SELF CARE WITH HERBS

a wise guide to starting out with

natural home remedies Simon Y Mills

© 2013 OurMedicine Publishing, Exeter, England Most statements in this book are backed up by evidence, usually in published academic papers, and all are based on personal experience over many years of practice. There are links from the Herbal Hub website to more information and you can also email feedback@herbalhub.net Note: This book is provided in good faith and with the best expertise available as a tool for readers to make their own health decisions and to help make them as safely as possible. However every illness and every person is unique and no general advice can be true in every case. This book is no substitute for an individual consultation. The authors and publisher cannot accept liability for individual cases where things go wrong.

Introduction

The word ‘drug’ derives from an old European word drogen referring to dried plants. All drugs, ancient and modern started with herbs. Over thousands of years, people had to work out which plants were useful and exactly how to use them. This information was passed down through history through every community, and noted in ancient texts from Assyria, Egypt, India, China, Rome and Greece. The ancient traditions have now been brought up to date to take account of modern medical research and in many countries is practiced by doctors and other health professionals alongside modern medicine. This booklet will offer an introduction to herbs that anyone can use at home. It will be under the following headings

page 1 Why choose herbs?

- the key questions!

2 Are herbs safe to try?

- “yes – mostly”!

5 What can I try herbs for?

- answers from those who have

7 Where to start?

- where to find reliable herbs

10 How do I prepare my herbs?

- turning a plant into a remedy

11 What dose works for me?

- am I getting enough?

14 The story of herbal medicine

- where this all began

This book is also an introduction to the Herbal Hub Self Care series (see the last page of this book for more titles). Here and also at www.herbalhub.net we will be learning how herbs may be useful, how we know whether they are useful, when they are worth trying and when to try something else. At best they can really make a difference, at worst they rarely do any harm and you can stop them quickly without after effects.

- 2 -

Why choose herbs?

Living creatures have always relied on plants, for food and also for medicine. Even animals eat plants that have medicinal rather than food properties and humans around the world have always used plants as their main source of medicines. Modern drugs started with plants and even now some are still extracted from them. Without hospitals and medical services to fall back on people found plants with the quickest and best effects to treat illness. There were common features to treatments being used around the world: when European settlers moved into the Americas they found local populations using plants in similar ways to them. (see the Story of Herbal Medicine on page 14) All this of course was before modern medicine transformed health care. A common question is whether herbs still have any value today. Synthetic drugs are often powerful and there is strong evidence of their results in fighting specific diseases. Herbs are now mostly used as more gentle treatments and there is less modern evidence for them. However many herbal treatments can quickly and safely be tested by personal experience, and have a plausible scientific case. If used wisely they can be a very useful complement to conventional treatment. Actually there is no need to make a choice between the two. Both have their place and can be used differently and sometimes together. In the Herbal Hub we will learn how to do this safely and effectively.

- 3 -

Are herbs safe to try?

Not all things in nature are safe. Most plants produce chemicals to defend themselves against infections and predators; some can be poisonous. Those that are grown for eating usually have these elements bred out so that they are nice and easy on the body (and on the taste buds!). By contrast the plants traditionally used for medicines were often valued because they were provocative: correcting illness can be hard work and some old treatment plans were robust! Now that we have modern drugs and surgery for serious medical treatments we can choose plant medicines that are more gentle. The ones we discuss at the Herbal Hub have a long track record of safe use. We even have modern evidence for this. Around the world plants are still used very widely as medicines. Modern adverse drug reporting systems include reports of negative reactions to herbs as well. The World Health Organisation International Drug Monitoring Centre in Uppsala, Sweden collects these from around the world and reports that they make up around 1% of the total of all medicine reports and that the vast majority are relatively minor symptoms. Interestingly in Europe there is both widespread use of plant-based medicines (‘phytomedicines’) and mandatory reporting of their adverse effects by professionals and manufacturers – the levels are still as low. Those who look at these reports all agree that there is not much of a public hazard out there. Most serious problems arise with poor quality products (see below) and the very occasional individual reaction that no one can predict. Nothing is risk-free and rare events are always possible, but the safety record for the prudent use of herbs is very good.

There are simple tips that can significantly reduce any risk of taking herbs. 1) Avoid self care with herbs ...

o when taking powerful prescription drugs (eg. for blood clotting, heart failure, diabetes, epilepsy, severe depression and psychosis, AIDs, and after transplant surgery),

o with kidney failure or liver disease o within 3 days of admission to hospital.

2) There are some plants that affect drug activity. Grapefruit

juice is likely to increase the effect of some important medicines. St John’s wort is likely to decrease activity. You should be particularly cautious in mixing these with any medication. Other possible interactions exist but are unlikely to be a risk except for very powerful drugs listed above.

3) Pause herbal remedies if ever you notice an unpleasant reaction. The main effect of many herbs is on the digestion and this is where uncomfortable effects can sometimes occur. Fortunately these effects are mostly temporary: they may include nausea, upset stomach or diarrhoea. Headaches and drowsiness or increased urinary flow may also be experienced. Again these are mostly passing symptoms and may be reduced by taking herbs after food rather than before, taking in more water or at a lower starting dose. However the obvious point is - if you feel uncomfortable: stop - and maybe seek help from a qualified practitioner who works with herbs.

4) Do not take herbal remedies longer than you need. For many

everyday cases discussed in the Herbal Hub this may be a few weeks or less. In cases where benefits are unlikely to show for much longer it would be wise to seek advice from a qualified practitioner who works with herbs.

5) Above all choose your herbs wisely. The international

market for herbal remedies is largely unregulated. Be aware that people really are not watching what you buy much of the time. There are too many cases where the product does not match up to the label or where the label is not clear. There are some cases where this has harmed people. We will be helping you find reliable herbs on our Herbal Hub site. If you live in or can get supplies from Europe or Australia or Canada you can get independently verified herbal products. In Europe there are registered or licensed herbal medicines and on this site we list those on the market for each condition (in the UK initially). In Australia herbal remedies should be registered under the Therapeutic Goods Act, and Health Canada licenses herbs as Natural Health Products. New Zealand is planning similar legislation. In other places you have to look diligently at the quality of product. Herbal Hub will produced and update guides to the market in the USA.

- 6 -

What can I try herbs for?

Herbs can be used to help with many everyday problems. In early days they were the basis of some powerful treatments for major conditions, because there were no other options. They have provided the basis for some of our most powerful modern drugs and also some robust techniques for helping the body defend itself against diseases. See The story of herbal medicine at the end of this book. Now that we enjoy the benefit of medical advances to diagnose and treat serious conditions we can look to herbs more as self care and support measures and choose those that are the safest to use for this purpose. Simple self care use is where the effect of the herb should be most evident, sometimes quickly. Below are conditions that are appropriate for trying herbal remedies and the length of time that positive results should be seen.

Herbal role Length of time to

show effects

Easing sore throats, coughs and other respiratory symptoms

one to three days

Improving digestion and bowel function

one to three days

Gentle calming for stress and irritability

a few days

Relieving headache

a few days

*Discomfort and difficulty in passing water

up to a week

Helping provide more energy

three or four weeks

Lifting low mood and minor depression

three or four weeks

Improving sleep

three or four weeks

Relieving period and premenstrual difficulties

up to 3 months

Relieving migraines

up to 3 months

Relieving arthritic problems

up to 3 months

Relieving eczema and other skin problems.

up to 3 months

Easing symptoms of the menopause

up to 3 months

In all cases do check with your health care professional before proceeding with self care in case the symptoms mask something more serious, especially if they have lasted for more than a few weeks or keep recurring; and in all cases marked with *. Other uses are harder to check progress yourself. However in the following cases there is a strong traditional reputation and they can be recommended if you take the relevant precautions.

Herbal role Review?

Helping to recover from illnesses* and when tired and run down

Take additional convalescent steps if no improvement in a month

Improving circulatory function in cardiovascular and diabetic illness*

Do not continue if medical markers do not improve in three months

Preventing respiratory infections* Do not continue if expected seasonal patterns are not significantly changed

In all cases the use of herbs should be reviewed every 3 months and the question asked: is this good to continue? If you come across claims that herbs can be used for more serious conditions than those listed here, be cautious. If you have a long term illness that you would like to try herbs for then you should consult with a qualified health practitioner who uses herbs professionally. In particular you should avoid products that are sold for the treatment of severe illnesses: these are almost by definition provided by people with little medical knowledge or care for your welfare.

- 8 -

Where to start?

Before finding your herbs it will help to be clear what you want them for: read the previous passage and then work out your health needs as well as possible. There are guides to individual conditions on the Herbal Hub and much good reliable information elsewhere. However be cautious about what you read on the internet – if the site is selling a product you should double check what it says against independent sources. When you have decided what you want the herbs for and how they may help then you can choose from the following sources. 6) Retail outlets or on the web. It is important to do your

homework here too. See the Box on page 9 for the difference between medicines and supplements. If you are able to find the appropriate medicine then at least you can be sure of the quality. In the UK these will be marked by licence or registration numbers on the pack (PL... and THR .... respectively). They will have permitted claims on the label to guide you in your choice and full information leaflets inside the pack. The Herbal Hub lists all herbal medicines available in the UK. Further national lists in Europe will follow. If you choose a supplement you should aim for a reliable manufacturer with a reputation to maintain, or source though someone that you trust or has professional experience. In general be particularly cautious when buying directly off the web as standards can be seriously defective on some sites. You may also choose herbs in their loose dried form. Do check that they are not too old, faded or musty. Dried herbs should be stored carefully and renewed at least annually. When good they should have bright colour and clean aroma. Some remedies like ginger and garlic can be sourced as foods – check quality in the usual way.

UK Traditional Herbal Registration logo

Is this herb a supplement, a medicine or something else? Herbal remedies are regulated in different ways around the world. Among those whose job it is to protect us from taking the wrong things into our bodies there has always been the view that what we eat is a food and what we use to treat illness is a medicine. Because medicines make changes to the body they need to be much more tightly controlled. They are expected to satisfy strict requirements on three criteria: that they work (efficacy), that their risks do not outweigh their benefits (safety), and that they deliver exactly what the label states (quality). Foods generally have to be safe for human consumption without the same strict controls. Herbs can be both foods and medicines or maybe something in between! In Europe (including the UK) they have tended to be classed as medicines if they are used for health purposes. It is now possible to register a herb as a medicine for minor conditions suitable for self care on the basis of its traditional use. This replaces the need to prove efficacy with expensive clinical trials. However other medicine requirements are the same and the user can be assured that safety is being actively monitored and that the medicine delivers the exact material and dose on label. In the USA by contrast herbal remedies are sold as ‘dietary supplements’ and are permitted to carry claims that they support a healthy function in the body. However without the formal requirements of medicine manufacture good and poor products cannot easily be distinguished and dosage and other quality standards may be hard to assure. You need to be diligent to be sure that you obtain reliable products from recommended manufacturers at an effective dose. There are also herbal ‘food supplements’ in Europe. Here they will have no claims on the label and will lack the THR... or PL ... registration number on the pack. An inspired blend of these two regimes is in countries like Canada, Australia and New Zealand where herbal products have to be produced to medicine quality although are not classified with synthetic medicines. .

7) Growing or collecting. This takes planning and skills. Growing will take time, collecting is usually confined to a few weeks each year. In both cases you will also have to know about drying and storing your remedies. In the case of collecting you will really need to identify your plant accurately. There are cases where people have poisoned themselves by choosing the wrong plant. Please use a good plant identification guide. You will also need to learn how to prepare your remedies – the following section should help.

8) A professional consultation. The advantage of seeing a herbal practitioner, naturopath or other health professional who uses herbs is that you both get a tailored formulation and usually get the herbs as well. The Herbal Hub Personal Advice page will progressively list directories of herbal experts around the world.

- 11 -

How do I prepare my herbs?

If you buy your herbs loose or grow or collect your own you will need to prepare them as useful remedies. For internal use the standard ways are to use hot water, either by infusion or decoction.

1) Infusions are like making tea. The herb is steeped in recently boiled water, usually covered to prevent loss of important volatile constituents. This is appropriate for leaves and flowers and powders, where the active principles are easily extracted.

2) Decoctions are used for plant parts

that are more resistant to leaching their constituents like wood, bark, and roots. They are chopped and boiled in water, either slowly with a cover on, or boiled down to the required quantity from a larger volume of water.

It is also possible to use powders mixed with food and drinks or even inserted into capsules at home. With powders be careful that they are fresh as possible: they deteriorate rapidly.

- 12 -

What dose works for me?

This is one of the most debated topics in herbal medicine! Most people now take doses lower than in the past and lower than most doses found effective in modern clinical trials. The question is are people taking enough to work? Human experience of herbs evolved when they were the only medicines available and were needed to treat severe conditions. Doses often had to be very high. However even for everyday family remedies the norm was to hit the condition quite hard. A typical dose for a family remedy was sometimes recorded in old household measures as 1oz of dried herb in 1 pint of water (by infusion or decoction – see above) with a wineglassful of this taken 3 times a day. For the more precise reader this converts into the equivalent of 2-4 grams of dried herb 3 times per day (depending on extraction rates). If this was taken in capsule form this could be the equivalent of up to 15 large capsules of dried herb at a time! This is clearly much more than the usual supplement dose. It is also far more than taking a teabag in a cup of hot water. Most modern clinical research also supports relatively high doses. To meet these in practice many of the leading herbal medicine companies produce concentrated extracts in standardized forms. For example the leading ginkgo medicine is 50 times more concentrated than the equivalent simple leaf capsule or tablet. Herbal practitioners will usually use more concentrated products as well. However there is also a tradition, notably in Germany, of using small doses. This sometimes merges with the very different homoeopathic tradition of using extremely small doses of fresh plant and promoting an energetic quality of the plant instead. There are

some low dose herbal products manufactured by companies that service both traditions in Europe. The manufacturing process may convey some extra benefits here. So what to recommend? When using simple herbs for yourself it is probably better to assume that you may have to take larger doses to see the full effect. However it is also advisable to start small and work up only when you are comfortable to do so. Doses a quarter of those found in the relevant pages on the Herbal Hub are quite a good starting point, working them up as they appear to help, and stopping them in good time if they do not suit. The main point to make about dosages however is that if you have not tried the herb at near its traditional dose you may not know what it can do. Unfortunately most users have missed out here.

The Story of Herbal Medicine

- 14 -

The modern idea of herbs as ‘supplements’ or as gentle remedies overlooks an important feature of traditional medicines. For thousands of years they were all we had! ‘Drugs’ were prepared by our ancestors to treat severe conditions and those used most were those that had the quickest and most dramatic effects. We know they could work: some of our modern drugs are direct conversions from traditional ones.

However to tap the real potential of traditional plant medicines we should understand that they were used very differently from modern medicines. Nowadays with all the benefits of scientific research we have become good at understanding what happens in diseases. In many of them we can get medicines that target what has gone wrong very precisely. In all earlier times diseases were seen by how they felt and looked. They appeared to be disturbances to the usual healthy state. Most early (‘acute’) symptoms, like fever, inflammation, pain, vomiting, coughing, and diarrhoea were

TRADITIONAL DRUGS

MODERN DRUGS

opium poppy

morphine, codeine and other pain relief

willow bark. Meadowsweet

salicylates such as aspirin and NSAIDs

senna, cascara, aloes

anthraquinone laxatives

calabar bean

physostigmine and eye medicines

foxglove, lily of the valley

digoxin and related heart drugs

squills, ipecacuanha Emetics (to induce vomiting) and expectorants (to clear the lungs)

coca

cocaine and local anaesthetics

henbane, nightshades, datura

antiasthmatic drugs, scopolamine,

signs that the healthy body was defending itself, the extent of the symptoms reflecting the vitality of the body as much as the severity of the disease. The first job of medicine was to understand what the body was trying to say and help it do its job better. The penalty for getting this wrong was also clear to our ancestors: badly managed acute symptoms could kill or maim, or if less serious could become embedded, long-term (‘chronic’) and much harder to treat. In this last observation our ancestors were not wrong! We often think we should prevent or suppress acute symptoms. However modern science also confirms that they all start as defensive responses to infection or damage. We now have much more chronic disease than we used to. Traditional medicines were classified by their ability to make defensive responses more effective and less harmful. For example we now treat fever and inflammation with anti-inflammatories. By contrast, in almost every culture in the past the aim was to give remedies to boost the fever and inflammation and help them finish the job with the least possible distress. Often we can see these as working by improving circulation: in the past these remedies were classified as ‘heating’ because that was how they felt. Coughs and mucus production were seen as attempts by the body to defend itself against noxious influences in the air. Depending on the type of trouble ‘heating’ or spasm-reducing medicines were chosen to improve the defence rather than suppress the symptoms. Digestive and bowel disturbances were treated with remedies (like most of the spices) that reduced spasm and pain yet also seemed to improve digestive performances. Sometimes remedies were chosen because they seemed to encourage natural excretions and were used to improve detoxification, as laxatives, diuretics, and emetics.

Many of these remedies were used to nudge or even kick the body into better defensive performance. Few were used for long and an average traditional prescription might be for a day or so at a time. Other remedies were then used to support recovery from illness. People had greater respect for the message that fatigue sends, the need to convalesce properly to avoid relapse. Recuperative care could sometimes be quite sophisticated. There would be a broad spectrum of rest and diet measures complemented with plants with strong reputations for building strength. We often refer to the medicines used for this purpose as ‘tonics’. This last group may be particularly relevant in modern times. Too often we assume that a disease is cured because it has been hit by an antibiotic, anti-inflammatory or anti-cancer treatment and forget that there should also be proper attention to recovery. Herbs can be very useful here. We will find out more in booklets on treating specific conditions. Exploring the principles of traditional European, Islamic, Chinese and Indian medicine offers many more such fascinating insights. We will be elaborating them in other books in the Herbal Hub series. They are not instant solutions to the world’s problems. Nor do we advise anyone to tackle serious disease on their own. However they can offer valuable tips for self-managing everyday ailments that are less dangerous.

MORE FROM

Natural family medicine that has stood the test of time and science! Take charge of your family health needs with these practical guides to the most effective things you can do at home:

o CONVENIENT - tried-and-tested approaches to each problem at your fingertips o USEFUL - organise your progress with your own PERSONAL JOURNAL and step-

by-step plan o TRUSTWORTHY - check out the evidence with links to the Self Care Llibrary and

other independently rated information sources o EFFECTIVE - create your long-term recovery plan for managing your symptoms

once and for all, and for building your future health We have studied the evidence and worked with patients for many years. These are the best approaches we can find! Coming up

o Sleep Workbook work through the best modern and traditional ways to get good sleep

o Back Pain Workbook

an integrated approach to managing back pain - from the experts!

o Fatigue Workbook learn age-old ‘convalescent’ approaches to restoring strength and energy with the right balance of rest, exercise, diet and natural ‘tonic’ remedies

o Coughs and Colds Workbook natural ways to fend off respiratory infections and quickly treat coughs, colds and sore throats when they happen

o Digestion Workbook get on top of your indigestion problems, food intolerances, IBS and other bowel upsets with this organized work plan, and the most valued natural remedies on the planet!

others to follow ...