Herbs & Herbal Medicine

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What is herbal medicine? Herbal medicine involves the use of natural and biologically based practices, interventions, and products to treat a variety of physical or emotional conditions. The World Health Organization estimates that 80% of the world s population, or about 4 billion people, currently use herbal medicine for some of their health care. Thirty percent of the US population uses herbal remedies each year. In the past 10 years, the use of high dose vitamins has grown over 130% and the use of herbal supplements has grown over 380%. What are the benefits? Many herbal preparations may have benefits. Others may have no obvious or proven benefit, and some, in fact, can be harmful. For most of the over-the-counter herbs you can buy, there is probably little risk of having a bad reaction if you follow the directions. For example, you might drink a cup of peppermint tea to settle your stomach. At worst, it can help your upset stomach; at best, it can taste nice, warm you up, and not have any negative side effects! As another example, certain echinacea extracts are accepted in some countries for the treatment of colds and cold symptoms. While the vast majority of herbs do not have any significant side effects, however, caution should be used if you are considering adding herbal supplements in your life. What are the risks? Anything that can improve health or do the body good also has the potential to do harm. Just because something is 'natural' doesn't mean it's better for you. It doesn t mean that it's always safe. The US Food and Drug Administration (FDA), which regulates and insures the safety of prescription medicines, does not test herbs. It does not study their safety, benefits, or the effects of their short- and long-term use. In addition, there are no regulations or standards for preparing or packaging of herbal medicines, so their dosages and strengths may not be consistent. Just because one brand of St. John's Wort seems to have an effect for you does not mean the next bottle will have the same effect. The content in this document is intended for general informational purposes only and is not a substitute for professional medical advice or treatment for specific medical conditions. No professional relationship is implied or otherwise established by reading this document. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Many of the resources referenced are not affiliated with Craig Hospital. Craig Hospital assumes no liability for any third party material or for any action or inaction taken as a result of any content or any suggestions made in this document and should not be relied upon without independent investigation. The information on this page is a public service provided by Craig Hospital and in no way represents a recommendation or endorsement by Craig Hospital. Craig Hospital 2015 All Rights Reserved Rev. 1/2015 Publication # 807 Page 1 of 5

There can be problems and unwanted reactions when herbal medications and high dose vitamins are combined with prescription medicines something that 20% of the US population does! The majority of these people rarely bother to tell their health care providers that they use supplements. Always let your doctor and other health care providers know what herbs you are taking, especially if they are going to be prescribing a new drug for you. You are especially likely to have a bad reaction or a dangerous complication if you combine herbal supplements with these prescription medications, so be careful: Heart medications (especially Digitalis) Asthma medications (especially Theophylline) Blood thinners and anticoagulants (especially Coumadin) Seizure medications Antidepressants (especially MAOI) Blood pressure medications Immunosuppressants Antibiotics It's hard to know what all these drugs are, and because of all the various names, it s difficult to always know if you're taking one. Be sure to talk about this with your health care providers. Certain herbs can also complicate existing conditions or problems, such as inflammation, allergies, pregnancy, or nursing. Some herbs St. John's Wort for example can make you more sensitive to the sun. In other words, with herbal preparations as well as for prescription medications, you need to be aware of possible adverse reactions. More importantly, some herbs on the market are found to be not recommended for human consumption. And as always, be safe and tell your prescribing physicians and other health care providers about all the herbal and vitamin supplements you are taking. Because the herbal industry is growing rapidly, there may be many irresponsible manufacturers looking to make a quick buck. Check with a qualified herbal practitioner to find out quality ratings for a manufacturer before you buy a product. Craig Hospital 2015 All Rights Reserved Rev. 1/2015 Publication # 807 Page 2 of 5

What to look for on the bottle? Because herbal supplements are not monitored or regulated by the FDA, it's up to you to figure out what is in the bottle. Amounts of active ingredients can vary from one manufacturer to the next, and even from one batch to the next. In one recent study of Chinese herbal supplements, 25% contained other contaminating substances such as pesticides. Sometimes substances are added, but not mentioned on the label. In that same study, researchers found that cortisone, a powerful anti-inflammatory steroid, had been added to increase the effect of the herb. To lessen your risk of getting a poor quality herbal supplement, only buy from responsible companies that use high safety and quality control measures. Look for the following information on the bottle: Expiration date FDA registration of manufacturing facility Lot/Batch number companies that are concerned about quality and consistency will code each batch of a product with a specific number that indicates when the product was manufactured Recommended daily dosage - this can vary bottle to bottle and between manufacturers. Without a recommended daily dose, you run the risk of over - or under dosing Milligrams of each ingredient per dose - you need to know how much of each active ingredient is in each dose Independent laboratory verification of dosage Return policy - responsible companies will refund unsatisfied customers Side effects/precautions - this can be as important as daily dosage. Look for warnings, potential interactions and side effects, the same as you would with prescription and over the counter drugs Research on the product Craig Hospital 2015 All Rights Reserved Rev. 1/2015 Publication # 807 Page 3 of 5

What to look for in a practitioner Some people choose to use an herbal practitioner (a person trained in herbal medicine) to advise them when using herbs either to treat a specific problem or to enhance health in general. When choosing a practitioner, pick someone who is: Competent like any profession, you should look for someone who has experience and shows a clear knowledge of what he or she is doing Licensed or trained A graduate from an accredited institution Recommended by his or her peers Aware of his or her limitations Willing to collaborate, communicate, and cooperate with your doctors and other health care providers Concerned and professional enough to carry liability insurance Is there any research about using herbs and herbal medication after SCI and TBI? Western scientists are just beginning to explore the uses of herbal remedies for a variety of conditions, so at the moment there isn't any specific research available for people with spinal cord or brain injuries. You may hear stories from other people about things they have tried and things they recommend. Be a smart consumer and make sure the information you are getting is accurate, reliable and factual. How can I learn more? If you are interested in using herbal preparations, you should be as informed as possible about the risks and benefits. Several resources are available on the Internet, and many books have been written. Check out the health section of a local bookstore for popular books, or go to a nearby medical library to see if there have been any studies published regarding herbs that interest you. An interesting web resource is the National Center for Complementary and Alternative Medicine (NCCAM) at http://nccam.nih.gov/. Here you can check to see if anything has been published on the topic you re interested in. For example, if you want to learn about the use of herbs for people with spinal cord injuries, you can type in the key words to see what's available. (The web site offers a very long list of approved terms that you can use.) Once you've found some information, it's always a good idea to use caution, check around to see if the information is valid, reliable, and relevant to you, and also learn about the possible risks and benefits. Craig Hospital 2015 All Rights Reserved Rev. 1/2015 Publication # 807 Page 4 of 5

You can also check The PDR Family Guide to Natural Medicines and Healing Therapies (PDR Family Guides), published by the Medical Economics Company (the same company that publishes the Physician's Desk Reference for prescription drugs). Once you have some solid information and feel ready to consider an herbal remedy, the next step is to talk to your doctors, pharmacists, or other reliable health experts. With the right information, you can take charge and consider all your options most effectively. Think before you leap If you choose to use herbal supplements, do your homework. Be aware of the potential risks. If you have doubts about the safety or wisdom of using a particular herbal supplement, seek qualified advice. The things to keep in mind include: The lack of regulation of herbal supplements How they may react with prescription medications The wisdom of treating yourself without supervision Don't expect supplements to take the place of a good diet, and don't assume all supplements are benign - especially when mixed with the wrong prescription medication or taken in higher than recommended dosages. Before you consider adding any herbal preparations to your daily routine, be sure to ask the following questions: Is it safe? Does it work? What's in the bottle? Is it worth it? How will it react with other herbs or with prescription drugs? Do I really know what I'm doing? Remember, smart consumers let all their health care providers know what prescription and nonprescription medications and supplements they are taking. By using good common sense, herbal therapy can be safe and beneficial. If you have questions, ask someone you trust and who is qualified to give you advice about herbal supplements. This brochure was prepared by the Complementary and Alternative Medicine (CAM) Committee of Craig Hospital. Craig Hospital 2015 All Rights Reserved Rev. 1/2015 Publication # 807 Page 5 of 5