1. Herbs, Herbs, Herbs Unit 7 HW205 Vitamins, Herbs &
Nutritional Supplements
Jennifer Neily, MS, RD, CSSD, LD
Adjunct Faculty - Kaplan University
Welcome to week 7! How is everyone doing? I think you are all doing terrific! We’re in the home stretch – just a few more weeks to go. Can you believe how fast this term has gone? Do you have any questions about Unit 6 and the accessory nutrients?
Make sure you check the announcements – I posted a new announcement about the final project due in week 9. Be sure to read it as well as the information in the course area. We can talk about any questions you have next week. But you probably want to get started on it soon.

2. Learning Outcomes
Identify common herbs and know when they would be recommended.  
Understand the categorization of herbs.  
Be able to define an herb.  
Know what the German Commission E Monographs are.  
Understand the issues surrounding herbs and potential contamination.
The learning outcomes this week are to:
Identify common herbs and know when they would be recommended.
Understand the categorization of herbs.
Be able to define an herb.
Know what the German Commission E Monographs are.
Understand the issues surrounding herbs and potential contamination.
There are several activities this week that we should talk about….(next slide)

3. Discussion Board
Discuss the article on herbs and/or herbal medicine that you selected when you completed the reading assignment and visited the BS Resource Room for the School of Health Sciences.
Be sure to cite the article, journal and any quotations using APA format.
Discussion board:
Discuss the article on herbs and/or herbal medicine that you selected when you completed the Reading assignment and visited the BS Resource Room for the School of Health Sciences.
Be sure to cite the article, journal and any quotations using APA format.
Read and Respond to at least two postings of your classmates. Try to choose postings that have not yet been responded to.
You should be learning about the Resource Room.
Go to the Resource Center and in the Virtual Library -> periodical database -> proceed into Health & Wellness Resource Center. Click Drugs & Herbal Remedies and type in your herb or supplement. The PDR (Physician’s Desk Reference) for Herbal Medicines is a great reference. Can also find areas for disease and condition, alternative medicine, websites (trusted).

4. Exercise
Using your Mosby’s book, the internet and a trip to a health food store, read about and compare three different herbs.
For each herb, find one standardized and one non-standardized brand.
Write down what is on the Nutrition Facts Panel and Ingredients as well as the price. Did the supplements with the standardization cost more? Were there other interesting differences like GMP or organic stamps on the standardized products?
Write a two page paper (APA format) on your findings.
This week’s exercise:
Using your Mosby�s book, the Internet and a trip to a health food store, read about and compare three different herbs.
For each herb, find one standardized and one non-standardized brand.
Standardization
Guarantees a certain level of a particular constituent is present in the formulation.
Expressed as total weight of product.
A way to check for quality in herbal preps.
Write down what is on the bottle in the Nutrition Facts Panel and Ingredients as well as the price.
Did the supplements with the standardization cost more? Were there other interesting differences like GMP or organic stamps on the standardized products?
This is in regard to the paper you have to write this week. You’re going to choose three different herbs: eg – echinacea, black cohosh, feverfew. Review what Mosby’s has to say about these.
Next go to the internet and research echinacea, black cohosh, feverfew. Then go to the health food store – you’re on a fact finding mission. Look for a standardized and non standardized product. In herbs you look for “standardization” that way you know it is guaranteed for purity and potency.
Compare and contrast the info you find.
Any questions before we move on?

5. Outline of Tonight’s Seminar
Introduce phytochemicals.
Define and categorize herbs
Introduce the German Commisson E Monographs
Discuss issues regarding safety, regulation and contamination
Q & As
Outline of tonight’s seminar – we’ve got a lot to cover.
Introduce phytochemicals.
Define and categorize herbs
Introduce the German Commisson E Monographs
Discuss issues regarding safety, regulation and contamination
Q & As
_____________________________
Before we get started…I have a riddle for you: Thousands of these are known to exist. They are not vitamins and they are not minerals. They have no calories. But they have been known to help decrease risk of chronic diseases like cardiovascular disease, and some cancers. What are they?

6. What are Phytochemicals?
“Nonnutrient” compounds found in plants that have biological activity in the body.
Tens of thousands of them exist.
Not considered essential because the body does not develop a deficiency disease if they are not consumed.
The body cannot make them.
What are the phytochemicals? Aka phytonutrients
“Nonnutrient” compounds found in plants that have biological activity in the body.
Tens of thousands of them exist.
Not considered essential because the body does not develop a deficiency disease if they are not consumed.
The body cannot make them.
The term "phyto" originated from a Greek word meaning plant. Phytonutrients are certain organic components of plants, and these components are thought to promote human health. Fruits, vegetables, grains, legumes, nuts, and teas are rich sources of phytonutrients. Unlike the traditional nutrients (protein, fat, vitamins, minerals), phytonutrients are not "essential" for life, so some people prefer the term "phytochemical.“ (WebMD accessed July 26, 2010)
Not one of the six nutrients. What are the six classes of nutrients? Protein, cho, fat, vitamins, minerals, water. Therefore it is called a nonnutrient. Give fruits and veggies their beautiful colors.
In a class called “functional foods” – foods that contain physiologically active compounds that provide health benefits beyond basic nutrition (Understanding Nutrition text, p 469) Can you think of certain foods that might be considered functional foods? Calcium fortified oj; Benecol or Promise Active;
In foods, phytochemicals impart tastes, aromas, color and other characteristics . They give hot peppers their burning sensation, garlic its pungent flavor and tomatoes their dark red color. In the body phytochemicals can have profound physiological effects, acting as antioxidants, mimicking hormones, and suppressing the development of diseases. (ibid)
Eat a rainbow of colors everyday
Fruitsandveggiesmorematters.com

7. Characteristics of Phytochemicals
Act as plant hormones.
Provide color, flavor and protect plants from insect, microbes and oxidation.
Over 2000 phytochemicals act as pigments and at least 600 carotenoids – orange, yellow, red.
Amount and type of phytochemical vary depending on the plant.
Characteristcs of phytochemicals
Act as plant hormones.
Provide color, flavor and protect plants from insect, microbes and oxidation.
Over 2000 phytochemicals act as pigments and at least 600 carotenoids – orange, yellow, red.
Amount and type of phytochemical vary depending on the plant.
_____________________________________
Last week we talked about accessory nutrients – one of them was actually a phytochemical…do you recall which one? Flavonoids – 6000 in its class

8. How Do Phytochemicals Work?
Act as hormone-inhibiting substances that prevent the initiation of cancer.
Serve as antioxidants that prevent and repair damage due to oxidation.
Block or neutralize enzymes that promote the development of cancer and other diseases.
How do phytochemicals work?
Act as hormone-inhibiting substances that prevent the initiation of cancer.
Serve as antioxidants that prevent and repair damage due to oxidation.
Block or neutralize enzymes that promote the development of cancer and other diseases.
______________________________
Phytochemicals may:
Serve as antioxidants
Cell to cell communication
Enhance immune response
Cause cancer cells to die
Repair DNA damage caused by smoking and other toxic exposures
Detoxify carcinogens
(Web MD accessed July 26, 2010)

9. Examples of Phytochemicals
Allicin – garlic, onions, leeks, chives, shallots
Capsaicin – hot peppers
Carotenoids – deeply pigmented fruits/veggies
Curcumin – tumeric
Flavonoids – berries, black/green tea, purple grapes/juice, soybeans/soy products, wine
Examples of Phytochemicals
Allicin – garlic, onions, leeks, chives, shallots – the biologically active compound in garlic. First reported in It exhibits antibacterial and antimicrobial properties. Allicin is garlic’s defense mechanism against attacks by pests.
Capsaicin – hot peppers - helps with blood clotting, may reduce risk of fatal clots in heart and artery dz.
Carotenoids – include hundreds, but some are beta carotene/lutein/lycopene. deeply pigmented fruits/veggies – like what for example: apricots/cantaloupe/carrots/pumplin/broccoli/spinach/sweet potatoes/tomatoes. Acts as antioxidant possibly decreasing risks of cancer and other dz.
Curcumin – tumeric – a yellow-colored spice. May inhibit enzymes that activate carcinogens. Common in what kind of cuisine?
Flavonoids – include flavones/quercetin/flavonals/isoflavones/catechins and numerous others. berries, black/green tea, purple grapes/juice, soybeans/soy products, wine. Antioxidants; inhibit cell proliferation.

10. Examples of Phytochemicals
Indoles – cruciferous veggies
Terpenes (eg limonene) – citrus fruit peels and oils
Phenolic acids – coffee beans, fruits, oats, potatoes, soybeans
Lignans – flaxseed, whole grains
P 470 UN
Indoles – cruciferous veggies – what are they? broccoli, brussels sprouts, cabbage, cauliflower; horseradish; mustard greens. May trigger production of enzymes that block DNA damage from carcinogens
Terpenes (eg limonene) – citrus fruit peels and oils - a large class including limonene. Include the essential oils of citrus fruits. Used as solvent and cleaner.
Phenolic acids – coffee beans, fruits, oats, potatoes, soybeans
Lignans – flaxseed, whole grains - Antioxidant

11. Examples of Phytochemicals
Phytic acid – whole grains
Phytoestrogens – soybeans, soy flour/milk, tofu, other legume products
Resveratrol – red wine, peanuts
Tannins – black-eyed peas, grapes, lentils, red/white wine, tea
Page 470 UN
Phytic acid – whole grains
Phytoestrogens – soybeans, soy flour/milk, tofu, other legume products – act as antagonists of estrogen. First observed in shown to be protective against some cancers. Conflicting studies re: soy and breast cancer.
Resveratrol – red wine, peanuts - found in the skin of grapes; therefore not as strong in white wine as red.
Tannins – black-eyed peas, grapes, lentils, red/white wine, tea
_________________________
What did I say earlier? “Eat a rainbow…..”
Also…five is fine but nine is divine and 13???

12. Health Benefits
Diets rich in fruits and vegetables are protective against CVD & certain cancers.
Reduce risk of macular degeneration and cataracts.
Reduce risk of infectious disease, type 2 DM, stroke, HTN, and other disorders.
Health benefits
Diets rich in fruits and vegetables are protective against CVD & certain cancers.
Reduce risk of macular degeneration and cataracts.
Reduce risk of infectious disease, type 2 DM, stroke, HTN, and other disorders.

13. Let’s do a poll! Let’s do a poll!
Dietary supplements including herbs must be tested for safety and effectiveness before they can be sold. True or false?

14. They can be sold without proof of safety or efficacy.
False!
They can be sold without proof of safety or efficacy.
False.
They can be sold without proof of safety or efficacy.
It’s a buyer beware market

15. Let’s do one more… Let’s do one more… True or false?
Herbal remedies have been used for over a hundred years in Germany so they are safe and effective

16. False!
Results of clinical trials - not historic use - are the gold standard for determining safety and effectiveness of herbal remedies and other dietary supplements.
False. Results of clinical trials - not historic use - are the gold standard for determining safety and effectiveness of herbal remedies and other dietary supplements.

17. What is an Herb? A plant lacking a permanent woody stem.
Many are flowering garden plants or other potherbs.
Some have medicinal properties.
We can all grow things ourselves such as rosemary, thyme, lavender.
What is an herb?
A plant lacking a permanent woody stem.
Many are flowering garden plants or other potherbs.
Some have medicinal properties.

18. The Science of Herbal Use
Phytotherapy – the science of using plant medicine to positively impact illness.
German physician Rudolf Fritz Weiss ( ) wrote the Textbook of Phytotherapy (Lehrbuch der Phytotherapie) which became one of the leading authorities as a reference for herbal medicine. Now called Herbal Medicine.
The science of herbal use:
Phytotherapy – the science of using plant medicine to positively impact illness.
German physician Rudolf Fritz Weiss ( ) wrote the Textbook of Phytotherapy (Lehrbuch der Phytotherapie) which became one of the leading authorities as a reference for herbal medicine. Now called Herbal Medicine.

19. Categorizing Herbs Adaptogens
Herbs that have a nonspecific effect of balancing the body systems.
Antioxidants
Help to fight against free radical damage.
Astringents
Have a tightening effect and help to promote a toning effect on tissue.
Ginseng, Photo Source: Wikipedia
Herbs are categorized on the basis of their physical and chemical properties they possess. The constituents present in herbs make them distinct from others. The usefulness of specific herbs becomes easy when its property and constituents are known. Here are some given properties of herbs.
Adaptogens: Herbs that have a nonspecific effect of balancing the body systems. Examples of adaptogenic herbs are ones that promote wellness in regards to stress reduction, enhance brain functioning, immune system regulators, and enhance energy. Most commonly recommended adaptogenic herbs are known for their role to help modulate stress and promote energy.
Examples of adaptogenic herbs include: Asian Ginseng, Astragalus, and Ashwagndha.
Antioxidants: Help to fight against free radical damage.
Examples of antioxidant promoting herbs include: Flavonoids- Apples, Green Tea, Onions, Cherries, Blueberries; Bilberry, Hawthorn, Milk Thistle
Astringents: Tannins are the main constituents of herbs that have been categorized as astringent. They have a tightening effect and helps to promote a toning effect on tissue. These herbs are beneficial in conditions of inflammation of the skin (eczema, dermatitis) and soothing mucous membranes. They can help stop diarrhea and soothe irritated tissues.
Examples of astringent herbs include: Witch Hazel, Oak Bark, English Walnut
Abortifacient ; Alterative ; Analgesic ; Anodyne ; Anthelmintic ; Antiasthmatic ; Antibacterial ; Anti-depressant ; Anti-diabetic ; Anti-hepatotoxic ; Anti-inflammatory ; Anti-oxidant ; Anti-periodic ; Anti-rheumatic ; Anti-scorbutic ; Anti-septic ; Anti-spasmodic ; Anxiety ; Aphrodisiac ; Astringent ; Bitter ; Cardiac ; Carminative ; Cathartic ; Cholagogue ; Demulcent ; Deobstruent ; Depurative ; Hepatic ; Hypnotic ; Insecticide ; Insomnia ; Laxative ; Memory tonic ; Mydriatic ; Narcotic ; Nephritic ; Nervine ; Nutritive ; Parasiticide ; Pectoral ; Purgative ; Refrigerant ; Resolvent ; Rubefacient ; Sedative ; Stimulant ; Stomachic ; Styptic ; Sudorific ; Tonic ; Vermifuge ;Vulnerary
Milk thistle, Photo Source: Wikipedia
Witch hazel, Photo Source: Wikipedia

20. Categorizing Herbs Carminatives
Peppermint, Photo Source: Medline
Carminatives
Derived from the Latin word ‘carminare’ meaning ‘to cleanse’.
Cholagogues
Help to stimulate both the production and flow of bile from the gallbladder.
Demulcents
Help to soothe or protect irritated mucous membranes due to their high mucilage content.
Chamomille, Photo Source: Medline
Categorizing herbs
Carminatives: This word is derived from the Latin word “carminare” meaning to cleanse.
Carminatives are used to help settle gastrointestinal upset including cramping, helping with infant colic, heartburn, irritable bowel syndrome, gas and bloating. It is there volatile oils which carry the carminative healing properties.
 Examples: Peppermint and Chamomile, Anise, Fennel, Ginger
Cholagogues: Help to stimulate both the production and flow of bile from the gallbladder. This is necessary for individuals who are having difficulty with digesting and utilizing fats in their diet. Those who may be in need of cholagogues include people who experience a sense of fullness or bloating following a meal which contains fat. This fullness may be due to their inability to digest and utilize the fat in that meal.
 Examples: Dandelion Root, Turmeric, Artichoke, Milk Thistle (notice two categories for milk thistle). 
Demulcents: These herbs help to soothe or protect irritated mucous membranes due to their high mucilage content.
 Examples: Marshmallow Root, Slippery Elm, Aloe Vera (leaves only), Fenugreek Seeds, Mullein Flowers
Turmeric & curcumin, Photo Source: Medline

21. Categorizing Herbs Digestive bitters
Help the digestion of foods eaten.
Immunomodulators
Promote healthy immune function.
Laxatives
Promotes elimination.
Bulk form or stimulant.
Echinacea, Photo Source: Wikipedia
Categorizing Herbs
Digestive Bitters: These help in the digestion of foods eaten. Ideal to take prior to a meal or immediately following to help with breakdown of the macronutrients, especially protein and fat.
 Examples: Gentian Root, Yellow Dock, Dandelion Root and leaves, Wormwood
Immunomodulators: Promote healthy immune function.
 Example: Echinacea, Astragalus, Eleuthero (Siberian Ginseng), Shiitake and Reishi Mushrooms, amongst other mushrooms.
Laxatives: Promote elimination. Bulk forming or stimulant.
 Bulk forming laxatives are safe and high in fiber. Their action in the body is to absorb water and “bulk”. This action promotes more regular elimination, helps to lower cholesterol and pull toxins out of the system. Make sure that individuals taking bulk forming laxatives are also drinking ample amounts of water to prevent constipation due to lack of water. Very safe for long term use. Examples: Psyllium Husk
Stimulant laxatives are not recommended for long term use, and possibly not at all. They do promote elimination by increasing parastalsis in the colon, but over time, the body gets used to these stimulants and does not work well with out them. Using stimulant laxatives for a prolonged period of time can create a dependency on the herb. Short term use of stimulant laxatives during a “cleanse” or to help with occasional constipation is fine, but not the long term answer. Example: senna or cascara sagrada.
Psyllium plant, Photo Source: Wikipedia

22. Remember This!
“You can call anything a dietary supplement, even something you grown in your backyard.” Donna Porter, PhD, RD
Supplements are loosely regulated by the FDA – they do not have to be tested. GMPs however are being phased in.
In regulating dietary supplements….remember this!
“You can call anything a dietary supplement, even something you grown in your backyard.” Donna Porter, PhD, RD
Supplements are loosely regulated by the FDA – the do not have to be tested. GMPs however are being phased in.
Do you remember what GMPs are?

23. FDA Regulations – Remember!
Supplements are considered safe until demonstrated to be hazardous by the FDA.
Few have been adequately tested.
Negative results in studies might not be reported.
The FDA receives thousands of reports of adverse effects of supps, involving over 100 deaths.
Must be labeled with a listing of ingredients.
Report problems to SAFEFOOD or
Sign up for MedWatch:
FDA Regulations – Remember!
Supplements are considered safe until demonstrated to be hazardous by the FDA.
A dietary supplement manufacturer does NOT have to prove a product’s safety and effectiveness before it is marketed
Few have been adequately tested.
Negative results in studies might not be reported.
The FDA receives thousands of reports of adverse effects of supps, involving over 100 deaths.
FDA was successful in banning ephedra – a weight loss supp - after thousands of adverse events, deaths, and a lengthy legal process.
Must be labeled with a listing of ingredients.
July 8, 2010 – FDA News Release Public Health Alert: Que She herbal weight loss supplement advertised as an “all-natural blend of Chinese herbs” widely distributed on internet and retail stores. Found that it contained fenfluramine (a stimulant drug withdrawn from US mkt in 1997 due to serious heart valve damage); propranolol (a rx beta blocker drug); sibutramine (rx weight loss drug marketed under Meridia); ephedrine (a stimulant drug legally marketed OTC for temporary relief of asthma but can pose risks)
Report problems to SAFEFOOD or
Sign up for MedWatch:
_____________________________________________________ .

24. Did You Know?
National surveys show that more than 50% of Americans take some form of dietary supplement.
Total sales from all supps in 2009 were more than $20 billion!
Est. herbal-supplement sales $5 billion (American Botanical Council)
Did you know?
National surveys show that more than 50% of Americans take some form of dietary supplement.
Total sales from supps in 2009 were more than $20 billion!
Estimated herbal-supplement sales $5 billion.
- best selling were cranberry, soy, saw palmetto, garlic, echinacea, ginkgo, milk thistle, ginseng (panax), black cohosh
About 30% of all modern drugs have been derived from plants.
Plant products known to treat disease are considered drugs but OTC herbs are not.
Drugs have been tested, herbs have not.
Drugs are highly regulated, herbs are not.

25. Top 16 Selling Individual Herbs in Food and Drug Market
Cranberry $31.3 million
Soy $ “
Saw palmetto $ “
Garlic $ “
Echinacea $ “
Ginkgo $ “
Milk thistle $ “
St. John’s Wort $ “
Top 16 Selling Individual Herbs in Food and Drug Market
Cranberry $31.3 million h. pylori, UTI (grade b), antioxidant, cancer (grade c)
Soy $ “ dietary source of protein, cholesterol (grade A), CVD, CA (grade c)
Saw palmetto $ “ prostate
Garlic $ “ heart, (high cholesterol – grade b)
Echinacea $ “ immune system (colds)
Ginkgo $ “ claudication (blood clot), demential (grade A), cerebral insufficiency (grade b)
Milk thistle $ “ liver
St. John’s Wort $ “ depression
Source: Blumenthal, HerbalGram.2009, as reported by Information Resources, Inc., Chicago, Il.

26. Top 16 Selling Individual Herbs in Food and Drug Market
Ginseng $ 8.3 million
Black cohosh $ “
Green tea $ “
Evening primrose $ “
Valerian $ “
Horny goat weed $ “
Bilberry $ “
Elderberry $ “
Top 16 Selling Individual Herbs in Food and Drug Market
Ginseng $ 8.3 million heart, high blood sugar, immune system (grade b)
Black cohosh $ “ menopause, hot flashes
Green tea $ “ genital warts (grade b); many others including cardioprotection, wt loss (grade c)
Evening primrose $ “ eczema (grade b); breast cancer, breasts cysts, diabetes, RA and many others (grade C)
Valerian $ “ insomnia
Horny goat weed $ “ Epimedium (horny goat weed) This herbal remedy has been used in Chinese medicine for centuries. It may help raise low levels of testosterone and thyroid hormone. There's little evidence about the safety or side effects of epimedium. It may cause breathing trouble in very high doses. (mayo clinic)
Bilberry $ “ similar to blueberry – diarrhea, stomach ulcer, glaucoma (grade C)
Elderberry $ “ anthocyanins – influenza (grade B)
Source: Blumenthal, HerbalGram.2009, as reported by Information Resources, Inc., Chicago, Il.
____________________________________
Grape seed, ginger, aloe vera and horse chestnut seed round out the top 20
Source: Blumenthal, HerbalGram.2009, as reported by Information Resources, Inc., Chicago, Il.

27. Did You Know?
Plant products known to treat disease are considered drugs but OTC herbs are not.
Drugs have been tested, herbs have not.
Drugs are highly regulated, herbs are not.
About 30% of all modern drugs have been derived from plants.
Did you know?
National surveys show that more than 50% of Americans take some form of dietary supplement.
Total sales from supps in 2009 were more than $20 billion!
Estimated herbal-supplement sales $5 billion.
- best selling were cranberry, soy, saw palmetto, garlic, echinacea, ginkgo, milk thistle, ginseng (panax), black cohosh
About 30% of all modern drugs have been derived from plants.
Plant products known to treat disease are considered drugs but OTC herbs are not.
Drugs have been tested, herbs have not.
Drugs are highly regulated, herbs are not.

28. Examples of Drugs Derived from Plants
Aspirin - White willow bark (Salix alba)
Cephalosporin - Marine fungus (Cephalopsorium acremonium)
Cyclosporin - Cordyceps (Cordyceps sp.)
Digoxin - Foxglove (Digitalis purpurea)
Morphine - Opium poppy (Papaver somniferum)
Taxol - Pacific Yew (Taxus sp.)
Pharmaceutical Drugs
Aspirin - White willow bark (Salix alba)
Cephalosporin - Marine fungus (Cephalopsorium acremonium) – abx
Cyclosporin - Cordyceps (Cordyceps sp.) - an immunosuppressant drug
Digoxin - Foxglove (Digitalis purpurea) - Digoxin a common heart medication (CHF, afib, arrhythmias) comes from the foxglove plant (Digitalis purpurea)
Morphine - Opium poppy (Papaver somniferum) - pain reliever
Taxol - Pacific Yew (Taxus sp.) - Paclitaxel (taxol) injection must be given in a hospital or medical facility under the supervision of a doctor who is experienced in giving chemotherapy medications for cancer.

29. Did You Know? Herbal remedies have side effects just like drugs do.
The benefits must outweigh the risks to be valuable.
Available evidence indicates that some herbal remedies are safe and effective while others are neither safe nor effective.
Did you know?
Herbal remedies have side effects just like drugs do.
The benefits must outweigh the risks to be valuable.
Available evidence indicates that some herbal remedies are safe and effective while others are neither safe nor effective.

30. German Commission E Monographs
Created in Germany, these monographs describe plant medicine, their health care applications, dosages and safety precautions. There are more than 300 monographs listed currently that have been reviewed by professionals in the field of natural medicine.
Which supplements are potentially beneficial?
German Commission E Monographs
Created in Germany, these monographs describe plant medicine, their health care applications, dosages and safety precautions. There are more than 300 monographs listed currently that have been reviewed by professionals in the field of natural medicine.
These Commissions are considered the most comprehensive and accurate available information on herbal medicine. The American Botanical Council has translated the German Monographs into English. These translated monographs are available for English speaking people who are interested in herbal medicine.
From Wikipedia (accessed May 5, 2010):
The German Commission E Monographs are a therapeutic guide to herbal medicine . There is an English translation[1] by the American Botanical Council, with 380 monographs evaluating the safety and efficacy of herbs for licensed medical prescribing in Germany. The commission itself was formed in 1978, and no longer exists.
The Commission E Monographs were imported into the United States with considerable fanfare in 1998 by The American Botanical Council. They were unequivocally endorsed in a foreword by the late Varro Tyler, a well-known professor of pharmacognosy at Purdue University. Tyler states in his foreword that "...safety data were reviewed by the Commissioners according to a "doctrine of absolute proof" and efficacy according to a "doctrine of reasonable certainty."
"Certainly worth studying, the Commission E monographs detail which herbs are approved or disapproved, along with their uses, dosages, contraindications, adverse effects, drug interactions, and pharmacologic actions. The therapeutic, taxonomic, and chemical indexes are helpful, as is the glossary." -- Journal of the American Medical Association, 1999[2]

31. Contamination and Quality Issues
Lack of regulation.
Governed by DSHEA, but no specifics as to quality.
Where they’re grown, soil content, how they’re harvested all play a role in potency, strength and quality.
No one profits from testing.
Herbs cannot be patented.
Contamination and Quality Issues
Lack of regulation.
Governed by DSHEA, but no specifics as to quality.
Where they’re grown, soil content, how they’re harvested all play a role in potency, strength and quality.
No one profits from testing.
Herbs cannot be patented.
Herbal Contamination and Quality Issues
There is lack of regulation in regards to herbs. Although many drugs actually begin from constituents found in plants (i.e. Digitalis), quality issues are not addressed in regards to herbs. This may be for a variety of reasons, but mainly it is economic. No one profits from testing, looking at quality and performing clinical trials and safety issues in researching an herb. Herbs can not be “patented” or bought due to their nature of being a plant. Large drug companies are the ones who invested millions of dollars into their products each year in order to put them on the market and sell them through pharmaceutical means. For this reason, large quantities of money are not spent on researching herbs for their efficacy and quality. (Introduction Mosby Book).
As discussed earlier, herbs are one of the classes of supplements that are governed by DSHEA. Although this government regulation exists, it does not give specifics as to quality, at this point. Where a plant grows, the soil content, how it is harvested, etc. all play a role in its potency, strength and quality. Was the herb grown in organic soil? Was it grown in its native soil or cultivated? How does that impact its quality?

32. Contamination and Quality Issues
Manufactured into different mediums
Teas, infusions, tinctures, tablets/ capsules, liquid extracts, solid extracts, bulk dried herbs, creams and ointments, suppositories
Standardization
Guarantees a certain level of a particular constituent is present in the formulation.
Expressed as total weight of product.
A way to check for quality in herbal preps.
Concerns about herbs imported into US
Possible contamination with heavy metals, pesticides, etc
Contamination and Quality Issues
Manufactured into different mediums
Teas, infusions, tinctures, tablets/ capsules, liquid extracts, solid extracts, bulk dried herbs, creams and ointments, suppositories
Standardization
Guarantees a certain level of a particular constituent is present in the formulation.
Expressed as total weight of product.
A way to check for quality in herbal preps.
Concerns about herbs imported into US
Possible contamination with heavy metals, pesticides, etc
Discuss recent report (May 2010) by GAO (next slide)
_____________________________
Herbal Contamination and Quality Issues
 The process of producing herbs is complex: growing, collecting, harvesting, storing, extracting and ultimately getting it to the end user. Herbs are maunfactured into different mediums, including:  Teas, Infusions, Tinctures, Fluid Extracts, Solid Extracts and Standardization Extracts. Standardization of an herb guarantees that a certain level of a particular constituent is present in that formulation. The quantity is expressed as a percentage of the total weight of the product. Standardization is one way to check for quality in an herbal preparation. Without the standardization identified, it is difficult to know if the therapeutic dose that you want to be taking is actually in the product. The actual ingredient may be present, but not in a the dosage range required. You are guaranteed a certain potency of an herb with Standardization Extracts.

33. GAO Report on Deception/Questionable Marketing Practices
US GAO Report – May 2010
Herbal Dietary Supplements: Examples of Deceptive or Questionable Marketing Practices and Potentially Dangerous Advice
US GAO Report
Herbal Dietary Supplements: Examples of Deceptive or Questionable Marketing Practices and Potentially Dangerous Advice
The GAO is the US Government Accountability Office – designed to determine that govt entities and agencies are doing what they are supposed to do – in this case the FDA. Make sure funds are properly used and complying with laws and regulations.
28 page report – also encourage to review

34. Be Aware and Be Safe! Not all herbs and supplements are the same.
You MUST know what you are looking for on the label before recommending or taking herbal products on your own.
Learn quality brands & look for standardization.
Know where to look for proper dosages.
German Commission E Monographs, your textbooks, links I posted in Webliography.
Don’t blindly trust the internet!
Be aware and be safe!
Not all herbs and supplements are the same.
You MUST know what you are looking for on the label before recommending or taking herbal products on your own.
Learn quality brands & look for standardization.
Know where to look for proper dosages.
German Commission E Monographs, your textbooks, links I posted in Webliography.
Don’t blindly trust the internet!
Because of the lack of strict regulation on herbs, there are concerns about herbs imported for other countries being contaminated with heavy metals, pesticides, etc. Bottom line take home message here: Not all herbs and supplements are the same. You MUST know what you are looking for on the label before recommending or taking herbal products on your own. You need to learn quality brands, look for standardization and know where to look for proper dosages (German Commission E Monographs and your text books are a good place to start!) Don’t trust the internet blindly…lots of things are put out there without screening. Better to be aware and be safe!

35. Feel free to email me anytime at jneily@kaplan.edu
Questions?
Feel free to me anytime at
Questions?
Feel free to me anytime at
Jake –