Uses and experience of highly standardised plant medicine extracts by UK medical herbalists

Introduction: Traditionally Western Herbal Medicine (WHM) uses ‘whole plant extracts’, typically presented as liquids, teas and powders, with no formal measurement of identified plant constituents. In contrast, 'standardised extract’ preparations offer a guaranteed minimum content of specified constituents, as identified in modern research. A limited number of these preparations, referred to here as ‘highly standardised extracts’ and largely presented as tablets, offer a much higher dose of ‘active constituent/s’ than is present in the whole plant extract. They are the focus of this study. The study investigated how herbalists have come to use highly standardised extracts and their attitudes towards them, with a view to informing the debate and the wider interested community.

Methods: An online survey, a mix of quantitative and qualitative questions, was distributed by UK herbalists’ professional bodies to members.

Results: Findings from a total of 78 respondents indicate that there is limited but clear use of single highly standardised extracts by a large minority of participants, with use influenced mainly by the growing body of research, historical influence of other herbalists and clinical evidence of ‘strength’. All herbalists reported accessing herbal research studies. The major identified limiting factor on highly standardised extract use was the strong emphasis on the ‘natural’ whole plant extract.

Conclusion: This survey indicated a strong focus of responding herbalists on the use of the natural whole plant extract. Despite limited use of research-based highly standardised extracts, all reported engagement with research. It is acknowledged that response bias limits strength of conclusions.