STANDARDISED EXTRACTS: USE, EXPERIENCES AND OPINIONS OF UK REGISTERED WESTERN HERBALISTS

Abstract

Traditionally Western Herbal Medicine (WHM) uses ‘whole plant extracts’ (WPEs), typically presented as liquid extracts, teas and powders. There is no formal measurement of any identified plant chemicals in WPEs. In contrast, preparations called ‘standardised extracts’ offer a guaranteed minimum content of specified plant constituents that have been identified in modern research studies. A limited number of these standardised extract preparations are in the form of ‘highly standardised extracts’ (HSEs), largely presented as tablets. They offer a much higher dose of identified ‘active constituent/s’ than is present in the WPE and are the focus of this study. This study uses a Grounded Theory (GT) with Mixed Methods Research (MMR) approach to investigate the use of these alternative herbal preparations (WPE vs HSE). It investigates how registered herbalists have come to use HSEs and their attitudes towards them, with a view to informing the debate and the wider interested community.
Findings indicate that there is limited but clear use of single HSEs by a large minority of participating respondents, with use influenced mainly by the growing body of research, historical influence of other herbalists and clinical evidence of ‘strength’. Other facilitating influences on HSE use were research-skills training which may have encouraged widespread open-mindedness, reduced historical controversy and lack of strong feelings against HSE. The major identified limiting factor in HSE use was the strong emphasis on the ‘natural’ WPE, with a ‘split’ in open-mindedness towards HSE. All herbalists reported use of herbal research, used for largely non-clinical reasons. Only limited evidence was identified of clinical ‘integration’ of research with practice by HSE users. Greater integration was suggested in a small minority of respondents which better reflects WHM practice in non-UK countries. Finally, it is acknowledged that response bias limits the strength of conclusions.