Herbal remedy

What over-the-counter or herbal remedies have you used for the pain ... 

The approach is quite similar to that for a well-established medical product, in that the applicant must submit bibliographic data supporting the safety, efficacy and duration of the traditional use of the herbal remedy (see Table 8.2). 

Van Arsdall A. Medieval herbal remedies. The old English Herbarium and Anglo-Saxon medicine. Routledge, Boca Raton, 2002. 

A wide diversity of herbal remedies have purported abilities to stimulate defense functions. Complexes of carbohydrate and lignin, which are present in some herbs, modulate enteric immune functions (Kiyohara et al, 2000), and the changes in cytokine secretion (Matsumoto and Yamada, 2000) can trigger systemic responses. The polysaccharides present in other herbal medicines augment production of immunoglobulin (Ig) A by the Peyer s patches in the small intestine (Sakushima et al, 1997 Yu et al, 1998). The responses of the enteric immune system to lectins are variable (Pusztai 1993), and can elicit systemic responses (Lavelle et al, 2000). Other phytochemicals provide protection by inducing detoxification pathways in mucosal cells (Williamson et al, 1998). 

St. John s wort This herbal remedy may induce CYP3A4 the certainty of an interaction probably rests on the specific preparation being used, but caution would dictate that this herbal product should be avoided in those receiving methadone treatment withdrawal symptoms have been noted in patients taking methadone maintenance who have added St. John s wort to their drug regimen. 

Black cohosh has been one of the most studied herbal remedies for vasomotor symptoms, and it has not demonstrated a substantial benefit over placebo. The mechanism of action, safety profile, drug-drug interactions, and adverse effects of black cohosh remain unknown. In non-placebo-controlled trials conducted for 6 months or less, black cohosh demonstrated a small reduction in vasomotor symptoms. It has not been shown to be effective for vasomotor symptoms in women with breast cancer.33 There have been case reports of hepatotoxicity with the use of black cohosh.36 Caution should be exercised when considering the use of this product, especially in patients with liver dysfunction. 

Johnson, L., Strich, H., Taylor, A., Timmermann, B. et al. (2006). Use of herbal remedies by diabetic Hispanic women in the southwestern united states. Phytother. Res., 20, 250-5. 

Elder The Amazing Healing Benefits of Elder, the Premier Herbal Remedy for Colds and Flu Keats Good Herb Guide Mars, Brigitte. 

Used for centuries and steeped in legend, elder provides a host of amazing benefits as both medicine and food. Today elder is rapidly gaining popularity as a premier herbal remedy for colds and flu with impressive scientific research proving its effectiveness. 

According to retail sales data, patients spent 3.24 billion for herbal therapies in 1997 [10]. It is estimated that a third of the nation s adults spend an average of 54 per year on herbal remedies [10]. The top 10 herbs... 

Herbal remedies that have been reported to be he-patotoxic include chaparral (Larrea tridentata), germander (Teucrium chamaedrys), and life root (Senecio aureus) [18]. Cases reported patients developing jaundice, fatigue, pruritus, markedly elevated serum liver enzyme levels, severe cholestasis, hepatitis, and hepatocellular injury or necrosis documented by serial liver biopsies [19-21]. Signs and symptoms may occur as early as 3 weeks to as late as 7 months following ingestion [20,21]. 

Johnston BA. One-third of nations adults use herbal remedies market estimated at 3.24 billion. Herbal-Gram 40 49, 1997. 

Barnes J, Mills SY, Abbot NC, Willoughby M, Ernst E. Different standards for reporting ADR to herbal remedies and conventional OTC medicines. Br J Clin Pharmacol 45 496-500, 1998. 

Tyler VE. What pharmacists should know about herbal remedies. J Am Pharm Assn NS36(l) 29-37, 1996. 

As indicated in previous sections of this chapter, there has developed a quite impressive international consensus on the general principles of bioequivalency determination for drug products regulated by agencies such as FDA. However, there are other materials used with therapeutic intent for which bioequivalency may also be a legitimate concern. Herbal remedies have, in recent years, demonstrated impressive increases in sales in many parts of the world. Other substances of natural origin have gained considerable attention for their possible curative potential. For example, shark... 

St John s wort is a yellow flowering plant that was first used medicinally by the ancient Greeks as a diuretic and a treatment for wounds and menstrual disorders. This herbal remedy is widely prescribed in Germany, where it has been studied extensively in clinical trials as a treatment for depression. In most countries, including the UK, it is available over the counter. In Ireland it is available only by prescription. Recently, a team of German scientists led by Klaus Linde at the University of Munich published a comprehensive review of 29 clinical trials of St John s wort, involving more than 5,000 depressed patients. They concluded that it is more effective than placebos and as effective as standard antidepressants in the treatment of major depression. 

I am not a great fan of St John s wort. For lasting control of depression, psychological treatment produces the best results, and medication does not add much - if anything - to it. Nevertheless, if a depressed patient wants medication, or if available alternative treatments are not sufficiently effective, this herbal remedy, taken under medical guidance, may be worth considering. 

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