Herbal remedies in global health care : classification, toxicology, and clinical management

Abstract

PURPOSE : Traditional herbal medicines are crucial in the health care system worldwide, particularly for individuals with chronic illnesses. These remedies are commonly classified by purpose, composition, mechanism of action, and origin, with the World Health Organization outlining 4 main categories: indigenous herbal medicines, those used in traditional systems, modified herbal medicines, and imported herbal products. The authors explored the toxicology of commonly used herbal remedies, including their mechanisms, signs and symptoms of toxicity, and treatment strategies. METHODS : Literature was searched using different published resources and databases, PubMed and ScienceDirect. The searched terms included “herbal medicine,” “herbal remedies,” “traditional medicine systems,” “herbal toxicity,” “herbal toxicity mechanism of action/toxicity,” among others. The searches were limited to the English language, with no restrictions on publication date. RESULTS : The perception that herbal medicines are inherently safe is misleading. Herbal remedies can be toxic due to the plant's intrinsic properties or through contamination and adulteration. Moreover, 15%–20% of individuals on prescription drugs concurrently use herbal supplements, increasing the risk of harmful interactions. Incidence of herb-induced toxicities, particularly hepatotoxicity, is related to the use of Kava, Chaparral, Comfrey, Germander, and green tea extract. Moreover, cardiovascular toxicity due to Chan Su and oleander-containing herbal remedy use is detected by assessing serum digoxin concentration and is treated with Digibind. Although advances in modern formulations and increased regulatory oversight have improved safety, shortcomings remain, particularly in public awareness and standardized regulations. CONCLUSIONS : Comprehensive clinical management, patient education, and integration of traditional medicine into mainstream health care ensures safe, effective, and responsible use of herbal products.