
federal health agency, has been compiling data on the safety and
efficacy of herbs and phytomedicines since 1978. Its 312 monographs,
covering 286 herbs and herb cocktails, represents probably the most
comprehensive library of information on herbs and their medicinal uses
in the world.

The monographs cover the use of the herb; what has been established
about its therapeutic benefit in clinical experments; any side
effects, contra-indications or precautions; and the correct dosage.
For the memory-enhancing leaf extract, gingko biloba, they recommend
"120mg to 140mg of native dry extract in two or three doses" and up to
160mg for the treatment of vertigo and tinnitus. For prostate

problems, they recommend the saw palmetto berry or 'sabal fructus', at
a dally dosage of 320mg.

The information is in German, but now the American Botanical Council
(ABC) has translated the monographs and is making them available to
consumers for the first time at the end of next month. ABC is hoping
that their publication in English will increase the acceptance of the
legitimate use of herbal therapies.

But one problem remains. The majority of the heralded herbal miracle
cures will probably always lack the backing of the degree of clinical
evidence that demonstrates how traditional pharmaceuticals work safely
in thousands of patients. There are two main reasons why the majority
of phytomedicines will never be subjected to medical trials. The first
is thatbecause plants or herbs cannot be patented (although specific
formulations can), there is no financial incentive for drugs companies
to develop them. Without a patent, a company cannot stop another from
stepping in and selling exactly the same product, without
spending the $200m needed to test it properly.

The second problem is the result of the fact that many herbal
medicines do not consist of one active ingredient, the "magic bullet"
of conventional western medicine. Instead they are a mixture of
chemicals, which combine to give a therapeutic effect. Within such a
cocktail it can be impossible to define one active ingredient.
Regulators are reluctant to give their approval to such indefinable
mixtures.

One European company is making headway in redressing the balance.
Phytopharm, based in Britain, is developing a treatment for eczema,
Zemaphyte, which is a mixture of herbs. A decision from Britain's
regulatory body, the Medicines Control Agency (MCA), on whether it can
be prescribed as a medicine in Britain is expected in 1999. A positive
decision would be a big step forward for phytomedicines, paving the
way for more plant potions to be accepted as safe and efficacious drugs.

Attitudes as well as legislation must change before the West can fully
embrace complementary medicine - or even just give sensible guidelines
on their therapeutic benefit. There will probably never be a single
answer to whether a particular herbal remedy is effective or not -
unless a brave pharmaceuticals firm with deep pockets decides to prove
the medical integrity of each of the world's so-called miracle cures.
Until then, look to Germany for the best advice on plants that cure
people.

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Shug's War on Drugs Library

http://www.shug.co.uk
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Checked-by: "Rich O'Grady"