July 20, 2003

It is clear that herbs are being marketed and purchased as drugs without regulation. There is very little evidence about the efficacy of weightloss products that are found in plenty

EVERY year Pakistanis, spend millions of rupees on a wide variety of alternative therapies. Many often abandon the treatments of their regular doctors. ‘Herbs’ are back in vogue. Apart from acting as curative agent in therapies, they are used for decorative purposes, for manufacturing fragrances and cosmetic products and have culinary uses. About a decade back they had to some extent evaporated.

For as long as civilization has existed, herbs have been used for healing. It is said that about 80 per cent of medicines till the mid-9th century was derived from herbs. Many conventional medicines are derived from plants.

The West has also discovered powerful plant-derived drugs for heart disease (from Fox Glove plant’s leaves), for cancer (from the Pacific Yew tree). Herbal medicine may take longer to work and the effects may be less dramatic at the outset. But it is said to be as potent as conventional drugs are. Remedies are taken in pill or capsule form, in the form of tea -obtained from dried plants, as oil to be consumed or applied fresh, or to be taken in ground or dried form. It depends, as prescribed by practitioners.

According to a WWF report, Pakistan has around ten major dawakhanas, fifty thousand registered tabibs and thousands of unregistered practitioners. Together, they administer herbal medicine worth millions of rupees.

Once, herbs were generally thought to be inexpensive and mild remedies for minor ailments such as a sore throat and cough. But today experts believe that herbal treatment could also be effective for serious maladies such as influenza, high cholesterol etc. One of the reasons for the popularity of herbal medicine is that they are still comparatively cheaper.

“Suffering from arthritis I had lost all hope of relief. I tried conventional medication, and even underwent treatment in America, but all in vain. When I came back to Pakistan I opted for herbal/plant derived drugs. It was a miracle! In a few weeks time, I was cured,” says a 65 year old women who would rather not be named.

Tariq, also a beneficiary of herbal medicine, says that he had opted for therapy before, he had taken so many combinations of pills that he had lost count. “Their worst aspect part was their side-effects,” he says. “Sometimes my feet would be so swollen that I would be unable to wear shoes. For months I would feel a tremor in my hands and couldn’t write. I turned to herbal medicines and now the effects are gone.”

Sabeen recently returned to Pakistan after a 15 years stay in the UK. She says, “My problem was acne from pollution and hormonal changes. I tried famous skincare brands, but found none to be effective. Later my friend suggested that I should try out a safe herbal range. I made the switch and positive results soon followed . Now I can’t think of life without herbal medicines”.

But contrary to popular perceptions, not all herbal drugs are risk-free — a fact especially those using herbs to lose weight should keep in mind. A tabeeb who wishes to remain anonymous prescribes herbs to patients for problems ranging from a cold to sleep disorders to hepatitis and for liver ailments. But while many of his patients have obtained relief, there are those who who have complained of side-effects.

Only recently a man in his 30s was reported to have died suddenly. One of his friends disclosed that he had been taking ‘herbal weight-loss products’, and had taken a double dose of the ‘natural’ pills a few hours before his death. The friend, who was himself on the same drug stopped taking the medicine immediately.

In recent researches, western scientists say that there is reliable data on the safety and efficacy of herbal medicine. But experts say most herbs if abused could cause adverse side-effects. Syed Nawazish-e-Hussain, Assistant Professor, Department of Pharmacology, Punjab University, cautions that “all herbal medicines are not risk-free. “Since some of these are categorized as ‘dietry supplements’ they are not subject to the same safety standards as applied to conventional drugs”, he says. “And when taken in high doses, some herbs can have dangerous consequences. Self-prescription is a big problem and one should never forget that different patients require different treatment according to need.”

Unfortunately, misinformation abounds. Manufacturers are even allowed to make certain health claims—-which have not been proven. One should beware of the herbal guide books available in health food stores. Many are written by herbalists or companies to promote their own products, and are not based on scientific scrutiny.

The Profesor says, “the manufacturers usually make blatantly false advertising claims. A company advertised a product promising to blast away some pounds, in a limited period those ugly pounds magically disappeared before your very eyes. Many manufacturers advertise in newspapers, on the internet, cable TV and so on. They make thousands of rupees but unfortunately in our country the authorities can’t nab them. Many of the false products are not even investigated. Some companies even cite research to back these ‘false claims’. But the bitter reality is that in many cases the medicine has not even been tested on animals before it was introduced in the market.”

He further reveals that,”the West deals with the people of our land as ‘experimental animals’.

A leading manufacturer recently launched a medicine named ‘Silibum Maryanum’ to cure liver disease. It was launched in Pakistan but has not been evaluated in clinical trials. Unfortunately no one has taken notice. In our country no system of checks and balances exists. Even local manufacturers use sub-standard food colours in soft drinks, medicated syrups etc——-especially the colour red. Even the plant -derived medicines of the local manufacturers are based on so-called fore-bearer’s formulas.

Advertisements on the internet are particularly dangerous since they are unregulated and unedited. The web offers ‘prescription’ drugs. Syed Nawazish-e-Hussain asks how can someone obtain a prescription drug without seeing a doctor? “There are lots of hazards involved in it”, he concludes.

Prof. Dr Bashir Ahmed, Pharmacologist, Faculty of Pharmacy, Punjab University, says that a few years ago, the diet drugs Fenfluramine and Dexfenfluramine were removed from shelves in America after reports revealed them to cause potential fatal heart and lung damage. So the weight-conscious switched to herbal products in a big way. “But because one doesn’t need a prescription for these diet aids and they haven’t been banned, it does not mean they are effective or safe,” he says.” Some of these have a frighteningly wide range of potentially adverse side-effects. They make your stomach hurt and lead to dehydration.There is plenty of evidence to suggest that some of the ingredients in these products may be harmful, particularly if taken in large doses or over long periods of time,” he continues.

“For instance Ephedra is known to have caused extreme side-effects and even death. Ephedra is the herb that contains Ephedrine (known by its Chinese name Ma-Huang, even a WWF report notes it as a cardiac stimulant).It is also found in many allergy and asthma drugs. Grown in Baluchistan, it is taken as an appetite suppressant and energy booster. It is said that it stimulates the central nervous system, speeds the metabolism and can cause blood pressure to soar, as well as heart palpitations and liver failure.”

So why is such a potentially dangerous herb available in the market without so much as a warning label?

In addition, other hazards have been associated with dieter teas——Senna teas——- which routinely contain laxative ingredients can deplete the body of important nutrients and eventually cause heart attacks. Dr Bashir says, Senna is also known as the Locust plant and Cassia. It is a herbal laxative. It stimulates the colon and leads to heart problems such as cardiac arhythmia.

Some people can become addicted to it and it can also cause fainting, loss of bowel function. Some other risky herbs include the Lobelia and Comfrey Root.”

“We have a responsibility to bring into force a law for consumer protection. It is necessary to consider warning labels and dosage limits on risky-drugs products,” he concludes.

The Pakistan Medical Research Council have been trying to establish a health research system in Pakistan. Let’s hope for a positive outcome. It is clear that herbs are being marketed and purchased as drugs without regulation as drugs. Indeed there’s very little evidence that any of the weight loss products (imported or locally manufactured) will help you lose-weight unless you burn a lot of calories by walking and running. There’s a herb that’s been proven to induce weight loss.

One should bear in mind that herbal remedies are not miracle drugs. Always heed the warning—-if it is there on the label. In general remember that herbs shouldn’t be taken by children and by pregnant or nursing women. It’s a good idea to inform your doctor of all the medications and supplements you take, including herbs. Always consult qualified tabeebs and avoid experimentation. And always remember that ‘miracle weight loss’ products are a waste of money.

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