By Kate Schuler, Special to USA TODAY
With the prospect of weeks of coughs, itchy noses and dark circles under their eyes, many Americans are no longer content to attack their allergies with just one or two drugs in their arsenal.
Dr. Xiumin Li with herbal mushrooms, one of the ingredients in her anti-asthma herbal medicine intervention.
Robert Deutsch, USA TODAY
Leonard Bielory, director of the Asthma and Allergy Research Center at the University of Medicine and Dentistry of New Jersey, says cold and allergy symptoms are one of the top reasons people seek out alternative treatments. A 2002 study by the National Center for Complementary and Alternative Medicine at the National Institutes of Health found that 36% of adults in the USA had used some kind of non-conventional therapy to treat a variety of maladies during a 12-month period. Most of those who sought alternative therapies used them in combination with prescription drugs or other conventional treatments. Despite the growing popularity of such treatments, there is scant scientific research on their effectiveness and safety.
"When a patient asks me whether they should try alternative or herbal medication, I counsel that it generally won't be harmful, but it's not likely to be beneficial, either," says Brian Smart, an allergist in Glen Ellyn, Ill. Smart recommends that patients talk to their doctors about any supplements or alternative medicine they are using. "And they should carefully watch for side effects," he says.
Little standardization Adding to consumers' uncertainty about the safety and effectiveness of alternative therapies is the way the Food and Drug Administration regulates supplements — as food, rather than drugs — so there is little standardization within the industry.
Mark Blumenthal, executive director of the American Botanical Council, a research and education group on supplements, says sorting through the information "is a daunting task and can be very confusing."But Blumenthal says alternative medicines have shown some promise for treating allergies. He cited promising early studies — one conducted by a Swiss allergy clinic and another by a U.S. naturopathic physician — of the herb butterbur and freeze-dried nettle leaves, as well as some herbal blends.
Doctors, however, don't always know which treatments have been proven effective in trials. Indeed, the NIH survey showed that only about a quarter of people who used complementary and alternative medicine said a doctor suggested it.A widely publicized study that appeared in The New England Journal of Medicine in July concluded that echinacea — the biggest-selling herbal supplement in the USA — was no better than a placebo at preventing or treating colds. (Some advocates countered that the dosage in the study was too low.)
"Yet people are still going to use it," Bielory says. "So we have to learn what they're using and if it has a positive effect, and what adverse effects" there might be."We want physicians to appreciate what is science and what is anecdote," he says. "And for that, more research is needed."
NIH has taken steps to fill that void. In 1992 it opened a research office on alternative medicine with $2 million funded by Congress, an initiative that has grown into a research center that grants nearly $108 million to scientists each year.
A possible 'botanical drug'
One of those researchers is Xiu-min Li at the Mount Sinai School of Medicine in New York. A doctor trained in both Western and traditional Chinese medicine, Li is studying the effect of a combination of three Chinese herbs — ling zhi, ku shen and gan cao — on patients with asthma, and she says that because so many asthma patients are affected by allergies, it is possible the formula could be used widely in treating common allergies.
With funding from NIH, she derived the three-herb combination from a more complex formula commonly prescribed in China. Clinical trials are expected to begin within the next few months.
“I think people are very excited," she says, about the possibility of a "botanical drug" that will have FDA approval. "This is a population that really wants to try an alternative approach."
Meanwhile, patients also can make minor changes in their daily lives to help control their allergies.
Smart suggests patients use nasal saline that can be bought in pharmacies or mixed at home. "It moisturizes nasal surfaces and it will wash out bacteria and pollen," he said.
"Close the house up and put the air-conditioning on," says Thomas Platts-Mills, president of the American Academy of Allergy, Asthma, & Immunology. "You can reduce the amount of pollen."
Platts-Mills adds: "There're lots of very sensible things people can do. It doesn't require taking medicine all the time."