Life Health & Wellbeing

Friday 29 August 2014

Your doctor needs to ensure natural remedies are not causing you harm

Ask the doctor

Dr Nina Byrnes

Published 17/06/2014 | 02:30

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All medicine, whether natural or pharmaceutical, deserves the same scrutiny.

I DON'T really like taking medicines. I'm always worried about their possible dangers and side effects, so I tend to go for homeopathic or herbal remedies when I'm unwell. I was recently diagnosed with high blood pressure and now I have a tablet I have to take. Can I keep taking my herbal remedies?

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Dr Nina Byrnes replies: THE definition of medicine is "a drug or substance used in the treatment or prevention of disease". So any substance you take in order to treat illness, whether it is "natural" or pharmaceutical, is a medicine.

The sale of herbal medicine and homeopathic remedies has grown exponentially in the past decade. There is a public perception that herbal means harmless however, this is not necessarily the case.

As a doctor I don't object to people taking remedies that are not known to cause harm, if they believe they are helping them. However, I feel very strongly that anyone taking any remedy should know exactly what they are taking, why, and the possible side effects of same.

All medicine, whether natural or pharmaceutical, deserves the same scrutiny.

Conventional medical practice is based in evidence-based medicine. Medicine prescribed by doctors in Ireland must be licensed by the Irish Medicines Board. This board will review the evidence and trials that are available to prove the efficacy and safety of a drug.

It will also review possible side effects and decide if any warnings or restrictions should be applied to its use.

Medicine prescribed by a doctor and dispensed in a pharmacy will also come with a product insert that allows the patient to read over its composition, use and side effects.

Herbal and homeopathic remedies have not been subjected to the same level of trials that pharmaceutically based products have. This means that there is not as much evidence available about their composition, mode of action, potency, safety, side effects and interactions.

Herbal and homeopathic remedies are not licensed drugs, therefore, their distribution, marketing and prescription is not regulated. Many patients don't think to mention to their doctor that they are using these remedies and many doctors don't ask.

Homeopathic remedies are just highly diluted quantities of herbs and other substances that are said to act according to the principle of similar. This means that a tiny quantity of something that can cause a condition is used to treat it.

We do have some therapies in medicine that are based on homeopathic principles. An allergy treatment called Grazex is a very small amount of grass pollen that is taken in a tablet, starting several months before allergy season, and can help with hay fever type symptoms.

Homeopathic remedies are so dilute that they are not known to interact with other medicines. However, they may not be as "natural" as we think. A homeopathic remedy in the UK was recently recalled because it was found to contain some penicillin which is a prescription medicine. This could have been life threatening to someone with a penicillin allergy.

Herbal remedies tend to be dried extracts of different parts of a herb or oils distilled from these herbs. In order to try and ensure safety and efficacy of herbal remedies, the American Food and Drug Administration has undertaken to subject some of the more popular herbal medicines to the same kinds of trials that western medicine is subjected to. Results have been mixed to date.

St John's Wort, which is commonly recommended for mood disorders, was shown to be, at best, a very weak antidepressant. What also became evident was that it interacts with other drugs and can reduce the efficacy of medicines such as warfarin (a blood thinner) and the contraceptive pill.

Black Cohosh, recommended for menopausal symptoms, was shown to be quite dangerous to the liver in some people and a warning has been attached to its use.

Some remedies are proving effective. Echinacea, commonly used for colds and flu, has some benefits in treating colds, however, the evidence does not support its use in preventing illness. Soy based oestrogens can be helpful in some women for menopausal symptoms. So how can you get reliable information about these remedies?

The National Institute of Health (NIH) in the USA has a National Centre for Complementary and Alternative Medicine. Each common herbal remedy is listed and they summarise the evidence behind its use and any interactions or adverse effects.

This is a good independent and reliable source of information. Beware of generalised internet searches as, for every piece of accurate information, there are many more poor sites.

Most importantly, always ensure you know what is in any remedy you take and ALWAYS mention these to your GP or any other doctor caring for you.

Your doctor needs to ensure the remedies you are taking are not causing you any harm and that they don't interact with other medicines you may be taking. At the end of the day, we take medicine in order to help improve our health. Being informed is a very important step.

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