Most herbal medicine in the US is not herbal at all, but is chemical medicine.  Most supplements and some herbs as made in the US are often derived from chemical reactions in a laboratory rather than from herbs or natural products.  The unfortunate law DSHEA enacted in 1994 by Orin Hatch, a senator from Utah with large family holdings in the supplement industry, made it legal to not only substitute chemicals for herbs, supplements, and vitamins, but also to make chemicals to mimic the intermediary breakdown products from these substances in the human body.  Therefore most suppliers of these chemicals sold as supplements and vitamins are from China, where there are very few quality controls and rampant fraud. See the section on supplement safety here before buying any supplements.

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Herbal medicine, in its purist form, is the use of herbs themselves, not derived products from herbs, pills, liquids, or any other form of the herbs.  Ayurvedic medicine, Traditional Chinese Medicine, and traditional American medicine used herbs as healing entities.  But Chinese herbs are difficult to grow in the US and are frequently imported from China, and are laced with lead and mercury that are untested and undisclosed.  Up to 22% of ayurvedic medicines are similarly contaminated because of the locations they were grown in fields that may have been near industrial waste sites.  

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If a person was to use herbal medicine in the US, the only way to be sure you are getting uncontaminated and pure herbs is to grow your own.  Buying them from a doctor's office or chiropractor is no different than ordering them off the internet since the doctors and chiropractors do not test the herbs for purity, and rely on the good will of the manufacturer to bring a pure product- something rare in the wild west of the supplement/herb/vitamin industry.  

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STEPS TO A SAFE HERBAL MEDICINE REGIMEN

1. Decide what diagnosis you are treating with the herbs

2. Look at the drug-herb interaction list  here  to make sure the herbs are safe to take with your medicines

3. Research the effectiveness of the herbs using www.pubmed.com by typing in the name of the herb and the term "Cochrane".  Ignore studies done in China or if all the names on the study are Chinese since the Chinese compare medical systems (including acupuncture, massage, movement medicine, and herbs) rather than the effect of one herb.  Unless you are willing to buy in to their entire system and practice it, their study results published on pubmed are bogus, and have been shown not to be reproducible in America.  There is a very high risk of bias in Chinese studies that ultimately invalidates the results.  Also, the Chinese have flooded the international literature in 2017 and 2018 with thousands of useless and nonsensical medical journal articles that contain the term "protocol".  This means the study has not been performed yet, but they are announcing a study will be done.  Legitimate researchers don't publish "protocols"- they just do the study.  The Chinese have found a way to get their names and journals significant amount of free press by announcing these "protocols" intermixed in journals with real studies.  You may also find legitimate information on this page about herbs. 

4. Grow your own herbs whenever possible.  Do not purchase them, even if grown locally since they may be grown in contaminated soil

5. Learn to process your herbs for consumption

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There were many Chinese herbal reviews with positive results, but because of extreme bias in the way the studies were conducted or the very low levels of evidence and poor conduct of the studies, all of these were eliminated from the lists below.

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POSITIVE HERBAL SYSTEMATIC REVIEWS

• Nigella sativa (Black Cumin) a spice from SE Asia, modestly improves blood sugar and triglycerides in diabetes mellitus  Complement Ther Med. 2017 Dec;35:6-13. 

• Pelargonium sidoides (African Geranium) is effective in the treatment and prevention of respiratory tract infections in children (Acad Pediatr. 2018 Jan - Feb;18(1):8-19)

• Jianzhong decoction is effective in the treatment of peptic ulcers compared to western medicine (BMC Complement Altern Med. 2017 Apr 14;17(1):215.)

• In the treatment of ADHD in children, low evidence could be found for Melissa officinalis, Valeriana officinalis and Passiflora incarnata. Limited evidence could be found for pine bark extract and Gingko biloba.  (Complement Ther Med. 2017 Feb;30:14-23)

• For mild-to-moderate depression, St John's wort has comparable efficacy and safety when compared to SSRIs.  (J Affect Disord. 2017 Mar 1;210:211-221.)

• Myrtus communis (Myrtle) and Cydonia oblonga (Common Quince) showed marked reduction in GERD symptoms comparable to omeprazole. Tongjlang and rikkunshito showed therapeutic effects for non-erosive reflux disease (NERD) where PPIs failed to show a promising effect. (J Altern Complement Med. 2017 Feb;23(2):82-95)

• Extracts of echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis, as does gingko biloba for selected vertigo.(Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Apr;134(2):95-99.)

• Danggui Shaoyao San has low level of evidence of effectiveness in the treatment of menstrual cramp pain. Maturitas. 2016 Mar;85:19-26. doi: 10.1016/j.

• For low back pain Capsicum frutescens (cayenne) reduces pain more than placebo. Although Harpagophytum procumbens (devil's claw), Salix alba (white willow bark), Symphytum officinale L. (comfrey), Solidago chilensis (Brazilian arnica), and lavender essential oil also seem to reduce pain more than placebo, evidence for these substances was of moderate quality at best. (Spine (Phila Pa 1976). 2016 Jan;41(2):116-33)

• Rumalaya and Shunti-Guduchi seem to be safe and effective drugs for treatment of osteoarthritis-patients, based on these data   (Rheumatol Int. 2015 Feb;35(2):211-32)

• Tongxinluo, a mixture of 12 Chinese herbs is 3 times as likely to be effective in the treatment of angina pectoris compared with nitrates (J Altern Complement Med. 2011 Dec;17(12):1109-17.)

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NEGATIVE HERBAL SYSTEMATIC REVIEWS

• Goshajinkigan, a Japanese herb, does not prevent peripheral neuropathy development in treatment for cancer.  Support Care Cancer. 2017 Dec 26. doi: 10.1007/s00520-017-4028-6 

• Echinacea was ineffective in the treatment or prevention of respiratory tract infections in children (Acad Pediatr. 2018 Jan - Feb;18(1):8-19) 

• Ginkgo biloba has no indications in tinnitus, presbycusis or anosmia following viral rhinitis. Traditional Asian medicine has no proven benefit in sudden deafness or laryngeal papillomatosis. Oral mistletoe extracts associated to conventional treatment for head and neck squamous cell carcinoma does not increase 5-year survival (Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Apr;134(2):95-99.)

• A study of Chinese medicines being used for peripheral neuropathy (commonly used) found insufficient evidence of safety or efficacy to recommend these medicines (Cochrane Database Syst Rev. 2013 Oct 6;(10):CD007796)

 

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UNSAFE HERBAL SYSTEMATIC REVIEWS

• Chelidonium majus (also known as greater celandine, swallow-wort, or bai-qu-cai) has been used for centuries in China for a wide variety of non-specific uses, including as a drug to promote liver health.  However this review found the herb is actually toxic to the liver and should therefore be avoided for all uses (Eur Rev Med Pharmacol Sci. 2017 Mar;21(1 Suppl):46-52.)

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TOP HERBAL MEDICINES IN THE US

• Acai Berry

• Alfalfa

• Almonds

• Aloe Vera

• Apples

• Arnica

• Artichoke

• Ashwagandha

• Asparagus

• Astragalus

• Avocado

• Banana

• Basil

• Beet Root

• Black Cohosh

• Black Currant

• Cat’s Claw

• Cayenne Pepper

• Celery

• Cherry

• Chickweed

• Cinnamon

• Coconut

• Corn Silk

• Dandelion

• Dill

• Echinacea

• Eucalyptus

• Evening Primrose

• Fenugreek

• Flaxseed

• Garlic

• Ginger

• Gingko Biloba

• Ginseng

• Goldenseal

• Grape Seed

• Green Tea

• Hawthorn Berry

• Hibiscus

• Hoodia Gordonii

• Hops

• Horse Chestnut

• Horsetail

• Jasmine

• Jojoba

• Lavander

• Lemon Balm (Melissa)

• Leongrass

• Licorice

• Marjoram

• Milk Thistle

• Mushrooms (Reishi)

• Mushrooms (Shitake)

• Onion

• Oolong Tea

• Orange

• Olive Leaf

• Papaya

• Parsley

• Passion Flower

• Peppermint

• Pineapple

• Rasberry Leaf

• Red Clover

• Red Yeast Rice

• Rosehips

• Rosemary

• Sage

• Sassafras

• Saw Palmetto

• Seaweed

• Senna

• Stinging Nettle

• St. John’s Wort

• Tea Tree

• Thyme

• Turmeric (Curcumin)

• Walnuts

• Wheatgrass

• White Oak Bark