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Natural Thyroid Medicine

YOU KNOW THE SISTER. She grows aloe vera for skin problems, sips echinacea tea at the first sign of a cold and swears by that juice called noni for just about everything that ails her. Maybe she's you.

Turning to alternative remedies is no longer something our grandmothers or the neighbor who "worked roots" did long ago; it has become decidedly mainstream. In a 1998 poll, 68 percent of Americans said they had bought nutritional supplements, including herbs and other dietary products, in the last six months. Sales were $13.9 billion that year, up from $8.6 billion in 1994. But does the popularity of these "natural" cures mean they're effective--and safe? Not necessarily. "The majority of herbal and nutritional supplements don't have sufficient clinical research to be routinely recommended for any disease or therapy," says Charles W. Fetrow, Pharm. D., author of the Professional's Handbook of Complementary and Alternative Medicines.

That's why we decided to compile research and expert comments on some of the best-selling natural remedies, including a few that are particularly popular in Black communities. Of course, you should talk to your health-care provider before taking any kind of supplement, especially if you are pregnant or breast-feeding.

GOOD EVIDENCE

SUPPLEMENT: GINKGO BILOBA

ANIMAL, MINERAL, VEGETABLE? Herbal extract from the leaves of the ginkgo tree.

CLAIMS: Ginkgo boosts short-term memory and concentration, treats dementia and Alzheimer's disease and protects against heart disease. It does its magic by improving blood flow to the brain, increasing circulation and destroying free radicals--unstable molecules that can damage brain and cardiovascular cells.

RESEARCH: A well-designed clinical trial of 309 people with dementia caused by Alzheimer's disease found that those who took the herb for a year scored better on cognitive and social functioning tests than those on placebos.

DOSAGE: Take 40 milligrams, three times a day.

CAUTIONS: Ginkgo biloba may cause mild upset stomach and, in rare cases, mild headaches for a day or two. A recent study linked its use to increased risk of infertility, but more research is needed. If you are taking drugs for circulatory or cardiovascular problems, consult your doctor before using this supplement.

SUPPLEMENT: HORSE CHESTNUT

ANIMAL, MINERAL, VEGETABLE? Herbal extract of horse chestnut seeds.

CLAIMS: Horse chestnut improves vein ailments like varicose veins, hemorrhoids and chronic venous insufficiency (CVI), a disorder whose main symptom is swollen legs. It contains an anti-inflammatory agent called aescin, which also improves the tone and elasticity of blood-vessel walls.

RESEARCH: Reliable studies have shown that horse chestnut decreases leg swelling and pain in those with CVI and is as effective as standard prescription drugs, according to a review in the Archives of Dermatology. However, there haven't been strong clinical studies on the herb's effect on varicose veins and hemorrhoids.

DOSAGE: For varicose veins and hemorrhoids, look for an over-the-counter cream containing horse chestnut. For CVI, use 90 to 150 mg a day initially, then 35 to 70 mg daily when you see improvement.

CAUTIONS: Kidney damage has been reported in people taking large quantities of aescin; those with liver or kidney disease should avoid horse chestnut. Unprocessed horse chestnut seeds may be poisonous.

SUPPLEMENT: SAINT-JOHN'S-WORT

ANIMAL, MINERAL, VEGETABLE? Herbal extract from the plant called Saint-John's-wort, scientifically named Hypericum perforatum.

CLAIMS: Saint-John's-wort relieves mild to moderate depression. Experts are not sure how this herb works. Studies suggest it may elevate certain mood-lifting chemicals in the brain.

RESEARCH: Solid evidence supports the claims. A review of 23 randomized clinical trials found that Saint-John's-wort relieved mild to moderate depression more effectively than a placebo. However, the studies were relatively short--no more than eight weeks--so long-term research is needed.

DOSAGE: Take one 300-mg capsule two or three times a day.

CAUTIONS: If you're depressed, see your doctor to rule out other conditions like thyroid disease, which may make you feel low. Do not take Saint-John's-wort if you are on any other antidepressants. A recent study linked the use of the herb to increased risk of infertility, but more research is needed. It may also make your skin more sensitive to the sun.

PROMISING, BUT THE JURY IS STILL OUT

SUPPLEMENT: COENZYME Q10

ANIMAL, MINERAL, VEGETABLE? A naturally occurring molecule found in nearly every cell of the body.

CLAIMS: Coenzyme Q10 counteracts the aging process and prevents heart disease by destroying free radicals that damage blood vessels and the heart. It also helps treat severe heart disease.

RESEARCH: Animal studies have demonstrated its antioxidant properties. Some data indicates that coenzyme Q10 may help treat congestive heart failure, but more research is needed.

DOSAGE: Take 15 to 30 mg a day.

CAUTIONS: It may cause stomach upset, diarrhea or nausea.

SUPPLEMENT: ECHINACEA

ANIMAL, MINERAL, VEGETABLE? Herbal extract from the root and leaves of the purple coneflower, scientifically known as echinacea purpurea.

CLAIMS: Echinacea boosts the immune system to ward off minor ailments like colds, flu and chronic respiratory infections. If you take it at the first sign of a viral illness, it purportedly staves off the infection or makes it milder.

RESEARCH: Hundreds of laboratory and animal studies have demonstrated revved-up immune activity, such as a rise in the number of white blood cells; more efficient macrophages, white blood cells that kill bacteria; and an increase in interleukins, compounds that help regulate disease-fighting cells. Only two notable placebo-controlled studies have been conducted.

DOSAGE: At the first sign of symptoms, take one tablet containing 500 to 1,000 mg of echinacea three times daily (with meals) for no more than two consecutive weeks.

CAUTIONS: Taken over the long term, echinacea may reverse its action and actually suppress the immune system. Don't use it if you have progressive systemic and autoimmune disorders such as AIDS, tuberculosis, connective-tissue disorders, lupus or multiple sclerosis. A recent study linked the use of echinacea to increased risk of infertility, but more research is needed.

SUPPLEMENT: ASIAN GINSENG

ANIMAL, MINERAL, VEGETABLE? Herbal extract from the root of a Chinese shrub called Panax ginseng.

CLAIMS: Ginseng boosts energy and physical performance; enhances alertness and concentration. It's referred to as an adaptogen, a substance that helps the body adapt to stress.

RESEARCH: Hundreds of small studies show that ginseng tends to have a positive effect on fatigue and stress, but the research is not overwhelmingly supportive. "Ginseng is difficult to study because the responses are vague and there is terrific variation in the quality and amount of ginseng in many products," explains Ara DerMarderosian, Ph.D., professor of pharmacognosy and medicinal chemistry at the University of the Sciences, Philadelphia College of Pharmacy.

DOSAGE: Take 1 to 2 grams a day.

CAUTIONS: Long-term use may lead to nervousness, headache, palpitations, insomnia and inability to concentrate. Be sure to check with your doctor if you're taking antipsychotic drugs, monoamine oxidase inhibitors (MAOIs) or drugs for heart disease, high or low blood pressure or diabetes.

SUPPLEMENT: KAVA KAVA

ANIMAL, MINERAL, VEGETABLE? Herbal extract of the roots of the piper methysticum shrub.

CLAIMS: Reduces nervous anxiety, stress, restlessness and pain. Through an unknown action on the central nervous system, kava acts as a sedative and muscle relaxant, and improves sleep.

RESEARCH: For its euphoric qualities, the kava plant has been used for thousands of years in the Pacific Island region as a ceremonial drink. This anecdotal evidence is backed by several small studies that have found it helpful in treating anxiety disorders, nervousness and stress.

DOSAGE: Take 250 mg once or twice daily. For a calming effect when feeling anxious, take 25 to 70 mg three times a day.

CAUTIONS: Kava kava may cause mild numbness in your mouth. Drinking alcohol may increase its potency. The drug may affect motor reflexes and judgment for driving. Prolonged use can cause a temporary yellowing of the skin, fish-scale-like lesions on the hands and feet, and facial swelling, says Fetrow. Kava kava has the potential to cause a druglike dependency, he adds. Don't use it if you're already taking drugs for depression or anxiety, or if you're taking barbiturates.

SCANT RESEARCH

SUPPLEMENT: DONG QUAI

ANIMAL, MINERAL, VEGETABLE? Herbal extract from the root of a Chinese plant, angelica polymorpha.

CLAIMS: Dong quai relieves menstrual cramps and menopausal symptoms such as hot flashes and sweating and may lower high blood pressure.

RESEARCH: Animal studies have found that dong quai dilates blood vessels and relaxes uterine muscles, which supports claims that it eases menstrual cramps. But there, is little research in humans proving this benefit. Despite anecdotal evidence that it relieves symptoms of menopause, one well-designed study of 71 postmenopausal women found that reduction of symptoms was the same for those on placebo as it was for those who used it. On the other hand, practitioners of traditional Chinese medicine typically prescribe dong quai along with other herbs for its synergistic effects, and various combinations are currently being studied at Columbia University.

DOSAGE: Take 3 to 15 grams daily.

CAUTIONS: Dong quai contains the chemical psoralen, which increases skin's sensitivity to the sun.

SUPPLEMENT: DHEA (Dehydroepiandrosterone)

ANIMAL, MINERAL, VEGETABLE? DHEA is a hormone produced by the adrenal glands that is converted into testosterone and estrogen. Our natural supply of DHEA peaks between the ages of 25 and 30.

CLAIMS: DHEA protects against disorders related to aging, such as heart disease, certain cancers, Alzheimer's disease, osteoporosis and diabetes. The theory is that the steady decline of DHEA after age 30 leads to a deficiency that contributes to these diseases, and, therefore, replenishing the hormone can help prevent them. DHEA is also taken to boost sports performance.

RESEARCH: A number of animal studies and small studies on people have shown promising effects for such ailments as diabetes, depression and heart disease, but these have not been demonstrated in a reliable clinical trial. Studies have shown that DHEA raises testosterone levels.

DOSAGE: If you need it at all, you wouldn't require it until you were well past your DHEA peak, around age 40. The recommended dose for women is 15 to 45 mg a day; for men, 30 to 90 mg a day.

CAUTIONS: Check first with your practitioner to evaluate your hormone levels. Don't take DHEA with medications that affect hormones, such as hormone-replacement therapy. Because DHEA increases testosterone levels, long-term use can result in acne, facial hair, irregular menstruation and loss of scalp hair. Also, because it raises estrogen levels, using too much for too long may increase the risk of endometrial cancer and breast cancer in women.

SUPPLEMENT: SUNDIAL TRADITIONAL JAMAICAN ORGANIC ORIGINAL MAROON RECIPE WOOD AND ROOT TONIC

ANIMAL, MINERAL, VEGETABLE? Blend of herbal extracts, including chancy root, goat corn, sarsaparilla root, black wiss, milk wiss, nerve wiss and African cayenne.

CLAIMS: "Cleanses the body and blood of mucus, toxic waste and infections."

WHAT WE LEARNED: We found no studies of this product, which contains obscure herbs that even some herbal practitioners are not familiar with. In fact, a search of the database in the National Institutes of Health's Office of Dietary Supplements turned up no studies at all on many of these ingredients. However, Therman Evans, M.D., a holistic physician and president of Whole Life Associates in Elkins Park, Pennsylvania, notes that sarsaparilla root and African cayenne have been used to help reduce mucus.

DOSAGE: The label says to take one teaspoon to half cup daily, as needed.

CAUTIONS: Side effects are unknown.

SUPPLEMENT: POL'NONI 100-PERCENT

PURE TAHITIAN NONI

ANIMAL, MINERAL, VEGETABLE? Fruit-juice extract.

CLAIMS: "The Polynesians have passed the wisdom of the Noni ... through many generations to encourage their families' good health."

WHAT WE LEARNED: We found no studies of this product. But according to Evans, noni contains antibacterial agents, anti-inflammatory agents and antioxidants. "It is a general immune-system enhancer," he says. "I've recommended it to people with arthritis, allergies and asthma."

DOSAGE: The label says take one tablespoon once a day, preferably before meals.

CAUTIONS: No known side effects.

SUPPLEMENT: SAMe (S-adenosyl-L-methionine)

ANIMAL, MINERAL, VEGETABLE? A naturally occurring compound found in every cell of the body.

CLAIMS: SAMe (pronounced Sammy) relieves mild depression, reduces pain from arthritis and may improve the health of the liver.

RESEARCH: Though it's quite new to the United States, SAMe has been widely used in Europe for treating depression, arthritis and liver disease for more than 20 years. Several European studies suggest that it may help these conditions, but more reliable research is needed.

DOSAGE: 800 milligrams a day for depression; 1,200 mg for arthritis and liver problems.

CAUTIONS: Do not take this supplement if you are already being treated for depression or anxiety disorders. See a physician before self-treating for either depression or liver disease.

SUPPLEMENT: ULTRA COLON CLENZ GENTLE ALL-NATURAL HERBAL SUPPLEMENT

ANIMAL, MINERAL, VEGETABLE? Blend of herbal extracts, including cascara sacrada, senna, rhubarb, peppermint, fennel, apple pectin, black walnut, aloe vera, Oregon grape, yellow dock, valerian, slippery elm and chlorophyll.

CLAIMS: "Contains a gentle blend of all-natural herbs chosen to help your digestive tract work the way nature intended."

WHAT WE LEARNED: We found no research on this product. Although it can be used for gastrointestinal problems such as constipation, it "may make you live in the bathroom," says Evans. "I would worry about this combination since most of the ingredients are laxatives," he adds. Since this combination of herbs hasn't been studied, you'd be safer--and get the same results--if you took senna alone, Evans notes. Then you won't run the risk of overkill or possible allergic reaction to one of the other ingredients.

DOSAGE: The label says to take one capsule with a glass of water once or twice daily; best if used before bedtime.

CAUTIONS: May cause diarrhea if you take too much or take it too often.

SUPPLEMENT: COBRA PERFORMANCE ENHANCER POWERFUL MEN'S FORMULA

ANIMAL, MINERAL, VEGETABLE? Blend of herbal extracts, including kola nut, oatstraw, nettles, yohimbe, siberian and Korean ginseng, epimedium, catuaba, muira puama, damiana and saw palmetto.

CLAIMS: "Improves your stamina, performance and virility."

WHAT WE LEARNED: Kola nut, oatstraw and ginseng are stimulants, which may energize men, says Evans. Yohimbe dilates blood vessels and, like Viagra, may enhance blood flow to a man's penis, improving his ability to have an erection. "A man might see some difference in energy and sexual performance using this combination, since the ingredients all affect stimulation," Evans notes. But he warns that the combination hasn't been tested.

DOSAGE: The label says to take two capsules once or twice daily.

CAUTIONS: The stimulants may cause irritability, headache, nervousness or sleep problems. Do not take if you have high blood pressure or heart disease.

Laurie Tarkan is a health writer living in New York City. She is the author of My Mother's Breast: Daughters Face Their Mothers' Cancer (Taylor, $14.95).

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