The choice between $75 prescription sleeping pills or a $5 herbal alternative is a no-brainer for Cathy and Bernard Birleffi, whose insurance costs have skyrocketed along with the nation's financial woes.
The Calistoga, Calif., couple seem to reflect a trend. With many Americans putting off routine doctor visits and self-medicating to save money, use of alternative treatments is on the rise — even though evidence is often lacking on their safety and effectiveness.
Climbing sales of herbal medicines have paralleled the tanking economy, according to an Associated Press review of recent data from market-watchers and retailers.
One prominent example: Austin, Texas-based Whole Foods Market Inc. says its stores nationwide have seen an increase in sales of nutritional supplements and herbal products in the past several weeks. That's "noteworthy" given the retail industry's financial slump, said Whole Foods spokesman Jeremiah C. McElwee.
While winter is usually a busy time for herbal medicine sales because it's the season for colds and flu, "more people are value shopping" now because of the economy, McElwee said.
Cathy Birleffi says she's among them.
"The doctors are so much higher (in cost), the insurance isn't paying as much," said the 61-year-old self-employed bookkeeper and notary. Her husband, a retired dispatcher, has high blood pressure and seizures. Recent changes in their health insurance coverage resulted in $1,300 in monthly premiums, double what they used to be.
Until they tried herbal alternatives, including valerian for insomnia, "every time I turned around, it was $50 here, $75 there" for prescriptions, Cathy Birleffi said.
High costs of conventional health care and worries about the economy also led Kristen Kemp of Montclair, N.J., to alternatives.
"Just going to the doctor will cost me $20 per kid and I have three kids," said Kemp, 34. Prescriptions are $20 each, too, under the family's insurance plan, so Kemp said she's been giving her kids tea with honey for sore throats and various Chinese herbs for colds and stomachaches. At $10 for a big bottle, the herbs are cheaper even than regular over-the-counter medicines, Kemp said.
"I'm trying to save money," said Kemp, an editor for Cafe Mom, a social networking Web site for mothers. Her husband is in the shaky banking industry.
"Just in case something bad happens to our jobs, I want more money in the bank," she said.
Among data reflecting the trend:
— For the three months that ended Dec. 28, nationwide retail sales of vitamins and supplements totaled nearly $639 million, up almost 10 percent from the same period in 2007. That includes a nearly 6 percent increase in sales of herbal supplements alone, according to Information Resources Inc., a Chicago-based market research firm. Its numbers do not include Wal-Mart or club stores.
— Nationwide herbal and botanical supplement sales totaled $4.8 billion in 2007, when the recession began, up 4.3 percent over 2006. That was a marginally higher increase compared with the previous year, according to Jason Phillips of the Nutrition Business Journal, an industry-tracking publication. Sales of animal oil supplements — mostly fish oils — were up 29 percent from 2006. While that was a decline from the previous year, both categories continued to show strong growth in a faltering economy.
— A government survey released in December said concerns about the cost of conventional medicine influenced Americans' decisions to try alternative remedies. "Nonvitamin, nonmineral natural products," including fish oil and herbal medicines, were the most commonly used alternatives, taken by almost 18 percent of Americans in 2007, the report said. Among those users, roughly a quarter said they delayed or didn't get conventional medical care because of the cost.
Report co-author Richard Nahin of the National Institutes of Health's National Center for Complementary and Alternative Medicine offered cautionary advice on the topic.
People taking herbal and other supplements should let their doctor know what they're using, said Nahin, acting director of the center's branch that oversees outside research the agency funds.
Supplements and other alternative treatments don't require rigorous testing and government approval. They also can interfere with prescription drugs, and combined, can be life-threatening in rare cases, Nahin said.
His agency also conducts its own research on alternative medicine and offers information about some of the most popular products at its Web site, http://www.nccam.nih.gov.
For example, echinacea is sometimes used for colds and flu. The agency Web site says evidence is mixed on whether it is effective, although one rigorous federally funded study found the herb worked no better against colds than placebo treatment. Echinacea can cause gastrointestinal upsets and allergic symptoms in people with ragweed allergies, the NIH site notes.
Valerian, the herb the Birleffis have used for insomnia, has been shown in some studies to help people sleep better, but evidence from well-designed research is lacking, the agency says. Using it for several weeks is generally thought to be safe, but long-term effects are unknown.
There's scant Western research on fritillary bulb remedies, the ancient Chinese herbal medicine that the Kemp family uses for colds. A test sample examined in a recent Chinese study found elevated amounts of cadmium, a heavy metal linked with cancer.
In December, an American Academy of Pediatrics task force report unrelated to the economic downturn noted that increasing numbers of children are using alternative remedies. It advised pediatricians to get more familiar with some of these treatments and to talk to parents about them.