UBC Reports | Vol. 47 | No. 16 | October 18, 2001

Herbal lore part of students' training

Pharmacists learn quality, effectiveness of alternative medicines to help patients make informed decisions

Ginseng, ginkgo and garlic -- these and other herbal supplements are often regarded as harmless, but Pharmaceutical Sciences students are learning that natural doesn't always equal safe.

Taken for everything from arthritis to depression, herbal medications are used by about 33 per cent of Canadians according to a survey done this year and sponsored by the Nonprescription Drug Manufacturers Association of Canada (NDMAC).

Many of these products are bought at pharmacies.

"The risks associated with herbal supplements can be significant," says Pharmaceutical Sciences instructor Lynda Eccott who, with colleague Kath MacLeod, developed an elective course called Alternative Medicines in Pharmacy Practice.

"That's why it's so important for our students to be prepared to counsel patients so they can make informed decisions about these products. Patients may be self-diagnosing a condition that should be under doctor's supervision, so it's critical that pharmacists ask the right questions."

The primary risks associated with herbal medicines are lack of quality and inappropriate use, says Eccott.

Because many of these products are sold as food supplements rather than drugs, they are currently unregulated so content can vary widely.

For example, of 10 different St. John's Wort products tested, seven did not meet label claims according to a 1999 study published by pharmaceutical and health products company Wampole Canada Inc.

In addition, there is a lack of information on product labels about dosage or potential side effects.

"Clearly, people are buying these products on blind faith," says Eccott. She adds that many people overuse the products because they are perceived as completely safe.

Students are taught to help patients decide if a herbal medication is appropriate for their condition and how to choose the best quality product.

They also offer advice about dose and duration of therapy and encourage patients to report side effects.

Other issues include direct toxicity, where herbs may have been adulterated with a harmful substance.

Negative herb-drug interactions, whether the patient is using prescription or over-the-counter drugs, can also be a problem and underlines the need for consultation with a trained health-care professional, says Eccott.

For example, serious negative interactions can occur when blood-thinning agents such as aspirin are taken with herbs that act in the same way such as ginseng, garlic or feverfew.

Pharmacists need to increase their profile in this area of expertise and make themselves more accessible to the consumers, says Eccott.

The NDMAC survey estimated that consumers use pharmacists and physicians only 10 per cent of the time for herbal product information and that they usually are guided by advice offered by family, friends or health books.