|
Drug-Herb
Interactions
by Shihan Mary Bolz,
Licensed Acupuncturist & Herbalist
Master Martial Arts Instructor
Is it safe to combine drug and herbal therapy simultaneously? It is important
that people who are taking medications and wish to
opt for a safer route, consult with a qualified, professional herbalist. A
Traditional Chinese Medicine practitioner is educated and qualified in
Chinese herbal pharmacology as well as acupuncture. It involves a long and
thorough study of not only the art and science of understanding the herbs
properties, actions and effects on the human body, but of deriving an
accurate diagnosis for the cause or imbalance underlying the patient’s
disease or feeling of ill health. A Western pharmacology course is also
included in the education. An degree in Oriental
medicine is a four-year academic program at a specialized school, after
undergraduate studies. Allopathic medicine doctors (M.D.’s)
and pharmacists do not have an education in herbal medicine (unless they also
went to Oriental medicine school). Because of this, there are allopathic medicine practitioners who advise their patients not to
take herbs while on medication. That may be good advice if the patient is
prescribing their own herbal therapy without any formal training. It may be
significantly poor advice if it is preventing the patient from using herbs
under the guidance of a qualified herbalist. In fact, the patient may miss
out on a wonderful opportunity for a great state of health and the
possibility of becoming drug free. The Oriental medicine doctor and the
allopathic medicine doctor can both be great guides for improving people’s
health and both can work together.
How can you, as a heatlh-conscious person work with
your Oriental medicine doctor and your allopathic medicine doctor? It is not
difficult. A professional Oriental medicine doctor will, in the process of
their consultation and exam, want you to supply them with a list of all the
prescription and over-the-counter (OTC) medication that you are taking, any
vitamins or other supplements and herbs, as well as your basic dietary and
liquid consumption habits (coffee, tea, sodas, energizing drinks, alcohol,
etc.) and whether you smoke. An Oriental medicine herbalist will be aware of
any major possible toxic side effects with certain medications, as well as
positive and synergistic effects. Most of the time, it is quite safe to
combine herbal and medication therapy as long as you take the herbs at least
2-3 hours apart from the drugs; 4 hours is even better. You must remember
that herbs are whole food-they are not merely constituent chemical components
like drugs or vitamins. With this understanding, you may realize that there
are drug-food interaction possibilities as well. There are herb-herb and
food-food adverse interactions. In Traditional Oriental Medicine (TCM), these
food-food and herb-herb interactions are well-known.
One of the most powerful over-the counter (OTC) drugs which many people
consume daily is coffee. It is greatly underestimated or unknown by many
people the negative effect of consuming this beverage. It is not only the
caffeine. Due to the unique nature of coffee, it is a great consumer of
nutrients and inhibitor of nutrient resorption,
since it eats away the villi of the intestines. It
is well-known among nutritionists that it significantly inhibits the
absorption of calcium inside the human body. (Soft drinks and diuretic
medications also do this.) The acids in coffee cause as much problem as the
caffeine. Women who consume coffee on top of a high-fat diet have a larger
risk of mammary and bladder cancer according to the Journal of the
American Chemical Society, page 253, 1407, 1995. It would be well for perimenopausal and menopausal women to realize this-the
connection between hormones and anxiety; calcium depletion and osteoporosis.
Coffee can provoke real havoc!
When it comes to substance interaction, there are basically two general
categories of how these interactions are classified: pharmacokinetic of
interactions and the pharmacodynamics of interaction.
Pharmacokinetic refers to the study of a drug from the moment it enters the
body to the moment it leaves the body. Examples of pharmacokinetic
interactions include: 1. Absorption: Concomitant administration of herbs and
drugs may either increase or decrease absorption of herbs and/or drugs. For
example, the absorption of herbs may be affected when given together with
some drugs which changes the pH in the stomach
ultimately decreasing the absorption of herbs. Examples include antacids; Tagamet, Pepcid, Axid, Zantac, Prilosec and Pravacid. 2. Distribution: How the prescribed drug is
distributed through the body. Some drugs are highly bound to protein and have
a narrow therapeutic range. The drug that is most susceptible to improper
distribution is Coumadin. 3. Metabolism: Some drugs
stimulate or suppress metabolism of drugs or herbs in the body. Most herbs
and drugs are metabolized by the liver to inactive derivatives. The rate in
which the liver metabolizes these herbs and drugs would determine the
duration in which these herbs and drugs stay effective in the body. Examples
of drugs that speed up liver metabolism include Dilantin,
Tegretol. The dosage of herbs may need to be
increased in order to maintain the same effectiveness. Examples of drugs that
slow down or inhibit liver metabolism include but are not limited to Tagamet, Erythromycin, Ethanol.
These drugs slow down or inhibit metabolsim-therefore
the dosage of herbs may ned to be decreased to
prevent from overdosing he patient.
Pharmacodynamic refers to the study of drugs as to
how they actually behave inside the human body. Pharmacodynamic
interactions are generally more difficult to predict and prevent. Most of
these interactions known now are documented through actual cases. The best way
to prevent pharmacodynamic interactions is to
follow the patient closely and monitor all clinical responses and signs.
It is virtually impossible to know every possible adverse interaction for any
professional, but the safety of consuming whole herbs and food with drugs is
likely far safer than drug-drug interactions. Most people are aware of
drug-drug interactions, but it seems they grossly underestimate just how
powerful these medications are. I am suggesting that whole herbs are much
safer an interaction with drugs than drugs, including OTC drugs.
A responsible Oriental medicine doctor does not advise the stopping of any
medication cold turkey and if the patient wishes to stop, it should be
gradual, with both the Oriental and allopathic medicine doctors’ monitoring.
Some examples of possible negative drug-herb interactions: Herb Siberian
ginseng with drug Digoxin. Antipsychotic agents
with kava and St. John’s wort.
Asian ginseng with antihypertensive medications. Beta-blockers are used to
treat high blood pressure as well as a variety of heart conditions. They work
by blocking nerve signals that cause the heart to beat faster and blood
pressure to rise. The drugs in this family are too numerous to list. You may
ask your doctor what kind of blood pressure medication yours is. It appears
that one of these drugs, altenolol, may form an unabsorbable complex with calcium in the intestine,
leading to reduced blood levels of the drug. One may avoid calcium
supplementation when taking this drug.
Dietary incompatibilities fall into two categories. Those foods which should
specifically be avoided by patients taking certain medicinal substances and
those who should avoid certain foods and certain food combinations related to
specific symptoms or diseases. For example, traditionally in China,
patients with fever were taught to avoid greasy foods or oils of any type.
Some prohibitions are more general, such as when taking herbs patients should
avoid raw, cold, greasy, or other relatively hard-to-digest foods. These can
upset the digestive tract and disturb the effects of the herbs. Many times
when people think they have the stomach flu, it really can be the result of
having consumed bad food or having consumed the wrong food combinations.,
or merely too much!
It is not in the patient’s best interest to abandon herbal treatment simply
for the fear of possible interactions. The solution to such a problem is in
the understanding of drug-drug and drug-herb interactions. With understanding
of the mechanisms, one can recognize potential interactions and take proper
actions to prevent their occurrences.
For
more information, contact Mary Bolz at 707-455-0638
BACK TO ARTICLES PAGE
|