The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava

Ernst et al., 2002 | Ann Intern Med | Meta Analysis

Citation

Ernst Edzard. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Ann Intern Med. 2002-Jan-01;136(1):42-53

Abstract

Because use of herbal remedies is increasing, a risk-benefit profile of commonly used herbs is needed. This article provides a clinically oriented overview of the efficacy and safety of ginkgo, St. John's wort, ginseng, echinacea, saw palmetto, and kava. Wherever possible, assessments are based on systematic reviews of randomized clinical trials. Encouraging data support the efficacy of some of these popular herbal medicinal products, and the potential for doing good seems greater than that for doing harm. The published evidence suggests that ginkgo is of questionable use for memory loss and tinnitus but has some effect on dementia and intermittent claudication. St. John's wort is efficacious for mild to moderate depression, but serious concerns exist about its interactions with several conventional drugs. Well-conducted clinical trials do not support the efficacy of ginseng to treat any condition. Echinacea may be helpful in the treatment or prevention of upper respiratory tract infections, but trial data are not fully convincing. Saw palmetto has been shown in short-term trials to be efficacious in reducing the symptoms of benign prostatic hyperplasia. Kava is an efficacious short-term treatment for anxiety. None of these herbal medicines is free of adverse effects. Because the evidence is incomplete, risk-benefit assessments are not completely reliable, and much knowledge is still lacking.

Key Findings

Because the evidence is incomplete, risk-benefit assessments are not completely reliable, and much knowledge is still lacking.

Outcomes Measured

anxiety
depression

Population

Field	Value
Population	See abstract
Sample Size	See abstract
Age Range	See abstract
Condition	anxiety

MeSH Terms

Anxiety
Dementia
Depression
Echinacea
Female
Ginkgo biloba
Humans
Hypericum
Intermittent Claudication
Kava
Male
Memory Disorders
Panax
Phytotherapy
Plant Preparations
Prostatic Hyperplasia
Respiratory Tract Infections
Risk Assessment
Serenoa
Tinnitus

Evidence Classification

Level: Meta Analysis
Publication Types: Journal Article, Meta-Analysis, Review
Vertical: ginkgo

Provenance

PMID: 11777363
DOI: (not available)
PMCID: Not in PMC
Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09