10.10.2007

Custom herbal formulas just don't work

There's new research out that attempts to answer the question of whether individualized herbal blends, as formulated by a practitioner, are better than single standardized herbs. I'll just skip right to the editorializing bit, because it's so well-reasoned and balanced:
This study sets a new benchmark for the tailored approach: not only must herbalists demonstrate that individualised treatment is superior to placebo, they must also
show, for reasons of cost and safety, that it is superior to standardised treatment. Claims by herbalists who use the individualised approach that their practice is evidence based are disingenuous; this is because evidence supporting the use of herbs for any indication has come almost entirely from the study of single, standardised herbal extracts, not from studies of individualised herbal medicine using combinations of several or many different herbs prepared from inherently variable raw plant materials. The paucity of data supporting the effectiveness of individualised herbal medicine, and the important safety concerns associated with this particular form of phytomedicine, should be taken into account by policymakers
concerned with the regulation of practitioners using this modality.
Overall, the results of the three studies included in this review do not provide support for the use of individualised herbal medicine in any indication.
So there you have it. Custom blending of herbal formulas just doesn't work.
This study is really just a research project where the authors selected 3 randomized, controlled trials from over 1,300 pubmed results. The trials covered Western herbs for osteoarthritis of the knee, Chinese herbs for irritable bowel, and Chinese herbs for chemotherapy support (this last one was terminated early due to difficulty recruiting subjects). With such limited results, why do the authors choose to call for increased regulation of herbal practitioners, rather than more, better, research?
Perhaps because Ed Ernst is at the helm. Jonathan Treasure has been following this man's career for the last little while, and the history is pretty interesting (his herblog reviews this latest study fully for your pleasure, although it comes with an 'adult language' warning). To me, it's just another fairly immature and certainly non-productive use of research time and money. In this climate of diversification, increased government worry and oversight, and the grassroots integration of effective, individualized herbalism into the modern medical system, Ernst's editorials may actually be irresponsible, too. I wish someone paid me a lot of cash to tool around pubmed with an agenda.

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