Herbs and Natural Supplements: 10 to Recommend

Feed

You’re a responsible consumer and a smart cookie. So when a friend urges you to try ginseng for an energy lift, your first impulse is to check with your doctor.

Good impulse, but there’s just one catch: Most doctors won’t dish out advice about natural medicines.
“It’s hard to find a doctor who will talk about herbs, because most haven’t been trained in herbal medicine,” says Ron Cotterel, M.D., who straddles the fence between Western and Eastern medicine for Sutter Health, serving as both a family practice physician and as the director of the Sutter Center for Integrative Health in Davis, where he puts his training in nutrition and herbal medicine to work. “Patients are always being told to talk to their doctors before trying anything new, but most conventional health practitioners haven’t really kept up their knowledge about herbs and other alternatives.”

And even if they wanted to become knowledgeable, they would likely find their efforts stymied by the lack of good data, notes Marcia Taylor-Carlile, a registered nurse and certified diabetes educator for Mercy Hospital of Folsom. “There have not been enough well-designed research studies about herbs and supplements, and the research that has been done shows very conflicting results,” she says. The fact that herbs and other natural supplements are not subject to the same FDA (Food and Drug Administration) review and approval process as standard pharmaceuticals also makes many doctors reluctant to recommend them to patients.

Still, there are signs that even the data-driven conventionalists are coming around. At Kaiser Permanente, a handful of natural medicines (such as St. John’s wort and echinacea) have been ruled safe and effective and are sold in its pharmacies. But progress comes slowly, and many issues remain, notes Kaiser’s Jerry Huang, D.O., an osteopathic family practitioner who takes a holistic approach to medicine. “Alternative medicine is a booming industry, but it is a difficult industry to understand,” he says. “Conventional medicine has a difficult time isolating the effective compound, and also has difficulty standardizing the purity. We may never have strong studies for the safety and effectiveness of all the different herbs.”

OK. So given that data is somewhat lacking—excepting, of course, the very compelling fact that other cultures have been relying on herbal remedies to heal their people for centuries—where do you look for guidance?

The answer: Right here.

With the expert guidance of several local health providers—all of them trained in both conventional and alternative medicines—we have compiled a list of 10 recommended herbs and supplements, and also five to avoid.

Oh, and one last thing: Even if your doctor isn’t trained in natural medicine, a consultation is always a good idea, if only to rule out the possibility of adverse drug/herb interactions. “As a patient, you need to develop a partnership with your physician to take an honest look at supplements,” says Huang. “Make sure your physician is involved in your decision making.”


The Top 10

1. Omega-3 fatty acids: High on the list of every expert we interviewed, Omega-3 fatty acids are vital to maintaining good health. “It’s one of the most important supplements anyone can take,” emphasizes Jeffrey Kauffman, M.D., M.Ac. (U.K.), a local acupuncturist and doctor of holistic medicine in private practice.

 “Omega-3 fatty acids are important for so many things in the body—for nerves, heart, blood vessels, skin and hair—and they reduce inflammation anywhere in the body.” Omega-3 fatty acids provide a multitude of desirable effects, including lowering cholesterol and triglyceride levels, reducing blood pressure, and aiding in the prevention of arthritis. Good food sources include deepwater fish (such as salmon or halibut), fish oil, and canola and flaxseed oil. In supplement (capsule or liquid) form, Kauffman recommends high doses—about 3,000 to 5,000 milligrams a day.

2. Ginkgo biloba: You’ve probably heard about this one, and it’s no surprise: Ginkgo is one of the world’s most popular herbal products. Known as the “smart herb,” ginkgo enhances blood circulation and increases the supply of oxygen to the heart, brain and other body parts, making it useful for improving memory and relieving muscle pains. “We have studies that show ginkgo’s positive effects on patients with Alzheimer’s disease and dementia,” says Huang, adding that it can also help to relieve tinnitus (ringing and/or buzzing in the ears). What’s more, it’s a powerful antioxidant, helping to detoxify and protect the body. In brief, ginkgo is great, but those who take anticoagulants (blood-thinners) or painkillers shouldn’t jump on the biloba bandwagon: internal bleeding is a possible side effect.

3. Saw palmetto: OK, guys, listen up: This one’s for you. If you’re getting up in the night umpteen times to urinate—or noticing that your “flow” is weaker than it used to be—saw palmetto may be your next best friend. “I recommend it to my patients, and I even use it myself,” admits Sutter’s Cotterel, who, at 50, is experiencing the same problem as a lot of men his age: nn enlarged prostate (also known as benign prostatic hyperplasia). “It’s a very common problem in men as they get older,” he explains. Saw palmetto’s effectiveness is widely acknowledged—even by The Journal of the American Medical Association, which in 1998 published a study reporting its usefulness. Cotterel suggests using a standardized extract, 160 milligrams, twice a day.

4. Black cohosh: And here’s one for the ladies. If you’re at that lovely stage of life when hot flashes appear, you may want to try black cohosh, an herb widely prescribed and revered in Europe. “It’s pretty wonderful for women who are menopausal and perimenopausal, because it really helps to alleviate hot flushes and night sweats,” says Cotterel. With more and more women rejecting traditional HRT (hormone replacement therapy) due to its links to breast cancer and heart disease, black cohosh is being touted as a safer, and perhaps equally effective, means of minimizing menopausal madness. Do not take the herb if you are pregnant or lactating.

5. St. John’s wort/Tryptophan: St. John’s Wort has become so popular in recent years that even most mainstreamers know about its usefulness in treating mild to moderate depression. But mention tryptophan, and most people think about how sleepy they get after overdosing on Thanksgiving turkey (turkey contains high levels of this amino acid). What they don’t know is that tryptophan—like St. John’s Wort—is a mood-elevator. “Tryptophan is used by the brain to produce serotonin, the transmitter to joy, contentment and relaxation,” explains Kauffman. “It’s so good for depression that it was actually taking away sales from Prozac in the ’80s.” Kauffman recommends taking 500 to 1,000 milligrams once or twice a day. Tryptophan is also great for insomniacs, notes Kauffman, as it’s a natural sleep-inducer.

5. St. John’s wort: St. John’s wort has become so popular in recent years that even most mainstreamers know of its usefulness in treating depression. But it's important to note that the herb has been found most effective in treating mild to moderate depression, so those suffering from serious or chronic depression should seek medical intervention (and, potentially, a prescription antidepressant). "It's not a magic herb," says Huang, "but it does have some place in treating depression." St. John's wort has not been FDA approved for any medical purpose, Huang notes, and the preparations may vary substantially from those tested in randomized trials.

6. Echinacea: Another ultra-popular herb in both mainstream and alternative worlds, echinacea is renowned for its ability to boost the immune system, and is an especially strong ally during cold and flu season. “Echinacea has a mild to modest effect in treating upper respiratory infections,” notes Huang. But the trick is to start taking the herb at the earliest hint of cold or infection—otherwise it may be of little to no use.

7. Glucosamine sulfate: Commonly used by osteoarthritis sufferers seeking pain relief, glucosamine sulfate is a “very useful supplement that’s made its way into the mainstream,” says Cotterel. “A lot of physicians are prescribing it.” A naturally occurring bodily substance, glucosamine is a form of amino sugar that is believed to play a role in cartilage formation and repair. Some studies show that glucosamine supplements are as effective for pain relief as nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen, with the added benefit of being better tolerated. Glucosamine is often taken alongside chondroitin sulfate, which helps to give cartilage elasticity, but the idea that the supplements work best in combination may be a myth, according to Huang. “We currently do not have evidence that the combination is better than either supplement alone.”

8. Coenzyme Q10: A powerful antioxidant and a naturally occurring substance in our bodies, Coenzyme Q10 helps to maintain a healthy heart and healthy cholesterol levels and boosts cellular energy, according to Kauffman. Does he recommend it for everyone? “Yes,” he says, “especially in our stress-laden society. But it’s especially important for people with heart or gum disease.” Kauffman suggests taking 200–300 milligrams a day, “but it’s expensive,” he warns.

9. Feverfew: Migraine sufferers may find relief from feverfew, an herb that has been shown to prevent migraines with an efficacy that compares favorably with beta-blockers and valproic acid (Depacon, Depakene, Depakote). “Feverfew can be pretty useful,” says Cotterel, “and certainly is safer than some of the standard migraine medications, which can have serious side effects.” There are some restrictions, however: Feverfew should not be taken during pregnancy or by people who take blood-thinning medications or painkillers.

10. Garlic: Last but certainly not least, good ol’ garlic still wears the crown as one of the most health-promoting of all the herbs. The list of its uses are endless, including killing bacteria and viruses, boosting the immune system, lowering blood pressure, lowering cholesterol, treating fungal infections, and aiding circulation and digestion. It may even aid in cancer prevention, according to some preliminary studies. “It’s a natural antibiotic that goes straight to the lungs, and to the rest of the body too,” notes Cotterel. Best of all, garlic is cheap and adds great flavor to virtually all foods. Note: some caution is indicated for people who are on anticoagulants orpreparing for surgery.