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August 9, 1999

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One More Voice Raised For Herbal Medicine

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R S Shankar

With Americans spending more than $ 1 billion a year on herbal medicines, and books by the likes of Andrew Weil selling in millions, physicians can ill-afford to dismiss the phenomenon or laugh at it, calling herbal medicine fake, attendees at a family medical conference in Columbus heard over the weekend.

But the physician in Columbus who raised the issue about herbal medicine also rushed to say that he was not advocating it per se but bringing the phenomenon to the attention of his colleagues.

Dr John M Weigand said some popular herbal remedies appear effective and safe -- while others haven't proved either. He urged his colleagues to study the growing body of literature on herbals. There are at least six publications, including Yoga Journal with a total circulation of about 2 million, devoted to herbal and holistic medicine. Many magazines and newspapers also carry articles on herbal medicine.

"The more mainstream doctors show interest in herbal medicine, the more opposition there will be from the establishment," says Dr Naras Bhat, who used Western and holistic medicine in his California facility.

"When we are about to enter the 21st century, it is only befitting that we pay more attention to the medicine that is centuries old," says Dr Majid Ali, who like Dr Bhat uses Western and herbal medication. But he is inclined to use herbal medicine much more.

"After about the fifth patient asked me about St John's Wort, I figured, 'I need to learn this stuff','' Dr Weigand said. "You can only tap-dance around the answers so long.''

According to some research, the popular herb -- taken as a tea or in pill form -- works as an antidepressant, Dr Weigand said. "That's one of the (herbal medicines) I'm more comfortable with.'' But recent studies have also shown that those who take St John's Wort and expose them to light therapy or too much of sunshine might damage their eyes.

Many American doctors are reluctant to deal with herbal medicines, he said, because the drugs aren't regulated by the US Food and Drug Administration and, consequently, haven't been subject to nearly the same amount of scientific research as prescription drugs. Some doctors are also afraid of being sued by patients who might have expected a miracle. Doctors also are concerned that herbal medicines aren't prepared to consistent standards, so dosage strength varies.

His views were echoed by Dr Bhat in parts. "Often mainstream doctors don't want to deal with herbal medicine because they do not know enough about them," he said. After a long pause, he sighed. "Often they don't want to know anything about them."

Dr Weigand would agree heartily with Dr Bhat.

At minimum, Dr Weigand said, doctors need to know how herbal drugs could interact with prescription drugs. And, perhaps just as important, they have to appear open-minded when patients ask them about herbal remedies. Often patients just do not have the confidence in their regular doctors to tell them that the patients are also taking herbal medicine.

Many holistic doctors say there could be a risk in holding back the information from mainstream doctors because certain herbal medicines could have an adverse effect if mixed with mainstream medicine.

Dr Weigand is known for urging his colleagues to learn about them and keep an open mind.

"If I am 'the herbal guy,' it's just because I looked it up,'' he said. "I see myself as being a voice for patients.''

Patients, possibly spurred by recent media coverage of the debate about herbals, are becoming more interested in trying relatively inexpensive, non-prescription medicines for a variety of illnesses. "The medical community was really caught off-guard by the popularity of these herbs,'' he said.

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