by Malinda Geisler, specialist, AgMRC, Iowa State University, malindag@iastate.edu.
Revised April 2008.
Overview
Medicinal herbs, some of the oldest medicines known to man, continue to be a major market and constitute a multi-billion dollar industry.
Herbs may be grown in a field, raised bed, greenhouse, containers, hydroponically or in the forest. Production requires a few acres of land. Herb crops may be sold wholesale, through farmers’ markets or through direct sales.
Herbs are a subset of botanicals, which are plants valued for medicinal or therapeutic properties, flavor and/or scent. They are sold in many forms: liquid or solid extracts; fresh or dried; tablets, capsules, powders or tea bags. Leading uses for herbal remedies include colds, burns, headaches, allergies, rashes, insomnia, premenstrual syndrome, depression, diarrhea and menopause.
Approximately 1,500 botanicals are sold as dietary supplements or ethnic traditional medicines. However, herbal formulations do not go through premarket toxicity testing by the U.S. Federal Drug Administration (FDA) to assure safety or efficacy. Since 1998, the National Toxicology Program has worked with the National Institutes of Health Office of Dietary Supplements, FDA, academia and others to define and implement research to address herbal medicines and their potential toxicities.
U.S. prescription drug sales were $286.5 billion in 2007. Sales of herbal and botanical products totaled about $4 billion in 2003, according to the latest figures available from FDA. Herbal and botanical products were part of the estimated $22 billion in annual dietary supplement sales in the United States.
The market for medicinal herbs is estimated at more than $3 billion, according to the Medicinal Plant Working Group. More than 60 million U.S. consumers take herbal remedies.
The aging U.S. population is a contributing factor to the increase in supplement sales. Baby Boomers are seeking a more holistic approach to their health care.
There is widespread use of supplements, especially among senior citizens, according to Moshe Frenkel, MD, an assistant professor in the Department of Family Medicine at the University of Texas Medical Branch at Galveston. Use of supplements among consumers over age 65 has doubled, according to Frenkel. Most of the supplement use is self-initiated and is done without physician approval. Frenkel says some supplements are okay, while others may have harmful effects.
With growing interest in medical alternatives, physicians and pharmacists are taking herbs, dietary supplements and other self-care options into account. For example, the American Pharmacists Association published the 15th edition of the Handbook of Nonprescription Drugs in April 2006. The textbook includes a comprehensive examination of all self-care options, including nutritional supplements and herbal medications.
Another concern is the possible drug-herb interactions. In one University of Chicago survey, up to 50 percent of patients scheduled for surgery were using herbal remedies that might have caused surgical complications if their physicians were unaware of the use.
Sources
AphA Publishes 15th Edition of Handbook of Nonprescription Drugs, American Pharmacists Association, 2006.
Dietary Supplements: The Latest Trends & Issues, Nutriceuticals World.
Dietary Supplements Overview, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, 2001.
Dietary supplements should spur doctor-patient discussions, Texas Medical Association, 2005.
Gottlieb, Scott, MD, Deputy Commissioner for Medical and Scientific Affairs, Food and Drug Administration – Annual Generic Drug Forum, 2006.
Herbal Therapeutics: The Top 12 Remedies, Emergency Medicine.
Herbs and Spices: Hot and Healthy, Food Product Design, March 26, 2008 - A number of herbs are under investigation for their health benefits.
Nature's Healing Pharmacy, Green Medicine, Medicinal Plant Working Group, Plant Conservation Alliance.
Some herbal teas could cause liver difficulties, Your Health Information, 2005.
U.S. Drug Sales Grew at Slowest Rate Since 1961: IMS, March 12, 2008.