Herbal medicines put into context
Using herbal medicines entails risks, but probably fewer than with synthetic drugs, argues Erzard Ernst
Recent reviews have rightly alerted us to the risk associated with herbal medicines.1 This is necessary and important. But the more important question probably is-do the risks of herbal benefits outweigh their potential for harm? Therefore I will try to put herbal medicines into context and consider the benefit they might bring.
The potential benefits of herbal medicines could lie in their high acceptance by patients, efficacy, relative safety, and relatively low costs. Patients worldwide seem to have adopted herbal medicines in a major way. Survey data from the United Kingdom show that herbal medicine has been tried by about 30% of the British population.2 The associated out of pocket expenditure was estimated to amount to £31m (US$47.7m; €45m) in the United Kingdom2 and £1300m in Germany.3 Herbal medicines are used predominantly for minor and self limiting indications, with respiratory tract infections heading the list.3 But even for those conditions