Echinacea: It works; oops, it works not
Saw palmetto not effective for BPH


A new system has been devised to rate the efficacy of herbal medicines according to published evidence. The Natural Standard Research Collaboration group in Cambridge, Mass. provides reviews of data on herbal medicines and alternative practices, evidence-based information on safe and drug-herb interactions, and an efficacy rating for herbal treatments.

Based on evidence and safety, the rating provides a National Standard Grade for each clinical application.

Definitive evidence of benefit

Quality evidence of benefit that is not definitive, with positive animal data

Data less than rigorous (such as in small trials or case-cohort studies), conflicting or derived only from laboratory or animal studies 

Fair evidence showing no effect.

The 10 most popular herbs were given the following ratings:

Herb Rating
Black cohosh  Menopausal symptoms - B; Joint pains - C 
Evening primrose oil Atopic dermatitis - B; preeclampsia, Raynaud's, asthma - C or D
Saw palmetto
Benign prostatic hypertrophy - A; male pattern baldness and underactive bladder - C
Valerian Insomnia - B; anxiety disorder - C; sedation - D.
St. John's wort Severe depression B or C; mild to moderate depression - A; anxiety disorder, obsessive-compulsive disorder, perimenopausal symptoms and premenstrual syndrome -C

Treating upper respiratory infections - B; prevention of upper respiratory infections , radiation-induced neutropenia, cancer - C; genital herpes - D
Vascular conditions, eye disease - C; improvement of night vision - D

Prevention of urinary tract infection - B; antiviral, antioxidant, antifungal, cancer prevention - C; treatment of urinary tract infection, kidney stones, dental plaque - C
Wild yam Menopausal symptoms, hyperlipidemia - C

Chemotherapy-induced and pregnancy-associated nausea - B; post-surgical nausea and motion sickness - C; rheumatoid arthritis, osteoarthritis, arthralgia and muscle pain - C.

For more information, visit the Natural Standard Research Collaboration's Website:
Group Rates Efficacy of Herbal Treatments Compriles Safety Data
Timothy Kirn. Internal Medicine News. April 1, 2004.

In the News!

Echinacea: It works; oops, it works not !
The NIH has bad news on a millions of users spending more than $150 M a year on Echinaea: for cough, runny nose and the common cold, it doesn't work. 399 volunteers on echinacea extract or placebo were squirted by rhinovirus up their noses. And the echinacea did not have any effect on the rate of infection or symptoms. Colds are self-limited, and it is easy to attribute improvement to echinacea rather than just tincture of time.
New England Journal of Medicine

Saw palmetto not effective for BPH
A rigorously designed trial, governemtn funded, controlled and double-blinded, found that saw palmetto produced no improvement in men with symptoms of moderate to severe BPH, a finding that differs from the bulk of previous literature.
Bent Kane, Shinohara K, et al.
N Eng J Med 2006;354:557-566