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Book Review |
Dean, College of Agriculture
California State Polytechnic University, Pomona
Tyler’s Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. Steven Foster, Varro E. Tyler, PhD. Binghamton, NY: The Haworth Herbal Press, 1999.
The first Honest Herbal was written by Varro Tyler at a time when herbal remedies were rapidly growing in popularity, yet there was no modern interpretation of efficacy and safety. The new updated version provides a systematic, concise review of each herb. The presentation is designed to assist the consumer and health care professionals decide whether an herb is useful, may be without value or may even be potentially hazardous—not just from toxic components, but from masking the symptoms that delay appropriate medical care.
The text begins with a discussion of the pros and cons of herbal use. The authors note that the interest in herbal remedies was stimulated by a decline of faith in modern medicines and in the inattentive physician who prescribed them, the belief that plant remedies were natural and thereby superior to man-made therapeutics and the reference to successful historical use by different cultures. Unfortunately, most of the information provided to the public has been more promotional than factual. The herbal products being sold have not been well controlled by government labeling regulations. The current herbal publications range from reproductions of materials more that a century old, to more polished texts containing glossy pictures of herbal plants, to descriptions of specific applications for groups such as the elderly, women and others. The great void remains a systematic, thorough review of scientific data that provides a basis for the determination of specific herbs and their efficacy when applied to medical problems. Similarly, there is a lack of scientific review of phytochemicals that may prevent certain degenerative diseases.
The second chapter reviews the laws and regulations pertaining to herbal remedies. The discussion is excellent, beginning with the Food and Drug Act of 1906 (prohibiting adulterated or misbranded drugs), followed by the Food, Drug and Cosmetic Act of 1938 (providing that all drugs sold in the US must be proven safe) and the Drug Amendments of 1962 (requiring proof that drugs are safe and efficacious). The Federal Department of Health in Germany created Commission E to review plant drugs for efficacy and safety; its findings are now available as monographs. The DSHEA of 1994 has provided an opportunity to sell most herbs in the food category as dietary supplements. Although the act enhances the availability of products, it allows third party information on the benefits of the products, that is, as purporting to be truthful and nonmisleading scientific information, but the burden of proof to show a product is adulterated or unsafe is left on government agencies.
During reviews of OTC drugs and herbal remedies, most were found to be lacking efficacy. However, the FDA used only the supportive materials provided. Thus, some compounds placed in category III were so placed as the result of incomplete support rather than a lack of efficacy or safety. More work needs to be done in this area. Another 250 herbs and spices are listed on the GRAS list, which does not infer medicinal use or safety.
DSHEA established an Office of Dietary Supplements within NIH to conduct, coordinate and collect data on dietary supplements and to advise the Secretary of Health and Human Services. A separate presidential commission on Dietary Supplement Labels was also formed that recommended creation of a FDA panel that would review nonprescription claims for botanical products to be used as drugs. Major pharmaceutical firms will be promoting and selling herbs.
Where can the consumer get required critical assistance? The remaining chapters of the text list and identify the needed comments for enhancing judgments on efficacy and use. Each section describes the herb, its proper nomenclature, the plant source, followed by comments on its uses. The authors include an evaluation and judgment about the utility of the herb.
The closing chapter evaluates herbal remedies and provides a summary table for quick reference. Tyler’s Honest Herbal still provides an important service to the consumer and health professional. It is a quick reference, easily used to obtain candid, critical comments on safety and efficacy for specific uses. The text complements well Tyler’s Herbs of Choice, which emphasizes specific herbal applications to health disorders. The Honest Herbal remains an essential desktop reference for everyone interested in herbs and who may need ready answers for public inquiry.
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