Herbs,
Vitamins and Pharmaceuticals: Working together safely
.pdf
version
1.
Safety First! Most herbs and vitamins are quite safe on
their own, and generally adverse events are very few. Deaths are
extremely rare. Combining herbs with pharmaceutical drugs provides
the greatest potential risk.
2. Some herbs are inherently toxic. Alkaloids in
plants such as Comfrey, Coltsfoot, Butterbur, Borage can damage
the liver if taken in large quantities. Other alkaloids, like those
in Ephedra, can dangerously raise blood pressure. Others still can
cause nausea, like Ipecac and Lobelia. Some folks have allergies
to certain plants as well – such as an allergy to members
of the Composite family (plants like Echinacea and Chamomile); allergy
to salycilates (aspirin, Meadowsweet, Willow barks).
3. Plant interactions with specific body systems:
a. Kidney and Renal: Irritating metabolites like
Juniper, Uva Ursi, Buchu; Oxalate-containing plants like Rhubarb,
Sorrel, Yellowdock (stones); Plants that affect electrolyte balance
like Licorice.
b. Hematologic (blood): Blood clotting is inhibited
by plants like Ginger, Turmeric, Garlic, Medicinal Mushrooms, Bromelain;
the effect of anticoagulants like Coumadin (Warfarin) is increased
by Horse chestnut, Sweet clovers, Bedstraw, Woodruff, Vanilla; and
decreased by plants high in Vitamin K like Alfalfa, broccoli, kale,
chard, brussel sprouts, Parsley, Spinach, Nettles.
c. Cardiovascular: blood pressure can be raised
by plants like Ephedra, Siberian Ginseng, Licorice, Rhodiola; it
can be unduly lowered, especially if a prescription blood pressure
medicine is also taken, by plants like Valerian, Crampbark, Ginkgo,
Rauwolfia; and Lily-of-the-Valley interacts with cardiac pharmaceuticals
like digoxin (digitalis).
d. Neuronal: Medications like MAOIs (monoamine
oxidase inhibitors), SSRIs (antidepressants like Prozac or Zoloft,
Paxil), and other antidepressants interact directly with St. John’s
Wort and should not be used at the same time.
e. Digestive: Some herbs can cause nausea or upset
stomach. This is rare; generally, they are powerful herbs that stimulate
elimination and fight infection, like Iris, Pokeweed, Lobelia. Other
plants may upset the stomach if taken with medications and without
food; take herbs with meals if this is a problem.
f. Immune system: There is some theoretical speculation
that certain immune-stimulating plants like Echinacea can aggravate
autoimmune conditions like rheumatoid arthritis, HIV/AIDS, thyroid
disease, or Chron’s disease. I have found this to be a rare
event, although it is true that Echinacea just isn’t right
for some folks. Try Astragalus instead, which is incredibly safe
and gentle, and works better as a preventative for colds and flus.
g. Blood sugar balance: Generally, herbs are safe
to take alongside oral hypoglycemic medications. For insulin-dependent
diabetes, caution and supervision are advised if trying herbs like
Bitter Melon, Gymnema, Ginseng, Andrographis or supplements containing
Chromium until their effects on blood sugar in your individual case
are determined.
h. Liver metabolism. In cases of liver and gallbladder
disease (jaundice, cirrhosis, hepatitis, gallstones, bile duct obstruction)
one should be very cautious in using bile-stimulating plants like
Dandelion, Celandine, Milk Thistle, Artichoke, Yellowdock, Burdock.
Additionally, for anyone (even without liver disease), herbs share
many of the metabolic channels that drugs use, and can therefore
increase or decrease the effectiveness of the pharmaceuticals. This
occurs primarily through the liver’s cytochrome P-450 enzyme
system, a complex family of metabolic enzymes that are constantly
filtering our blood. Drugs such as antihistamines, birth control
medicines, blood pressure regulators, antidepressants, tranquilizers,
statins (Lipitor, e.g.), anti-inflammatories (like Tylenol) can
be affected by herbs through these enzyme pathways. INHIBITORS generally
increase drug half-life an presence in the blood, potentially increasing
primary and side effects; examples include Grapefruit and citruses,
Garlic, Red Wine, Parsley, Angelica, Dong Quai, Ginkgo, Kava-Kava.
ACTIVATORS decrease drug half-life and presence in the blood, reducing
the effectiveness of the medication (generally); examples include
St. John’s Wort.
4. Beneficial interactions. Not all herb-vitamin-drug
interactions are harmful! Often herbs can be used alongside drugs
to buffer some of the side effects:
a. Chemotherapy: nausea is alleviated by Ginger;
loss of appetite is helped by digestive Bitters; low blood counts
(white / red blood cells) can be buffered by taking herbs such as
Astragalus, Siberian Ginseng, Rehmannia.
b. Sexual side effects of medications
such as antidepressants respond well to Ginkgo.
c. Many drugs are damaging on the liver, especially
if taken for prolonged periods of time. Here, a simple remedy like
Milk Thistle can be extremely supportive and reduce overall side-effects
from the medication.
The above are general points of information and suggestions only.
Please discuss any herbs or supplements you are taking with your
doctor; if you want to know more about herbal medicines and are
curious about their safety in your specific condition, consult with
a qualified herbalist.
