News You Can Use: Herbals and Cardiovascular Disease

Herbs and food supplements (sometimes called neutriceuticals) are continuing to gain in popularity; 60% of us are taking or have tried an herbal medication or vitamin supplement to treat a specific health concern.

Advertisements come across my desk almost daily touting weight loss, blood sugar control, memory and sexual enhancement, and control of menopausal symptoms through one product or another. Many of my patients ask, "what do you think about this herb, or this supplement to help me to...(fill in the blank with any of the above)?"

I tell them the truth, when I know it, but the knowing isn't always possible. We thought we knew that black cohosh was helpful to decrease the symptoms of menopause, such as hot flashes and sleeplessness. Many of my patients take a black cohosh product called RemiFemin, by the makers of Bayer aspirin; the majority of them think it helps.

The pharmaceutical company certainly thought the studies were strong enough in favor of the herb being helpful; this belief caused them to invest in the production of a commercial product. But then in December 2006 a study was released that indicated that cohosh may not be as effective as we thought, especially at controlling hot flashes.

This appears to be a pretty well controlled study, but the authors point out its limitations, including the fact that only one cohosh product was used. This keeps them from saying that the other cohosh products, such as RemiFemin, are equally ineffective as the product they studied. The jury is still out on this one, and if you are safely taking a black cohosh product and feel that it is controlling your symptoms, you probably don't have to stop.

Take Supplements Safely

So what do I mean by taking a product "safely?" Herbal medications can interact with prescription medications in the same way that various prescription medications can. It is important that you let your health care provider know before you take an herbal supplement so that he or she can advise you as to whether or not it will be safe with your current medications. If unaware of your supplements your provider could also prescribe a new medication whose action could be increased or decreased when combined with the herbal.

Most providers now have hand-held computers with medication programs installed in them. These programs usually have a significant number of herbal medications in them, and where they have been tested, info about their potential interactions. They can ask the program about the herbal medication they you want to try and its potential effects on your current prescriptions. If your provider doesn't have this type of program an alternative is to ask your pharmacist. There is a "Physician's Desk Reference" for herbal medications and it is available to the pharmacist for reference. Ask the pharmacist to check for interactions for you.

Important Interactions

One common heart-related medication that is affected by herbals is warfarin (Coumadin), which is used to prevent blood clotting. Some herbs make warfarin work more, putting you at increased risk of bleeding and others make it work less, which can cause you to form clots.

If you take Coumadin you may have been advised to eat certain foods on a consistent basis if you like them. For example, spinach has a lot of vitamin K in it, and this decreases the effectiveness of Coumadin. People who like spinach are asked to eat it consistently, for example in a salad every other day, so that its effects on the Coumadin can be predicted and the medication dose adjusted to account for it.

The same can be done with an herbal medication so long as your provider agrees to it and monitors your blood accordingly until your Coumadin dose is stable. The herbal medications that begin with the letter "g," such as ginseng, green tea, garlic, ginger, and ginkgo can all effect Coumadin. Other drugs that may be affected by these herbs are the other prescription blood thinners such as Ticlid (ticlopidine) and Plavix (clopidogrel), and the drugs used for inflammation called the "NSAIDS," such as Naprosyn (Naproxyn Sodium), ibuprofen (Motrin/Advil), and Celebrex.

Blood pressure medications can also be affected by herbals; black cohosh, devil's claw, ginseng, goldenseal, hawthorn, licorice, Ma Huang and yohimbe can all interact with them.

People with diabetes also have to be concerned with the mix of herbals and prescription medications. Herbs that affect blood sugar control include garlic, ginger, ginseng, hawthorn, Ma Huang, and nettle all may cause your blood sugar to become out of control.

Do Your Homework

Remember, herbal medication bottles won't warn you of their potential interactions with your prescription medications. They are not regulated by the FDA and may not have consistent amounts of the herb from pill to pill, bottle to bottle.

Do some research on your own before you take herbal medications, and consider the implications of your choices. Find a reliable source for your herbal medications and consistently use the same company's products -- your pharmacist is a good resource for information about the products available in your pharmacy. A very good source of information about herb and prescription medication that available to you is at The People's Pharmacy; use the link on the left called the "herb library," then click on the link to the herb you are interested in reading about. Each monograph contains what is known about that herb's interactions with prescription medications. Another great web location for information and research is the site of the National Center for Complementary and Alternative Medicine

Herbal medications can be safe and effective, as long as you arm yourself with the knowledge necessary to take them correctly and inform your health care provider of all of them that you are taking now, or are considering in the future.

Take care, Laurie

Related Topics:

• Herbal First Aid Kit
• Safe Use of Dietary Supplements

On Life, Living and Dying

Recently I have discovered the books of Dr. Brian Weiss, a traditionally trained phychologist who stumbled into using "past life" therapy with his patients. In his first book, Many Lives, Many Masters, Dr. Weiss describes his work with "Catherine," a woman with anxiety and nightmares who sought his help. Initially their work used traditional "talk" therapy but Catherine's symptoms did not respond to treatment; they then turned to hypnosis, a technique that Dr. Weiss often used with individuals seeking treatment.

He was astonished when Catherine began to describe "past-life" experiences while under hypnosis and that these memories seemed to be key to her reoccurring nightmares and anxiety. Although Dr. Weiss had used hypnotherapy before to assist people to relax and be more receptive to therapeutic suggestions, this was the first time that anyone under his care had responded with such a memory.

A graduate of Columbia University and Yale Medical School, Dr. Weiss M.D. is currently the Chairman Emeritus of Psychiatry at the Mount Sinai Medical Center in Miami. He relates in his book how astounded he was when this patient began to channel messages from "the space between lives," which contained remarkable communications from his deceased son and father, and current revelations about Dr. Weiss's family.

As a emergency room nurse practitioner I see a number of individuals each week who are depressed and some who are suicidal. I am always saddened by anyone who feels that life is desperate enough to feel as though killing oneself is a solution.

I can't say that I have ever felt suicidal but I have enough life experience to understand that people with substance abuse problems are likely to feel suicidal at some point. After working as a nursing professional for 20 years I have certainly seen elders who are depressed enough about their physical limitations to consider suicide.

As a result of these experiences I have always wondered what is lacking for these individuals that helps them to remain hopeful despite the physical and emotional challenges in their lives. After all , there are many individuals with these same symptoms who aren't depressed and don't consider or attempt suicide. My observation is that people who face physical and emotional challenges and don't become depressed or suicidal have something that gives them resilience, and that "something" is often a set of spiritual beliefs. By that I don't mean that they are necerssarily "religious," but that they have a belief in a power or spirit that is greater than they are, and to whom they look for support and spiritual guidance.

Recently Dr. Helen Smith and her husband did a podcast on suicide, particularly in men. They point out that suicides outnumber homicides in the United States and that middle-aged and older men are particularly at risk for suicide. There seem to be a cluster of reasons why this is true, including the fact that men tend to have substance abuse problems in the middle years, and that older men believe that they are losing physical abilities; if depressed older men may feel that this loss disproportinately to the actual functional loss.

How do you view suicide ?


We have forgotten our true natures and it is our task to reawaken and remember. When you do understand the importance of this school we call earth and when you are truly spiritual, you do not cut classes early. - Brian Weiss

Related Topics:

• Spirituality Prevents Depression in Old Age
• Men and Suicide

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