Herb-drug reaction studies contribute to debate
June 24th, 2006A Canadian study, whose findings were presented at the North American Research Conference on Complementary and Integrative Medicine in Canada last week, found few potential drug-herb interactions in patients with osteoporosis. While a report published in the March issue of Geriatric Nursing found that older women mixing herbal and prescribed medication could be risking their health.
In the first study, 1.3 percent of the 1069 patients assessed were using a contraindicated drug-herb combination.
“In this randomly selected, population-based sample we found a relatively low rate of potential drug-herb interactions, most of which were among subjects using specific cardiovascular medications”, the University of Calgary authors concluded.
The second study, at the University of Florida College of Nursing, looked at 58 women over the age of 65 who were taking both herbal and over-the-counter prescription medication. 74 percent of the study’s 58 participants were found to have a moderate or high-risk drug interaction.
“Many of these older women do not consider over-the-counter and herbal medications ‘real drugs’ and therefore don’t report them”, said the Florida study leader, Dr. Saunjoo Yoon, “However, it is clear that many healthcare providers are not following through to learn their patients’ complete medication history.”
Controversy over drug-herb reactions has come hand-in-hand with the growing popularity of nutraceuticals.
The US retail market for dietary Supplements was worth $8.3bn in 2005 – representing a growth of 6 percent over 2004 - estimates Euromonitor International. What makes critics wary is that such Supplements do not require pre-market approval in the US – instead it is up to companies to report adverse reactions.
The pendulum continues to swing back and forth between those who say the public does not carelessly combine medical and traditional remedies, and those who say they do and that resulting damage is not known.
One of the few points researchers and industry spokespeople seem to agree on is that adverse reactions can be prevented by consulting a doctor - a doctor who is open to Herbal Medicine that is.
“Cases of herb-drug interactions are extremely rare and, with a little medical supervision and with more knowledge of complementary and Alternative Medicine on behalf of more physicians and pharmacists, easily avoided,” National Nutritional Foods Association president Daniel Fabricant told NutraIngredients-USA.com.
Fabricant also hinted that the energy and fuss surrounding the drug-herb debate might be better redirected towards the issue of mixed prescription medications.
“The safety of Botanical dietary Supplements, based on the evidence, must be considered much more favorably than that of prescription medications (drug-drug interactions), so the risk should be attributed appropriately.”
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Warren Matthews of Xtend-Life comments: I am always a little bemused by some of these studies. Why? Because there is such a Focus on the potential negative effects of a natural product when combined with a drug, whilst the real problem is ignored! I am talking about drug-to-drug contraindication! This is where the serious stuff is!
Whereas the first study showed that 1.3% of the participants were using a contraindicated drug-herb combination, this is nothing when compared to drug-to-drug interaction when there are 2 or more drugs involved. But in these cases we are talking about major life threatening risks, not minor ones which are generally the case with herb/drug interaction.
Over recent years the number of people who are taking more than 2 drugs at the same time has increased dramatically. So have the deaths related to drugs. The reality is that once you are taking three drugs or more the interaction between them is very much guesswork and is not even understood fully by most bio-scientists let alone a doctor who relies on the published literature from the drug company.
Often people will contact us regarding possible interaction of drugs with our Supplements. Usually there is not a problem so long as they leave a three hour gap between their drugs and the Supplements. However, sometimes we have to advise against taking a supplement because of a potential interaction with some drugs.
But, in many cases we cannot advise at all because the potential customer is taking three or more drugs, and in some cases as many as seven. This is dangerous stuff so we have to ‘pass the buck’ and refer them back to their physician…who unfortunately is no better equipped to advise than we are…but we cannot advise on something that is so crucial and unknown.
My only further comment on this subject is that if you are taking three or more drugs work with your physician and ideally try and get off all of them, or, at the very least get back to two drugs only. Question the real need for each drug and ask to see all the spec sheets.