One other insight about herbals (as compared to extracted active components or to synthetic pharmaceuticals)-- they tend, on average, to be less "clean" from a pharmacology standpoint.

They frequently have several mechanistic effects at multiple receptor types, and often have variable activity depending upon season and location of harvest, age of plant material harvested, etc. etc.

Foxglove, anyone?

The actual problem, though, is that as often as not, the active principal is unknown-- at best, it may be assumed based on structure-activity analogies.

Hawthorn would be a 'cardiac' drug cocktail in this category; unknown mechanism, unknown active agents, unknown concentrations, unknown, unknown, unknown... all that IS known about it is that the action seems to be "not ____" (since it doesn't 'compete' with a number of other known drug classes), and that the known components don't explain its activity by any stretch.

Okay, so if you assume that "molecule A" is the active ingredient, and you standardize on that basis, what happens if you're... er.... well, wrong? What if it is actually molecule H that has the activity that is desirable?

That concentration might vary WILDLY in an herbal preparation if it isn't even being evaluated, leading to study results which really ARE merely anecdote and placebo effect.


So that is reason number one why I'm personally not a fan of any herbal that isn't already a widely used foodstuff. I make an exception for, say, cranberry juice capsules or fish oil.

The other reason why I'm particularly wary is that, as Val indicated, the neuropharmacology of many pharmaceuticals is simply not well-studied in children to start with. What is known about that pharmacology suggests very strongly that neurochemistry and receptor populations can be permanently altered by the administration of some substances (including some natural ones).

Okay-- back to 'pharmacological cocktail, much of it unknown' for a moment:

the reason why toxicity/adverse event reporting is often so scarce with herbals is that they aren't well-studied to start with. Most of the people doing the research studies in this field aren't looking for those effects. Nor are they looking longer-term.

This is the reason why I'm wary of newly approved mainstream pharmaceuticals, too. I consider the first five years of rollout to be another clinical trial phase. LOL.

The difference is that at least there IS an agency keeping track of that stuff for pharmaceuticals. There isn't one for herbals.

The problems have to be massive in scope and in scale for an herbal to be pulled from the market. (Ephedra, for example.)

http://www.ncbi.nlm.nih.gov/pubmed/22928722

http://www.ncbi.nlm.nih.gov/pubmed/10948380

Please note what the FDA recommends for toxicity studies in herbals:

http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm070491.pdf

but bear in mind that this is VOLUNTARY. I know of no company actually doing all of those things to the extent that it probably should be done.

While not all of the best quality in terms of citations, this is a good starting point for anyone considering an herbal as a DIY intervention:

http://en.wikipedia.org/wiki/List_of_herbs_with_known_adverse_effects

Don't misunderstand me-- I'm all for risk-benefit analysis. If I were ever in a position where I had no modern pharmacology to rely upon, I'd certainly use what I know about ethnobotany to improve the health of my family with herbals. As noted above, we already do use a select handful of things. The more I understood about the pharmacology/toxicology, though, the smaller that number of trusted herbals became for me personally. MOST herbals (and not a few vitamin supplements) are in the "not worth it" pile for me personally at this point.

Would I give my own child Rhodiola? Probably not. But I'm not someone who is seeing potential benefit as being worth the risk that I know about for any herbal product. I'm not living in Irena or Ultramarina's shoes, though.



Schrödinger's cat walks into a bar. And doesn't.