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April 19, 2000 -- Some popular herbal supplements, including St. John's wort and echinacea, scored low in a huge Consumer Reports survey ranking the effectiveness of alternative medical therapies.
About 46,000 of the magazine's readers took part in the survey, which asked them to describe how they treated the two worst medical conditions they had experienced in the past two years -- and how well those methods worked. About a third reported using some form of alternative treatment, but in general, those therapies fared poorly when compared with conventional medicine.
For the 43 medical conditions reported, surgery ranked tops in providing relief, followed by prescription drugs, the survey found. About 40% of the respondents said "alternative manual" therapies, such as massage and chiropractic treatment, helped them feel much better -- about the same proportion who gave high marks to lifestyle changes such as diet and exercise.
But often, mind-body techniques, herbals and other supplements, and nonprescription drugs provided little or no relief, the survey found.
Consumer Reports also looked at treatments used for 10 specific medical conditions, including depression. Dead last in this category was St. John's wort, which fewer than 20% of respondents said helped them feel much better. About three times as many people said the herb helped "only a little or not at all."
Another popular herb fared poorly for treating respiratory infections. Echinacea, a supposed immune-system stimulator, ranked last in this category, with more than 40% saying it didn't help much. Echinacea also brought up the rear in the allergy category, just behind homeopathy. In fact, echinacea, as a member of the aster family of plants, has been known to actually cause allergic reactions.
Further, almost half of those who reported using saw palmetto for prostate problems got little or no relief from the herb. Garlic supplements also consistently scored poorly.
One expert says the report should not lead to a wholesale condemnation of herbs.
"The key word here is instantaneous or quick effects," says June Riedlinger, PharmD, director of the Center for Integrative Therapy and Pharmaceutical Care at the Massachusetts College of Pharmacy in Boston. "Herbs overall take a longer time to create changes. But that longer time taken is allowing the body to use many more of its own processes to correct the imbalance."
Riedlinger says Americans tend to be impatient -- which could account for some dissatisfaction with herbs -- plus, people may be using them relatively late in the disease process. "One of the problems we have in this country is [health care professionals] are not communicating with patients. We're not really using the treatments and tools available to help people when these imbalances start early on."
But Consumer Reports suggests that things are changing: Its survey found that about a quarter of those who tried alternative therapies did so on the advice of a doctor or nurse. Among patients who told their doctors they had used an alternative therapy, just 5% reported getting a negative reaction.
When it comes to supplements, the doctors' reactions don't necessarily mean they believe in their effectiveness, says John Renner, MD, president of the National Council for Reliable Medical Information. "There are just so many people talking about herbs," he says. "Physicians are just part of society."
Renner says the supplement industry effectively neutralized the Food and Drug Administration in 1994 with passage of the Dietary Supplements Health and Education Act, which restricted how the FDA can regulate dietary supplements. He worries that new legislation in Congress may have the same effect on the Federal Trade Commission, which keeps an eye on product claims.
"I think we've got some serious problems, at a time when there are an awful lot of good medicines available," he says. "We're fighting some awfully strange battles."
Supplements and herbs weren't the only therapies getting low marks in the Consumer Reports survey. Take magnets, which some respondents used for back pain and arthritis. In both situations, the majority of users found they provided little or no relief. Still, one manufacturer says they're worth a try.
"It does come down to this," says George Hou, executive vice-president of Magnetic Ideas Inc. in Sevierville, Tenn. " have no side effects. If a person is in severe pain it behooves them to try various products that don't have side effects." And unlike herbs, he says, magnets work quickly -- if they're going to work at all.