MEDICINAL PLANTS
Medicinal plants are usually parts of plants, sometimes shredded, extracted or otherwise prepared, used to improve the state of health. Nutraceutical Foods, the most recent and generic term, are a set of natural substances that includes medicinal plants, products such as cholesterol-lowering margarines and psyllium-enriched products (Psilio), used as dietary supplements and considered food.
Traditional medicine systems have been used for centuries throughout the world. Some ancient methods, such as traditional Chinese medicine, Ayurveda (the system of holistic Indian medicine) and Tibetan medicine are still widely used, especially in the countries of origin. In the United States the interest for this type of method is growing, particularly for the treatment of chronic diseases. These therapies, usually referred to as complementary or alternative medicines (overview of alternative and complementary medicine), include medicinal plants, acupuncture and massage. In most cases they have not been scientifically studied and almost all of them lack regulation.
The most common alternative therapy is dietary supplements, which include medicinal plants and natural products. Following the widespread spread of dietary supplements, the United States Government approved the Dietary supplement Health Education Act (DSHEA) in 1994. This measure defines as food supplement any product (except tobacco) containing a vitamin, a mineral, a herb or an amino acid and which is considered an addition to the usual diet. The measure requires that the label of a food supplement identify it as such.
The label must specify that the effects attributed to the dietary supplement have not been assessed by the Food and drug Administration (FDA) US agency. The label must also indicate each ingredient by name, quantity and total weight, as well as identify the parts of the plant from which each ingredient originates.
Most dietary supplements used in alternative medicine are of plant origin, while others are of animal origin. Since such dietary supplements are natural, some patients assume that they are safe to use. However a substance is not safe just because it is natural. For example, many powerful poisons, such as hemlock, are plant products and some, such as snake poisons, are animal products. In addition, almost all substances that act on the body, whether they are food supplements or drugs approved for medical use by the Food and drug Administration (FDA), the American Food and Pharmaceutical Agency (with or without obligation to prescription), may have unwanted side effects.
Safety and effectiveness
Since dietary supplements are not regulated as drugs by the FDA, manufacturers do not have an obligation to test their safety and efficacy (even if their safety needs to be documented). As a result, only a few supplements have been rigorously studied in terms of safety and efficacy (although in the final analysis some are able to prove themselves safe and effective). Moreover, since only recently has the need to assess human supplements been recognised, many available information has not been collected systematically or scientifically and is therefore difficult to assess. On the other hand, both prescription and non-prescirzione drugs have been extensively and systematically studied by researchers and evaluated at ministerial level to establish safety and efficacy (efficacy and safety).
Some of these studies have been conducted on animals to detect the development of tumours and organ damage, and others on humans to detect any signs of toxicity.The quantity and the quality of the tests to support the effectiveness of the supplements vary greatly. For some supplements, there is convincing evidence to support effectiveness. However, in the majority of cases, scientific studies have not been carefully designed to give clear and reliable answers.
For some supplements, the only evidence to support the efficacy is the personal reports of consumers or studies carried out on animals.
Purity and standardization
Other areas of interest are the purity and standardization of supplements. Supplements, unlike drugs, are not regulated to ensure the purity, presence of ingredients or the amount of active ingredient indicated on the packaging. As a result, the supplement may contain other substances, including, in some cases, prescription or bench medicines and even hazardous substances, such as mercury.
The amount of active ingredient contained in a supplement dose may be variable, especially if whole plants are ground or reduced to extract to produce a tablet, capsule or solution. The buyer is likely to assume a lower, higher or, in some cases, nothing, of the active substance contained in a supplement.
Standardization requires that the formulation of each individual dosage of the product contains a precise quantity of one or more of its active ingredients. However, most herbal products are made up of mixtures of various substances and it is not always known which is the most active. Therefore, it can be difficult to determine which component should be considered active and therefore subject to standardization. Some supplements, particularly those produced in Europe, have been standardized and can be brought back to the label.
The indications on how to choose a pure and standardized product vary between one specialist and the other. Most of them recommend buying products manufactured in Germany, because they carry out checks on the most stringent supplements compared to the United States.
Even if the content of a supplement is not standardized, it is the way it is produced. In 2007, the FDA created current good Manufacturing Practices (BPF) that standardize the production, packaging, labelling and preservation of food supplements. These BPF help to ensure the quality of food supplements and to protect public health.
Drug interactions
Supplements can interact with prescription and counter medications. These interactions sometimes enhance or reduce the efficacy of a drug or cause serious side effects. Before taking supplements, it is preferable to consult your doctor in order to avoid the interactions.
Few studies have been conducted to evaluate drug-integrating interactions; Therefore, most of the information about interactions comes from sporadic individual reports.