US Herbal Remedy Sales
Total $3.8 Billion In 1998
By Suzanne Rostler
NEW YORK - Herbs, once relegated to the ranks of snake oil or voodoo in the eyes of the medical establishment, are joining the mainstream as people look for fast, cheap ways to cure ailments such as depression, anxiety and memory loss.
Led by baby boomers bent on staying young, Americans spent an estimated $3.8 billion on herbs and other "botanicals" in 1998, up from $2.5 billion in 1995, industry data shows.
"We are the generation that said, 'Never trust anyone over 30.' We don't want to get sick and we certainly don't want to get old," said John Cardellina, a chemist with the Council for Responsible Nutrition, a group that promotes supplements.
This rapid growth has forced doctors and government regulators to take a closer look at the virtues and dangers of herbs and pushed pharmaceutical makers and even food companies to start jockeying for shares of these lucrative markets.
In an attempt to refine its regulatory approach, the federal Food and Drug Administration will meet with industry groups, consumer advocates and health experts next month to discuss tighter restrictions on health claims.
Interest in herbs has been fueled by greater understanding of the link between diet and disease. That interest has turned into an explosion of sales with the help of the Internet, television commercials and the burgeoning number of companies that now market dietary supplements.
A recent Louis Harris survey found 90 percent of doctors and 96 percent of pharmacists reporting an upsurge in consumer demand for herbal supplements over the past five years. Health experts say this trend reflects an attempt among aging baby boomers to stay young and healthy through "natural" methods.
But the perception of herbs as natural can have dangerous consequences. Synthetic drugs as powerful as heart medication digitalis are based on natural plant ingredients. And like synthetic drugs, herbal products can be dangerous when mixed with food and other medication.
"Natural does not necessarily mean safe," Cardellina said.
The government classifies botanicals as dietary supplements, which are regulated like food. Companies can therefore market these products without the rigorous approval process required for drugs and the FDA can recall a product only after it has been found to be dangerous.
"Anyone can claim that inside a bottle is St. John's wort. I suspect there are less-than-quality products out there," said Raymond Chang, a New York-based oncologist who uses herbs to treat many patients. He accused the media of exaggerating the number of cases of tainted herbs for the sake of a good story.
"Obviously in large quantities, inappropriate doses, or if the batch is tainted it can be dangerous, but by and large herbs are very safe," Chang said.
A growing body of scientific evidence could bear out his claim and help bring the United States up to speed with Asian and European countries with long histories of using herbs.
In the past few years, medical journals have published studies, many of them European, showing that some herbs do have health benefits when tested in controlled clinical trials. For example, saw palmetto has been shown to help men suffering from the effects of an enlarged prostate, ginkgo biloba may help some Alzheimer's patients and St. John's wort seems to help some people with mild symptoms of depression.
But other studies have shown no benefits. A recent trial showed that valerian, promoted as a sleep aid, did not help a significant number of patients. Another recent study found that high doses of St. John's wort may impair fertility.
These studies and market surveys illustrating consumer demand for herbal products have prompted a handful of pharmaceutical companies such as Bayer, American Home Products and SmithKline Beecham to release their own brands.
Warner-Lambert launched its line in October after the Louis Harris survey found that nearly half of all Americans have used herbal supplements at some time in their lives.
"Surveys started to signal to us that the mainstream medical community was opening up to natural compounds," Barry Turner, vice president of complementary medicine at Warner-Lambert, said. "We want to help them understand how to integrate them into their medical practice."
Indeed, the Louis Harris survey found that while most doctors are interested in herbal supplements few understand them. In an attempt to educate physicians, the publisher of the popular Physician's Desk Reference of prescription and other drugs issued a PDR for Herbal Medicines in November.
"The reality is that there is a marketplace and it's just good business to be there," CRN's Cardellina said.
Food companies also hope to get a slice of the market. Products that have hit the shelves so far include potato chips enhanced with kava kava, a herb promoted as relieving anxiety; iced tea spiked with ginseng, alleged to have a range of benefits, and chicken soup laced with echinacea, which supposedly boosts the immune system and wards off colds.
While clinical tests on these supplements have shown mixed results, such "functional foods" now are a nearly $15 billion a year industry, says the Grocery Manufacturers of America.
The many products in this category, which includes Power Bars, Gatorade, and foods fortified with vitamins and minerals, may carry claims about health benefits of herbs, plant extracts and other ingredients. They may not make specific claims to treat, mitigate, diagnose, cure or prevent a disease.
"Most mainstream food companies don't market diet supplements - they market functional foods," Gene Grabowski, a spokesman with the Grocery Manufacturers of America, said. "But the line between the two is getting closer and closer."