Why a common hedgerow fruit that helps with Covid doesn't have government backing

Herbal medicines effective against Covid can be better and cheaper alternatives to NHS prescribed drugs, a top academic says.

Using them to help treat and prevent the virus “makes perfect sense” and red-tape is behind GPs’ reluctance to prescribe plant-based remedies commonly used across the world, said Professor David Heinrich.

The professor of pharmacology at UCL said: “Some herbal medicines would offer a cheaper solution to what the NHS currently accept and these are in fact 'evidence-based herbal medicines' recognised by many regulators globally.

“The problem we have, and that’s a rather complex question, is we in the UK do not recognise many of these herbal medicines as fully licensed medicines, making them less acceptable to health care professionals.”

The elderberry is a common hedgerow plant in the UK

Herbal medicines are those with active ingredients made from plant parts, such as leaves, roots or flowers.

With Brits told to “live with Covid” as restrictions come to an end in England this month, Prof Heinrich said: “I’m very keen for this (herbal medicines) to be seen as an adjuvant treatment, an add-on.

“It does provide a basis for managing risks and reducing symptoms and that’s the purpose the medicines can fulfil very well.”

He explained essential oils could kill Covid in the air while lozenges made from plant extracts can help prevent serious illness.

Prof Heinrich stressed that only herbal medicines that have been verified as safe and effective by the regulator, the MHRA, should be used.

But added that some herbal remedies which can help fight Covid are not available in the UK because its licensing rules were “too restrictive”.

These included elderberry-based medicines - traditionally used by Swiss hikers in the Alps to ease cold symptoms.

And Andrographis, or green chiretta, which is widely grown in India and said to help stop cold and flu viruses from entering the body.

“We cannot say, ‘right, we are lifting all the restrictions therefore take some herbs and it’s going to work’. I think that would be in many ways completely wrong,” he said.

“Mask wearing is a protective measure which makes perfect sense; taking herbal preparations equally makes perfect sense.

“We can do it and we should do it and there are good preparations (of herbs) on the market.”

He added: “What is a medicine in Germany may be a food supplement here and is then called a listed medicine in Australia. If you were to include the US, it would simply be regulated as a food.

“So I think we are sometimes too restrictive in accepting herbal products, which can provide therapeutic benefits since they are relatively well studied.”

In the UK, herbal medicines can only be sold under the MHRA’s Traditional Herbal Registration (THR) scheme.

They must have been “traditionally used to treat the stated condition” for 30 years to be granted the trademark.

At least 15 years of those need to be in the UK or an EEA (EU plus Iceland, Liechtenstein and Norway) country.

This excludes Switzerland where traditional elderberry remedies have been backed by scientific studies as well as southern and south-eastern Asian countries where Andrographis is cultivated.

Yet these are two remedies Prof Heinrich recommended for the prevention and treatment of Covid symtoms, along with Echinacea, a North American daisy plant, and umckaloabo, the root of the African Geranium.

Echinacea

He said: “Both of them are widely on the market.

“The problem with elderberry is we don’t have any products on the market where I would be confident the quality is acceptable.

“Another one is Andrographis. Here, a problem is we don’t have any high quality of those on the market.

“There are products especially in Nordic countries in Europe and in Asia, some of them are very good but because obviously they have a licence in Sweden but they are more difficult to get.”

Unlike homeopathic treatments, he believed herbal medicines would be beneficial if offered on the NHS.

He said: “Homeopathy is not science. If you are positive it’s medical art, if you are negative it is quackery.

“I think there’s an advantage for those medicines for which there is a sufficient body of evidence for their quality, safety and therapeutic benefits.”

Andrographis

The plant scientist told of his frustration over how a lack of public understanding saw the soaring numbers of bogus cures being sold online during the pandemic.

He accepted the “cowboy” sellers will have “inevitably” attracted people with reservations over conventional medicine, such as vaccine-sceptics.

“It’s common no doubt, even I think it has become more common during the pandemic.

“And that’s really the great frustration: if people would seek the right advice they may actually get a benefit out of it,” he warned.

“If you do it you may as well buy a bottle of tonic water over the internet and claim it has a medical function. The issue here is as soon as there’s a medical claim associated with it, it becomes problematic. So the MHRA is pushing very strongly, don’t make medical claims with products that clearly are not a medicine.”

The professor said he had contributed to six major studies that found between 25 to 40 percent of unregulated herbal medicines sold online “are of poor quality”.

Elderberry products were “definitely more than 40 percent” and medicines based on the popular St John’s Wort flowering plant were found to be deliberately bulked up with synthetic food dyes.

He said: “This stuff isn’t really dangerous, but it obviously is not something you expect in a medical product and six of these eight products which we investigated and contained these food dyes came from the US, so that tells you they have a problem with an unregulated market.

“The other problem we need to look at, is the material in those products where they are doing the right thing, do they get it right?

“One issue is what I call the cowboys of the market, although that is a bit unfair on the cowboys, but they just do whatever they want to get a cheap product at the highest price out. “The other one is you need to control your supply chain and this today is more complex than it was 20 or 30 years ago because the supply chains are more complex.”

Umckaloabo is the root of the African Geranium

He recommended buying regulated herbal medicines according to your symptoms - such as using cold treatments to help with mild Omicron infections.

Urging people to steer clear of any unregulated products claiming to have any medicinal benefits, he explained: “It’s a symptom specific treatment I would say. So depending on what the symptoms are, you can decide what’s the best intervention.

“Herbal preparations which help you cope with the challenges to the immune system are definitely useful, there’s no doubt to this.

“Now, marketing people love to shout out ‘use immune boosters’ - immune boosters are exactly the wrong thing, you want immuno-modulation, so you want to make sure that your immune system doesn’t overshoot and it doesn’t do things which is basically detrimental to your health.”

He added: “One of the big issues with the Covid-19 infection remains that the immune system is messed up tremendously.

“In a virus which basically messes up your immune system and your respiratory system which may go on their heart muscle and cause problems with the heart it may result in all sorts of other health problems, second in the GI tract and then obviously mental problems.

“Long Covid is then a long term detrimental effect on the human body, so this is a very different challenge, you have a weakened system and there other medicines can help in supporting your regeneration in the end.”

Prof Heinrich said he didn’t routinely take herbal remedies to protect himself from Covid as his work didn’t put him at an increased risk.

But for those who do face a greater risk, such as frontline workers or teachers, he said: “I would think how can I mitigate it and I wouldn’t have a problem of thinking about something, for example using elderberry, there are some simple lozenges you can use which basically act in the mouth and in the upper respiratory tract in a preventative way so that would be something I would definitely do and I would say wear a mask and all the usual stuff.

“There are two points to make, one is I can give you a few examples of plants for which there are some evidence of some therapeutic benefits, the second point is I can’t do it unless these are products which have proper quality. And here we enter the big issue of the regulation or the lack thereof of herbal medicines.”

The academic is currently writing a paper comparing the regulatory status of herbal medicines across the world.

Warning Brits to leave elderberry remedies to the experts, he added: “I think if there is an experienced person preparing it at home or they get it from a herbalist I would have great confidence that yes it works. If you just do it without any experience I would be rather concerned that you do something wrong. Because it can be toxic because people may not know how to use it etc. It’s not a tradition we find a lot in rural communities in Britain.

“Elderberry has been very famous for having had medicinal uses in for example south eastern European countries, the former Yugoslav countries, Bulgaria, Romania, Poland, Austria, Switzerland, there you have lots of homemade products on the market. If you go hiking in the Alps in the Autumn, you see people harvesting it.”

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