Paging Dr. Frischer - Herbal Medicine

Patients regularly come into my office and state that they have stopped their "dangerous" prescription medication in favor of some "natural", "safer" herbal remedy. Oftentimes a relative or hairdresser has convinced them to make this bold move. It's time to discuss the risks of taking herbs.The earliest recorded evidence of herbal medicine use dates back 5,000 years. It is discussed in ancient Indian, Chinese, Egyptian, Greek, Roman, and Syrian texts. Today, it is a rapidly growing marketplace that measures in the multi-billions of dollars annually. Many herbs have been studied scientifically, and have proven benefits - prescription drugs are often made, or were originally made, from herbal ingredients. Herbal remedies can offer a valid alternative for patients who are disillusioned or dissatisfied with traditional pharmaceuticals or big pharmaceutical companies. On the other hand, along with their often-lower side effects frequently comes far less efficacy than their prescription counterparts. Furthermore, many do have some degree of risk, and it's critical that patients be fully informed of potential complications. The first concern is that a seriously ill patient might stop their effective prescription and substitute a safer but less effective herb. As a rule, you should consider herbs for minor or chronic, but not life-threatening problems. Examples might include digestive problems, menstrual cramps, joint/arthritis problems, skin irritations, minor anxiety and depression, or headaches. Be highly skeptical if an herbal product offers miracle cures. Consider that scientists are doing research all over the world and competing to see who can come up with effective treatments first. Data and research findings are presented in formal scientific forums on a regular basis. It's extremely unlikely that someone acting independently has come up with a miracle cure without the scientific community being aware. There is no global conspiracy keeping effective treatments from the public. Trust me, if it works and will sell, a gigantic profit-based pharmaceutical company will jump all over it. Herbal medicines may be effective in treating a chronic problem, but after long-term use, some tend to accumulate in the body and actually become toxic. The affected organ is usually the liver, whose job it is to detoxify most chemicals. The chemicals in an herb that restores depleted levels in your body over, say, a three-month period may reach excessive levels after 12 months. Most herb-taking consumers have no idea as to which ones may accumulate and become toxic, and which ones will not. Another pitfall is when herbal remedies are mixed with prescription drugs. It is a two-fold problem: the doctor is often unaware that a patient is taking the herb, and the patient is unaware of the risks of the drug interaction. Further, doctors are not formally trained in herbal medicine, so even if they know which one you are taking, they may not be aware of the dangers. For example, a commonly used and effective herb, glucosamine chondroitin, can both thin the blood and exacerbate diabetes. That is particularly dangerous if the patient is already on a blood thinner or has poorly controlled diabetes. Finally, some herbal treatments may be downright dangerous. While there is little harm in taking ginseng, there certainly could be with ephedra. Ephedra can elevate blood pressure, speed up the heart, and has even triggered heart attacks. Consumers self-prescribe these substances, and since they are not regulated by the FDA (which some feel is a benefit), the risks are often unknown to the buyer. Herbs are often changed, contaminated, modified, or added to other herbs with unpredictable consequences. Remember, claims made by the manufacturer need not pass FDA scrutiny. Clearly, patients must educate themselves regarding benefits and risks of herbs before choosing to take them. Herbs originate from natural sources, but so do many prescription medications. Like prescription medications, they have the potential for risks and serious complications, and must be treated with respect. It is certainly time to add some study of herbal medicine to the medical and pharmacy school curriculums. Because so many of us have taken or continue to take herbal supplements, their effects and interactions with prescription medications should be added to pharmacy computer databases so that patients can have drug-herb interactions checked before taking them. My parting suggestions: •Tell your doctor if you are taking any herbal supplements •Learn about the effects and side effects of anything you are taking •Educate yourself on the possible interactions between any herbs you may take and your prescription medication •Never automatically trust the claims made by those marketing herbal products Good health to you all! Dr. Alan Frischer is former chief of staff and current chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: July 10, 2009 - Volume 8 - Issue 12