Integrating Herbs with Conventional Medicine
#1

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Objectives
 Identify the difference between nourishing and medicinal herbs
 Identify how nourishing herbs are provided
 Identify how medicinal herbs are provided
 Know reasons to use nourishing or medicinal herbs
 Learn about 9 popular herbs
 Learn some of the problems with herbal marketing and preparations
 Time for questions and individual concerns
Nourishing herbs
 Nutrient rich
 Bio-available
 Generally considered safe, side effects uncommon
 Dosage and strength less important
 Tend to be local, whole, and common
 Large amounts used, in contrast to medicinal plants
 Includes tonics
 Supportive to body systems
 Long term use is usually beneficial
 Internal use
 Infusions
 Water based
 Vinegar based
 Whole plant
 Cooked
 Raw (salad)
 External use
 Compress
 Poultice
 Salve
Medicinal Herbs
 Dosage and strength important or critical
 Tend to utilize more toxic parts of plant
 Stimulate or sedate
 More likely to have side effects
 Are often plants that are less common, or rare
 Long term use is generally discouraged
 More extensive knowledge is needed to use safely and effectively
 Tinctures
 Alcohol based
 Glycerin
 Extracts
 Capsules
Case Study: Prophylactic Use of Echinacea angustifolia and purpurea Tincture for Management of a Recurrent Staphylococcus Infection
 46 yo female CHF
 Heart cath age 53, followed by staph infection
 Broad spec. antibiotics no effect
 Echinacea ang. 30-40 drops every 3 hours
 Symptom improvement within 2 hours
 Two days both, stopped Ech. Symptoms returned within 4 hours
 Ech and Antibiotic together, no symptoms
 MD stopped antibiotics, pt. stopped Ech. Symptoms returned
 Ech. as before - symptoms gone
 One day without Ech, some symptoms
 Ech 10 drops day no symptoms
 For next 7 years, until death, two skipped days symptoms return -proven at least five times
Significant points
 Echinacea fought an antibiotic resistant infection
 Low dose (nourishing) as effective as high dose (stimulating)
 Low dose safe to use long term
 Long term use was necessary
 Mechanism of action for effect of low dose unknown
Popular Herbs
 The Herbs
Ginkgo biloba
St. John’s wort
Garlic
Echinacea
Goldenseal
Saw palmetto
Milk thistle
Black cohosh
Ginger
Powdered leaves
 Tincture or infusion
 Most ancient tree known
 Uses: cerebral insufficiency, Alzheimer’s Ds, intermittent claudication, tinnitis
Ginkgo
 Increases vascular flow
 diabetic peripheral vascular disease
 Raynauds syndrome
 Other circulatory benefits fro varicose veins, hemorrhoids, eye disorders
 Affinity for cerebral circulation
 Inhibits platelet activity factor
 Used to relieve tension, anxiety, elevate mood
 Contains flavanoids, terpene lactones, ginkgolides A, B, and C, bilobalide, quercetin, and kaempferol.
 ginkgolides control allergic inflammation, anaphylactic shock and asthma
 antioxidant
What to watch for
 Can increase blood flow
 Discontinue before surgery
 Do not use with menstrual flooding
 Do not use with other bleeding problems (ulcer, bruising, etc.)
 Not suggested with blood thinners, aspirin, etc.
 Gingko biloba & Dementia
 52 week RCT, double blind, multi-center
 Outcomes in 309 pts (ITT):
 Pt cognition: tx no change, placebo worse (p=0.04)
 Caregiver assess: tx slight improve, placebo worse (p=.004)
 Dose: 120 mg/d of EGb 761
 Safety: side effects equal
 Problems: high dropout rate (50% tx, 62% placebo)
 Ginkgo & Claudication
 Meta-analysis of Egb 761
 5 placebo controlled trials
 Moderate to large effect (0.75 Cohen’s d) on pain-free treadmill walking distance
 Ginkgo - Toxicology
 Adverse events
 GI complaints
 bruising & spontaneous bleeding
 Avoid if taking warfarin, heparin, or NSAIDs
 Can increase insulin levels
 May increase sedation with trazodone
 St. John’s Wort
Hypericum Perforatum
Used as tincture, extract in pill form, topically as oil or salve
Popular as anti-depressant.
Also used for muscle aches, nerve pain, nerve regeneration, for herpes outbreaks, bruising
 St. John’s Wort
 P450 Cytochrome system
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#2
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#3

INTRODUCTION

The integration of herbal and other forms of traditional medicine ™ can be done in one of the following three ways: First, it can be incorporated as an integral part of a country’s formal health care system, with each being separately recognized as legitimate forms of health care within the same framework. Second, it can be practice integrated with modern medicine by individual health care practitioners. Third, traditional and modern practices can be integrated as two branches of medical science, with the ultimate incorporation of elements of both to form a new branch (World Health Organization 2000a). The incorporation of traditional and modern evidence-based medicine (EBM) as integral parts of a country’s formal health care system is most likely to be achieved and has been demonstrated to be practicable in many countries, particularly in Asian countries such as China, Japan, Korea, and India, among others (World Health Organization 2001). On the other hand, the incorporation of traditional medical modalities such as herbal medicine into modern or EBM by either the second or third method of health care integration is not easily achieved for a host of reasons, including scientific, cultural, educational, and legal.
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