Homeopathy touted, herb-drug interactions warned against

Homeopathy has some new research behind it for pain management.

Specifically, homeopathy is extolled in new research:

A recent German medical study showed the use of a homeopathic remedy to be as effective as a prescription medication for post-surgical foot pain and discomfort.

Homeopathy is one of the most common medical systems worldwide.

It is based on the idea that a person who is sick can be treated with a vanishingly small concentration of a substance (remedy) that at higher concentrations would cause similar symptoms of illness in a healthy person.

In homeopathy, the more dilute the remedy, the stronger the action. This is in stark contrast to traditional medicine where the higher concentration of drug, the stronger the action.

Homeopathy does not lend itself well to the usual research format since remedies are tailor-made for each patient and can change as the patient's condition changes. For example, the initial remedy that a person might take for high blood pressure could change over time as the blood pressure improves. In traditional medicine, the patient may stay on a specific medical regimen, possibly for life.

As a result, few clinical trials comparing homeopathic remedies to commonly used medications have been done. However, the recent German study was a well-designed clinical trial, and the results were published in the peer-reviewed Journal of Alternative in Complementary Medicine.

Under the heading, Complementary and Alternative Medicine and Multiple Sclerosis, a CD is being advertised, entitled: The Mindful Brain: The Neurobiology of Well-being.

Someone warns to watch out for adverse herb-drug interactions:

As I have become more involved in using functional nutritional therapy in my practice, I have come to realize that many people are still confused about the safety and effectiveness of various dietary supplements. Because these products are "natural", many feel they are always safe to use. Although supplements and herbs can be safer than pharmaceutical drugs, they can still function as drugs in the body and should be used with caution and respect.

It is estimated that over 80% of the world's population and 60 million Americans use some form of complementary and alternative medicine (CAM). However, although many believe CAM compliments their current traditional healthcare, most do not inform their physicians that they are taking these products. And, many providers don't ask or discuss CAM use with their patients, although one survey of 181 cardiologists found that half of them took antioxidant vitamins, themselves.

What many people don't realize is that there is no regulatory agency in charge of the supplement industry. Herbal products are not tested for purity, effectiveness and safety as drugs are. In 1994, the Dietary Supplement Health and Education Act (DSHEA) was enacted that requires the FDA to prove beyond any doubt that a supplement is unsafe before removing it from the market. Other than regulating what can be included on the label, they are unable to enforce any other regulation.

There is no incentive for supplement companies to conduct research because they are unable to patent 'natural' products. Those marketing herbs and other supplements save millions of dollars not spent on research, or worse, yet, conduct their own "research", which often does not include rigorous controls. Although there are many excellent and reputable supplement companies on the market, the typical consumer is unlikely to know who the credible ones are. Many independent sales representatives only know what the company tells them, and are as unaware as the consumer.

Even if the supplements are pure and not harmful by themselves, problems arise when combined with drugs. Dietary supplements may compete with drugs, leading to toxicity or treatment failure of that drug. An estimated 4 million people are at risk for herbal-prescription drug interactions.

Here are some of the most problematic and common herb-drug problems:

* Warfarin (Coumadin) is used to prevent blood clotting for those at risk for deep vein thrombosis, stroke, or heart attack. Supplements that can change bleeding time controlled by this drug include flaxseed oil and fish oil supplements, goldenseal, saw palmetto, feverfew, garlic, ginseng, and willow bark, just to name a few.

* Digoxin is another heart medication. Ginseng has been noted to falsely elevate blood digoxin levels. Some herbs that will affect drug effectiveness include senna, licorice, aloe, cascara, hawthorne, foxglove, goldenseal and guar gum.

* Phenytoin is a drug used for seizures. Herbal interactions to be aware of include ginkgo biloba, white willow, lemon balm, skull cap, kava kava, and valerian root, to name a few. It is also important to know that Folate supplementation is necessary with Phenytoin, but excess Folate can be harmful.

* It's important to take calcium supplements and vitamin D two hours apart from taking either Phenytoin or Digoxin in order to not interfere with these drug's effects.

Every physician should screen patients during the intake regarding use of herbal supplements, and be alert for potential herb-drug interactions. This makes good clinical sense these days, as well as malpractice liability risk management.