AHP began producing monograph standards and therapeutic compendia in 1994 for some of the most commonly used botanicals used in Ayurvedic, Chinese, and Western herbal medicine. The first full AHP monograph—on St. John’s wort (Hypericum perforatum, Clusiaceae)—was published in 1997 as a special insert in HerbalGram #40. According to its website, AHP monographs “provide standards, guidance, and validated methods needed for all aspects of botanical identification and quality control.”1 The recently released American ginseng root and slippery elm inner bark monographs bring the total number of AHP monographs to 32.
American Ginseng Root
AHP Executive Director Roy Upton described cultivated American ginseng as “one of the most widely adulterated herbs” in the Western herb market in a December 2011 press release.2 “We have found leaf material marketed as root, exhausted marc being sold as crude root, and materials cut with 45% dicalcium phosphate,” he said. “The monograph provides all the characterizations that any quality control team requires for making an authentic and quality product.” (“Marc” refers to the remaining inert herbal material [mainly fibers and/or starch] after all or most phytochemicals have been extracted with a solvent.)
Preparations from cultivated American ginseng have been used traditionally to support the immune system, strengthen the nervous system, and to help prevent certain chronic conditions. Research on American ginseng has focused on blood sugar control for type 2 diabetes and quality of life in cancer patients. A patented, chemically defined (polysaccharide-based) extract made from cultivated American ginseng roots has shown efficacy in helping to prevent and treat upper respiratory tract symptoms related to colds and flu.3
Upton said consumers should be aware of potentially adulterated products when shopping for American ginseng supplements. “If it is cheap, then it is because cheap ingredients were used,” he said (e-mail, February 14-20, 2012). “If you open a capsule and it is gritty, it may contain a large amount of flow agent or filler (e.g., magnesium stearate).”
For almost 40 years, wild American ginseng has been protected under an international treaty known as the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). The treaty requires the US Fish and Wildlife Service (FWS) to regulate the wild herb’s export and to ensure that it is harvested in a sustainable manner.4 According to a 2011 FWS report, the main threats to wild American ginseng are illegal harvest, irresponsible harvest, consumption by white tail deer, invasive plant species, and habitat loss and destruction.5
The American Herbal Products Association (AHPA), the leading trade association dealing with herbs in the United States, released good stewardship practices for wild American ginseng in 2006.6 The same year, FWS reverted to a 5-year age minimum for harvesting wild American ginseng—half that of the 10-year minimum briefly established in 2005—after receiving feedback from growers, harvesters, and other industry representatives.4 AHPA’s good stewardship brochure includes information on the plant’s life cycle, obtaining permission to harvest, and how and when to sustainably harvest the herb.
Wild American ginseng can be found in 34 states, but only nineteen are permitted by FWS to export the herb. In 2010, the total harvest of wild American ginseng was 32 tons, approximately 10 tons less than the amount harvested in 2009—the largest annual harvest since 1997.5 AHPA reports that the biggest markets for wild American ginseng are Asian countries, which import roughly 30 tons of the herb every year.6
Wisconsin, in particular, is known for its high-quality cultivated American ginseng. During the last 20 years, Wisconsin farmers have struggled to keep up with international competition—especially from Canada and China—and manufacturers that falsely claim their American ginseng is Wisconsin-grown. In 1991, the Ginseng Board of Wisconsin, a nonprofit organization representing Wisconsin ginseng farmers, created the Wisconsin Ginseng Seal Program to identify products that contain 100% pure and authentic Wisconsin-grown ginseng roots.7
Slippery Elm Inner Bark
AHP announced the release of monograph standards and a therapeutic compendium for slippery elm inner bark in March 2011. This popular botanical native to America is commonly found in throat lozenges (e.g., Thayers®; Henry Thayer Co., Westport, Connecticut) and herbal teas (e.g., Throat Coat®; Traditional Medicinals, Sebastopol, California; and Essiac®; Essiac Canada International, Quebec, Canada). Slippery elm is one of the few herbs approved by the US Food and Drug Administration (FDA) as a safe and effective non-prescription drug ingredient that can be sold over-the-counter (OTC) as a demulcent for soothing sore throats.8
Upton explained some of the reasons for FDA’s approval of slippery elm as a botanical drug. “It was originally grandfathered in as an ‘old drug,’” he said. “Then, when FDA was reviewing ‘old drugs,’ Thayers—who was the first to introduce the lozenge historically and [had] the primary interest in slippery elm lozenges—was there to provide FDA with enough data to maintain the classification.”
Other botanicals, Upton continued, have not been approved by FDA as non-prescription drugs because of the prohibitively high cost. “It now costs approximately $750 million to prove a drug is safe and effective,” he said. “No one will do that for chamomile tea.”
In addition to sore throat relief, slippery elm has been used traditionally as a topical treatment for healing wounds and skin diseases and internally to treat inflammation of the digestive, respiratory, and urinary systems. According to the AHP Therapeutic Compendium, slippery elm was also one of the most widely used nutritive herbs historically, with reports of Civil War soldiers subsisting on the bark of slippery elm for weeks, demonstrating the plant’s nutritive as well as medicinal qualities.8 Further, according to the National Geographic’s Guide to Medicinal Herbs, George Washington and his troops reportedly survived for 12 days at Valley Forge on slippery elm porridge during the American Revolution. The porridge, with a nutritional content similar to that of oatmeal, can be made from ground inner bark and water or milk.9
In recent years, illegal stripping of slippery elm trees has been reported in some national forests in the United States. However, the modest price of slippery elm has prevented it from becoming a widespread problem among illegal harvesters. More serious threats to the tree include land development, logging, and habitat depletion.10
AHP chose to review slippery elm inner bark, in part, because of its popularity and occasional quality control issues. “There are significant quality issues associated with slippery elm, including supplies—which are impacted by Dutch elm disease—and poor quality material ([e.g.,] not meeting swelling index-mucilage values),” Upton explained, referring to the quality of the slippery, viscous fluid extracted from the tree’s inner bark.
One of the main goals of AHP’s monographs is to ensure consumer access to high-quality herbal materials. “As mandated by current and future [GMPs], the fields of information [in the monographs] provide industry with a scientifically valid means to ensure the authenticity, purity, and quality of botanical ingredients and dietary supplements,” AHP states on its website.1
Today, the FDA-approved botanical ingredient can be found in many herbal throat lozenges and is commonly sold in drug stores. “Slippery elm lozenge has been a very important preparation for generations,” said Upton.
The American ginseng root and slippery elm inner bark monographs are available through AHP’s website. PDF copies are available for $39.95 each and hard copies can be purchased for $44.95 each. For more information, visit www.herbal-ahp.org.
1. AHP monographs. American Herbal Pharmacopoeia website. Available at: www.herbal-ahp.org/documents/newsroom/AHP_Monographs.pdf. Accessed February 24, 2012.
2. AHP releases monograph standards and therapeutic compendium for American Ginseng root (Panax quinquefolius L.) [press release]. Scott’s Valley, CA: American Herbal Pharmacopoeia. December 7, 2011. Available at: www.herbal-ahp.org/documents/press_releases/ American%20Ginseng%20PR%20final.pdf. Accessed February 20, 2011.
3. American ginseng. University of Maryland website. Available at: www.umm.edu/ altmed/articles/american-ginseng-000248.htm. Accessed February 20, 2011.
4. Cavaliere C. U.S. FWS reinstates 5-year age limit for exported wild American ginseng. HerbalEGram. 2006;3.
5. Gnam R. Advice for the export of roots of wild and wild-simulated American ginseng (Panax quinquefolius) lawfully harvested during the 2011 harvest season in 19 states. Washington, D.C.: US Fish and Wildlife Service; 2011.
6. Good stewardship harvesting of wild American ginseng (Panax quinquefolius). US Fish and Wildlife Service website. Available at: www.fws.gov/international/DMA_DSA/CITES/ pdf/2010wild-simulatedginseng.pdf. Accessed February 22, 2011.
7. Wisconsin ginseng farmers fight to protect product reputation. HerbalGram. 2007. 75:54-61.
8. AHP releases monograph standards and therapeutic compendium on slippery elm (Ulmus rubra Muhl.) inner bark [press release]. Scott’s Valley, CA: American Herbal Pharmacopoeia. March 10, 2011. Available at: www.herbal-ahp.org/documents/press_releases/ Slippery%20elm%20press%20release.pdf. Accessed February 22, 2011.
9. Johnson RL, Foster S, Low Dog T, and Kiefer D. National Geographic Guide to Medicinal Herbs: The World’s Most Effective Healing Plants. 2011: National Geographic Press; Washington, D.C.
10. Cavaliere C. Illegal stripping and conservation of slippery elm trees. HerbalGram. 74:54-61. Available at: http://cms.herbalgram.org/herbalgram/issue74/article3123.html.