How Quickly should Herbs Work?

One of the most common questions I have from my new patients when recommending or prescribing them herbal medicines for the first time, is ‘how long will it take to work’? This is totally understandable, particularly when they are often grappling with a serious health complaint, or have pushed their budget to afford to pay for an unsubsidised consultation and herbal treatment.

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When my answer is invariably that that they should notice an improvement either straight away or within a short space of time, the reaction is usually one of surprise. This is because there seems to be a fairly common misconception among consumers and many health practitioners that herbal medicine and the ‘natural approach’ to treating a health ailment usually takes a long time to manifest results.

There is no question that certain drugs such as the steroid prednisone, can invoke a dramatic and sudden amelioration in inflammation or related symptoms, or that use of nitrolingual spray has a virtually instantaneous effect in angina.  However, for most everyday human health conditions, herbs work as quickly as drugs in resolving the problems concerned.

Diarrhoea and dysentery, are situations where a rapid rather than protracted response is called upon when taking a remedial treatment. Until a couple of hundred years ago when refrigeration was invented and human public health measures improved, such lurgies were also extremely common. Back then and still today in many countries, most communities relied heavily on the use of local tannin-rich herbs with astringent properties, to help manage such problems. These ranged from Agrimony (Agrimonia eupatoria) and Oak bark (Quercus robur) in European herbal medicine, to Koromiko (Hebe salicifolia) and Tanekaha (Phyllocladus trichomanoides), in traditional Mâori medicine. Tannin-rich plants were also applied as poultices and other topical preparations to help stop bleeding from battle wounds or accidents, where again rapid haemostatic actions which halted such bleeding and promoted healing as quickly as possible, were very important. Such use included well known plants such as Tormentil (Potentilla tormentilla), Harakeke (Phormium tenax) and Pohutakawa (Metrosideros excelsa). It is also reflected in the Latin names of other well-known plants such as Yarrow (Achillea millefolium), used by the Greek warrior Achilles on his soldiers spear and sword wounds.

One of the best treatments for bruises, strains and sprains, Comfrey (Symphytum officinale), starts providing pain relief and an anti-inflammatory effect within 30 minutes of application, according to clinical trials on an ointment preparation. This is just as rapid as mainstream gel treatments containing non-steroidal anti-inflammatory drugs (NSAID’s).

Despite drug companies throwing billions of dollars at research aiming to develop a superior analgesic, the Opium poppy derived alkaloid morphine remains the most highly regarded and used analgesic for major pain. This status has been maintained not only because of its ability to overcome intense pain, but also the speed of its onset of action. Similarly, the rapidity of onset of mood changes following marijuana smoking, is another testament to how quickly herbs can produce their many pharmacological effects.

Insomnia can be a highly debilitating condition which requires effective and fast acting remedies. The use and reputation of well-known herbs such as Valerian, Kava, Passionflower and Skullcap as aids to sleep, is based upon acute or single dose ingestion shortly before retiring, in the same manner as sleeping tablets such as zopiclone. Their effectiveness varies from person to person, and is of course dependent on adequate doses of sufficiently good quality product, but they should either work straight away, or there’s little point in persisting. Use of these and other herbs as part of an approach to managing anxiety disorders, should also invoke some degree of relaxation within an hour or so of ingestion, in a similar manner to benzodiazepine drugs such as diazepam (Valium®). Both drugs and herbs seem to work on the same sites of action (GABA, gamma-aminobutyric acid receptors) within the body, to produce these anxiolytic actions.

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However, just as with drugs, not all herbs produce resolution of symptoms straight away, and the improvement in feelings of depression following appropriate treatment, is an example of where a longer timeframe is involved. Like antidepressant drugs, the herb St Johns Wort (Hypericum perforatum),  only manifests its antidepressant action after 3-5 weeks of daily administration in most cases. This is probably related to the time required for its active phytochemicals to modulate serotonin and other involved neurotransmitter systems, in order to produce an antidepressant response.

To summarise, we are often mislead into thinking that ‘herbs take longer to work than drugs’. While the timeframe between starting herbal treatment and a response being achieved is highly variable depending on the condition and person being treated, effective herbal medicine treatment should in most cases take no longer than that of drug treatments.

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