Article on Herb Drug Interactions on Rheumatism

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Herb-Drug Interactions Rheumatism Date: February 15, 2006 Re: Use of Herbal Remedies by Rheumatology Patients Holden W, ph J, on L. Use of herbal remedies and potential drug interactions in rheumatology outpatients. Ann Rheum Dis. 2005;64:790. Concerned about possible risks involved with the use of complementary and alternative therapies by rheumatology outpatients, these authors conducted a study to quantify the proportion of outpatients who were taking herbal or over-the-counter remedies and to assess the potential risk of harmful interactions with conventional rheumatological drugs. They also examined how patients perceived the risks associated with the remedies they used and whether they sought advice from a health care professional before starting the

remedies.At three centers in the United Kingdom (Oxford, Swindon, and Cirencester), 238 rheumatology outpatients completed an anonymous questionnaire about their diagnosis, conventional drug treatment, and use of herbal and over-the-counter remedies during the previous six months. The patients were asked whether they were aware of any side effects from the herbal remedies or any interactions with their prescription medications, and whether they had sought advice from a doctor or pharmacist before starting the herbal remedies.Of the 238 participating patients, 105 (44%) reported using herbal or over-the-counter remedies during the previous six months. The most commonly used products were cod liver oil (used by 83 patients); glucosamine and/or chondroitin (50 patients); and evening primrose oil (Oenothera biennis) (26 patients). The authors note that 26 patients (or 11% of the total number of participants) were taking remedies that might interact with

conventional drugs. Of the patients who were taking disease-modifying antirheumatic drugs, say the authors, 4% faced an increased risk of hepatotoxicity by also taking echinacea (Echinacea spp.), with no reference to support this claimed risk. [Note: in the U.S., these drugs do not qualify for the designation "disease modifying.] Of all 238 patients who were taking nonsteroidal anti-inflammatory drugs or corticosteroids, the authors indicate that 10% increased their risk of bleeding disorders by also taking ginkgo (Ginkgo biloba), garlic (Allium sativum), or devil's claw (Harpagophytum procumbens). {Note: Increased bleeding is a purely theoretical side effect since no clinical trial has shown any of these herbal preparations to increase this risk.]Twenty-four of 26 patients were unaware that they were risking harmful interactions, and 10 of 26 had sought advice from a health care professional before starting the herbal remedy.In conclusion, the authors urge health

care workers to "be particularly vigilant to ask about herbal remedies when taking a drug history. Both patients and prescribers need more education on the risks and potential interactions of these preparations."-Shari Henson Herbs for Health Suzi What is a weed? A plant whose virtues have not yet been discovered. health/ http://suziesgoats.wholefoodfarmacy.com/

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