All Posts tagged drug-herb interactions

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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