Lana Dvorkin

Herbs for Benign Prostatic Hyperplasia

OBJECTIVE: To review and evaluate the literature relative to the use of herbal therapies in the treatment of benign prostatic hyperplasia. DATA SOURCES: Literature was identified by MEDLINE, Embase, International Pharmaceutical Abstracts, and the International Bibliographic Information on Dietary Supplements searches and through cross-referencing of selected articles. STUDY SELECTION/DATA EXTRACTION: All articles identified from the data sources were evaluated and all information deemed relevant was included in this review. DATA SYNTHESIS: A large percentage of men >50 years old begin to experience signs and symptoms of benign prostatic hyperplasia (BPH). Herbs hold promise in the treatment of BPH. Serenoa repens, Pygeum africanum, Urtica dioica radix, and Cucurbita peponis semen are some of the botanical therapies used in the treatment of BPH. CONCLUSIONS: There are many European studies examining efficacy, dose, and adverse effects of these plants in the treatment of BPH. However, numerous questions remain. These include issues concerning long-term beneficial and adverse effects of herbal therapy, prevention of complications, standardization of extracts, and concomitant use with “mainstream” medications. Based on the information available today, these botanical therapies can be used for treatment of a number of objective and subjective symptoms in patients with BPH, stages I and II.

Supplement use growing among children and adolescents.

Many pediatric patients, especially those with chronic or recurrent conditions, use dietary supplements. It is critical that physicians open a dialogue with their patients and their families about the use of dietary supplements and herbal remedies. It is important for parents to research what is known about the efficacy and safety of a supplement when considering giving it to their children. Physicians must become familiar with evidenced-based resources, as well as federal and professional guidelines.

Views of Pediatric Health Care Providers on the Use of Herbs and Dietary Supplements in Children

Herbs and dietary supplements (HDS) are widely used by adults for treating illnesses and/or preserving good health, and many parents use HDS for their children as well. Previous reports suggest parents will not divulge HDS use to health care providers for fear of their skepticism or disapproval. Yet the views of pediatric health care providers on HDS use in children are not well known. This study investigated the attitudes and practices of pediatric nurses and physicians regarding HDS use in children, in order to identify those characteristics associated with a high degree of confidence in initiating a dialogue on the topic of HDS with families in their practice. A written survey on attitudes and practices toward HDS was developed, piloted, revised, and then administered to a convenience sample of practitioners attending a regional postgraduate course in general pediatrics. Only 42% of 204 pediatric health care providers sampled felt confident in initiating discussions about the therapeutic use of herbs and dietary supplements with families in their practice. Confidence in discussing HDS with families correlated with both personal use of an HDS (OR 3.22; p=0.033) and length of time in practice less than 10 years (OR 8.26; p=0.007). Less than 18% felt that HDS were safe for children under 6 months of age; and only 35% felt they were safe for use in children < 24 months old. Only 7% felt that parents should be allowed to give their hospitalized child an herb or dietary supplement they had brought with them from home, although this increased to 35% if the herb or dietary supplement had been prescribed by a physician. Ninety-two percent of practitioners thought that HDS should be more closely regulated by the FDA. Only a minority of pediatric community practitioners felt confident in discussing HDS with families of children in their practice. Those who had been in practice for a shorter time and who had used HDS themselves were more likely to report confidence in initiating such discussions. The provision of more postgraduate educational opportunities to learn about herbs and dietary supplements may alleviate some practitioners’ concerns about their own competency in discussing HDS with families in their practice.

Regulation of Dietary Supplements in the United States of America

Abstract The importance of dietary supplements regulation in the United States of America becomes clear when the prevalence of this form of therapy is recognized. One of the most important pieces of legislature affecting dietary supplement manufacturing and distribution is the Dietary Supplement Health and Education Act of 1994. The Act and its amendments have provided definitions and guidelines to dietary supplement industry and public. These laws address Labeling and Claims, Good Manufacturing Practices, Adverse Event Reporting mechanisms and a number of other areas. The legislation is still undergoing changes. It is believed that strict implementation of the regulations and educating of health care professionals and patients will help dietary supplement field become safer and better understood.

The Regulations of Herbal Therapies Around the World. A Commentary

Herbal therapieshave been us ed by divers e culturesaround the world for centuries. The utilization of plants is greatly affected by geography, climate, endemic illnesses, discoveries of new drugs and other major influencing factors. At the present time, we are witnessing the increasing worldwide legitimization of herbs and botanical preparationsfor treatment of a number of health complaints . Such growth in herbal industries is paralleled by efforts to establish guidelines and standards for their regulation and control. As with their use, however, herbs are regulated differently from country to country. Today, we come together to voice our biggest concerns and to compare and contrast how each nation regulates its herbal industry. These five articlesdiscussthe lawsin Germany, Canada, Hungary, India, and the United States of America. We take a close look at five different medical and pharmacy systems, five diverse approaches toward regulating the pharmaceuticalsand traditional medicines(i.e., guidelines , laws, directives; education, reporting, publishing). In some countries, absence of effective control over marketed plant products is echoed in unsuspected adulteration and substitution, as well as in preparation of low potency products. The herbal industry has a much smaller economic and financial incentive in comparison to conventional pharmaceutical manufacturing due to