Inside Europe's Pharmacies

For decades Europeans have taken herbs and supplements to enhance their health. While interest in alternative therapies is growing, natural remedies are not as widespread in the United States.

by Jeffrey Laign

A middle-aged man shuffles through the door of a pharmacy in Frankfurt, Germany, hacking, sneezing and sniffling. From behind the counter at Apotheke an der Hauptwache, pharmacist Ulrike Jager quickly sizes up his symptoms. "Is your throat scratchy?" she asks. "Do you have a fever?" Moments later the man walks out with Sinupret, a mix of sorrel and other herbs for colds and sinusitis.

"We want to help the customer to take the medication that is best for him," Jager explains. "And in many cases, herbal remedies work the best."

"The U.S. system can be dangerous," says botanist and pharmacologist Joerg Gruenwald, lead author of the Physicians' Desk Reference for Herbal Medicines. Earl Mindell, a U.S. pharmacist and natural medicines expert, agrees. "What's happening in the United States today," he says, "is that synthetic drugs are becoming quite dangerous. Most natural medicines don't have the horrendous side effects that some synthetic drugs can produce. In Europe, they're way ahead of us."

Gruenwald, Mindell and other experts think the United States should adopt a medical system similar to the one in Germany, which leads Europe and the rest of the world in researching and using natural medicines. Consider the following facts about the German system:

• Eighty percent of German physicians prescribe herbal remedies for patients.
• Twelve percent of all German prescriptions are for herbal preparations. In fact, herbal medicine is the prescription of choice for a number of common ailments, including depression, sinusitis and memory loss.
• German herbal remedies are labeled with precise instructions.

The practice of natural medicine enjoys a venerable history in Europe, where healers have used herbs for thousands of years to treat a variety of ailments. But instead of abandoning folk remedies when synthetic drugs were developed, the German government established a review board in 1978 to test and revise them. Composed of physicians and plant specialists, Germany's Commission E spent 15 years studying more than 300 herbal medicines, including many used by medieval German healer and mystic Hildegard of Bingen.

The commission then developed monographs on each herb, delineating medicinal uses, potential side effects, and recommended dosages. Since 1980, all herbal remedies sold in German pharmacies have undergone the same rigorous testing as over-the-counter drugs. And today there are more than 300 clinical trials of herbs under way in Germany. Such tests cost money-hundreds of thousands of dollars, in fact. Money the German government believes is worth spending on health.

Unfortunately, the U.S. Food and Drug Administration does not recognize most herbs and supplements as medicines, and thereby prevents manufacturers from making specific health claims. That's ironic, when you consider the growing popularity of natural medicines in this country. Since 1994 hundreds of natural remedies have flooded the market and herb sales have more than doubled. But pick up a bottle of garlic, ginkgo or echinacea, and you're likely to find only vague, cryptic instructions, such as, "Take as needed."

It was not always this way. Fifty years ago, every pharmacy school in the United States employed specialists in plant-based medicines. But with the advent of antibiotics and other synthetic "miracle drugs," doctors put a damper on herbal treatments. Today pharmacists in this country spend at least five years learning their occupation, but few understand how natural medicines work.

"I hear pharmacists everywhere saying, 'We're selling this stuff, and we don't know anything about it,' " says Norman Farnsworth, who teaches a course on plant medicine at the University of Illinois in Chicago.

Different drugstores

Germany, pharmacists are trained to dispense herbs and supplements as well as synthetic drugs. And if a doctor prescribes a natural medicine, it's covered by state health insurance. Among the herbs Jager prescribes most are valerian to ease jangled nerves, St. John's wort for depression and echinacea for colds and flu. Other popular natural medicines include black cohosh for hot flashes and horse chestnut for varicose veins.

On the other hand, it's much easier to purchase an over-the-counter drug in the United States than in Germany and other European countries. There you have to go to a pharmacy to buy even the most common remedies. "I am astounded that in the United States you can buy aspirin in the supermarket," Jager says. "In Germany you can buy it only at a pharmacy."

Europe's favorite natural remedies

After all, doctors in Europe routinely prescribe herbs, supplements and other natural remedies as a first line of treatment. Throughout Portugal, for example, it's glucosamine you'll receive if your doctor hands you a diagnosis of arthritis. Many European physicians, in fact, turn to conventional arthritis drugs only when glucosamine proves to be ineffective.

In France, ginkgo biloba accounts for 4 percent of all prescription medicines. And the herb comprises 1 percent of prescription sales in Germany, where it's licensed for treatment of "cerebral insufficiency" and used to treat problems ranging from impaired memory, dizziness and tinnitus, to headaches, nervousness and anxiety. Total sales across the European continent average more than $500 million a year. "Research on ginkgo and Alzheimer's is producing extremely good results in France and Germany," says herbal expert and researcher Daniel B. Mowrey, Ph.D.

Indeed, Europeans have been using ginkgo biloba extract for years to fight off Alzheimer's and other cerebral disorders associated with aging including forgetfulness, mild confusion, tinnitus or ringing in the ears, and inability to concentrate. In some countries, in fact, ginkgo is a registered drug, among the most commonly prescribed for treating organic brain disorders. In lower doses, ginkgo is sold over the counter in many European countries, just as it is in the United States.

St. John's wort has been a popular antidepressant in Europe for years. In Germany, where its use is covered by health insurance as a prescription drug, more than 20 million people take the herb.

"St. John's wort isn't something they've just discovered across the Atlantic," says author and expert Harold Bloomfield, M.D. "It's been used by German and other European physicians since ancient times. It comes as a surprise to us here in the United States because we've chosen to sever our roots with herbal medicine."

Feverfew contains a compound called parthenolide, which helps to control expansion and contraction of blood vessels in the brain. When you begin to get a migraine your brain releases the neurotransmitter serotonin and your blood vessels constrict. Feverfew appears to counteract your brain's order by causing blood vessels to dilate. In addition, feverfew appears to neutralize chemicals called prostaglandins, which are linked to pain and inflammation. In 1978 scientists speculated in the British journal Lancet that feverfew might share some properties with aspirin. Two years later Lancet published a study that appeared to confirm this theory.

Kava kava, an herb revered for centuries by South Pacific islanders, is used extensively in Europe as a safe, effective natural tranquilizer. In Germany, researchers conducted a double-blind study of 58 patients suffering from common anxiety syndrome. Half of the patients received a placebo. The other half took 100 mg of kava extract three times a day for four weeks. The researchers then administered several tests to assess patients' anxiety levels. After one week, patients who took kava demonstrated a significant reduction in anxiety symptoms, compared with patients who took the placebo. What's more, the kava patients continued to improve throughout the 28-day study.

German researchers also have found that kava induces deep muscle relaxation, modulates emotions and promotes sleep as effectively as synthetic tranquilizers-but without causing side effects.

They provide model examples of health systems that work. The U.S. could take a hint. Yet, while the dissemination of information on herbal therapies has so far been limited in the U.S., alternative medicine circles are beginning to take incremental, albeit significant steps toward edu cating the general public on natural remedies from around the world.

Europe's
Anti-Aging Drugs

Europeans have used supplements for decades to prevent and treat a number of diseases associated with aging. While the U.S. Food and Drug Administration has not approved these medicines for use in this country, it does allow consumers to purchase offshore drugs for personal consumption. Under the personal-use policy, several pharmacies and distributors ship European supplements to Americans.

Some of the most widely used European supplements:

• Aminoguanidine. This supplement works by preventing cross links caused by glycosylation. Animal studies have concluded that aminoguanidine can prevent diabetic, atherosclerotic blood vessel aging and molecular cross-linking in cells throughout the body. In Alzheimer's patients, aminoguanidine prevents destructive cross-linking of collagen and elastin fibers in the brain. This is a primary cause of brain and muscle degeneration in the elderly.

• Biostim protects against illnesses caused by bacteria, fungi and viruses. Numerous medical trials indicate that a once yearly treatment is effective at preventing a number of illnesses.

• Centrophenoxine is an anti aging drug widely used to boost brain energy by increasing uptake of glucose, which is essential for energy production. Centrophenoxine appears to be effective in treating brain damage caused by old age, stroke, chemicals and drugs, and excessive alcohol consumption. It may also protect against toxic environmental chemicals. In addition, studies have found that centrophenoxine has extended the life span of laboratory animals. And it increases learning and memory capacity and reduces cellular damage caused by excessive free-radical activity in cell membranes.

• KH3. For decades doctors in more than 70 countries have been recommending this anti aging drug, which contains procaine and a compound called hematoporphyrin. Clinical studies show that KH3 can improve alertness, concentration, memory, physical coordination and blood circulation in the brain.

• Picamilon is highly effective for improving blood flow to cerebral vessels. Picamilon easily crosses the blood-brain barrier to protect neurons against the effects of oxygen flow. In Russia, picamilon is sold as a drug. Actually, its a vitamin-like compound consisting of a niacin analog (n-nicotinoyl) bonded to GABA (gamma aminobutryic acid). It is the synergism between these molecules that enables picamilon to work so well.

• Pyritinol (more info at Pyritinol.info) is used in Europe for treatment of several forms of neurologic impairment, including early-stage Alzheimer's disease, stroke, vertigo, head trauma and age-associated mental impairment. Pyritinol enhances neuronal metabolic function by increasing brain cell energy levels.
  
  CAUTION: Pyritinol can cause acute pancreatitis.