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CAM Therapies for Specific Conditions: General Precautions

In CAM Therapies for Specific Conditions, complementary and alternative treatments for specific conditions, organized by particular illness or ailment, are summarized.

This information is not intended to replace the medical care of a physician or other licensed clinicians. All persons suffering from any of the following conditions should consult their physicians and licensed practitioners.

A detailed description of specific herbal indications, dosages, forms of preparation, contraindications, and cautions and warnings is given under the section for the condition most commonly treated with that herb.

General Precautions

  • Keep all conventional and CAM medications and supplements out of the reach of children.

  • If you are planning a pregnancy, are pregnant, or are breast feeding, you should talk with your doctor before taking any supplements or herbs.

  • Among the supplements currently on the market are a number of controversial substances whose health benefits have not been definitively proven by randomized clinical trials (RCTs).

  • Not all CAM interventions are harmless. Some are dangerous when used inappropriately or to excess. Consumers should be cautious when selecting herbs. Since the herb industry is essentially unregulated, because the practice of botanical medicine is not formalized, and due to the fact that herbal medicine is not generally taught in the vast majority of medical and pharmacy schools, consumers have essentially been left to their own devices in determining how they will use botanical products. Some herbs themselves also have potentially harmful side effects, and should not be used without an understanding of the full range of their biological activity, and the advice of a physician.

  • Some traditional Chinese medicine and Ayurvedic herbal preparations manufactured by companies in Asia are currently being imported into the United States. There is a lack of quality control in the manufacture of these products, resulting in questionable standards of purity, sanitation, and standardization. Many herbal compounds from China and India may be contaminated with biological materials, as well as with heavy metals, such as arsenic, mercury, or lead. However, some common Chinese and Ayurvedic preparations are now being produced by U.S. companies, and these are much safer.

  • Herbal labels may be inaccurate. A finding published in the September 2, 1998, issue of the Los Angeles Times tested ten common over-the-counter (OTC) products labeled as St. John's wort. Out of the ten products, seven contained between 75 percent and 135 percent of the labeled hypericin and three contained no more than half of the amount stated on the label. Although this focused on St. John's wort, there is a similar unpublished study of wide variation in ginseng content, and it is likely that many other herbs and supplements may be inadequately or even inaccurately labeled.

  • It is important to underscore that there are no long-term safety or efficacy studies on herbal preparations. Actually, there are also too few such studies on conventional pharmaceuticals.

  • Grapefruit is a common food that increases the potency of many conventional medications, such as calcium channel blockers for high blood pressure, angina or chest pain, and arrhythmias; also Seldane, withdrawn from the market but formerly used for allergic rhinitis; and the benzodiazapenes commonly prescribed for anxiety and sleeplessness. Interaction effects of grapefruit or other common foods with herbs are not known. It would be prudent to avoid grapefruit while using herbs appropriate to any of the foregoing conditions.

  • All herbal dosages and recommendations are based upon studies with adults. Safety and efficacy with children is completely unknown.

  • Adults over sixty-five may have diminished liver or renal function and need to be particularly concerned about herbal or supplement excess and/or toxicity. Liver function assessments should be monitored periodically while taking herbals, supplements, as well as many conventional pharmaceuticals.

  • Five excellent, ongoing sources for both public and professional information on alternative medicine are Alternative Medicine Alert from American Health Consultant at (800) 688-2421; Alternative Medicine Advisor from Rebus Publishers (publishers of the Berkeley Wellness Letter and the Johns Hopkins Medical Letter) at (877) 212-1933; Complementary Medicine for the Physician from Churchill Livingstone Publishers; The Integrative Medicine Consult from Intergrative Medicine Communications at (617) 641-2300; and Dr. Andrew Weil's Self Healing from Thorne Communications at (617) 926-0200. For reliable information on herbals, the best source is the American Botanical Council, which published the German Commission E Monographs, in Austin, Texas, at (512) 926-4900; the Encyclopedia of Natural Medicine by Dr. Michael Murray and Dr. Joseph Pizzorno; and most important, the new PDR for Herbal Medicines from Physician's Desk Reference Publishers in Des Moines, Iowa. Finally, the best source of updates on insurance coverage, new clinics, and business opportunities is The Integrator, published by John Weeks in Seattle, Washington.


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Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.
Reprinted by permission of Simon & Schuster, Inc., New York, New York.

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