Herbs: types, efficacy, safety, side effects and ways to use them

Herbs are whole plants or plant parts (like fruits, seeds, flowers, roots) that are used for various purposes including foods, supplements, flavouring and perfumes. Herbs are also used as preservatives and medicines. They can be used in both fresh and dried forms and consumed as an infusion, tea, tablets, powder, pastilles and capsules. Culinary herbs are either put in the recipe or sprinkled over food to make it more flavourful; salves, oils and ointments are some of the topical herbal formulations.

Here is all you need to know about herbs and their myriad uses, both medicinal and non-medicinal.

Culinary herbs
Herbal medicine
Ways to take herbs

Culinary herbs

Culinary herbs are usually aromatic plant parts including plant flowers, leaves and stems that are used for cooking, baking or adding flavour to food as a garnish. Experts say that you can use culinary herbs whichever way you can imagine. Herbs can be used to make sauces or chutneys, soups, desserts, vinegar, butter, flavoured oils, marinades and even drinks. They can be used in both dried and fresh forms, provided you use them in the right amounts. However, here are some rules that may help you cook better with herbs:

Herbs can be used in any combination, provided you put them in the right amount without overpowering the taste of the original ingredient/dish. However, certain herbs work well with others; for example, the combinations of oregano, basil and thyme, the one of garlic, basil and chillies and that of dill, chives and garlic. Mixing a strong and mild herb may work well.
Not all herbs that you add to food are eaten. Some are just used to add flavour to the dish and discarded while eating; for example, cloves and bay leaves.
Since dried herbs have more concentrated flavours, they are usually used in smaller amounts than fresh herbs. Generally, ¼ teaspoon of ground herbs can be substituted for two to four teaspoons of fresh herb or ¾ to one teaspoon of crumbled herbs.
Dried herbs are usually added in the beginning or middle of the cooking process so they release their flavours while being cooked with the food. On the other hand, fresh herbs work well when used as garnish or put in at the end of the cooking process. It is also best to mince fresh herbs nicely before adding them to food. This is because the herbs will then release more of their flavours readily.
Dried herbs last longer than fresh herbs. For example, seeds can be kept for over a year, whole roots may be used for up to three years and whole spices last between a year or 1.5 years. Ground herbs can be used for about a year. However, with time, the flavour of any herb gradually fades.
Leaves that are attached to the stalk tend to have more robust flavours than loose leaves.

Herbal medicine

Herbs and herbal preparations have long been used as medicines and drug ingredients. As per the National Health Portal, India, a huge proportion of the world’s population still relies on herbs for the management of their primary healthcare needs and more than 30% of all plant species have at least once been used for the treatment of a health condition.

In the 21st century, herbal medicine has also seen a resurgence in Europe and the USA. Many people are actively studying herbology to make their own remedies at home.

Active ingredients in herbs are used to prepare drugs. Estimates suggest that about 25% of all drugs in the US and about 80% of drugs in India and China are sourced from plants. Some examples of plant-based drugs include quinine (obtained from Cinchona bark), aspirin (from willow bark), and morphine (obtained from opium poppy).

Herbal medicine classification
Are herbal medicines regulated?
How effective are herbal medicines
Safety of herbs and herbal medicine

Herbal medicine classification

Based on their origin, evolution and type of use, the World Health Organization divides herbal medicines into the following categories:

Indigenous herbal medicine: Indigenous herbal medicines are those that have been in use for long in a specific region. The recipes for these medicines are not usually known though most local people use them freely. If these medicines are to be sold commercially, they have to meet standard requirements for safety and efficacy laid down by the government.
Herbal medicines in various systems: This category includes herbs that have been documented in specific systems of medicines including Ayurveda, Unani and Siddha. Some of the traditional medicine systems that include herbal medicine are:
- Ayurveda: Ayurveda has been in practice in India for thousands of years. In this system of medicine, herbal preparations are given in the form of powders, mixture, tablets or syrups for the treatment of various diseases. Along with herbs, Ayurveda also emphasises on diet, food, and a healthy lifestyle. Additionally, ayurvedic treatment involves various procedures including enemas, massage, sweating and oleation therapies to help eliminate various toxins from the body and balance the three gunas - vata, pitta and kapha.
- Traditional Chinese medicine (TCM): Just like Ayurveda, TCM is yet another traditional system of healing that also involves the use of herbal medicines. However, unlike the three gunas in Ayurveda, TCM focuses on balancing yin and yang, two opposing energies present in the universe.
- Unani medicine: Unani medicine is a Graeco-Arabic medicine system belonging to the Middle East and South Asia. Originating in Greece 25,000 years back, this medicine system consists of 90% herbal products and the rest include products of animal and mineral origin. In this system of medicine, the temperament of a person along with their diet and state of digestion are given specific importance. As per this system, people who take a proper diet have good humoral balance and vice versa. Medicines help bring back this balance, hence treating the person.
- Siddha: Siddha is believed to have originated in Tamil Nadu, India, around 3rd to 10th century BC. It is believed to be even older than Ayurveda and just like Ayurveda, Siddha medicine works on the principle of three humours - vatham, pitham and kapham. However, unlike Ayurveda, Siddha medicine also includes the use of metals and minerals like mercury, mica and sulphur. The maanida maruthuvam category of treatment in Siddha medicine includes the use of herbal products.
- Homeopathy: Homeopathic medicines are not just made from herbs but also from animal products, minerals and other drugs. The right way to collect these substances and make medicines from them are written down in the homeopathic pharmacopoeia of a country. These medicines are given in the forms of pills, droplets or tablets and are given in highly diluted doses.
- Western herbalism: Traditional Western Herbalism or western herbal medicine involves the use of various plants and plant parts (flowers, roots, seeds, fruits, leaves etc) for the treatment and prevention of various ailments. This system of medicine uses Mediterranean herbs (including a lot of culinary herbs with volatile oils), Native American herbs (including roots and barks) and herbs from Northern Europe (usually the herbs or the green part of a plant). Western herbalism is inspired from various civilisations including the Greeks, Egyptians, Middle East, British Isles and Romans. Herbs in this system of medicine are increasingly being studied by researchers around the world for their therapeutic properties.
Modified herbal medicines: Modified herbal medicines include herbal medicines that have been changed in form, dosage, mode of administration etc for use. These medicines generally have to meet certain national guidelines and requirements.
Imported products with herbal medicines as the base: This category includes herbal medicines, raw material and any product containing herbs in it. Such products have to be registered and marketed in their origin country and their safety and efficacy data should be submitted to the governments or national authority of the country where it is being imported. Additionally, the products should meet the standards of the importing country.

Are herbal medicines regulated?

If you are buying a herbal preparation, it is important to note that the FDA does not regulate them under drugs, rather these are regulated under foods or supplements. This means the manufacturers do not have to follow as strict guidelines to prepare herbal medicines as they would if they were making actual drugs. As a result, these medicines don’t necessarily have a consistent formulation and it may even vary between herbalists.

On the other hand, herbal medicines in India are regulated under the Drug and Cosmetics Act (D&C) 1940 and Rules 1945. However, it is important to note that this act regulates only the medicines in traditional medicine systems including Ayurveda, Siddha and Unani. Local herbal medicines and folk medicine are not covered under this. The AYUSH (Ayurveda, yoga and naturopathy and Unani, Siddha and homeopathy) ministry regulates the licencing, production and marketing of herbal medicines in India.

Similarly in Europe, the European Directive 2004/24/EC lists the guidelines for the regulation of herbal products. As per these regulations, any herbal medicine needs to be regulated by national authorities in specific countries before they are marketed in that country. The sellers have to ensure the safety and efficacy of their products with the national authorities. To be registered, the herbal products must have sufficient evidence of medicinal use over a period of time. This period is about 30 years in the European Union and at least 15 years for products from outside the EU.

However, since every country has different regulation norms, it becomes really difficult to regulate herbal medicines and products. An old survey conducted by the World Health Organization in about 129 countries also indicated some of the following reasons for this problem:

Not enough research information and data
Lack of expertise within the national health authorities
Absence of proper control mechanisms to regulate herbal products
Lack of safety monitoring of the drugs and methods to check the safety and efficacy of the herbal products

How effective are herbal medicines

A lot of herbs have shown therapeutic actions including antimicrobial, antinociceptive, anti-inflammatory and antioxidant. The effects of herbs like ginger have also been shown in human/clinical trials. However, when it comes to the efficacy of most herbal medicines, and herbalism in general, the research evidence is not conclusive enough.

Experts suggest that one of the major advantages of herbal products is that they contain a number of active ingredients. Together, they potentiate the action of each other and provide several health benefits. On the downside, the presence of so many active compounds makes it difficult to identify the exact mode of action of the herb. When preparing herbal extracts, practitioners should keep a tab of where and when they isolated the herb and if the said herb was exposed to any specific environmental factor or artificial pollutant. This is because the presence of certain factors, for example, temperature, flood or drought, can change the composition of the phytochemicals in a plant and hence its effects and efficacy.

Changes in phytochemical composition and difficulty in identifying all the active ingredients in a herb make it impossible to standardize herbs the way drugs are. Even when a single component is standardized, the presence of this component in every commercial product is not guaranteed.

Safety of herbs and herbal medicine

A lot of people think that just because they are natural, herbs and herbal medicines are safe to consume. However, this is not the case.

Herbs like henbane and belladonna are highly toxic and may cause allergic or toxic reactions when consumed.
Every herb usually has a safe dosage, above which they may lead to side effects in both short or long term.
Since herbs contain active biological constituents, they tend to react with conventional medicines. In fact, experts suggest that most cases of reactions to herbal medications occur in case of self-medication.
If you are not experienced enough, you may end up misidentifying a herb or buy contaminated or adulterated herbs, leading you to fall sick.

Hence, it is always best to consult an experienced physician or a herbalist before you take any herb in any form. They will ask you about your overall health, age and presence of any comorbidities and will consider any medications you are taking before prescribing you any herbs.

One of the major side effects of herbal medicine is to the environment. Increasing use of herbal medicines and remedies has led to over-harvesting of certain herbs. Data suggests that several endangered medicinal plants are now threatened with extinction because of careless and over-harvesting.

Ways to take herbs

Herbs can be taken in various forms depending on your need and as directed by your healthcare provider. Here are some of the most common forms that herbs are taken in:

In food: This category includes culinary herbs like garlic, ginger, black pepper and turmeric that are used to add flavour to the food. However, the amount added in most recipes is not enough to provide medicinal benefits.

Infusions and teas: Infusions and teas are one of the most common ways to consume herbs. They involve the intake of herbs by steeping them in boiling water for a specific period of time - some herbs take longer to infuse than others. However, it is best to consult a herbalist to know the right time and dose to prepare an infusion since some herbs may become toxic when infused for longer and in high doses.

Decoctions: Decoctions are made by boiling or heating a plant part (usually hard parts like roots and bark) in a liquid (water or milk for example) for a certain amount of time. As it’s heated, the plant releases its volatile compounds into the liquid, imparting therapeutic effects.

Capsules and tablets: Capsules and tablets are a no fuss way of having any herb. They are usually standardised and have been studied for their effectiveness and safety and are hence best for taking the right dosage for you. Again, the right dosage as per your health and age would only be determined by a healthcare practitioner.

Extracts: Plant extracts are preparations that involve extracting certain active ingredients of a plant or plant part in a specific solvent - water, ethanol, chloroform etc.

Tinctures: Tinctures are prepared by soaking a plant or plant part in alcohol or vinegar for a certain period of time. Both these solvents pull out the active ingredients from the plant and get their medicinal properties too.

Lotions, salves and creams: By mixing various other ingredients with a particular herb, you can make topical preparations including gels, creams, lotions and salves. The amount and ratio of the herb and other ingredients are again crucial for the preparation to work effectively and not cause any side effects.

Oils: Infusion oils and essential oils can be prepared with herbs to extract some of their components. Essential oil extraction is a complex process which involves vaporization and condensation of the plant oils. These oils are pure and usually not applied directly to the skin or consumed without mixing them in a carrier oil first. On the other hand, infusion oils are milder and are prepared by steeping the said herb in a carrier oil (say coconut oil or olive oil) for a specific period of time. The bottle is kept sealed or airtight in a cool and dry place and shaken in between to let the contents mix properly.