Fwd: Experts urge caution with herbal remedies

[Guest guest]

>Experts urge caution with herbal remedies

>Sun, 11 Jun 2000 18:44:55 -0700

>

>Experts urge caution with herbal remedies

>

>

>

> Sunday, 11 June 2000

> Experts urge caution with herbal remedies

>

> By Carla McClain

> ARIZONA DAILY STAR

>

> A transplant patient suffered acute rejection of his new heart after

>taking the popular herbal anti-depressant St. John's wort to lift his mood.

>

> A woman began hemorrhaging through the irises of her eyes after

>taking both aspirin and the popular herb ginkgo biloba for several days.

>

>

> Click to enlarge graphic

> A man using a common drug, clonidine, to control hypertension

>suffered a dangerous spike in his blood pressure after ingesting yohimbe

>bark - the " herbal viagra " - for his impotence.

>

> Dieters who mixed the Chinese herb ma huang, also known as ephedra,

>with caffeine, have dropped dead during exercise.

>

> • • •

>

> With nearly half of all Americans now medicating themselves with

>popular herbal remedies and nutritional supplements, the dangers of mixing

>them with conventional medical drugs are suddenly very real, experts are

>warning.

>

> " People assume herbs and nutrients are 'natural' and therefore safe,

>so they often push the doses they take way over the edge, " said Francis

>Brinker, a naturopathic physician with the University of Arizona's

>Integrative Medicine program.

>

> " It's herbal abuse that accounts for most of the bad interactions

>with mainstream drugs, " Brinker said, speaking at the American Holistic

>Medical Association meeting this month in Tucson.

>

> It is this tendency of many consumers to take overdoses of readily

>available herbs and nutrients - hoping to fight cancer, lift depression,

>lose weight, ward off colds, help the heart, prevent infections, protect

>the brain - while failing to tell their doctors what they're taking, that

>is setting the stage for trouble, Brinker and others warn.

>

> The issue made national headlines in the last week with reports of

>high rates of kidney failure and bladder cancer in European women taking a

>weight-control pill that accidentally contained the Chinese herb commonly

>known as fangchi.

>

> That has prompted renewed calls for the federal government to

>regulate the sales and claims of herbs and dietary supplements - an

>industry that was deregulated by Congress in 1994, permitting widespread

>over-the-counter sale of these products.

>

> At the very least, people are urged to tell their doctors what

>they're taking.

>

> " That's the crucial issue, the weak link in all this - communication

>between the doctor and the patient, " Brinker said.

>

> " People are reluctant to tell their doctors about their herbs simply

>because they fear being treated with arrogance by a doctor who disapproves.

>

> " But it's time to start paying attention to what can happen. And

>doctors have to start cultivating their own awareness of this, and they

>must start screening and questioning their patients. "

>

> Several recent surveys target the problem. A Texas study showed that

>70 percent of surgery patients taking herbal supplements failed to tell

>their doctors - even when their doctors asked.

>

> Yet some of the most popular herbs on the market today - ginkgo

>biloba, ginger, garlic, ginseng and feverfew - can cause excessive bleeding

>during surgery, because they all have blood-thinning effects.

>

> This has forced the American Society of Anesthesiologists to issue a

>warning to all patients facing surgery to stop taking herbal supplements at

>least two weeks before the surgery.

>

> Similar warnings are being issued to cancer patients in the face of

>surveys that show they rarely reveal their herb- and-vitamin-taking habits

>unless strongly prodded by their doctors.

>

> Out of about 200 patients starting treatment for cancer, only 13

>admitted on a standard questionnaire that they were taking some kind of

> " alternative " therapy, a University of Pennsylvania study found.

>

> Only after being asked specifically if they were taking herbal or

>vitamin remedies did another 66 patients acknowledge doing so.

>

> Yet this information is crucial if patients are undergoing

>chemotherapy, radiation or immunotherapy to fight cancer.

>

> A letter to all chemotherapy patients at the Arizona Cancer Center

>warns:

>

> " It is not recommended that people receiving chemotherapy take

>additional antioxidants like vitamins E and C, selenium or beta-carotene.

>Most anti-cancer drugs are effective because they kill cancer cells.

>

> " One potential method can involve oxidation. Taking antioxidants

>could potentially interfere with this oxidative process, compromising the

>effectiveness of the anticancer drug. "

>

> Patients are also advised against taking some of the B vitamins with

>certain cancer drugs during treatment. And there are warnings about some

>immune-enhancing herbs - such as echinacea, astragalus, garlic, maitake and

>shiitake mushrooms - despite a lack of scientific evidence that they

>interact with chemo drugs.

>

> " There's really not enough research out there yet on these

>interactions to hang our hats on, but with so many people taking such large

>amounts of supplements today, we have to err on the side of caution, " said

>Cyndi Thomson, cancer center nutritionist and research instructor.

>

> " If there is a suspicion something will interfere with treatment, we

>don't absolutely forbid taking the supplement, but we do strongly advise

>taking only moderate doses of it - not therapeutic levels of it, which may

>interfere. "

>

> New surveys are showing that nutrition and dietary supplements are

>the No. 1 issue cancer patients want information about, according to

>Thomson.

>

> But getting it from doctors may be tough, doctors themselves are

>admitting. Patients aren't the only ones under fire for failing to discuss

>the problem.

>

> " Most doctors are pretty ill-informed about these things, I'm

>afraid, " said Dr. Jane Orient, president of the Pima County Medical

>Society.

>

> " Maybe herbal remedies are good, but they may be harmful with other

>drugs. I have to admit I don't know as much about it as I should. These

>things are kind of like drugs, and I do need to know what my patients are

>taking. "

>

> Orient blamed part of the problem on the pressures of managed care

>on doctors.

>

> " In that system, doctors are so extremely busy, there is just no

>time for them to investigate and become knowledgable about both (medical

>drugs and herbs), " she said.

>

> And there is the " intimidation factor, " she added. " It's a big one.

>Many doctors are quite negative about the whole alternative (medicine)

>issue, and patients are afraid of that. "

>

> But patients are turning to their pharmacists - who dispense

>prescription drugs and sell herbal remedies and dietary supplements over

>the counter.

>

> " We've seen a noticeable increase in questions about interactions in

>just about the past year, " said Michael Polzin, spokesman for Walgreen

>drugstores.

>

> That has prompted the chain to include all herbs and supplements in

>patient computer profiles, along with warnings about interactions with

>their drugs.

>

> No warning labels have appeared on products to alert consumers to

>possible interactions, but that may happen soon with some of the most

>popular herbs, UA naturopath Brinker said.

>

> St. John's wort, for example - used by millions for depression and

>mood elevation - has been found to dilute the effectiveness of many drugs,

>including some asthma and cardiac drugs, anti-rejection drugs for organ

>transplants, and AIDS anti-viral medicines.

>

> As a result, doctors - who have long depended on the " bible " of

>prescription drug information, the Physician's Desk Reference - are being

>urged to consult a new PDR for botanical and herbal remedies.

>

> " It's out now and it's useful, " said Dr. Tracy Gaudet, executive

>director of the UA's intergrative medicine program. " It's a good start. "

>

> Reporter Carla McClain can be reached at 806-7754 or by e-mail at

>cmcclain

>

>

>--------

 

______________________

Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com