Wellness Learning Center
Botanical Medicine
The Role of Botanicals in Integrative Medicine
Sue H. Mustalish, RN, HNC
Roger W. Mustalish, MPH, Ph.D.
As anyone who reads newspapers or magazines, listens to the radio, or watches television knows, herbal medicines and supplements have made it to the mainstream of American health consciousness. Whether using Ginkgo to improve mental clarity, Echinacea for immune system boosting, or St. John’s Wort to elevate mood, many Americans are making botanical medicines an option of first choice in their health care. This translates into big sales for manufacturers of herbal products. Indeed, sales of herbal products have been doubling every four years, growing into a multibillion dollar industry (PDR, 1998). But does this explosion of interest in and use of botanical medicines merely suggest a growing demand by Americans for more natural alternatives to synthetic pharmaceuticals, that research suggests are more dangerous, more expensive and with more side effects? The answer is both YES and NO.
Certainly there is increasing clinical literature that supports the use of botanical medicines for symptomatic relief of a wide variety of ailments. The PRD for Herbal Medicines (1998), for example, presents clinical applications for over 600 species of medicinal plants involving 90 therapeutic categories including: analgesic agents, antidepressants, antispasmodics, antidiarrheals, anti-inflammatory agents, diruetic agents, urinary anti-infectives, and more. Similarly, Duke (1992) catalogued over 3,000 active ingredients from more than 1,000 plant species. Integrating botanical medicines into programs for symptomatic relief of ailments is therefore not only feasible, but already being practiced. However, as the National Institutes of Health (NIH) stated (1994), conventional medicine’s reliance on finding a single “magic bullet” for each disease it confronts has left it ineffective for most multifaceted, chronic diseases. The same could be said of herbal “magic bullets.” NIH concludes that “for health care reform truly to succeed…,disease prevention must be the ultimate focus of the primary health care system rather than disease treatment.” It is in this realm, health promotion and disease prevention, that botanical medicines, integrated with other patient-centered modalities, may be most effective.
Houghton (1995) presents compelling evidence that whole plant botanical remedies contain many (sometimes hundreds) of phytochemicals (as they occur in nature) that may not all be directly pharmacologically active, but enhance the effectiveness of the active agent(s) through buffering, enhancing absorption, and reducing side effects, among others. As a result, botanical medicines exhibit biological activities not found in synthesized, single compound pharmaceuticals. Among these physiological actions unique to botanical medicines are:
- Adaptogenic: returns the body’s processes to normal when faced with stress or damage; i.e. the Ginsengs (Chinese, American, Siberian).
- Amphoteric: normalizes function; that is, returns to normal a system, whether it is over responding or under responding. Reishi Mushroom and Siberian Ginseng are examples.
- Trophorestorative: synonymous with amphoteric, except that it targets a particular organ or tissue. For example, Hawthorn for the heart.
- Alterative: produces gradual benefits in the body, usually by improving elimination via the major eliminatory organs: liver, kidneys, skin, lungs, colon or lymph. Examples include Burdock Root and Red Clover.
- Immune Stimulant: stimulates components of the immune system such as phagocytes, various T-cells, and Natural Killer Cells; and enhances the functioning of endrocrine organs, i.e. adrenals and hypothalmus. Examples are Echinacea, Astragalus, and Cat’s Claw.
Botanical medicines, therefore, when integrated into a comprehensive person-centered health care strategy can be effective in: health promotion, disease prevention, symptom relief, as well as disease treatment (McCaleb, 1996). Consider heart disease.
NIH (1994) reports that about 7 million Americans suffer from coronary artery disease resulting in about 1.5 million heart attacks and 500,000 deaths annually. Each year, $9 billion is spent on approximately 300,000 coronary artery bypass operations, although the operations prevent premature deaths in only a small minority of patients with the most severe conditions. Yet modern medicine recognizes that heart disease is significantly associated with poor diet, especially high saturated fat intake, and risky lifestyle factors such as smoking, stress, lack of exercise, and excessive alcohol consumption. Were integrative health promotion and disease prevention effected, fewer Americans would incur heart disease necessitating costly, dangerous surgical interventions and drug therapies. The role for botanicals in this scenario could include: Garlic, to reduce cholesterol and platelet aggregation; Hawthorn, to increase coronary perfusion, reduce blood pressure and inhibit atherosclerosis; Gugulipid to lower serum lipid levels and increase the uptake and metabolism of LDL cholesterol; Gingko, as an antioxidant, inhibitor of platelet activating factors, and to improve circulatory flow; and the Ginsengs as adaptogens to deal with stress (Mashour, N. et al., 1998). Couple these with improved diet; flavonoid-rich foods (i.e. apples, blueberries, onions and green tea); sources of soluble fiber (i.e. psyllium); and stress management through meditation and/or yoga, and one can begin to see how a comprehensive, integrated approach to health and healing could be developed to prevent heart disease (Goleman and Gurin, 1993).
In the United States, health care is evolving from a strict mechanistic paradigm to embrace a more integrated system espoused by Murray (1998), Light (1997), and others. A key component is that health promotion and disease prevention begin with the individual accepting responsibility for self-care. As a result, it will be imperative to view the whole person and not the disease, and to seek out the underlying cause(s) of illness rather than merely suppress symptoms. Botanical medicines, in the form of functional foods, teas, tinctures (liquid plant extracts), capsules, aromatherapy essential oils, and topical applications, offer effective strategies for the individual and their health care provider, be it for health promotion or disease treatment, especially when part of a comprehensive integrative medicine program.
Literature Cited
Duke, J. 1992. Handbook of Biologically Active Phytochemicals and Their Activities. Boca Raton, FL: CRC Press. 181pp.
Goleman, D. and J. Gurin. 1993. Mind/Body Medicine. Yonkers, NY: Consumer Reports Books. 480 pp.
Houghton, P. 1995. The Role of Plants in Traditional Medicine and Current Therapy.
The Journal of Alternative and Complementary Medicine 1(2): 131-143.
Light, K. 1997. Florence Nightingale and Holistic Philosophy. Journal of Holistic Nursing 5(1): 25-40.
Mashour, N., G. Lin, and W. Frishman. 1998. Herbal Medicine for the Treatment of Cardiovascular Disease. Archives of Internal Medicine 158: 2225-2234.
McCaleb, R. 1996. The Four Modalities of Medicinal Herb Use. Presented at The Natural Formulary. Washington, D.C. October 9-10.
Murray, M. 1998. The Time is Right for Natural Medicine. Natural Medicine Journal 1(1): 1-7.
National Institutes of Health. 1994. Alternative Medicine: Expanding Medical Horizons. NIH Publication No. 94-066. Washington, D.C.: U.S. Government Printing Office. 372pp.
PDR for Herbal Medicines. 1998. Montvale, NJ: Medical Economics Company. 1244 pp.
