Safety First When Selecting Herbs

Choosing the right herbs for your practice can be a bit bewildering, if not downright overwhelming. How can you know which herbal company offers the highest-quality products? What are the things to look for -- and to avoid?

In order to help you narrow down your choices, Acupuncture Today PracticeINSIGHTS went straight to the source - the herbal manufacturers themselves. We asked them to tell us what they would look for if they were shopping around for high quality products.

Obviously, business people will tend to emphasize their company's best points. Rather than simply publish those, we looked for major points of agreement among the competitors in order to provide you with guidelines you can use no matter which company you ultimately work with. Here's what they had to say.

Safety First

Overwhelmingly, the biggest factor in deciding on herbal products was safety. In fact, five of the seven manufacturers surveyed mentioned safety and quality of ingredients as a top issue.

Kris Yang, LAc, OMD, and president of Bio Essence (www.bioessence.com), located in Richmond, Calif., suggests, "Identify in which country these products being made and what standards they are following. Supplements made in the U.S.A. require just dietary supplement cGMP or food cGMP standards, whereas in Asian countries, herbal remedies always need pharmaceutical cGMP standards. To validate the quality, you can check whether or not the factory has an internationally recognized certificate for quality control. The quality and safety will be better in those factories that have more than one certificate for quality control."

Greg Zimmerman, LAc, and natural products specialist at Brion Herbs (www.brionherbs.com), located in Irvine, Calif., agrees with Yang about the importance of knowing as much as possible about safety standards followed by the manufacturer or supplier. He says, "Customers should concern themselves about who is the actual manufacturer or supplier of the products and ingredients. People often mistake a distributor for a manufacturer and should request information from their distributor about the actual manufacturer or grower. Additionally, they should have concern regarding quality, authenticity, and safety. This vital information can be obtained by requesting the proper Certificates of Analysis (COA)."

Bill Egloff, president of Crane Herb Company (www.craneherb.com), based in Mashpee, Mass., offers several safety questions practitioners should be asking of potential herbal suppliers: "Is the company cGMP compliant? Is the company COA easily available to the practitioner? Many companies will e-mail the COA within an hour, if you have the product's lot number and expiration date. Does the company define the different COA tests, the testing limits and their relevance for the practitioner?"

Jason Tsai, operations supervisor for KPC Herbs (www.kpc.com), also based in Irvine, agrees with Egloff about the need to verify quality issues with herbs. He states, "It is important to have some way to verify the safety of the herbs. Like any plant-based industry, growers have an economic incentive to use pesticides and sulfur fumigation to increase the size and improve the color of their herbs, which leads to better prices. They also are tempted to export herbs of lesser quality to increase their revenues. Therefore it is imperative to have a supplier you trust."

Wilson Lau, vice president of sales and marketing at Nuherbs, Co. (http://nuherbs.com), located in Oakland, Calif., also stressed the fact that not all safety testing is the same: "Not all tests are created equal. Some companies test for a few pesticides. You should also be concerned with heavy-metal and microbacterial levels. Look and find out if the herb in question has been processed properly to maximize properties of the herbs and eliminate safety concerns."

[pb]Ease of Use

You can select the freshest, highest-quality herbs on the market, but it won't make a difference if your patients can't take them. Making herbs easy for patients to take can make a world of difference.

According to Dr. Zee Lo (www.drzeelo.com), a Los Angeles-based acupuncturist and herbologist, said ensuring patient compliance is key. He explains, "After the herbs/formula are dispensed, is the patient going to follow instructions? Are the instructions too hard to follow? Is the patient willing and able [to follow the instructions for dosing]?"

Jennifer Knapp, sales and marketing manager at Honso USA, Inc. (http://honso.com/index.php), out of Phoenix, Ariz., says that the key to patient compliance is efficacy in processing, thereby making it easier for patients to take the herbs. She notes, "Granule packaging in individual dose sachets allows for fixed and precise dosages, giving practitioners full confidence in administering this form to patients and allowing for higher patient compliance in an easy-to-use form."

Egloff adds that there may be other patient lifestyle considerations when selecting herbs. If a patient is vegetarian or keeps to a strict kosher diet, this may affect your choice in herbs. Convenience for travel may also come into play, as liquid formulations or those may be more difficult to transport. Flavor is another concern. A patient is far more likely to take herbs that don't have an unpleasant odor or taste to them.

When it comes to taste and texture, Yang actually recommends trying them out yourself. If you find the herb too unpleasant to swallow, chances are that your patient will have the same reaction: "You can experience [the herbs] by tasting and chewing some of the products, or dissolve them into tea form and try them to see their strength and flavors."

Standardized Processing

According to our vendor experts, another important consideration is the manufacturing process. Specifically, that the manufacturing process has been standardized so that each batch of herbal products has the same strength and quality of ingredients.

As Lau explains, "[Look at] whether the herb in question has been processed properly to maximize properties of the herbs or eliminate safety concerns."

Knapp agrees, explaining that if the processing is of top quality, the end product will be more effective: "There are many things to consider when deciding the best herbal protocol for your patients, but a common thread always remains, efficacy. Efficacy encompasses a variety of components in order to make it sustainable."

Tsai stressed the importance of being able to trust the herbs being sold. He notes, "Because of the combined complexity of the vast selection of Chinese herbs and the international supply chains that deliver them, it is important to be able to trust the integrity of the herbs. Because it's difficult for any individual to acquire the overwhelming volume of expertise necessary to tell one herb from another, many practitioners prefer to purchase granules from trusted herb companies."

It All Goes Together

In many ways, all three of these considerations - safety, ease of use and standardized processing - go together. Clinicians can be assured that standardized herbal formulas will have undergone rigorous testing for safety, efficacy and ease of use. All of which means satisfied patients and a healthy practice for you.