A recent survey shows that over a third of people in the UK use herbal medicine. This might be surprising in a country where people have access to free healthcare. Even so, these natural medicines remain popular. Whether they are supplied by herbalists or over-the-counter. The popularity of herbal remedies is at least partly because they are generally seen as being safe, natural and gentle treatments. They also offer support for long-term or chronic degenerative conditions. An area of medical care in which conventional medicine often fails to satisfy patients.

We generally trust herbal remedies because they have a long tradition of use. Records show that plants have provided medicine for hundreds, even thousands of years. Yet, critics say herbal medicines do not have the same level of scrutiny as conventional drugs. They say these natural remedies do not have the same level of evidence for use in a healthcare setting.

Many herbalists might welcome comparative studies between the medical efficacy of plants versus pharmaceuticals. But, it is difficult to test the use of plant medicines in the setting of clinical practice. Herbalists tend to use combinations of medicinal herbs that are personalised for an individual. Such herbal combinations are formulated following a lengthy consultation. Each person can develop a medical condition due to different underlying circumstances. So, each herbal prescription can be unique, even if the patients have the same diagnosed condition.

Compare this to a clinical trial under scientific conditions, where a single herb or medicine might be given to a large number of people with the same diagnosis, regardless of the uniqueness of the patient and their needs.

Polypharmacy and synergy

Herbalists use several herbal medicines in a formula because of the benefit of interactions between the plant constituents. The synergy between the active ingredients enhances treatment, whilst minimising side effects. As quoted by Aristotle “The whole is greater than the sum of the parts”.

This synergy can also enhance the effects of conventional drugs, such as antibiotics. Herbal medicines alongside antibiotics demonstrate this effect. And can help to reduce the development of antibiotic resistance.

So, herbal medicines have a lot to offer. Yet in the past, research into herbal remedies was limited. Mainly because there is little financial incentive to study herbal medicines. The financial rewards are simply not there as herbs can not be patented.

More recently, research into natural medicines has begun to grow. Several rigorous and well-designed trials are underway. With a suitable evidence base, plant-based medicines may contribute to mainstream healthcare. Offering safe and effective treatments for chronic and long-term conditions.

Evidence for the benefit of herbal medicines

Chronic degenerative diseases make demands on modern healthcare that herbal medicine could ease. Now, the evidence for the benefit of natural healthcare in these conditions is increasing.

In the recent review, by the European Herbal & Traditional Medicine Practitioners Association (EHTPA)

Studies show the use of herbal medicines for these chronic conditions:

• treatment of cardiovascular conditions
• management of diabetes
• treatment of skin conditions
• treatment of irritable bowel syndrome
• antibacterial herbs that help combat antimicrobial resistance
• treatment of respiratory conditions including asthma
• for treatment of depression
• treatment of arthritis
• for the treatment of other conditions including gynaecological disorders

Altogether, these studies provide good quality evidence for the efficacy and benefit of herbal medicines. With a possible role in the management of several common chronic conditions.

While natural remedies show some benefits for these conditions, conventional treatments may not be satisfactory. This may especially be true for antibiotic treatments. Antimicrobial resistance means the effectiveness of current treatments is beginning to wane.

Professional herbalist organisations such as the EHTPA welcome scientific research into herbs. But, in the long term, methods of research may have to allow for polypharmacy and the real-world use of herbal medicines.