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The Herbal Industry

Feeling a little depressed? You could get a prescription for Prozac or try psychotherapy. But 7.5 million Americans in the past year have instead gulped down an extract made from a bright yellow flower called St. John's wort--available without a prescription at the health-food store in the mall or at the local Wal-Mart. Fear the onset of cold and flu season? You could get a flu shot. Or, like 7.3 million Americans, you could swallow a capsule made from echinacea, a purple-petaled daisy native to the Midwest. Worried that your memory is fading? Then write down this name: ginkgo biloba. It's made from the fan-shaped leaf of a tree found from China to South Carolina, and 10.8 million Americans regularly remind themselves to take it.

Whether they seek to brighten their moods, stave off disease, rev up their sex lives or retain their youth, more and more Americans are supplementing and replacing prescription medicines with a profusion of pills and potions that contain various medicinal herbs, vitamins and minerals. Some are proved safe and effective; many are not. Consumers spent more than $12 billion on natural supplements last year--nearly double the amount spent in 1994, and sales continue to grow at better than 10% a year. Shoppers can stock up not only at incense-scented tofu-and-sprouts shops but also at corner pharmacies and supermarkets, and from mail-order houses, websites and Amway distributors who rattle their pillboxes door to door. Preparations made from herbs--from aloe for regularity to valerian for restful sleep--are the hottest of all, with some 60 million Americans now swallowing doses regularly. And for those who crave a tastier fix, there are new so-called functional foods--concoctions such as fruit juice laced with ginseng, or corn chips with kava, the one claiming to perk you up and the other to calm you down.

This blossoming market for all things herbal has attracted growing interest from everyone from Ann Landers (who recommends herbs as an alternative to Viagra) and Larry King (whose radio ads credit ginseng for his youthful, uh, glow) to professors of medicine and Wall Street investors. The Journal of the American Medical Association (J.A.M.A.) released an issue devoted entirely to studies of herbs and so-called alternative remedies. Among the eye-opening findings: Americans today make more visits to nontraditional physicians, including naturopaths who claim expertise in herbs and other natural therapies, than to their family doctors. And they spend almost as much out of pocket (not reimbursed by health insurance) on alternative medicine ($27 billion) as on all unreimbursed physician services ($29 billion).

The growth of the herbal-supplement industry continues at approximately 30 % per year (Foster and Tyler, 2000). In a survey conducted between 1998 and 1999, about 49 % of American adults, some 100 million people, tried remedies from plants. Of these, 25 million individuals (24%) considered themselves regular medicinal herb consumers (Castleman, 2001).

The frantic expansion of the market for herbs and other supplements, though, comes at some risk to consumers. These products are not regulated in the U.S. nearly as strictly as over-the-counter drugs or even foods--in sharp contrast to countries like Germany, where the government holds companies to strict standards for ingredients and manufacturing. Experts say that while the top U.S. and European manufacturers pay close attention to the safety, effectiveness and consistency of their products, parts of the industry resemble a Wild West boomtown, where some 800 lightly regulated U.S. companies compete ferociously with fly-by-night hucksters. "When you open a bottle of nutritional supplements, you don't know what's inside," says Jeffrey Delafuente, a pharmacy professor at Virginia Commonwealth University in Richmond. "There may be some ingredients not listed. You do not know how much active ingredient is in each tablet. They can make all kinds of claims that may not be accurate."

The market in dietary supplements is booming. Total sales were about $9 billion in 1997, double that of five years ago. According to a poll conducted by Multi-Sponsor Surveys, 43% of American adults took some kind of vitamin or mineral last year, compared with 33% in 1991. But dietary supplements also include herbal remedies: Americans spent $600 million on such products last year.


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