Herbalist Catherine Pantaleo leads a customer interested in trying an alternative hay fever treatment to a middle aisle in Pharmaca Integrative Pharmacy, located in downtown Boulder, Colo. She points out three options—a Chinese herb, a Western-style medicine that contains stinging nettles and a homeopathic remedy. She spends a few minutes noting the pros and cons of each, finally recommending the Western medicine based on the customer's complaints of itchy eyes and head-rattling sneezes.
"People want to do the natural route, but they don't know what to get," she says when asked about the questions she fields at the pharmacy, which stocks conventional and alternative medicines as well as personal care products. She adds that many people seem more interested in learning about the options than they are concerned about safety or side effects. The majority of consumers who say they shop at least occasionally for natural, organic and health products have a moderately positive opinion on the safety of herbal products, according to a consumer survey conducted by AVERO Research on behalf of The Natural Foods Merchandiser.
One part of the survey asked respondents the extent to which they agreed with the following statement: "Herbal products are generally safe and rarely cause negative side effects."
Approximately 58 percent of naturals shoppers either completely or somewhat agreed with the statement. Nearly 25 percent had no opinion. About 15 percent somewhat disagreed, while less than 2 percent completely disagreed that herbal products are generally safe. AVERO's research indicates that during the last four years positive and negative attitudes toward herbal supplements have declined, with negative opinion dropping faster. Those in the middle ground—with no opinion either way—grew from 20 percent in 2004 to 31 percent in 2007.
Survey respondent Sue McNamara of Chicago said she purchases products like herbal teas and supplements such as liquid chlorophyll to promote a healthier lifestyle for her family. "I want to live long enough to see my kids grow up," she says. While she said that she completely agrees that herbal supplements are safe, McNamara says she is still cautious, particularly when something as ordinary as pet food can become contaminated.
"The reason I don't give [supplements] to my children a lot is because I'm not really sure, in some cases, of the origins or the safety of some of them, if they're good for my kids," she says.
That attitude—and the survey results—weren't too surprising for industry experts. "I suspect that the more committed natural food shopper and [dietary supplement] user, the so-called 'core shopper,' has less concerns about the general safety of herbs than the more mainstream or 'peripheral' shopper, who is probably more easily influenced by the plethora of negative media reporting and often misreporting [of] information on safety issues related to herbs and other [dietary supplements]," says Mark Blumenthal, executive director of Austin, Texas-based American Botanical Council.
Blumenthal notes that "the overwhelming amount of available evidence strongly supports the general safety of most of the herbs" sold as teas, dietary supplements and spices in the United States. High-profile cases such as the 2004 ban by the U.S. Food and Drug Administration on dietary supplements containing ephedrine alkaloids leave long-lasting black eyes on the industry, he notes, but they are the exceptions.
"There are few adverse events being reported for most of the herbs being marketed," he says. "Of course, as various knowledgeable observers have commented, the relative lack of reports of adverse reactions does not equal positive proof of safety. Yes, granted. And yet, if herbs constituted such a potential public health threat to warrant more regulatory oversight—there already are numerous regulations that are not necessarily evenly or consistently enforced by the FDA—one would be able to point to them. However, such glaring examples simply do not exist."
Daniel Fabricant, vice president of scientific and regulatory affairs for the Natural Products Association, says retailers understand that generally no single study is the final word on safety or efficacy when it comes to herbal products. He advises retailers to consider the source of studies, and to consult third-party resources like www.webmd.com for additional information.
"The retailers understand that pretty well," he says. "Passing that message on to consumers is very important."
One conclusion drawn by the survey researchers: "It may be that consumers are becoming more open to herbal medicine. Is a fresh herbal renaissance around the corner?"
Woody Smith, president of AVERO Research, says that interest in alternative and natural medicines seems to run in cycles, and it appears we may be in an upward trend. "It may be, if we put our futurist hats on, with rising costs in conventional drugs and medicines and continuing mistrust of that system, that there's an opportunity for people to give a frank look to herbal products and herbal medicines. That's supposition based on what we're seeing."
The survey also found that those respondents who had the most confidence in the safety of herbal products listed recommendations from friends and acquaintances as the top reason for trying a botanical-based supplement. Becoming a new mother was another major reason for trying an alternative medicine. The advice of a health practitioner came in sixth.
Smith says it is a little surprising that advice of a medical professional came in lower than other factors, but adds, "One thing we've definitely seen is that the advice of a … health practitioner … is often seen as a trusted source of information."
McNamara says she relies on her local store, Sunrise Health Foods of Lansing, Ill., for information about products. Nearly 50 percent of naturals shoppers report using store employees as a source of information on such supplements. Store nutritionists, in-store demonstrations and literature are also important sources of information, according to naturals shoppers in the survey.
Pantaleo says many customers come to the pharmacy on the recommendation of a health practitioner, whether it's a traditional doctor, chiropractor or naturopath. She says she spends upwards of a half-hour working with clients on finding the right product, whether it's conventional or traditional."Education is huge," she says. "We want people to make well-informed decisions. We're not just selling products."
Natural Foods Merchandiser volume XXVIII/number 8/p. 41-42