BAHSHE Luton. 2005

Western Herbal Medicine – An Overview

History of Herbal Medicine in Britain

Current Legal Status of Herbal Medicine in Britain

Herbal Medicine and Herb/Drug Interactions

Herbal Medicine and Student Health

Neanderthal Man. Pollen Found in Gravesite

Marshmallow (Althea spp) Soothing healing mucilage for irritated throats & GI tract.

Grape hyacinth (Muscari genus) Diuretic

Yarrow (Achillea millefolium)Diaphoretic, diuretic, insect repellant.

Ephedra (Ephedra sinica) Asthma remedy, cardiac stimulant.

Quacks Charter

‘……..any subject who has knowledge and experience of the nature of herbs, roots and waters should be allowed practice their art without suit, vexation, trouble, penalty or loss of their goods. ‘

Currently Statutory Self Regulation.

Complementary and alternative medicine: House of Lords Select Committee on Science and Technology 6th report [session 1999-00]

2001. DOH produced document outlining steps necessary for HM to achieve SSR.

Now –Joint Working Group being formed, which will ultimately develop a shadow council, then an General Herbal Council.

Issues currently debated = protection of title, accreditation of courses (minimum standards), grandparenting etc.http://www.users.globalnet.co.uk/~ehpa/ For more info.

National Institute of Medical Herbalists

• Established 1864• Oldest & largest governing body for herbal

Medicine• Run a yellow card reporting scheme in

conjunction with MHRA• Members are recognised as being able to

diagnose• Ability to sign people off work• Impeccable safety record (No cases of

fatalities reported in 141 yrs )• To contact tel 01392 426022

Herbal Medicine and Herb/Drug Interactions

Difference between whole plant remedies & Standardised extracts.

Whole plant remedies and synergyConcept more widely accepted in field of nutrition.

Vitamins & minerals. Whole food diets. Link between food & medicine.

Pharmacodynamic synergyIndividually – sub therapeutic levels. Frank

pharmacological effect in combination. No one pathway is saturated. (Hypericum perf – SSRI &MAOI)

Pharmacokinetic synergyBioavailability enhanced by presence of other

secondary metabolites. (Lipo-solubility –of hepatoprotective lignan silybin is

enhanced. )

Both of above may be present (Kava kava)

Standardised extracts & OTC products.

• Standardisation to ensure minimum quantity of perceived active constituents. This concept may result in conflict with orthodox medicines as high concentrations of specific phytochemicals may act to significantly affect certain biochemical pathways (ie cytochrome P450).

• Problems highlighted in press etc in recent years are almost exclusively related to OTC’s.

General public’s perceptions of OTC preparations as herbal medicines which are natural & therefore safe may lead to problems in this area, ie:-

Taking many times in excess of recommended dosage

Not taking advice re pregnancy, hypertension, medications etc.

Other problem areas include:-Variability of quality OTC remedies.Potential adulteration of herbal preparations.

As a practising herbalist, orthodox medicines causing the most concern are relatively few in number, and would includemedications which

a)Pose potential serious health implications if levels are disturbedb)Have a narrow therapeutic window.

Therefore - drugs requiring caution may include:-

WarfarinAnti-epileptic drugsImmune suppressantsLithium

Summary

Risks of Herb/drug interactions are minimal if consulting qualified herbalist. (Where whole plant remedies are used)

Low if choose recognised brand, follow instructions.

Take appropriate advice - Contact a Medical Herbalist.

Case Study

Male Age 70s

Poor appetite. Ate next to nothing for approx six weeks – subsisting on Cranberry juice & taking warfarin meds.

Admitted to hospital with INR >50 (Prev stable)

Died of GI and pericardial haemorrhage. ----------------------------------------------------------------------------

Warfarin = primarily metabolised by p450 CYP2C9 pathway

Cranberry juice contains flavonoids which may inhibit this pathway.

This man had no vitamin K intake from his food for 6 weeks. Over anti-coagulated.

Broad spectrum anti-biotics had been used (cephalexin) which acts to reduce non dietary vit K absn via its effects on gut flora.

Herbal Medicine and Student Health

Potential areas where Herbal Medicine can be of help include:-

Stress. Calming and coping herbs. Reducing the incidence of students on anti-depressants.Insomnia. Dietary & lifestyle advice. Simple coping measures.

The herbal consultation as a therapeutic tool. (Overcoming isolation, being listened to.)

Inexpensive source of medicines.