PREVALENCE OF HERBAL MEDICINE USES AND DEMONSTRATED SAFETY CONCERNS

Use of plants product and plant derived medication with the purpose of disease prevention and treatment are called herbal medicines. Those plants with medicinal potency on certain parts or whole plant are used since quite long. Those system of medicines whose primary ingredients are plants and other natural derivatives are called complementary and alternative medicines (CAM). Since these medications are used from ancient time to till date and somehow incorporated in human culture, are considered as autonomous treatment system. Alternative in the sense that medicines which are primarily used first line as conventional treatment all over the world are allopathic. 

                                                                                                   

          Historical perspective and current use of herbal medicines:

India being the country with high biodiversity, thousands of medicinal plants are identified and used since ancient time. The oldest medical system i.e. Ayurveda was originated from India almost 4000 years back. Ayurveda is the mainly related to use of herbal medicines as treatment and preventive aspects. Ayurveda describes 2000 medicinal herbs with thousands of formulations from medicinal herbs.  Now government of India AYUSH ministry, oversees homeopathy, Ayurveda, yoga, siddha and UNANI under complementary and alternative medicine (CAM), are . theses systems are considered to be Indian system of medicine. Other than India, use of herbal medicine as primary care is in practice worldwide with different nomenclature.

   

1. The history of the use of herbs as medication is as old as history itself. First recorded use of herbs for medical treatment began over 4000 years ago. The origin of this type of medical treatment began in China and India.
2. A World Health Organisation survey indicated that about 70-80% of the world populations rely on non-conventional medicine mainly of herbal sources in their primary healthcare. according to few studies, more than 70 % of German populations is using herbal medicine in any form for minor diseases.
3. In one study conducted in Delhi with 200 doctors working on tertiary care center shows that 58% of them uses CAM for their own health issues. mostly practiced were homeopathy and Ayurveda. Many doctors view CAM therapies as not part of legitimate medical practice, but  many have a positive attitude towards it. This shows how cultural practice is deeply rooted in human mind.
4. In recent years, it is witnessed that the increasing growth in popularity of over-the-counter (OTC) health foods, nutraceuticals, and medicinal products from plants or other natural sources in developed countries. This indirectly indicates that the public is not satisfied with their orthodox medical (OM) treatment.
5.  A 2012 report by the American Botanical Council disclosed that herbal products sales exceeded US$5.3 billion in the United States in 2011, a 4% growth compared to 2010 . In 2013, sales increased by 8%, reaching a total of approximately US$6 billion .
6. Traditional Chinese medicine centers on interactions between the body and the environment. A mixture of treatments, including herbs, acupuncture, and massage, is then prescribed
7.  More than 60 to 70% of modern medicines in the world market are directly or indirectly derived from plant products. 

Few examples that demonstrate safety concerns of herbal medicines:

1. Some herbal products were found to contain 0.1 to 0.3 mg of betamethasone per capsule aftersome patients developed corticosteroid-like side effects.
2. Owing to misidentification of the medicinal plant species, plant materials containing aristolochic acid were used for manufacturing herbal products, which caused severe kidney failure in patients in several countries. In Europe it was being used for weight reduction. It was
3.  Kava kava is An herb native to islands in the South Pacific. This was being used to relieve   stress, anxiety, tension, sleeplessness, and problems of menopause. The U.S. Food and Drug Administration advises users that kava kava may cause severe liver damage
4.  Reports have been received by drug safety monitoring agencies of prolonged prothrombin times, increased coagulation time, subcutaneous hematomas, and intracranial hemorrhage associated with the use of Ginkgo biloba. It also retards absorption of aspirin when used conjointly.
5. A number of women in Belgium attending a slimming clinic developed kidney failure after being given a herbal medicine containing the wrong botanical herb, the toxic Aristolochia fangchi in 1990. Since then safety of herbal medicine became social issue.
6. Aconitum kusnezoffii Reichb. and Aconitum japonicum Thunb, which is used in TCM (traditional Chinese medicine) for a wide range of indications, including many chronic conditions caused the cardio- and neurotoxicity by improper use in China, India, Japan and some other countries has led to a high risk of severe intoxication.
7.  Ephedra when used with caffeine, stimulant and decongestant is found to be addictive.
8. Psyllium, cosmopolitan herb for digestive disorder when used with coumarins derivatives decrease the absorption.

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