Weighing Alternatives

Give us some examples of herbal side effects.

Gingko biloba may improve memory, but at higher doses it's a blood thinner. St. John's wort shows great promise as an antidepressant, but one of its common side effects is an uncomfortable rash that appears on the skin after exposure to the sun. The danger is that people are taking many herbs and adding on lots of vitamin supplements, and they're not adding up the amount they're getting. They're thinking, If a little is good, then a lot is better. That can be a real problem.

Where should we turn for guidance?

People are wandering into vitamin shops and listening to clerks who have absolutely no medical background. And studies suggest that 80 percent of the people using complementary modalities are not telling their primary-care physicians. New information will help. Pharmacists are now putting together continuing-education programs because they're getting so many calls from people inquiring about the safety of mixing herbs and other supplements with conventional medications. And last year the first Physicians' Desk Reference devoted to herbal medicines was published. It describes hundreds of different herbs and talks about their recommended uses and side effects.

We still need a more comprehensive research database. And we still need more knowledgeable doctors. Physicians and nurses and other health professionals need to study this field. They do not need to advocate herbal medicine, but they should understand it. Remaining ignorant is a disservice to their patients.

Many people are turning to complementary medicine not because they're sick but because they feel generally stressed out. Can it help?