Register | Sign In


Understanding through Discussion


EvC Forum active members: 65 (9162 total)
1 online now:
Newest Member: popoi
Post Volume: Total: 915,817 Year: 3,074/9,624 Month: 919/1,588 Week: 102/223 Day: 0/13 Hour: 0/0


Thread  Details

Email This Thread
Newer Topic | Older Topic
  
Author Topic:   Safety and Effectiveness of Herbs and Pharmaceuticals
Percy
Member
Posts: 22392
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.3


Message 1 of 209 (445477)
01-02-2008 3:45 PM


Steven Novella of The Skeptics Guide to the Universe also maintains a blog called NeuroLogica Blog that combines his interest in science and skepticism with his background in medicine (he's a practicing neurologist on the faculty at Yale).
His January 2nd entry is titled The Plant vs Pharmaceutical False Dichotomy, and it touches on an issue we debated a couple months ago about the error of stressing "natural" over safety and effectiveness.
Novella defines a drug as any "any chemical or combination of chemicals that has biological activity within the body above and beyond their purely nutritional value." By this definition an herb is a drug, and it is my position that the only measures that matter regarding drugs like herbs and pharmaceuticals are demonstrated safety and effectiveness.
[forum=-11] is probably the best destination.
--Percy

Replies to this message:
 Message 3 by Sonne, posted 01-02-2008 6:49 PM Percy has seen this message but not replied
 Message 4 by Granny Magda, posted 01-03-2008 7:13 PM Percy has seen this message but not replied
 Message 74 by rockondon, posted 04-06-2010 9:46 PM Percy has seen this message but not replied
 Message 111 by Buzsaw, posted 04-10-2010 9:13 AM Percy has seen this message but not replied

  
AdminNWR
Inactive Member


Message 2 of 209 (445497)
01-02-2008 4:48 PM


Thread moved here from the Proposed New Topics forum.

  
Sonne
Member (Idle past 5930 days)
Posts: 58
Joined: 05-20-2006


Message 3 of 209 (445529)
01-02-2008 6:49 PM
Reply to: Message 1 by Percy
01-02-2008 3:45 PM


Hi Percy,
By this definition an herb is a drug, and it is my position that the only measures that matter regarding drugs like herbs and pharmaceuticals are demonstrated safety and effectiveness.
I was involved in the alternative medicine field a few years ago and worked closely with a traditional Chinese herbalist. The herbs were deemed "natural drugs", so therefore effective and safe. The demonstrated safety and effectiveness was evidenced by "thousands of years" of successes, and supported by case studies, testimonials (we had a wall in the clinic dedicated to them), etc.
If the herbs didn't have the desired effect an explanation is found somewhere - such as the patient indulged in the wrong kind of food, had a stressful week, etc. The herb/treatment is not at fault.
Also, some herbs were contra-indicated for pregnancy, migraines, etc. I believed this demonstrated that the herbs had been tested.
If you haven't learned how to think critically - especially how to evaluate evidence - then it all seems perfectly plausible and believable. This is the root of the problem, I think.
Our governments need to regulate these industries. Until then the safety and effectiveness of herbs will continue to be evidenced by testimony and anecdotes.

This message is a reply to:
 Message 1 by Percy, posted 01-02-2008 3:45 PM Percy has seen this message but not replied

  
Granny Magda
Member
Posts: 2462
From: UK
Joined: 11-12-2007
Member Rating: 4.0


Message 4 of 209 (445750)
01-03-2008 7:13 PM
Reply to: Message 1 by Percy
01-02-2008 3:45 PM


Hi Percy,
Hi Percy,
This issue is one that regularly has me spitting blood. "Natural" has become a synonym for good and it is a particular shibboleth of the alternative medicine crowd, but its influence is becoming increasingly widespread. "Natural" has become the advertiser's favourite buzz-word.
Highly processed breakfast cereals are described as "natural", just because they have a few freeze-dried strawberries thrown in. In my experience, wild strawberries are quite a bit smaller than the ones in the cereal packet, and they don't come freeze-dried.
It is in the field of "alternative medicine" however, where this fallacy is most prevalent and most dangerous. People see natural remedies as being innately safer, better and well, just friendlier, but this is just not true. A prime example is that of aspirin. The salicylic acid upon which aspirin is based, has been used for centuries, in the form of willow bark, a natural source of the chemical. The problem is, that if you take enough nice, eco-friendly, hippy-dippy, natural willow bark, the acid will cause gastrointestinal upsets, and strip out half the lining of your stomach. With that nasty old pharmaceutical aspirin however, this effect is greatly reduced, plus it comes in a handy pill form, instead of some disgusting tea-bark brew.
I've even heard people decide what recreational drugs to take based on this kind of thinking. I once overheard someone at a party saying that he disapproved of LSD, but liked magic mushrooms, because "they're natural". He was immediately rounded upon by another party-goer and myself, both lecturing him on the flaws in this idea. Neither substance can really be considered "safe", and nasty synthetic LSD doesn't present you with the very real risk of mistakenly eating a poisonous (but natural) mushroom of some other species.
Natural=good is idiotic rubbish. Hemlock, herpes and haemophilia are all natural, and I would argue that they are all bad (I know, I like to court controversy). Cameras, computers and cakes are all artificial, and yet I think that they are all quite good.
Remember, laughter is the best medicine. Unless you've got syphilis, in which case it's penicillin.

Mutate and Survive

This message is a reply to:
 Message 1 by Percy, posted 01-02-2008 3:45 PM Percy has seen this message but not replied

  
Percy
Member
Posts: 22392
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.3


Message 5 of 209 (445872)
01-04-2008 8:28 AM


Well, there isn't going to be much discussion if no one from the other side of the issue joins this thread. LindaLou and PurpleDawn are both advocates of natural products and naturopaths, and they participated in a couple threads on closely related issues a while back, but no sign of them here yet.
Steven Novella just posted a followup to his The Plant vs Pharmaceutical False Dichotomy entry, here's the link: More On Herbs and Drugs. This is an even more excellent read than the first one, because he goes into detail about what constitutes valid evidence for safety and effectiveness.
--Percy

Replies to this message:
 Message 6 by purpledawn, posted 01-04-2008 2:02 PM Percy has replied

  
purpledawn
Member (Idle past 3457 days)
Posts: 4453
From: Indiana
Joined: 04-25-2004


Message 6 of 209 (445932)
01-04-2008 2:02 PM
Reply to: Message 5 by Percy
01-04-2008 8:28 AM


Well Lumpy,
You haven't actually said anything to debate.

This message is a reply to:
 Message 5 by Percy, posted 01-04-2008 8:28 AM Percy has replied

Replies to this message:
 Message 7 by Percy, posted 01-04-2008 2:30 PM purpledawn has replied

  
Percy
Member
Posts: 22392
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.3


Message 7 of 209 (445942)
01-04-2008 2:30 PM
Reply to: Message 6 by purpledawn
01-04-2008 2:02 PM


purpledawn writes:
You haven't actually said anything to debate.
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."
--Percy

This message is a reply to:
 Message 6 by purpledawn, posted 01-04-2008 2:02 PM purpledawn has replied

Replies to this message:
 Message 8 by purpledawn, posted 01-04-2008 6:21 PM Percy has replied
 Message 9 by Taqless, posted 01-04-2008 6:58 PM Percy has replied
 Message 87 by Hyroglyphx, posted 04-09-2010 9:33 AM Percy has seen this message but not replied

  
purpledawn
Member (Idle past 3457 days)
Posts: 4453
From: Indiana
Joined: 04-25-2004


Message 8 of 209 (446042)
01-04-2008 6:21 PM
Reply to: Message 7 by Percy
01-04-2008 2:30 PM


So why do you feel I would take issue with that position?

This message is a reply to:
 Message 7 by Percy, posted 01-04-2008 2:30 PM Percy has replied

Replies to this message:
 Message 11 by Percy, posted 01-05-2008 10:11 AM purpledawn has replied

  
Taqless
Member (Idle past 5914 days)
Posts: 285
From: AZ
Joined: 12-18-2003


Message 9 of 209 (446047)
01-04-2008 6:58 PM
Reply to: Message 7 by Percy
01-04-2008 2:30 PM


I'll try the opposing position
Hi Percy,
First, Novella's "any chemical or combination of chemicals that has biological activity within the body above and beyond their purely nutritional value." would imply that all chemicals have a nutritional value....I do not think this is true, or I'll grant it might be a semantic issue.
"Herbs...are typically marketed based upon tradition and anecdote with insufficient scientific evidence for safety or efficacy."
1) I find the first part of the statement funny in that tradition and anecdotes are how medicine and pharmacy as professions came to be. In fact, simply because the FDA comes along and stamps an approval on a drug does not make our "tradition" of drug prescription better. Imo, some of the language used by Novella, such as "tradition" and "anecdotes" appears to be used to conjure up ideas of less civilized times....like shamans, etc.
2) Safety and efficacy of drugs introduced by pharmaceutical companies are determined by administering the drug to a group of people and seeing what happens. This has already been done for the naturalist (arguably minus the control population) and is somehow seen as non-scientific because for some herbs it was done LONG before the FDA was in existence?
Given the above considerations I see no need to add herbal remedies to the FDA's jurisdiction.
disclaimer: I have not read Novella's blog.

Probable impossibilities are to be preferred to improbable possibilities.-Aristotle

This message is a reply to:
 Message 7 by Percy, posted 01-04-2008 2:30 PM Percy has replied

Replies to this message:
 Message 10 by Percy, posted 01-04-2008 7:35 PM Taqless has replied
 Message 16 by Granny Magda, posted 01-05-2008 6:41 PM Taqless has replied

  
Percy
Member
Posts: 22392
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.3


Message 10 of 209 (446053)
01-04-2008 7:35 PM
Reply to: Message 9 by Taqless
01-04-2008 6:58 PM


Re: I'll try the opposing position
Tagless writes:
First, Novella's "any chemical or combination of chemicals that has biological activity within the body above and beyond their purely nutritional value." would imply that all chemicals have a nutritional value....I do not think this is true, or I'll grant it might be a semantic issue.
Probably a semantic issue, since I'm sure he didn't intend to imply that all chemicals have nutritional value. Would it read differently to you had he said, "any chemical or combination of chemicals that has biological activity within the body above and beyond *any* purely nutritional value."
1)...In fact, simply because the FDA comes along and stamps an approval on a drug does not make our "tradition" of drug prescription better.
Actually, Novella *is* making the point that an FDA stamp of approval is superior to tradition and anecdotal evidence, because it means the drug has gone through clinical trials that can ferret out a host of effects and relationships.
2) Safety and efficacy of drugs introduced by pharmaceutical companies are determined by administering the drug to a group of people and seeing what happens. This has already been done for the naturalist (arguably minus the control population) and is somehow seen as non-scientific because for some herbs it was done LONG before the FDA was in existence?
There's complete agreement that many herbs have been in use for a long, long time. And perhaps you're already aware that many pharmaceuticals developed from studying plants. But while many herbs have a long history of use, what they don't have is any history of systematic data gathering in clinical settings. Anecdotal data gathering is almost always absent even the basics of such measures as blood pressure, temperature, blood analysis and weight tracking, just to mention a few. And since there's no data gathering, there's also no data analysis.
The negative effects of a drug like Vioxx, which only became evident when the number of users went from hundreds in the clinical trials to millions after release, would be impossible for tradition and anecdote to ever detect. That the negative effects of smoking took so long to demonstrate scientifically also demonstrates the difficulty of detecting long-term effects, and if not for the contributions of science we still wouldn't be aware of the dangers of cigarette smoking. And of course the dangers of ephedra, in use for 5000 years in China, only became evident after use skyrocketed in the United States. A 2005 study (The severity of toxic reactions to ephedra: comparisons to other botanical products and national trends from 1993-2002) reported:
2005 Ephedra Study writes:
CONCLUSION: Ephedra-containing botanical products accounted for a significant number of toxic exposures with severe medical outcomes reported to poison centers. Hazard rate analysis suggests poison center-reported events involving ephedra-containing botanical products were much more likely to result in severe medical outcomes than those involving nonephedra-containing botanical products. These data support recommendations by policymakers that the sale of ephedra should be prohibited to protect consumers. Our data suggest that the botanical product, yohimbe, may also be associated with unacceptably high risks of toxicity and should receive close scrutiny from health policymakers.
But 5000 years of use in China didn't reveal these problems.
--Percy

This message is a reply to:
 Message 9 by Taqless, posted 01-04-2008 6:58 PM Taqless has replied

Replies to this message:
 Message 17 by purpledawn, posted 01-07-2008 7:25 AM Percy has seen this message but not replied
 Message 19 by Taqless, posted 01-07-2008 11:08 AM Percy has seen this message but not replied

  
Percy
Member
Posts: 22392
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.3


Message 11 of 209 (446220)
01-05-2008 10:11 AM
Reply to: Message 8 by purpledawn
01-04-2008 6:21 PM


purpledawn writes:
So why do you feel I would take issue with that position?
Because you believe clinical studies of pharmaceuticals are tainted by sources of funding and that anecdotal data is not only every bit their equal but even superior because of the absence of bias. Further, we know you have little confidence in clinical studies or in traditional medicine in general because you've frequently made statements like this from Message 24 in thread Misunderstanding Empiricism:
purpledawn writes:
I've lived long enough to know that experts can be right within the limits of the information available to them. I also know that scientists can be wrong, peers can be wrong, doctors can be wrong. Experts can be wrong. I also know that some discoveries that change the way we do things today were not considered viable by their peers.
Given this position that you've advocated in past discussions, it seems reasonable to conclude that you would be unlikely to agree that the safety and effectiveness of herbs hasn't already been established.
--Percy

This message is a reply to:
 Message 8 by purpledawn, posted 01-04-2008 6:21 PM purpledawn has replied

Replies to this message:
 Message 12 by purpledawn, posted 01-05-2008 1:53 PM Percy has replied

  
purpledawn
Member (Idle past 3457 days)
Posts: 4453
From: Indiana
Joined: 04-25-2004


Message 12 of 209 (446260)
01-05-2008 1:53 PM
Reply to: Message 11 by Percy
01-05-2008 10:11 AM


Lumpy,
I try to look at each thread as a new beginning. No mistakes, no misconceptions, etc.
I'd appreciate it if you'd let me assume my own position in a thread.
You don't seem to understand me very well concerning this issue.
Please keep that in mind should I decide to participate.
Thanks

This message is a reply to:
 Message 11 by Percy, posted 01-05-2008 10:11 AM Percy has replied

Replies to this message:
 Message 13 by Percy, posted 01-05-2008 4:57 PM purpledawn has replied
 Message 38 by nator, posted 01-08-2008 7:45 PM purpledawn has not replied

  
Percy
Member
Posts: 22392
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.3


Message 13 of 209 (446322)
01-05-2008 4:57 PM
Reply to: Message 12 by purpledawn
01-05-2008 1:53 PM


Should you decide to participate, please keep in mind that any dissembling will not be ignored.
--Percy

This message is a reply to:
 Message 12 by purpledawn, posted 01-05-2008 1:53 PM purpledawn has replied

Replies to this message:
 Message 14 by purpledawn, posted 01-05-2008 5:05 PM Percy has replied

  
purpledawn
Member (Idle past 3457 days)
Posts: 4453
From: Indiana
Joined: 04-25-2004


Message 14 of 209 (446323)
01-05-2008 5:05 PM
Reply to: Message 13 by Percy
01-05-2008 4:57 PM


Should I participate, make sure you aren't the one creating the false front.
I only have to stay true to the position I present as mine.

This message is a reply to:
 Message 13 by Percy, posted 01-05-2008 4:57 PM Percy has replied

Replies to this message:
 Message 15 by Percy, posted 01-05-2008 5:19 PM purpledawn has seen this message but not replied

  
Percy
Member
Posts: 22392
From: New Hampshire
Joined: 12-23-2000
Member Rating: 5.3


Message 15 of 209 (446326)
01-05-2008 5:19 PM
Reply to: Message 14 by purpledawn
01-05-2008 5:05 PM


You've already posted four times to the topic and have yet to actually say anything about it. You asked why I thought you might have a different opinion from mine, and I explained why, including a quote from you.
If you'd like to actually participate in the thread, then please begin participating.
If you're instead only interested in making content-free "no you're wrong" assertions, then please just go away.
--Percy

This message is a reply to:
 Message 14 by purpledawn, posted 01-05-2008 5:05 PM purpledawn has seen this message but not replied

  
Newer Topic | Older Topic
Jump to:


Copyright 2001-2023 by EvC Forum, All Rights Reserved

™ Version 4.2
Innovative software from Qwixotic © 2024