Unsafe and potentially safe herbal therapies

Unsafe and potentially safe herbal therapies are discussed. The use of herbal therapies is on the rise in the United States, but most p harmacists are not adequately prepared educationally to meet patients' requ ests for information on herbal products. Pharmacists must also cope with an environment in which there is relatively little regulation of herbal thera pies by FDA. Many herbs have been identified as unsafe, including borage, c alamus, coltsfoot, comfrey, life root, sassafras, chaparral, germander, lic orice, and ma huang. Potentially safe herbs include feverfew, garlic, ginkg o, Asian ginseng, saw palmetto, St. John's wort, and valerian. Clinical tri als have been used to evaluate feverfew for migraine prevention and rheumat oid arthritis; garlic for hypertension, hyperlipidemia, and infections; gin kgo for circulatory disturbances and dementia; ginseng for fatigue and canc er prevention; and saw palmetto for benign prostatic hyperplasia. Also stud ied in formal trials have been St. John's wort for depression and valerian for insomnia. The clinical trial results are suggestive of efficacy of some herbal therapies for some conditions. German Commission E, a regulatory bo dy that evaluates the safety and efficacy of herbs on the basis of clinical trials, cases, and other scientific literature, has established indication s and dosage recommendations for many herbal therapies. Pharmacists have a responsibility to educate themselves about herbal therap ies in order to help patients discern the facts from the fiction, avoid har m, and gain what benefits may be available.