10 herbs you need to know; your guide to some of the most useful herbs on the market

Better Nutrition, May, 2002

Store shelves full of herbal supplements are proof of the surging popularity of natural remedies--ginseng and St. John's wort are practically household names. Of course, there are many other herbal remedies that promote health and wellness, but learning about them can seem overwhelming. We prepared this herbal primer to use when you visit your doctor, herbalist or specialist at your natural products store. Consult it to start a dialogue, ask questions or find the product you need.

Horse Chestnut (Aesculus hippocastanum)

PRIMARY USES: * Venous insufficiency (chronic) * Varicose veins (legs) * Symptoms associated with varicose veins such as swollen legs, pain and heaviness in legs, and calf pain

AVERAGE DAILY DOSE: Dry extract from dried seed (standardized to 16 percent to 20 percent triterpene glycosides): 250 to 312.5 milligrams (mg), twice daily, equivalent to 100 mg escin daily. Dry extract front fresh seed (standardized): two tablets containing 63 to 90 mg each, three times daily (equivalent to 120 mg escin daily). After one to two weeks reduce to one tablet, three times daily.

NOTE: Unprocessed horse chestnut seeds should not be eaten or made into tea.

ADVERSE EFFECTS: Rare adverse effects can include severe itching, nausea, stomach complaints, irritation of the stomach's lining and reflux. An isolated horse chestnut seed chemical, escin Ib, might partially delay or even inhibit emptying of the stomach. This possibly adverse effect can be minimized by taking the extract in an enteric-coated tablet with the main meal.

Evening Primrose Oil (Oenothera biennis)

PRIMARY USES: * Atopic dermatitis * Painful breasts during menstruation * Breastfeeding aid * Uremic skin symptoms * Nutritional deficiencies (essential fatty acids) * Seborrhoeic dermatitis (milk crust) * Infant formula fortification * Raynaud's disease * PMS * Diabetic neuropathy * Rheumatoid arthritis

AVERAGE DULY DOSE: Capsules (500 mg each): Atopic dermatitis: four to six capsules, twice daily. Painful breasts during menstruation: six capsules, daily for four to six months. Diabetic neuropathy: eight to 12 capsules. Breastfeeding aid: four capsules, twice daily. Rheumatoid arthritis: 10 to 20 capsules. Uremic skin symptoms: two capsules, twice daily.

ADVERSE EFFECTS: Adverse effects are rare at recommended dosages. Occasionally, headache, mild nausea and abdominal bloating may occur.

Saw Palmetto (Serenoa repens)

PRIMARY USES: * Alcoholic liver disease * Alcoholic liver cirrhosis * Infectious hepatitis * Drug-induced hepatitis

AVERAGE DAILY DOSE: Crude berries: 10 grams, twice daily. Liquid extract: 1 to 2 milliliters (mL), twice daily. Soft native extract: 160 mg, twice daily. Dry normalized extract: 400 mg, twice daily.

ADVERSE EFFECTS: Gastrointestinal disturbance occurs rarely. Large amounts may cause diarrhea. Taking saw palmetto on an empty stomach may cause nausea. High blood pressure occurred in 3 percent of patients involved in one clinical study.

Ginkgo (Ginkgo biloba)

PRIMARY USES: * Memory loss and poor concentration related to dementia or Alzheimer's disease * Ringing in ears * Dizziness * Increase in pain free walking distance in cases of poor circulation to lower legs * Altitude sickness

AVERAGE DAILY DOSE: Dry extract (standardized) Dementia: 40 to 60 mg tablets or capsules, two to three times daily (total of 120 to 240 mg per day). Leg pain, vertigo and ringing in the ears: 120 to 160 mg, taken in 40 to 60 mg doses, two to three times daily.

ADVERSE EFFECTS: Stomach or intestinal upsets, headaches or allergic skin reactions occur rarely. Dizziness and throbbing heartbeat may also occur.

Valerian (Valeriana officinalis)

PRIMARY USES: * Anxiety * Insomnia * Sleep disorders * Restlessness linked to some nervous disorders * Enhanced mood based on improved sleep

AVERAGE DAILY DOSE: Tea: Pour 150 to 250 mL boiling water over 2 to 3 grams of fresh or dried root, once to several times daily. Liquid extract: 0.5 to 1 teaspoon (1 to 3 mL), once to several times daily. Tea or dry extract (sleep aid): Single close 30 minutes to one hour before bedtime, with earlier dose in evening if necessary.

ADVERSE EFFECTS: While valerian is generally considered safe, adverse effects can include headache and stomach upset.

Hawthorn (Crataegus monogyna, C. laevigata, C. piperi, C. rivularis)

PRIMARY USES: * Congestive heart failure

AVERAGE DAILY DOSE: Hawthorn leaf with flower Tea: Pour 150 mL boiling water over 1.5 grams dried herb, steep for 10 to 15 minutes, three to four times daily, during or after meals. Dry extract (standardized to 30 to 168.7 mg procyanidins or 3.5 to 19.8 mg flavonoids): 160-900 mg, in two to three individual doses.

NOTE: Patients should not attempt to self-medicate for suspected or properly diagnosed cardiac conditions. Seek the advice of a healthcare provider for appropriate treatment.

ADVERSE EFFECTS: None known.

Licorice (Glycyrrhiza glabra)

PRIMARY USES: * Inflammation of the upper respiratory tract mucous membranes * Oral ulcers * Gastric and duodenal ulcers