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The Media Loves to Write About “Dangerous Chinese Herbs”

The Vancouver Sun recently wrote an article titled, “Chinese herbs mixed with medications can be hazardous.” Now, the article doesn’t really say that Chinese herbs themselves are dangerous. It discusses how patients (particularly those from China) often take Chinese herbs, but don’t tell their medical doctors about it. And the onus of blame for health risks from drug-herb interactions always lands on the herbs, not the pharmaceuticals.

Chinese herbs mixed with medications can be hazardous

Using traditional Chinese herbal remedies while also taking prescription medications can cause potentially life-threatening reactions. After a survey of Chinese immigrants in Vancouver found that many use traditional herbs and fail to disclose it to
 
Chinese herbs, drug-herb interactions, Vancouver Sun dangerous Chinese herbs
 

The Good Side of Awareness for Drug-Herb Interactions

A group of medical students is working with an emergency medical doctor at Vancouver General Hospital to provide a checklist of common Chinese herbs with a listing of the herbs’ actions. The intent is to provide the list to TCM practitioners, TCM herbalists, and TCM doctors to have them check the box next to any of the herbs they prescribe to each of their patients. The idea is that the patient would then provide this checklist to their MD.

I do agree that dangerous drug-herb interactions need to be avoided. 

I do agree that it’s important that patients notify their MDs about any herbs or supplements they are taking. And that they also tell their TCM health professional (and any other health providers) about medications they are taking.

I do agree that Chinese herbs can have powerful medicinal effects. This actually is refreshing to me to hear medical students and a VGH ER doc note the potent physiological actions of Chinese herbs. TCM offers effective medicinal results, and too often the conventional side questions the efficacy. This group of conventional health providers do not question that there are medicinal effects. Bravo! 

Should We Be Concerned About Dangerous Chinese Herbs?

But, is it really the Chinese herbs themselves that are the problem?

How herbs are being taken

Part of the problem is it that patients may take herbs improperly, taking the health advice of a friend or family member (or Dr. Google), rather than seek the help of a qualified TCM doctor or herbalist.

As a registered doctor of Traditional Chinese Medicine, I know that when we prescribe Chinese herbs, the herbs are almost never prescribed as a single herb. We gather a lot of information from our patients about their health conditions, their medications (we too learn about drug-herb interactions), their other supplements, and a long list of symptoms, life patterns, and medical history. We do this so that we can work to avoid side effects and negative interactions.

British Columbians are lucky. TCM is a regulated profession. TCM herbs are prescribed by health professionals who are registered, licensed, and insured. We are held accountable, just like MDs, nurses, physios, and other health professionals under the Health Professions Act. So, make sure the person who tells you to take your Chinese herbs is actually qualified to do so. Note that if you want Chinese herbs, check our regulatory body’s website and choose only those with Dr.TCM, R.TCM.P., or R.TCM.H. Registered acupuncturists (R.Ac.) are not qualified to prescribe Chinese herbs.

What about the pharmaceuticals?

How about the pharmaceutical medications themselves? Do they hold some responsibility, or is it a dysfunctional blaming relationship? “It’s not me, it’s you.”

For example, the blood thinning drug warfarin (that they mention in the Vancouver Sun article) does not play well with others. Many others. Including A.S.A. (e.g. Aspirin), ibuprofen (e.g. Advil), and acetominophen (e.g. Tylenol); thyroid medicine, some antibiotics, and some antidepressants; and even many foods, like grapefruit, avocado, large amounts of kale or other otherwise healthy dark leafy greens, and store-bought mayo, salad dressings, and margarine.

I’m not against the proper use of pharmaceutical medicine. I work in an integrative medicine clinic with MDs and an ND who prescribe them. My mother is a nurse practitioner. I will take an Advil or Tylenol if I am suffering pain and need quick relief. But, too many people are too over-medicated because it’s easy to do. Because MSP or extended health plans pay for the medications, but not our herbs, vitamins, and other supplements. Because of scary articles like this one in the Vancouver Sun.

Why aren’t patients telling their MDs about their herb use?

Then, of course, there’s the big question…why aren’t patients telling their MDs about the herbs, vitamins, and other supplements they are taking? This article provides an answer, “A survey her group conducted of more than 300 Chinese immigrants to Vancouver revealed many don’t disclose their use of such remedies because they feel they’ll be harshly judged.” 

That is a problem!

And it’s not just Chinese immigrants who feel that way. Many patients have told me that they take supplements or get treatments (like acupuncture, chiropractic, osteopathy, and more) despite the flak they take from their MDs. Some have learned to just shut it when it comes to that discussion. Easier not to have to argue. Or justify. Or try to explain how it’s actually working for them. 

So, will my taking the time to print, fill out, and hand that checklist to each patient who receives Chinese herbs from me help?

Maybe a bit. Maybe it will open up some much needed dialogue between health professions so we can work better together. *I’m lucky because I work in an integrative medical clinic alongside MDs who are open-minded and who practice functional medicine–which really actually uses TCM foundational principles.

But, if only 1% of the herbal formula I make for someone is licorice root, will the MD still have them stop their herbs if they are taking warfarin? 

And, above all, if patients feel they can’t discuss their health choices with their MDs, will they even hand that list to their MD? 

 

http://www.webmd.com/drugs/2/drug-3949/warfarin+oral/details/list-interaction-medication 
http://www.ihtc.org/patient/blood-disorders/clotting-disorders/coumadin-interactions-with-food/ 

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TCM is a New Medicine!

Yes, Traditional Chinese Medicine has been around for 3000-5000 years. Yes, it is the oldest continuously practiced medicine in current practice. Yes, other medicine like Aryuvedic and other native medicinal practices also have long historical records of practice.

But, the “new” medicine, the current buzz word in conventional medicine, is “Functional Medicine”. What is functional medicine?

  • It addresses the underlying cause of disease
  • It focuses on the patient instead of the disease
  • It addresses the whole person–body, mind, and spirit
  • Practitioners spend more time with their patients to gather information on a variety of levels
  • Practitioners create an individualized treatment plan for each patient

Hmmmm…that’s what TCM does. We have always done that. But conventional medicine has relatively recently identified this “new” way of practicing medicine!

It kind of reminds me of this quote:

2001 BC Here, eat this root.

1000 AD That root is heathen. Here, say this prayer.

1850 AD That prayer is superstition. Here, drink this potion.

1920 AD That potion is snake oil. Here, swallow this pill.

1945 AD That pill is ineffective. Here, take this penicillin.

1955 AD Oops… bugs mutated. Here, take this tetracycline.

1960-1999 AD 39 more “oops”… Here, take this more powerful antibiotic.

2000 AD The bugs have won! Here, eat this root.

I love it! 🙂

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More from Dr. Frank Lipman (MD)

Written by an MD, this newsletter that I have just subscribed to puts conventional medicine in perspective. This is a cut and paste of the last e-newsletter I received. You can check it out yourself by googling his name and signing up for it yourself. Of course, I’ll probably post more from him if it keeps of interest to me.

Changing our Disease care system to a Health care system

Although we call our system a health care system, it is actually a disease care system. Doctors are trained to treat disease, not to keep people healthy. Our two primary tools as Doctors of Modern Western Medicine are drugs and surgery. We have no tools to keep people healthy.

We are not trained in nutrition or other lifestyle modalities that keep people healthy, nor other medical systems that have been helping other cultures for centuries. At medical schools, we doctors are taught to treat the symptoms of disease, rather than how to create health and prevent people from getting sick. For example, in our entire training as doctors, we receive very few lectures on nutrition, even though diet is fundamental to good health.

I am not saying there is no place for this disease care model in the new model of medicine I am proposing. I am the first to acknowledge that Modern Western Medicine and science have made phenomenal advances and alleviate much pain and suffering. Surgery is often lifesaving and many new surgical techniques are quite remarkable. Trauma treatment, burn treatment, emergency room management and the management of acute medical and surgical emergencies are incredible. And certain drugs when used appropriately are life saving. We are blessed to have all this as part of our arsenal and we need Modern Western Medicine for all this. I would not encourage someone to see a herbalist or Acupuncturist for any of the above.

But this medical model is not adequately addressing almost 75% of the problems that most people go to their Doctor for, including most chronic problems. It has failed miserably to address the majority of problems people have today and because of this, many people suffer unnecessarily.

Apart from antibiotics where the drug can kill the bug causing the problem, most drugs treat symptoms, not the cause. Similarly with surgery, it usually addresses the symptoms, not the cause. For instance, bypass surgery, (which can be lifesaving!!!), does not address the underlying reason why your arteries are getting blocked in the first place.

And with both drugs and surgery, there are often side effects, which are then addressed with more drugs. Many patients end up on multiple drugs and often it is only the first 1 or 2 which were given for the original problem. The other 5-10 are dealing with the side effects of the original 2 drugs or the interactions of the other drugs.

The tragedy is that for many of these problems, changing lifestyle, behavior, diet and taking some supplements can often deal with the underlying processes causing the problems and no drugs (and therefore side effects) would be necessary. Unfortunately, it does not suit the drug industry to have patients take a drug which cures or eliminates the problem. It is much more lucrative for them if the drug can manage the symptoms, so you have to stay on them for life (eg statins, anti- hypertensives etc)

Modern Western Medicine is a disease care system, it is not preventive nor does it teach patients how to stay well. In fact what we call Preventive Medicine in Modern Western Medicine…Pap Smears, Breast exams, certain blood tests etc are really early detection medicine. They are not teaching patients how to stay healthy.

So the best medicine is using Modern Western Medicine for what it is good at….crisis care medicine, acute medical and surgical emergencies, when you break a bone, when you are acutely ill etc, and using diet, supplements, exercise, stress management and other benign modalities for prevention and initially for most non acute problems.

In this new model of medicine I am talking about or in a true health care system, we look for the underlying imbalances or dysfunctions and the root causes of the problem (to be discussed in a future “pearl”). We are not content with waiting for disease to occur nor with just suppressing symptoms.

One Love,

Frank

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