Herbal Medicine

[juliejjulie]

Is everyone aware that the government are about to ban the sale of herbal medicines without a prescription?
This means that you may not even be able to buy a tube of arnica cream or even nettle tea. Please take a look at www.pranapositive.com/shm/ for more information and sign the petition. Many thanks.

I'm all for herbal medicine, if someone finds it helpful then that is great and I wouldn't want them to be stopped from using it. However a bit more regulation would be good. Not all herbal remedies are without their side effects or interations. All ok for those who know their stuff and can interpret info to know the pros and cons but not everyone can/will do that for themselves and some need a bit of guidance. The shops selling herbal stuff that I have gone into in the past it appears the staff have had little/no training about the products and cannot offer any advice. Also many products don't have enough info on the pack.

I don't know the answer but it might be good if it was something a bit similar to in a pharmacy when you ask over the counter about a product and they can tell you about it and advise you about how it might interact (or not) with other medicines and pregnancy etc.

Discussion paper 2006:

"The MHRA is aware that in a number of traditions, notably traditional Chinese and Ayurvedic medicine ? but also western herbalism - significant use is made of herbal medicines commissioned by the herbal practitioner from a 3rd party. Some of these medicines are of a nature and complexity such that it would not be realistic for a practitioner to manufacture them him/herself. In principle the MHRA would wish to accommodate this practice by registered practitioners within an updated regime, providing important requirements are met."

www.mhra.gov.uk/home/groups/es-herbal/documents/websiteresources/con2024908.pdf

After the practitioner has done whatever they want to individualise the treatment, half of them get an inert substitute.

You certainly could test whether herbalists were prescribing well that way, but you couldn't do a big drug-style trial. What looks 'all the same symptom' to an allopathic medicine doesn't look the same to a herbalist. You are not comparing like with like.

Again though, if you don't want to use this stuff don't use it. I want to, lots of people want to. Maybe they'll work out good testing methods ultimately or ways to bend the prescribing systems that will allow for bigger samples.

My question is, why should I wait around for that to happen?

...for the safety of the population, presumably.

I can't find the link on the MHRA site this evening (I'm sure it's there somewhere; I'm tired), but this is from Ayurveda UK

"The MHRA (UK Medicines and Healthcare Products Regulatory Agency) have declared their intention to implement the Directive in a sensitive manner - interpreting it to allow the continuance of systems such as Traditional Chinese Medicine and Ayurveda. "
www.ayurvedauk.com/regulation.htm

Yes, you could do a big style drug trial. Get 5000 people to see a herbalist, then give 2500 placebo treatment of whatever the herbalist prescribes. Stratify for confounding factors, crunch the numbers, and compare Group A with Group B to see if there's any statistically significant difference in self reported or objectively quantified symptoms.

You could very easily test a remedy for a condition.

If a remedy is used for more than one condition, then that would require more trials.

And this protocol is used all the time for herbal remedies.

It is simply false that herbal medicine is un-testable.

As to why a product should only go on sale once it has demonstrated safety and efficacy, it's generally considered unethical to sell it and certainly I'd have trouble with any practitioner recommending therapies that they don't know are effective.

I don't think that increases patient choice.
It skews it through deception.

LCPO thanks for the info...

Trial: that wouldn't tell you what a drug trial tells you. It would tell you in a big, undifferentiated blob whether 'herbal medicine works' or not. Sort of... some remedies work in seconds, others in months. You'd need different trials for different types of conditions and levels of acute/chronicness... etc.

What you're talking about would start to screen for placebo on the methods generally -- I'm all in favour of that! But it wouldn't tell you the 'effectiveness of individual remedies' because the individual remedies often don't work that way.

"safety of the population"? But I'm still waiting to here where the unsafety is; posted a big link showing that toxicity is something that is already under far better control in herbs than in other forms of medicine. I mean far better. There's no big panic about toxicity of herbs generally... do you have something that I should look at on that? Some figures that show serious danger?

DBennett but what are you calling a 'condition'? A particular symptom? A molecular lesion? Not all prescribing is done on the basis of 'conditions', that's all I'm saying. It'll work for simples with definite indications. That's not the way Chinese herbs are prescribed though, for example.

In any case, toxicity is not an entirelt unknown factor here as I keep saying. Toxicities are well known in herbs, often in minute detail.

"Trial: that wouldn't tell you what a drug trial tells you. It would tell you in a big, undifferentiated blob whether 'herbal medicine works' or not. Sort of... some remedies work in seconds, others in months. You'd need different trials for different types of conditions and levels of acute/chronicness... etc."

• that's what I meant, and it's by no means impossible to do. Why should alternative medicine be exempt from the same scientific rigour as allopathic medicine?

And just because there are a lot of iatrogenic problems with allopathic drug toxicity, doesn't mean that herbal remedies can be ignored. Again, why should they be exempt from safety testing just because they're 'natural'? Belladonna and aspirin are natural; doesn't mean they're safe.

Is your safety link to the website run by Dr Rath?

The Matthias Rath who says that vitamin c is better for AIDS/HIV than ARVs?

And when called on it, sued the Guardian for libel?

And then lost to the tune of £700,000?

Yeah, it is.

But if you want to side step that for now, we don't know about herbal safety in the same way we don't know about effectiveness.

But we learn about both at the same time.
For example,

Kava is effective for mild anxiety but is probably too dangerous to consider due to risk of liver failure.

St. John's Wort is a decent mild anti-depressent but has some side effects and has some very dangerous drug interactions.

You have to examine something to know if it's effective or dangerous.

That is what this legislation will enforce.

"DBennett but what are you calling a 'condition'? A particular symptom? A molecular lesion? Not all prescribing is done on the basis of 'conditions', that's all I'm saying. It'll work for simples with definite indications. That's not the way Chinese herbs are prescribed though, for example."

Maybe they should be....

But for that example, you would use a crossover trial. You can look for whatever answer you want - even something as vague as "how good do you feel out of ten?". The person acts as their own control, and is blinded to whether they're using the real herbal prescription or not (treatment or non-treatment), then they cross over to the other for a defined period of time (non-treatment or treatment). Some of these trials have as few as a dozen people, but can be useful for rare conditions, or difficult to define cases. Still a useful scientific tool.

Will it stop us from importing from th US?

@DBennet: That is what this legislation will enforce. Yes, but those side effects and interactions are already being studied which is how you get your info.

If all leaves, roots, flowers and berries come with appropriate health warnings, no prob. I want to know that I will still be able to get them in the first place, if I do keep up with the research and do know what I'm doing when I buy. The message I keep getting from the people who supply me (who make no claims about effectiveness BTW) is no, I won't be able to.

@LCPO: No they shouldn't be, trust me! Sure, that kind of trial could tell you something. I'm just not sure why I have to wait for it to be done.

What concerns me is suddenly not being able to get what I'm used to getting. I don't say other people who consider it a bad idea to use herbs have to use them! I want to continue using them.

Could someone link me to any studies showing the overall risks of say, TCM? Anything not featuring 'Amazing Randi'-esque accusations of 'baloney' and so on? All I can find is contraindications and interactions for individual herbs, and I already knew about those. Research is constantly being done and one can look it up anytime on the net. Is there any overall view that suggests a sudden ban on all previously-untested remedies is going to improve health overall?

"What concerns me is suddenly not being able to get what I'm used to getting."

If you are concerned, why don't you approach the suppliers and ask if they have applied for/been granted licences for the stuff you use?

As I mentioned, I'm being told much of what I use won't be available.

You asked for appropriate health warnings, it is impossible to do this without having researched it.
That's what the legislation is pushing for.

And although you may be able to get all you want without any therapeutic claims being made, this is unusual.

For example the website you linked to earlier, by the infamous Dr Rath, is full of unsupported and unsupportable claims.

And research of public impressions appears to support the idea that the common belief is that all of these therapies already have the same safety and effectiveness data as over-the-counter pharmaceuticals.

Which they often don't.

^You asked for appropriate health warnings, it is impossible to do this without having researched it.
That's what the legislation is pushing for.^

You know about the interactions of St John's Wort, how? Because tests are already being done. I've worked through a few herbals and know about the problems associated with some form of liquorice, say... many of these herbs have been tested for ages.

Now you may say that others aren't as thorough in checking out what they buy as I am. That could be -- but it seems to me that if herbs I rely on are suddenly unavailable to me, I'm being penalized for the fact that a) Some are misusing them; and b) On ordinary leaves/roots/berries/flowers, there isn't the bottom line incentive to get them approved that there would be on a preparation or manufactured pill that a shop or manufacturer can sell exclusively.

I think herbs should go right on being tested. But I wanted to use them now.

"I think herbs should go right on being tested. But I wanted to use them now.I think herbs should go right on being tested. But I wanted to use them now."

they (the supplying companies) had years to do the testing.

"I think herbs should go right on being tested. But I wanted to use them now."

I think we're getting into an area that I find really interesting.

You bring up Liquorice (Glycyrrhiza Glabra for nerds).
Might have some benefit in stomach conditions, probably not in anything else and has got some serious risks attached (most notably high blood pressure due to fluid retention).

Now, I assume you know this and are, for what ever reason happy to make this choice.

But it is objectively a bad one.

There are safer and more effective pharmaceuticals for all the conditions that Liqourice has been tested for.
Probably cheaper too.
The risk /benefit analysis fails to be positive for any condition.

To what degree as society are we happy to let people make bad choices with their health?

To what degree as society are we happy to let people make bad choices with their health?

There are two different answers for that. The first (mine) applies if you think TCM has any sound theoretical basis at all, the second (yours) assumes it doesn't, and that therefore only the kind of symptom--->cure allopathy you're talking about has or should have any relevance to anyone.

Personally, I think that discussion is a bigger one than would fit here. But I would be very, very sad the day I had to secretly use herbs because some knowall presumed they understood my health so well that any choices I made on it must be wrong. It wouldn't surprise me if that did happen for some short while in the future, but it will prove unsustainable long term.

My whole argument is civil liberties-based. What you consider 'bad choices' I consider excellent ones based on direct experience and theory that works extremely well for me. Am I, a person in excellent health with no illness at all, to be allowed to exercise my right to choose as I please for reasons that seem justified to me? Or is the knowall attitude perhaps one day to be so enshrined in law that a person may not dissent? I don't do my "risk/benefit analysis" using only the methods you use. My good health (doctors agree) is evidence that I don't make bad choices. My attachment to herbs is practical, not sentimental -- economical too, of course.

Like I say, I'm not up for a discussion about the theoretical differences. Perhaps you believe your theory is so all-embracing that you could in good conscience ban all others... personally I think you have no idea what you would be throwing away. That's your decision! But allow me to make a different one, and judge the results by my health.

I think that's it for me on this thread.

BTW it's uralensis not glabra.

"BTW it's uralensis not glabra."

Ah, Chinese Liquorice not Liquorice root.

Almost no human research done with mixed data in models and cell studies.

Linked to liver damage and heart failure.

And I can't agree with the post-modernist idea of equally valid truths.

Something is effective for a condition.
This can be measured.

Something might have risks.
This can be measured.

I don't care if that something comes from Traditional Chinese Medicine, German Herbalism, American Naturpathy or the lab bench of "big pharma".

I just want to know it works and how safe it is.

And, to link back to the original topic, that is what this legislation is designed to do.

And I can't agree with the post-modernist idea of equally valid truths.

Oh I don't hold with that idea either. That 'post-modernist' line has become an over-easy shorthand for people who can't follow the idea that western medicine might be true but incomplete.

You've never actually addressed the points I've made about toxicity. I've agreed with measuring risks every time you've raised it, but it was work that was going ahead anyhow, and this legislation is not the only way to get more of it done.

As far as effectiveness is concerned, you're not going to take the point I see. Here endeth the thread for me, since it's only circling now anyway.

I posted two links to papers on toxicity of herbal medicine, specifically a herbal medicine you mentioned.

Obviously you want more, I'm just not sure what.

In a lazy attempt to be all encompassing, I'll suggest to you a section of the website What's The Harm?

I'd personally distrust anecdotes but you've mentioned you own experience a couple of times so you may feel differently about them.

The whole point is that you've missed the point and this should be a matter of individual choice. Don't forget we are supposed to live in a democracy.
The European Directive on Traditional Herbal Medicinal Products (THMPD) was first enacted back in March of 2004. This legislation established new rules and regulations for the use of herbal products that have been freely traded for hundreds of years.
According to InfoWars.com, ?This directive requires that all herbal preparations must be put through the same kind of procedure as pharmaceuticals. It makes no difference whether a herb has been in common use for thousands of years.
?The costs for this are far higher than most manufacturers, other than Big Pharma, can bear, with estimates ranging from £80,000 to £120,000 per herb, and with each herb of a compound having to be treated separately.?
This is a massive infringement each person?s ability to prevent and treat illness in ways that he or she sees fit. Cleverly cloaked as issues of ?public safety? this directive, and similar laws that are being considered in the United States, are nothing more than Big Pharma?s attempt to wipe out the competition.
Dr. Robert Verkerk of the Alliance for Natural Health, International (ANH) describes the problem of requiring drug-like compliance on herbal preparations:
?Getting a classical herbal medicine from a non-European traditional medicinal culture through the EU registration scheme is akin to putting a square peg into a round hole. The regulatory regime ignores and thus has not been adapted to the specific traditions. Such adaptation is required urgently if the directive is not to discriminate against non-European cultures and consequently violate human rights.?
These companies know that when people become educated about the power of holistic remedies and the dangerous side effects of pharmaceutical drugs, they will lose their profitable stranglehold on society.
Rest assured, pharmaceutical companies have a vested interest in keeping people sick and dependent on their medications. A healthy population has no need for Big Pharma!
If you believe that every human has the right to utilize the medical treatment and health maintenance methods of their choice, take action now!
In the EU: Go to this page to find out who is your MEP and the contact information. Then, send a letter that states, in no uncertain terms, that you strongly support the ANH?s actions in trying to suspend the implementation of THMPD and that you hope they will also take a stand in support of the people?s right to choose herbal treatments.