The Problem of Herbs
No doctor would feel comfortable working with a half-missing medication list. But unfortunately, many health care professionals do not realize that pharmaceuticals only make up a part of each patient’s inner chemistry. Anything that is eaten, drunk, or inhaled can potentially affect a patient. And while doctors are usually pretty good at including tobacco use, diet, or life style in their decisions, perhaps they should also be taking a look at their patients’ gardens as well.
Herbal supplements are often ignored by modern medicine. Partly this is a historical precedent, but when physicians tackle the problem they find that actually categorizing and studying herbal compounds can be incredibly complicated. Each species or individual plant can have multiple names (for example St. John’s wort can also go by Tipton’s weed, chase-devil, and Hypericum) or, worse still, share names between plants. Furthermore, unlike the highly refined chemicals found in pharmaceuticals, natural compounds are often composed of hundreds or thousands of potentially affective chemicals, all of which can vary wildly in dose. For these reasons, many doctors do not even include these in a patient’s medication list, nor do they ask about them.
This is a mistake. Interactions between natural compounds and pharmaceuticals are likely to be much more common than any preliminary studies suggest. These interactions are not always bad, some may be beneficial, but they should be taken into account. Especially given that many supplements have been shown to affect blood clotting (ginkgo, saw palmetto), blood sugar (goldenseal, agave, stinging nettle), liver enzymes (red clover), and blood pressure (bloodroot, mistletoe, ephedra). Variations in any of these can have potentially serious effects or interactions with drug activity.
Many new studies are underway to study the chemical nature of these supplements and alternative medicines; furthermore, centralized indexing is making these results easily accessible to doctors and researchers. But this is slow going and, really, the best thing any doctor can do currently is simply talk to their patients. By encouraging an open dialogue and keeping these potential interactions in mind, doctors will be better able to advise and direct patient care.