Medicinal herbs in the United States: Research needs

Virtually all cultures have, throughout history, used a variety of plants o r materials derived from plants for the prevention and treatment of disease . Evidence of the beneficial therapeutic effects of these medicinal herbs i s seen in their continued use. Additionally, the development of modern chem istry permitted the isolation of chemicals from medicinal herbs that have s erved as drugs or starting materials for the synthesis of many important dr ugs used today. Many more modern drugs have been synthesized as a result of knowledge gained from studies of mechanisms of actions of chemicals first isolated from medicinal herbs. Thus, medicinal herbs have played a major ro le in the development of modern medicine and continue to be widely used in their original form. Whereas it is generally agreed that most medicinal her bs are safe under the conditions used, some are toxic and should be avoided even though they are readily available, and others have significant advers e side effects when misused. Also, little has been done to investigate pote ntial adverse effects that may be associated with extended or high-dose use of medicinal herbs. Thus, concern has been expressed that the lack of qual ity control used in the preparation of medicinal herbs, plus their unregula ted sale and uninformed use, pose potential adverse health effects for cons umers. There is also concern regarding potential herb/herb or herb/drug int eractions and possible untoward health effects of medicinal herbs in sensit ive subpopulations such as the young and the elderly and certain geneticall y predisposed individuals. In this paper, we discuss these concerns at some length and make recommendations for additional research and education disc ussed in the recent International Workshop to Evaluate Research Needs on th e Use and Safety of Medicinal Herbs.