JAMA: Cranberry for UTIs is the only herbal supported by some scientific evidence

By Stephen Daniells

- Last updated on GMT

"The Patient Page is flat-out wrong to suggest that only one herb is supported by scientific evidence," said Steve Mister, president and CEO of CRN. Image: © iStockPhoto / darios44
"The Patient Page is flat-out wrong to suggest that only one herb is supported by scientific evidence," said Steve Mister, president and CEO of CRN. Image: © iStockPhoto / darios44

Related tags Food and drug administration Pharmacology

Herbal medications and supplements are lacking clear proof of any beneficial effects, except cranberry for UTIs, states a new Patient Page in the Journal of the American Medical Association (JAMA).

The JAMA Patient Page​ (“a public service of JAMA”) states that patients should talk to their doctors about the products, but cautions that, with the exception of cranberry, “the efficacy of other commonly used herbal medications has not been proven”​.

“For instance, the beneficial effect of St John’s wort for short-term treatment of mild to moderate depression is still debated. Use of Echinacea for treatment of colds is not supported by scientific data. Similarly, there is questionable evidence on the efficacy of ginseng, which is often used to improve physical and cognitive performance,” ​write Graziano Onder, MD, PhD, and Rosa Liperoti, MD, MPH.

“Ginkgo biloba has been marketed to improve memory and cognitive performance, but there is no consistent scientific evidence to support this use. The efficacy of garlic in lowering cholesterol levels, treating hypertension, and reducing cardiovascular risk is uncertain.

“Furthermore, no beneficial effect has been attributed to ginger for treatment of nausea or to soy for control of menopausal symptoms.”

The piece goes on to state: “There are numerous concerns related to the use of herbal medicines because unlike conventional medications, they are not regulated by the US Food and Drug Administration and manufacturers do not have to prove the safety and efficacy of herbal medications before they are made available to the public.”

“Flat-out wrong”

In response to the Patient Page, Steve Mister, president and CEO of the Council for Responsible Nutrition (CRN), said: “The Patient Page is flat-out wrong to suggest that only one herb is supported by scientific evidence—a quick search of PubMed for any particular popular herb will produce dozens of scientific studies linking these products to research on various health conditions. Granted, this research may not be focused solely on randomized clinical trials (RCTs) as drug research would, but RCTs are necessary for drugs because they are used to treat disease and can have serious side effects.

“In contrast, herbs have been used safely for thousands of years by different cultures globally and are primarily used today as dietary supplements to maintain health and for mild health conditions. Further, from a practical standpoint, consumers may be more interested in their own experience of benefits rather than the results of clinical trials. Many patients would prefer to take products that may offer some benefit, rather than take nothing while waiting for the perfect clinical trial. It is important that these patients communicate openly with their doctors about their choices. 

Steve Mister CRN
Steve Mister, CRN

Mister continued: “By focusing on alarmist tactics, cherry-picking the science, and spreading misinformation, rather than embracing the patient’s desire to focus on a health-based lifestyle that goes beyond prescription medications, physicians could be losing an important opportunity to ensure that their patients are open about what they’re taking.

“The authors may not like the way supplements are regulated, but it is inaccurate to state they are not regulated by the US Food and Drug Administration (FDA). Supplements are subject to extensive manufacturing and labeling requirements and FDA has enforcement tools to be sure they are followed. Further, even with highly-regulated pharmaceuticals, pre-market testing doesn’t prove safety, and as we are all aware, sometimes these drugs are later recalled for safety issues.”

“A missed opportunity for dialogue and patient trust”

Mister did say that CRN does agree that patients should let their physicians and other healthcare practitioners know about the herbal supplements they use and how much they are taking, just as they should let them know about their prescription drugs, over-the-counter medications, and even significant changes in diet.

“Research shows that supplement users engage in a constellation of healthy practices and are higher educated than non-supplement users. We believe that supplement users want to play an active role in identifying ways to stay healthy and live longer; and they are looking for doctors to be partners, sharing their knowledge but being open to a patient’s interest in a healthcare paradigm that goes beyond an over-reliance on pharmaceuticals as the only means to stay healthy.

“The reason this is all so important is because doctors and other healthcare practitioners do need to know what their patients are putting into their bodies. Some supplements can reduce the effectiveness of prescription drugs, just as there are prescription drugs that result in nutrient depletions. In fact, there are even some interactions resulting between foods and prescription medications.

“So the JAMA Patient Page on Herbal Medications is, in theory, a necessary educational tool that raises some important discussion points for doctors and patients. Unfortunately, its close-minded approach creates a missed opportunity for dialogue and patient trust.”

Source: JAMA​ 
March 8, 2016, Volume 315, Number 10, Page 1068, doi:10.1001/jama.2015.19388
“Herbal Medications”
Authors: G. Onder, R. Liperoti

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Pharma Forces: Forever seeking polarity of deception

Posted by Janeway,

First, sincere thanks to the editor as I am so grateful to know of the well-articulated knowledge base and consumer representation that is being extended on our behalf by Steve Mister, CRN; meaning, may he continue with this essential effort and trust that he is seriously appreciated.

Secondly, it matters not what the purported science says when I can so affirmatively attest from real life experience how, in place of cranberry, the simple sugar known as D-Mannose is even better at binding to remove the eColi which is the primary pathogen involved with acute infection of UTI.

Thirdly, even though most Soy in this country is now of GMO alteration and has been heavily sprayed with the "probable carcinogenic" known as Glyphosate, I can also attest to how there was enough phyto-estrogenic (plant based) potency in the long ago trial of Silk's Chocolate Soy Drink to the extent that it was able to overpower (block) most function of the Thyroid gland and by third day, cause worse adverse effect of Hypothyroidism. When one knows that between the major hormones of Estrogen and Thyroid, it is always the mighty Estrogen which wins out while both compete for same uptake inhibitor in the brain, believe me, I have seen how processed Soy can be profoundly active and quite deleterious to one's metabolic health. In actuality, the only form of Soy that is "healthy" (as Asian cultures have known for centuries) is when it is in 'fermented' form, such as with the condiment known as natto paste. But again, most Soy in the US is both processed and not fermented.

Again, I so applaud the integrity of Steve Mister, CRN and would implore those who attempt to mislead at JAMA's "Patient Page" to cease and desist, primarily because there are millions of us out here who have known for many years after the careful choices and thoughtful trial and error how these intuitive bodies are never suffering from a deficiency of pharmacology, but rather, must procure the historically organic and often vitamin/mineral/plant based raw materials that are so innately (biochemically compatible) with our BEST reality of healthy restoration and healing.

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More JAMA Troll Lies JAMA is Garbage

Posted by Dan Gilliland,

I won't even waste my time diving into the scientific evidence proving JAMA's claim as garbage. Just for fun, 3 examples. "administration of hydro-alcoholic extracts of Crataegus curvisepala Lind flowers to hypertensive patients (age range 40–60 years) for 3 months induced a decrease in both SBP and DBP by around 13 and 8 mmHg, respectively" Front Pharmacol. 2015; 6: 323 Ginkgo biloba (EGb 761): A Proprietary Leaf Extract of Ginkgo biloba Is Found to be Safe and Effective for Treating Dementia. Holist Nurs Pract. 2015 Sep-Oct;29(5):330-3 grape extract serve as a potential source of natural antioxidants against the IR-induced oxidative stress and also inhibit apoptosis Indian J Exp Biol. 2015 Nov;53(11):753-61.

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