Herbals Flashcards
What is CAM?
A group of diverse medical and health care systems, practices, and products, that aren’t considered to be part of conventional medicine
What are herbal products?
Medicinal agents obtained from plants
Are herbal products considered dietary supplements?
Yes
Give me some examples of herbs
Flowering plants, shrubs, trees, moss, ferns, algae, seaweed, fungus, flowers, fruits, leaves, twigs, bark, roots, and seed.
Basically, fucking everything.
Decade when natural health had a rebirth
1960’s
Fuckin’ hippies, man
The Office of Alternative Medicine (NIH) was established in 1991 for this reason
Cost of healthcare was rising –> trying to make more options
The National Center for Complementary and Alternative Medicine (CAM NIH) was formed in 1998 for this reason
To research the efficacy of CAM options
As part of the Dietary Supplementand Health Education Act, the FDA created a “dietary supplement” category in 1994(under which herbal remedies fall). Tell me about this category of “medications”
Require no proof of efficacy or safety
Sets no quality control standards
They are exempt from pharmaceutical regulations
The products MAY claim an effect (boots immune system), but can’t claim a cure or treatment (treats colds)
Due to the lack of control of for efficacy, safety, or quality control in herbals, consumers do not know…
1) If active ingredients are even in the product
2) If ingredients are bioavailable
3) If the dosage is appropriate
4) If each bottle or even each pill has the same components
Give me an example of the poor quality control seen in herbal supplements
Amount of Ginseng and potency of Ginseng varies widely between manufacturers and even between batches.
The potency of Ginsenosides (active ingredient) varied WIDELY between manufacturers and batches
Labels were inaccurate
The ginseng was contaminated with other substances like scopolamine and heavy metals
Additives were not on the label (NSAIDs, steroids, sedatives, etc)
Why aren’t manufacturers compelled to do trials to prove efficacy?
1) They aren’t required to
2) They wouldn’t be able to recover the cost of proving that the herbal is safe
The claims of an herbal’s efficacy is mostly based on
anecdotal reports
Are toxicities for herbals listed?
No.
Toxicities are determined by clinical trials, which herbals do not undergo. Plus each pill/batch/manufacturer all have different ingredients and doses so it would be impossible to control
Classification system of herbal safety and toxicity
Class 1: Safe if used appropriately
Class 2: Restrictions unless otherwise directed
a) External use only
b) Do not use if pregnant
c) Do not use i f breastfeeding
Class 3: Only use under the supervision of an expert
Class 4: Insufficient data is available
__% of Americans use some sort of CAM
35%
__% of Americans presenting for surgery use herbal medications
23%
50% take multiple herbs
25% also take prescription drugs
__% of those using herbs don’t tell their doctor or anesthesia provider
70%
Need to ask them about it because often people don’t think of herbs as worth mentioning!
