Letters The herbalists’ marketeer

Herbal drugs and public choice

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g4157 (Published 24 June 2014) Cite this as: BMJ 2014;348:g4157
  1. Michael McIntyre, herbal practitioner/acupuncturist1,
  2. George Lewith, professor of health research2,
  3. Andrew Flower, National Institute for Health Research postdoctoral research fellow2,
  4. Sarah Price, research fellow2
  1. 1European Herbal and Traditional Medicine Practitioners Association, Tewkesbury GL20 5TY, UK
  2. 2Aldermoor Health Centre, University of Southampton, Southampton SO16 5ST, UK
  1. ehap{at}globalnet.co.uk

The Medicines and Healthcare Products Regulatory Agency (MHRA) and the Traditional Herbal Medicinal Products Directive (THMPD) do not promote herbal drugs or mislead consumers; they seek quality control and safety of herbal drugs.1 The THMPD does not guarantee efficacy; it describes traditional use. By granting traditional herbal registrations, the MHRA enables the provision of quality controlled herbal drugs that have a history of safe use.

Given the widespread use of herbal remedies, it would be irresponsible for the agency not to do this. A survey conducted for the MHRA in 2009 showed that 35% of UK adults had used a herbal drug in the previous two years.2 The next stage is to investigate these remedies, taking into account the synergistic multitargeting actions of their phytopharmacology. Herbal remedies are subject to the yellow card reporting system, so any adverse drug reactions will be recorded.

In contrast to what McCartney says:

  • Devil’s claw has been shown to be effective for short term use in non-specific low back pain.3 There are data on the safety of long term use—evidence of at least 30 years of safe use was needed for the drug to qualify for a traditional registration

  • McCartney equates devil’s claw with harpagoside; however, devil’s claw is Harpagophytum procumbens, whereas harpagoside is an iridoid glycoside, a constituent of the plant

  • McCartney uses one homeopathic (not herbal) reference for arnica and a second for a topical gel treatment for hand osteoarthritis in a Cochrane review, which states it is equally effective to ibuprofen gel4

  • Preliminary evidence suggests that feverfew has promise “as a viable preventative treatment for migraine.”5

Because herbal drugs are so widely used, it is right that the medicines regulator ensures the quality and safety of these remedies as far as possible.


Cite this as: BMJ 2014;348:g4157


  • Competing interests: MMcI is chair of the European Herbal and Traditional Medicine Practitioners Association, for which he receives some income and expenses. He works as a herbalist in private practice and teaches at various institutions for which he also receives payment. AF and SP are also herbal practitioners in private practice.

  • Full response at: www.bmj.com/content/348/bmj.g3194/rr/698973.


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