At left, Echinacea
For two days, I have been defending my occupation against mostly-anonymous shills for the drug companies over at Alas, a blog. If they aren't actual shills for BigPharm (which are in fact all over the net and get paid very well for it), they can come over here and say so, and this time, they will answer my direct questions (helpfully placed in bold) or git the hell out.
It started with a derail, of course. Mandolin wrote that she is experiencing heavy bleeding, and I recommended Chaste Berry (Vitex) and all hell broke loose. Never mind that other questionably-effective remedies are discussed, including artificial cancer-causing hormones of varying strengths, invasive surgery, expensive fertility specialists (!) and that's all understood to be fine and dandy. I just mentioned a fucking PLANT! OUT OUT DAMNED SPOT! I said there were no side effects--when I admit that I should have said FEW. (Or maybe I should have just been honest and said, I have never had anyone report any side effects to ME; in fact, I was comparing the weak side effects of herbs, to the serious side effects of the therapies being discussed.)
Anyway, with that, we were off to the races. First from some drug-company shill (I have no idea if she is or not, merely judging from her RAH RAH WESTERN MEDICINE! posts, and her refusal to answer the question of whether she is) named Dianne:
No. Any drug that is strong enough to have a clinical effect is strong enough to have side effects. It doesn’t matter if it comes from a tree or a lab or was given to you directly by hyperintelligent aliens who designed it just to help you. It may be perfectly fine and helpful and do wonderful things for you, but it is a drug and should be treated with the same caution that you would treat Merck’s latest product. More: nature doesn’t care about being sued and most medicinal compounds that plants make are actually made in an attempt to keep the plant from being eaten–poisons, in other words.
I dislike being patronized and assumed to be stupid by someone who hauls out the profanity MERCK when preaching to me, and I replied:
I will amend my statement: the side effects are negligible compared to either pharmaceutical or over-the-counter remedies.
...Someone seems a bit hypersensitive (hostile) towards herbal medicine. Drug company rep? Doctor?
Maia:
daisydeadhead - to imply that anyone who has a problem with the marketing of alternative medicine is doing so because they’re bought off is offensive and completely unfounded.
I think a sizeable proportation of alternative medical practitioners are thieves and charlatans. I think the vast majority of pharmaceutical companies, or companies that sell ‘alternate medicine’ are pretty much the epitome of evil.
I don’t think the battle is between two groups of people who want to sell us different health products. I think it’s about whether health is a commodity to be bought and sold or a right.
I replied:
Maia, I detected some hostility in Dianne’s comment, when all I did was suggest an herb, which has shown very few (any?) documented side effects. I got two rather hostile paragraphs, and I don’t think my suggestion deserved that. And now, you seem hostile also. (?)
And I didn’t see any discussion of “marketing” of alternative medicine; I saw a bizarre reference to aliens. Why the sarcasm and patronizing? Was that necessary? Yes, I replied in kind.
And BTW, I was not recommending anything I didn’t learn from my grandmother, and she from her grandmother. I am not foisting some evil nefarious industry on anyone.
Brossa, another commenter, wrote:
From one of the research articles in DaisyDeadhead’s initial Chaste Berry link: “The most frequent adverse events are nausea, headache, gastrointestinal disturbances, menstrual disorders, acne, pruritus and erythematous rash.”
Me:
Same as for birth control pills, but even less occurrence of these.
Why do you all ignore the same negatives for prescription drugs? It’s like you have a blind spot for those–and I could dig up countless malpractice suits and trash-talking blogs dedicated to every single one.
Ignoring my question, Brossa continues:
Dianne’s point is a legitimate one. The active ingredients in chaste berry have real physiological effects, which may benefit or worsen a given medical condition. If it had absolutely no physiological effect, like a homeopathic tincture, then there would be less reason to be wary of ‘just giving it a try’.
Me:
I will amend my statement: the side effects are negligible compared to either pharmaceutical or over-the-counter remedies.
Dianne:
I know very little about chaste berry in particular, but if this statement refers to herbal medications in general, it is nonsense. Herbal medications can have side effects just like any other medication.
Specific examples: There have been deaths due to kava and ephedra. Other herbs can alter the metabolism of other drugs with potentially lethal side effects. Then there’s the PC Spes story. PC Spes was once touted as an example of successful use of CAM in cancer. It appeared to work periodically–not always, not particularly better than “allopathic” medicine, but sometimes–on prostate cancer. Then people taking it started getting clotting and/or bleeding problems. It turns out that the company that makes PC Spes was adding a synthetic estrogen to the mixture to make it effective. But estrogens can cause clotting. So they added coumadin. And a benzodiazapiem to make people happy about taking it. Unmonitored coumadin is a disaster waiting to happen and benzos are addictive. It was withdrawn from the market once this was discovered.
Regarding my remark that "I detected some hostility in Dianne’s comment," Dianne replies:
Well, yes, but it wasn’t directed towards you, but rather at the “herbal supplement” industry. Which is totally unregulated and has caused a number of deaths, both directly and indirectly. Perhaps you are obtaining your herbs by gardening or searching the woods for appropriate plants (please be careful if so), but most people buy them. The makers of these medications are not wise men and women working deep in the Amazon rain forest with nothing but knowledge hoarded from generation to generation, but large companies that make them for the same reason that drug companies make drugs–to make a profit. Often they are branches of “big pharma” houses. Some herbal supplements are contaminated with heavy metals. Others do not contain the ingredient listed as “active”. If you must buy herbal supplements, buy them from Germany. Germany does regulate its supplement industry and so you’ll at least be reasonably sure that what is listed on the package insert is what is in the bottle.
Dianne also claims:
My mother used to give me aspirin when I was sick as a child. She learned that from her mother. It turns out that we were both simply lucky in that we did not die from Reye’s syndrome. On the other hand, she also learned that breast feeding is a good idea and I benefited from that. Traditional wisdom is a crapshoot: might help, might kill.
DaisyDeadhead (me on ALAS) writes:
Quoting Dianne: I know very little about chaste berry in particular, but if this statement refers to herbal medications in general, it is nonsense. Herbal medications can have side effects just like any other medication.
First, I didn’t say this about all herbal meds. You are extrapolating. But if you wanna go there, fine.
Specific examples: There have been deaths due to kava and ephedra.
The death of the baseball player, supposedly due to ephedra was due to an overdose. There have been far more overdoses due to regular diet pills–and I grew up when diet pills like Dexedrine were given to any overweight teenager who asked for them, myself included . Ma Huang, the herb ephedra is extracted from, has been used for thousands of years in China, and is very safe if used properly. It’s historic use was for ASTHMA, not weight loss, which is how it was marketed in the West.
Deaths from kava? Details? I know of some concurrent liver issues with people ON OTHER DRUGS who took kava also (and if you have pre-existing liver problems, DO NOT TAKE KAVA–this is why you go to a proper herbalist who knows this stuff). But I know of no deaths solely from kava. Also, these deaths were in Germany, if memory serves, where local supplement companies did not know the correct part of plant that was historically used in Tahiti. Perhaps they should have asked the locals? Western arrogance strikes again.
Like Ma Huang, Kava-kava has been safely and successfully used as a cocktail (actually sold in cocktail bars in Tahiti as the cocktail “Nakamal”) for millenia. Didn’t you have any when you went to Tahiti? If so, that’s what you drank, just as ROOT BEER was once historically Sarsaparilla.
Drug companies have been very aggressive in marketing these few scare-stories, though, even though Vioxx, Celebrex, Fen-Phen and even garden-variety Ibuprofen have caused far more damage. Yet, people are terrified of herbs, which as I said, have been historically used for MILLENIA, not for the few scant decades that prescription drugs have been used (and idolized).
At this point, Dianne hauls out something arcane that I never heard of, as if it is a mainstream example:
Then there’s the PC Spes story. PC Spes was once touted as an example of successful use of CAM in cancer.
Me:
Well, I’ve been in herbal medicine for decades, and I have never heard of this. Guess it ain’t much of a story, huh? Which herb is this?
Dianne ignores the question, and plows onward:
It appeared to work periodically–not always, not particularly better than “allopathic” medicine, but sometimes–on prostate cancer. Then people taking it started getting clotting and/or bleeding problems. It turns out that the company that makes PC Spes was adding a synthetic estrogen to the mixture to make it effective.
Me:
So, it was the company’s meddling with the herb, not the herb itself. Figures.
Um, where did they get this estrogen? They had a doctor, with prescribing capabilities, working for them? Sounds hinky.
Dianne is unimpeded:
But estrogens can cause clotting. So they added coumadin. And a benzodiazapiem to make people happy about taking it. Unmonitored coumadin is a disaster waiting to happen and benzos are addictive. It was withdrawn from the market once this was discovered.
Me:
You are saying an herbal company added TWO EXPENSIVE PRESCRIPTION DRUGS to their formula? Forgive me for my skepticism, but do you have a link? How were these obtained without prescription? Are you saying they had the power of prescribing?
Which company was this?
I fully admit, that one must be conscious and aware before using herbs, as one would when using anything else, including food. But certainly, no herbs can cause the harm prescription drugs can, WHEN TAKEN PROPERLY and advised by someone knowledgable.
DaisyDeadhead (me) replies:
Do you believe even external use, as in Arnica gel (or essential oil) for joint pain, is ineffective?
Aloe vera for burns? Lavender essential oil for relaxing people during massage? Peppermint has NO effect on migraines? I guess those migraine-sufferers who claim different are all full of shit, then, yes? Eucalyptus is bullshit and does NOT open sinuses? (Do the cough-drop and cough-medicine makers know this, because they use LARGE AMOUNTS of Eucalyptus, Thymol and Menthol in their products.)
And White willow bark is crap, too? Then, we should stop taking aspirin to prevent heart attacks? You realize, that is where aspirin comes from, no?
I could go on, of course, but those are the best-selling herbs.
Dianne:
The makers of these medications are not wise men and women working deep in the Amazon rain forest with nothing but knowledge hoarded from generation to generation, but large companies that make them for the same reason that drug companies make drugs–to make a profit.
Me:
My favorite herbal company is Gaia Herbs, a local company from Brevard, NC. I have been there myself, several times, and I have seen how they farm herbs, and prepare their formulas. I have eaten their stuff raw, out of the ground. And they sell a great kava formula that I have taken many times.
Many companies do not get my seal of approval, and some do. It’s like ANYTHING ELSE. One must learn to discern and judge–not throw out the baby with the bathwater.
Germany, huh? Like where the kava fiasco occurred? Regulation doesn’t mean shit, and needs to be AVOIDED. (Sorry, now you are tapping into my anarchism, sorry about that.)
Dr Andrew Weil has an excellent rule of thumb: Western medicine is for crisis, Eastern medicine is for chronic. Cancer, broken bones, acute pancreatitis, etc=Western medicine. Acid reflux, sinuses, insomnia, arthritis, etc=Eastern medicine.
Western medicine is great for crisis situations. That’s its strength, that’s how it was forged. The problem is, western medicine treats EVERYTHING like a crisis–ruining people’s digestion with Prevacid, getting them hooked on Ambien (I talk to at least 2 Ambien addicts a week, some by telephone, so it isn’t just a local problem) and garbage like that. (The best sleep and arthritis aid, marijuana, is not legal for medical use in my state, another outrage.) Herbs and other supplements such as digestive enzymes would be preferable for acid reflex, and in this matter I speak from personal experience also.
Eastern medicine understands the relationship of mind and body, and can ferret out dietary causes of illness in a shot. However, they are likely to prescribe herbs for broken bones and cancer, and NO, you can’t do that. I have actually pleaded with my customers to go to doctors before–the medical profession has scared so many people and repeatedly lied to them, patronized them, etc– people avoid them even when doctors are obviously necessary.
I’ve heard about 3 iatragenic illnesses in just the past week; people who went to the hospital for one thing and came out with something else. Conventional Western medicine has PLENTY to answer for.
The problem with the Weil thesis is that at some point, chronic can become crisis, or crisis can revert to chronic. In a civilized society (not this one), an herbalist and doctor might work together for the betterment of the patient, not continually be at odds, as you seem to prefer.
Brossa replies:
“Why do you all ignore the same negatives for prescription drugs? It’s like you have a blind spot for those–and I could dig up countless malpractice suits and trash-talking blogs dedicated to every single one.”
I don’t ignore the negatives for prescription drugs; I just want to point out that herbs have indications and contraindications, effects and side effects, and favorable and unfavorable interactions, just like prescription medications do. Just because you can eat them out of the ground does not mean that they are all inherently safe, or even that they do what it is claimed that they can do.
I believe that homeopathic tinctures, where any possible active ingredient has been diluted to the point of nonexistence, are no more effective than placebo. One last time: I do not dispute that herbs have physiological effects under the proper conditions. Deadly nightshade got that name for a reason. My own experience with aloe vera for a burn resulted in a pretty unpleasant skin reaction, akin to a poison ivy rash. Western medicine has derived a huge number of highly effective drugs from plant/fungal/animal sources. But citing the historicity of a given herbal treatment does nothing to establish its efficacy or side effect profile.
I encounter more people who think that herbs are perfectly safe than I do people that are terrified of them.
Me:
My remark about “eating them out of the ground” was in reply to any doubts about Gaia’s process and purity, which I feel very confident about. This is not some huge evil conglomerate, it is a local business I approve of, have thoroughly checked out, and therefore do business with. I don’t think anyone added any estrogen, etc (!) (still waiting to hear which company did this?) to any of their products.
Umm, I wouldn’t be much of an herbalist if I thought “all herbs are safe”–why does it jump from my stated opinion that “herbs can be better than Rx drugs for certain conditions” to the straw-herbalist argument “you think all herbs are safe”? No, that is not my opinion. Stop putting words in my mouth and read what I said: I think Eastern and Western medicine can work together. You are the one proposing the superiority of Western medicine to all else.
Some herbs are safe if used in extract and not externally; some you can smoke and some will kill you that way. Some can heal and the VERY SAME HERB, USED WRONGLY, can hurt. I realize this; it’s my job.
As we say about abortion, it’s better to be legal and safe, than illegal, driven underground, with information and resources scarce and/or nonexistent. (PS: some abortions are dangerous and some are safe–that doesn’t mean all abortion is unsafe.) Wouldn’t you agree?
Brossa:
When I propose “the superiority of Western medicine to all else”, feel free to quote me.
When you trash herbs, you trash Ayurveda and all traditional medicine. YES, YOU DO.
Perhaps I misunderstood your earlier statement:
But certainly, no herbs can cause the harm prescription drugs can, WHEN TAKEN PROPERLY and advised by someone knowledgable.
Is this not a claim that, unlike prescription drugs, no herb can cause harm when taken properly and under supervision? Or that the side effects or interactions of herbs are always more benign than those of prescription medications? Because that claim is patently false.
A Google search on PC SPES will provide a large number of references about the testing and withdrawal of the product. I will address one point: prescription medications are only expensive and hard to get if you produce them legally and are subject to the expense of testing and product liability. Coumadin is a brand name for warfarin, which is itself a synthetic derivative of coumarin, which was isolated from moldy sweet clover. Warfarin was produced as a rat poison, and is dirt cheap in bulk, especially if purity is not much of a concern.
Dianne Writes:
But I know of no deaths solely from kava.
I guess you didn’t read the link, then, since it mentioned four deaths from the use of kava and no other drugs or herbal supplements, in people who had no prior history of liver problems.
And Dianne sees fit to tell me, after I have told her several times that I've been an herbalist for years:
Actually, willow bark is not aspirin. It is salicylic acid, not acetylsalicylic acid. The difference is quite important if you want your stomach lining to remain intact.
Oh for chrissake: I
said it COMES FROM White willow bark. Can you read? Didn't Merck train you to READ before letting you loose on the web? Stop patronizing me, please.
My stomach lining is barely intact, after barfing over this thread. :P
Dianne continues the arrogant condescension, teaching me Herbology 101:
Of course many medications are derived from plants. Besides aspirin, you could have mentioned digitoxin, taxol, vincristine, opiates, and many others. Yet people take taxol for their breast cancer, not yew bark extract. Why? Several reasons. First, yew bark is not standardized (the plant makes a variable amount depending on any number of changes in its environmnent) and so simply taking a given amount of it doesn’t guarantee a given dose of active ingredient. Second, it is far more effective, with far fewer side effects (i.e. more a drug and less a poison) if taken IV instead of by mouth. I’ll leave the question of what would happen if you injected bark to the readers’ imaginations. Finally, taxol, the drug, can be synthesized. This is critical: before the synthesization was worked out, there was fear that demand for taxol would drive the yew tree into extinction. After, there was no problem. Much like viagra–an effective drug for impotence–is helping save the rhinocerous by driving down the demand for rhino horn, a traditional, but entirely ineffective, treatment for impotence.
I was then asked:
Are we talking about FDA approved substances?
Dianne raps on:
Ah, that’s the beauty of the thing for Big Naturpathy: the FDA doesn’t regulate “herbal supplements”. They aren’t allowed to because of a bill pushed through by the oh-so innocent companies that sell these supplements. All they have to do is label them in such a way that they don’t make an overt claim to cure any disease and they are “nutritional supplements” and not subject to regulation, not “medicines” which, plant derived or not, are.
More on the dangers of taking herbal medications listed, for example, here. The long list of references to cases of non-permanent injury, permanent injury, and death related to the injestion of various herbal and ostensibly herbal medications is particularly interesting.
Ah, we get to the heart of it. Dianne, spokesdoctor for BigMotherGov/BigPharm wants "regulation." And when I hear the words "regulation"--I reach for my gun.
And Mandolin adds the big indictment:
My sister-in-law used to sell herbal medications.
Well, there you go.
And I used to work in traditional western health care, too... so? My brother-in-law used to mow lawns at Six Flags Over Georgia, but this doesn't mean I know anything about roller coasters.
Dianne:
Because, after all, plants are never addicting. (Opium, tobacco, marijuana, alcohol…nope, no addiction problems there.)
Me:
First rule of herbology: Two of these are not like the other two–opium and alcohol require a lot of preparation (fermentation, in the case of alcohol) to use, and are transformed into food-like (processed) products, while marijuana and tobacco require no processing. Opium and alcohol are therefore distilled, extracted and much stronger. They have passed out of the herbalist category. Marijuana and tobacco remain in their natural state.
Mandolin:
I have no problem believing some alternative medicines work. But if they work, why not prove they work? The scientific method is not an impassable barrier.
If the problem is funding the tests, then that’s a reasonable concern. Or maybe you feel the FDA has been biased about this drug, in the way they’ve been biased about things like plan B. That’s fine. But I still generally prefer scientifically gathered evidence to anecdote-based evidence. I prefer evidence that controls for factors like patient’s other treatment and placebo effects, and that monitors for unexpected side effects.
For instance, take your recommendation (which I totally appreciate the spirit of, by the way). You are telling me you know it’s safe because your grandmother took it. I am glad that it’s been beneficial for you and yoru family. But if we aren’t very similar physiologically, it could have very weird effects on my health. I’m allergic to a lot of stuff that most western Europeans aren’t, for instance. And also, I’m very susceptible to mood effects from plants or drugs.
I tend to have extreme reactions to medications, anyway. If there’s a nasty (non-fatal, non-permanent) side effect, I’ll usually get it. I like to have warning.
Dianne:
The idea that we have already discovered every plant that has any potentially useful medicinal qualities and every potential medicinal quality of all known plants is extremely implausible. Proving which ones work and which don’t is one important issue. But I’d still be in favor of isolating the active ingredient*, synthesizing it, and giving it as a “western”-style medication (”western” is in quotes because not all allopathic medications are discovered or developed in places we’d think of as the “west”) for several reasons. First, increased ability to standardize dosing. Second, decrease the chances of side effects due to other toxic components of the plant. Third, ease of transport and administration. Finally, decrease the likelihood that demand for the medication will endanger the plant’s survival.
*Whenever possible. I can, at least in theory, imagine a situation in which the plant is producing a large number of ingredients, all of which have a low level of activity in different ways such that no one can be isolated and used separately because no single component is responsible for the effect. However, I know of no such situations in real life, though I have some suspicion that the anti-nausea effect of cannibus may be more than just THC.
First of all, it's spelled CANNABIS, which I am surprised that you don't know, as patronizing and arrogant as you are.
Me:
The FDA can ban anything, as it did L-trytophan. OTOH, it does not “approve” herbs, but if any supplement is judged a “food” for some unfathomable bureaucratic reason (some amino acids, kombucha, etc) it does have power to approve or not.
Certain vitamins and other herbs are now claiming to be “whole food”–which to me is playing gotcha with the FDA, but hey, their choice, and they claim they can stand up to any analysis, so I say go for it.
Interestingly, these particular companies are rarely challenged, so maybe it’s all how you go about it?
Is this not a claim that, unlike prescription drugs, no herb can cause harm when taken properly and under supervision? Or that the side effects or interactions of herbs are always more benign than those of prescription medications? Because that claim is patently false.
No, that is not my claim. (Sorry for unclear writing.) My position is that any possible harm would not equal the possible harm of an RX drug. They simply are not as strong.
Why does everyone see this matter in black and white?
A Google search on PC SPES will provide a large number of references about the testing and withdrawal of the product.
Oh, dear God.
You brought it up and I am not going to do your searching for you. I searched enough to see that 1) no participating company is mentioned that is currently in operation and 2) you can’t name any herb that is in this remedy. I’ll ask again: WHAT HERB DOES THIS MYTHICAL CONCOCTION CONTAIN? Because if this is your example of evil herbal medicine, and you can’t name a single herb that it supposedly contains, I’d say it’s a pretty shitty example, wouldn’t you say?
Your kava example, again, is mistaken. All of the people were taking concurrent ibuprofen, according to the German monograph accounts I have read. Why are you concentrating on some Germans who used (as I said, please read carefully) the wrong part of the plant, rather than the Tahitians who have used it for millenia? Do the Tahitians not exist?
Are you therefore against all Eastern medicine modalities, including acupuncture, Ayurveda, etc? Because if it’s like that, that is a simple cultural bias that you have not examined or studied.
I also provided the link to
CONSUMER LAB, which tests herbs to insure other excipient ingredients have not been added, as in the mythical PCES example given above.
And I ended with:
Since you are all WESTERN MEDICINE UBER ALLES, with highly ethnocentric arguments… I am ending this discussing before I accuse someone of cultural ignorance and xenophobia, as well as a belief in the superiority of the West–which I thought died out with Claude-Levi Strauss. Shows what I know!
If you want to continue this conversation, I will be posting on this thread at my blog, where I can’t get banned for accusing people of ethnocentrism, colonialism, and all that lefty stuff.
It’s been real! :)
Before continuing, Dianne needs to come clean regarding what she does for a living, as I have. If she doesn't, I will assume she works for BigPharm or the medical establishment, and is a lackey for the Western-ethnocentric status quo. I am ready to defend herbalism from
all over the world, not just exhibit some garden-variety, predictable, spoon-fed-by-drug-commercials, June-Cleaver-on-Kaopectate USA bias.
Anyone else wants to jump in, remember, this isn't ALAS, and all assumptions that "The West is the best/get here and we'll do the rest" will be challenged as the racist, evil, ethnocentric arrogance it is, and when you trash the traditions, history and disciplines of another culture, you will be expected to answer for the entire tradition you are defending, including
the medical experimentation done on slaves and
Jews during the Holocaust. You are expecting me to answer for all of herbalism, and accusing me of defending all abuses of herbology, and I will therefore hold you to the exact same standard. Yes, I will haul out
the entire sordid history of the American profit-driven medical medicine. If you are ready to go there, bring it on.
Brought to you by your local hippie herbalist. Toasting with a kava cocktail!
