Hold the Herbals?

By John F. Lauerman / September / October 2000
October 29th, 2007
With 40 percent of Americans embracing alternative medicine, and many more unaware they’re taking alternative-medicine products, researchers are not only taking notice — they’re becoming concerned.

“There are patients of mine walking down the aisle at the grocery store who say, ‘Oh, this vitamin is for energy,’ and unknowingly buy a supplement containing ginseng,” says School of Medicine neuropsychiatrist Curt LaFrance.

In the spring issue of the Journal of Neuropsychiatry and Clinical Neurosciences, LaFrance and a group of researchers from the American Neuropsychiatric Association conclude that far too little is known about the side effects of many of these products and how they interact with one another and with traditional medications. The group based its findings on a review of the published data on alternative medicines.

Since the National Institutes of Health began collecting information on herbal alternatives and supplements eight years ago, unexpected health problems have begun cropping up. For example, the LaFrance review points out that St. John’s Wort, an herb widely used an antidepressant, may interfere with the activity of such prescribed drugs as the protease inhibitor indinavir, which is used to treat HIV infection. The herb also may interfere with immune suppressants used in organ transplants. According to a report published this year in Lancet, St. John’s Wort has been implicated in at least two heart transplant rejections.

Similarly, high doses of several herbs, including ginkgo biloba (used for dementia) and garlic (used for lowering high cholesterol), have been associated with abnormal bleeding in the brain. Taking more than three grams per day of ginseng root has been associated with nervousness, hypertension, sleeplessness, diarrhea, and skin rashes.

If patients don’t know what they’re getting into when they take alternative medications, their doctors should, LaFrance says. Physicians must be increasingly on the alert, especially when patients report unexpected side effects from prescribed medication. “People will come to the office and say, ‘I’ve had a little trouble sleeping since I started taking this medicine you prescribed,’ ” he explains. Too often, he adds, patients “don’t consider the herbs they are taking to be medicine.”

LaFrance believes the widespread use of alternative medicines raises the urgency of conducting more research on their effects. “This lack of knowledge,” he says, “impacts people’s health.”

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September / October 2000