Hot-selling herbs including ginko, garlic and St. Johns infuse the debate on FDA standards on remedies.
		USA TODAY file

But new research on many dietary supplements is conflicting. And even if some of the health benefits are true, it is difficult for the consumer to determine the right dosage or to figure out the differences between brands on the market. (Related item: Research on hot-selling herbs)

Part of that problem may be solved if new rules proposed by the Food and Drug Administration take effect in a year or so. The rules would set standards for making and labeling dietary supplements so consumers can make more informed choices.

Herbal remedies have been widely used in other countries for centuries, and the products enjoyed a surge in popularity in the USA during the late '90s. Sales of herbal supplements tallied $4.18 billion in 2001, up from $4.12 billion in 2000, according to the Nutrition Business Journal, an industry newsletter.

Still, herbs have been surrounded by controversy recently. Some studies have shown that the products aren't effective. And ephedra, promoted as a weight-loss aid, has been linked to health problems, including heart attacks and strokes. It also has been linked to a number of deaths.

So are herbal products safe and effective?

"In general, the record clearly shows that herbal products are relatively safe," says Mark Blumenthal, founder of the American Botanical Council, a research and education group that supports responsible use of supplements.

A lot of research has been done that has shown the herbs are effective for various conditions, he says. For instance, he says, there is good evidence that saw palmetto helps symptoms of benign enlarged prostates, a condition called benign prostatic hyperplasia, which causes urination difficulties.

But others say the answers on the safety and effectiveness of herbs aren't in yet. "We're still trying to figure out what these herbs do and what they don't do," says David Schardt, senior nutritionist with the Center for Science in the Public Interest, a consumer group based in Washington, D.C. "It's clear they have some biological effect, but we really don't have a handle how significant that effect is."

Herbs under the microscope

Many studies have raised questions about the effectiveness of herbs. For instance, St. John's wort is said to ward off depression, but one large study in the USA found that it was not effective in treating moderate to severe depression. Botanical experts say the product is intended for mild depression. A government-funded study on mild depression is in the works.

Garlic is supposed to lower cholesterol. One government agency reviewed the literature and concluded that garlic may lower cholesterol levels in the short term, but there's no evidence that it lowers cholesterol in the long term, Schardt says. Still, there are indications garlic may have other benefits for heart health, he says.

"We need good research," Schardt says. "It's good that the government is getting into it, because they have the resources to do these studies properly."

Maintaining the purity

Physician Tod Cooperman, president of Consumerlab.com, knows how much the quality of products can vary. His company has tested more than 700 products since 1999. Many products failed to meet the standards the company established after reviewing the scientific data on the herb. (Names of products that have passed are available to subscribers on the Web site.)

"I see a place for herbals, but people have to be careful because the quality is variable from one brand to another," Cooperman says. Some herbal products didn't contain enough of the active ingredients to be effective, and some products were contaminated with pesticides, he says.

Compared with vitamin and mineral supplements, herbals are the most ripe for problems because of the complexity of manufacturing them, he says. They need to have the right active ingredients that have been shown to be effective in clinical trials. They have to be made from the right species of plants and the right parts of the plants. And they have to be dried properly. Plus, they shouldn't be contaminated with metals from the soil or pesticides used on the herbs, Cooperman says.

"For the sake of the consumers and the manufacturers themselves, the quality of these products has to be consistently higher," he says.

Blumenthal says when the FDA eventually issues final manufacturing rules, "consumers and health professionals will have a higher level of confidence in all of these supplement products."