Back to the roots - why are herbal remedies replacing modern medicine?
Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.
Life outside our window is developing at leaps. It refers to all areas of our life, starting from cosmonautics and to medicine. Thousands of people work hard to create something new and to improve the things we already have. Human DNA editing, robot-neurosurgeons, endoprosthesis controlled by the power of thought, breakthroughs in the fight against cancer - these are only some of the scientific advances of recent years.
What’s more, whilst medicine is shifting to a new level, humanity is… returning to the roots. A bit of a paradox, isn’t it?
However, it is completely true. According to the report presented by the World Health Organisation (WHO), there is a clear trend in the development of national policies for the use of traditional and complementary medicine among the Member States between 1999 and 2018. In particular, there is a significant increase in the number of Member States having a national policy on traditional and complementary medicine, with the number almost doubling between 1999 and 2005, and then doubling again between 2005 and 2018. In fact, by 2018, a total of 98 countries (which is more than 50% of the 194 Member States) had a national policy on traditional and complementary medicine.
Meditation, yoga, acupuncture, magnetic intervention, and other complementary wellness treatments are gaining enormous popularity across developed countries. This can be due to the increasing acceptance of these alternative treatments among the general population. As a result, this is going to cause an increase in the number of meditation centres, yoga studios, spas, and complementary wellness facilities. As a matter of fact, the size of the global complementary and alternative medicine market exceeded the mark of $69 billion in 2019, registering a CAGR of almost 20% over the forecast period.
A crucial role in boosting the adoption of Complementary and Alternative Medicine (CAM) is played by government initiatives. In addition to this, increased funding, establishing government facilities dedicated to complementary therapies, and the expensive nature of conventional treatment options are secondary factors that are encouraging companies all over the world to invest in the development of the market for complementary and alternative medicine.
Clear evidence showcasing growth in the complementary and alternative medicine market confirms that integrative and holistic treatments like diet and acupuncture are finally recognised and accepted by the people and the medical world.
At one point in time, the term “alternative medicine” was perceived as the argument of shamans, crackpots, and charlatans. However, times are changing, and this period was enough for people to reconsider their views on alternative medicine radically. In the past few years, many doctors, along with conventional healthcare institutions in the US, have shown a new acceptance of philosophies and treatments that, historically, were quite far from mainstream medicine. To this date, the term “alternative medicine” is more and more often substituted with “integrative medicine”, which addresses the full range of a patient’s emotional, physical, environmental, and spiritual influences. This term also includes therapies that extend beyond the drugs and surgeries that have historically defined the American medical establishment. It is not a surprise that the general public’s opinion about the effectiveness of this type of treatments in comparison with modern medicine was divided.
Along with this, the position of alternative medicine and integrative medicine proponents regarding conventional medicine also differs. More specially, alternative medicine supporters tend to reject allopathic or conventional medicine, while believers in integrative medicine claim there is a room at the table for all treatment options.
Integrative medicine proponents state that while procedures and medications still help millions of patients worldwide, there is growing evidence that diet and nutrition, natural therapeutics such as vitamins, supplements, acupuncture, and herbs, along with lifestyle behaviours such as smoking cessation and exercise can also have a direct impact on disease. Meanwhile, doctors, healthcare executives, and patients all over the world state that the primary driver of this trend is overwhelming patient demand which is backed up with positive results of their treatments.
Despite the global adoption of herbalism and alternative medicine in general, there are still a lot of sceptics claiming this is nothing more than a placebo effect. The key question is - whether this is actually true and our ancestors simply didn’t have other options, or it can really give us effective results?
Let’s dive deep in the history of herbal medicine and look for the origins of alternative treatments.
Art of herbal medicine - when did it all start and what to expect next?
Today, we have no chance to say for sure whether our ancestors were satisfied with their life and treatment, or they didn’t have any other options. They didn’t have computer diagnostics, robotic surgery, and potent drugs. However, they managed to cope with some diseases and conditions without all the benefits of modern medicine. The only thing we can do nowadays is to try to understand the way of their thinking and remind ourselves of the traditions that have come before us, as well as to respect all the remedies that live around today.
Most of our ancestors came from animalistic cultures, which believed that all things around, including plants, hold a spirit. Even today, in the epoch of global technological growth, the indigenous people worldwide still honour much of the natural world as sacred and guard the plant spirits within. Times are changing, although for much of humankind, possessing plant knowledge, or having access to a person who did, still made the difference between life and death. Nowadays, the majority of the world still relies on traditional medicine, and even in industrialized countries, different folk remedies are still used to treat a wide range of various illnesses every day.
Traditional or alternative medicine often has a significant herbal component which was the main reason for the occurrence of such a term as “herbalism”, or as we used to hear more often - herbal medicine. The use of plants as medications predates written human history.
According to archaeological evidence, humans were using medicinal plants during the Paleolithic, approximately sixty thousands years ago. Plant samples that were gathered from prehistoric burial sites have been thought to support the claim that Paleolithic people had knowledge of herbalism and widely used it to treat illnesses. For example, large amounts of pollen from eight plant species, seven of which are used as herbal remedies even nowadays have been found in the 60,000-year-old Neanderthal burial site in northern Iraq.
Other regions have also saved traces of the wide use of different plants by our ancestors. In Mesopotamia, the written study of herbs dates back over 5,000 years, according to the clay tablets with lists of hundreds of medicinal plants such as opium and myrrh, most likely created by Sumerians. Texts found in ancient Egypt are also of particular interest for the modern scientists. One of such examples is the Papyrus Elbas - text which serves to illuminate or relieve some of the assumptions regarding ancient herbal practices. This document consists of different diseases and their treatments. It includes a variety of ailments, ranging from skin conditions to limbs diseases, as well as information about more than eight hundred plant medicines, such as aloe, cannabis, juniper, garlic, mandrake, and castor bean.
Another example of the ancient herbalism is Ayurveda or alternative medical system in the Indian subcontinent. It dates back as early as 4000 BC and included many herbs and minerals. The first documents which serve as confirmation of Ayurveda system existence include the earliest Sanskrit writings, such as Atharva Veda and Rig Veda. Later, many other herbs and minerals were described by ancient Indian herbalists such as Sushruta and Charaka during the first millennium BC. These herbalists have described more than seven hundred plants along with sixty-four preparations from mineral sources.
The list of ancient herbal remedies and treatments in different countries can be continued, although the one thing already seems clear - the history of herbalism is rooted deep in the past. In addition to this, based on numerous written sources, it becomes obvious that our ancestors actively used different herbs to treat various illnesses and investigated the health benefits of plants and preparations to cope with diseases.
In our world today, it is the 21st century outside the window, and what do we have?
Herbal medicine is gaining popularity again despite a wide range of other treatment options and diagnostic methods. Whether herbal medicine is the escape from technological reality or really effective treatment? Taking into account the scale of herbalism popularity worldwide and predictions for the future, more and more people, including sceptics, reconsider their views on “ancient treatments”. Let’s put aside the spiritual connection with the ancestors and the closeness with mother nature and evaluate some numbers. The size of the global herbal medicine market was valued at $71.19 billion in 2016, and it seems like it isn’t going to stop.
No one knows how large will be the market size in the near future, although all experts agree on one thing - the herbal medicine market is expected to exhibit profitable growth. Such an astonishing development of herbalism is a chain of logical events that follow from each other. People decide to try alternative medicine which does not cause overdose toxicity and has significantly less adverse effects and get effective results. Increasing preference of consumers due to the positive results triggers the growth of the demand for herbal remedies. The increased demand, in its turn, entails more research investments and funding, supporting the market growth. Eventually, the herbal medicine market growth “sheds light” on treatment options that are completely different from conventional medicine, attracting more and more potential consumers. Simple and ingenious.
Another moment that makes people choose alternative medicine instead of allopathic medicine is the cost of the treatment.
Herbal medicines, in comparison with conventional drugs, cost significantly less and can demonstrate therapeutic benefits in more than one medical condition due to many chemicals in their composition. Its constituents, such as alkaloids, polysaccharides, phenols, resins, terpenoids, and glycosides, can be used to treat a variety of different diseases and conditions. Herbal medications reached a new level and moved from unconfirmed anecdotal evidence to significant consideration at a global level. These cost-effective treatment options for such conditions as kidney disorders, cold and cough, chest congestion, and digestive problems are expected to enhance the further acceptance of herbal medicine in countries all over the world.
Herbal medications are currently available in the form of:
- Tablets and capsules
The first segment offers the highest dosage accuracy in comparison with other dosage forms and thus, is expected to undergo the fastest growth in the near future. In addition to this, tablets and capsules are easy to carry and don’t have the bad odour or the risk of being spilt. However, herbal extracts have higher absorption rates in comparison with other dosage forms and are also supposed to drive the herbal medicine market over the forecast period. The herbal extracts segment exceeded the mark of $27 billion in 2016 and is expected to reach $44.6 billion by 2024.
As for segmentation by the region, Europe dominated the global herbal medicine market in 2016 and is expected to retain the share further. The use of alternative medicines in Europe is promoted by such associations as European Herbal & Traditional Medicine Practitioners Association (EHTPA) and British Herbal Medicine Association, which organise various seminars to increase the awareness regarding the therapeutic benefits of using herbal medications. The fastest growth of the herbal market is expected in the Asia Pacific due to increasing awareness of such herbal products as dietary supplements, drugs, and skincare products. China and India are considered the major markets for herbal medicinal products in the region as they have a strong background. The Indian Ayurveda system has been proving effective treatment options for a range of digestive system and respiratory system disorders since ages. The rapidly developing trend of traditional medications usage is expected to strengthen the market and contribute its growth.
The perspectives for the herbal medicine market impress with their scale, while experts predict even greater growth in the near future. Let’s check the health benefits of herbalism and the possibilities of its alignment with conventional medicine.
Herbalism as a mainstream - an insight into all the popular herbal medicines
Herbal medicine has transformed from old legends and beliefs about the healing properties of herbs and extracts to scientifically justified treatment options. To date, pain treatment is at the forefront of herbalism and represents one of the most noticeable shifts toward a more integrative approach to global patient care.
The main reasons for making pain treatment a primary aim of herbalism include the difficulty to identify and treat pain, and the opioid epidemic, which affected the whole world and can’t remain unnoticed.
The opioid epidemic or, as it usually called “opioid crisis” is the overuse or misuse of addictive opioid drugs that lead to serious medical consequences, including overdose death. Opioid drugs or opioids represent a diverse class of potent painkillers and are often prescribed for pain management when other medications can provide the patient with the results needed. Opioids include such drugs as hydrocodone, oxycodone, fentanyl, and other opiates, such as heroin and opium-derived morphine. Nowadays, opioids are widely used to treat both acute and chronic pain, while for acute pain, they are considered more effective as in case of chronic pain risks often outweigh the benefits.
The effectiveness of opioid drugs is undoubtedly high, although the constantly increasing number of opioid-related deaths put this issue in the top of modern problems in medicine that have to be resolved. For the period from 1999 to 2017, the number of opioids deaths in the United States has risen from 8048 to 47600 and continues its growth. Statistics collected for the period of 2016 to 2017 states 130 people worldwide die every day from opioid-related overdoses, while 11.4 millions of patients misused prescription opioid drugs. Besides the terrifying numbers of opioid deaths and misuse, there is also a significant impact of the opioid crisis on the US Healthcare System. Total annual expenses of overdose-related costs to the US healthcare system comprise $11 billion, while total annual hospital costs across 647 healthcare facilities nationwide are $1.94 billion.
Currently, non-pharmaceuticals options, such as tai chi, electrotherapy, meditation, as well as supplemental therapies and diets are considered the potential ways to substitute opioid treatment or, at least, minimise the number of opioid drugs needed. According to Dr Robert Bonakdar, the Director of pain management at Scripps Center for Integrative Medicine in La Jolla, California, the health benefits provided by these treatments may give a better result for the patient in comparison with monotherapy.
In addition to this, herbal remedies and supplements can alleviate side effects that can come from the increasing use of NSAIDs (non-steroidal anti-inflammatory drugs). Moreover, it is assumed that conditions such as osteoarthritis may have a metabolic component, especially glycemic control, even in those patients who don't suffer from excessive weight. Thus, a balanced diet, along with necessary supplements and vitamins, may reduce the risk of these diseases significantly.
Herbal medicine continues confirming its effectiveness, although we shouldn’t “build illusions” regarding its omnipotence - not all herbs are beneficial for our health. Moreover, some of them can worsen the patient’s condition instead of alleviating it. We collected the most effective herbal options that can be used for a wide range of different illnesses and will not cause harm to your health.
Let’s check out the main uses, health benefits, and safety aspects of these plants.
- Echinacea: Echinacea or, as many people call it - “coneflower”, belongs to the category of flowering plants and is a popular herbal remedy. This plant comes from North America, where Native American practices have long used it to treat a variety of diseases, such as sore throat, wounds, burns, toothaches, and upset stomach. Many echinacea users state that its roots give the strongest effect, although most parts of the plant, including the petals, roots, and leaves can be used for medicinal purposes. The herb is usually taken as a tea, although it can also be applied topically or taken as a supplement. To date, echinacea is most often used to prevent or treat the common cold. Safety of this plant rates 4.5 of 5, although it still may have some side effects. Allergic reactions are possible and adverse effects, such as nausea, skin rash, and stomach pain have occasionally been reported. Research of this herb is limited, but it is believed it can reduce your risk of catching a cold by up to 20%. Echinacea is available in most supermarkets and health food stores, and besides colds could be also beneficial for bronchitis, immunity as well as upper respiratory infections.
- Ginkgo biloba: Ginkgo biloba or simply Ginkgo is a herbal medicine derived from the maidenhair tree. Ginkgo is one of the oldest homoeopathic plants and a key herb in Chinese medicine, where it has been used for thousands of years and still remains a best-selling herbal supplement even nowadays. Ginkgo Biloba contains a variety of potent antioxidants and is best known for its ability to boost brain health. The seeds of this plant are used to make tinctures and teas, while the leaves can also be used to create extract and tablets, as well as be consumed as a tea when dried. Studies investigating the therapeutic potential of this herb say Ginkgo can be used for the treatment of patients with mild to moderate dementia diagnosis and can slow cognitive decline in Alzheimer's disease. Besides this, Ginkgo Biloba can be beneficial for:
- Eye health
- Sexual dysfunction
- Heart disease
- Bone healing
Ginkgo has a safety index 3 out of 5 and, although it is well tolerated by most consumers, can increase the risk of such side effects as digestive issues, headache, skin reactions, and heart palpitations. In addition to this, long-term use of this plant may increase the risk of liver and thyroid cancer, as it has been seen in animal studies. Also, you should note that Ginkgo seeds are mildly toxic and are not recommended to be taken while raw.
Ginkgo Biloba is traditionally used to treat different diseases, although, as with most of the herbs that can be potentially used for medical purposes, modern research has yet to prove its efficacy for these illnesses.
- Ginseng: The health benefits provided by ginseng make it a popular option to make tea when steeped or powder when dried. In traditional Chinese medicine, this medicinal plant is frequently used to boost immunity, energy levels, brain function, as well as to reduce inflammation. There are several varieties of this plant, although the main popular are Panax ginseng (Asian type) and Panax quinquefolius (American type). The first type is considered as stimulating, while the American ginseng, vice versa, is believed to cultivate relaxation. According to several animal studies, the unique compounds of ginseng called ginsenosides can potentially provide antidiabetes, neuroprotective, anticancer, and immune-boosting properties. However, despite the fact that this medicinal herb has been used for centuries, more human research supporting its efficacy is still needed. Ginseng is claimed to be a relatively safe plant, although the side effects from its long-term use remain unclear. Among the side effects that may occur during treatment with ginseng are digestive issues, poor sleep, and headaches.
- Elderberry: Elderberry is another representative of ancient herbal medicine. It is made from the cooked fruit of Sambucus nigra plant and is toxic when eaten unripe or raw. This popular plant has long been used to relieve constipation, headaches, toothaches, viral infections, and cold. Today, elderberry is primarily used as a treatment for symptoms associated with cold or flu. What is interesting is that there is no standard dosage for elderberry taking. Some people prefer using it as a syrup or lozenges, while it can also be taken as a tea or cooked with other ingredients, such as ginger and honey. Ginger has antimicrobial, antiviral, and antioxidant properties, and, accordingly to some human studies, can be used to shorten the duration of flu infections. Additional larger studies are also needed to determine whether elderberry is more effective than other conventional antiviral therapies and how expedient is its use. Short-term use of elderberries is considered to be safe, but its raw fruits are toxic and may cause adverse effects such as diarrhoea, nausea, and vomiting.
- Turmeric: Turmeric (or Curcuma longa) belongs to the ginger family and is well-known as one of the key herbs in Indian alternative medicine practice called Ayurveda. For more than four thousand years, this herb has been used in medicine and cooking and has recently got increased attention due to its potent anti-inflammatory properties. Multiple studies confirmed the assumption that turmeric can be used to alleviate pain associated with arthritis. Moreover, in terms of effectiveness, this herb was in no way inferior to such popular anti-inflammatory medications as ibuprofen. The major active compound in turmeric is curcumin. This component can potentially treat a wide range of conditions, including anxiety, pain, chronic inflammation, metabolic syndrome, joint arthritis, and a variety of dermatologic diseases. Turmeric can be taken as a supplement or topically for people suffering from arthritis to relieve discomfort symptoms. All over the world turmeric is used as a delicious, antioxidant-rich cooking ingredient, while its sunny orange colour won’t let you pass by in the supermarket. Both turmeric and curcumin are considered safe, but high doses of these supplements may cause diarrhoea, skin irritation or headache.
- Chamomile: Of course, how we can get without chamomile in this list. Chamomile is rightfully considered one of the most popular herbal medicines in the world. For thousands of years, this plant has been used as a remedy for constipation, diarrhoea, stomach pain, wounds, urinary tract infections, nausea, and upper respiratory infections. The numerous chamomile benefits are due to more than a hundred active compounds contained in its chemical composition. The anti-inflammatory, antioxidant, and antimicrobial properties of this plant was demonstrated by a range of test-tube and animal studies, although more human research is necessary. Several human studies demonstrated the ability of chamomile to treat emotional disturbances, diarrhoea, as well as to alleviate crampings associated with premenstrual syndrome (PMS). In addition to this, it is also believed to be effective in reducing pain and inflammation induced by osteoarthritis. Some of the studies also assumed chamomile could have a beneficial influence for people with different types of cancer, although there is not enough evidence to confirm it and additional research is needed. This herb is considered safe, although people who have allergy for similar plants, such as ragweed, daisies, and marigolds should take it with caution as chamomile may cause an allergic reaction.
Herbal remedies can be highly effective for the treatment of a wide number of diseases and conditions and are considered to be much safer than conventional drugs. However, you shouldn’t think that herbs are something like a magic wand, which would treat all your illnesses in a wink without any adverse effects. Unfortunately, it isn’t so, and, as well as medications offered by conventional medicine, the herbal treatment also requires a competent approach to the dose, quality, and safety. For example, some herbs may interact dangerously with antidepressants, while others may have adverse effects on the organism of pregnant or breastfeeding women.
Another vital factor that has to be considered is that herbal remedies are not regulated as strictly as other medications. Moreover, herbal manufacturers don’t have to provide proof of the purity of the herbs before marketing their products. Therefore, some supplements may list ingredients improperly or contain compounds that are not stated on the label. It is highly recommended to consult your healthcare provider before starting herbal treatment and double-check places where you purchase herbs.
CBD and herbalism - partners or rivals?
The global medicinal cannabis hype has covered the whole planet, unceremoniously invading into modern medicine, changing it, and turning everything upside down.
Cannabidiol (CBD) is one of the active ingredients in cannabis. Unlike tetrahydrocannabinol (THC), CBD doesn’t get you high, although it can still provide you with a wide range of different health benefits. Today, research on the use of CBD for various health conditions is growing, revealing more and more new healing properties of this cannabinoid and evaluating its effectiveness for the range of cases. CBD is claimed to be effective in treating and alleviating many different diseases and conditions, such as anxiety, depression, insomnia, pain syndromes, and even difficult-to-treat epilepsy syndromes, such as Lennox-Gastaut syndrome (LGS). According to researchers and health experts, cannabidiol is becoming a potent alternative to pharmaceutical medications providing similar effects, as the number and severity of side effects of CBD taking differs significantly.
If CBD has all the chances to substitute some of the well-known conventional treatments, what about its competitiveness with herbal remedies? To answer this question, let’s look at how CBD affects our body.
The health benefits provided by CBD are due to its interaction with our ECS or endocannabinoid system, which is responsible for regulating such vital processes as mood, anxiety, sleep-wake cycles, pain, inflammation, metabolism, and brain health.
ECS plays a key role in regulation, balance, maintenance, and optimal health. Any of our diseases are a result of certain malfunctions in the ECS work and loss of homeostasis. While affecting our endocannabinoid system, CBD “returns” it to balance state, thereby improving our condition and alleviating most of the symptoms. CBD has been shown to be effective in the treatment of dozens of conditions, although it is not the only “natural” solution available today. There are many non-cannabis plants that are able to mimic the cannabinoids functions. In fact, these plants may have a similar effect, but may not be as potent as cannabidiol alone.
The main benefit of herbal medicine is that it is very complex as one of its plants can contain hundreds of different compounds working together to be maximally effective and provide the desired therapeutic effect. Most herbalists recommend using the whole plant products to allow all plant components work synergistically. According to health experts, among the CBD alternatives can be such herbs as:
- Ginger root: Ginger root is well known for its cannabinoid, antioxidant and anti-inflammatory properties. It also can relieve pain associated with premenstrual syndrome and knee arthritis. In addition to this, ginger root can also be used to alleviate nausea and vomiting.
- Echinacea: Being long used by native Americans, echinacea is effective in treating pain, sore throat, and cough. Besides this, echinacea has a compound known as N-alkyl amides, allowing it to interact with our immune system, combating inflammation and pain just like THC but without any intoxicating effects.
- Magnolia: Magnolia bark has been used in traditional medicine for centuries and continues to be one of the main components of traditional medicine nowadays. Magnolia is known for its ability to treat anxiety and depression, while can also be used to promote a calming effect on our body and reduce the effects of stress by interacting with the endocannabinoid system. In addition to this, researchers also claim it may promote more restful sleep.
- Peony: This native flower of China is also rich with cannabinoids. Peony is able to regulate the signalling pathways of the endocannabinoid system, which control the perception of pain. Moreover, peony has the ability to calm muscle spasms and fight off inflammation in gout and other joint diseases.
- Clove oil: Clove oil contains beta-caryophyllene - a special terpene that is also found in the cannabis plant. This plant has antimicrobial properties and has traditionally been used for toothache, muscle pain, digestive upset, and respiratory conditions, such as asthma and cough.
All of these natural remedies are able to regulate the ECS in much the same way as cannabidiol. Nevertheless, cannabinoid experts state that each herb constituent has a different mode of action within the endocannabinoid system. One of the main differences between CBD and the herbs listed above is how it is produced. All CBD products are manufactured to highlight CBD through standardisation, while herbs aren’t necessarily standardised to exploit the cannabimimetic components. This difference makes it a challenge to compare the potency of cannabidiol to other herbs that may influence the ECS in a similar way.
The bottom line
Although CBD and medicinal herbs could very well be competitors, we still think they are on one side of the barricades.
The main thing that unites them is the competitiveness with conventional medications and striving for the adoption of traditional medicine. Unfortunately, not all of us are ready to substitute the usual drugs with their natural alternatives, even knowing about their health benefits and effectiveness. More scientific research and clinical trials on humans are needed to prove the effectiveness of cannabinoids and herbalism to convince patients with the need of including more natural remedies in their treatment. We all need time to think it over and include something new in our life. Herbal treatments, as well as medicinal cannabis, are developing with astonishing speed, and statistics show more and more people stopped their choice on alternative medicine. Quite possibly, in the near future, herbalism and cannabinoids will substitute conventional drugs and then it will be expedient to talk about their rivalry, while now they walk the same path - the path of natural and effective treatment.