Q: Why is research necessary to prove that herbs work?
A: Research studies are the backbone of conventional medicine. They have provided us with a wealth of valuable information in all fields, including human biology and the health sciences. The whole issue, however, is complicated by nonscientific factors that influence which therapies are given funds for research and which are not. Research is costly, running into the millions, and most natural products do not have any major funding behind them. In Europe - where many herbal medicines are classified alongside pharmaceutical products, prescribed by doctors, and covered by the national health plans - it's a different story. Because herbal medicine is accepted in Europe as a legitimate form of therapy, the drug companies there have the financial incentive to do the necessary research.

Q: How can I work with my doctor when he seems to be so against herbal medicines?
A: In the best of all possible worlds, your doctor would be familiar with herbal remedies and would prescribe them as needed. I believe most doctors are motivated and curious to find the best, least harmful approaches to helping their patients. I therefore recommend that outake this book or something similar to your doctor to introduce him to the benefits of herbal medicine. He may be skeptical, but draw his attention to the scientific references at the back of the book and encourage him in a non-arguementative way to look them up and read them. Sharing this knowledge can help you, your doctor, and his or her other patients.

Remember, there are times when it's important to seek professional medical help - for example, in cases of high blood pressure, liver ailment, enlarged prostrate, severe depression, or deteriorating mental function. All are potentially serious conditions and should be checked out before you embark on a self-treatment program.

Q: What is echinacea?
A: Echinacea purpurea, or purple coneflower, is a decorative plant that has been one of the most popular herbal medications in both the United States and Europe for over a century. Echinacea is the primary remedy for minor respiratory infections in Germany, where doctors write over 1.3 million prescriptions for it annually. Native Americans used the related species, Echinacea angustifolia, for a wide variety of problems, including respiratory infections, inflammation of the eyes, toothache, and snakebite. In the nineteenth century, before the advent of sulfa drugs, echinacea was the number-one cold and flu remedy in the United States.

Q: What does echinacea do?
A: Echinacea is useful for treating colds and flus, ear infections, bronchitis, bladder infections, and even yeast infections. Echinacea can be used both to increase your resistance to illness as well as to relieve the symptoms once a cold or flu begins. Unlike antibiotics, which do little if anything in these cases, studies show at least a 20% drop in occurrence of illness and reduction in symptoms. It works best for those who are prone to get colds, since it boosts their weak immune system.

Q: Can children take echinacea?
A. Yes. As we all know, once children start day care or school, they often pick up colds, flus and ear infections from exposure to other kids. An excellent preventive measure during the cold and flu season is a daily dose of echinacea. Children prefer a glycerin based tincture or a tea, which can be given two to three times a day. A two-day break is recommended every 8 weeks. One of my patients brought in her five-year-old son, who had been catching every bug that came to school, then passed it on to the rest of the family. I suggested the glycerin-based tincture for him, and the alcohol-based tincture for the mother. Both remained free of illness for the rest of the season!

Q: What is garlic?
A: Besides keeping vampires away, garlic is useful as a plant medication. The human cultivation of garlic (Allium sativum) goes back at least 5000 years, and today this herbal medicine can be found almost everywhere in the world, from Polynesia to Siberia. In the first century A.D., Dioscorides, Hippocrates, and other ancient Greek physicians recommended garlic for many conditions including respiratory problems, parasites, and poor digestion. Garlic is principally used to prevent and treat heart disease, hardening of the arteries, high blood pressure, and high levels of cholesterol and triglycerides.

Q: Can garlic reduce cholesterol levels?
A: High blood levels of cholesterol and triglycerides, which are lipids (fats), are related to a higher incidence of heart disease. Thus, physicians recommend keeping your cholesterol and triglyceride levels down. Especially important to control is your low density lipoprotein (LDL), or "bad" cholesterol. The high density lipoprotein (HDL) form, or "good" cholesterol, is protective, while LDL form is destructive to the arteries.

At least twenty-eight controlled clinical studies have shown that garlic can lower total cholesterol levels by about 9 to 12 percent, as well as improve the ratio of good to bad cholesterol. In a 1990 German study, 261 patients were given either 800 mg of standardized garlic or a placebo daily. Over the course of sixteen weeks, patients in the garlic group had a 12-percent drop in total cholesterol and a 17-percent decrease in their triglyceride levels.

A European study comparing garlic to the drug bezafibrate found garlic to be just as effective at lowering cholesterol, and without the drug's side effects. Like prescription drugs, garlic appears to interfere with the manufacture of cholesterol in the body. Some studies have been less successful. The differences may be due to manufactring differences in the particular garlic used.

Q: What is Ginkgo biloba?
A: Ginkgo biloba, or ginkgo, as it's commonly known, is the most widely prescribed herb in Germany. More than 6 million prescriptions are written there for ginkgo in a typical year. Used mainly to treat failing mental faculties, including memory loss, in the elderly, it is also used for a variety of circulatory problems. Over 200 million years old, the ginkgo is the oldest surviving species of tree on the planet, and individual trees may live for 1000 years. The bi-lobed, that is double lobed leaf gives the plant the name "biloba.". Since the 1950s, the focus of medical research has been on the extracts of ginkgo leaves.

Q: What is Alzheimer's disease, and how does ginkgo help it?
A: A serious and increasing problem, Alzheimer's disease, or "senile dementia,", literally means "impaired mental function of the elderly". It affects approximately 4 million Americans, which includes nearly 30 percent of the people over the age of 85.

It has been found that ginkgo improves memory and the ability to concentrate, elevates the mood, and relieves dizziness and anxiety. Moreover, taking ginkgo actually stops or significantly slows down the progression of Alzheimer's. This can enhance quality of life and improve the ability to function adequately. It can take up to twelve weeks of treatment to take full effect, so don't give up too quickly. However, be aware that while ginkgo can reduce the symptoms and progression of Alzheimer's in many people, it will not cure the disease.

Q: What is ginseng?
A: Ginseng is one of the most venerable herbs. It has been in continuous use in China, to restore vital energy, for over 2000 years. There are actually three different herbs commonly called ginseng - Asian ginseng (Panax ginseng), American ginseng (Panax quinquefolius), and Siberian ginseng (Eleutherococcus senticosus). The last herb is actually not ginseng at all although it is believed to function in a similar way. Sometimes called adaptogens, the ginsengs increase resistance to stress, enhance mental alertness, and improve stamina and immunity.

Q: What is ginseng used for today?
A: Ginseng appears to protect us from stress, which is a significant health problem in modern day life. As a part of the adaptogenic effects, ginseng also stimulates the mind, increases physical performance, strengthens immunity, and helps the hormones to better regulate bodily functions. It helps to protect the liver, which might account for its ability to speed the processing of alcohol in the body. Ginseng also increases oxygenation in the cells and tissues of the body, thereby boosting endurance, alertness, and visual-motor coordination. Its effect on brain function makes it useful for the elderly, and it combines well with ginkgo for maximum effect.

Q: What is kava?
A: Kava (Piper methysticum) is a member of the pepper family that has been cultivated by Pacific Islanders for over 3000 years for use as a social and ceremonial drink. The first description of kava came to the west with Captain James Cook, who traveled through the South Seas in a number of celebrated voyages. To this day, when village elders or others in the Pacific Islands come together for a significant meeting, they begin with an elaborate kava ceremony. Currently, kava is used in Europe and increasingly in the United States to treat stress, anxiety, and insomnia.

Q: What about its use for sleep?
A: Kava is an excellent bedtime sedative, to be taken in place of prescription drugs. It has the advantage of not suppressing rapid eye movement (REM) sleep, the stage in which dreaming and inner mental processing takes place. People report waking up refreshed and ready to start the day. The commonly used sedatives - the benzodiazepines such as Restoril, Ativan, or Valium - suppress REM sleep and often lead to a groggy, hungover feeling the next morning. Moreover, these prescription drugs are addictive, causing a withdrawal syndrome that includes rebound insomnia, which is often worse than the original problem.

Q: Can kava help athletes?
A: In my book Kava: Nature's Answer to Stress, Anxiety, and Insomnia, I describe where a colleague of mine gave kava to professional hockey players to help them to focus. It was a tremendous success. Dose is around 70 mg of kavalactones (eg 250 mg of 30% extract = 75 mg.; 2000 mg would be 60 mg). It's best to experiment - everyone is different, weight nothwithstanding.

Q: Is kava useful for treating menopausal symptoms?
A: Clinical experience and research, including an eight week study, show kava to be an excellent treatment for menopausal symptoms, including anxiety and hot flashes. In treating menopausal symptoms, kava is often combined with other herbs, such as black cohosh and dong quai, and other supplements as well.

Q: I don't see anywhere if Kava interracts with Synthroid, Warfarin, Pulmicort or Ativan, all of which I use daily, or indeed with Ventolin which I use only rarely. No use asking my family doctor. He tells me he knows absolutely nothing about herbs and doesn't want the responsibility of recommending anything other than standard medicine. I would dearly love to get off the 1 mg Ativan I take every night, but insomnia has cardiac consequences for me.
A: Kava is useful for replacing Ativan. You can use Valerian as well. See the appropriate section in my kava book. A gradual weaning from Ativan is best done under your doctor's supervision. You could show him that section in my book, too. Remember, kava potentiates Ativan, so combine with care, on a gradual replacement schedule. You might consider other products as well to help you deal with your medical problems.

Q: What is milk thistle?
A: The seeds, fruit, and leaves of milk thistle (Silybum marianum) have been used for medicinal purposes for more than 2,000 years. The Roman writer Pliny the Elder, who live from A.D. 23 to 79, reported that the juice of milk thistle mixed with honey "could carry off bile." In Europe, the herb was widely used up through the early twentieth century for the treatment of liver ailments, as well as insufficient lactation.

Q: How does milk thistle work?
A: Silymarin is a powerful antioxidant. We are constantly exposed to toxins such as cigarette smoke, car exhaust, pesticides, and other chemicals in our air, food, and water. This is in addition to the toxins that our bodies produce as by-products of our own metabolism. All these toxins produce free radicals, which cause cell damage. They can, however, be neutralized by substances called antioxidants. Two major antioxidants produced by the body, glutathione and superoxide dismutase (SOD), are greatly enhanced by silymarin. Thus, milk thistle acts as an antioxidant in the liver, protecting it from free-radical damage. Animal studies suggest that milk thistle extract can also protect against many poisons, from toluene, a common solvent, to acetaminophen, the main ingredient in Tylenol.

In Europe, doctors often prescribe milk thistle as extra protection for patients taking medications that are known to case liver problems. I often recommend it to patients who are on medications such as antidepressants, which are metabolized (broken down) in the liver. Milk thistle can also protect against future toxic exposure.