September 9, 2011

Buyers of Herbal Medicines – BEWARE! - P4

Then the final piece of the puzzle is governmental actions that make the picture grim for all concerned. And this is also the most puzzling part of the mistake picture. Government legislation is often passed to correct mistakes, but the agencies do not enforce what they have on the books and ignore some of the powers already granted to them. The FDA, USDA, and several other governmental agencies have neglected to due their due diligence in the area of herbal medicines.

The majority of herbal medicines and supplements are classified under the category of food and unless they advertise that it treats a disease or something that it does not, generally they are left alone until AMA decides they want to rattle cages and get the support of a few members of congress that decide to see if there is anything to actually be concerned about. Sometimes there is, but most of the time there is much posturing and nothing more. That is politics.

Occasionally an manufacturer will add something that is not permitted and not added to the list of ingredients, over add an ingredient and not change the percentage, or will get brave and decide to advertise something they should not and then the FDA steps in and does an investigation and often orders a recall, and assesses a fine. The only time FDA orders an herbal medication banned is when it is doing harm and has damaging health effects.

Most of the time everything works like it should and when this happens, the AMA is sure to step in to stir the pot and attempt to get congress to take some action.

While I do not always agree with the attempts by the AMA to shut the herbal manufacturers down and put them out of business, this is part of the checks and balances that have become part of our regulatory system. It just needs to be recognized for what it is.

Another mistake made by government is not testing random samples. The FDA does have this authority, but seldom uses it unless there is evidence of prohibited substances in a product.

Another area which may or may not be a mistake has to do with studies that could be done to determine when and if herbal supplements or medicines have any value for the average consumer and to what limit and at what dosage for different health problems. This could settle many arguments and be helpful to consumers.

September 8, 2011

Buyers of Herbal Medicines – BEWARE! - P3

This blog is about the errors committed by manufacturers of herbal medicines. Unless the manufacturers make major mistakes and get caught in the government web, you seldom hear about their mistakes. Getting caught by the government is often for serious mistakes and making advertising claims that brings them under scrutiny. Or they committed an error that has the American Medical Association up in arms. Some of these mistakes are unintentional and not serious, but the AMA feels it is in their best interest to put them on the hot seat.

Manufacturers make all kinds of stupid mistakes and some could be sabotage caused, greed, or putting ingredients into a supplement and not on the label. The last cause is their most common mistake and often the most serious. They want to have something that will do what it is not supposed to do and generally they get caught.

Herbal manufacturers are a different breed of manufacturers that often are looking for the one item that will make them have something that no one else has thought of and make them rich.

The one mistake that I believe all herbal medicine manufacturers make is not doing due diligence in guaranteeing the consistent formula manufacturing, guaranteeing consistent quality of product, and meeting some of the manufacturing standards they proclaim to follow.

They are constantly under attack by the AMA and a few other groups for the wrong reasons, but they have not consistently raised their manufacturing standards to follow a guide set forth by the Federal Drug Administration called the “Good Manufacturing Practices” standard. Even though many of the herbal manufacturing associations claim they are, consistently it is found that there are rogue manufacturers that violate these standards.

In this article by Jon Barron, he does make some valid points, but you need to get past a lot of rhetoric and almost hysteria to understand what he is saying. His mantra against the AMA is well based and valid, but he needs to leave the rhetoric out to be more convincing.

In the final blog in this series, I will look at the mistakes on the government side.

September 7, 2011

Buyers of Herbal Medicines – BEWARE! - P2

In this blog I will pull together some of the errors made by doctors in dealing with herbal medicines. Be aware that the American Medical Association has a public position against herbal medications and supplements and most doctors do follow this position.

This section is not meant as a diatribe against doctors, but to just list some of the reactions I have seen and had people tell me about how their doctors have reacted to their list of herbal medications or supplements. Doctors are aware of herbal medicines and supplements. It is their actions that determine how successful they are in dealing with these.

The first reaction I saw was total disinterest and a comment that I should not be taking any of them. When he got to vitamin D, I was told that I got enough of that from the sun and enriched foods. I was not aware that he had requested a test for this and when he showed me that the reading was 25 and more than enough to stop taking vitamin D, I almost believed him. I was fortunate to have been reading several medical blogs that felt that a reading of 25 was the lowest anyone should have and if they are that low they should be taking vitamin D supplements.

Another doctor just pooh-poohed the necessity of herbal supplements, or minerals and said that if I was eating the right foods they were totally unnecessary. In fact he basically warned me to stop. This reinforces what other people have told me about reactions their doctors have had to herbal medicines and supplements.

This comprises the largest mistake by doctors – totally ignoring or advocating against taking them at all. Most people do take some and many people take a lot of herbal supplements. Doctors need to recognize this if they want cooperation in the future from patients, they should just make note of these and if necessary ask about others that are not listed. Their reactions to patients taking herbal supplements will determine future problems that the patients may face. The patient may need to take precautions since the doctor is not willing consider or discuss anything herbal or berates the patient for using them. In these circumstances, I would suggest locating a different doctor.

One comment I have had from others points out a second mistake by doctors. This is just writing a prescription without reviewing the list or asking the patient if they were taking any of the herbal medicines that would react unfavorably with the prescription. In this case the patient had an excellent pharmacist that did ask and advised the patient correctly to stop taking the herbal supplement while on the prescription and explained what could happen if the patient did not stop.

Another mistake a friend had the doctor make was prescribing a supplement that was about 15 times more expensive than could be purchased over the counter in most stores and pharmacies. Again a pharmacist saved the day. These types of mistakes are commonly made by doctors that do not recognize herbal supplements and medicines.

My next blog will cover mistakes of manufacturers.

September 6, 2011

Buyers of Herbal Medicines – BEWARE! - P1

While I try to respect both sides on the debate about herbal medicines, there are some facts that cannot be escaped and must be discussed to enlighten the general public. Neither side is blameless and public safety still needs to be front and center. Most herbal medicines are in fact fairly safe – on the surface. It is when we get below all the hype and misinformation that we can sometimes see some real causes for concern and even sometimes find real dangers.

Most, but not all of the dangers arise from abuse and overuse of herbal medicines in situations where prescription medications are also taken at the same time as herbal medicines. Who is at fault? There is plenty to go around - physicians, herbal medicine manufacturers, and patients are all at blame. Much depends on the particular circumstances. Then the final piece of the puzzle is governmental actions that make the picture grim for all concerned.

Since I am a patient, I start where I have the most knowledge and experience. Patients as a whole do quite well with most herbal medicines and are not abusing them in most cases. Where most patients go wrong is not having a list of which ones they are taking and sharing this with their doctors. Most feel that since they are herbal and from nature that there is no reason to be concerned and their doctors do not need to know what they use.. This is the first mistake – and a huge one. Some herbal medications do react unfavorably with prescription medications and some can even cause death.

The second mistake some patients make is taking either too large a dose or too small of a dose. Of course, there are instructions on the packaging for the herbal medications, but they can sometimes be misleading as they are for the “average” patient and not necessarily for the patient taking them. This is when the doctor can be a valuable resource to discuss this with and the doctor may be able to do some tests to determine the appropriate dosage. Sometimes this will not be of help, but the patient has more to gain than lose.

The third mistake patients make is not researching the herbal medications they take. For many this involves just reading the paper that comes with the packaging. Then when these papers of instructions are not part of the packaging, patients need to make sure that they ask for information from the sellers, the manufacturers, and not take them until all questions have been answered.

The forth mistake patients are prone to make is not rechecking the information when prescriptions are added to the mix or when herbal treatments are added to the prescription mix. Both can have severe consequences when this is neglected.

The last mistake many patients make do have conflict potential and must be handled diplomatically or not – depending on how the doctor reacts to herbal medicines and supplements. The American Medical Association has an adverse policy to herbal medications and supplements. Some doctors have the same attitude while other doctors respect herbal medicines and the patients' right to use them.

In the next blog I will discuss mistakes by doctors. Please read the following article about some of the many problems patients often ignore and the dangers.

September 5, 2011

When Will Cardiologists Learn – Eliminate Wheat

I am happy that cardiologists are investigating alternative ways to lower blood pressure, but most are not considering the elimination of modern wheat from their patient's food. The good thing, and a big step in the right direction, is that they are investigating ways to help patients instead of automatically prescribing statins or other medications.

John Bisognano, M.D., PhD, and Kevin Woolf, M.D., a cardiology fellow at the University of Rochester Medical Center, conducted a comprehensive review of the evidence behind a wide range of non-prescription drug interventions for the treatment of high blood pressure. The review is featured in the September issue of the Journal of Clinical Hypertension.

One of the best statements made is this one – Quote Woolf said” “There is not enough data to recommend any of these alternative options on a routine basis, but on an individual basis he thinks they are useful. Patients have different backgrounds and different approaches to living their lives. This is where the art of medicine comes in; getting to know patients and what they will and will not embrace can help physicians identify different therapies that suit their patients' habits and that will hopefully make a difference for them." Unquote

If only more physicians would see this and do this to help their patients. If physicians got to know their patients and what they will or will not embrace, they just might learn how to become better physicians. While most cardiologists will not listen to the the ideas put forth by cardiologist Dr. William Davis, you should take time to read this blog (link now broken) and search his blogs for more information about high blood pressure, cholesterol, and blood glucose.

Dr. Davis has had some wonderful results in his efforts to reduce these and most revolve around the elimination of modern wheat from our diets. Dr. Davis has many blogs about wheat and what it does to our bodies. His book “Wheat Belly” is an excellent book and you should read an excellent review in this blog by Tom Naughton.

Read this article for the supplements, herbal medicines and other ways reviewed to improve high blood pressure.