U.S. Demand for Herbal Medicines Waning, But . . .

More multivitamins now include natural remedies, study finds

TUESDAY, Feb. 15, 2005 (HealthDayNews) -- America's decade-long love affair with herbal supplements may be ebbing, with sales of individually bottled herbals leveling off by 2002, according to a new study.

However, the researchers also note that many multivitamins now include some kind of herbal as an ingredient, so more consumers than ever may be taking herbals each day, whether they realize it or not.

According to researchers at Boston University's School of Public Health, consumption of alternative medicines -- particularly herbal products -- increased dramatically in the United States during the 1990s, so that by 2001 Americans spent $4.2 billion annually on herbs and other botanical remedies.

However, consumer demand for herbals may finally be on the wane, with consumption leveling off in 2002.

"Herbal and natural product use is common in the U.S. population, but the growth in the use of herbal products has slowed," said co-author David W. Kaufman, the associate director of Boston University's Slone Epidemiology Center.

In their study, researchers used phone interviews to gain data on 8,470 consumers who were questioned on their use of over-the-counter and prescription drugs as well as dietary supplements in the week prior to the interview. The surveys were conducted from 1988 through 2002.

From 1998 to 1999, the Boston team found, 14.2 percent of those interviewed were taking some form of dietary supplement. That figure increased to 19.8 percent by 2001, but then leveled off to 18.8 percent by 2002.

While the use of many supplements increased, the use of Ginko biloba and Panax ginseng dropped during the period, the researchers say. At the same time the addition of herbals such as lutein to multivitamins increased from 1999 to 2002. Lutein is an antioxidant that some believe may be protective against age-related macular degeneration, a prime cause of vision loss in the elderly.

"Our observations regarding lutein use were unexpected," the authors note. In addition, the researchers found that the antioxidant lycopene was also added to multivitamins in 2003, based on studies that suggest it may help prevent cancer.

Kaufman speculates that individual herbal compounds come in and out of fashion, perhaps because they don't provide quite the effect people hope for. "Herbal medication are chosen by individual users, not prescribed by physicians, so they are more susceptible to rises and falls in popularity. And for many of these products the effectiveness is not really proven," he said.

Patients should always inform their doctors about any herbal medications they are taking because "these are medicines too." Kaufman stressed.

Physicians need to be concerned about what their patients are taking beyond traditional medicines," he added. "And it is important that physicians know that patients are getting herbals in multivitamins, because of the potential interaction of herbal medicines with drugs."

Two powerful and historically incompatible trends may be influencing the use of medical therapies over recent years, said Dr. David L. Katz, an associate clinical professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "One is the increasing emphasis that providers and payers place on scientific evidence, and the other is the increasing premium patients place on 'natural' therapies," he said .

These trends have been incompatible because the evidence base for many natural treatments, such as herbs and nutraceuticals (food products thought to fight disease), lags behind that of conventional pharmaceuticals, Katz said. "Patient interest in natural remedies has been rivaled by physician reticence," he explained.

Katz believes that these trends may finally be converging, however. "Perhaps a better informed population of patients is maintaining an interest in natural therapies, but approaching them somewhat more cautiously. Perhaps trends are being influenced by the increasing volume of information on the Internet," he said.

"Whatever the reason, a plateau in use of herbals is likely a good thing," Katz said. "Like their counterparts born in test tubes, remedies of natural origin can help, harm, or do neither. Certainly safety cannot be assumed simply because a product is natural."

More information

The National Institutes of Health can tell you more about dietary supplements.

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