Botanical Dietary Supplements: Quality, Safety and Efficacy. (Book Review).
285 p. Swets & Zeitlinger Publishers B.V., Lisse, The Netherlands 2001. Price U.S. $ 79.95, DF 175.00; [euro] 79.50 ISBN 90265 1855-2 (HC).
Plants and plant products have been used in medicine for centuries. Rapidly increasing popularity of natural products in developed countries in recent years has been spurred by the growing public interest in alternative medicine and by the lure of the financial profit from their growing markets. In some countries, including the USA, the herbal medicinal products are classified as botanical dietary supplements and therefore are not subjected to the same strict regulations as pharmaceuticals. As more and more botanical products are being offered for common use, physicians and consumers alike are pondering over their quality, safety and efficacy.
The book written by Drs. Mahady, Fong and Farnsworth comes out at the right time. The authors are renowned scientists of the University of Illinois at Chicago working in the field of medicinal plant research and herbal medicines at the UIC/NIH Center for Botanical Dietary Supplements Research, Program for Collaborative Research in Pharmaceutical Sciences. They have been investigating herbal medicines for the Traditional Medicine Program organized by the World Health Organization. Dr. Farnsworth's outstanding career alone has led to more than 240 publications in peer-reviewed journals and several books. He has also established the NAPRALERT database, the world's largest and probably the most complete database of natural products. Considering the attractiveness of the topic and experience of the authors, this recent book is expected to be a success as well.
And the book certainly lives up to its high expectations. It describes in detail some of the top selling botanicals from all over the world, namely black cohosh, chaparral, comfrey, cranberry, echinacea, ma huang, evening primrose, feverfew, garlic, german chamomile, germander, ginger, gingko, horse chestnut, kava, milk thistle, nettle, Siberian and Asian ginseng, saw palmetto, St. John's worth and valerian. Furthermore, it offers a comprehensive introduction to the botanical market, regulatory status and standardization of botanicals and botanical products on the world.
Each of the 22 individual monographs of the specified botanicals begins with a useful synopsis of the most important information included in the chapter. A short but comprehensive Introduction includes a scientific name, geographic location and historical medicinal use of each botanical. The major chemical constituents present in the plant are described in the Quality Information section. The Medical Uses section lists the medical use of the botanical among ethnic groups around the world and the Clinical Evidence section includes all the clinical trials carried out with the botanical. The authors also add a critical analysis of the value of these trials and their outcome. When known, information about the Mechanism of Action of these botanicals can also be found. A pharmacokinetics section wisely included in each monograph shows an alarming lack of information in this area. Almost 50% of the botanicals included in the book do not have any pharmacokinetic data reported. It is difficult to know what drug intera ctions may happen when botanicals and prescription drugs (such as those known to be metabolized by cytochrome P450) are consumed concomitantly. Information about adverse reactions, contraindications, drug interactions, toxicology, dose and dosage forms is included in the Safety Information section. It allows the reader to make decisions about safety, efficacy and quality of the described botanicals. All the information given in the individual sections is fully referenced allowing the reader to access details when needed.
The book is very well organized, balanced, and written in a comprehensible language. Its scope will surely satisfy experienced professionals, physicians and life science researchers. It may also stimulate research particularly in areas that have not been extensively covered, such as pharmacokinetics and pre- and clinical studies. It will certainly not deter less experienced readers or consumers of botanical products looking for scientific data. Overall, the authors have accomplished their goal of providing accurate scientific information about the safety, efficacy and quality of these top-selling botanicals to the general public. I consider the book a must for all readers with a serious interest in medicinal botanicals.