From: matus [matus@SNET.Net]
Sent: Thursday, October 17, 2002 12:25 AM
To: matus@SNET.Net
Subject: MFD List - Local Letter to the Editor on Unregulated natural
remedies

(This is a wonderfull commentary written by a concerned local resident and
sent to 'The Day'.  It was published in the perspective section and written
by a local pharmacist chastising a previous artile and The Day in general
for not being critical enough of 'natural' remedies. - Mike)

Unregulated 'natural' remedies can endanger your life

http://www.theday.com/news/ts-re.asp?NewsUID=0600F8EF-6F40-4611-A2D9-4F91583
9D4B5

Published on 08/05/2002

By Kim Labrie, R.Ph.

The Day's July 29 article "Taking the alternative route" is a fine example
of why newspapers are a questionable source of health information. The
premise that women on hormon replacement therapy are uninformed, clueless,
unhealthy people blindly popping pills given to them by male doctors simply
to control hot flashes is itself uninformed. Most women go on HRT to protect
their skeletons and, up until now, their hearts.

The idea that Western medicine remedies are all bad because they are
regulated, or because their negative effects are publicly reported, is
ludicrous. Thank goodness the HRT study was done, but is anyone really under
the assumption that an adverse event from using herbal remedies is an
impossibility?

This pharmacist advises you ponder the following:

The FDA requires that regulated medications contain within 25 percent of the
labeled dosage (for example, a capsule claiming to be 100 mg must contain
between 75 mg and 125 mg). Yes, this is quite a lot of variability, but do
you realize that without regulation in the herbal industry there legally can
be only trace amounts in a "100 mg" capsule? If you don't know this, then
how informed are you really? How do you know how much natural remedy you're
actually taking?

Are you familiar with the terms "double-blind," "controlled" and
"randomized" in reference to study design? Would you understand a "p value,"
a major benchmark of measuring a study's validity, if you saw one? If not,
then how informed are you really? How can you judge Western medicine, and
how can you spot and trust a bogus herbal remedy study if you aren't
familiar with proper study design? Your Western medicine practitioners know
the difference, and the information gleaned from proper studies allows us to
make the most informed decisions possible.

Are you familiar with the terms "bioequivalence" and "bioavailability"? If
not, then how informed are you really? How do you know that the St. John's
Wort tortilla chips will work just as well as the capsules a store clerk
sold you before? How do you know your herbal remedy is actually being
absorbed by the body (if it's supposed to) and used by the body, rather than
just passing through?

Western medicine practitioners are required to report all adverse drug
reactions resulting from FDA-regulated medication. How do you know that your
herbal remedy didn't maim or kill someone? Unfortunately, the negative
effects of most herbals may never be aptly attributed because of their lack
of regulation; lack of adverse event reporting requirements; and a general,
but not complete, lack of proper studies to gain valid information.

The FDA has been known to temporarily (or permanently if necessary) shut
down manufacturing plants under their jurisdiction because of unsanitary
conditions. Will anyone shut down the maker of your herbal remedy when it
contains more "essence de cockroach" than herbal remedy?

I'm not totally against natural remedies. There are many life-saving,
quality-of-life preserving, naturally-derived medications embraced by
Western medicine and in wide use. A few examples include digoxin, opium,
aspirin and Taxol. The problem is with the herbal industry's lack of
regulation, which would ensure a pure, clean, properly dosed product about
which safety and efficacy have been ascertained to the best of our present
ability.

People need to stop thinking of herbals as harmless and healthy. In the
wrong amounts or combinations, herbals can harm or even kill you. Just
remember, cocaine, opium and marijuana are all natural, but are they healthy
in their unregulated form? You wouldn't want to partake of an unregulated
amount of belladonna alkaloid or digitalis, but they're all natural.

There are many promising herbal remedies out there, and perhaps the next
blockbuster drug will be all natural. Just don't entirely shun Western
medicine; many of our therapies are all-natural and plant-derived, but well
studied.

How is paying for visits to an herbalist, receiving herbs, and taking them
really any different from visiting your M.D. and taking a prescribed
medication - except that there will be an abundance of information available
from credible sources, and some, if not all, of your visit and Western
remedy will be covered by insurance? Which of the two options sounds more
like blind faith, and which sounds more like an empowering, informed
decision?

I'm not advocating HRT. I'm just leery about taking advice from someone who
is "willing to try anything that is over-the-counter or natural." But alas,
Judy Mann, if your 16 healthy remedies a day (that isn't "screwing with
nature"?), should fail you, Western medicine will still be there for you.

Kim LaBrie, R.Ph., is a registered pharmacist in Waterford

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