Guest guest Report post Posted March 24, 2010 Hi everyone, I received this info from David Winston a few days ago, I've read articles by Jonathan Treasure like this about PubMed. This is really sad to see educated people acting like politicians! Last month a paper was published in the Journal of the American College of Cardiology. This paper, by Tachjian, et al, Use of Herbal Products and Potential Interactions In Patients With Cardiovascular Diseases, purports to be an authoritative look at the risks and dangers of people using herbs along with cardiac medications. Unfortunately while there are very real risks, especially patients taking blood thinners such as Warfarin and anticoagulant herbs, this paper does a tremendous disservice to anyone trying to gain accurate information on the topic. The poor quality of this work raises several important issues. First, the three authors (two of which are MD's) obviously have no experience with herbal medicines and their writing this paper is about as valid as me writing a paper on the use of pharmaceuticals in treating heart disease. I am sure they are very good cardiologists, but in my opinion they should stick to what they know and were trained for. The second issue is this work is so full of errors one wonders how it ever got through a peer review process. Many people have suggested there is a double standard in peer review medical journals when it comes to negative articles on herbal medicine. Since so many of these articles are so seriously flawed one could easily assume there is an anti-herb bias and that anything saying herbs are dangerous will get published no matter how erroneous it may be. While I will not go as far as to say there is an active conspiracy against herbs, I would say that in the general medical community ignorance and fear of herbs and their uses is so vast and so broad that these journals are incapable of adequately vetting these articles. I would even put forth a " radical " proposition that perhaps in the future any article about herbal medicine in a medical journal or any study of herbal medicines should actually include a clinical herbalist as part of the design and research team. Unfortunately I doubt researchers or editors will actually take my suggestion seriously. Some of the significant errors found in this article include: · Foods such as soy milk and grapefruit juice are listed as foods. · Also included as " herbs " are Chan Su (Chinese toad skin extract), Gossypol (an experimental male contraceptive derived from Cotton seed, only used in China), Tetrandrine (an alkaloid extracted from Stephania tetrandra and not available in the U.S. or Europe), and Yohimbine (an alkaloid extracted from Yohimbe, Yohimbine is a prescription drug). · The authors also include Uzara root, an herb so obscure I have never heard of it and Gynura divaricata which is a little-known folk medicine in China. · Beyond these " small faults " the article mentions two cardiac glycoside containing plants, Strophanthus (misspelled as Storphanthus in the article) and Oleander, neither of which is available in the U.S. or Canada as a herbal product. · Finally, the authors have selectively chosen (it is possible sheer ignorance is at fault here) to list adverse effects of herbs, even when more recent studies have disproven these theoretical risks. Many books and articles suggest that there might be a risk of administering Hawthorn along with cardiac glycosides. A 2003 human trial (Tankanow, et al, 2003), clearly showed that there was no interaction between these 2 medications. · Also cited is the widely discredited clinical report by Siegel on Ginseng Abuse Syndrome. In this paper the author noted many effects of Ginseng use including hypertension, behavioral changes and diarrhea, all of which turned out to be caused by excessive coffee drinking by test subjects. It is truly sad when such uninformed and flawed papers are given the medical " seal of approval. " It creates and adds to the medical profession's and public's fear of herbs, most of which are very safe. Secondly, it spreads misinformation which, as we see by the Siegel article published in 1979, is difficult to erase. And finally it obscures the accurate information that could benefit the medical profession, such as possible interactions between St. John's wort and Digoxin or garlic and Dan Shen (Salvia miltiorrhiza) with anticoagulants. The last part of the article discusses the lack of regulatory oversight and quality control with herbal products. I whole-heartedly agree the authors of this and similar articles need more regulatory oversight and quality control as this article is ample evidence of neither in many medical journals. Bibliography Dharmananda, S., Safety Issues Affecting Chinese Herbs: The Case of Ginseng, Instit Trad Med, Dec., 2000, www.itmonline.org/arts/ginseng.htm Siegel, R.K., Ginseng Abuse Syndrome: Problems With the Panacea, JAMA, 1979;241:1614-5 Tachjian, A., MD, Viqar, M., et al, Use of Herbal Products and Potential Interactions in Patients with Cardiovascular Diseases, Journal of the American College of Cardiology, 2010; 55(6):515-525 Tankanow, R., Tamer, et al, Interaction Study Between Digoxin and a Preparation of Hawthorn (Crataegus oxyacantha), J Clin Pharmacol, 2003;43(6):637-42 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted March 24, 2010 Patrick, Do you have any links for this paper? On Mar 24, 2010, at 9:33 AM, PatrickE wrote: > Hi everyone, I received this info from David Winston a few days ago, I've read articles by Jonathan Treasure like this about PubMed. This is really sad to see educated people acting like politicians! > > Last month a paper was published in the Journal of the American College of Cardiology. This paper, by Tachjian, et al, Use of Herbal Products and Potential Interactions In Patients With Cardiovascular Diseases, purports to be an authoritative look at the risks and dangers of people using herbs along with cardiac medications. Unfortunately while there are very real risks, especially patients taking blood thinners such as Warfarin and anticoagulant herbs, this paper does a tremendous disservice to anyone trying to gain accurate information on the topic. > > The poor quality of this work raises several important issues. First, the three authors (two of which are MD's) obviously have no experience with herbal medicines and their writing this paper is about as valid as me writing a paper on the use of pharmaceuticals in treating heart disease. I am sure they are very good cardiologists, but in my opinion they should stick to what they know and were trained for. > > The second issue is this work is so full of errors one wonders how it ever got through a peer review process. Many people have suggested there is a double standard in peer review medical journals when it comes to negative articles on herbal medicine. Since so many of these articles are so seriously flawed one could easily assume there is an anti-herb bias and that anything saying herbs are dangerous will get published no matter how erroneous it may be. While I will not go as far as to say there is an active conspiracy against herbs, I would say that in the general medical community ignorance and fear of herbs and their uses is so vast and so broad that these journals are incapable of adequately vetting these articles. I would even put forth a " radical " proposition that perhaps in the future any article about herbal medicine in a medical journal or any study of herbal medicines should actually include a clinical herbalist as part of the design and research team. Unfortunately I doubt researchers or editors will actually take my suggestion seriously. > > Some of the significant errors found in this article include: > > · Foods such as soy milk and grapefruit juice are listed as foods. > > · Also included as " herbs " are Chan Su (Chinese toad skin extract), Gossypol (an experimental male contraceptive derived from Cotton seed, only used in China), Tetrandrine (an alkaloid extracted from Stephania tetrandra and not available in the U.S. or Europe), and Yohimbine (an alkaloid extracted from Yohimbe, Yohimbine is a prescription drug). > > · The authors also include Uzara root, an herb so obscure I have never heard of it and Gynura divaricata which is a little-known folk medicine in China. > > · Beyond these " small faults " the article mentions two cardiac glycoside containing plants, Strophanthus (misspelled as Storphanthus in the article) and Oleander, neither of which is available in the U.S. or Canada as a herbal product. > > · Finally, the authors have selectively chosen (it is possible sheer ignorance is at fault here) to list adverse effects of herbs, even when more recent studies have disproven these theoretical risks. Many books and articles suggest that there might be a risk of administering Hawthorn along with cardiac glycosides. A 2003 human trial (Tankanow, et al, 2003), clearly showed that there was no interaction between these 2 medications. > > · Also cited is the widely discredited clinical report by Siegel on Ginseng Abuse Syndrome. In this paper the author noted many effects of Ginseng use including hypertension, behavioral changes and diarrhea, all of which turned out to be caused by excessive coffee drinking by test subjects. > It is truly sad when such uninformed and flawed papers are given the medical " seal of approval. " It creates and adds to the medical profession's and public's fear of herbs, most of which are very safe. Secondly, it spreads misinformation which, as we see by the Siegel article published in 1979, is difficult to erase. And finally it obscures the accurate information that could benefit the medical profession, such as possible interactions between St. John's wort and Digoxin or garlic and Dan Shen (Salvia miltiorrhiza) with anticoagulants. > > The last part of the article discusses the lack of regulatory oversight and quality control with herbal products. I whole-heartedly agree the authors of this and similar articles need more regulatory oversight and quality control as this article is ample evidence of neither in many medical journals. > > Bibliography > > Dharmananda, S., Safety Issues Affecting Chinese Herbs: The Case of Ginseng, Instit Trad Med, Dec., 2000, www.itmonline.org/arts/ginseng.htm > > Siegel, R.K., Ginseng Abuse Syndrome: Problems With the Panacea, JAMA, 1979;241:1614-5 > > Tachjian, A., MD, Viqar, M., et al, Use of Herbal Products and Potential Interactions in Patients with Cardiovascular Diseases, Journal of the American College of Cardiology, 2010; 55(6):515-525 > > Tankanow, R., Tamer, et al, Interaction Study Between Digoxin and a Preparation of Hawthorn (Crataegus oxyacantha), J Clin Pharmacol, 2003;43(6):637-42 > > Chair, Department of Herbal Medicine Pacific College of Oriental Medicine San Diego, Ca. 92122 Quote Share this post Link to post Share on other sites
Guest guest Report post Posted March 24, 2010 Hi Z'ev, I'm pretty sure this is what David is writing about; http://content.onlinejacc.org/cgi/content/abstract/55/6/515 I'll try to contact him and be sure. It looks like you have to pay to get access to the full article. Patrick --- On Wed, 3/24/10, <zrosenbe wrote: > <zrosenbe > Re: FYI > > Wednesday, March 24, 2010, 12:26 PM > Patrick, > Do you have any links for this paper? > > > On Mar 24, 2010, at 9:33 AM, PatrickE wrote: > > > Hi everyone, I received this info from David Winston a > few days ago, I've read articles by Jonathan Treasure like > this about PubMed. This is really sad to see educated people > acting like politicians! > > > > Last month a paper was published in the Journal of the > American College of Cardiology. This paper, by Tachjian, et > al, Use of Herbal Products and Potential Interactions In > Patients With Cardiovascular Diseases, purports to be an > authoritative look at the risks and dangers of people using > herbs along with cardiac medications. Unfortunately while > there are very real risks, especially patients taking blood > thinners such as Warfarin and anticoagulant herbs, this > paper does a tremendous disservice to anyone trying to gain > accurate information on the topic. > > > > The poor quality of this work raises several important > issues. First, the three authors (two of which are MD's) > obviously have no experience with herbal medicines and their > writing this paper is about as valid as me writing a paper > on the use of pharmaceuticals in treating heart disease. I > am sure they are very good cardiologists, but in my opinion > they should stick to what they know and were trained for. > > > > The second issue is this work is so full of errors one > wonders how it ever got through a peer review process. Many > people have suggested there is a double standard in peer > review medical journals when it comes to negative articles > on herbal medicine. Since so many of these articles are so > seriously flawed one could easily assume there is an > anti-herb bias and that anything saying herbs are dangerous > will get published no matter how erroneous it may be. While > I will not go as far as to say there is an active conspiracy > against herbs, I would say that in the general medical > community ignorance and fear of herbs and their uses is so > vast and so broad that these journals are incapable of > adequately vetting these articles. I would even put forth a > " radical " proposition that perhaps in the future any article > about herbal medicine in a medical journal or any study of > herbal medicines should actually include a clinical > herbalist as part of the design and research team. > Unfortunately I doubt researchers or editors will actually > take my suggestion seriously. > > > > Some of the significant errors found in this article > include: > > > > · Foods such as soy milk and grapefruit juice are > listed as foods. > > > > · Also included as " herbs " are Chan Su (Chinese toad > skin extract), Gossypol (an experimental male contraceptive > derived from Cotton seed, only used in China), Tetrandrine > (an alkaloid extracted from Stephania tetrandra and not > available in the U.S. or Europe), and Yohimbine (an alkaloid > extracted from Yohimbe, Yohimbine is a prescription drug). > > > > · The authors also include Uzara root, an herb so > obscure I have never heard of it and Gynura divaricata which > is a little-known folk medicine in China. > > > > · Beyond these " small faults " the article mentions > two cardiac glycoside containing plants, Strophanthus > (misspelled as Storphanthus in the article) and Oleander, > neither of which is available in the U.S. or Canada as a > herbal product. > > > > · Finally, the authors have selectively chosen (it is > possible sheer ignorance is at fault here) to list adverse > effects of herbs, even when more recent studies have > disproven these theoretical risks. Many books and articles > suggest that there might be a risk of administering Hawthorn > along with cardiac glycosides. A 2003 human trial (Tankanow, > et al, 2003), clearly showed that there was no interaction > between these 2 medications. > > > > · Also cited is the widely discredited clinical > report by Siegel on Ginseng Abuse Syndrome. In this paper > the author noted many effects of Ginseng use including > hypertension, behavioral changes and diarrhea, all of which > turned out to be caused by excessive coffee drinking by test > subjects. > > It is truly sad when such uninformed and flawed papers > are given the medical " seal of approval. " It creates and > adds to the medical profession's and public's fear of herbs, > most of which are very safe. Secondly, it spreads > misinformation which, as we see by the Siegel article > published in 1979, is difficult to erase. And finally it > obscures the accurate information that could benefit the > medical profession, such as possible interactions between > St. John's wort and Digoxin or garlic and Dan Shen (Salvia > miltiorrhiza) with anticoagulants. > > > > The last part of the article discusses the lack of > regulatory oversight and quality control with herbal > products. I whole-heartedly agree the authors of this and > similar articles need more regulatory oversight and quality > control as this article is ample evidence of neither in many > medical journals. > > > > Bibliography > > > > Dharmananda, S., Safety Issues Affecting Chinese > Herbs: The Case of Ginseng, Instit Trad Med, Dec., 2000, > www.itmonline.org/arts/ginseng.htm > > > > Siegel, R.K., Ginseng Abuse Syndrome: Problems With > the Panacea, JAMA, 1979;241:1614-5 > > > > Tachjian, A., MD, Viqar, M., et al, Use of Herbal > Products and Potential Interactions in Patients with > Cardiovascular Diseases, Journal of the American College of > Cardiology, 2010; 55(6):515-525 > > > > Tankanow, R., Tamer, et al, Interaction Study Between > Digoxin and a Preparation of Hawthorn (Crataegus > oxyacantha), J Clin Pharmacol, 2003;43(6):637-42 > > > > > > > Chair, Department of Herbal Medicine > Pacific College of Oriental Medicine > San Diego, Ca. 92122 Quote Share this post Link to post Share on other sites
