Herbal medicine

Herbal medicine uses plants, or mixtures of plant extracts, to treat illness and promote health. It aims to restore your body's ability to protect, regulate and heal itself. It is a whole body approach, so looks at your physical, mental and emotional well being. It is sometimes called phytomedicine, phytotherapy or botanical medicine.

The two most common types of herbal medicine used in the UK are

• Western herbal medicine and
• Chinese herbal medicine

Some herbalists practice less common types of herbal medicine such as Tibetan and Ayurvedic medicine (Indian).

Many modern drugs are made from plants. But herbalists don’t extract plant substances in the way the drug industry does. Herbalists believe that the remedy works due to the delicate chemical balance of the whole plant, or mixtures of plants, not one particular active ingredient.

Western herbal medicine

Western herbal medicine focuses on the whole person rather than their illness. So the herbalist looks at your personal health history, family history, diet and lifestyle. Herbalists use remedies made from whole plants, or plant parts, to help your body heal itself or reduce the side effects of medical treatments. Western herbal therapies are usually made from herbs that grow in Europe and North America but also use herbs from China and India.

Chinese herbal medicine

Chinese herbal medicine is part of a whole system of medicine called Traditional Chinese Medicine (TCM). TCM includes

• Herbal remedies
• Acupuncture
• Massage therapy
• Traditional breathing and movement exercises called qi gong (pronounced chee goong)
• Movement exercises called tai chi (pronounced tie chee)

TCM aims to restore the balance of your Qi (pronounced chee). TCM practitioners believe that Qi is the flow of energy in your body, and is essential for good health. Chinese herbalists use plants according to their taste and how they affect a particular part of the body or an energy channel in the body. They usually use a mixture of plants.

Herbal medicine has been used for centuries to treat many different health conditions. As with most types of complementary or alternative therapy, people may use it to help themselves feel better or feel more in control of their situation. Herbal medicine is often promoted as a natural way to help you relax and cope with anxiety, depression and other conditions such as hay fever, irritable bowel syndrome, menstrual (period) problems and skin conditions such as eczema.

Herbal medicine is one of the most commonly used complementary and alternative therapies (CAM) by people with cancer. Some studies have shown that as many as 6 out of every 10 people with cancer (60%) use herbal remedies alongside conventional cancer treatments. There are many different types of herbal medicines and some of them overlap with foods. Commonly used plants include echinacea, St John’s wort, green tea and ginger.

There is information about why people with cancer use complementary therapies in this section of CancerHelp UK.

At your first visit, the herbalist will ask you some general questions about your health, lifestyle, diet and medical history. They will also do a physical examination, which may include

• Feeling your pulse (heart rate)
• Taking your blood pressure
• Examining your skin and nails
• Feeling your abdomen
• Looking at your tongue
• Looking in your eyes

The herbalist will then decide which remedies you need. They will usually make it while you wait. The remedy may be

• A tincture (a diluted alcohol solution of plant parts)
• Tablets or capsules
• Raw herbs that you take home and boil in water, to drink as a tea
• A cream or ointment for skin problems

Your herbalist is likely to recommend that you come back for another appointment about 2 to 4 weeks later. How long you continue seeing them will depend on why you are using herbal medicine.

There is currently no strong evidence from studies in people that herbal remedies can treat, prevent or cure cancer. But trials are looking into this. Some randomised clinical trials seem to show that some Chinese herbs may help people to live longer, reduce side effects and help to prevent cancer coming back, especially when combined with conventional treatment. But many of the studies are published in Chinese, and some of them don't list the specific herbs used. Some of these journal articles don't describe in enough detail how the studies were done. So it is difficult to know how reliable this research is and which herbs may be helpful. 

This section has information about the current evidence for herbal medicine 

• Preventing cancer
• Relieving symptoms or side effects
• Treating cancer

There is also information about recent evidence from trials.

Preventing cancer

There is no substantial evidence that herbal remedies can prevent cancer. But one German study reported in 2009  that women who used phyto oestrogens and black cohosh for menopausal symptoms had a lower risk of cancer than those who didn't. We need more studies to confirm this.

Relieving symptoms or side effects

There is some evidence that particular herbal remedies may help to prevent or relieve the symptoms of cancer or treatment side effects. Researchers believe there may be others that could help people with cancer. But we need more studies using these plants before we will know for sure. And we also need results from large clinical trials to show which herbs are safe to use alongside conventional cancer treatment. 

Treating cancer

Some plants or plant extracts have been found in laboratory tests to have anti cancer effects and have been turned into cancer drugs (such as Taxol from the yew tree). But there is no scientific evidence from patient trials that herbal medicine can cure cancer. We need to run large trials to find out whether some herbal products have anti cancer properties. Examples of herbal remedies that people have claimed can help to treat cancer are carctol and chaparral. But there is no evidence to support these claims. 

Recent evidence from trials

You can find information about some herbal medicine trials by typing 'Herbal medicines and cancer' into the search box on the NHS Evidence website. 

One review of 55 Chinese trials reported in 2010. It looked at trials using traditional Chinese medicinal herbs (TCMHs) to treat advanced or late stage stomach cancer. The review found the following

•  6 trials showed that TCMHs alone or combined with chemotherapy helped people to live longer
• 13 trials showed that TCMHs improved quality of life
• 10 trials improved the number of people whose cancers shrank or were controlled
• 3 trials showed that more people were able to continue with chemotherapy treatment if they took herbal medicines
• 1 trial showed that fewer people got low white blood cell levels
• 1 showed less nausea and  vomiting in people taking TCMHs
• 4 trials looked at a specific treatment called Huachansu and showed that people taking it were less likely to get low white blood cell levels due to chemotherapy

But the authors stated that most of the studies were low quality and they found no strong evidence that TCMHs improved quality of life or shrank or controlled the growth of the cancers. Generally the TCMHs also had no effect on reducing the side effects of chemotherapy, or helping people to live longer. Limited and weak evidence showed that people taking Huachansu were less likely to get low white blood cells due to chemotherapy. But Huachansu and chemotherapy did not shrink tumours more than chemotherapy alone. So we need larger, high quality trials to test whether TCMHs can help people with cancer.

Earlier research in China in October 2007 looked at a range of studies of herbal medicine for many medical conditions, including chemotherapy side effects. They found that some standard herbal medicines could be helpful, but remedies made up specifically for individual patients were not helpful.

Cochrane Reviews published in the Cochrane Library pull together the results of several research studies to see how well treatments work. One Cochrane Review looked at using Chinese herbal medicines to treat chemotherapy side effects in people with bowel cancer. Overall the evidence was not strong enough to prove either benefit or harm. Several other Cochrane Reviews are looking at using herbal medicines to treat symptoms or side effects of lung, breast, bowel and stomach cancer and cancer of the food pipe (oesophagus).

You can find information on evidence for the medical use of plants in the CancerHelp UK sections about

• Aloe
• Ayurvedic medicine
• Black cohosh
• Bach flower remedies
• Carctol
• Chaparral
• Echinacea
• Essiac
• Green tea
• St John's wort

You can also find information about some less commonly used plants in the questions and answers about complementary therapies section of CancerHelp UK. We also have information about the latest research into complementary therapies on the complementary and alternative therapies research page.

The American Memorial Sloan Kettering Cancer Centre website About herbs, botanicals and other products has clinical summaries on many different types of herbs and plant remedies.

Many people assume that because a product is marketed as natural or herbal, this means it’s safe to use. Some herbal medicines are safe but others can have serious and dangerous side effects

Some herbal medicines may interact with treatments from your doctor, including chemotherapy, radiotherapy, biological therapy or hormonal therapy. A review published by the American Journal of Clinical Oncology found that some common herbal remedies, such as garlic, ginkgo, echinacea, ginseng, kava and St John’s wort, can interact with cancer treatments.

Some herbal treatments may affect the way drugs are broken down by your body, or the way drugs are carried around your body. For example, information published by the US National Cancer Institute (NCI) suggests that St John’s wort can speed up the time that your body takes to get rid of the anti cancer treatment, imatinib (Glivec) by 44%. This could potentially mean that the treatment is less effective at fighting your cancer. Some herbal medicines may increase the effect of cancer drugs, meaning that you could be over treated.

Other examples include Asian ginseng and bilberry – they can interfere with some drugs and may increase the risk of bleeding after surgery. Some herbs can make your skin more sensitive to light and you should not take them during a course of radiotherapy. We need more research into how herbal treatments interact with cancer treatments.

There is information on the Medicines and Healthcare products Regulatory Agency (MHRA) website about

• The safety of herbal medicines including what you need to know as a consumer
• Herbal safety news, which has advice and guidance on taking specific herbs

The Medicines and Healthcare products Regulatory Agency (MHRA) has recently changed the law regarding the registration of herbal products bought over the counter in health food shops and pharmacies. Companies now have to meet quality standards and provide information about their product, including the exact content and dose of the product and how safe it is. It is important to use only herbal products that are registered under the Traditional Herbal Remedies (THR) scheme. Remedies that are registered under the scheme have a THR mark and symbol on the packaging. THR products have been tested for quality and safety. 

The Medicines and Healthcare regulatory Agency (MHRA) in the UK states that there is a big variation in how unlicensed traditional Chinese medicines are made. Some have been found to contain illegal substances and toxic herbs. These substances may not be listed on the packaging of the product. The amount of the active ingredient can also vary widely between products.

It is safest to buy plant remedies from a fully qualified herbal practitioner who is trained to work out which herbal medicines are appropriate for you. They can also trace where their herbs and plants come from. Lower down this page is information about finding a herbal therapy practitioner.

Each type of herbal remedy may have its own side effects. Some are safe to use and don’t have any noticeable side effects. But some plants are poisonous to humans and can have serious and severe side effects. Some herbal medicines may interact with your conventional cancer treatments.

Always tell your doctor if you are using any type of herbal remedy. If you feel worse or ill while you are taking herbal medicine, let your herbalist know as well as your doctor. It can also help to ask your herbalist for a list of all the ingredients in your herbal remedy. Then if you do have any side effects, your doctor will know what you have taken. Your doctor or herbalist will report the side effect to the Medicines and Healthcare Regulatory Authority (MHRA). The MHRA is the UK regulatory body that collects information about the side effects of drugs including herbal medicines. 

To find out about the side effects of individual herbal remedies, and possible interactions with other drugs, look on the American Memorial Sloan Kettering Cancer Centre website about herbs, botanicals and other products. You can also look at their section on frequently asked questions about herbs, botanicals and other products. It lists many herbal products you should avoid taking during cancer treatment.

This depends on which herbal medicine you want to take. It is important to check with your doctor before taking any herbal remedies if you

• Have any medical condition, including cancer
• Are taking other medicines (conventional, complementary or alternative)
• Are having radiotherapy
• Are pregnant or breast feeding
• Are due to have surgery in the next few weeks

Your first consultation with a herbalist will usually cost between £40 and £80 for an hour. Further appointments are usually shorter so are likely to cost less, perhaps around £30. You will also have to pay for the herbs you are prescribed. These costs vary from place to place within the UK. It is very important that you have your treatments with a qualified herbal therapist.

Currently in the UK, there is no single professional organisation that regulates herbal medicine therapists. Therapists can join several associations. They don’t have to join any by law, but most reputable therapists do belong to one of the useful organisations listed below. From April 2012 traditional Chinese medicine practitioners and herbal medicine practitioners will be regulated by the Health Professions Council, which will register them. 

The best way to find a reliable therapist is to

• Contact an organisation below and ask for a list of therapists in your area
• Ask the therapist how many years of training they've had and how long they've been practising
• Ask them if they have treated cancer patients before
• Ask if they have indemnity insurance (in case of negligence)

For more information about finding a reliable therapist and the questions you should ask look in our about complementary therapies section.

You can get further information about herbal medicines from the following organisations.

European Herbal and Traditional Medicine Practitioners Association (EHTPA)
25 Lincoln Close
Tewkesbury
Gloucestershire
GL20 5TY
Tel: 01684 291605
Email: info@ehpa.eu
Website: www.ehpa.eu/index.html

The EHTPA covers a group of organisations representing Ayurveda, Chinese Herbal Medicine, Traditional Tibetan Medicine and Western Herbal Medicine within Europe. They are working together to develop a minimum set of practice and training standards for herbal medicine. 

British Herbal Medicine Association (BHMA)
PO Box 583
Exeter
Devon
EX1 9GX
Tel: 0845 680 1134
Email: secretary@bhma.info
Website: www.bhma.info

The BHMA aims to protect herbal medicine users, practitioners and manufacturers. It has an information service and can refer to locally qualified herbal practitioners.