Chapter 21: Over-the-Counter Dietary Supplements and Herbal Products

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Hey everyone and welcome back for another deep dive.

Today we're going to be looking at herbal and over -the -counter remedies.

Sounds good.

You guys specifically requested a breakdown of the surrounding the use of herbal remedies especially as these products you know they're becoming more and more mainstream and the numbers here they really paint an interesting picture.

Oh yeah.

You ready to hear this?

Yeah let's dive in.

Okay so back in 1990 only about 2 .5 percent of Americans were using herbal products.

Okay.

But get this by 1997 that number jumped to 12 percent.

Wow.

And then by 2007 nearly 18 percent of Americans were incorporating herbal remedies into their lives.

Huge.

Huge.

That translates to a lot of billions of dollars and a big chunk of that is going toward products that address mood, anxiety, and sleep.

Yeah that makes sense.

So I mean what's driving this surge in popularity?

On one hand it makes sense right we've been using plants for medicine for centuries.

Right.

Morphine from poppies, aspirin from willow bark.

It's a proven concept.

Plus there's that natural appeal right that's definitely a factor for a lot of people.

For sure.

But is this all hype or could we be on the brink of some major breakthroughs in herbal medicine?

I mean what do you think?

Well that's a great question and while the potential for new discoveries is always super exciting it's really important to approach this topic with you know like a healthy dose of caution.

Okay.

Because honestly this boom in herbal remedies it has kind of a shadow side.

Okay so what's the shadow side all about?

You've piqued my curiosity.

The biggest issue is that there's a lack of regulation.

Oh okay.

And like those prescription medications that you just mentioned you know the ones that go through that rigorous testing and have to get approval by the FDA.

Right.

Herbal remedies they're just not held to the same standard.

So someone could basically just bottle up any plant slap a fancy label on it and market it as like a miracle cure.

Pretty much.

Wow.

Yeah and that's that's where things get kind of dicey.

Okay.

There is the USP seal though.

Okay.

It stands for the US Pharmacaia and seeing that on product means it's been independently checked for quality and potency.

Okay.

So that's at least one thing to watch out for.

That makes sense.

So not all herbal products are created equal.

Right.

But if we're not careful about what we're buying what are the risks we're facing?

Honestly some of the research findings are pretty alarming.

Oh no.

Yeah there have been cases where products were tested and they contain absolutely no active ingredients.

Zero.

Zero.

Others have been found to be contaminated with heavy metals like lead or arsenic.

Oh wow.

And get this some have even been found to contain hidden pharmaceuticals.

Wait hidden pharmaceuticals that's illegal right.

You would think so but a lack of regulation makes it really hard to crack down on these practices.

Wow.

So it really is a bit of a wild way out there.

Yeah kind of.

For anyone listening who's thinking about trying herbal remedies or maybe their patients are asking about them I mean where we even begin to navigate this.

Honestly the most important thing is open and honest communication with your health care provider.

Okay.

And it might surprise you to learn that studies have shown that around 70 percent of people using herbal remedies don't even mention it to their doctors.

70 percent seriously.

But why.

I mean wouldn't you want your doctor to know everything you're taking just in case.

Absolutely.

But there can be many reasons why people hesitate you know.

Some people might just forget.

Right.

While others might worry about being judged or think that their doctor won't understand.

Yeah I guess it can feel kind of awkward bringing up something you found like online or at a health food store.

Exactly.

But that open communication it's just vital especially because of the risk of drug interactions.

OK.

You see some herbals can interfere with the way prescription medications work and that can sometimes lead to serious side effects.

That's a really good point.

So besides talking to our doctors what else can we do to make sure we're making safe and informed decisions about herbal remedies.

Well research is key but it can be tricky.

You see because herbs can't be patented there isn't a lot of funding available for the kind of large scale research we see with pharmaceuticals.

Oh that makes sense.

But don't worry there are still some reliable resources out there.

Like what.

Well the USP website we mentioned earlier is a good place to start.

OK.

And there are always credible medical journals that you can explore.

Right.

The key is to just you know double check your sources and make sure that they're reputable.

So natural doesn't always equal safe or effective and we can't just rely on marketing claims or what we read on some random website.

Right.

Exactly.

Got it.

Speaking of research our sources included a really helpful table that breaks down some of the most common herbal remedies and their potential benefits and risks.

Yeah.

Should we take a closer look at that.

Absolutely.

It's fascinating to see the range of potential outcomes with these remedies.

Yeah.

Some like St.

John's work show real promise for certain conditions but even those come with some pretty important caveats.

Yeah St.

John's word was specifically mentioned in the sources as a option for depression.

Right.

And it's been studied quite a bit.

There's evidence suggesting that it can be helpful for mild to moderate depression.

OK.

But and this is a big but it can interact with a whole range of medications.

Really.

We're talking birth control pills

antidepressants even heart medications.

Oh wow.

Yeah.

And the source actually went into detail about the sheer number of potential interactions with St.

John's word.

Yeah.

It's a long list.

Wow.

So even something that might seem harmless could actually have serious consequences if it's mixed with the wrong medication.

Exactly.

That's that's a pretty sobering thought.

It is.

And it just really undersers why that open dialogue with your doctor is so crucial.

Right.

You know they can help you navigate those potential interactions and make informed decisions.

OK.

So St.

John's words a bit of a mixed bag.

Yeah.

What are some other commonly used remedies that we should be well there's Sammy which has also been studied for depression.

But again you know more research is needed to really understand its efficacy and safety profile.

Right.

And then you've got omega 3 fatty acids and some studies suggest that they might have a positive impact on mood disorders even conditions like bipolar disorder.

Right.

And then there was folic acid which is interesting because it's already widely prescribed alongside traditional antidepressants.

Exactly.

It's a great example of how some herbal and supplemental approaches are already being integrated into conventional medicine.

That definitely highlights the complexity of this landscape.

Yeah.

So we've talked about some remedies with promising research but what about those where the jury's still out.

Melatonin is a good example.

OK.

It can be helpful for sleep discurbences but we're learning that even at higher doses it might worsen depression in certain people.

Interesting.

And then you've got ginkgo biloba which is often marketed for memory enhancement.

But the research on its effectiveness is limited and there are potential side effects to consider.

So some potential benefits but still some unknowns.

Right.

And I'm guessing there are also some remedies that are best avoided altogether.

Unfortunately yes.

Like what?

Well yohimbine for example is often marketed for erectile dysfunction but it's been linked to increased anxiety in some individuals.

Oh wow.

And then there's kava kava which is sometimes used for anxiety but it's been associated with liver toxicity in some cases.

Oh jeez.

Yeah.

So we're really seeing a full spectrum here you know.

Right.

Remedies with proven benefits.

Those with potential but still needing more research and those we should probably just steer clear of.

Yeah.

And it all comes back to personalized medical advice.

What works for one person might not work for another and what's safe for one person could be risky for someone else.

Right.

That's why that conversation with your health care provider is so essential.

That makes perfect sense.

So as we wrap up this part of our deep dive,

what would you say is the biggest takeaway for our listeners when it comes to navigating the world of herbal remedies?

The key is to be informed and cautious you know.

Don't just assume that because something is labeled natural it's automatically safe or effective.

Right.

Do your research, talk to your doctor and make informed decisions that align with your individual health needs and goals.

Great advice.

Thank you.

This has been incredibly eye -opening so far.

Good.

We'll be back in a moment to continue this discussion so don't go anywhere.

Sounds good.

Welcome back.

Before we go any further and delve more into specific remedies I think it's important to remember this.

This is a constantly evolving field.

Absolutely.

New products and new research.

I mean they're emerging all the time.

Yeah it's hard to keep up with.

It's like trying to keep up the latest you know trends.

Yeah.

But it's with our health on the line.

Right.

You know what I mean?

It could feel a little overwhelming to be honest.

Yeah I understand that feeling.

You mentioned earlier that herbs themselves can't be patented.

Does that mean that the research is lagging behind simply because there's not like as much profit to be made?

That's definitely a factor.

Okay.

But there's an interesting trend that we're seeing emerge.

Oh tell me about it.

Pharmaceutical companies they're actually becoming more interested in isolating and synthesizing active compounds that are found in these plants.

So they're looking for ways to create like patentable drugs derived from natural ingredients.

Exactly.

That makes sense from a business perspective.

Right and that shift could actually lead to more rigorous research and development of

standardized FDA approved medications that are based on herbal sources.

That's a really cool thought.

It can kind of bridge the gap between those traditional herbal remedies and conventional medicine.

Right.

But until those developments become more mainstream it sounds like skepticism is still our best defense.

Absolutely.

Okay.

We need to balance being open -minded with you know with a critical eye.

Not everything that's marketed as natural is actually safe or effective.

Yeah that's a great point.

But I'm sure a lot of listeners are thinking about you know those

who swear by certain herbal remedies.

Are they all just fooling themselves or is there something to those you know anecdotal experiences?

Well it's really important to distinguish between anecdotal evidence and scientific evidence.

Right.

Just because someone had like a positive experience with an herb it doesn't necessarily mean that it's going to work for everyone or even that it's safe in all cases.

Right.

We can't rely solely on personal testimonials or online reviews.

No.

We need well -designed studies to back up those claims.

Exactly and that's where we run into some challenges.

Okay.

As we discussed earlier there's a lack of large -scale clinical trials for a lot of herbal products and part of that is due to the funding limitations we talked about.

It sounds like a bit of a catch -22 like we need more research to really understand these remedies but the research is limited by a lack of funding.

It can definitely feel that way.

But thankfully there are dedicated researchers and organizations out there that are working to fill those gaps in our knowledge.

That's reassuring.

Yeah.

Are there any particular organizations or researchers that like our listeners should keep an eye on?

Well the National Center for Complementary and Integrative Health or NCCIH is a really great research.

Okay.

They fund research on a variety of alternative therapies including herbal medicine.

Okay so NCCIH could be a good starting point for finding credible information.

Now kind of shifting gears a bit are there any specific conditions where herbal remedies show particular promise even if you know the research isn't totally conclusive yet?

There are definitely some areas of interest.

Okay.

We already touched on St.

John's word for depression but another example is melatonin for sleep disturbances.

While more research is needed it does seem to have some potential for regulating sleep cycles.

And melatonin is readily available over the counter.

It is.

I know a lot of people who use it for occasional sleep issues.

Yes and that brings up a really important point.

What's that?

While caution is definitely warranted it's crucial that we don't dismiss the potential benefits of herbal remedies entirely.

Some of them may actually hold real therapeutic value.

Okay so it's about finding that balance between being open to those possibilities while also you know thinking critically and demanding evidence.

Exactly.

Speaking of exploring different approaches our sources also touch on some emerging treatments in mental health and there were a few developments that really caught my eye.

Oh yeah.

What do you think about this?

Yeah there's some really exciting research happening.

Okay.

One treatment that's been generating a lot of buzz is ketamine.

Ketamine?

I thought that was like an anesthetic.

Right it is and it's also been known for its recreational use but recent research has actually revealed that it can have really rapid antidepressant effects especially in people who haven't responded well to traditional antidepressants.

So this is a ketamine works on a different neurotransmitter system than most antidepressants.

Okay.

It targets something called the NMDA receptor.

That's really fascinating.

What's the current status of ketamine as a depression treatment?

Is it readily available?

Well it's still relatively early in the research process but the initial findings are really promising.

Okay.

In fact a form of ketamine called s -ketamine has already been approved by the FDA for treatment resistant depression.

Wow.

And it's used in conjunction with other antidepressants.

That's a significant step forward.

I mean that could be a game changer for people who haven't found relief with other treatments.

Absolutely.

But are there any downsides or risks associated with ketamine treatment?

Like any medication ketamine does have potential side effects.

Okay.

Some people experience things like dissociation, nausea or dizziness.

Okay.

And long -term effects of using ketamine for depression are So it's really important to weigh those potential benefits against the risks and have those open and honest conversations with your doctor before considering this treatment, right?

Absolutely.

And it's crucial to remember that ketamine treatment should always be administered by qualified medical professionals in a controlled setting.

Okay.

It sounds like the field of mental health is constantly evolving with new discoveries and treatments emerging all the time.

It is.

Yeah.

It's both exciting and a bit overwhelming.

I agree.

We're in a time of just incredible advancements in neuroscience and psychiatry.

Absolutely.

What else is kind of on the horizon?

Any other treatments we should know about?

One area with just immense potential is the use of psychedelics in treating mental health conditions.

Psychedelics.

You mean like LSD and magic mushrooms.

Yes, exactly.

While these substances have been associated with recreational use for decades,

researchers are now exploring their potential therapeutic application.

This is definitely a It is.

How are they being used therapeutically?

There are ongoing clinical trials investigating the use of psychedelics like psilocybin, which is the active ingredient in magic mushrooms.

Okay.

And MDMA, also known as ecstasy.

Okay.

They're being studied for their potential to treat conditions like depression, anxiety, and PTSD.

Wow, that's incredible.

Yeah.

What's the rationale behind using these substances for therapeutic purposes?

Well, psychedelics have been shown to alter consciousness and perception.

Okay.

Which may help individuals to process trauma, overcome negative thought patterns, and even foster a sense of connection and wellbeing.

So it's not just about masking symptoms, but potentially addressing the root cause of these conditions?

Precisely.

And early research is suggesting that psychedelic assisted therapy can be very effective with some individuals even experiencing lasting positive results after just a single session.

That's truly remarkable.

Yeah.

It feels like we're on the verge of a paradigm shift in mental health treatment.

It certainly seems that way.

But it's crucial to remember that research is still in its early stages.

Yes.

And these therapies should only be administered in a safe, controlled setting with trained professionals.

Yeah, absolutely.

Right.

Self -medicating with these substances is definitely not advisable.

No.

There are some inherent risks involved.

For sure.

We need to proceed with caution and continue with rigorous scientific inquiry, but the potential of these treatments is undeniably exciting.

I agree.

This whole conversation has been such an eye -opener.

Good.

We've covered so much ground.

We have.

From the intricacies of herbal remedies to the cutting edge of mental health treatment, it's amazing how much this field is constantly evolving.

It is.

It's a reminder that we need to be proactive in our own health and wellbeing.

Absolutely.

Staying informed about these new developments.

I mean, it's key.

Well said.

Thank you.

We'll be back, average or short break, to wrap up this fascinating deep dive.

Okay.

Stay tuned for more.

And we're back for the final part of our deep dive into the world of herbal remedies and emerging treatments.

It's been quite a journey, hasn't it?

It really has.

I mean, from traditional herbal wisdom to the mind -blowing possibilities of psychedelic therapy, it's clear that there are so many different approaches to health and wellness.

So many.

But with so much information out there,

it could be tough to know where to turn for reliable guidance.

Yeah.

So how do we sift through all the noise and make informed choices?

Well, that's where critical thinking becomes super important.

We've talked a lot about research during this deep dive, but there's another layer we need to think about, influence of marketing and cultural trends.

Because just because something's trending on social media or has like a celebrity endorsement, that doesn't necessarily mean it's actually backed by solid science, right?

Exactly.

I mean, the wellness industry is a multi -billion dollar market.

Wow.

And sometimes marketing just gets ahead of the research.

It's so easy to get caught up in the hype, especially when we're desperate for solutions to health concerns.

Absolutely.

So do we avoid falling into that trap?

What are some red flags that our listeners should watch out for?

I think the first step is to be mindful of our own biases and motivations.

Like, what are we hoping to achieve with a particular product or treatment?

Right.

And what are our underlying beliefs about health and wellness?

That's a good point.

I mean, we all kind of come to this with our own preconceived notions, whether we realize it or not.

Absolutely.

And those are shaped by so many factors, right?

Like our upbringing, personal experiences, the media we consume, taking a moment to actually examine those influences can help us approach information with a more critical and discerning eye.

It's like checking our internal compass before we set off on any health journey.

I love that analogy.

It's about grounding ourselves and making sure we're not just blindly following trends or getting swayed by clever marketing.

Okay.

Once we've got our bearings, what are some strategies for evaluating the information that we come across?

Always look for credible sources.

Stick with reputable medical journals, government websites like the NCCIH that we mentioned earlier, organizations like the USP.

Those are all excellent resources.

Yeah.

So it's really about being active, informed, and engaged participants in our own health journeys, right?

Absolutely.

We can't just absorb information or blindly follow, you know, the latest fads.

We need to be critical thinkers, questioning what we hear and demanding evidence.

And sometimes that means challenging the status quo and exploring different approaches.

Absolutely.

That's part of what makes this field so dynamic and exciting.

There's always more to learn and new possibilities to discover.

Well, on that note of exploration and discovery, we've reached the end of our deep dive.

Oh, wow.

Time flies.

I hope this conversation has empowered our listeners to approach the world of fertile remedies and emerging treatments with both curiosity and a healthy dose of skepticism.

I think so.

You know, it's been a pleasure sharing these insights with you.

Me too.

Remember, knowledge is power when it comes to making informed choices about our health.

Absolutely.

A huge thank you to all of our listeners for joining us on this adventure.

Thanks for having me.

And as always, if you have any thoughts, questions, or suggestions for future deep dives, we'd love to hear from you.

Yes, please reach out.

Until next time, stay curious, stay informed.

And remember, the journey to well -being is a lifelong exploration.