Nearly Half Of All Women 65 And Older Now Use Herbal Products To Feel Better, But Don’t Tell Their Doctors

January 29, 2001

GAINESVILLE, Fla. — Nearly half of all women over 65 now use herbal therapies to prevent or treat health problems, but they rarely inform their health-care providers, according to a new University of Florida study.

Because many of these women also take prescription and over-the-counter medications, they are putting themselves at risk for dangerous drug interactions, nurse researchers say.

“People may think herbal remedies are safe because they are natural and take them even though they don’t know if the product is effective,” said Saun-Joo Yoon, a visiting assistant professor and graduate of the UF College of Nursing. “But these products can interact with prescription or over-the-counter medicines that may result either in serious complications or ineffective treatment for serious health conditions.”

In a study of 86 senior women reported in the January issue of the Journal of Advanced Nursing, UF nurse researchers found 45 percent had used an average of 2.5 herbal products in the previous year. The women reported 85 percent of the remedies were used on a continual basis and had been used on average for nearly three years.

In the first study to specifically target herbal product use among older women, participants also reported taking an average of 3.2 prescribed medicines and 3.8 over-the-counter medicines, such as aspirin, vitamins and calcium, said Yoon, who also is associated with the UF Institute on Aging.

Previous studies by other researchers have looked at herbal remedies as only one of many different alternative therapies or at younger users of herbal products.

In the current study, research participants were selected from a pool of 8,344 women 65 and older in North Central Florida. In face-to-face interviews in 1998, the participants reported they had used a total of 98 herbal products in the previous year.

The most frequently reported herbal products were ginkgo biloba (alone or in combination with other herbs), garlic tablets and cloves, and glucosamine with chondroitin. Other herbal products included aloe, herbal teas, echinacea, ginger, St. Johns wort, vinegar with honey, primrose and ginseng.

“The product had to be taken for medicinal reasons to be included in the study,” said Yoon. “If they drank cranberry juice to prevent a kidney problem, we included it. But if they drank cranberry juice because they like it or for good nutrition, we did not include it.”

Of those who did use herbal remedies, 41 percent said they used the products to maintain health or prevent possible health problems, for example to prevent memory loss or to improve memory. Another 36 percent used herbal therapies to both prevent and treat health problems, while 23 percent used herbal products only to treat a health problem. The most common conditions treated with herbal remedies included arthritis, high blood pressure and other cardiovascular health problems, and digestive problems.

Study participants perceived that about half of the herbal products they took were somewhat or very effective, but said they did not know if the remaining products were effective.

“In spite of not recognizing an immediate benefit from using herbal products, the women were willing to continue purchasing and using herbal products because they perceived them to be potentially beneficial and not harmful,” said Yoon, who is a registered nurse.

“Consumer use of herbal products should be of great concern to health-care providers,” she said. “Although study participants had visited at least one type of health-care provider in the previous 12 months, the health-care providers were only aware of about one-fourth of the total number of herbal products used.”

Less than half the users (41 percent) reported taking herbal remedies to their health-care providers. Those participants who did report such usage, they only reported only slightly more than half of the products actually being used. Overall, of the 98 herbal products reported in the study, 72 percent of the products were not reported to the participants’ health-care providers, Yoon said.

“Health-care providers can prescribe conventional medications without the knowledge of their clients’ use of herbal products, but certain combinations can be unsafe,” said Claydell Horne, an associate professor at the UF College of Nursing and co-author of the article.

For example, Horne said, previous research has shown gingko biloba and ginseng can interact with warafin, a blood-thinning medication taken by some heart patients. Previous research has shown hemorrhages can result when patients take both warafin and either gingko biloba or garlic. Ginseng has been found to decrease warafin’s effectiveness, said Horne, who also is associated with UF’s Institute on Aging.

Although participants selected for interviews were drawn from a random sample, all but one woman in the study were white, so the data are not representative of all ethnic groups.

“In today’s world of mass media and promises, it is not surprising that the women in this study used additional nonprescription and herbal therapies. Providers need to know what the individual is taking so we might offer suggestions that could increase safe use,” said Ellis Quinn Youngkin, a women’s health care nurse practitioner and associate dean of nursing at Florida Atlantic University.

Yoon said, “Nurses need a better understanding of the herbal products that people use since nurses are often the first health-care providers to interview individuals seeking medical assistance. Most nurses, however, have minimal knowledge about herbal remedies.”

Youngkin said, “The study reminds providers to remain current as new research findings on such therapies become available and certainly points out the gaps in our knowledge base.”