โ Scribed by Harpal S. Buttar; Kenneth L. Jones
No coin nor oath required. For personal study only.
Herbal remedies and alternate therapies have been used since time immemorial, and some useful modern medicines (digitalis, atropine, coumarin, morphine, caffeine, quinine, phytoestrogens, dietary supplements, etc.) have been derived from plants or botanicals. Even some substances of abuse (cocaine, nicotine, D-9-tetrahydrocannabinol, opium), and potent poisons (strychnine, ricin, physostigmine) come from plants. It has been recognized recently, however, that the multiple ingredients, often of unknown concentration, in herbal products may be associated with toxic effects such as immune suppression, allergies/asthma, endocrine disorders, loss of appetite, and some other undesirable effects. Major adverse events, including death, have been recorded in case reports and post-marketing surveillance when herbal and dietary products were used chronically alone or in combination with prescription medicines. Moreover, some herbal products and dietary supplements have been found not only adulterated with prescription medicines but are also inaccurately labeled that make false and misleading claims unsupported by scientific evidence. The promotion of herbal and alternate remedies in the lay press may give consumers a sense of security that simply may not exist. As a result, there is an increasing consumer expectation from the regulatory agencies for pre-market screening and post-market surveillance to provide assurance of herbal and dietary products quality, efficacy and safety, as is done with pharmaceutical products.
Traditionally, medicinal herbs are most often given orally. The multiple ingredients in herbs may modify the intestinal pH and motility, and inhibit or induce intestinal drug transporters (PgP) and major hepatic drug metabolizing enzyme (CYP 450 3A4), thereby altering the rate and extent of absorption, metabolism, and disposition of prescription drugs. Further, the additive, potentiative, or synergistic therapeutic interactions between herbal constituents and drugs may complicate the dosing regimen of long-term medications, or lead to undesirable side effects. Interactions between drug-herb or drug-food may be significantly important for drugs with narrow therapeutic margin (e.g., warfarin, digoxin, antiarrhythmics), and in organ transplant patients as well as in women using oral contraceptives.
Some reliable epidemiological surveys have shown that herbal products are used by approximately 70% of North Americans. They are widely used by sensitive
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