tropicalfish
Veteran Member
Lesson 2 : Using Herbal Medicine SAFELY
Topic 1: Medicine's Double Standard
Topic 2: The Issue of Dose Control
Topic 3: General Safety Guidelines for Using Medicinal Herbs
Topic 4: Potentially Problematic Herbs
Lesson 2 Topic 1
Lecture and Discussion
Using Herbal Medicine SAFELY
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
Medicine's Double Standard
Until quite recently, mainstream medicine promulgated a double standard concerning dissemination of information about medicinal herbs. Specifically, mainstream medical journals have been notoriously quick to publish reports on the hazards and side effects of herbs, sometimes using studies of questionable scientific merit. On the other hand, the very same journals have been slow to publish reports of herbal benefits, sometimes ignoring studies that are scientifically rigorous.
Fortunately, in the last few years, mainstream medical journals have adopted a more objective view. The journals include not only more reports of herbal benefits, but also well-documented, less lurid reports of their side effects.
Despite the changing perspective in medical journals, doctors and the public still generally believe that pharmaceuticals are more trustworthy than herbs simply because pharmaceuticals are more tightly regulated by the Food and Drug Administration.
However, some herbs have much longer histories of use. In fact, for decades, centuries, and even millennia, the presence and use of herbs has withstood the test of time. Furthermore, according to recent surveys by various mainstream medical authorities, herbs have been proven to be much safer to use than pharmaceuticals.
Each year the American Association of Poison Control Centers in Washington, D.C., compiles figures on accidental poisonings around the country. For one recent year, pain relievers, cough and cold preparations, antibiotics, sedatives, and antidepressants accounted for more than 480,000 poisonings (both intentional suicide attempts and accidental overdoses). Medicinal herbs accounted for only a few dozen; overwhelmingly, these were reactions to Chinese ephedra (ma huang) taken as an amphetamine-like intoxicant.
In a report by the Journal of the American Medical Association, researchers at the University of Toronto combed 30 years of medical literature (1966-96) for reports of drug side effects among hospital patients. Extrapolating from 39 of the most scientifically rigorous studies, the researchers estimated that drug side effects account for an astonishing 106,000 U.S. hospital deaths a year and cause 2.2 million serious nonfatal medical problems.
In other words, adverse reactions to pharmaceuticals rank as the U.S.'s fourth leading cause of death and kill more people than AIDS, suicide, and homicide combined. Surprisingly, these side effects did not result from any medical error but, rather, occurred when drugs were administered in accordance with FDA dosage guidelines (Lazarou, J., et al., Journal of the American Medical Association [1998], 279:1200).
Given the statistics, it is clear that pharmaceuticals are more hazardous than herbs and that toxic reactions to herbs are not a major public health problem. One unfortunate result of mainstream medicine's longstanding prejudice against herbs has been an equally uninformed backlash by some herb advocates who have claimed that herbs cannot possibly cause harm. This line of thinking is incorrect, since some of the most potent poisons are botanical.
As briefly discussed above, ma huang can be hazardous when misused as an intoxicant. Further, in the 1980s, researchers discovered that comfrey and coltsfoot contain potentially liver-damaging pyrrolizidine alkaloids. Responsible herbalists no longer recommend their ingestion. As discussed in Lesson 1, Socrates was put to death with a cup of poison hemlock, an herb that resembles parsley. Never eat wild parsley. Another potent herbal poison is the Amanita ("death cap") mushroom. Never pick wild mushrooms unless you're certain you can identify them correctly.
Like drugs, any plant with the potential for healing when used appropriately also has the potential for harm when used irresponsibly. The most popular medicinal herbs -- including all of the herbs discussed in this course -- are reasonably safe for most people, most of the time, and when taken in their recommended amounts. However, medicinal herbs contain pharmacologically active compounds that have drug effects on the body. And all drugs have the potential to cause allergic reactions, side effects, possible fetal harm, and interactions with other herbs and drugs. Overall, herbs are safer than pharmaceuticals, but they can still cause harm, and anyone who uses them should do so cautiously and responsibly.
Lesson 2 Topic 2
Lecture and Discussion
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
The Issue of Dose Control
Herb critics contend that herbs are hazardous since the typical directions -- 1 to 2 teaspoons of dried herb per cup of boiling water steeped for 10 to 20 minutes -- yield preparations with highly variable doses of the medicinally active compounds. In contrast, when taking pharmaceuticals, users know precisely how much they're ingesting.
Herb critics have a point: herb potency depends on plant genetics, growing conditions, maturity at harvest, time in storage, the possibility of adulteration, and preparation method. On the other hand, one needs to look no further than the suicide statistics to know that precise dose control is no guarantee that pharmaceuticals will be used safely.
In addition, a drug's effect depends on the weight of the individual using it. For instance, a standard dose of a pharmaceutical taken by a person who weighs 120 pounds has a greater effect than the same dose ingested by someone who weighs 200 pounds. Also, individuals vary and people often have very different reactions to the same drugs.
In general, medicinal herbs cause fewer side effects than pharmaceuticals. Pharmaceuticals tend to be highly concentrated and pills and capsules have little taste, factors that make it easier to take an overdose. With herbs, active constituents are typically less concentrated, and the fact that most taste bitter helps discourage overdose. Still, anyone who uses healing herbs must strive for good dose control.
The doses recommended in this course represent a consensus of the opinions found in both traditional herbals and scientific references. Where sources disagreed, this course recommends a smaller amount. After all, it's best to err on the side of caution.
At present time, there are an increasing number of herbal medicines available as "standardized extracts." This means that the plant was grown from seeds or clones known to produce a certain concentration of its pharmacologically active compounds. The herb is then cultivated, harvested, stored, and prepared under well-controlled conditions in order to produce a fairly reliable dose uniformity. Standardized extracts are not as accurately dose-controlled as laboratory-synthesized pharmaceuticals, but they're close, and considerably more dose-controlled than ordinary bulk herbs. Whenever possible, you should buy standardized extracts.
Lesson 2 Topic 3
Lecture and Discussion
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
General Safety Guidelines for Using Medicinal Herbs
·Before you take any herb, research it. You can consult the safety discussions that will be included in subsequent lessons of this course as well as the texts for this course, which contain extensive safety discussions. Take any warnings seriously. If you experience doubt about the safety of any herb for your particular medical condition or medical history, don't use it.
·Don't take herb identity for granted. Look for products that identify herbs by their Latin binomial names -- genus and species.
·Stick to the recommended dosage and do not exceed it. Some people erroneously assume that if a little is good, more must be better. Herbal dosage recommendations are based on scientific research and often centuries of clinical experience.
·When using commercial preparations (teas, tinctures, pills, capsules, etc.), follow the label directions.
·Respect your individuality. You might be allergic to one or more herbs. Or you might develop unusual reactions. When using herbal medicines, be aware of adverse reactions such as abdominal upset, diarrhea, headache, itching, rash, or anything out of the ordinary. If you notice unusual symptoms that appear to be linked to a medicinal herb, stop taking it and discuss your reaction(s) with your doctor.
·Older people tend to be more sensitive to herbs because aging increases sensitivity to herbs and drugs. If you're over 60, pay close attention to how herbs affect you. You might start by taking a low dose. You can always increase the dose later, if appropriate. In addition, older people often take other medications and may develop problematic herb-drug interactions. Remember: if you believe a symptom is linked to your use of a medicinal herb, you should stop using it and consult your physician.
·Sensitivities to herbs tend to be more common among those who have allergies such as hayfever, hives, or illnesses linked to allergies (asthma and eczema), or those who have suffered a serious allergic reaction (anaphylaxis). It is unlikely that medical herbs will cause anaphylaxis, but it is possible. The main symptom is difficulty breathing. If you develop any trouble breathing, call 911 immediately and tell the operator you suspect anaphylaxis. Paramedics should be sent. Act quickly. Anaphylaxis can be fatal.
·Even if you're not allergic, it's possible that, out of the blue, you may react badly to an herb generally considered safe. It happens. Pay attention to your body. If things go awry and you suspect an herb, stop taking it, and consult your physician.
·With few exceptions (for example, raspberry), pregnant and nursing women should not use medicinal preparations of herbs. Herbs that cause no problems for adults may harm the unborn and newborns. Pregnant and nursing women should only use herbs medicinally with the consent and supervision of their obstetrician or nurse-midwife. (However, pregnant and nursing women may drink popular beverage herb teas, which are less potent than medicinal preparations.)
·With a few exceptions -- apple, cinnamon, chamomile, cranberry, dill water, and ginger -- don't give medicinal herbs to children under age 2. When giving herbs to kids, dilute them in accordance with the child's weight. Standard herb doses assume a 150-pound individual. Therefore, if a child weighs 50 pounds, give about one-third the adult dose.
·Be very careful with herbs if you're already taking pharmaceuticals for any chronic condition. In general, it's a mistake to duplicate drug effects with herbs. If you're taking an antidepressant, don't take St. John's wort, the herbal antidepressant. If you're taking an anticoagulant such as aspirin, don't take garlic. If you're taking a tranquilizer or anti-anxiety medication, steer clear of kava, an herbal tranquilizer.
·Be very careful when taking a newly popular herb or an old herb with a new use. In the mid-1990s, when St. John's wort was shown to have an important new use as an antidepressant, it flew off the shelves. As the number of users jumped into the millions, new side effects began to show up, for example, an interference with protease inhibitors, the most powerful AIDS medications. Until St. John's wort became so popular, too few people took it for this problem to be noticed.
·Be very careful when using herb oils, the constituents that give aromatic herbs their fragrances. The "essential" oils of aromatic herbs are highly concentrated and small amounts may cause serious harm. As little as a teaspoon of pennyroyal oil can cause death. Many herb oils are available commercially. If you ingest any, take only a drop or two at a time. Keep them well out of children's reach.
·Pay attention to any symptoms of toxicity. If you develop an upset stomach, nausea, diarrhea, and/or headache within an hour or two of taking any herb, stop taking it. When in doubt, call your local Poison Control Center (in the white pages under "Poison"), 911, or your physician or pharmacist.
·In any medical consultation, tell the doctor which herbs you take and why. Full disclosure helps prevent potentially harmful herb-drug interactions.
·If you're scheduled for surgery, stop taking anticoagulant herbs at least two weeks beforehand. Anticoagulant herbs include evening primrose oil, garlic, ginger, turmeric, and willow.
Herb Safety
For more information on the safe use of herbs, see Chapter 2, 'Tempest in a Teapot," in "The New Healing Herbs." Much of The Complete Guide to Herbal Medicines is devoted to safety issues -- read the foreword and preface to get an idea of the authors' perspective. Turn to this book every time you consider using an herbal remedy, especially if taking other medication simultaneously.
Lesson 2 Topic 4
Lecture and Discussion
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
Potentially Problematic Herbs
Some widely used herbs are more likely to cause problems than others. Herb users should become familiar with these herbs and exercise extra caution when using them.
·Stimulants: Stimulants are the herbs most likely to cause trouble. Large doses of Chinese ephedra (ma huang) can cause amphetamine-like effects and potentially fatal heart problems. Unusually large doses of other herbal stimulants can also cause problems. Herbs with stimulant action include ginseng and any herb that contains caffeine, such as coffee, tea, cocoa, chocolate, maté, kola, and guarana. Don't exceed recommended doses and, in the case of the herbs that contain caffeine, don't take more than what you're used to. In addition, don't take two or more stimulant herbs at the same time; the effects are additive.
·Laxatives: Aloe vera, buckthorn, cascara sagrada, and senna all contain potent laxative compounds (anthroquinones). Even in their recommended doses they may cause violent purgation and abdominal distress. In larger doses, they can cause bloody diarrhea and a host of other problems. Chemical laxatives -- both herbal and pharmaceutical -- should be last-resort treatments for constipation. A better choice is the high-fiber herb psyllium, conveniently available in over-the-counter formulations.
·Tranquilizing and sedative herbs: This group includes valerian, catnip, chamomile, hops, kava, lavender, lemon balm, and passionflower. Just as over-stimulation can be hazardous, so can over-sedation. Beware of using medicinal preparations of more than one of these herbs at a time. (However, this warning does not apply to beverage herb teas.) Don't use these herbs with alcohol, which is a very potent tranquilizer-sedative. Finally, don't use these herbs with pharmaceutical tranquilizers (Valium, etc.) or sedatives (Ambien, etc.).
Lesson 2 Assignment
Activity: Using Herbal Medicine SAFELY
Most people, even those who consider themselves "into" herbs, know little about herbal safety issues. Talk about herbal safety with a few friends who use herbal medicine. Ask if herbal medicine is safe and what a person using herbs should watch out for, if anything. Chances are that your friends know less about herbal safety than you now know.
Any good introductory text on herbal medicine will devote some portion of its content to discussing herbal safety. In your course text, The New Healing Herbs, read Chapter 2, "Tempest in a Teapot."
Lesson 2 Review
Activity: Using Herbal Medicine SAFELY
1. Comfrey and coltsfoot should not be ingested because:
A. They contain liver-damaging pyrrolizidine alkaloids
B. They cause vomiting
C. They may cause blurred vision
D. They cause kidney damage
2. For best dose control, buy herbs available in:
A. Bulk
B. Standardized extracts
C. Controlled preparations
D. Tamper-proof containers
3. Before taking any medicinal herb you should:
A. Gargle
B. Drink a glass of water
C. Research it
D. Mix it with water
4. The recommended dosage of any herb:
A. Can be safely doubled
B. Can be safely tripled
C. Applies only to children and the elderly
D. Should not be exceeded
5. If you are already taking pharmaceutical medication to treat a chronic condition:
A. Feel free to take herbs that also treat that condition
B. Don't take herbs that treat that condition
C. Alternate your drugs and herbs
D. Use only herbal tinctures along with pharmaceutical medication
6. Herbal oils should not be ingested because:
A. They taste awful
B. They cause vomiting
C. They turn the tongue blue
D. As little as a teaspoon can be toxic, even fatal
Topic 1: Medicine's Double Standard
Topic 2: The Issue of Dose Control
Topic 3: General Safety Guidelines for Using Medicinal Herbs
Topic 4: Potentially Problematic Herbs
Lesson 2 Topic 1
Lecture and Discussion
Using Herbal Medicine SAFELY
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
Medicine's Double Standard
Until quite recently, mainstream medicine promulgated a double standard concerning dissemination of information about medicinal herbs. Specifically, mainstream medical journals have been notoriously quick to publish reports on the hazards and side effects of herbs, sometimes using studies of questionable scientific merit. On the other hand, the very same journals have been slow to publish reports of herbal benefits, sometimes ignoring studies that are scientifically rigorous.
Fortunately, in the last few years, mainstream medical journals have adopted a more objective view. The journals include not only more reports of herbal benefits, but also well-documented, less lurid reports of their side effects.
Despite the changing perspective in medical journals, doctors and the public still generally believe that pharmaceuticals are more trustworthy than herbs simply because pharmaceuticals are more tightly regulated by the Food and Drug Administration.
However, some herbs have much longer histories of use. In fact, for decades, centuries, and even millennia, the presence and use of herbs has withstood the test of time. Furthermore, according to recent surveys by various mainstream medical authorities, herbs have been proven to be much safer to use than pharmaceuticals.
Each year the American Association of Poison Control Centers in Washington, D.C., compiles figures on accidental poisonings around the country. For one recent year, pain relievers, cough and cold preparations, antibiotics, sedatives, and antidepressants accounted for more than 480,000 poisonings (both intentional suicide attempts and accidental overdoses). Medicinal herbs accounted for only a few dozen; overwhelmingly, these were reactions to Chinese ephedra (ma huang) taken as an amphetamine-like intoxicant.
In a report by the Journal of the American Medical Association, researchers at the University of Toronto combed 30 years of medical literature (1966-96) for reports of drug side effects among hospital patients. Extrapolating from 39 of the most scientifically rigorous studies, the researchers estimated that drug side effects account for an astonishing 106,000 U.S. hospital deaths a year and cause 2.2 million serious nonfatal medical problems.
In other words, adverse reactions to pharmaceuticals rank as the U.S.'s fourth leading cause of death and kill more people than AIDS, suicide, and homicide combined. Surprisingly, these side effects did not result from any medical error but, rather, occurred when drugs were administered in accordance with FDA dosage guidelines (Lazarou, J., et al., Journal of the American Medical Association [1998], 279:1200).
Given the statistics, it is clear that pharmaceuticals are more hazardous than herbs and that toxic reactions to herbs are not a major public health problem. One unfortunate result of mainstream medicine's longstanding prejudice against herbs has been an equally uninformed backlash by some herb advocates who have claimed that herbs cannot possibly cause harm. This line of thinking is incorrect, since some of the most potent poisons are botanical.
As briefly discussed above, ma huang can be hazardous when misused as an intoxicant. Further, in the 1980s, researchers discovered that comfrey and coltsfoot contain potentially liver-damaging pyrrolizidine alkaloids. Responsible herbalists no longer recommend their ingestion. As discussed in Lesson 1, Socrates was put to death with a cup of poison hemlock, an herb that resembles parsley. Never eat wild parsley. Another potent herbal poison is the Amanita ("death cap") mushroom. Never pick wild mushrooms unless you're certain you can identify them correctly.
Like drugs, any plant with the potential for healing when used appropriately also has the potential for harm when used irresponsibly. The most popular medicinal herbs -- including all of the herbs discussed in this course -- are reasonably safe for most people, most of the time, and when taken in their recommended amounts. However, medicinal herbs contain pharmacologically active compounds that have drug effects on the body. And all drugs have the potential to cause allergic reactions, side effects, possible fetal harm, and interactions with other herbs and drugs. Overall, herbs are safer than pharmaceuticals, but they can still cause harm, and anyone who uses them should do so cautiously and responsibly.
Lesson 2 Topic 2
Lecture and Discussion
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
The Issue of Dose Control
Herb critics contend that herbs are hazardous since the typical directions -- 1 to 2 teaspoons of dried herb per cup of boiling water steeped for 10 to 20 minutes -- yield preparations with highly variable doses of the medicinally active compounds. In contrast, when taking pharmaceuticals, users know precisely how much they're ingesting.
Herb critics have a point: herb potency depends on plant genetics, growing conditions, maturity at harvest, time in storage, the possibility of adulteration, and preparation method. On the other hand, one needs to look no further than the suicide statistics to know that precise dose control is no guarantee that pharmaceuticals will be used safely.
In addition, a drug's effect depends on the weight of the individual using it. For instance, a standard dose of a pharmaceutical taken by a person who weighs 120 pounds has a greater effect than the same dose ingested by someone who weighs 200 pounds. Also, individuals vary and people often have very different reactions to the same drugs.
In general, medicinal herbs cause fewer side effects than pharmaceuticals. Pharmaceuticals tend to be highly concentrated and pills and capsules have little taste, factors that make it easier to take an overdose. With herbs, active constituents are typically less concentrated, and the fact that most taste bitter helps discourage overdose. Still, anyone who uses healing herbs must strive for good dose control.
The doses recommended in this course represent a consensus of the opinions found in both traditional herbals and scientific references. Where sources disagreed, this course recommends a smaller amount. After all, it's best to err on the side of caution.
At present time, there are an increasing number of herbal medicines available as "standardized extracts." This means that the plant was grown from seeds or clones known to produce a certain concentration of its pharmacologically active compounds. The herb is then cultivated, harvested, stored, and prepared under well-controlled conditions in order to produce a fairly reliable dose uniformity. Standardized extracts are not as accurately dose-controlled as laboratory-synthesized pharmaceuticals, but they're close, and considerably more dose-controlled than ordinary bulk herbs. Whenever possible, you should buy standardized extracts.
Lesson 2 Topic 3
Lecture and Discussion
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
General Safety Guidelines for Using Medicinal Herbs
·Before you take any herb, research it. You can consult the safety discussions that will be included in subsequent lessons of this course as well as the texts for this course, which contain extensive safety discussions. Take any warnings seriously. If you experience doubt about the safety of any herb for your particular medical condition or medical history, don't use it.
·Don't take herb identity for granted. Look for products that identify herbs by their Latin binomial names -- genus and species.
·Stick to the recommended dosage and do not exceed it. Some people erroneously assume that if a little is good, more must be better. Herbal dosage recommendations are based on scientific research and often centuries of clinical experience.
·When using commercial preparations (teas, tinctures, pills, capsules, etc.), follow the label directions.
·Respect your individuality. You might be allergic to one or more herbs. Or you might develop unusual reactions. When using herbal medicines, be aware of adverse reactions such as abdominal upset, diarrhea, headache, itching, rash, or anything out of the ordinary. If you notice unusual symptoms that appear to be linked to a medicinal herb, stop taking it and discuss your reaction(s) with your doctor.
·Older people tend to be more sensitive to herbs because aging increases sensitivity to herbs and drugs. If you're over 60, pay close attention to how herbs affect you. You might start by taking a low dose. You can always increase the dose later, if appropriate. In addition, older people often take other medications and may develop problematic herb-drug interactions. Remember: if you believe a symptom is linked to your use of a medicinal herb, you should stop using it and consult your physician.
·Sensitivities to herbs tend to be more common among those who have allergies such as hayfever, hives, or illnesses linked to allergies (asthma and eczema), or those who have suffered a serious allergic reaction (anaphylaxis). It is unlikely that medical herbs will cause anaphylaxis, but it is possible. The main symptom is difficulty breathing. If you develop any trouble breathing, call 911 immediately and tell the operator you suspect anaphylaxis. Paramedics should be sent. Act quickly. Anaphylaxis can be fatal.
·Even if you're not allergic, it's possible that, out of the blue, you may react badly to an herb generally considered safe. It happens. Pay attention to your body. If things go awry and you suspect an herb, stop taking it, and consult your physician.
·With few exceptions (for example, raspberry), pregnant and nursing women should not use medicinal preparations of herbs. Herbs that cause no problems for adults may harm the unborn and newborns. Pregnant and nursing women should only use herbs medicinally with the consent and supervision of their obstetrician or nurse-midwife. (However, pregnant and nursing women may drink popular beverage herb teas, which are less potent than medicinal preparations.)
·With a few exceptions -- apple, cinnamon, chamomile, cranberry, dill water, and ginger -- don't give medicinal herbs to children under age 2. When giving herbs to kids, dilute them in accordance with the child's weight. Standard herb doses assume a 150-pound individual. Therefore, if a child weighs 50 pounds, give about one-third the adult dose.
·Be very careful with herbs if you're already taking pharmaceuticals for any chronic condition. In general, it's a mistake to duplicate drug effects with herbs. If you're taking an antidepressant, don't take St. John's wort, the herbal antidepressant. If you're taking an anticoagulant such as aspirin, don't take garlic. If you're taking a tranquilizer or anti-anxiety medication, steer clear of kava, an herbal tranquilizer.
·Be very careful when taking a newly popular herb or an old herb with a new use. In the mid-1990s, when St. John's wort was shown to have an important new use as an antidepressant, it flew off the shelves. As the number of users jumped into the millions, new side effects began to show up, for example, an interference with protease inhibitors, the most powerful AIDS medications. Until St. John's wort became so popular, too few people took it for this problem to be noticed.
·Be very careful when using herb oils, the constituents that give aromatic herbs their fragrances. The "essential" oils of aromatic herbs are highly concentrated and small amounts may cause serious harm. As little as a teaspoon of pennyroyal oil can cause death. Many herb oils are available commercially. If you ingest any, take only a drop or two at a time. Keep them well out of children's reach.
·Pay attention to any symptoms of toxicity. If you develop an upset stomach, nausea, diarrhea, and/or headache within an hour or two of taking any herb, stop taking it. When in doubt, call your local Poison Control Center (in the white pages under "Poison"), 911, or your physician or pharmacist.
·In any medical consultation, tell the doctor which herbs you take and why. Full disclosure helps prevent potentially harmful herb-drug interactions.
·If you're scheduled for surgery, stop taking anticoagulant herbs at least two weeks beforehand. Anticoagulant herbs include evening primrose oil, garlic, ginger, turmeric, and willow.
Herb Safety
For more information on the safe use of herbs, see Chapter 2, 'Tempest in a Teapot," in "The New Healing Herbs." Much of The Complete Guide to Herbal Medicines is devoted to safety issues -- read the foreword and preface to get an idea of the authors' perspective. Turn to this book every time you consider using an herbal remedy, especially if taking other medication simultaneously.
Lesson 2 Topic 4
Lecture and Discussion
Any drug or herb that has the potential for good when used responsibly also has the potential for harm when used irresponsibly or ignorantly. This lesson provides guidelines for the safe, responsible use of herbs.
Potentially Problematic Herbs
Some widely used herbs are more likely to cause problems than others. Herb users should become familiar with these herbs and exercise extra caution when using them.
·Stimulants: Stimulants are the herbs most likely to cause trouble. Large doses of Chinese ephedra (ma huang) can cause amphetamine-like effects and potentially fatal heart problems. Unusually large doses of other herbal stimulants can also cause problems. Herbs with stimulant action include ginseng and any herb that contains caffeine, such as coffee, tea, cocoa, chocolate, maté, kola, and guarana. Don't exceed recommended doses and, in the case of the herbs that contain caffeine, don't take more than what you're used to. In addition, don't take two or more stimulant herbs at the same time; the effects are additive.
·Laxatives: Aloe vera, buckthorn, cascara sagrada, and senna all contain potent laxative compounds (anthroquinones). Even in their recommended doses they may cause violent purgation and abdominal distress. In larger doses, they can cause bloody diarrhea and a host of other problems. Chemical laxatives -- both herbal and pharmaceutical -- should be last-resort treatments for constipation. A better choice is the high-fiber herb psyllium, conveniently available in over-the-counter formulations.
·Tranquilizing and sedative herbs: This group includes valerian, catnip, chamomile, hops, kava, lavender, lemon balm, and passionflower. Just as over-stimulation can be hazardous, so can over-sedation. Beware of using medicinal preparations of more than one of these herbs at a time. (However, this warning does not apply to beverage herb teas.) Don't use these herbs with alcohol, which is a very potent tranquilizer-sedative. Finally, don't use these herbs with pharmaceutical tranquilizers (Valium, etc.) or sedatives (Ambien, etc.).
Lesson 2 Assignment
Activity: Using Herbal Medicine SAFELY
Most people, even those who consider themselves "into" herbs, know little about herbal safety issues. Talk about herbal safety with a few friends who use herbal medicine. Ask if herbal medicine is safe and what a person using herbs should watch out for, if anything. Chances are that your friends know less about herbal safety than you now know.
Any good introductory text on herbal medicine will devote some portion of its content to discussing herbal safety. In your course text, The New Healing Herbs, read Chapter 2, "Tempest in a Teapot."
Lesson 2 Review
Activity: Using Herbal Medicine SAFELY
1. Comfrey and coltsfoot should not be ingested because:
A. They contain liver-damaging pyrrolizidine alkaloids
B. They cause vomiting
C. They may cause blurred vision
D. They cause kidney damage
2. For best dose control, buy herbs available in:
A. Bulk
B. Standardized extracts
C. Controlled preparations
D. Tamper-proof containers
3. Before taking any medicinal herb you should:
A. Gargle
B. Drink a glass of water
C. Research it
D. Mix it with water
4. The recommended dosage of any herb:
A. Can be safely doubled
B. Can be safely tripled
C. Applies only to children and the elderly
D. Should not be exceeded
5. If you are already taking pharmaceutical medication to treat a chronic condition:
A. Feel free to take herbs that also treat that condition
B. Don't take herbs that treat that condition
C. Alternate your drugs and herbs
D. Use only herbal tinctures along with pharmaceutical medication
6. Herbal oils should not be ingested because:
A. They taste awful
B. They cause vomiting
C. They turn the tongue blue
D. As little as a teaspoon can be toxic, even fatal