A "Wort" to the Wise
Use caution when taking natural herbs and remedies

When it comes to herbs, plant extracts and other "alternative" medicines, many are called natural wonders – and the operative word in that sentence is: "wonder." Why? Because few clinical studies have been done to test the claims made about herbs and supplements. Consequently, physicians, pharmacists and other health care professionals warn consumers to be cautious about adding "natural medicines" to their traditional medication programs.

"Manufacturers of herbal dietary supplements don't have to meet the same rigorous FDA protocols that pharmaceutical manufacturers do," says Mary Lea Gora-Harper, Pharm.D., clinical pharmacist and director of the University of Kentucky Drug Information Center. "So the successes they claim are often based on anecdotal reports, not scientific data. That means we can't really say that herbs or vitamins don't influence a condition .... but we also can't say they do."

One of today's most popular "new natural therapies" is the use of St. John's Wort to alleviate depression and anxiety. Although used for centuries for various ailments, St. John's Wort – like all medications – can have negative as well as potentially positive effects.

"We don't know for certain that St. John's Wort has a measurable effect on patients who are clinically depressed," said Gora-Harper. "The clinical trials simply haven't been done. It's a plant and, consequently, is called 'natural.' But, remember: Just because it's extracted from a plant doesn't mean it's always safe."

Scientists speculate that St. John's Wort may work like prescription antidepressants, and may also possess activity similar to monoamine oxidase (MAO) inhibitors. If so, it's possible that St. John's Wort can produce the same side-effects of other MAO-inhibitor prescription medications, such as Parnate.

"That would mean that people taking St. John's Wort may have higher sensitivity to sunlight, and may have to stay away from certain tyramine-high foods when taking the medication," she said.

Tyramine is an amino acid found in various foods including wine, cheese, sausage, bologna, chocolate, smoked fish and caffeine. Normally, tyramine in the body is eliminated when it enters the gastrointestinal tract and the body's supply of MAO inactivates the tyramine. But, when an individual is taking an MAO-inhibitor such as Parnate – or possibly St. John's Wort – there could be a negative effect. In extreme cases, severe headaches, heart palpitations and dangerously heightened blood pressure can result.

Gora-Harper also recommends using only the specified dosages of herbal medicine and vitamins and suggests that consumers to talk to their physician or pharmacist before combining one herbal medicine with another. Mixing St. John's Wort and ginseng has been known, in some cases, to produce headaches, tremulousness and manic-like symptoms.

Healthcare professionals also worry that patients may discontinue their prescription medications in favor of alternative – often marketed as "natural" – therapies.

"Patients may stop taking their high-blood-pressure pills and just take garlic pills instead – thinking they are lowering their blood pressure naturally, " said Gora-Harper. "But, there's no real proof that garlic has any effect on blood pressure. What we do know, however, is that high doses can have an adverse effect on kidneys."

Some "natural" therapies can actually interfere with the prescription medications. For example, large doses of calcium can decrease the body's ability to effectively absorb certain antibiotics.

Gora-Harper emphasized that consumers should talk to their pharmacist or physician before taking any new medication. Patronizing one pharmacy allows a pharmacist to watch for potential duplication or drug interactions. But that doesn't guard against potential interactions between prescription and over-the-counter medications or "natural" therapies such as herbs, vitamins and other dietary supplements.

"The patient has to provide that information to the pharmacist. Then the pharmacist can advise the patient whether adding another medication is safe, she said.

Barbara Greider is former senior information specialist for the UK Chandler Medical Center Office of Public Affairs

Back to February Issue

Back to Healthy Lifestyle Index

Copyright 1996-98, by Kentucky Business Online, LLC.  All rights reserved.

Editorial content is copyright 1998, Lane Communications Group
All editorial materials is fully protected and must not be reproduced in any manner without prior permission. 

Buzzword and the Buzzword balloon are registered trademarks of Buzzword, Inc.  The Lane Report is a trademark of Lane Communications Group.  All other trademarks are the property of their respective owners.