Thursday, March 05, 2009

CAM Paper Part VIII: Herbal Remedies III

Several herbs are used to treat nausea, most commonly ginger, peppermint, and cannabis. All three have been shown to have mild anti-emetic properties for chemotherapy, motion sickness, and post-operative nausea. Only ginger has been shown in clinical trials to be effective for morning sickness, but anecdotal reports suggest that peppermint and cannabis smoking are also effective for morning sickness. Cannabis in particular has a long history of being used to treat chemotherapy-induced and HIV drug-induced nausea. Ginger and peppermint should be used cautiously in pregnancy due to a possible risk that they promote menstruation. There does not appear to be any contraindication for the use of cannabis in low to moderate doses.(16)

Cold and Flu
The most popular herbal remedy used to treat cold symptoms is echinacea; in fact, echinacea is the most popular herbal remedy on the U.S. market in general. Although it is very popular and has a long history of use, echinacea may not be very efficacious against cold symptoms. Some studies did find that echinacea could shorten the duration of a cold by one or two days. In addition, there is no evidence that echinacea can be used prophylactically to prevent colds. There are few side effects due to echinacea, but people who are allergic to ragweed and other pollens may be at risk of having an allergic reaction.(13)

Other popular natural products use to treat colds include vitamin C and zinc. These two agents may provide a modest decrease in cold symptoms, but the evidence in favor of either agent is not very strong. Vitamin C is generally safe, although it may cause GI symptoms at very high doses. Zinc can cause anosmia (loss of the sense of smell) if taken intranasally. As with echinacea, neither zinc nor vitamin C can be used as a prophylactic to prevent catching a cold.(13)

Common natural products used to treat the flu include elderberry and ginseng. Elderberry appears to have reasonably good efficacy in reducing the duration of flu symptoms based upon the results of two clinical trials. The main side effect is GI symptoms. Ginseng may be useful as prophylaxis against the flu based on two preliminary trials. However, it has some potentially troublesome side effects, including insomnia and possibly cardiac effects. Oscillococcinum is a popular homeopathic remedy used to treat the flu. Since it contains no active ingredient and is considered to be a placebo, there is no contraindication against it.(13)

Cholesterol Reduction and Cardiovascular Disease
Common natural products used to lower cholesterol include dietary oats, psyllium fiber, soy, plant sterols, policosanol, garlic, and omega-3 fatty acids. The effect of eating oatmeal is very mild, yielding a drop in LDL of about 6 mg/dL. One clove of fresh garlic per day can lower total cholesterol about 5%. Psyllium, plant sterols and soy can decrease LDL about 10%. Policosanol, a waxy substance that can be made from beeswax, can decrease LDL around 20%, and also increase HDL about 20%. Omega-3 fatty acids are used to lower triglycerides. None of these compounds has any major side effects, but policosanol, garlic, and omega-3 fatty acids could possibly increase some people’s risk of bleeding.(13)

Along with garlic and omega-3 fatty acids, other compounds used for primary and secondary prevention of cardiac disease include coenzyme Q10, hawthorn, arginine, and carnitine. Coenzyme Q10 decreases blood pressure and improves heart failure symptoms, and has few side effects. It should not be used concurrently with doxorubicin. Hawthorn appears to improve heart failure symptoms and increase exercise capacity. It may potentiate the effects of digoxin. The amino acids arginine and carnitine are well-tolerated and improve exercise capacity in patients with heart failure. Vitamin E should not be recommended, as it does not decrease the risk of cardiovascular disease. In fact, the mortality rate increases with high dose vitamin E.(13)

No comments: