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How to read this handbook

What is verified here, what is judgement, and the difference between the two.

guide

This handbook is built in two layers, and they carry different weight.

The quoted findings — every sentence inside a bordered card under "What the studies found" — are copied verbatim from the abstract of a paper indexed in PubMed. The build refuses to publish a quotation that is not literally present in the abstract it is attributed to, so a quotation is a fact about what that paper says. It is still only what that paper says: a systematic review of poor trials reports poor evidence, and a meta-analysis with very low certainty is a real finding whose certainty is very low. The grade on each card is PubMed's own index term, not a score added here.

The prose — the standfirst, the summary, the cautions, the red flags, the preparation notes — is the author's reading of that literature and of ordinary clinical practice. It is useful and it is not a quotation. Where the prose makes a claim that could hurt someone, it either carries a citation to a study or it is written as ordinary practice that any herbalist or nurse would recognise.

How the evidence is graded on this site:

• Meta-analysis and systematic review — a structured search and synthesis. The
• Randomized controlled trial — the design that can show cause. A single small one is
• Review — narrative overview. Useful for orientation, not for a verdict.

What this site will not do. It will not give a drug dose, a dose for a child, or a dose in pregnancy. It will not tell you a plant is edible or that a preparation is safe for you. Those questions need your medication list, your kidneys, and your pregnancy status, and this page cannot see any of them.

What the studies found

Cautions and interactions

• A natural product is a category, not a safety rating. Hemlock, foxglove and nightshade are natural.
• Absence of evidence is not evidence of absence, and it is also not permission. Where no trials exist, this site says no trials exist.
• Nothing here is a substitute for a diagnosis. A remedy that works on a symptom can hide a disease that needed looking at.

When this is not a self-care problem — get help

• Chest pain, difficulty breathing, sudden weakness or slurred speech on one side, a seizure, a fever above 103 F / 39.4 C, a stiff neck, confusion — emergency care, not a preparation.
• Bleeding that will not stop, vomiting blood or coffee-grounds material, black tarry stool, a sudden severe headache — emergency care.
• A baby under 3 months with a fever, or any child who is drowsy, floppy or breathing fast — emergency care.

Related

• The placebo and nocebo effects, and why a real effect is not the same as a drug effect
• Regression to the mean: why you always feel better
• Publication bias, and the herbal literature's positive-results problem

Sources

1. Herbal medicine for Hashimoto's thyroiditis: A systematic review and network meta-analysis. Journal of ethnopharmacology 2024; doi:10.1016/j.jep.2023.117663 PubMed 38181936
2. Clinical effects of Hibiscus sabdariffa Linn. on obesity treatment: A systematic review and meta-analysis of randomized controlled trials. Complementary therapies in medicine 2024; doi:10.1016/j.ctim.2024.103063 PubMed 38878905
3. Acupuncture combined with Chinese herbal medicine in the treatment of perimenopausal insomnia: A systematic review and meta-analysis. Medicine 2023; doi:10.1097/MD.0000000000035942 PubMed 37960761