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Sales of herbal medicines soar

EXETER, UNITED KINGDOM. Professor Ernst at the University of Exeter presents a short update on the current state of herbal medicines. He points out that sales of herbal supplements in the United States is now approaching $4 billion/year. Several randomized clinical trials involving thousands of patients have confirmed that St. John's wort is an effective antidepressant (sales increased in one year by 2800 per cent), gingko biloba delays the progression of dementia, saw palmetto is an effective treatment for benign prostate hyperplasia (enlarged prostate), and horse chestnut seed extracts are fully comparable to conventional medicines in the treatment of chronic venous insufficiency (dull ache in legs, edema, and superficial varicose veins). Dr. Ernst specifically notes that saw palmetto was found to be as effective as the leading prostate drug finasteride (Proscar). He also acknowledges that there is still much to be learned about how herbal medicines work and which parts of a herb are the active ones. For instance, up until quite recently it was believed that hypericin was the active ingredient in St. John's wort; evidence is now accumulating that hyperforin may be equally important.

Dr. Ernst cautions that some commercial herb preparations may be adulterated or not contain what the label specifies. He also warns of possible drug/herb interactions (eg. ginseng and warfarin). Nevertheless, he concludes that medical doctors need to become more knowledgeable about herbal medicines and should also consider changing their often negative attitude towards them.
Ernst, E. Herbal medicines: where is the evidence? British Medical Journal, Vol. 321, August 12, 2000, pp. 395-96 (editorial)

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