December 1, 2015 // Kate Welch
As both a licensed pharmacist and a practicing herbalist, I often find myself in one or the
other of two disparate communities: either that of conventional medicine (such as a
hospital, or pharmacist conference) or alternative medicine (like an herbal healing
conference or health-food store).
The negative reactions I sometimes get from members of one community about the other
no longer surprise me, but I often wonder why they are so severe, and how someone can
wholly dismiss another way of thinking completely in one fell swoop. Conventional
medical practitioners who state that herbal remedies are worthless and anyone who
vouches for them charlatans, for example. Or: alternative medicine practitioners who
insist that the entire corpus of conventional allopathic medicine is poisonous and corrupt.
It’s not that I don’t expect these two philosophies to disagree. They often do, as they are
based upon different principles of healing. It’s just that I find it hard to condemn any
body of knowledge wholesale that springs from sincere human experience as well as
thorough scientific investigation. Take what you like and leave the rest, as they say.
The fact is, most of my patients use both alternative and conventional medicine,
sometimes intermittently, sometimes at the same time. A 2007 survey through the
Centers for Disease Control revealed that 38% of adults used some form of
complementary and alternative therapy (you can see what the survey considers to be
Most important to me, as a pharmacist, is knowing what kinds of vitamins, minerals, and
herbal supplements my patients are taking, as they can sometimes interfere with
prescription medications. The 2007 survey cited above revealed that the most popular
supplements patients used were fish oil/omega-3 fatty acids; glucosamine; Echinacea;
flaxseed; ginkgo; garlic; and coenzyme-Q-10. All of these supplements can potentially
interact with prescription drug therapy in myriad ways, but all of them can be taken
safely with prescription drugs if dosed and monitored properly.
Patients often decline to disclose to their providers that they are taking certain
supplements for fear of being told not to take them. Since many providers know little
about supplements, they can react negatively and simply recommend their patients not
take any at all.
It’s hard to argue with this approach, since taking NO herbal or dietary supplements
along with prescription drugs IS, indeed, always the safest option when it comes to
preventing drug interactions. However it is not always the practical or ideal option, since
not only can herbal and dietary supplements improve health, but also they can help
empower the patient to make positive investments in their own care.
What follows are some general statements regarding the realms of conventional and
alternative medicine, which can serve as guidelines to why you might choose one method
over the other at any given time:
1) Conventional drugs are single-molecule entities; herbal medicines are comprised of
multiple compounds. Most conventional OTC and prescription drugs are single
molecules aimed at affecting a specific biological target: for example, the popular
“statin” drugs, which block an enzyme in our bodies that produces cholesterol., thus
reducing the amount of cholesterol in our bodies that can cause problems. Most herbal
medicines, on the other hand, are comprised of whole plant extracts, either extracted in
water (tea) , alcohol (tinctures) or powdered for whole consumption (capsules) which
contain a variety of components (sometimes hundreds) that are found in the plant.
We do not always know which component of an herbal medicine is responsible for its
desired effects; in many cases, it turns out that more than one component is at work. For
example, St. John’s Wort, a plant used to treat depression; for a long time the molecule
hypericin was thought to be the only active principle in the plant, but it turns out that
hyperforin, another component, is just as important. The two components appear to act on
different biological targets implemented in depression, and therefore work synergistically
to treat symptoms of depression. In addition to hypericin and hyperforin, St. Johns Wort
contains other compounds that may help treat depression or modify the actions of the
active constituents in a beneficial way.
The take-home message here is that the benefit of conventional pharmaceutical drugs is
that they are purified molecules that have a specific target in treating a symptom or
disease, and are therefore usually more direct, predictable, and potent in their effects.
Herbal supplements, on the other hand, contain many molecules with varied targets and
potential co-modifications inherent to the whole plant, and are therefore generally less
potent or specific in effect. Plant-based medicines are, as a result, safer when consumed
in their most traditional forms: as teas, tinctures, or ground up as powders added to food
or in capsules.
Of course there are many dietary supplements like vitamins, minerals, and supplements
that are single-molecule entities; like Vitamin K, or Co-Enzyme Q10. These supplements
therefore do act more “drug”-like, and, while generally safe, can cause more acute or
chronic problems if taken in large doses incorrectly.
2) Conventional drugs support the offense; herbal and dietary supplements support the
defense. Conventional medicine is sometimes called “allopathic” medicine, the Greek
roots here “allo” meaning “other” and “pathic” meaning “treatment”. In this context,
“allo” suggests that conventional drug therapies work by “opposing” whatever pathology
is leading to an unwanted disease or symptom, acting “against” it.
In this way, most conventional drugs work like soldiers in a war: they are sent out to
block or destroy an “enemy” target that is causing discord or disease to the otherwise
healthy host. Think about antibiotics: these are drugs that target invading bacteria
directly, making it impossible for them to survive or to reproduce, thus getting the
numbers down until the host defense system can take over and symptoms from the
Herbal drugs and dietary supplements, however, excel at supporting the defensive
resources of a host, assisting it in combating an acute infection and perhaps keeping the
host healthy enough to ward off a mounting bacterial infection in the first place.
Although there are many herbs that have excellent direct antibiotic properties, in general
they are not potent enough to treat an acute bacterial infection as quickly as may be
needed to prevent long-term complications or even death. In this regard, it is better to use
herbs and dietary supplements to help shore up and restore the natural defenses we are all
born with. Think about the herb Echinacea here, or the Reishi mushroom, or good old
Vitamin C: all have been shown to increase the number and activity of human immune
3) Conventional drugs excel at treating acute and severe health problems; herbal and
dietary supplements excel at treating chronic and mild health-care issues. Conventional
drugs, as the single-molecule “soldiers” that directly attack or address the immediate
cause of the problem, are essential as the short-term, quick fix to an immediate,
Take steroid drugs like prednisone, for example. If you encounter an allergen that causes
your body to break out in red welts or causes your lungs to become inflamed, prednisone
acts quickly and efficiently to block the molecules in your body that are reacting to the
allergen and causing the disturbing symptoms of inflammation in your lungs and skin.
The prednisone is essentially blocking your body’s first-line immune system here, which
can sound scary but at this juncture it has to since this can save your life if, say, you can’t
breathe because of the inflammation.
Herbs can rarely act like this; nor should they. As sources of many different chemical
components with a myriad of targets, herbs are better used to help support the body’s
own mechanisms rather than fight against them. Prednisone, for example, does not
address the cause of the inflammation, which is the allergen itself and the body’s over-
reaction to it. Furthermore, it is not safe to take prednisone for long periods of time as it
can cause bone weakening and diabetes.
An herb like Stinging Nettle, on the other hand, appears to reduce the amount of
histamine released in response to some allergens. However, it does not work quickly like
prednisone or an OTC antihistamine; it is better taken regularly throughout the allergy
season to prevent symptoms rather than treat them.
These are all general ways of characterizing conventional drugs and herbal medicines as
a way of thinking about where they best fit in one’s overall health picture. There are
many exceptions and many ways of working with both conventional drugs and
herbal/dietary supplements. The important thing is to let all your health-care providers
know what drugs and supplements you are taking and how often you are taking them, and
go over your specific health-care goals for each one as a way of determining whether or
not they are working for you in the short or the long term.