We've all been there. Coughing all night from a sinus infection, some of our friends give us more than just a sympathetic ear...they also give us an earful on why we should use herbal remedies in lieu of traditional treatments like antibiotics. We start to roll our eyes, but the truth is that we have no idea: Which herbal treatments actually work, and which are a waste of money?
Alternative medicine is a multi-billion-dollar industry, but most alternative treatments (defined as medicine based on cultural or historical precedents, rather than pure science) aren't FDA-approved and haven't undergone double-blinded studies to learn whether they truly work...or could even be harmful. You should always let your healthcare provider know if you're using herbal supplements, which are intended to supplement your intake of nutrients or vitamins that you otherwise might not receive in such large quantities. Although these products occur naturally, you need to tell your doctor if you're taking any because many can actually inhibit or change the effects of other medications that your doctor prescribes.
Here's what we found when we asked experts about five common herbal supplements:
1. Not Worth It: St. John’s Wort. $13.
St. John's wort is one of the most commonly purchased herbal products in the United States. According to the University of Maryland Medical Center, St. John's wort "has antibacterial and antiviral properties and, because of its anti-inflammatory properties, has been used topically to help heal wounds and burns." It is frequently used as a treatment for depression and has been proposed as a treatment for psychological problems such as obsessive compulsive disorder and social phobias.
But, it turns out that St. John's wort can actually be dangerous because it interacts badly with many medications, from allergy meds, to birth control pills, to HIV treatments. We caught up with Alexandra Greer, a doctoral candidate in biomedical sciences at the University of California at San Francisco, who authored "State of the Science: Health, Vitamins and Supplements," which addresses the safety and efficacy of herbal remedies. She told us that St. John's wort can "cause serotonin syndrome (which is potentially life-threatening) if the person is also taking an SSRI for depression. I think that for a small group of people, this supplement could potentially be beneficial...but depression is dangerous, and I think anyone having trouble should look to their therapist or psychiatrist for pharmaceutical advice."
Moreover, in 2001, the Journal of the American Medical Association released a report that stated that St. John's wort is not effective in the treatment of major depression, and a 2008 study found that it is not effective in treating attention deficit/hyperactivity disorder. Our conclusion? Not worth the money or the risks. (Read this if you're trying to figure out how much to budget for mental health.)
Product example: Solaray
2. Maybe Worth It: Melatonin. $7.
Melatonin is a hormone that helps regulate other hormones and maintain the body's internal clock. As a result, it's been used to treat conditions like insomnia, narcolepsy, and depression. According to the Medscape Journal of Medicine, melatonin may even help with seizures and prevent certain forms of cancer. That said, "unequivocal evidence of its efficacy has been established only for a few conditions — jet lag, depression, and insomnia." Melatonin can have some adverse side effects, and "long-term safety data are lacking." The reputable medical journal article takes a stance that unregulated and uncontrolled use of melanin should be "prevented unless and until clear benefits are demonstrated." Melatonin has been proven effective for jet lag and insomnia, so it may be a viable option if you're having sleep issues...but make sure to check with your doctor before jumping on the bandwagon.
3. Not Worth It: Aloe Vera. $5.50.
Aloe vera can be taken in the form of a capsule, juice, oil, gel, or as a plant leaf. It’s is most commonly used for minor burns, wounds, and skin irritations, for which it's been found effective by a review of scientific literature (though there have been other, more mixed studies). People have also pointed to aloe as a possible treatment for problems as diverse as constipation and diabetes, but the plant can cause cramping in the treatment of the first, and has not been definitively proven effective for the latter. The University of Maryland Medical Center recommends against consuming aloe in capsule form: "Taking aloe latex orally may cause severe intestinal cramps or diarrhea and is not recommended. Pregnant women should never take aloe latex because it may cause uterine contractions and trigger miscarriage. Nursing mothers should not take aloe latex either because the effects and safety for infants and children are not known." We asked Dr. Stephen Barrett, who has achieved national renown as an author, editor, consumer advocate, and creator of Quackwatch.org. He said, "I would never in a million years use aloe vera internally. With external use, the evidence is conflicting."
So, we'll never take aloe orally, and we don't think that bottled aloe (like this "pure beauty oil") is worth it—if you want soothing aloe gel, simply buy a leaf from your local health food store and slit it lengthwise.
Product example: Jason Natural Cosmetics
4. Not Worth It: Ginkgo Biloba. $24.
In Europe and the United States, ginkgo supplements, believed to improve memory, are among the best-selling herbal medications. But, according to the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health, "A trial sponsored by the National Institute on Aging of more than 200 healthy adults over age 60 found that ginkgo taken for 6 weeks did not improve memory." Many ginkgo supporters point to the plant as a possible treatment for memory impairment and Alzheimer's disease, but Dr. Barrett told us, "Well-designed studies have shown there is no value to ginkgo preventing Alzheimer's disease or improving the average person's memory. Gingko has some ability to increase circulation to the brain but that doesn’t necessarily have any practical effect. It’s a waste of money in my opinion."
Product example: Now Foods
5. Not Worth It: Omega-3 Fatty Acids. $18.
Researchers have found that fatty acids found in fish may actually help protect people's hearts. All fish contain omega-3 fatty acids, which is why the American Heart Association recommends eating fatty fish at least twice per week. If you don't eat fish, go for some flaxseed or walnuts, which also contain the chemical. According to an article published by the Cleveland Clinic Journal of Medicine, "Experts generally believe that omega-3 fatty acids reduce arrhythmic events. Nevertheless, we lack clear evidence of [the] clinical effectiveness [of omega-3 fatty acids], and their use for such purposes is off-label." In short, although omega-3 acids are important for your diet, supplements may not to be worth the money: Just go eat some fish.
Product example: Olympian Labs
In the end, most of our experts were generally skeptical of herbal supplements. Dr. Barrett said outright, "The whole herbal supplement industry is smoke and mirrors." He takes issue with the lack of quality control in the industry, and the fact that even though a few herbs have a legitimate effect, there are generally more effective ways to deal with the same medical situations. He also said: "The vast majority of people who prescribe or recommend herbs are not qualified to make diagnosis or recommend treatment. If you’re talking about treating real diseases, I don’t think herbs have any benefit."
Dr. Stephen Bent, who addressed the topic in the Journal of General Internal Medicine, has a more tempered but still highly skeptical view of the industry: "Unfortunately, there is limited scientific evidence to establish the safety and efficacy of most herbal products. Of the top 10 herbs, 5 (ginkgo, garlic, St. John’s wort, soy, and kava) have scientific evidence suggesting efficacy, but concerns over safety and a consideration of other medical therapies may temper the decision to use these products."
In the end, we feel that the best defense is to eat healthy foods and exercise, which has very clearly shown medical benefits. If saving up for exercise costs is an issue, check out our articles on how to save on gym fees and how to work out for free at home. As Dr. Bent says, a big part of leading a healthy lifestyle is eating well. So, in a similar vein, how important is it to always choose organic food? (Check this out for one specific great way to buy organic food for less.)