How much do you know about alternative medication?

[evilolive]

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It's been pretty clear that more and more people run to alternative treatments and "natural" products due to the stigma associated with side effects from traditional therapies. Most people don't consider the occasional herb they eat to be a drug. How do you all deal with this in practice? Do you know enough to be able to help people with questions about efficacy and safety? As a student, I don't know where I would even begin to find reputable information for this field given how vast it is.

 

[Moxxie]

The Natural Medicines Comprehensive Database (part of the Pharmacist's Letter) is awesome for info about herbal supplements. So far I've taken an elective in Natural & Complimentary Medicine and a lot of our therapeutics courses go over natural alternatives to conventional therapies.

Do I feel like I know enough to recommend natural products on a daily basis? Probably not. But I know where to find info and I know the basics about a lot of the top supplements - garlic, St. Johns Wort, cinnamon, fish oil, etc.

What I think is important to emphasize to people is that natural does not always equal safe. Many people take loads of vitamins/supplements and don't tell their pharmacist or physician about them because they figure that if they can get it OTC at the store it must be fine. But there can be a lot of drug interactions and some supplements can exacerbate certain disease states.

 

[Old Timer]

What I think is important to emphasize to people is that natural does not always equal safe. Many people take loads of vitamins/supplements and don't tell their pharmacist or physician about them because they figure that if they can get it OTC at the store it must be fine. But there can be a lot of drug interactions and some supplements can exacerbate certain disease states.

I know a patient who decided to treat his BPH with saw palmetto and massive doses of zinc. Opps, his cholesterol hit 300. To much zinc is a no no. Then there was the trypotphan fiasco. Most if you folks don't remember the DMSO debacle in the late 70's early 80's.

The pharmacists letter is excellent. Facts and Comparisons has great herbal/natural edition that actually gives the relevant studies. I don't know if the German Kommission E which regulates supplements in Germany is available in English.

 

[Quiksilver]

we have a class that looks specifically at herbs and other phytochemicals that have medicinal purposes. Pretty interesting stuff. The professor usually consults with the German Commission E. So i am assuming that it can be found in English.

I am in the class right now. So far, it seems the best they can do is to help a little, since most natural herbs have these chemicals at very minute concentrations. But at the least, the class is pretty interesting.

Remember, the FDA says that these herbs cannot make claims to cure disease states without their consent, and therefore have had studies to back it up.

 

[Old Timer]

Remember, the FDA says that these herbs cannot make claims to cure disease states without their consent, and therefore have had studies to back it up.

Unfortunately, this is not true. The supplement industry purchased the United States Congress and these products are NOT under the DRUG umbrella of the FDA, but under the Department of Agriculture and are regulated as a food product. No safety, no proof of efficacy. For more information, see this.

 

[Pharmavixen]

And St John't wort is an inducer of CP3A4 and 2C19, so you can end up with sub-therapeutic levels of indinavir.

I hope they're teaching you homeopathy is bunk.

 

[Old Timer]

I don't know if it's bunk, I just know there is no proof for a great deal of the claims made by the industry.

I only have personal anecdotal evidence:

• B-Complex helps with carpal tunnel syndrome.
• Bilberry Extract reduces the duration of viral URI's
• B-6 helps with PMS
• Plant estrogens reduce the hot flashes due to menopause.
• Lysine for re-current cold sores.

There are no studies to back me up, just what I have experienced myself, with members of my family and many patients......

The problem is the supplement industry makes outlandish claims and that taints the research that is out there, most of it is European, that shows benefit for these compounds.

 

[SpenceRx]

I'd like to know more about complementary medicines.

One of my assignments last term involved reviewing a complementary medicine and presenting it to the class. Ultimately we had to answer the questions "would you recommend this product to a patient". Most students presentations ended with "there is little or no evidence of efficacy but it also doesn't harm so I would sell it if the patient asked for it".

There will always be people who prefer natural products so I'd like to be more competent in recommending them.

 

[Hels2007]

Scary as it is, I am going to be lecturing on it. 🙄😀

I loved my experience in Germany, there is something in mixing herbal teas from a doctor's prescription, pulling all the jars, weighing stuff out... while the pharmacy where I worked was in a big shopping mall and was ultramodern, I loved one I have seen on a trip to Wolfenbuettel, which has been there for over 500 years, and still had herbs hanging in the window... 🙂

 

[evilolive]

Scary as it is, I am going to be lecturing on it. 🙄😀

I loved my experience in Germany, there is something in mixing herbal teas from a doctor's prescription, pulling all the jars, weighing stuff out... while the pharmacy where I worked was in a big shopping mall and was ultramodern, I loved one I have seen on a trip to Wolfenbuettel, which has been there for over 500 years, and still had herbs hanging in the window... 🙂

Rustic 🙂 Are they really obscure herbs that are native to the area? Or are they an imported collection of known plants across the globe?

 

[Hels2007]

Rustic 🙂 Are they really obscure herbs that are native to the area? Or are they an imported collection of known plants across the globe?

Which ones? The ones in the window? That is purely for decorative purposes. I wouldn't remember what they are - the pharmacy was closed anyway, it was a Sunday, so I couldn't do more than look into the window when walking by. Something long-stemmed, probably camomile and maybe wormwod come to mind). As far as the ones used in compounding - both. Of course, vast majority of them were European in origin, but there were some Asian and American herbs too (echinacea and black cohosh are examples of American ones).