Herbal tea. Why doesn't your doctor recommend it?

What is a medicine?

I need to start a little further away to make my point understandable.

According to the Medicines Act, a medicine is a substance or a mixture of substances that is applied to the human body or to man for the purpose of preventing, diagnosing, treating disease or for maintaining, restoring, improving or modifying physiological functions.

Medicines contain active substances and excipients. The active substance is responsible for producing the effect; it generally directly influences the body's functions. In large amounts it can even be toxic. Excipients are necessary so the medicine can be formulated in the appropriate dosage form. For example, ointments mix the active ingredient into a cream base. Tablets also use excipients to create the tablet form. Excipients mostly have no effect on the body.

A medicine can be used effectively as a "healing agent" only if there is precise information about the amount of the therapeutic substance. To dose it and reach optimal effect you must know how much to take.

Every single tablet of a medicine is guaranteed to contain the specified amount of active ingredient. There are no surprises, no deviations. The manufacturer guarantees this and regulatory authorities check it.

What is herbal tea?

Herbal tea refers to a drink made by pouring hot water over medicinal plants. In herbal shops and pharmacies you can buy single-plant varieties and blends. The patient information leaflet indicates the method of preparation and application as well as the composition.

The method of preparation and application is very important, because improperly prepared herbal tea can have a low active ingredient content (and thus be ineffective) or conversely be too concentrated (which can cause discomfort).

Here's the catch!

The active ingredients in herbal tea are not balanced and are far from identical! The active ingredient content of a plant depends on

• the geographical location of cultivation – obviously a plant grown on sandy plains, in volcanic soil near Eger, or in the Balaton Uplands will differ (just as the terroir affects the taste of wines)
• the method of cultivation – there is a difference between wild-collected plants and those grown on large-scale fields with fertilizer
• the method of harvesting and drying – mechanical mowing and hand-picking yield different products. Likewise, drying in the sun or in drying chambers produces different results
• the way of packaging – a tea containing the whole plant (stem, leaf, root) will have completely different active ingredients than one made only from leaves

The differences in the raw material are further amplified by the method of preparation. The active ingredient content of herbal tea depends on

• the amount of material used – it matters whether you put one or three teaspoons of tea into the same amount of water
• the amount of boiling water used – if you add twice as much water, you get a more diluted solution with less active ingredient
• the water temperature – lukewarm water extracts little, while hot water extracts much more active substances
• the steeping time – if you only pour over the plant briefly, less active ingredient goes into the tea than if you soak it for hours

Since the quality of the tea in each sachet is different, you get a different result with each preparation. The active ingredient content in the cup is unknown and uncertain. It follows that the effect is not as predictable as with a medicine. It's almost certain that you prepare herbal tea a little differently from cup to cup, and its effect will vary accordingly.

This uncertainty is why most doctors are reluctant to recommend herbal teas. They prefer medicines to natural substances because the amount of active ingredient in medicines is known and they can "estimate" the expected effect.

How can you prove that the amount of active ingredient fluctuates?

It's very simple! Do a few experiments!

First test

• Boil half a liter of water.
• Take two mugs and put one tea bag in each. Earl Grey black tea is common enough; try that.
• Pour boiling water over both.
• Remove the tea bag from one after 10 seconds.
• Leave the other in for 30 minutes.

Result evaluation:

• The mug in which the tea bag steeped for 30 minutes will produce a substantially darker tea.
• Taste both! The briefly steeped one tastes pleasant, while the 30-minute one is strong, astringent, and almost burns the mouth lining.
• The 10-second brew has little effect, perhaps just refreshing. After drinking the 30-minute brew you may experience palpitations, pounding headache, or even heartburn.

In 10 seconds only a small amount of active substances dissolved from the tea, while after 30 minutes considerably more did.

Second test

• Take two mugs and put a tea bag in each.
• Boil some water.
• Pour boiling water over one mug.
• Pour cold tap water over the other.
• Remove both tea bags after 1 minute at the same time.

Result evaluation:

• The mug you poured with hot water produced a significantly darker tea.
• Taste both! The tea steeped with cold water has almost no taste, while the hot-water tea tastes pleasant.
• The cold-steeped one has little effect; the hot one refreshes.

Cold water extracts far fewer active substances from the tea.

With this I think you have demonstrated that there are not two identical active-ingredient contents in tea, and therefore doctors are right that herbal teas cannot be dosed as precisely as medicines.

So is herbal tea good for nothing?

That's not the case — rather, the active ingredient content of herbal teas cannot be controlled as precisely as that of medicines. Therefore, their effects cannot be planned during the treatment of serious illnesses. For example, treating high blood pressure or administering surgical anesthesia requires drugs that can be dosed very precisely. Herbal tea does not meet this requirement.

Although their role is limited in treating existing diseases for this reason, that doesn't mean they have no place in health maintenance and disease prevention!

For example, in the Indian Ayurvedic medical system, and in traditional Tibetan and Chinese medicine, maintaining health rests on three pillars: diet appropriate to body type, physical activity, and the regular consumption of herbal teas. In other words, herbal teas have beneficial effects on health.

However, this requires great care in preparation! Always make the tea as recommended and always the same way (the same tea and water amount, the same water temperature and steeping time). This way you will get approximately the same effect each time. The emphasis is on approximately.

This is perfectly adequate in most cases. Herbal tea can be very useful for aiding digestion, soothing coughs, improving appetite, supporting the immune system, and many other purposes. But don't think of it as medicine — think of it as a helper for your health, part of your diet.