The use of herbal preparations has grown faster than any other form of complementary/alternative medicine in the United States. Countrywide, sales exceed $150 million per year. Despite this widespread and growing popularity, medical researchers do not yet feel that we have an adequate database for their clinical evaluation.

The questions, of course, are 1) do they work? 2) do they work because we want them to work and believe they will (placebo effect)? 3) what are the risks?

There have been only a few randomized clinical trials, the evaluation methodology most frequently used be physicians to determine positive features, and side effects, of drugs. The results of trials of six herbals were reported earlier this year in the Annals of Internal Medicine.

Gingko:	may have some positive effect on dementia may have some positive effect on leg pain due to poor circulation there is questionable effect on memory loss the effect on tinnitus (ringing in the ears) is unclear
St. John's Wort:	may be somewhat effective for mild depression interferes with prescribed anticoagulants, oral contraceptives, anti-viral agents
Ginseng:	has not been shown to be effective for any condition has severe side effects
Echinacea:	weak, inconclusive findings regarding prevention, treatment of colds
Saw Palmetto:	reduces symptoms of benign enlargement of the prostate in the short term
Kava:	may be effective for short-term treatment of anxiety

The author, Dr. Ernst, pointed out "None of these herbal medicines is free of adverse effects. Because the evidence is incomplete, risk-benefit assessments are not completely reliable, and much knowledge is still lacking."

Because herbals are considered dietary supplements, the FDA has limited control over their use. Unlike prescription drugs, manufacturers do not have to prove that a product is safe or effective before it goes on the market.

USER BEWARE!!

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