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Life Extension Magazine

LE Magazine September 1999


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European Pharmacies Inside
Europe's
Pharmacies

For decades Europeans have taken herbs and supplements to enhance their health. While interest in alternative therapies is growing, natural remedies are not as widespread in the United States.

by Jeffrey Laign


A middle-aged man shuffles through the door of a pharmacy in Frankfurt, Germany, hacking, sneezing and sniffling. From behind the counter at Apotheke an der Hauptwache, pharmacist Ulrike Jager quickly sizes up his symptoms. "Is your throat scratchy?" she asks. "Do you have a fever?" Moments later the man walks out with Sinupret, a mix of sorrel and other herbs for colds and sinusitis.

"We want to help the customer to take the medication that is best for him," Jager explains. "And in many cases, herbal remedies work the best."


Herbal medicine is the prescription of choice for a number of common ailments, including depression, sinusitis and memory loss.
At Jager's pharmacy-and at pharmacies throughout Europe-you'll find rows upon rows of herbal medicines and supplements. Natural remedies are showing up on the shelves of U.S. drugstores, too. But there's a big difference. In Europe, doctors and pharmacists routinely prescribe natural remedies, and they're trained extensively to help consumers use them. In this country, few health practitioners have a knowledge of herbs and supplements.

"The U.S. system can be dangerous," says botanist and pharmacologist Joerg Gruenwald, lead author of the Physicians' Desk Reference for Herbal Medicines. Earl Mindell, a U.S. pharmacist and natural medicines expert, agrees. "What's happening in the United States today," he says, "is that synthetic drugs are becoming quite dangerous. Most natural medicines don't have the horrendous side effects that some synthetic drugs can produce. In Europe, they're way ahead of us."

Gruenwald, Mindell and other experts think the United States should adopt a medical system similar to the one in Germany, which leads Europe and the rest of the world in researching and using natural medicines. Consider the following facts about the German system:

  • Eighty percent of German physicians prescribe herbal remedies for patients.
  • Twelve percent of all German prescriptions are for herbal preparations. In fact, herbal medicine is the prescription of choice for a number of common ailments, including depression, sinusitis and memory loss.
  • German herbal remedies are labeled with precise instructions.

The practice of natural medicine enjoys a venerable history in Europe, where healers have used herbs for thousands of years to treat a variety of ailments. But instead of abandoning folk remedies when synthetic drugs were developed, the German government established a review board in 1978 to test and revise them. Composed of physicians and plant specialists, Germany's Commission E spent 15 years studying more than 300 herbal medicines, including many used by medieval German healer and mystic Hildegard of Bingen.

The commission then developed monographs on each herb, delineating medicinal uses, potential side effects, and recommended dosages. Since 1980, all herbal remedies sold in German pharmacies have undergone the same rigorous testing as over-the-counter drugs. And today there are more than 300 clinical trials of herbs under way in Germany. Such tests cost money-hundreds of thousands of dollars, in fact. Money the German government believes is worth spending on health.

Unfortunately, the U.S. Food and Drug Administration does not recognize most herbs and supplements as medicines, and thereby prevents manufacturers from making specific health claims. That's ironic, when you consider the growing popularity of natural medicines in this country. Since 1994 hundreds of natural remedies have flooded the market and herb sales have more than doubled. But pick up a bottle of garlic, ginkgo or echinacea, and you're likely to find only vague, cryptic instructions, such as, "Take as needed."

It was not always this way. Fifty years ago, every pharmacy school in the United States employed specialists in plant-based medicines. But with the advent of antibiotics and other synthetic "miracle drugs," doctors put a damper on herbal treatments. Today pharmacists in this country spend at least five years learning their occupation, but few understand how natural medicines work.

"I hear pharmacists everywhere saying, 'We're selling this stuff, and we don't know anything about it,' " says Norman Farnsworth, who teaches a course on plant medicine at the University of Illinois in Chicago.

Different drugstores

Germany, pharmacists are trained to dispense herbs and supplements as well as synthetic drugs. And if a doctor prescribes a natural medicine, it's covered by state health insurance. Among the herbs Jager prescribes most are valerian to ease jangled nerves, St. John's wort for depression and echinacea for colds and flu. Other popular natural medicines include black cohosh for hot flashes and horse chestnut for varicose veins.


In Germany, pharmacists are trained to dispense herbs and supplements as well as synthetic drugs. And if a doctor prescribes a natural medicine, it's covered by state health insurance.
"The consciousness is changing," Jager says as she collects herbal remedies from a floor-to-ceiling cabinet stocked with hundreds of pullout shelves. "People today-especially younger people-are more interested in natural medicines than ever before." Wolfgang Schatton, a doctor of pharmacy at Frankfurt's Apotheke am Eschenheimer Turm, agrees. "Natural medicines are growing in popularity because of the side effects that chemicals can have," Schatton says, as he prepares an herbal remedy behind a counter lined with antique apothecary jars and scales.

On the other hand, it's much easier to purchase an over-the-counter drug in the United States than in Germany and other European countries. There you have to go to a pharmacy to buy even the most common remedies. "I am astounded that in the United States you can buy aspirin in the supermarket," Jager says. "In Germany you can buy it only at a pharmacy."

Europe's favorite natural remedies

After all, doctors in Europe routinely prescribe herbs, supplements and other natural remedies as a first line of treatment. Throughout Portugal, for example, it's glucosamine you'll receive if your doctor hands you a diagnosis of arthritis. Many European physicians, in fact, turn to conventional arthritis drugs only when glucosamine proves to be ineffective.


Side by side, you will find aspirin, synthetic medications and loads of herbal supplements throughout Europe's pharmacies.
Glucosamine is an amino acid that helps connective tissue to repair itself. In 1982, more than 250 Portuguese doctors participated in a nationwide study to determine the supplement's effectiveness in treating arthritis. The physicians gave 1,506 osteoarthritis patients a daily dose of 1,500 mg of glucosamine for six to eight weeks. In another group, 1,077 arthritis sufferers were treated with NSAIDS such as ibuprofen, or corticosteroids. At the end of the trial, 95 percent of patients in the glucosamine group showed marked improvement, compared with 70 percent of patients in the NSAIDs group. Consequently, Portuguese doctors rated glucosamine a better arthritis treatment than standard drugs.

In France, ginkgo biloba accounts for 4 percent of all prescription medicines. And the herb comprises 1 percent of prescription sales in Germany, where it's licensed for treatment of "cerebral insufficiency" and used to treat problems ranging from impaired memory, dizziness and tinnitus, to headaches, nervousness and anxiety. Total sales across the European continent average more than $500 million a year. "Research on ginkgo and Alzheimer's is producing extremely good results in France and Germany," says herbal expert and researcher Daniel B. Mowrey, Ph.D.

Indeed, Europeans have been using ginkgo biloba extract for years to fight off Alzheimer's and other cerebral disorders associated with aging including forgetfulness, mild confusion, tinnitus or ringing in the ears, and inability to concentrate. In some countries, in fact, ginkgo is a registered drug, among the most commonly prescribed for treating organic brain disorders. In lower doses, ginkgo is sold over the counter in many European countries, just as it is in the United States.

St. John's wort has been a popular antidepressant in Europe for years. In Germany, where its use is covered by health insurance as a prescription drug, more than 20 million people take the herb.

"St. John's wort isn't something they've just discovered across the Atlantic," says author and expert Harold Bloomfield, M.D. "It's been used by German and other European physicians since ancient times. It comes as a surprise to us here in the United States because we've chosen to sever our roots with herbal medicine."


European countries have made great strides in educating consumers on natural medical breakthroughs that are saving the lives of people world-wide.
In England feverfew has been studied extensively as a treatment for migraine headaches ever since a local miner reported miraculous cures after chewing a few leaves in the late 1970s. He passed on his discovery to the wife of the chief medical officer of Great Britain's National Coal Board, who also suffered greatly from migraines. After taking feverfew for 14 months, her migraines disappeared. Impressed by his wife's recovery, her husband relayed the story to Dr. E. Stewart Johnson of the City of London Migraine Clinic. Johnson was intrigued and decided to test feverfew on his patients. He found that the herb was remarkably effective for treating migraines.

Feverfew contains a compound called parthenolide, which helps to control expansion and contraction of blood vessels in the brain. When you begin to get a migraine your brain releases the neurotransmitter serotonin and your blood vessels constrict. Feverfew appears to counteract your brain's order by causing blood vessels to dilate. In addition, feverfew appears to neutralize chemicals called prostaglandins, which are linked to pain and inflammation. In 1978 scientists speculated in the British journal Lancet that feverfew might share some properties with aspirin. Two years later Lancet published a study that appeared to confirm this theory.

Kava kava, an herb revered for centuries by South Pacific islanders, is used extensively in Europe as a safe, effective natural tranquilizer. In Germany, researchers conducted a double-blind study of 58 patients suffering from common anxiety syndrome. Half of the patients received a placebo. The other half took 100 mg of kava extract three times a day for four weeks. The researchers then administered several tests to assess patients' anxiety levels. After one week, patients who took kava demonstrated a significant reduction in anxiety symptoms, compared with patients who took the placebo. What's more, the kava patients continued to improve throughout the 28-day study.

German researchers also have found that kava induces deep muscle relaxation, modulates emotions and promotes sleep as effectively as synthetic tranquilizers-but without causing side effects.

They provide model examples of health systems that work. The U.S. could take a hint. Yet, while the dissemination of information on herbal therapies has so far been limited in the U.S., alternative medicine circles are beginning to take incremental, albeit significant steps toward edu cating the general public on natural remedies from around the world.