Killer Herbs

An Australian forensic pathologist, Professor Roger Byard, wades into the herbal remedy debate with the dire warning Herbal remedies can kill. This is rather over the top, even for an aussie. Sure, there have been fatalities from herbal remedies, especially some of the Chinese ones that contain things that are suspiciously non-herbal. But you can kill yourself with paracetamol quite easily  and there isn’t a medication made that is 100% safe.

In the US alone at least 100,000 people die every year from the side effects of conventional medicine – around 10,000 from simple medication errors. Before the herbalists start gloating, though, I should point out that the vast majority of conventional medicines are considerably stronger in their effects than the herbal versions. Herbal medicines get their “safety” profile from the fact that most of them are considerably weaker and, usually, less effective – particularly in the types of doses recommended by the manufacturers.

Quite a number of deaths attributed to herbal remedies are, in fact, caused by the concomitant consumption of a conventional medicine. Prof Byard cites the classical example of this in the admixture of St John’s Wart (usually taken for depression or menopausal symptoms) and Warfarin. St. John’s Wort prolongs the action of Warfarin, making you more likely to bleed or have a haemorrhagic stroke (bleed on the brain). The problem here is not with the St John’s Wort, which is one of the more useful herbals, but with its use with Warfarin (it is also potentially dangerous with antidepressants such as Prozac). Note that taking St John’s Wort with Warfarin is not actually a problem – you just need to use a good quality brand of the herb (so that the dosage is fairly constant) and you need to take frequent blood tests until your clotting time (INR) settles to its new level. Typically, you will be taking less warfarin.

Likewise, most of the herbals can safely co-exist with conventional drugs, but it is essential your doctor knows that you are taking them. Doctors are notoriously bad at asking about herbals – we just don’t think about them. It is therefore important you volunteer the information. Some doctors will then attempt to get you off your herbal meds. I can’t advise you here as they may well be doing the right thing. However, if you are unhappy with your GP’s attitude, you always have the choice to find someone more sympathetic.

By far and away the biggest problem with herbal medicine is not their side effects or the dangers of taking them, it is the dangers of taking them in preference to conventional medicine. While St John’s wort appears to be effective in mild to moderate depression, a severely depressed person almost certainly requires conventional drugs and psychotherapy. While Saw Palmetto seems quite effective for benign prostate enlargement, it is utterly useless for prostate cancer. These remedies are not necessarily useless, just inadequate for the purpose. Taking them can lead to delays in diagnosis and treatment with sometimes fatal results.

Herbal remedies are no better or worse than conventional drugs in general. Just because something is “natural” does not mean it is safer, less harmful or better for you. Deadly Nightshade is a herbal drug, as is aconite (Wolfsbane), but you wouldn’t want to be taking either of them.

Not for long, anyway.

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