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»Safety With Herbs »Avoiding hebal-Drug Interaction »Herbal-Food Interaction |
Safety With Herbs I want to talk to you about Safety. There are a lot of common misconceptions out their regarding herbal healing, and I hope with this to be able to clear some of those up. Safety with any treatment is essential for overall health and well being, whether it is allopathic or alternative in nature. Herbs Are Medicine! They should be treated with the very same respect that most of us give to prescription drugs. Many herbs can be harmful in large or prolonged dosages, as can most anything in this life, I might add. Many herbs can be addictive after long term improper use. Some are poisonous. Some can have toxic side effects if not properly balanced with herbs that counteract those effects. They should not ever be used indiscriminately without the proper guidance of a health care professional. They should not ever be used on a daily basis without the proper guidance of a health care professional. Many people feel that just because herbs are natural, they can't hurt them. Nothing can be further from the truth. More Is Not Better! Many people feel that if a little makes me feel better, a lot will make me feel fantastic. This is not the case with herbs. Dosages need to be carefully controlled, as with any medicine. You wouldn't swallow a whole bottle of antibiotics at one time to kill a bacterial infection. Apply the same caution to herbal medicines. It is possible to overdose! Herbs work slowly, with the body and its own natural defenses. You must give herbs time to work before changing your dosages. In this modern world of a "pill for everything", folks have come to expect instant cures, instant relief. You should note that with chronic illness, even prescription drugs take time to work. The same applies with herbal medicines. Give them time to work. Support them with a proper diet, with exercise, and with proper attention to yourself. If the herbs aren't working for you, then you either have the wrong combinations, the wrong dosages, or you aren't adhering to a proper healing regimen. Contact a health care professional for guidance as to what works for you. One Dose Does Not Fit All! You wouldn't give a small child the same amount of cough syrup you give an adult. The same applies with herbal medicines. The dose must fit the individual. The dosages need to be based on the illness treated, your past and present medical history, your age, your weight, and several other factors. Combinations must be chosen so as not to interfere with any specifics with your particular body, and so as not to further aggravate that which is being treated. A health care professional can help you choose the proper combinations and dosages for your unique body and health concerns. Tell Your Doctor What You Are Taking! You wouldn't hide the fact that you are a smoker or a drinker or have a heart condition from your physician. You shouldn't hide the fact that you are using herbal medicines, either. Some herbs can have serious adverse reactions when improperly mixed with prescription drugs. Just because they are natural doesn't mean there can't be reactions! Many chemical drugs are derived from healing plant constituents. So you could be causing a serious problem for yourself if you are getting far too much of something that is supposed to be helping you. There is no reason to hide. Herbal healing is becoming much more mainstream today, and many physicians are learning about herbs as medicine. If yours isn't, then help educate him or her. Or find a doctor that can help you work with your herbs. Most communities have herbal professionals, naturopathic doctors, Chinese Medicine practitioners, and other professionals that are trained in the proper uses of the healing herbs. Seek one out before you make some major mistakes with your precious body. But The Drug Companies Are Recommending Herbs! Indeed, there are growing numbers of drug companies that are jumping on the natural health bandwagon. However, these does not give you license to just use whatever you see in hopes that it will improve your condition. Again, most herbs should not be used on a daily basis over the long term. That can actually do more harms than not using an herb at all. Educate yourself before reaching for that one-a-day herb. You may not need it for what you think you do. Just because it has a "name" behind it does not make it safe for continued daily use. Seek guidance if you are confused or unsure of what to do with these new products. Following these guidelines will help you to get the most from your herbal treatments. You will be healthier and happier if you don't fall for media hype. Stick to what is known. Don't indiscriminately choose an herb without knowing exactly what to expect from it, good and bad. Always treat your herbal medicines with respect, and they will do the same for you. Top Avoiding Herbal-Drug Interaction People of all ages aren't turning just to pharmaceuticals for what ails them. People also are consuming herbs and dietary supplements in record quantities, usually without their physicians' knowledge. "It's gotten to be a 'don't ask, don't tell' mentality between patients and physicians," said Joe Graedon, a pharmacologist, who along with his wife, Terry, has created the People's Pharmacy multimedia empire. "Patients don't want to see or hear the disdain, and physicians are not well versed in what these remedies offer." The silence and ignorance can be very dangerous. A variety of herbs interact with pharmaceuticals and can cause devastating damage. For example, St John's Wort causes problems when combined with channel blockers. Gingko can cause serious coagulation complications in-patients taking coumadin or other blood-thinning medications. Alcohol and antianxiety herbs such as Kava do not mix well. Other interactions occur with commonly used herbal remedies. Mr.Graedon provides an in-depth review of 50 top herbs, along with potential drug interactions with herbs, alcohol, food, and other nutrients on his Web site at www.peoplespharmacy.com. Mr.Graedon offers physicians these suggestions: »Ask questions and learn everything a patient is taking on a regular basis, including over-the-counter medications, herbs, and dietary supplements such as DHEA and glucosomine. » Educate yourself on the uses and potential side effects and interactions of common herbal remedies. »Ask tough questions of all pharmaceutical company representatives with whom you interact. »Wait a reasonable amount of time before prescribing newly approved drugs to avoid problems seen with Rezulin and the other drugs pulled off the shelves in the last 22 years. »Make no assumptions about safety. Do not rely solely on package inserts or even the Physicians' Desk Reference for answers. If in doubt, contact the pharmaceutical company directly. »Don't rely on the spoken word. If you tell a patient more than two or three things, write them down or they will be forgotten. Doctors, patients need to know drug-herb interaction. Natural remedies are big news. Thousands of articles flood the media, from daily newspapers to magazines to the Internet. While one article touts St. John's wort as a natural remedy for depression, however, another chronicles abuses that may scare consumers away from trying herbs at all. Members of the American Medical Association called in June for their professional group to push for stronger federal laws on labeling of dietary supplements, especially now that major vitamin companies are beginning to market herbal combination formulas with health claims. Concerns were expressed about lack of standards for quality control and research to substantiate health claims. "Those are valid concerns, although patients can use supplements safely and effectively if they know how to select products and if they work with a knowledgeable doctor," said Chris D. Meletis, N.D., Chief Medical Officer at the National College of Naturopathic Medicine. He has written a physician's guideline on interactions among drugs, herbs and nutrients. All physicians are concerned about their patients self-prescribing a new supplement on the basis of a book or an article they read, Dr Meletis said. "I saw a patient who was taking warfarin for her heart condition, and who was excited about taking gingko to improve her memory. Gingko works by improving blood circulation and warfarin blocks blood clotting. Both are beneficial, but taken together, they could have disastrous consequences if bleeding occurs. " Dr. Meletis and other graduates of accredited four-year, post-graduate naturopathic medical schools such as NCNM are the only licensed primary care physicians with extensive training in the therapeutic use of herbs and nutrients to treat acute and chronic conditions. They receive hundreds of hours of training in botanical medicine and clinical nutrition, as well as pharmacology, and they are especially well-trained to advise patients on drug-herb-nutrient interactions. These topics are not routinely taught in M.D. medical schools, although many medical doctors have sought to educate themselves. Founded in 1956, NCNM is the oldest accredited naturopathic medical school in the U.S., carrying forward the century-old tradition of natural medicine in this country. It offers a doctor of naturopathic medicine (N.D.) degree and a Master's of Science in Oriental Medicine. Drug-Herb-Nutrient Interactions Some herbs on the market, such as ginseng and gingko, have proved effective for a variety of conditions in scores of studies and trials. These have been written about widely in the professional and popular press. But less attention has been paid to the negative interaction. For example, there is increasing publicity about taking a small amount of aspirin routinely to prevent clotting and arterial blockage, but a person who does so should not take gingko. This herb works by increasing circulation, so these two beneficial over-the-counter substances could have a very negative interaction in the event of any profuse bleeding. Chris D. Meletis, N.D., Chief Medical Officer of the National College of Naturopathic Medicine, has written a doctor's guideline on interactions between drugs, herbs and nutrients. Here are some examples: »Valerian, an herb known for its soothing effect on the nerves, is popularly taken for insomnia, anxiety and other nervous conditions. But don't take this with prescription sedatives, such as Valium, Xanax and Elavil; the combination will intensify the effect of the prescription drug. »CoQ10, an enzyme much publicized for its effect to increase overall energy by making the heart use oxygen more efficiently, should not be taken with prescription heart medications such as Warfarin (coumadin) because it decreases the effectiveness of that anti-clotting drug. »Yohimbe, the first and only herb approved by the U.S. FDA for impotence, is popularly available in health food stores as an aphrodisiac, but it should not be used by those who are taking an MAO-class antidepressant, because it decreases the drug's effectiveness. »Licorice, an herb used for stomach upset, ulcers and gastritis, should not be taken with diuretics, or with digoxin, which is prescribed for those with congestive heart disease. The combination causes a potassium deficiency, which can result in rapid and irregular heartbeat, muscle weakness, cramping or spasm, irritability, vomiting or diarrhea. Even everyday foods we eat can disrupt the effectiveness of our medications: »Grapefruit contains a bioflavinoid called naringenin that effects the ability of the liver to metabolize certain drugs. One example is calcium channel blockers taken by heart patients; the effect is that these drugs are not processed as quickly and stay in the blood, potentially leading to elevated levels of the drug as repeated doses are taken. »Fiber in large amounts can decrease the absorption and distribution of any drug, especially anti-depressants; but this can be mitigated by not taking both the drug and the fiber in the same sitting. Also, a high-fiber diet has the ability to lower blood sugar levels, which can be dangerous to those with hypoglycemia or diabetes. Picking the right products »Even when you are taking the right herb in the right dose under the right conditions, you still have to pick a manufacturer that creates a high-quality product that will be therapeutically effective. This is a case of getting what you pay for: high quality ingredients produced in standardized format cost more money. Here are some tips for picking such manufacturers. »Look for full-disclosure labeling, not just what's inside, but in what measure, how many milligrams, etc. »Manufacturers who impose quality control on their process can produce a certificate of analysis on request. »Many reputable manufacturers are members of a self-policing professional organization called the National Nutritional Foods Association, and put this information on their labels. »Look for labels that specify organic or wildcrafted ingredients. Top Herbal Food Interaction Herbs and Foods May Lead to Complications if you take them with Drugs Many people have the mistaken notion that, being natural, all herbs and foods are safe. This is not so. Very often, herbs and foods may interact with medications you normally take that result in serious side reactions. It is always a good practice to tell your doctor or health practitioners what you are taking so that they can advise you of possible complications, if there is any. You should also keep an eye for unusual symptoms. Very often, this may foretell the symptoms of a drug interaction. Experts suggest that natural does not mean it is completely safe. Everything you put in your mouth has the potential to interact with something else. The medication that is taken by mouth travels through the digestive system in much the same way as food and herbs taken orally do. So, when a drug is mixed with food or another herb, each can alter the way the body metabolizes the other. Some drugs interfere with the body's ability to absorb nutrients. Similarly, some herbs and foods can lessen or increase the impact of a drug. Alcohol is a drug that interacts with almost every medication, especially antidepressants and other drugs that affect the brain and nervous system. Some dietary components increase the risk of side effects. Theophylline, a medication administered to treat asthma, contains xanthines, which are also found in tea, coffee, chocolate, and other sources of caffeine. Consuming large amounts of these substances while taking Theophylline increases the risk of drug toxicity. Certain vitamins and minerals impact on medications too. Large amounts of broccoli, spinach, and other green leafy vegetables high in vitamin K, which promotes the formation of blood clots, can counteract the effects of heparin, warfarin, and other drugs given to prevent clotting. Dietary fiber also affects drug absorption. Pectin and other soluble fibers slow down the absorption of acetaminophen, a popular painkiller. Bran and other insoluble fibers have a similar effect on digoxin, a major heart medication. As more and more people discover new herbs, there is more and more potential for the abuse of these herbs and the patients may end up in serious problems. The following are the examples of known interaction between popular herbs, foods, and prescription and over-the-counter drugs: Hawthorn, touted as effective in reducing angina attacks by lowering blood pressure and cholesterol levels, should never be taken with Lanoxin (digoxin), the medication prescribed for most for heart ailments. The mix can lower your heart rate too much, causing blood to pool, bringing on possible heart failure. Ginseng, according to research, can increase blood pressure, making it dangerous for those trying to keep their blood pressure under control. Ginseng, garlic or supplements containing ginger, when taken with the blood-thinning drug, Coumadin, can cause bleeding episodes. Coumadin is a very powerful drug that leaves little room for error, and patients taking it should never take any medication or otherwise before consulting a qualified health professional. In rare cases, ginseng may overstimulate resulting in insomnia. Consuming caffeine with ginseng increases the risk of overstimulation and gastrointestinal upset. Long tern use of ginseng may cause menstrual abnormalities and breast tenderness in some women. Ginseng is not recommended for pregnant or lactating women. Garlic capsules combined with diabetes medication can cause a dangerous decrease in blood sugars. Some people who are sensitive to garlic may experience heartburn and flatulence. Garlic has anticlotting properties. You should check with your doctor if you are taking anticoagulant drugs. Goldenseal is used for coughs, stomach upsets, menstrual problems and even arthritis. However, the plant's active ingredient will raise blood pressure, complicating treatment for those taking antihypertensive medications, especially beta-blockers. For patients taking medication to control diabetes or kidney disease, this herb can cause dangerous electrolyte imbalance. High amount of consumption can lead to gastrointestinal distress and possible nervous system effects. Not recommended for pregnant or lactating women. Feverfew, believed to be the natural remedy for migraine headaches, should never be taken with Imitrex or other migraine medications. It can result in the patient's heart rate and blood pressure to rise dangerous levels. Guarana, an alternative remedy being used as a stimulant and diet aid, contains 3 percent to 5 percent more caffeine than a cup of coffee. So, if you are taking any medication that advises you against taking any drink with caffeine, you should avoid taking this stimulant. It may cause insomnia, trembling, anxiety, palpitations, urinary frequency, and hyperactivity. Avoid during pregnancy and lactation period. Long term use of Guarana may lead to decreased fertility, cardiovascular disease, and several forms of cancer. Kava, a herb that has antianxiety, pain relieving, muscle relaxing and anticonvulsant effects, should not be taken together with substances that also act on the central nervous system, such as alcohol, barbiturates, anti depressants, and antipsychotic drugs. St. John's Wort is a popular herb used for the treatment of mild depression. The active ingredient of St. John's Wort is hypericin. Hypericin is believed to exert a similar influence on the brain as the monoamine oxidase (MAO) inhibitors such as the one in major antidepressants. Mixing MAO inhibitors with foods high in tyramine, an amino acid, produces one of the most dramatic and dangerous food-drug interactions. Symptoms, which can occur within minutes of ingesting such foods while taking a MAO inhibitor, include rapid rise in blood pressure, a severe headache, and perhaps collapse and even death. Foods high in tyramine include aged cheese, chicken liver, Chianti and certain other red wines, yeast extracts, bologna and other processed meats, dried or pickled fish, legumes, soy sauce, ale and beer. Some patients report that Saint Johns Wort caused excessive stimulation and sometimes dizziness, agitation and confusion when taken with other antidepressants or over-the-counter medications like Maximum Strength Dexatrim and Acutrim. It also caused their blood pressure to shoot up. White Willow, an herb traditionally used for fever, headache, pain and rheumatic complaints may lead to gastrointestinal irritation, if used for a long time. It exhibits similar reactions as aspirin (aspirin is derived from white willow.) Long term use may lead to stomach ulcers. Drug Interaction and Food Drug interaction risk isn't limited to herbal supplements. Certain foods can interact with medications. People taking digoxin should avoid Black licorice (which contains the ingredient glycyrhizin). Together, they can produce irregular heart rhythms and cardiac arrest; licorice and diuretics will produce dangerously low potassium levels, putting a patient at risk for numbing weakness, muscle pain and even paralysis. Licorice can also interact with blood pressure medication or any calcium channel blockers. Aged cheese (Brie, Parmesan, cheddar and Roquefort), fava beans, sauerkraut, Italian green beans, some beers, red wine, pepperoni and overly ripe avocados should be avoided by people taking MAO antidepressants. The interaction can cause a potentially fatal rise in blood pressure. And because Saint Johns Wort contains the same properties as these MAO antidepressants, it stands to reason that people ingesting the herb should avoid these same foods. Grapefruit juice interacts with calcium channel blockers (including Calan, Procardia, Nifedipine and Verapamil), cholesterol control meditations, some psychiatric medications, estrogen, oral contraceptives and many allergy medications (Seldane, Hismanal). The juice modifies the body's way of metabolizing the medication, affecting the liver's ability to work the drug through a person's system. Orange juice shouldn't be consumed with antacids containing aluminum. 'The juice increases the absorption of the aluminum. Orange Juice and milk should be avoided when taking antibiotics. The juice's acidity decreases the effectiveness of antibiotics, as does milk. Milk also doesn't mix with laxatives containing bisacodyl (Correctol and Dulcolax). You might find the laxative works a little "too well" in the morning. Large amounts of oatmeal and other high-fiber cereals should not be eaten when taking digoxin. The fiber can interfere with the absorption of the drug, making the act of swallowing the pill a waste of time. However, don't stop eating your cereal right away, because that could cause digoxin levels in your system to soar to toxic levels. A professional should make the dietary changes after carefully examining the digoxin levels. Leafy green vegetables, high in vitamin K, should not be taken in great quantities while taking Coumadin. These vegetables could totally negate the affects of the drug and cause blood clotting. Caffeinated beverages and asthma drugs taken together can cause excessive excitability. Those taking Tagament (Simetidine), quinolone antibiotics (Cipro, Penetrex, Noroxin) and even oral contraceptives should be aware these drugs may cause their cup of coffee to give them more of a Java jolt than they expected. Grilled meat can lead to problems for those on asthma medications containing theophyllines. The chemical compounds formed when meat is grilled somehow prevent this type of medication from working effectively, increasing the possibility of an unmanageable asthma attack. Regularly consuming a diet high in fat while taking anti-inflammatory and arthritis medications can cause kidney damage and can leave the patient feeling, drowsy and sedated. Alcoholic beverages tend to increase the depressive effects of medications such as benzodiazepines, antihistamines, antidepressants, antipsychotics, muscle relaxants, narcotics or any drug with sedative actions. It's a good idea to not consume any alcoholic beverages or at least scale way back, when taking prescription medications. Antioxidant and beta-carotene intensify alcohol's effect on the liver. Other commonly used over-the-counter medications can cause interaction problems also. Aspirin can modify the effectiveness of arthritis medications, strong prescription steroids and diuretics. Combining aspirin with diabetic medications can drop blood sugars to dangerous levels. Aspirin can also cause toxicity when taken with glaucoma and anticonvulsant (antiseizure) drugs and cause bleeding episodes when combined with blood thinner, like Coumadin. Acetaminophen can also cause interaction complications when overused. Heavy drinkers who take acetaminophen for hangover relief risk liver damage. Taking high doses of acetaminophen with Coumadin can cause bleeding episodes. Antacids taken with antibiotics, heart and blood pressure or thyroid medications can decrease drug absorption by up to 90 percent. Over-the-counter antihistamines - sold under the names Actifed, Tavist, Theraflu, Dimetapp, Benadryl and Comtrex should be avoided if you are also taking antianxiety or antidepressant medications. Oral contraceptives are less effective when taken with barbiturates, antibiotics, anti-fungal or tuberculosis drugs. Turnips contain two goitrogenic substances, progoitrin and gluconasturtin, which can interfere with the thyroid gland's ability to make its hormones. Although moderate consumption of goitrogens is not a hazard for healthy people, they can promote development of a goiter (an enlarged thyroid) in persons with thyroid disease. Tomato contains small quantities of a toxic substance known as solanine that may trigger headaches in susceptible people. They are also a relatively common cause of allergies. An unidentified substance in tomatoes and tomato-based products can cause acid reflux, leading to indigestion and heartburn. Individuals who often have digestive upsets should try eliminating tomatoes for 2 to 3 weeks to see if there is any improvement. Strawberries, Raspberries, Spinach, and Rhubarb: These contain oxalic acid, which can aggravate kidney and bladder stones in susceptible people, and reduce body's ability to absorb iron and calcium. Raspberries contain a natural salicylate that can cause an allergic reaction in aspirin sensitive people. The seeds from fruits such as Apple, apricot, and Quinces contain amygdalin, a compound that turns into Hydrogen Cyanide in the stomach. Eating large amount of seeds can result in cyanide poisoning. Potatoes: Avoid potatoes with a green tint to the skin, and remove any sprouts; they will taste bitter and may contain solanine, a toxic substance that can cause diarrhea, cramps, and fatigue. Plums, Peaches, Apricots, and Cherries: These fruits may produce allergic reaction in individuals with confirmed allergies to apricots, almonds, peaches, and cherries. People who are allergic to aspirin may also encounter problems after they have eaten plums or peaches as they contain salicylates. The pits of plums, like peaches and apricots, contain amygdalin, a compound that breaks down into hydrogen cyanide poisoning if consumed in large amounts. Horseradish: Very high doses of horseradish can cause vomiting or excessive sweating. Avoid if you have hypothyroidism. Turmeric: should be avoided by persons with symptoms from gall stones. The drug food interaction is summarized in the table below: 
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