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Monday, May 18, 2015

Herbal Therapy What You Don't Know, Can Hurt You

By: MSF Staff and reviewed by the MSF Medical Advisory Board

Herbal medicine is nothing new. In fact, it's been around for tens of thousands of years. From 1820 to 1920, herbal medicine was particularly popular in the U.S. Then, in the mid-1920s, conventional medicine began to replace the herbal remedies of old.


"There has been a recent revival of interest in herbal medicine, and herbs are currently one of the most frequently used forms of CAM (complementary and alternative medicine)," writes Allen C. Bowling, M.D., Ph.D., in his book Alternative Medicine and Multiple Sclerosis. "The use of herbs by Americans nearly quadrupled between 1990 and 1997."


The most important difference between drugs and herbs is that the majority of drugs consist of a single chemical compound, but herbs consist of many different ones. Some may be beneficial, some may be harmful, and some have unknown effects on the human body.


This is because herbs have not been studied as extensively as drugs and it is still unknown which chemicals in herbs are the active ingredients. There is also a lot to be learned about the side effects of herbs and their interaction with conventional drugs.


"Herbs should be used with caution by people with MS. There are many herbs with no well-documented benefits that may potentially worsen MS or interact with MS medications. If a therapy is strong enough to produce beneficial effects, it usually is also strong enough to produce harmful effects," said Dr. Bowling.


This does not mean that herbs are off limits. What it does mean is that you need to be informed. Do some research, talk to your doctor and pharmacist, and weigh the risks and the benefits before using herbal medicine.


SYMPTOM INTERACTIONS

The medications often prescribed for those with MS, such as Baclofen®, Valium®, Klonopin® and Zanaflex®, can produce fatigue or other sedating side effects. So it is important to be aware of any herbs that could cause even more sedation. Some of the more common ones include chamomile, goldenseal, kava kava, St. John's wort, valerian, Siberian ginseng and Asian ginseng.

Some herbs may irritate the urinary tract or worsen the effects of a urinary tract infection. Frequent or high doses of these herbs may irritate the urinary tract even when no infection exists. Coffee is the leading culprit. Other herbs include cinnamon, eucalyptus, myrrh gum, and sassafras.


If you've experienced depression, you may be familiar with the older class of antidepressants known as tricyclic antidepressants. These include amitriptyline (Elavil®), nortriptyline (Pamelor®), and others. If you are taking one of the tricyclic antidepressants, St. John's wort, henbane, belladonna, mistletoe and scopolia should be avoided. If you are taking one of the newer antidepressants known as SSRIs, (Prozac®, Zoloft® or Paxil®) steer clear of St. John's wort as well. It may decrease the levels of these and other prescription medications in the bloodstream.


DRUG INTERACTIONS

Amantadine is frequently prescribed to treat fatigue. Sedation or confusion may result if amantadine is taken along with certain herbs. These include belladonna, pheasant's eye, scopolia or henbane.

Steroids are sometimes used to treat MS attacks. Therefore, it is important to be aware of those herbs that may worsen steroid side effects, such as increased blood sugar or decreased blood potassium. Other herbs may actually increase the potency of the steroids. The more common ones include Asian ginseng, ephedra (ma huang), senna and licorice.


Methotrexate, a chemotherapy drug, is sometimes used to treat MS. If combined with aspirin-like chemicals known as salicylates, adverse effects may occur. Certain herbs contain salicylates and should be avoided when taking methotrexate. These include meadowsweet, poplar, sweet birch, black cohosh, willow and wintergreen. Another herb, echinacea, may produce liver toxicity when combined with methotrexate.


Consumption of echinacea, popular for its long history of treating infections, may aggravate MS by stimulating the immune cells (macrophages and T cells) and impairing the activity of MS medications, such as the ABCR drugs. Regardless, echinacea is sometimes recommended for people with MS and continues to be used by a large number of people with the disease.


Many herbs, despite limited toxicity evaluations and significant toxic effects, are still available in the U.S. Some potentially dangerous herbs that are sometimes recommended for MS include borage seed oil, yohimbe, lobelia, chaparral and comfrey. These may produce high blood pressure, psychiatric problems, rapid heart rate, seizure, and other serious complications.



For more information, read Dr. Bowling's book, Alternative Medicine and Multiple Sclerosis. It is available through the MSF lending library. 





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