buat yg suka pake herbal medicine rgrd rifa
----- Original Message ----- From: "Luluk Lely Soraya I" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, July 28, 2005 9:32 AM Subject: [sehat] [Artikel] WHO : Herbs for health, but how safe are they? > www.who.int/entity/bulletin/archives/79(7)691.pdf > > Herbs for health, but how safe are they? > > Herbal medicines are popular. They are > extensively used in the developing world, > where in many places they offer a more > widely available and more affordable alternative > to pharmaceutical drugs. In Africa, > for example, up to 80% of the population > depends on them, according to WHO > estimates. A recent study by the Roll Back > Malaria Initiative found that in Ghana, Mali, > Nigeria and Zambia, herbal medicine is the > first choice for home treatment of nearly two > thirds of children with high fever. In India, > where the traditional Ayurvedic medicine > employs over 1200 different herbs, herbal > medicine is regularly used by about 65% > of the population. > > Herbal medicines are also popular in > developed countries - the same WHO > estimates state that 50% of Canadians and > 75% of people in France have tried complementary > or alternative medicine, which > often includes herbal remedies. And in Japan, > 85% of doctors prescribe not only modern > medicine but also the traditional herbal > medicine (called Kampo), which is covered > by health insurance. > > Herbal medicines are also profitable. > Worldwide, they represent a market value > of about US$ 43 billion a year, according to > WHO. In the US, alone, over 1500 herbal > medicines are sold annually for a total of nearly > US$ 5 billion and now constitute the fastest > growing sector of the US pharmaceutical > market, according to the US president's > commission on dietary supplements. > The growing popularity of these remedies > is fuelling - and is to some extent > fuelled - by increasing scientific interest > in herbal medicine. WHO estimates that of > the 35 000-70 000 species of plants that are > used for medicinal purposes around the > world, some 5000 have been submitted to > biomedical scrutiny. Scientific evidence of > efficacy is beginning to emerge from randomized > controlled trials in which herbs > compare favourably with placebo. Examples > include St John's wort for mild depression, > ginkgo biloba for some forms of dementia, > saw palmetto for benign prostatic hyperplasia, > and horse chestnut seeds for chronic > venous insufficiency, to mention only four. > And, of course, a number of commonly used > pharmaceutical products are of botanical > origin - aspirin, digitoxin, and quinine are > three well-known examples. > > Another reason for the growing popularity > of herbal medicines is that many people > believe they are safer, ''more natural,'' than > pharmaceuticals. But as Dr Saul Green, a > biochemist and board member of the > nonprofit US National Council Against > Health Fraud, notes: ''Natural doesn't mean > safe. You can find a dozen or more poisons > that are totally natural.'' > > Herbal medicines, however natural, > can cause serious illnesses, from allergy to > liver or kidney malfunction, to cancer, and > even death. In terms of carcinogenicity, for > example, the toxicological potential of natural > plant chemicals is roughly the same as > that of synthetic chemicals, according to > US toxicologist Dr Lois Gold, head of the > carcinogenic potency project at the University > of California at Berkeley. And the fact > that herbal products tend to be taken for long > periods at doses close to their toxic range > doesn't help, she notes. > > Blindness, too, has been attributed > to the use of herbal medicines. A study > published in the Journal of Tropical Medicine and > Hygiene in 1994 reported that 25% of corneal > ulcers in the United Republic of Tanzania > were linked to the use of traditional eye > medicines, of which many are based on herb > extracts. Another study, published in the > British Journal of Ophthalmology in 1976, found > that they were associated with 26% of > childhood blindness cases in Malawi. A lack > of proper sterilization, along with inclusion > of urine, saliva, or breast milk in some of > these medicines, gives pathogens ample > opportunity to thrive in eyes already hard > hit by injury or infection. > > Perhaps the biggest problems with > herbal medicines are a lack of standardization > and of safety regulations. Standardization of > a herbal medicine that may contain hundreds > of chemical constituents, with little or no > evidence indicating which might be responsible > for the presumed or proven therapeutic > effect, is a particularly thorny issue. > > FOOD OR MEDICINE > > Moreover, rules and regulations concerning > herbal medicines vary greatly from country > to country. ''Some countries regulate them > as food, others as medicines,'' says Dr Alan > Randell of the FAO/WHO Food Standards > Programme in Rome. For the most part > herbal medicines aren't tightly regulated. > > ''This is an industry that's out of control > and has been for a very long time. By and > large, the people running the industry want > it to stay that way,'' says Randell. In 1997, > the Codex Alimentarius Commission, an > international body that regulates food > standards, considered issuing rules for > potentially harmful herbs and dietary supplements. > But, according to Randell, the > health food industry pressured the Codex > against regulating herbs, and the Codex > ultimately decided that herbal medicines > didn't fall under the category of food > and thus weren't subject to its regulations. > > Worldwide, only 64 of WHO's > 191 member states regulate herbal medicines. > Dr Xiaorui Zhang, head of WHO's traditional > medicine unit, agrees that the regulation and > standardization of herbal medicines ''clearly > represent important problems'' but she points > out that considerable effort is being put into > tackling the problems. In 1998, for example, > WHO published a review of regulatory > information from 50 countries. > Last year, Zhang's unit published > guidelines on methods of evaluating traditional > medicine therapies, including herbal > medicines. > > Over the past decade WHO's work on > herbal medicines has included the preparation > of a series of monographs on medicinal > plants, based on input from an international > panel of 170 experts. About 100 monographs > are planned, of which 28 appeared in 1999 > in a first volume, a further 30 are in press in > a second volume and work is well advanced > on the remaining 40 or so, which will > appear in a third volume. For each plant, the > monographs give a definition, synonyms > (including vernacular names), a description, > identification of material of medicinal interest > in the plant, and a wealth of scientific > information about purity, chemical tests, > pharmacology, warnings, precautions, > adverse reactions, dosage, plus a copious > scientific reference list. Zhang's unit has also > started a project to run clinical trials-being > conducted in collaboration with the Roll > Back Malaria initiative-of medicinal herbs. > Trials of three herbs with antimalarial > potential are under way in Africa. > > In Europe, the European Medicines > Evaluation Agency (EMEA) set up a herbal > medicinal products working party in May > 1997 that, among other things, prepares > guidelines for manufacturers seeking marketing > authorization for their products. In the > UK, the Medicines Control Agency (MCA) > has launched an ethnic medicines forum > to improve safety and quality standards > of ''unlicensed ethnic medicines''. And > Germany boasts a widely acclaimed regulatory > body, its ''Commission E'', that was > set up in 1978 to assess the safety and efficacy > of herbal medicines and has done so for > about 400 of them, although, some critics > complain, with insufficient information > about scientific sources. > > FDA reports > > In the US, a 1994 law reportedly pushed > through by herbal industry representatives > prevents government officials from tightly > regulating herbal supplements. The only > safety measure in place is a system whereby > consumers and health professionals can > voluntarily report herb-related adverse > events to the Food and Drug Administration. > The FDA makes these reports available > publicly, and on a few occasions has issued > recalls of products deemed especially dangerous. > For instance, in February of 2000, the > FDA recalled five Chinese herbal products > after discovering that they contained potentially > dangerous levels of two prescription > diabetes drugs, glyburide and phenformin. > And in August 2000, in a move to encourage > better manufacturing practices in industry, > the FDA issued a ''guidance for industry'' > document that sets out the criteria it urges > manufacturers to comply with when they > wish to market a botanical drug product - > ''including those botanical products currently > lawfully marketed as foods and dietary > supplements''. > > The US Pharmacopoeia, a non-governmental > organization that establishes medicine > quality standards recognized around > the world, is launching a new programme > to assess the quality of dietary supplements, > including herbals. And the government > sponsored National Toxicology Program > is currently assessing about a dozen herbal > medicines for safety, including goldenseal, > comfrey, pulegone, gingko, Echinacea, aloe, > ginseng, kava kava, milk thistle, and Thujone. > Clearly, without strict safety regulations, > dangerous herbal preparations are reaching > consumers. In Belgium, 70 people who took > a regimen of Chinese dietary herbs developed > renal problems serious enough to require > dialysis or a kidney transplant. A research > team lead by Dr Joelle Nortier at the > Universite´ Libre de Bruxelles discovered that > among the herbs consumed by these people > was Aristolochia fangchi, which contains high > concentrations of the potent carcinogen > and kidney toxin aristolochic acid, and which > was mistakenly included in the regimen by > the manufacturer. > > Contamination problems > Pesticide residues present in or on herbs are > another problem. In a study published this > year in the Bulletin of Environmental Contamination > and Toxicology, researchers at the Suez > Canal University in Ismailia, Egypt, examined > five spices -caraway, ginger, cumin seeds, > cinnamon, and anise - they had purchased > at a local market in Egypt. To their dismay, > they discovered that the cumin seeds showed > high levels of the organophosphate pesticide > profenofos - 0.37g/kg, or nearly twice > the residue the WHO and Codex Alimentarius > Commission permit in vegetables. > > This pesticide is known to cause headaches, > nausea, dizziness, intestinal cramps, and > diarrhoea in high doses. The finding is > especially troubling because Egyptian parents > commonly give their children cumin to > relieve coughs, aches, or itching, and children's > low body weights make them especially > vulnerable to the pesticides' effects. > In the US, Dr Richard Ko, a food and > drug scientist at the California State Department > of Health Services in Sacramento, > says that of 260 Asian herbal products his > department has tested, about one in three > were found to contain heavy metals or > undeclared ingredients, including prescription > drugs. A US company, ConsumerLab. > com, has tested hundreds of herbal products > and posted the results on its website. ''We've > found ginseng products contaminated with > pesticides and St John's wort with small levels > of cadmium,'' says Dr Tod Cooperman, > the company's president. ''In our latest tests, > we found one Echinacea product that had > three times the WHO accepted level > of microbial contamination.'' > > All in all, herbal medicines inhabit a > largely uncharted territory. Even the jungle of > names for the different herbs is a regulator's > nightmare. Is Eupatorium perfoliatum ''feverwort'', > ''thoroughwort'', or ''boneset''? Take > your pick. The same for Serenoa repens or Sabal > serrulata or Corypha repens or Brahea serrulata. > Clearly, though, when it comes to safety, > what's in a name is not what counts, but > what's in the herb itself. And that's another > nightmare. > > Christie Aschwanden, Nederland, Colorado, USA > Bulletin of the World Health Organization, 2001, 79 (7) > > > > ========================================================================== > " SEHAT mailing list is supported by Hewlett-Packard StorageWorks Division. > SEHAT Internet Access & Website are supported by CBN Net " > ========================================================================== > > > > > > > Yahoo! Groups Links > > <*> To visit your group on the web, go to: > http://groups.yahoo.com/group/sehat/ > > <*> To unsubscribe from this group, send an email to: > [EMAIL PROTECTED] > > <*> Your use of Yahoo! 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