|
Register | Sign In |
|
QuickSearch
Thread ▼ Details |
|
Thread Info
|
|
|
Author | Topic: Safety and Effectiveness of Herbs and Pharmaceuticals | |||||||||||||||||||||||||||||||||||||||
Apothecus Member (Idle past 2441 days) Posts: 275 From: CA USA Joined: |
Hey rockondon.
quote: Indeed, but I think you're representing a rosier picture of SJW than is supported by credible sources. Ignoring Wiki for the moment, according to NIH's NCCAM Study:
An extract of the herb St. John's wort was no more effective for treating major depression of moderate severity than placebo, according to research published in the April 10 issue of the Journal of the American Medical Association. To be fair, although the study also compared SJW to sertraline (Zoloft), the differences between the two as to effectiveness according to DSM-IV criteria were not statistically significant (lest you think I'm rah-rahing Big Pharma).
quote: This is also a mischaracterization. Most medications (rx or otc) will list possible side effects observed in controlled clinical studies, but most will also be shown to occur in less than 5% of people. This is usually clinically and statistically indistinguishable from placebo, but do they occur? You bet they do; whether by actual processes or psychosomatic processes, they will occur. To write off the possible side effects of any drug based on the fact that, clinically they are infrequent, is to shoot myself in my pharmacist-foot (esp. when considering little studied "supplements" like SJW). And that doesn't even begin to touch upon the fact interactions that SJW has with other medications. It potentiates an important enzyme responsible for breakdown of other meds you may be using, thus possibly contributing to toxicity of those medications. Not a good thing, especially for the depressed grandma who is also taking heart medications such as digoxin.
quote: Possibly true for most people, but a dangerous blanket statement for the above reasons.
quote: Setting aside the falsity of the "virtually no side effects" part, to answer your question, perhaps it's because 9 out of 10 times a pharmacist will steer a patient toward a product which has the weight of years and years of clinical trials vs. a product which "has not been evaluated." Don't get me wrong: I'm not a supplements-basher. Many herbals are marginally effective, and actually don't have much of a side-effect profile. But in my daily practice, I need to weigh the risk/benefit profile of each and every product I recommend. Since I have a better idea of the effects of most of the mainstream antidepressants (more studies), and also have at my disposal the rest of the patient's medication profile when considering whether those antidepressants are appropriate, is more than enough to move SJW to the bottom of my list of treatment options. Hope this helps. Have a good one. "My own suspicion is that the Universe is not only queerer than we suppose, but queerer than we can suppose. J.B.S Haldane 1892-1964
|
|||||||||||||||||||||||||||||||||||||||
Granny Magda Member Posts: 2462 From: UK Joined: Member Rating: 4.1 |
Hi rockondon,
However, one herb that has shown to be effective is St. John's Wort. It has a side effect profile similar to placebo. To put it another way, its about as harmful to you as drinking water. I don't know what they're putting in the water round your way, but...
quote: For the record, I got the above from a relatively pro-alternative medicine site; Page not found – Personal Health Zone St John's wort is a real drug, with real active ingredients, so naturally, it acts like a real drug, complete with a range of unfortunate side-effects. The real danger here is that SJ'sW (and herbal medicine in general) has such a whiter-than-white reputation that people under-estimate the seriousness of taking it. Few people are aware that there could be harmful interactions with other medications, so few patients tell their doctors that they are taking it - thus exacerbating the problems. The example of St John's wort only serves to demonstrate the point that has been made throughout this thread; that herbal medicines must be treated just as any other chemical, with full evaluations of both efficacy and risk. Mutate and Survive
|
|||||||||||||||||||||||||||||||||||||||
Coragyps Member (Idle past 764 days) Posts: 5553 From: Snyder, Texas, USA Joined:
|
that herbal medicines must be treated just as any other chemical, GM, you have highlighted one of my pet peeves. I'm a chemist by trade (in the American sense, not the British sense of "the chemist's shop") and it irritates the crap out of me that herbal fans go on about how their wares "contain no chemicals." Of freakin' course they contain chemicals! They are made up entirely of chemicals! And "all-natural, organic" tetrodotoxin will kill you just as dead as anything I can whip up in an Erlenmeyer flask, too. At the base, it's another piece of anti-science similar to creationism. Based on different superstitions, but still on anti-facts.
|
|||||||||||||||||||||||||||||||||||||||
Apothecus Member (Idle past 2441 days) Posts: 275 From: CA USA Joined: |
Hey Coragyps.
...it irritates the crap out of me that herbal fans go on about how their wares "contain no chemicals." I deal with this myth almost every day. Someone will walk up to the counter (after nosing around the "Natural Foods" section for awhile) with a jug of echinceablackcohosheveningprimroseredriceyeast and say, "Is this good for my [insert any malady here]?" Well, I think to myself, "Oh, great! A question about an herbal that I can actually answer since I read about this in my latest pharmaceutical journal." Then I come to realize that waaaait ... that "study" referenced the "standardized" extract, not the "standardized" flower parts like this bottle says it contains. So I attempt to consult the literature I have at my disposal about the flower parts type of product, and lo and behold, there is none. Anywhere. Nor can I find a product which actually contains extract of the above ingredient. Nor is there any literature describing the conversion factor to determine how much of one = how much of the other. So I attempt to tell the patient this, and also that I cannot say either way if this product is "good"; at this point the patient sniffs, looks at me, then back at the bottle -- and I can feel a form of "IDIOT" stigmata pop out on my forehead for only this patient to see. The patient turns on her heel, and walks off, presumably to treat/toxify herself.
This, in regard to herbal supplements, is what "The FDA has not evaluated these statements" means to someone in my profession. By and large, most products have few side effects (indeed, most have few "effects" at all) and I have no problem recommending one. But many times the liability I face is too great, and I punt it away...whether this makes me look like I know next to nothing, I don't know. But it's not a tough call to make, in any case...
At the base, it's another piece of anti-science similar to creationism. Based on different superstitions, but still on anti-facts. This is interesting. I'd never thought of it this way before, but it makes sense to me. Most folks equate OTC/herbals as "safe" vs prescription products, though they may be quite the opposite. I try to get this across to people with this misconception, but the minute I start in on it, the glaze-over begins and you can tell the battle's lost before it began since I didn't start by telling them what they wanted to hear. "My own suspicion is that the Universe is not only queerer than we suppose, but queerer than we can suppose. J.B.S Haldane 1892-1964
|
|||||||||||||||||||||||||||||||||||||||
New Cat's Eye Inactive Member |
Avoid the following substances when using St.-John's-wort: Amino acids tryptophan and tyrosine; amphetamines; asthma inhalants; beer, Count me out.
|
|||||||||||||||||||||||||||||||||||||||
rockondon Member (Idle past 4955 days) Posts: 40 Joined: |
Hi Apothecus,
Indeed, but I think you're representing a rosier picture of SJW than is supported by credible sources. Ignoring Wiki for the moment, according to NIH's NCCAM Study... I'm aware that there is at least one study that shows that SJW isn't effective for MAJOR depression and that study avoided testing patients with mild and moderate depression which is where the positive effects of SJW would likely have been more clinically significant. I never said SJW works for all types of depression in all circumstances. No antidepressants do. What I do contend is that it is effective for some types of depression in some circumstances. If you disagree with that, I'd love to hear it.
a pharmacist will steer a patient toward a product which has the weight of years and years of clinical trials vs. a product which "has not been evaluated."
I suspect you don't like wiki so I dug up one of the journal articles that tested the effectiveness of SJW.
The available evidence suggests that the hypericum extracts (St John's Wort) tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants. I even did an APA style reference and everything. Hope you enjoyed it Linde K, Berner MM, Kriston L. (2009) St John's wort for major depression. Evidence based mental health. 12(3):78. Lets go back to this point for a moment...
a pharmacist will steer a patient toward a product which has the weight of years and years of clinical trials vs. a product which "has not been evaluated." ...and the previous study you mentioned which I found here. I presume you will agree that SSRI's are effective based on the "years of clinical trials," if you don't then please correct me.In that study you brought up, they compared SJW, a placebo, and an SSRI (sertraline). Their findings were... They also found that approximately 24 percent of patients taking St. John's wort had full responses to treatment versus about 32 percent for placebo and 25 percent for sertraline. It seems that placebos are superior to SJW AND the SSRI for treating major depression!!! (according to the study you provided. Thanks for that) Incidentally, the other point I'm making is that the side-effect profile of SJW is lower than other antidepressants. If you disagree with that, I'd love to hear more about that too. Hi Granny magda!
I don't know what they're putting in the water round your way, but... I'm not saying that SJW is harmless, all I'm saying is that the side-effects of SJW is markedly less than more conventional antidepressants.
|
|||||||||||||||||||||||||||||||||||||||
Kitsune Member (Idle past 4330 days) Posts: 788 From: Leicester, UK Joined: |
Agreed, Granny Magda. I tried St. John's wort once and got terrible stomach cramps, and I felt like I was on the planet zog. The problem is that people who have experienced no side effects, read that there are none, and know of no one who has experienced them, end up believing this stuff is 100% safe. SJW is really a mild SSRI.
I have, and continue to, use some herbs that have given me great relief from some symptoms (the root cause of which I am still working on sorting out). In the past I used Relora when I had adrenal problems, and currently I use ginkgo biloba and ashwagandha. I've tried various other things too, some of which did not agree with me. (I have also taken pills from herbalists whom I trust.) I use herbs sparingly, give them the respect they deserve, and research what I am doing. I am uncomfortable about claimed-but-not-properly-studied effects of anything; I do not want to set my body up as a lab experiment. Occasionally people have recommended herbs to me that I have discovered are known to cause serious problems, and that's disturbing. While I want to retain my right to buy herbs and use them, I do feel that more clinical studies would help because I want to know what the actual (as opposed to mythical) effects are. I would also like to see more standardisation. If I decided to change my brand of ginkgo, I would have no idea what I'd be getting from another product in comparison; even the same amount can vary by content, purity and processing.
|
|||||||||||||||||||||||||||||||||||||||
Apothecus Member (Idle past 2441 days) Posts: 275 From: CA USA Joined: |
Thanks for the reply rockondon...
I think you're misunderstanding my position. At no point (other than citing the study) did I comment on the effectiveness of SJW, except to say this (which supports your contention as to effectiveness):
Apo writes: To be fair, although the study also compared SJW to sertraline (Zoloft), the differences between the two as to effectiveness according to DSM-IV criteria were not statistically significant (lest you think I'm rah-rahing Big Pharma). What I was getting at was your blatant use of rose-colored glasses pertaining to safety. I see this all the time with people who misinterpret studies and conclude that an herb being freely available OTC translates to it being "about as harmful as drinking water." That's a fallacious comparison, one which could prove deadly.
What I do contend is that it is effective for some types of depression in some circumstances. If you disagree with that, I'd love to hear it. I've got no qualms with this, as I said in my reply to your initial post.
I even did an APA style reference and everything. Hope you enjoyed it It really did make my day, thanks.
I presume you will agree that SSRI's are effective based on the "years of clinical trials," if you don't then please correct me. Again, I wasn't arguing for effectiveness of SSRI's vs SJW, I was arguing against your characterization of SJW as "safe as drinking water." When speaking of safety, in the case of SSRIs, which have been around for years, the side effect profiles and interaction profiles have been pretty much fleshed out. It seems they're finding new interactions and side effects for SJW every month, which is what you'd expect when you need to rely on anecdotal reporting with herbal products, as opposed to scientific trials with prescription meds (notwithstanding the limited trials with SJW). Now that's not saying SSRIs don't have interactions of their own (please don't ignore this part and reply with 600 drugs interacting with Prozac), but the fact that a patient needs to see a doctor and get Prozac at the pharmacy seriously diminishes the likelihood of toxicity. We do employ software which catches these interactions (as well as the one in my brain) but who's going to catch the potential problem when SJW walks out the door of GNC?
Incidentally, the other point I'm making is that the side-effect profile of SJW is lower than other antidepressants. If you disagree with that, I'd love to hear more about that too. I'd agree with you that for mild cases of depression, there are many people who could benefit from SJW. I never said otherwise -- you seemed to put those words in my mouth. There are indeed people with severe depression who need prescription medications, but a case could be made that SSRIs would not be first choices in those cases. But I digress. My point (if you haven't ascertained it already) is that for most patients, I'd recommend seeking the advice (and Rx, if warranted) of a physician and subsequent Rx antidepressant obtained from a pharmacy. This way, safety can be more adequately assured and treatment (however you may feel about Rx medications) can proceed without excessive concerns about overdosage, toxicity, or drug interactions. Unfettered access to dangerous substances is the crux here, rockondon. Not supposed effectiveness. Have a good one. "My own suspicion is that the Universe is not only queerer than we suppose, but queerer than we can suppose. J.B.S Haldane 1892-1964
|
|||||||||||||||||||||||||||||||||||||||
Granny Magda Member Posts: 2462 From: UK Joined: Member Rating: 4.1 |
Hi rockondon,
Let's try a little comparison; What you claim you're saying;
rockondon writes: I'm not saying that SJW is harmless, all I'm saying is that the side-effects of SJW is markedly less than more conventional antidepressants. What you actually said;
rockondon writes: St. John's Wort. It has a side effect profile similar to placebo. To put it another way, its about as harmful to you as drinking water. Now I hope you realise that those two statements are contradictory. If you want to be taken seriously, perhaps you might try googling before making silly claims, or admitting when you are wrong. There may indeed be a place for the use of SJW in treating depression, but if it is used outside of professional medical settings, in an unregulated environment, it is going to cause problems. Misinformation like that which you posted above only makes this situation much worse. Doctor and science journalist Ben Goldacre writes;
quote: Source; Mixing medicines – Bad Science If people are going to use herbal medicines, they need to be aware of the risks. Experience tells us that most will not make themselves aware of the risk, nor will the snake oil salesmen of the alt-med industry tell them of the risks. That is why I support legal controls on herbal medicine. Mutate and Survive
|
|||||||||||||||||||||||||||||||||||||||
Granny Magda Member Posts: 2462 From: UK Joined: Member Rating: 4.1 |
Hi CS,
Well, I don't drink much, so I can probably live with that... Here's one that jumped out at me though;
quote: Coumarin is an anti-coagulant chemical found in several herbs, such as vanilla grass and sweet woodruff. I occasionally pick woodruff from the wild and use it to sweeten apple juice - delicious! The coumarin is harmless in small quantities. Of course sweet woodruff is also used as a herbal medicine, available to buy online. One site thoughtfully gives this warning;
quote: Conventional medicines. Not herbals though. I guess that must be fine then. Wanna bet that no-one out there is taking both woodruff and St John's Wort? Mutate and Survive
|
|||||||||||||||||||||||||||||||||||||||
Theodoric Member Posts: 9202 From: Northwest, WI, USA Joined: Member Rating: 3.4 |
Another great site for researching alt medicine is Quackwatch.
Here is some info on St. John's Wort from there.
quote:Source Kind of hard to rely on this stuff doing anything with consistency of dose like that. Also, a rather large potential side effect risk for certain people. quote:Source Take herbals at your own risk. Facts don't lie or have an agenda. Facts are just facts
|
|||||||||||||||||||||||||||||||||||||||
Hyroglyphx Inactive Member |
Maybe I didn't summarize enough of Novella's comments. His basic point is that herbs are, in many cases, untested drugs of unknown safety and effectiveness that should be placed under the jurisdiction of the FDA. At one point he says, "Herbs...are typically marketed based upon tradition and anecdote with insufficient scientific evidence for safety or efficacy." There is truth to both. The whole "holistic" market is replete with alternatives to pharmaceuticals. We tend to forget that ancient people's used various forms of traditional medicines and alchemy in the past, but that we also falsely rely on them. As you stated, many are untested by the FDA or their international equivalents. The problem is that there is also a false sense of pharamceuticals too which often have side effects worse than the actual condition you want to treat. How many drugs are being pulled off the shelves and how many lawsuits are in effect because the product is dangerous? A lot. There is no discounting the good that comes from the too, but honestly I feel like it's a crap shoot. You just can't tell how your body and your chemistry is going to react to these meds. My wife was taking certain meds that were making her more sick, in the form of serious memory loss and a very serious case of akathisia. As soon as she was off those meds, she had made marked improvements. How ironic?! She took the meds to sedate her anxiousness and it made the condition ten times worse! I refuse to take drugs in most instances, unless I am very sick (which is very rare). I won't even take Alleve or Tylenol for headaches because all it does is dull your senses. It treats the symptom, not the cause of the problem. 9 out of 10 times, just drink more water. Your body is telling you are dehydrated. There are specific reasons why you get headaches, so treat the problem, not the symptom. "Political correctness is tyranny with manners." -- Charlton Heston
|
|||||||||||||||||||||||||||||||||||||||
Theodoric Member Posts: 9202 From: Northwest, WI, USA Joined: Member Rating: 3.4 |
I refuse to take drugs in most instances, unless I am very sick (which is very rare). I won't even take Alleve or Tylenol for headaches because all it does is dull your senses. It treats the symptom, not the cause of the problem. 9 out of 10 times, just drink more water. Your body is telling you are dehydrated. There are specific reasons why you get headaches, so treat the problem, not the symptom.
I agree wholeheartedly. If I have a hangover I drink lots of water(not that I have a LOT of hangovers). All a painkiller does is dull things. They don't cure anything. The same with cold medicines. By the time you notice you are sick your body is usually recovering. Cold medicines usually don't do anything. Studies on cold medicines have shown that a lot do not even relieve symptoms. People think they do because they start feeling better when they take them, but studies have shown that some of these have no effect at all.
quote:Source Facts don't lie or have an agenda. Facts are just facts
|
|||||||||||||||||||||||||||||||||||||||
New Cat's Eye Inactive Member |
I refuse to take drugs in most instances, unless I am very sick (which is very rare). I won't even take Alleve or Tylenol for headaches because all it does is dull your senses. It treats the symptom, not the cause of the problem. I'm like that too, but... They're good for things like allergies, where the problem is the symptoms. Also, for things like the flu, where your body naturally fights it off, its nice to dull the aches in the meantime while you wait. Or like a sprain, there's nothing you can do to treat the problem, all you have is treating the symptoms. So for some things I think they're useful.
|
|||||||||||||||||||||||||||||||||||||||
Hyroglyphx Inactive Member |
So for some things I think they're useful. I'm not saying they don't serve a purpose. Acetominephine is one of the more tried and true drugs out there, I am just giving you an alternative. Some people are reliant on drugs when they don't have to be. I know people addicted to meds and what is supposed to be treating them is actually the cause of their problems. I dated a girl in high school who was addicted to Afrin (a nasal decongestant). If you take the product more than 3 days, it actually causes your nasal cavities to clog up because it stops the bodies natural mucous system. There is also some concern that things like autism (which is dramatically increasing) is due to government mandated vaccinations. The claim is that "thimerosal," an additive in vaccines made from the compound, mercury, is the main cause. A court ruling recently determined that no significant link can be made. The debate is back and forth, I honestly can't say whether there is a link or not. One thing is for certain, it seems to me. Something in the environment or something we are ingesting is the cause, because there is no reason why there should be an increase as dramatic as it is unless it is something we are regularly in contact with. "Political correctness is tyranny with manners." -- Charlton Heston
|
|
|
Do Nothing Button
Copyright 2001-2023 by EvC Forum, All Rights Reserved
Version 4.2
Innovative software from Qwixotic © 2024