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A capacity audience of Center on Aging members, community members, and UCLA faculty, staff and students attended the January 20 Winter Community Meeting titled "Alternative Medicine: What we know and what we don't know about medicinal herbs." Speaker Dr. Susan Stangl, assistant professor of family medicine at UCLA, discussed eighteen herbs including Echinacea, Ginkgo biloba, Ginseng, and St. John's wort.

Dr. Stangl stated that some herbs are mild, safe and effective alternatives to prescription drugs. However, although theses herbs may be labeled "natural," they may also contain drugs. Thus, there are important safety issues to consider - for example, medicinal herbs are largely unregulated by the Federal Drug Administration. The therapeutic effect of the herb depends on purity, potency, and dosage, and these elements vary from company to company. In addition, many studies examining therapeutic benefits of plants are not conducted in a scientific manner, and do not include long-term follow-up information. "Much research is needed into the effectiveness and side effects of herbal or alternative medicines, and their potential interactions with prescription and over-the-counter drugs, and with each other," Dr. Stangl stated.

Stangl described how St. John's wort (Hypericum perforatum) may affect neurotransmitters to alleviate depression, symptoms of menopause, and fatigue. Also known as "herbal phen-fen," side effects of St. John's wort include skin rash with sun exposure, especially if taken with tetracycline. St. John's wort should not be taken with other psychoactive drugs. Because research on the effects of remedies like St. John's wort is not comprehensive, Dr. Stangl advised attendees to consult their doctor for more information on herbal medicines before taking them.

Ginko biloba is the most popular phytomedicine on the European market, and its popularity in the United States continues to grow. It is commonly used to improve memory and sharpen mental acuity. This extract of the Ginkgo plant has been steadied extensively in comparison to other herbal medicines, and is considered safe for most patients at appropriate dosages. However, patients who are using other remedies including garlic, vitamin E, warfarin, aspirin, non-steroidal anti-inflammatory agents, steroids, or any other agents with anti-coagulant effects should consult their physician prior to using Ginkgo biloba extract. It has been linked, in rare cases, to complications related to bleeding.

Echinacea, often used today as a prevention and treatment for colds, flu, sore throat, and other common ailment for colds, flu, sore throat, and other common ailments, is also quite safe for most patients. The most common side effect is the unpleasant taste. However, because long-term use can cause immuno-supression, it is not recommended for patients with auto-immune diseases such as lupus, or those with systemic conditions including MS, HIV, or Tuberculosis.

"The bottom line in using herbal medicines is to remember the importance of consulting your physician, especially if you have pre-existing medical problems," said Stangl. "Although they may be 'natural,' many herbs have strong mechanisms of action in the body that can cause interactions with other agents, or make certain diseases worse. As with any medication, be sure you have all the information you need before you begin taking it!"