"So Eric, if I don't embrace EBM unequivocally I am hostile to it, but if you criticize herbals you are not?"

No, I think you still misunderstood what is meant by EBM. You seem to be equating it to mainstream medical practice in general or the "pharmaceutical industry" (??), and viewing herbalism as something apart from it. A certain amount of herbalism falls under evidence-based medicine, and I certainly support that part, as well as using principles of EBM to evaluate the remainder.

As to side effects of drugs, I think the point is clear enough. Effective drugs which have marked effects on human physiologic reactions will by their very nature be more prone to side effects. Antibiotics which are powerful enough to vanquish life-threatening infections may be strong enough to damage healthy human tissue; the benefits have to be weighed against the risks. To cite a herb sometimes used against infection; garlic has a much milder mode of action than, say, vancomycin, and without significant side effects in most cases; on the other hand it will be useless against the serious cases of infection for which vancomycin works well.

I did not imply that you haven't had success using herbs.

Science is the worst method of discovering the truth...........except for all the others

It's really amazing what early physicians would do to their patients prior to EBM becoming a standard of Western medicine, like bloodletting.

Some say that Chinese herbalists were the first to utilize EBM although that wasn't a term coined until the early 1990's.

Florence Nightingale was a big contributor to EBM. She provided the evidence to skeptics that cleaning the filthy hospitals would reduce sickness and that having trained nurses would prevent deaths.

Evidence Based Medicine has been a wonderful advance in the treatment of patients as there is a lot less guesswork involved.

The question remains, what constitutes as evidence? The population on which things are tested, and the results may not be representative of all the studies that are completed on a given topic (published and unpublished) or may be misleading due to conflicts of interest.

That aside, I think herbalism is very evidence based, just not defined by the same standards as modern proponents of the theory.

Florence Nightingale, Ignaz Semmelweis, Louis Pasteur, or any of the well-known pioneers of advances in sanitation and/or infectious disease would have welcomed modern standards of EBM, and in fact used a form of it in their work. After Nightingale began working at a military hospital in the Crimea in the 19th century..."It is directly through her thorough observations that the association linking sanitary conditions and healing became recognized and established. "Within 6 months of her arrival in Scutari, the mortality rate dropped from 42.7 percent to 2.2 percent"."

Note the part about "thorough observations", which sounds comparable to the collection of detailed clinical evidence by practitioners with clinical expertise that is a part of modern EBM. She did not rely on folklore, hearsay and testimonials to acquire her knowledge and save lives.

"The question remains, what constitutes as evidence? The population on which things are tested, and the results may not be representative of all the studies that are completed on a given topic (published and unpublished) or may be misleading due to conflicts of interest."

There are different types of studies that can be published, ranging from simple case reports all the way to large scale, well-conducted double blind clinical trials, which (especially when repeated with the same results by different researchers) form a gold standard for scientific research. Medical researchers are constantly refining our state of knowledge, not content with a static body of beliefs that have for the most part never been rigorously tested (as is the case with herbalism in general). The scientific community (including respected medical publications) as you know has been implementing more stringent policies to identify and publicize potential conflicts of interest. I would hope that the journals that publish reports about botanical drugs are planning to adopt similar standards.

So, will the research arm of EBM always get things right the first time, and always be 100% free of bias? Nope - but science is continually self-correcting and our knowledge improves constantly. Some users of alt med see this debate and constant change as a weakness*. The most astute know that no rigid set of beliefs is immune to challenge and that re-examination of medical practices is key to discarding useless or harmful procedures and developing the best possible ones to assure the best outcomes.

*I've actually heard chiropractors proudly announce that their beliefs are unchanged since the days of Daniel Palmer well over a century ago. ;)

Eric, are you speaking to me when you write "Note the part about "thorough observations", which sounds comparable to the collection of detailed clinical evidence by practitioners with clinical expertise that is a part of modern EBM. She did not rely on folklore, hearsay and testimonials to acquire her knowledge and save lives."?

Because that is what I was saying! Florence Nightingale was one of the first in modern days to use statistics and compile evidence to prove her theory of sanitation and its connection to disease reduction. She has been called a fore fighter to the EBM movement. She did not rely on testimonials? Who is to say? She had to get her theory from somewhere. She may have heard it from her nurse friends. She may have heard it from her mother, aunt, sisters. She's just the first to show evidence on which to base her theory. She also proved that births at home were less dangerous simply because homes were kept cleaner than hospitals at the time.

Had she not provided evidence that trained nurses were more capable than untrained nurses, and that having trained nurses would reduce the death rate, would the rate of death from those nurses go up or down? No. But because of her research more nurses were trained and the death rate went down.

"Medical researchers are constantly refining our state of knowledge, not content with a static body of beliefs that have for the most part never been rigorously tested (as is the case with herbalism in general)."

Herbalism has been rigorously tested!!! Where do you think aspirin came from? Most drugs come from nature, and from self-studies over time that result in the masses knowing if you chew this bark your pain will go away. Not the most effective, as it will also eat your stomach lining and who wants to chew on bark anyway... but refining that knowledge is another step in our evolution.

Being able to prove something is effective is wonderful and necessary for treatment. But the ways in which things are tested, and the population on which its tested and the people who test it can also skew the results. Just look at the last major testing on homeopathy. The lab assistant was biased in favor and once they did blind testing all positive (in favor of homeopathy) results went out the window.

"(Nightingale) did not rely on testimonials? Who is to say? She had to get her theory from somewhere."

A theory is only the first step. As the Wiki link relates, her thorough observations were a key step towards proving her theory. And that's how EBM essentially works - a theory undergoes rigorous research evaluation and trained clinical observation before it becomes accepted.

"Herbalism has been rigorously tested!!! Where do you think aspirin came from?"

It was invented by a German chemist, Felix Hoffman, in 1897. The initial use of salicylate, of course, was in preparations of willow bark, but the highly effective and (relatively) safe preparations we use today for pain, fever, to prevent blood clots etc. are based on research and clinical trials, some of which continue today. For every drug like aspirin though, there are lots of herbal remedies (apple cider vinegar, anyone?) that claim to solve long lists of health problems but have not had any kind of rigorous study to back up the claims. Much research has been done and more is occurring, and I anticipate that some folklore herbalism will be borne out; a much larger percentage will be found to be highly exaggerated, false, or prone to toxicity or other problems.

"But the ways in which things are tested, and the population on which its tested and the people who test it can also skew the results."

See my last post.

Some herbs are sold in right along with regular medicines esp in Germany. According to a friend that lives there they are very common and have regular testing for strength etc. He was surprised that we did not have the same type of system. Perhaps other readers that have been in Germany can confirm. He is from the former East German area and perhaps that area is still following presplit practices.

When we lived in West Germany many years ago I heard that herbs were prescribed and sold just like other Rx drugs. I did not go to German Doctors tho so didn't have first hand knowledge or the advantage of this system.

"The question remains, what constitutes as evidence?"

This is the question isn't it. It seems to me on this forum there are some who believe that double blind scientific studies are the only answer to this.

IMO anecdotal evidence, clinical observation, and personal experience combined can often provide evidence of the usefulness of a treatment. While the placebo effect is very real, I doubt it works 100% so many testimonies of an effect might be evidence of an actual effect.

I think Florence Nightingale was just an intelligent woman who did not fear change and who was not lazy. It should have been apparent to all Doctors in those days that filth was not healthy and washing your hands between patients made sense. However they were too weighed down by tradition.

Many years ago an MD told me that if ASA were to go thru clinical trials it would not pass. However, it has been accepted as a safe drug for so long that it is deemed safe.

There have been studies which show that the attitudes of the scientists involved had an effect on the outcome of the study. Not that they deliberately influenced the results but that in some way the results were affected by their attitudes. Anyone want to get into woo-woo physics? ;-) Scientists have stated that most physics books are out of date as the theories are changing so quickly. I wonder if the same thing happens in medicine, the extent of it, and how it affects EBM studies and treatments.

While science is continually self-correcting I think that once something has been shown to be of value under EBM it is somehow protected from further evaluation and it will be sometime before it is challenged and perhaps corrected. This is why I do not accept everything said at face value. I have seen too often that many ideas/treatments which were said to be valuable were later found to be not only of little value but dangerous.

Goshen, I looked under wholistic kidney stone treatments in Google...hope you will call your doctor if this doesn't help.

A lot of people do not realize this, but Medical Assistance (for those under 65) or Medicaid are always available to people whose medical expenses go severely over their income.

If you need to be hospitalized again, be clear with the hospital that you are already under water with medical bills, and that they MUST help you to apply for MA.

A lot of agencies and institutions are being a lot more helpful under the new president than formerly...good luck with this.

Here is a link that might be useful: Earthclinic.com

"It seems to me on this forum there are some who believe that double blind scientific studies are the only answer to this."

I've not seen anyone say this. If you look at the definition of EBM listed in a previous post, it refers to both systematic research and knowledgeable clinical observation as being necessary, and not that double blind studies are the only answer. There are cases where it is not ethical or practical to conduct double-blind studies (for example, no one would sanction a study in which people who suffer cardiac arrest are treated two ways - one, do nothing, or two, conduct advanced cardiac life support according to modern protocols, and see which group had better survival).

"While science is continually self-correcting I think that once something has been shown to be of value under EBM it is somehow protected from further evaluation and it will be sometime before it is challenged and perhaps corrected."

No, nothing gets grandfathered into semi-permanent use under principles of EBM. New ideas and studies are constantly shaking up ways of thinking about problems.

"It should have been apparent to all Doctors in those days that filth was not healthy and washing your hands between patients made sense. However they were too weighed down by tradition."

Are some herbalism advocates too weighed down by tradition to accept that many of their treatments are ineffective, superseded by better therapies, or too hazardous to use? Or are they willing to accept evidence-based change?

"There have been studies which show that the attitudes of the scientists involved had an effect on the outcome of the study. Not that they deliberately influenced the results but that in some way the results were affected by their attitudes."

We often see emphasis by alt med advocates on perceived faults and missteps by scientific researchers, as though instances of error or bias somehow negate the whole system.
To look at a somewhat analogous situation, take law enforcement. Along with the many instances of crimes prevented and solved by police, and lives saved through police action, there are well-publicized instances of police using excessive force or taking graft. When these failings come to light, do we say "Get rid of the police, let's take care of crime ourselves"? Well, a few out on the fringes might, but nearly everybody realizes that 1) police malfeasance will occasionally occur, 2) we need to maximize professional training and standards to minimize difficulties, and 3) have proper oversight to combat problems when they occur.
Choosing anarchy is not an option.

Anarchy is when every scientific/medical proposition is considered valid without regard to the facts, and whoever shouts slogans and testimonials the loudest wins the day.

With regard to the scientific method and medicine, it's like Brandon said earlier. It doesn't work perfectly all the time - it's just vastly preferable to every other alternative. And it's constantly improving itself and increasing our store of knowledge.

Here is a link that might be useful: Testimonials, science, and how not to be fooled

Sorry folks, I don't see a single person address the cost of health care. Do all of you have your heads in the sand and don't know how bad our economy is basicaly due to the high cost of health care and not only to the cost of housing. Most of you cannot except that possibly you will be in the same boat within a year.I hope you wont but chances are you will be. Than an asprin might seem like a lifesaver. See you on the way down. Sure hope not.

Cost is one of the many reasons to embrace evidence-based medicine. By emphasizing the use of truly effective therapies, EBM leads to the discarding of wastefully expensive modalities. If certain types of surgeries, drugs, supplements and various treatments don't make the grade, government and/or insurers will not fund them and more money will be left to spend on effective health care.

It'll be challenging to fight all the lobbies for outmoded or substandard treatments, but it needs to be done.

hmm - I was raised to play both ends off the middle in a world where the 'disinfecting' ingredient in Listerine is a herbal extract called Thymol, digitalis is both a heart drug pill...and a favorite garden flower, and the greeks were right about electric eels and certain blue-green molds, and wrong about some other stuff...

but then, I don't 'get' the religon-vs-science arguements either - I see them both as needing the other to provide relevance and context.

I do see a difference between profit-driven health care economics, the world of medicine and surgery, and the whole idea that health care should revolve around promoting and maintaining health... the latter two are sides of the same coin, the first is just another form of greed.

I love that now there are chemical confirmations of active ingredients in many herbs, and the increased dialog on the various subjects...

but honestly? evidence doesn't do any good if you're not looking for it, and willing to compare different sources - whether you're talking about herbs, dermatology, or pizza.

Chinacat:

"...but honestly? evidence doesn't do any good if you're not looking for it, and willing to compare different sources - whether you're talking about herbs, dermatology, or pizza."

LOL. Isn't that the truth!!!

Well it's been awhile but have turned up again. Been a rough couple of months. Passed a couple of kidney stones. Still alive. Amazing how much pain the human body can stand. Decided to see a doctor a couple weeks ago.My mind decided to go ahead and pass the stone before hand. Saw doctor anyway. He's more concened about my heart. Since i've no fear of death. i just giggled at him. As stated above "Evidence does no good if you're not looking for it."

Have to argue a little about FN being the first to push washing hands between patients tho. Nostradamus was the first that i know of during the plague.
eric, i really hope you were'nt really pushing the American police State as a shining example.MSNBC had an article recntly that America has more people in jail or prison than any other country in the world,bar none. Every 1 in 10 people are in jail or prison at any one time and most are considered political prisoners not criminals. Hopefully the President will address that as well as the health care mess and the Economy.
Thanks for the referances however ER treatment can be free but longterm care is not to be had. Even University care from students is not free. I honestly hope none of you will be in such a position.
Hay on the upside it is spring. The flowers are blooming.
I'll be looking into the more non aggressive kidney stone treatments. I am doing great now. It's a beautiful world.

Glad you're feeling better.

I'm a little confused about the "American police State" and what that has to do with evidence-based medicine. Though if we were all in jail there'd be free medical care, of sorts.

I don't think Nostradamus was the first to call for hand-washing between patients, though I hear he had a vague prediction that it would happen some day. "A rushing river flows through the continent under two suns, and a great leader is cured." ;)

Goshen, I am really glad you're doing better.

I don't know who said FN was the first to push washing hands. I was saying that other people have pushed sanitation but she was the first to gather evidence and present it in order to get people to change their behavior. (and she probably had to gather evidence because no one would believe a female and a nurse in those days without it) Hence the "evidence based".

Eric, Goshen mentioned the police state because you mentioned it in relation to EBM and why it works. I agree with Goshen, probably a bad example:)

"To look at a somewhat analogous situation, take law enforcement. Along with the many instances of crimes prevented and solved by police, and lives saved through police action, there are well-publicized instances of police using excessive force or taking graft. When these failings come to light, do we say "Get rid of the police, let's take care of crime ourselves"? Well, a few out on the fringes might, but nearly everybody realizes that 1) police malfeasance will occasionally occur, 2) we need to maximize professional training and standards to minimize difficulties, and 3) have proper oversight to combat problems when they occur.
Choosing anarchy is not an option. "

I suppose one would have to believe we live in a "police state" to make that leap of, um, logic.

" I agree with Goshen, probably a bad example:) "

Pick any field where adherence to scientific principles is considered important. In another thread someone who identified himself as having a degree in engineering was suggesting that testimonials were enough for him. I don't think he responded to a question about whether he'd feel safe going over a bridge whose construction was based on testimonials rather than sound design. There was a tragic bridge collapse in Minnesota because of faulty design. Because of that would you discard the whole idea of designing bridges for proper load and wear, and go by untested recommendations?

Usually weather forecasters are good at predicting hurricane strength and destination. Sometimes the forecasts are less than completely accurate. As a result, would you rely on an almanac or the reading of entrails to tell where and when a hurricane will hit?

As noted, basing medical therapy on sound scientific/clinical evidence doesn't guarantee a perfect result. It just works vastly better than any other system.

Eric, are you saying the police force is based on scientific principles? I still think this is a lousy example, no matter how you twist it and shouldn't be used to compare the effectiveness of EBM. Where are the test studies of alternate means of "controlling" a population?

I'm not sure which thread you're referring to about the bridges, nor do I want to go looking. I agree that clinical evidence is important but will not discard herbalism simply because double blind studies have not been done on every remedy. It's wonderful when they can work together and that we have a choice of which to use for our problems.

I agree that herbalism should be considered complementary to "mainstream medicine", and that physicians who are knowledgeable about what herbs their patients are taking can help optimize their therapy and avoid problems.

Not sure what the posted link has to do with herbalism, though.

The thought of doing away with the "less effective" concerns me a bit.

Some herbs are less effective, but more affordable and available to some people.

Additionally, "less effective" for who? Many studies have only been done for males or certain age groups. Additionally, modern medicine has conveniently ignored, for a long time, the differing effects of medications and treatments on people of different genomes.

Evidence-based medicine doesn't imply that all "less effective" drugs be eliminated, but that we shouldn't rely on useless ones.

Intresting debate. However for a better debate How would it be for eric_oh to take the side for using herbs and everyone else take up for Western Medicine.

Am i wrong? This is an herbalism forum that i've been reading all day. I just joined BTW. spent part of the day on the vegatable forum. They agreeably talk about growing veggies.

Poor Eric seems so defensive about the medical system and jumps at the chance to be contentious about anything herbal. I wonder if he by chance has had a bad experience with something herbal and is out to get all herbalists or herbs in general.

BTW Nostradamos was a doctor and went through the French countryside caring for people with the plague and preaching that people should wash their hands between caring for patients.

Western Medicine is a boon to mankind but it never would have come about without herbalists to show the way.plus the ancient medicine men who experimented with surgeries. Modern doctors simply did not arise one day and say "I'm superior and know it all." They learned slowly on the backs of many men and women, who came before them and learning the hard way.
I can honestly say i've never met anyone who instantly knew all there is to know about medicine.Even any graduate from a medical school.

Eric, Lucy, and myself are not against herbs, we are just against ineffective treatments. Efficacy is important to us.

"This is an herbalism forum that i've been reading all day. I just joined BTW. spent part of the day on the vegatable forum. They agreeably talk about growing veggies."

Do newly registered posters over there start out by criticizing long-time forum participants, or does the agreeable atmosphere come about through civil discussion of forum-related topics?

>> Eric, Lucy, and myself are not against herbs, we are just against ineffective treatments. Efficacy is important to us.

You are not only opposed to ineffective treatments, but also to effective treatments which simply have not been documented in the style you demand, to the degree which will personally convince you.

help! the antagonism is stifling!!!

even on the hot topics forum people disagree cheerfully. i think something is rotten here...

It doesn't even have to be cheerful, just civil (post #2 in this thread is a good example of the type of post it is pleasurable to read, whatever one's viewpoint is).

As indicated previously, EBM is not a creation of individual posters in this forum intended to stymie herbal remedies. It's an accepted and increasingly valuable way to optimize medical treatment of all types for the benefit of patients (see the posted link for details). When a particular therapy does not measure up by evidence-based standards, useful responses include getting the necessary evidence or, if it can't be found, considering whether to switch to proven treatment.

BTW, my limited exposure to the Hot Topics forum suggests that it is not always sunshine and lollipops there either :)

"You are not only opposed to ineffective treatments, but also to effective treatments which simply have not been documented in the style you demand, to the degree which will personally convince you."

So is everyone. Unless you have a personal conduit to higher truth (if you say yes I will suggest you see a shrink) then you are relying on something you would call evidence. The difference is that I do not trust anecdotes. Any form of evidence that can equally well prove two diametrically opposed points of view isn't worth much to me. If I ran around spouting anecdotes or anecdotal traditions about how an herbal remedy was dangerous you would call me out on it and demand that I provide a study, I just ask for the same standard of evidence everywhere.

Sorry guys, Thought i was just talking like everyone else here. May i ask for a scientific viewpoint then?
Lets say i'm a medicine specialist from the island of Java. I have a man come see me with a plant that his brother found and gave some to everyone in his village who had diarrea and vomiting except for 5 people who refused to take it. The next day everyone who took the plant was completely well however the 5 who refused it were much worse and than died. Now a question for Eric and Brandon and everyone else of course. Say you came downwith the same illness on the same day. Would you take the plant or insist on doing double blind research before taking the plant. It's a question to be debated nicely if you want. What if you were really in this situation? What would you do? It is possible one day you could really be in this situation. What would you do? What would be the commen sense thing to do? I know what i'd do. I'd take the plant in a heartbeat.
Now does anyone think this is an ugly unfair situation to ask? Or is this a good situation to debate nicely?

I would take the plant because i saw people who took it get well and people who did'nt die. I have a small spark of comman sense that tells me the odds are overwelmingly in my favor to take the medicine right then and not wait for someone to complete a double blind study. specially since those who did'nt take it died.

If 2 men died who took this plant and 2 got better who did'nt take the plant i'd still figure the odds were on my side.

I considered using a pill for the plant but decided this was an herbal forum and the plant was more suitable.Should anyone want to use a pill. Well dogone it have at it. ;)
Again i hope everyone takes this in the friendly spirit given and accept my apoligies for any insult i may have inadvertantly given previously.

In an extreme situation with no trained medical help available I might have to take a chance on something unproven. If I was on a remote tropical island and got bitten by a venomous snake known to cause fatality in a very high percentage of cases, and the only help around was from the local witch doctor who had a magic herb and could cast convincing spells, I'd probably go for it. But that is not the type of situation commonly encountered, in life or in this forum.

Usually that sense of urgency and extremely limited options does not exist. Here, typical questions might be "I want to lose weight and will this herbal mixture help me?" Or, "Can I burn off what I think is skin cancer with this herbal salve?"

In such instances there are other, better options and one can (and should) rank proven efficacy and safety highly in making a health care choice.

Oh, and as to enthusiastic testimonials, let's take dral's hypothetical situation in Java and expand on it. Suppose a person did approach the doctor with a story about a wonder healing herb that resulted in a number of very sick people getting better. The doctor investigates and finds the man's brother has a website listing positive testimonials. An epidemiologist looks into the matter further, and finds that of 30 people with similar symptoms, half did not take the herb and all but three of them got better with rest and fluids. Of the half that did take the herb (along with rest and fluids), all but four got better (the herb promoter explains that those four should have gotten better, but had a bad attitude or didn't take the herb properly). The epidemiologist concludes there is no evidence that the herb works for this illness, and that controlled studies may be desirable. The herb seller goes on adding positive testimonials to his website and selling the herb over the Internet.

That's a hypothetical with real-world implications. :)

OK! Lets say the FDA comes along and investigates the epidemiologist and finds out the good doctors brother just happens to own a company that sells a pill that will improve the symptoms though nobetter than the plant and can afford to pay for the forthcoming study and the scientific results. Greed and corruption happen on both sides of the fence in todays society. I'm sorry to say. Should both sides be as heavily regulated as the other and who will regulate the regulaters.

When one gets more complicated than the simple situation first posted. There are too many variables to say "This is ultimate truth" on any side. Thus any one individual can never be sure and may as well just toss a coin unless he personally knows the reliability of the researchers.Be he herbalist or Doctor. A pill never acts exactly the same on any one person in a group neither does an herb.

"We can't trust anybody so let's listen to the people with the most appealing testimonials" is a recipe for disaster.

Yes, there are ethical lapses in all walks of life. But that doesn't mean we can afford to disregard all the advances scientific research has brought us, or to toss out the rigorous methods that made those advances possible.

There apparently are people who are willing to "just toss a coin" when it comes to their health, and that's their prerogative. Lots of us, before we take a pill, supplement or raw herb want good evidence on its safety and efficacy.

And that's where evidence-based medicine comes in.

Disclaimers by any other name = evidence of no absolutes:
(1) see long lists of possible side effects accompanying pharmaceuticals
(2) see FDA dodge on packaging of herbs (ie: "not intended to diagnose, treat ...)

First of all, the correctly described "dodge on packaging of herbs/supplements" is not attributable to the FDA. It's a ploy used by herb/supplement sellers to stay within the boundaries of DSHEA. That's the legislation passed by Congress that lets these companies get away with dodgy health claims without needing to supply evidence for them. The FDA has largely been taken out of the equation.

Listing of possible side effects from prescription drugs (whether common or rare) represent disclosure to clinicians and patients made possible by clinical trials, a form of evidence-based medicine.

The arguments that "there are no absolutes" and "every patient is different" are used by alt med advocates to try to denigrate scientific research (excepting of course research that seems to support their claims). These assertions are at best a gross exaggeration. With proper clinical testing of drugs (herbal or non-herbal), we can know whether the vast majority of people taking them will experience significant benefits or some other outcome. Individual side effects may vary - but we are all Homo sapiens and there are not such marked differences among us that we can never hope to predict how a clinically tested drug will work in the general population (clinical testing can be and has been expanded to include diverse groups that include both sexes, different races and children as well as adults).

It never ceases to amaze me that the proponents of "no two people are alike, what works for one may not on another, you have to try it to know for yourself" apparently expect us to sample all manner of different non-pharmaceutical drugs/supplements on an experimental basis. We're supposed to be guinea pigs for unproven remedies and have lots of money to shell out on things that have no reasonable expectation of working.

Thanks, but I'd rather not take these kinds of chances with my health or my wallet. Let me see that evidence for efficacy and safety before I take any drug or supplement.

Found an interesting blog that discusses EBM from a British perspective.

As evidence that there's increasing interest in evidence-based herbalism among patients and practitioners, here are a couple of recently published books on the subject.

Eric I am new to this forum too. I came here to learn about herbs so I can get back into it and even start growing them in my garden.

I really do not want to offend you. Just looked how long you have been a member and seen that you like perennials and tree's

Can I ask you why you are interrested in herbs? Sorry if it has been answered or written somewhere already. I am just starting to work through the threads and somehow you are in each one of them rofl.

simplemary are you into holistic healing?

Lucy

Here's a recent thread in which I and other posters talked about why we like to post here.

I've actually participated on GardenWeb since 1996 (before membership was required) and began posting on the Herbalism forum shortly after it was added to the site (it's been ten years or so).

Since you like to grow herbs you may also find the separate Herbs forum of interest.

Eric thank you for the link. Gave me a little more insight to this forum and some folks.

Also reminding me that I can also look up at the Herbs forum. But my main intrest is here right now and the day only has so many hours and only so much time to play on the computer instead in the garden.

Thanks Lucy

I actually agree with Eric that that's not a dodge on packaging by the FDA. Since anyone can claim anything on a package it's good to know what has and what has not been tested and found accurate by the FDA (even if they aren't the most stringent agency out there!). Otherwise anyone could say anything on the box "cures cancer" or "makes you beautiful" and consumers would believe it to be true because the box says so.

But... I also have really big issues with the long list of side effects. For me personally I'd rather try (first) for, example, sleep issues:

aromatherapy, massage, yoga, chammomile tea... etc... (ie things that have not perhaps been clinically studied and double blind tested)

than say, Ambien, which may cause me to do things while sleeping that I have no memory of the next day, may cause severe allergic reaction, or a host of other side effects like:

Daytime drowsiness
Dizziness
Diarrhea
Difficulty with coordination
Lightheadedness
Dry mouth
Heart palpitations
Tiredness
Inflammation of the sinuses (sinusitis)
Unexplained rash
Abnormal dreams
# Suicidal thoughts
# Confusion
# More outgoing or aggressive behavior than normal
# Strange behavior
# Depression (see Symptoms of Depression)
# Hallucinations (seeing, hearing, or feeling things that are not really there)
# Agitation or restlessness
# Fainting
# Slurred speech
# Coordination problems
# Vision changes

I would rather go by the low-dose, herbal knowledge that has been passed on and is based on historical evidence rather than clinical evidence because all the clinical evidence tells me is that in this case, if ambien were my only choice I think I'd rather have insomnia.

I appreciate evidence-based medicine principles and think they are good. But I don't think the resulting medicines are necessarily better. Having standardized methods for determining effectiveness of drugs is great, prevents a lot of unnecessary deaths and injuries and enables a more comprehensive idea of what truly does and doesn't work.

But, if chamomile tea does help me sleep, and there is no proof yet from the scientists, does it make the tea work less? Perhaps it is the placebo effect. Personally, if it is placebo, and there is not harm done, no outrageous cost, I'd rather sip my tea than pop a pill. Relying on testimonials for minor health issues is not dangerous if done with prudence (as with any health recommendations followed, including those from a licensed physician). The answer is that no one knows the answer yet.

Going back to the recent thread on the teenager who was having problems with insomnia and whose mother wanted to know what herbal remedy to use, there was a general consensus among those of us responding that personal/school issues and lifestyle questions needed to be looked into before any sleep aid was recommended. And it makes a lot of sense to try non-drug modalities before going for any medication/supplement (which, if it works, is likely to be habit-forming).

It seems to me that this was mentioned before, but providing a comprehensive listing of a drug's possible side effects (which often looks scary, especially if you are unaware of the frequency and severity with which these may present) is a part of evidence-based medicine.

"...if ambien were my only choice I think I'd rather have insomnia."

You'd likely feel differently if you were plagued with insomnia. I've known people with this problem for whom it was a major health/quality of life issue, and after trying various approaches they'd sooner deal with the possibility of side effects and habituation than go through an endless succession of nights with poor quality or no sleep.

"And it makes a lot of sense to try non-drug modalities before going for any medication/supplement (which, if it works, is likely to be habit-forming)."

Exactly. Which is why a lot of us try herbs prior to medications. I don't consider chamomile a drug or a supplement, nor do I consider most herbs drugs or supplements.

I have had insomnia. It's horrible, and anyone who can get relief however they can get relief is ok with me. But for me, personally, I'd rather have insomnia than take Ambien. Personally. Not recommending this to anyone. As you said, looking at lifestyle is the first step.

If one is overweight they should look into diet and exercise prior to taking a pill or whipping up an herbal concoction. But for me, my first step is diet/exercise/stresses/lifestyle. My second step is balance/deficiencies. My last step is Western medicine.

Unless I am about to get a migraine, which happens once or twice a year. Then I pop two pain relievers and am a very happy camper.

Why do you think that Herbs aren't medication?

Well... I don't consider yogurt to be a medicine. I consider it food. Same with chamomile, mints, oregano, stevia, cinnamon, etc. I will take milk thistle (food) if my stomach is hurting prior to busting out the pepto-bismol (medicine). Epsom salts, also not medicine.

I guess I consider medicine to be things that are manufactured and altered. Herbs are not drugs. They are food.

Perhaps it's not scientific or doesn't agree with what others define as foods/medicine... but it's the way I think.

On the other hand, it's useful to consider herbs taken for medicinal use as medicine.

Food is something we ingest casually. Medications/drugs get more thought, including consideration of potential interactions and side effects, not to mention whether we need them in the first place.

I don't ingest anything casually, most of all food. I consider every little thing that goes in my mouth, comparing nutrition and trying to balance. (check out the Diet Club!) Honestly I don't think of medicines more than food. But I am lucky in that I do not have any that I must take, therefore potential for interactions is low. Other than the occasional strep throat outbreak there are no prescriptions on my shelf.

? Anybody see previous USA Surgeon General Dr. Kessler's published book implicating modern diet with addiction like neurochemical alteration ?

I didn't, but I believe it. I know several people who "can't live" without their fast food and soda pop.

I consider my eating to be very "clean". I eat mostly fruits, vegetables, whole grains, fish, cheese (aged, real cheese), and some beef/chicken/pork on occasion. I don't drink soda. I do drink red wine and vodka. My meals are simple and I don't eat processed foods often, although I do love a burger and fries sometimes.