Like religion and dot-com investments, buying into herbal products often requires a leap of faith. It usually starts like this: You have some irritating health problem, and herbs sound like a gentle-acting natural remedy that correlates to your natural-living worldview. So you surf the 'Net, talk to a friend who vouches for a particular herb or brand, vaguely remember something you read in a magazine and go to your local natural products store in hopes you can find the cure-all for your malady.
Only then, in the aisles, you feel like you're in the scene from "Moscow on the Hudson," that 1984 movie starring Robin Williams, who, fresh from Russia, stands in an American supermarket fairly overwhelmed with the boundless selection, and passes out.
But you're smarter. You have a cell phone. Or maybe you were savvy enough to keep your Web printouts so you can ferret through them looking for a particular supplement brand name. Except nobody's home and nothing's mentioned. You take a closer look at the bottles and boxes, trying to glean something from the labels that makes sense.
For Colorado shopper Bernita Curley, buying supplements is a numbers game. "This per serving has 1.9 grams of protein, and this other bottle has two grams," she says. "I'm taking the one with two grams in it." We're Americans—more is better, right?
What really happens when you enter the all-too-confusing botanicals marketplace? Do you purchase the most expensive of 10 different brands with the idea that you get what you pay for? Or do you go for the cheapest under the assumption that all brands are the same? Who has the most alluring label? What label has the most numbers on it? Do you feel more confident if an herb is a "standardized extract"? Nature's endless variations and industry's bewildering manufacturing processes don't make your choices any easier.
Read All About It
The US Food and Drug Administration (FDA), the regulatory agency in charge of dietary supplements, does not preapprove herbs before they go on the market as they do with drugs. Yet far from being "unregulated," as some in the mass media will have you believe, the FDA does in fact limit what can be written on labels. Vitamin, herb and other supplement labels cannot contain the five "drug" words—diagnose, prevent, treat, mitigate and cure—but they can use language regarding an herb or herb component's influence on the structure or function of a body organ or system. Thus, an echinacea label cannot say the product "cures the common cold," but it can read, "supports healthy immune function." It's up to shoppers to read between the lines.
"It's very confusing to me as a consumer," says John Hollingsworth, a national advertising executive. "I read the labels, but they don't tell me what I need to know. I have to have someone tell me that if I take X, it'll meet my individual needs."
Declaring an herb a "standardized" extract has helped fill the information gap because it connotes scientific reckoning—quality—plus it's a gauge of quantity.
Trouble is, there's no standardization standard set by any regulatory agency, leaving corporations to decide for themselves. For instance, nettle root (Urtica dioica) is standardized by one company to 5 percent amino acids, by another to 8 percent sterols and yet a third to 35 parts per million scopoline.
"There used to be 15 kinds of echinacea, and you had to choose by colors. Now you have 15 brands, and you choose by numbers," says Michael McGuffin, president of the American Herbal Products Association (AHPA).
To manufacturers, "standardized" means to identify, measure and consistently produce a particular compound in an herbal product to ensure batch-to-batch consistency. To consumers, it means a bottle of St. John's wort "standardized to 0.3 percent hypericin" contains the right amount of the plant part that researchers determine will treat their mild to moderate depression.
Here's the thing: Hypericin displays no physiological effect. It is not the active ingredient. So why, then, is such a tiny number so boldly printed on the label?
The answer is that, unlike drugs, which are composed of a single chemical compound, herbs contain literally thousands of compounds. Some are active ingredients, others are benign markers unique to the species. Which of those to standardize to is far from a unanimous decision. In fact, the active ingredient in St. John's wort is still a mystery. Most likely, it's a number of compounds working together. To be fair, the standardized number at least shows shoppers that the manufacturer has a system in place that values batch-to-batch consistency.
At Rexall Sundown, the largest dietary supplements manufacturer in the country, $3 million worth of laboratory equipment is used to identify and assay the quality of the brown St. John's wort powder when it arrives. A battery of tests gives the sample a "fingerprint" of its chemical constituents. Computers then compare this to its reference library data to ensure that the herb on the dock matches its official fingerprint. If the powder has 0.3 percent of the unique chemical identification marker called hypericin, it is verified as St. John's wort, and should therefore contain 99.7 percent of other constituents that, taken together, work to ease depression.
"To the untrained eye, one brown powder can look like another brown powder," says Ray Stadnick, vice president of quality at Rexall Sundown. "The concept of markers to demonstrate quality has been used in pharmaceuticals for many years."
A standardized marker, then, is a useful shopping aid because it lists herb compounds and their quantity. However, notes AHPA's McGuffin, markers are also nothing more than marketing tools. In fact, many smaller companies offer consistently high-quality herbs without reference to standardized marker compounds. Handcrafted herbal products, like handcrafted microbrews, can get you a quality the Budweisers of the herb world cannot offer. Plus, not every company has $3 million to spend on high-tech gadgetry.
"The big companies standardize because they don't know what live herbs look like. Raw materials come to them as a powder," says Lorenzo Hayes, a boutique herb farmer and president of Homegrown Herbals, which produces a line of herb tinctures and formulas. "A raw material to me is a succulent plant."
But how do you, Mr. or Ms. Herb Shopper, know which product is better? "It really is difficult," says Stadnick. "On many of our product labels you'll see, 'Manufactured in accordance with USP good manufacturing practices [GMPs].' Those [United States Pharmacopoeia] GMPs are similar to those in effect for pharmaceutical drugs, which are beyond reproach."
AHPA member companies often replace USP with AHPA on such label claims, again signifying there is no single standard. One caveat: While "GMPs" mean a manufacturing facility is up to snuff, it makes no assessment of herb quality.
Contrary to popular opinion, "standardization" is more than listing numbers on a label. Rather, it is—or should be—a set of quality-control standards, from seed to shelf, that any self-respecting herbalist or herb product manufacturer follows to decrease nature's inherent variability and to ensure a quality product.
True standardization has five criteria, only the last of which routinely makes it on a label. It starts with seed selection. It continues with proper raw material identification, including the genus and species and the part of the plant shown to be most therapeutic. Third is harvesting at the optimal time—every herb's constituent profile fluctuates throughout the growing season, even throughout the day. Fourth involves processing and drying, because variations in temperatures or drying times can affect the therapeutic quality of the herb. Finally, for those wanting to characterize the plant for clinical studies or to determine marker compounds to differentiate one product from another on the shelf, the word everyone knows as "standardization" can be used.
"When we talk about standardization of one constituent, that's only one part of the quality-control check," says Roy Upton, executive director of the American Herbal Pharmacopoeia (AHP).
The AHP publishes authoritative herb monographs that help professionals and interested consumers gain a deeper understanding of botanicals. The monographs include traditional history, clinical results and identifying characteristics, whether looking at the herb in a field or analyzing it with high-tech equipment. The main reason for publishing them, Upton says, is because existing information is inconsistent. Even something as seemingly elementary as knowing the right time to harvest a particular herb is "absolutely not" universally known, Upton says. (For monograph subscriptions, visit herbal-ahp.org.)
Know Thy Herb
The lingering uncertainty about how to make herb quality consistent and understand which herb component to standardize to has not stopped the industry from trying. An international consortium of 35 suppliers and manufacturers have banded together to use the same methods to test raw herb materials and to use the same marker compounds. Other industry groups have also briefed the FDA on their efforts, which will likely be enough to stave off government regulations or legislation in the future. The exception to this is the herb ephedra, or ma huang, which contains an amphetamine-like alkaloid used and abused in weight-loss products.
In response, the FDA recognizes the need to help consumers cut through the confusion and is establishing a ten-year administrative plan to improve the scientific platform underlying botanicals.
New and Improved
So, things are improving. But the onus is still largely on consumers to put their purchase decisions—and their health—in their own hands. How to choose an herb product you can count on? One tack is to trust an established brand name that has been on the market for years. Your retailer can steer you toward a brand, either from personal education or experience.
And read labels. The Supplement Facts panel, similar to the Nutrition Facts panel on food boxes, should give you the herb's common name, Latin name, plant part and amount of herb per serving expressed as grams or milligrams. All this label information can then be cross-referenced with reputable sources to see if the marked standardized constituents are the same ones validated in studies. Stores often shelve reference books nearby. Use them.
"Understanding how to read a product label is very important," says herbalist Steven Foster, co-author of Tyler's Honest Herbal (The Hawthorn Herbal Press). "As more shoppers get the meaning of specific dosages and the meaningfulness of standardization to specific compounds, we'll move away from the situation where the media and other aspects of our society think of herbs as snake oil."
Todd Runestad is senior editor of Nutrition Science News.