|
PORPHYRIA FACTS: NUTRITION - SUPPLEMENTS
&
HERBAL MEDICINES
ACETYL-CARNITINE
Will Acetyl L-Carnitine helpme regain muscle use thathas been lost due to
porphyric PN?
Swanson's Acetyl L-Carnitineis highly promoted as a special formuladesigned
for the brain and body to give muscle nourishment.
No study or evaluation hasbeen undertaken to establish validity of the claims.
Keep in mind that it has not been established by the FDAnor have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
++++++++++++++++++
ALPHA LIPTOIC ACID
What is "alpha lipoic acid"?
Alp[hae lipoic acid use has not proven to be affective in correcting imbalances in
glucose matabolization.
SOURCE:
Jeff Kerns PhD
Biochemistry & Nutrition
++++++++++++++++++
In theory high doses of alpha lipoic acid help keep the body balances and chiefly
metabolizes the glucose.
Keep in mind that it has not been established by the FDA nor have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP
+++++++++++++++++
BETA CAROTENE
Where are Vitamin A and/or Beta Carotene found?
Vitamin A and /or Beta Carotene are found in milk, cheesem cream. kuver,
kidney, and in cod and halibut oil.
SOURCE:
John McIntosh
Nutrition Report
Remedy Winter 2002
++++++++++++++++++++
Should porphyria patient avoid grapefruit when looking for sources of beta
carotene?
GRapefruit while containing beta carotene, is to be avoided by porphyria
patients since it is known to induce heme synthesis.
SOURCE:
Madeline Waggoner PhD
Biochemistry and Molecular Medicine
+++++++++++++++++++
Do vegetables contain Beta Carotene?
Vegetables such as carrots, pumpkin, sweet potatoes, winter squash, grapefruit,
apricots, broccoli, and dark leafy vegetables contain beta carotene..
SOURCE:
John McIntosh
Nutrition Report
Remedy Winter 2002
+++++++++++++++++++
Does Beta Carotene help in the making of Vitamin A?
Beta carotene is a building block of Vitamin A and has antioxidant properties.
It is thought to protect cells from damage that can cause heart disease and some
types of cancer.
SOURCE:
John McIntosh
Nutrition Report
Remedy Winter 2002
+++++++++++++++++++++
A presacription form of Beta Carotene has been advocated as the therapy for
one form of porphyria only and has not proven effective in treating other forms.
SOURCE:
Robert Johnson M.D.
Internal Medicine
++++++++++++++++++++++
CHITOSAN
What does Chitosan do for containing the fat intake in a porph high carb diet?
Chitosan is a supplement thatclaims to be an "all-natural"fat-absorbing fiber.
Keep in mind that it has notbeen established by the FDA nor have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD
++++++++++++++++++++
COENZYME Q-10
Is it safe to use Coenzyme Q-10?
Avoid taking Coenzyme-10 with: Warfarin (Coumadin) - a blood-thinning
medication or with Chemotherapy .
The use of warfarin and coenzyme Q-10 ogether increases your risk of
excessive bleeding.
SOURCE:
Robert Johnson M.D.
Internal Medicine
++++++++++++++++++++
Coenzyme Q-10- should not be taken with Propranolol or some other forms of
medication for hypertension as the Coenzyme-Q-10 can alter the effectiveness
of the blood pressure medication.
SOURCE:
Lawrence Riopelle RPhm
+++++++++++++++++++
Coenzyme Q-10 may reduce the effectiveness of some chemotherapy.
SOURCE:
Roalie Summers RPh
++++++++++++++++++++
The use of Coenzyme Q-10 can alter the outcome of blood serum glucose
testing.
Robert Johnson M.D.
Internal Medicine
+++++++++++++++++++
Some drugs, such as those used to lower cholesterol, blood sugar and
blood pressure (beta blockers such as Inderal, can alter coenzyme Q-10's
effectiveness.
Also, people with diabetes should be aware that coenzyme Q-10 may decrease
their need for insulin.
SOURCE:
Mayo Education & Research
Mayo Clinic
Rochester, Minnesota
++++++++++++++++++++++++
DHEA
DHEA is a supplement that is promoted as a hormonal support or "mother
hormone" wich is by promoted considered to serve as a natural precursor to both
estrogen and testosterone.
DHEA is certainly not a recommended product for porphyria patients who need
to refrain from the use of
horones.
Keep in mind also that DHEA has not been established by the FDA nor have
FDA approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
+++++++++++++++++++++
DMAE
Will using Country LIfe DMAE help me with my general weaknessand my mental
fatique due to acute porphyria?
DMAE by COuntry LIfe isa combination of DMAE,
Vitamin B-6 andpantothenic acid which issupposedly all formulatewd to boost
mental alertness and one'senergy level.
Much has been purported in regard to Vitamin B-6 and acute porphyria, but the
fact remainsthat no evaluations of this comination'of drugs has been made.
Keep in mind that it has not been established by the FDA nor have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
+++++++++++++++++++++++++++
FISH OILS
Coral calcium and fish liver oil are promoted to help nourish bones and facilitate
the vital metabolic processes throughout the body.
The combination as a supplement had not been evaluation to establish such
claims.
Keep in mind that it has not been established by the FDA
or have FDA approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
++++++++++++++++++++
Much as been said about the use of fish oils, however to date there is no valid
data to authenticate such claims.
SOURCE:
Nylene Nelson PhD
Nutritional Medicine
++++++++++++++++++
Omega 3s may lower your level of triglycerides.
Intake of cold-water fish should be watched because of the potential for mercury
contamination.
Mercury is a dangerous substance for porphyria patients.
SOURCE:
Sheryl Wilson, RD
+++++++++++++++++++
DGL
WIll the use of DGL help with thedistention of my stomach andthe abdominal
pain?
DGL is deglycrrhizinated licoriceroot extract.
Manufacturers of DGLtote it's benefit as a way tosoothe and settle a
troublesome stomach much in the way that rolaids do.
DGL has not undergone anyevaluation of any kind, and licorce is also not
tolerated bymany acute porphyria patients.
Keep in mind that it has notbeen established by the FDA nor have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
+++++++++++++++++++++
5=HIP
WIll using Swanson 5-HTPhelp regulate mood andmental stability duringacute
attacks?
Use of 5-HTP by normal healthy people has not beenshown to regulate mood
aspromoters claim.
No studies have beenundertaken to prove any benefits from the use of 5-HTP.
Keep in mind that it has notbeen established by the FDA nor have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
++++++++++++++++++++
GARLIC
Is garlic safe for porphyria patients?
Garlic is promoted for lowering cholesterol and blood pressure levels.
Garlic contains various sulfur-containing compounds, which are derived from
allicin.
Chopped garlic-and-oil mixes left at room temperature can result in fatal botulism
food poisoning according to the FDA.
Clostridium botulinum bacteria are dispersed throughout the environment but are
not dangerousin the presence of oxygen.
The spores produce a deadlytoxin in anaerobic, low-acid conditions.
The garlic-and-oil mixture produces that environment.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++++
GINGER
Can Ginger be used to treat Migraine headaches?
Fresh ginger chewed during a migraine attack can be effective treatment for a
migraine.
Also consuming Ginger tea.
SOURCE:
Vitamins and Minerals:
Healthy Doiet & Safe Supplementation
Denise Mortimore
Element
2001
++++++++++++++++
GINKGO BILOBA
Will Ginkgo Biloba help with the mental confusion of porphyria?
Ginkgo Biloba gives a lot of' claims, none of which have beenestablished by the
FDA.
Swanson supplements advertiseGinkgoBiloba as giving a person a sharp and
active mind.
Keep in mind that it has not been established by the FDA nor does it have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
+++++++++++++++++++++++
MELATONIN
What is Melatonin?
Melatonin is a hormone that is involved in sleeppatterns.
SOURCE:
Vitamins and Minerals:
Healthy Diet & Safe Supplementation
Denise Mortimore
Element
2001
+++++++++++++++++++++++
MILK THISTLE
Has the use of milk thistlebeen studied for use in the liver?
Swanson Herbs promotestheir MIlk Thistle as "helping to protect liver tissues"
and this hasfor years been talked about in porphyria circles.
Keep in mind that Milk Thistle has not been studied or claimsestablished by the
FDA.
Milk Thistle does it have FDA approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
++++++++++++++++++++++
MSM 500
Why is MSM 500 mg dangerous for acute porphyria patients to use?
Natural MSM 500 mg whish isa standard nourishment used by many, is
contraindicated for acute porphyria patientsbecause the substance isnaturally
rich in sulphur.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
+++++++++++++++++
TUMERIC
Will the use of Turmeric help keep the stomach and liver healthy?
Turmeric has a high concentrationof xurcuminoids which process powerful
antioxidant capabilities.
However studies and evaluation of the use of Turmeric has not been made.
Keep in mind that it has not been established by the FDA nor have FDA
approval.
SOURCE:
Sheryl Wilson MSN, RD [HCP]
+++++++++++++++++++++
Problems with Herbal Medicines
Can herbs be harmful?
Herbs are powerful, biologically active products that do have important biological
effects.
Those effects can be useful at some times and harmful under other
circumstances.
SOURCE:
Memorial Sloan-Kettering
Medical Education
New York City NY
++++++++++++++++
Why are we cautioned against the use of herb supplements?
Although natural, and therefore popularly considered harmless, herbal
supplements contain active ingredients thatmay not safely mix with prescription
or over-the-counter (OTC) drugs.
Tell your doctor about any herbal supplements you take.
SOURCE:
Herb and drug interactions
Mayo Foundation
Medical Education & Research
11-07-02
+++++++++++++++
Some medical problems may increase your risk of adverse effects if you take
herbal products.
Talk to your doctor before taking any herbal products if you have any of the
following medical conditions: high blood pressure, thyroid problems, depression
or other psychiatric problems, Parkinson's disease, enlarged prostate gland,
blood-clotting problem, diabetes, heart disease, epilepsy, glaucoma, history of
stroke or history of transplant (as well as the acute porphyrias.)
SOURCE:
Herb and drug interactions
Mayo Foundation
Medical Education & Research
11-07-02
++++++++++++++++++
Are herbs and other natural medicines beneficial?
Some studies have proven that certain natural substances do have benefits,
though in nearly all cases research is mixed.
Herbs also can be dangerous.
SOURCE:
Memorial Sloan-Kettering
Medical Education
New York City NY
+++++++++++++++++
Invalidation of Assays
Does the use of herbal medicines invalidate the results of laboratory tests?
Several herbal products interfere with immunoassays used for monitoring the
concentrations of therapeutic drugs.
Therefore, the common belief that anything natural is safe is not correct.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++
Testing
Can use of herbal drugs alter laboratory test results?
Herbal medicines can alter test results by direct interference with certain
immunoassays.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++++++
The use of herbal medications immediately preceeding and during medical
testing should be avoided.
Some herbal medications can chemically change the values of the test results.
SOURCE:
Robert Johnson MD
Internl Medicine
+++++++++++++++++++
Drug Interactions
Can use of herbal medicinescause drug reactions and
abnormal metabolism?
It has been suspected that herbal remedies could interact with otherherbals or
even prescription drugs. Ingestion of St. John's wort has resulted in several
clinically significant interactions with drugs that are metabolized by CYP1A2 or
CYP3A.
These interactions are most likely due to induction of the cytochrome P450
isozyme orthe drug transporter and havecaused decreased plasma
concentrations of prescription drugs.
In the case of cyclosporin, subtherapeutic levels resulted in transplant organ
rejection.
It is likely that many drug-herbal interactions exist but have not yet been
detected.
It is therefore important that health care providers obtain a complete drug history
thatincludes herbal remedies and other natural products and dietary
supplements and that they be alert to potential interactions.
SOURCE:
David A. Flockhart MD PhD
Professor of Medicine
Director of Clinical Pharmacology
and Toxicology
Indiana University School of Medicine
++++++++++++++++++++
Drug-Interactions
Can use of herbal medicines cana change in the therapeutic outcome of a
another drug?
Drug-herb interactions can result in unexpected concentrations of therapeutic
drugs.
For example, low concentrations of several drugs (eg, cyclosporine,
theophylline, digoxin) can be observed in patients who initiated self-medication
with St John's wort.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++++++
Are Herbs safe to useif you are taking regular drugs?
Herb and drug interactions are not always safe.
You may think herbal supplements are safe because they're labeled"natural."
However many herbal supplements contain active ingredients that canharm you
if taken with certain prescription or over-the-counter (OTC) drugs.
SOURCE:
Mayo Education & Research
Mayo Clinic
Rochester, Minnesota
++++++++++++++++++
Blood coagulation
Can the use of herbal medicines cause problems with Coumadin(wayfarin)
dosage?
Warfarin is an anticoagulant with a narrow therapeutic range.
The drug has potentially serious consequences if bleeding complications
develop or if a subtherapeutic level occurs, thus failing to protect the patient
from thromboembolic events.
Several herbs interact with warfarin.
The herbs that may increase the risk of bleeding (potentiate effects of warfarin)
include angelica root, arnica flower, ansine, bogbean, borage seed oil,
capsicum, feverfew, garlic, ginger, ginkgo, horse chestnut, licorice root, and
willow bark.
The herbs with documented interaction with warfarin include Dan Shen, ginseng,
Siberian ginseng, Devil's claw, and dong quai, among others.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++
Do some herbs cause coagulation problems for porphyria patients?
Garlic capsules and gingko biloba can hinder blood coagulation.
SOURCE:
Memorial Sloan-Kettering
Medical Education
New York City NY
++++++++++++++++++
Risks
What are some of the risks of herbal products?
Certain medical conditions areespecially risky if you takeherbal products.
Such conditions include:
High blood pressure
Thyroid problems
Depression or other psychiatric problems
Parkinson's disease
Enlarged prostate gland
Blood-clotting problems
Diabetes
Heart disease
Epilepsy
Glaucoma
History of stroke or organ transplant
SOURCE:
Mayo Education & Research
Mayo Clinic
Rochester, Minnesota
+++++++++++++++
Surgery & Anesthesia
Should the use of any herbal products be stopped before any surgurical
procedure?
The American Society of Anesthesiologists suggested that patients should
discontinue their herbal medicines at least 2 weeks before surgery.
Garlic and ginseng should be discontinued at least 7 days before surgery
because both herbs have been reported to aggravate bleeding.
Ginkgo biloba should be discontinued 3 days before surgery because it inhibits
platelet aggregation, causing bleeding.
Kava should be discontinued at least 24 hours before surgery because kava can
increase the sedative effect of anesthetics.
Ma huang (ephedra) should be discontinued 24 hours before surgery because
ma huang increases the blood pressure and the heart rate.
St John's wort should be discontinued 5 days before surgery.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++
Glucose levels
Fenugreek, ginger, nettle, sage, and devil's claw can affect glucose levels.
Karela has been shown to improve glucose tolerance.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++++
Lead poisoning
Unexpected lead poisoning may occur owing to the use of herbal medicines
contaminated with lead.
Lead poisoning due to the Chinese herbal medicine Cordyceps has been cited.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++++
Drug Concentration
Can there be Abnormal Drug Concentrations Due to Use of Herbal Medicines?
Several herbal medicines lower the seizure threshold maintained by
phenobarbital, offsetting the beneficial anticonvulsant activity.
Evening primrose oil is used as a remedy for premenstrual syndrome, diabetic
neuropathy, and attention-deficit/hyperactivity disorder.
Evening primrose oil contains gamolenic acid that lowers the seizure threshold
maintained by several anticonvulsants.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++
Heavy Metals
Are herbal medicine from import shops contain heavy metals?
Asian patented medicines obtained from herbal stores
contain lead, arsenic, and mercury.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++
Lead Poisoning
Can there be lead poisoning associated with the use of herbs?
Unexpected lead poisoning may occur owing to the use
of herbal medicines contaminated with lead.
Lead poisoning due to the Chinese herbal medicine Cordyceps has been cited.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++
Surgery
Should herbal medicines be discontinued prior to surgery?
It is recommended for discontinuation of herbal products before surgery.
The American Society of Anesthesiologists has suggested
that patients should discontinue their herbal medicines at least 2 weeks before
surgery.
It is recommended that garlic and ginseng should be discontinued at least 7
days before surgery because both herbs have been reported to aggravate
bleeding.
Ginkgo biloba should be discontinued 3 days before
surgery because it inhibits platelet aggregation, causing bleeding.
Kava should be discontinued at least 24 hours before surgery because kava can
increase the sedative effect of anesthetics.
Ma huang (ephedra) should be discontinued 24 hours before surgery because
ma huangincreases the blood pressure and the heart rate.
St John's wort should be discontinued 5 days before surgery.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++
Toxicity
Can herbal medicines be toxic?
Herbal medicines can cause toxic effects, leading to
abnormal test results.
Therefore, the common belief that anything natural is safe is not correct.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++
Are toxic effects associated with the use of herbal medicines?
Many commonly used herbal medicines are toxic.
Toxic effects of herbal medicines range from allergic reaction to cardiovascular,
hepatic, renal, neurologic, and dermatologic toxic effects.
Although ginseng is considered safe, the toxicity of ginseng has been reported
in the literature.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++
Seizures
Are the herbal drugs starflower and shankhapushpi safe for seizuresin
porphyria?
Borage oil (starflower) also contains gamolenic acid.
Shankhapushpi, an ayurvedic medicine for epilepsy, has adversely affected the
effectiveness of seizure
medications.
Loss of seizure control after self-medication with shankhapushpi has been
observed.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++
Death
Can the use of some herbalmedicines cause death due
to their toxicity?
Use of toxic herbal products such as ma huang (an ephedra-containing herbal
product), Chan Su, and comfrey may cause death.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++
Usage of Herbal Medicines
What percentage of patients use herbs?
A published a survey of 369 patient-escort pairs and reported that 174 patients
(47.2%) used herbs.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++++++
Toxic Effects
What toxic effects do some herbalmedicines have on a person?
Some toxic effects of herbal medicines include cardiovascular toxic effects,
hematologic toxic effects, neurotoxic effects, nephrotoxic effects, carcinogenic
effects, and allergic reactions.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
++++++++++++++++++
Several herbal medicines lower the seizure threshold maintained by
phenobarbital, offsetting the beneficial anticonvulsant activity.
Evening primrose oil is used as a remedy for premenstrual syndrome, diabetic
neuropathy, and attention-deficit/hyperactivity disorder.
Evening primrose oil contains gamolenic acid that lowers the seizure threshold
maintained by several anticonvulsants.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++++
Contrary to popular belief that natural is safe, herbal medicines can cause
significant toxic effects and even death.
St John's wort demonstrated significant and potentially dangerous drug
interactions with several Western medicines.
Several Chinese medicines such as Chan Su, Dan Shen, and ginseng can
interfere with digoxin immunoassay results.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++++
Regulation of Herbal Medications
Are Herbs approved by the F.D.A.?
Dietary supplements are not regulated by the U.S. Food and Drug Administration
or any government agency.
That means the potency in one bottle of St. Johns wort, for example, can -- and
often does -- vary dramatically from that in another bottle.
Furthermore, pne can not even be sureyou are getting St. Johns Wort.
Anybody can put anything on a bottle and put it on a health food store shelf.
Some of the herbal remedies have virtuallynone of what is assumed to be the
active ingredient, some have much higher levels and some are contaminated
with other substances.
SOURCE:
Memorial Sloan-Kettering
Medical Education
New York City NY
++++++++++++++++++
Regulation of herbal medicines
The US Food and Drug administration (FDA) mandates that only medicines have
to be proven to be safe before being released into the market.
Herbal products do not fall under the category of drugs as long as they are not
marketed for the prevention of any diseases, and, as such, FDA approval is not
needed.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++++
The US Food and Drug administration (FDA) mandates that only medicines have
to be proven to be safe before being released into the market.
Herbal products do not fall under the category of drugs as long as they
are not marketed for the prevention of any diseases, and, as such, FDA
approval is not needed.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++++++++++++++
Herbal products in the United States are classified as "dietary supplements" and
are marketed pursuant to the Dietary Supplement Health and Education act of
1994.
However, herbal products are regulated differently in other countries.
In the United Kingdom, any product not granted a license as a medical product
by the Medicines Control
Agency is treated as a food, and no health claim or medical advice can be given
on the label.
Similarly, herbal products are sold as dietary supplements in the Netherlands.
In Germany, herbal monographs are prepared by an interdisciplinary committee
(German Commission E),using historic information; chemical, pharmacologic,
clinical, andtoxicologic studies; case reports; epidemiologic data; and
unpublished manufacturers' data.
If an herb has an approved monograph, it can be marketed.
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++
What Effect is there of Herbal Medicines on Clinical Laboratory Testing?
Abnormal laboratory test results due to the use of herbal medicines can be
classified in 3 categories:
1.. Abnormal test results due to direct interference of a component of the herbal
medicine with the assay
2.. Unexpected concentration of a therapeutic drug due to drug-herb
interactions
3.. Abnormal test results due to toxic effects of the herbal product
SOURCE:
Review of Abnormal Laboratory Test
Results and Toxic Effects Due to
Use of Herbal Medicines
Amitava Dasgupta, PhD,
Department of Pathology and Laboratory Medicine,
University of Texas-Houston Medical School
American Journal of Clinical Pathology
2003; 120(1):127-137
+++++++++++++++
Herb and drug interactions
Although natural, and therefore popularly considered harmless, herbal
supplements contain active ingredients that may not safely mix with prescription
or over-the-counter (OTC) drugs.
Tell your doctor about any herbal supplements you take.
In addition, some medical problems may increase your risk
of adverse effects if you take herbal products. Talk to your
doctor before taking any herbal products if you're pregnant or
nursing or have any of the following medical conditions: high
blood pressure, thyroid problems, depression or other
psychiatric problems, Parkinson's disease, enlarged
prostate gland, blood-clotting problem, diabetes, heart
disease, epilepsy, glaucoma, history of stroke or history of
transplant.
Here are 10 herbs and the prescription and OTC drugs you
shouldn't mix them with:
Feverfew, garlic, ginger, ginkgo
Avoid mixing with:
Aspirin
Ticlopidine (Ticlid)
Clopidogrel (Plavix)
Dipyridamole (Persantine)
Warfarin (Coumadin)
These herbs may augment the anticoagulant effect of these
drugs and may cause spontaneous and excessive bleeding.
St. John's wort
Avoid mixing with any prescription medications. In particular,
avoid taking St. John's wort (SJW) and:
Antidepressants
Indinavir sulfate (Crixivan), a protease inhibitor used to
treat the human immunodeficiency virus (HIV)
Digoxin (Lanoxicaps, Lanoxin), a drug used to
increase the force of contraction of heart muscle and
to regulate heartbeats
Theophylline (Slo-bid, Theo-Dur), an asthma
medication
Cyclosporin (Neoral, Sandimmune, SangCya), an
immunosuppressant
Chemotherapy
SJW has been shown to affect your body's metabolism of all
of these drugs. Many other drugs are likely to be affected
too. Until more is known about SJW's ability to alter the
metabolism of pharmaceutical medications, it is probably
best not to combine such medications with SJW.
Also, the combination of SJW with some antidepressants,
such as selective serotonin reuptake inhibitors, may cause
an excess of serotonin (serotonin syndrome). Typical
symptoms include headache, stomach upset and
restlessness.
Ephedra
Avoid mixing with:
Caffeine
Decongestants
Stimulants
Heart drugs
Antidepressants
Ephedra by itself has been shown to increase risk of heart
attacks, strokes, seizures or death. Combined with these
drugs, it becomes even more risky. Ephedra is a potent herb
that is present in many products, especially those designed
to give pep or lose weight. It goes by many names, such as
ma huang, herbal ecstasy, mahuang, mahuanggen and ma
huang root. Suspect any "natural" product that claims to
cause weight loss or increase energy to have ephedra in it,
and review the product's contents with your doctor or
pharmacist before assuming it doesn't.
Ginseng
Avoid mixing with:
Warfarin (Coumadin), an anticoagulant
Phenelzine sulfate (Nardil), an antidepressant
Digoxin (Lanoxicaps, Lanoxin), a drug used to
increase the force of contraction of heart muscle and
to regulate heartbeats
Used with warfarin, ginseng can increase risk of bleeding
problems. Used with phenelzine sulfate, it may cause
headache, trembling and manic behavior. Used with digoxin,
it may interfere with the drug's pharmacologic action or the
ability to monitor its activity.
Kava
Avoid mixing with:
Sedatives
Sleeping pills
Antipsychotics
Alcohol
Drugs used to treat anxiety or Parkinson's disease
Kava can be addictive. Combined with these drugs, kava can
produce deep sedation and, in some cases, even coma. In
late 2001, following reports from Europe of liver problems in
several people who used kava, the U.S. Food and Drug
Administration started investigating the safety of kava. Until
more is known, don't start taking kava or products that
contain kava.
If you already use it, contact your doctor for
advice and ask if you need liver function tests to check for
unexpected liver problems. Don't take kava if you have a
history of liver problems, if you're depressed or if you take
antidepressants or prescription sedatives. Report any
possible side effects to the Food and Drug Association
MedWatch program by calling 800-332-0188.
Echinacea
Avoid mixing with:
Anabolic steroids
Amiodarone (Cordarone, Pacerone), used to treat
arrhythmia
Methotrexate (Methotrexate), used to treat
rheumatoid arthritis
Ketoconazole (Nizoral), an antifungal drug
Cyclosporine (Neoral, Sandimmune, SangCya), an
immunosuppressant
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Drug metabolism
t has been suspected
that herbal remedies could interact with other herbals or even prescription
drugs.Ingestion of St. John's wort has resulted in several clinically significant
interactions with drugs that are metabolized by CYP1A2 or CYP3A.
These interactions are most likely due to induction of the cytochrome P450
isozyme orthe drug transporter and have
caused decreased plasma concentrations of prescription drugs.
In the case of cyclosporin, subtherapeutic levels resulted in transplant organ
rejection. It is likely that many drug-herbal interactions exist but have not yet
been detected.
It is therefore important that health care providers obtain a complete drug history
that includes herbal remedies and other natural products and dietary
supplements and that they be alert to potential interactions.
SOURCE:
David A. Flockhart MD PhD
Professor of Medicine
Director of Clinical Pharmacology
and Toxicology
Indiana University School of Medicine
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