Studies come and go. The study du jour might tout medicinal herbs or trash them. But people who focus only on the latest study lose something important—perspective. Want to use herbs confidently? Then take the long view. Examine the evidence that accumulates slowly over many years. The following 16 herbs have stood the test of time and are proven to be reliable healers. Not every study supports their use (the same could be said for most pharmaceuticals), but the weight of the evidence clearly shows that these herbs are safe (with certain caveats) and effective. They deserve a place in your medicine cabinet.
Aloe (Aloe vera) is the herb for minor burns and cuts. In one study published in the Journal of Dermatological Surgery and Oncology, 27 people had burns treated with aloe or standard medical care. In the standard-care group, healing took 18 days, but in the aloe group, it took only 12 days. “Aloe is my first choice for burns,” says botanist James Duke, Ph.D., former chief of the U.S. Department of Agriculture’s Medicinal Plant Research Laboratory and author of The Green Pharmacy (Rodale, 2000). “Keep a potted aloe on your kitchen windowsill. For minor burns, snip off a thick leaf. Slit it open. Scoop out the inner leaf gel and apply it to the burn once or twice a day.” Aloe requires no care beyond weekly watering.
Dosage: If you use a commercial aloe gel, follow label directions.
Red Flags: Aloe helps heal superficial wounds but not deep wounds, such as surgical incisions.
American Indians first introduced colonists to black cohosh (Cimicifuga racemosa), which they used to treat many conditions, including menstrual problems and recovery from childbirth. For 40 years, Europeans have used black cohosh to treat menopausal discomforts. During the past decade, the herb has become popular in the United States. Occasionally, a study questions its benefit, but the clear majority shows black cohosh effective for hot flashes. How the herb works is still a mystery, but it does not act like estrogen, so it’s safe for women who can’t take the female sex hormone—for example, those with a history of breast cancer. “Black cohosh is definitely worth a try,” says Mark Blumenthal, executive director of the Austin, Texas-based American Botanical Council (ABC), the nation’s leading herb-education organization, “especially now that hormone replacement therapy has been shown to do more harm than good.”
Dosage: Follow label directions.
Red Flags: Side effects are rare but possible: A few users have reported stomach distress, dizziness, headache and allergic reactions. Commission E, the German equivalent of the U.S. Food and Drug Administration, says black cohosh should not be taken for longer than six months. After that, consult your doctor or herbalist.
Remember The Tale of Peter Rabbit? After the young bunny’s “hare”-raising adventures, his mother soothes his jangled nerves and upset stomach with chamomile tea. Peter’s mother was right. Chamomile (Matricaria recutita) soothes both the nervous system and the gastrointestinal tract.
Dosage: 1 tea bag or 1 to 2 teaspoons of dried flowers per cup of boiling water. Steep a few minutes and drink as much as you’d like.
Red Flags: Allergic reactions are possible, especially if you’re allergic to pollens.
Cranberry juice—and the dried berries and extract—prevent bacteria from sticking to the bladder wall long enough to cause infection, according to a 2004 article published in Clinical Infectious Disease. Many studies confirm the value of cranberry (Vaccinium macrocarpon) in the prevention of urinary tract infections (UTIs). In a 2002 study, Canadian researchers gave 150 women one of three treatments: cranberry juice (three cups a day), cranberry tablets (3 daily) or a placebo. One year later, compared with the placebo group, the women who took cranberry experienced significantly fewer UTIs. Cranberry juice cocktail and dried cranberries are available at health-food stores and supermarkets. Capsules containing cranberry extract are available at health-food stores and many pharmacies. “I recommend cranberry for UTI,” Duke says. “But if you drink the juice, you have to drink a lot of it. It’s usually easier to munch on the dried berries or take capsules.”
Dosage: If you use cranberry juice cocktail, drink at least three cups a day. Try to select one with less sugar and a higher content of cranberry juice, or drink 100-percent cranberry juice diluted in apple juice. If you use dried cranberries, munch on a handful or two a day. If you use commercial cranberry extract, you should follow label directions.
Red Flags: None.
For reasons that remain unclear, the root of daisy-like echinacea (Echinacea spp.) bolsters the immune system and helps the body fight colds. An occasional study shows no treatment benefit, but most show that echinacea minimizes symptoms and speeds recovery by at least a day or two. The most comprehensive investigation of echinacea’s cold-fighting power was a University of Wisconsin analysis of nine studies. Eight showed significant treatment benefit—milder symptoms and briefer colds. Most recently, Canadian researchers gave echinacea or a placebo to 128 people coming down with colds. They took 10 doses the first day and four doses for the next seven days. The echinacea group had 23 percent milder symptoms. However, echinacea does not prevent colds. “I don’t recommend it for cold prevention,” Duke says. “But as soon as my wife or I feel a cold coming on, we take echinacea. Our colds are mild and brief.”
Dosage: Echinacea is available in teas, juice, tinctures and capsules. Follow label directions. Typical directions are to take it several times a day at first, and then taper off as you begin to feel better.
Red Flags: Liquid echinacea products can cause temporary, harmless numbing or tingling of the tongue. Some people don’t like echinacea’s sharp taste. Minor stomach upset is possible with tincture. If symptoms persist beyond two weeks, see a doctor.
Flaxseed (Linum usitatissimum) is rich in plant estrogens (phytoestrogens). At Laval University, Quebec, researchers gave 25 menopausal women hormone replacement therapy (HRT) or flaxseed (1.5 ounces daily mixed into food). Six months later, flaxseed relieved hot flashes as well as HRT. Flaxseed also mimics HRT’s bone-preserving ability. Oklahoma State researchers gave a placebo or flaxseed (1.5 ounces daily) to 38 postmenopausal women for 14 weeks, and measured calcium excretion in their urine, an index of calcium loss from bone. The flaxseed group showed decreased calcium excretion, meaning reduced bone loss. Recent research published in Drug News and Perspectives also suggests that flaxseed lowers cholesterol and risk of heart disease.
Dosage: 1.5 ounces per day, mixed into food.
Red Flags: Women who cannot take estrogen should consult their doctors before using flaxseed.
Researchers at Penn State University gave men with high cholesterol either garlic (Allium sativum) or a placebo. The herb lowered their total cholesterol 7 percent. For every 1 percent decrease in total cholesterol, risk of heart attack drops 2 percent. So according to this study, garlic can reduce heart attack risk by 14 percent. Occasionally, a study shows no benefit, but the vast majority shows that garlic reduces cholesterol and helps prevent heart disease. However, garlic does not reduce cholesterol as much as the statin drugs. If your cholesterol is really high, you may need medication.
Garlic also helps prevent several cancers. In the Iowa Women’s Health Study, researchers followed 41,387 middle-aged women for five years. Those who ate the most garlic had the lowest risk of colon cancer. Fruit and vegetable consumption in general helps prevent cancer, but in this study, of all plant foods analyzed, garlic yielded the greatest preventive benefit. Other studies show that garlic also helps prevent prostate, esophageal, stomach and bladder cancer.
Dosage: Most studies have used approximately the equivalent of one clove a day. Garlic works best when it’s raw or only slightly cooked. Or take garlic supplements, including deodorized brands, which have a similar cholesterol-lowering effect. Garlic supplements with proven benefit include Kwai and Kyolic. Follow label directions.
Red Flags: Garlic impairs blood clotting. If you have a bleeding disorder, don’t take it. If you notice increased bruising, stop taking it, and consult your physician. Stop taking garlic at least two weeks before scheduled surgery, and make sure to inform your physician/surgeon of garlic supplementation.
Perhaps your grandmother gave you ginger ale for an upset stomach. Ginger (Zingiber officinale) is an indigestion soother that also relieves nausea. Australian researchers gave 120 pregnant women either a placebo or capsules containing 1.5 grams of ginger powder (about a teaspoon). Almost immediately, the ginger group experienced significantly less nausea.
Several studies also show that the herb prevents motion sickness. Danish researchers tested it on 80 naval cadets in heavy seas. Compared with those who took a placebo, the ginger group experienced 72 percent less seasickness. To prevent motion sickness, take a capsule containing 1,000 mg of powdered gingerroot about an hour before you embark, and every two hours during your journey. “I use ginger to prevent seasickness,” Duke says. “It works for me.”
Dosage: Start with 1,000 to 1,500 mg. If necessary, take more. Ginger is safe. Or brew a tea using 2 teaspoons of fresh grated root per cup of boiling water. Or drink ginger ale—just make sure it contains real ginger. The label should say ginger extract, not artificial flavor.
Red Flags: Heartburn is possible.
Because of genetics, aging or work that requires extended standing or sitting, the walls of leg veins can weaken. As a result, blood pools in the calves and fluid leaks into surrounding tissue, causing unsightly varicose veins. Mainstream medicine treats varicose veins with support hose and surgery. Add horse chestnut seed extract (Aesculus hippocastanum) to the list. It contains a compound (aescin) that strengthens vein walls, decreasing fluid leakage. Several studies show that it’s effective for varicose veins. German researchers gave 240 varicose vein sufferers either compression stockings or horse chestnut (50 mg aescin twice a day). After 12 weeks, both groups experienced equal relief. Horse chestnut won’t eliminate every little spider vein and it may not help varicose veins you’ve had for years. Many herbalists take it before long plane flights.
Dosage: Follow label directions. Studies use 50 mg of aescin once or twice a day.
Red Flags: Off the tree, horse chestnuts are toxic. Ingestion has killed children. Commercial extracts are detoxified and safe.
Mainstream medicine doesn’t have much to offer those with liver disease (such as hepatitis and cirrhosis). But seeds of milk thistle (Silybum marianum) help. They contain three compounds, collectively known as silymarin, that have a remarkable ability to protect and heal the liver. Italian researchers have shown that milk thistle speeds recovery from hepatitis. Several studies show that the herb helps treat alcoholic cirrhosis. In an Austrian study, compared with alcoholics who did not use milk thistle, those who did were significantly more likely to survive. Milk thistle also helps prevent liver damage from powerful drugs. Most remarkably, this herb treats amanita (“death cap”) mushroom poisoning better than mainstream medical treatments. Swiss researchers analyzed 452 cases of mushroom poisoning. Among those who received standard treatment, 18 percent died. But in the silymarin group, the death rate was only 10 percent, a highly significant difference. “Anyone who drinks alcohol and takes medication regularly might benefit from milk thistle,” Duke says.
Dosage: The typically recommended dose is 140 mg silymarin three times a day.
Red Flags: Side effects are rare, but headache, stomach distress, nausea, hives, itching and joint pain are possible.
Today’s after-dinner mints are an echo of peppermint’s (Mentha ×piperita) traditional use as a stomach soother. German researchers gave 96 indigestion sufferers either a placebo or a peppermint-caraway (Carum carvi) combination. (Caraway seed is another traditional stomach soother.) Four weeks later, 21 percent of the placebo group was much improved, but in the herb group, the figure was 67 percent. “Whenever I get indigestion,” Duke says, “I go out to the garden, pick some peppermint leaves and chew them.”
Dosage: A cup or two of peppermint tea usually produces relief.
Red Flags: None.
Abundant evidence shows that St. John’s wort (Hypericum perforatum) is an effective treatment for mild to moderate depression. While an occasional study suggests otherwise, the vast majority show that for mild to moderate depression, St. John’s wort works as well as Prozac and Zoloft. Researchers in Montreal gave 87 depression sufferers either the herb (900 to 1,800 mg a day) or a standard dose of Zoloft (50 to 100 mg a day). After 12 weeks, both groups showed the same mood elevation based on standard psychological tests. But the herb caused fewer side effects. And a German study shows that the herb is as effective as Prozac—again with fewer side effects. “For mild to moderate depression,” the ABC’s Blumenthal says, “the evidence is strongly in favor of St. John’s wort.”
Dosage: Follow label directions. Studies showing benefits have used 600 to 1,800 mg a day. Most studies have used 900 mg a day.
Red Flags: Stomach upset is possible. St. John’s wort reduces the effectiveness of birth control pills. If you take this herb, don’t use the Pill. The herb also interacts with many other drugs, possibly reducing their effectiveness. If you take medication regularly, consult your physician or pharmacist before using St. John’s wort.
After age 50, the male prostate gland expands and pinches the urethra (urine tube). As a result, men develop urinary problems, notably, the need to urinate several times at night. In a study of 1,098 men with prostate symptoms, European researchers compared saw palmetto (Serenoa repens, 160 mg twice a day) with Proscar, the pharmaceutical treatment. After 26 weeks, both treatments were equally effective, but the herb caused fewer side effects. Minneapolis researchers analyzed 21 studies of saw palmetto for prostate enlargement. Their conclusion: It works as well as Proscar but causes fewer side effects. “I’ve used saw palmetto myself for years,” says Duke, now in his late seventies. “Every man I know who’s my age has had prostate surgery—except me.”
Dosage: 160 mg of saw palmetto extract twice daily or 320 mg once.
Red Flags: None. However, at some point surgery may still be necessary.
Tea (Camellia sinensis) is very high in antioxidants, which help prevent both heart disease and cancer. A five-year Dutch study of 3,454 older adults showed that compared with nondrinkers, those who drank two daily cups of tea had 46 percent less risk of heart attack. Drinking tea also improves survival odds after heart attack, according to 2002 study published in Circulation. Meanwhile, University of California, Los Angeles, researchers surveyed 1,100 Asian women, half of whom had breast cancer. Those who were cancer-free drank the most tea. Japanese researchers have discovered that as breast cancer survivors’ tea consumption increases, their risk of recurrence decreases. Tea also appears to protect against cancers of the colon, rectum, pancreas and esophagus.
Note: All types of tea come from the leaves of the same plant. Drying the leaves produces green tea. Fermenting them yields black tea. Both green and black tea help prevent heart disease and cancer. But for reasons that remain unclear, only green tea reduces risk of breast cancer.
Dosage: One to four cups a day, or as much as you enjoy. A cup of tea has approximately half as much caffeine as a cup of instant coffee and one-third the caffeine of a cup of standard brewed coffee.
Red Flags: Tea contains caffeine and may cause insomnia, jitters and irritability.
Several studies have validated valerian’s centuries-old reputation as a sleep aid, and show it often works as well as pharmaceutical sleeping pills. German researchers gave 202 chronic insomniacs either valerian (Valeriana officinalis) or a pharmaceutical sedative. After six weeks, both treatments were equally effective. But unlike sleeping pills, valerian is nonaddictive. “Valerian doesn’t knock you out like sleeping pills do,” Blumenthal explains. “It can take a few weeks for it to work. But if you keep taking it, valerian usually helps.”
Dosage: Follow label directions.
Red Flags: Raw valerian root smells and tastes terrible. Use a commercial preparation. Some include other tranquilizing herbs, such as hops or lemon balm.
The ancient Greeks called vitex “chaste tree” in the mistaken belief that its berries suppress libido. Actually, its berries balance levels of estrogen and progesterone, which minimizes the mood swings, breast tenderness and bloating of PMS. Many studies show that vitex (Vitex agnus-castus) works. When 1,634 German PMS sufferers took it for three months, 93 percent reported relief from mood upsets, in a study published in 2000 in the Journal of Women’s Health & Gender-Based Medicine. In tests against two other popular PMS treatments, vitamin B6 and Prozac, vitex worked almost as well as the popular antidepressant and “considerably” better than the vitamin. It may take up to three months of daily use to experience benefit. “Vitex is safe,” Blumenthal says, “and the studies are convincing.”
Dosage: Vitex is available in pills, capsules and tincture. Follow label directions.
Red Flags: Some women report side effects, such as stomach distress, headache and increased menstrual flow.
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