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Ten local remedies that work

3 August 2010: Ever drank peppermint tea to soothe an upset stomach? Or perhaps you swear by echinacea if you’re suffering from a cold?

Wherever you are in the world, you are likely to come across local remedies for everything from insect bites to heart disease and cancer. But do any of these ‘natural cures’ really work?

Natural remedies

Dr Sneh Khemka, Medical Director at Bupa International, takes a closer look at the evidence behind some of the most commonly used local remedies around the world.

In many countries – particularly in Asia and Africa – people depend on traditional medicines for first line care.1 These remedies generally haven’t gone through the same thorough regulation process as conventional medicines – and in these days of evidence-based medicine, it’s easy to dismiss them as folklore. However, chances are even the most cynical among us have probably used a treatment that at least has its origins in traditional medicine. If you have ever taken an aspirin for instance – you’re taking a pill whose roots began in ancient Greece with the discovery of salicin from willow trees.

The following ‘local’ remedies have become popular around the world due to increasing evidence to support their use, and in many cases have even been incorporated into mainstream medicine.

St John’s wort

First noted for its medicinal properties in ancient Greece,2 extracts of St John’s wort have been used for centuries to treat depression and other mental disorders.2 Although the herb does not appear to be effective in people with severe depression,2 there is some good quality evidence to support its use in mild to moderate depression.3 However, a word of warning: St John’s wort is known to interact with numerous medicines, which may reduce or enhance their effects.2

Ginger

If you’re a mother or mother-to-be then chances are you’ve heard of this one; ginger has been used for years in Asian medicine as a treatment for stomach ache, nausea and diarrhoea – and is now widely recommended as a remedy for ‘morning sickness’ in pregnant women.4 There is certainly some evidence – albeit limited – to support its effectiveness in in morning sickness.4-6 However it’s important to note that the active ingredient in ginger has not been identified and its effectiveness may vary depending on its exact composition.

Acupuncture

The reputed benefits of acupuncture – where needles are used to stimulate trigger points on your body – have been known to the Chinese for thousands of years. But it’s only in the past few decades that the therapy has become integrated into conventional medicine. There is now good scientific evidence to support the use of acupuncture in knee pain due to arthritis, sickness due to chemotherapy or surgery, dental pain, headache and migraine.7-12

Echinacea

The herb echinacea – native to the USA and southern Canada – is believed to stimulate the immune system and has been traditionally used to treat or prevent colds, flu and other infections.13 While the evidence regarding prevention of colds and flu is lacking,13, 14 some trials have demonstrated echinacea may shorten the duration and reduce the severity of cold symptoms if taken early on in the illness.13, 14 If you use echinacea, be aware that many different preparations of the plant exist, and it is still unclear which are the most beneficial.14, 15

European mistletoe

Used for centuries to treat seizures, headaches and other conditions, European mistletoe has more recently been studied as a treatment for cancer and is now among the most prescribed cancer therapies in certain European countries, such as Germany.16+18 But does it really work? The jury’s still out on this one – although a number of trials have reported benefits of the therapy, most have had major weaknesses in their design that invalidate their findings.16, 18, 19 More research is needed until scientists can say for sure if it works.

Peppermint oil

Peppermint is a herb common throughout Europe and North America.20 Widely used as a remedy for digestive complaints such as indigestion and irritable bowel syndrome, there is now some promising evidence to support its use in this field.20, 21

Pygeum (Prunus africana)

Of the hundreds of herbal medicines used in Africa, pygeum is the one that has probably developed the greatest following outside of the continent – and with apparently good reason. The herb has been known for years in Africa for its ability to relieve symptoms of benign prostatic hyperplasia (enlarged prostate) – and a review carried out by US researchers now supports this claim.22 Not only did the review find that it gives a ‘modest, clinically significant improvement in symptoms’, it was also found to be well tolerated and cheaper than most prescription medicines.
 

Cranberries

This native fruit of North America has been historically used for a wide variety of problems – with diabetes and liver problems to name but a few.23 Nowadays, cranberry juice and other cranberry-based products are often hailed as an effective means to prevent recurrent urinary tract infections in women, with evidence growing to support this claim.24, 25
 

Aloe vera

Known to the ancient Egyptians as the ‘plant of immortality’,26 people have been using the gel produced by leaves from the aloe vera plant for thousands of years to help heal wounds and treat skin conditions, and as a laxative.26 It’s now an ingredient in hundreds of skin products used around the world. Good quality evidence on the alleged benefits of aloe vera is scarce; however, there is limited evidence to support its use for first- and second-degree burns.27
 

Hawthorn

Fruit from the hawthorn shrub – common throughout northern Europe - has been used since the first century for heart disease, as well as digestive and kidney problems.28 Scientific evidence has shown that hawthorn extract, when used in conjunction with conventional treatments such as ACE inhibitors and diuretics, can indeed help control symptoms of chronic heart failure, such as shortness of breath and fatigue.29 There isn’t enough evidence to determine whether it is useful for any other condition.28

Conclusion

There are of course thousands more local remedies used throughout the world – but for most, this high quality evidence just doesn’t exist. It’s also important to note that herbs and plants have as much potential to do harm to our bodies as good. The lack of regulations in different countries can also make it difficult to ensure safety and quality of traditional medicines.1

This doesn’t mean we should just dismiss these treatments. But it’s sensible to employ caution until their effectiveness and safety can be properly tested. So while local knowledge should never be underestimated, as with any type of medicine, ‘natural’ or otherwise, it’s always best to get the advice of a medical professional before you take it.

Next steps

  • Sources

    1. Traditional medicine. World Health Organization. www.who.int/topics/traditional_medicine/en/, published December 2008

    2. St John’s Wort. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/stjohnswort/ataglance.htm, published March 2008

    3. Linde K, Berner MM, Kriston L. St John's wort for major depression. Cochrane Database of Systematic Reviews 2009, Issue 4. doi:10.1002/14651858.CD000448.pub3

    4. Ginger. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/ginger/, published May 2008

    5. Nausea and vomiting in early pregnancy. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published June 2009

    6. Jewell D, G. Y. Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews 2009, Issue 1. doi:10.1002/14651858.CD000145

    7. White A, Foster N, Cummings M, et al. The effectiveness of acupuncture for osteoarthritis of the knee: a systematic review. Database of Abstracts of Reviews of Effects (DARE) 2009

    8. Mapping the evidence base and use of acupuncture within the NHS. Department of Public Health and Epidemiology. 2007, report number 59. www.rep.bham.ac.uk/2006/Mapping_Acupunture.pdf

    9. Kwon YD, Pittler MH, Ernst E. Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Database of Abstracts of Reviews of Effects (DARE), 2008

    10. Lee A, Done ML. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis. Anesth Analg 1999; 88:1362

    11. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for tension-type headache. Cochrane Database of Systematic Reviews 2009, Issue 1. doi:10.1002/14651858.CD007587

    12. Melchart D, Linde K, Berman B, et al. Acupuncture for idiopathic headache. Cochrane Database of Systematic Reviews 2001, Issue 1. doi:10.1002/14651858.CD001218

    13. Echinacea. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/echinacea/ataglance.htm, published March 2008

    14. Linde K, Barrett B, Bauer R, et al. Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2009, Issue 4. doi:10.1002/14651858.CD000530.pub2

    15. Common cold. BMJ Clinical Evidence. www.clinicalevidence.bmj.com/ceweb/conditions/rda/1510/1510_I5.jsp, published 9 June 2008

    16. Mistletoe extracts. National Cancer Institute. www.cancer.gov/cancertopics/pdq/cam/mistletoe/Patient/page2, accessed 11 June 2010

    18. Horneber M, Bueschel G, Huber R, et al. Mistletoe therapy in oncology. Cochrane Database of Systematic Reviews 2010, Issue 4. doi:10.1002/14651858.CD003297.pub2

    19. Ernst E. Mistletoe as a treatment for cancer. BMJ, 2006; 333:1282-83.
    doi:10.1136/bmj.39055.493958.80

    20. Peppermint oil. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/peppermintoil/, published June 2008

    21. Irritable bowel syndrome. BMJ Clinical Evidence. www.clinicalevidence.bmj.com, published 5 Jan 2010

    22. Wilt T, Ishani W. Pygeum africanum for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews 2008, Issue 4. doi:10.1002/14651858.CD001044

    23. Cranberry. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/cranberry/#science, published March 2008

    24. Jepson RG, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews 2009, Issue 4. doi:10.1002/14651858.CD001321.pub4

    25. Recurrent cystitis in non-pregnant women. BMJ Clinical Evidence. www.clinicalevidence.bmj.com/ceweb/conditions/woh/0801/0801.jsp, published July 2008

    26. Aloe vera. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/aloevera/, published April 2008

    27. The efficacy of aloe vera used for burn wound healing: a systematic review. Database of Abstracts of Reviews of Effects (DARE). www.mrw.interscience.wiley.com/cochrane/cldare/articles/DARE-12007003049/frame.html,

    28. Hawthorn. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/hawthorn/, published May 2008

    29. Guo R, Pittler MH, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database of Systematic Reviews 2008, Issue 1. doi:10.1002/14651858.CD005312.pub2
     

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If you have ever taken an aspirin for instance – you’re taking a pill whose roots began in ancient Greece with the discovery of salicin from willow trees.

Dr Sneh Khemka

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