Efficacy and Safety
Modern Day Witchhunt…
‘Dangerous’ Remedies or ‘Quackery’
Hear these in the media a lot? Yawn… Exactly what ‘alternative therapy’ this referring to, it often fails to say?! Homeopathy, Massage Therapy, Reiki, Aromatherapy, Herbal Medicine, Nutrition? My bone of contention is that ‘Natural Therapies’ are often lumped together and branded with the same old generalisations and warnings; however the reality is that each therapy is unique and entirely different from another and so naturally, each has a totally different risk/evidence profile. Generalisations like this do not help!
If you really want to generalise, it has to be said that on the whole (especially when under professional guidance), natural therapies have a fantastic safety rating – in fact much safer than most drugs on the market! Now that is not to say there won’t be adverse effects, but these are relatively rare. In this section I’ve included some possible safety issues that may arise and some tips to consider when using natural therapies. However, to put your mind at ease, remember that a qualified naturopath/nutritionist/herbalist etc… is trained to work within their scope of practice and they will generally consider all risks when devising a treatment plan. This expertise is what you pay for!
First, before I go on – I want to say I am most certainly not ‘anti-drugs’! Modern Medicine is incredible and doctors have specialist skills that many herbalists/naturopaths do not. There are many instances where natural remedies cannot compete and I would choose a pharmaceutical option over a herbal option. Just as there are instances where I would personally choose a Natural Health Practitioner and Herbs over pharmaceuticals, depending on the issue at hand. It is not black and white! What I do want is a fair and safe health system – with freedom of choice.
Anyway, here are some pointers on the topic of safety when taking Herbs:
Be Savvy! Get educated…
It all comes down to education and proper guidance – this is why it is always recommended to consult with a qualified Natural Health professional for accurate advice. Do your own research into the type of therapy you are considering. Similarly, if you are self-prescribing then be sure to get educated and read up about all the possible risks and contraindications.
In regards to plants as medicine specifically… yes – of course not all plants are good and not all plants are gentle. In fact many are dangerous enough to kill an adult and should be avoided at all costs! Keep this in mind if you decide to self-treat and pick your own herbs in the wild! Luckily– the herbs that Herbalists use (and are allowed to use) have a long history of use and generally excellent safety records. There are some herbs to treat with caution, but as I said, a trained herbalist will be aware of these and take adequate precautions. This is not to say you can’t self-treat with many of the well known backyard and local hedgerow herbs, just make sure you read up and know what you are doing beforehand! Human intuition alone is valuable but not foolproof!
A warning on self-diagnosing and self-prescribing
Self-diagnosing and self-prescribing can also be harmful for another reason, because minor symptoms can be a sign of a bigger underlying issue (which you might not necessarily pick up on – but a trained professional would).
Be aware of Interactions with medications
These days when people are on so many medications, there can of course be interactions. However if you disclose all your medications in the consultation, your therapist will consider this and will avoid any herbs/foods/supplements that could interact. Regular monitoring is also an important aspect of the treatment plan.
Bad reactions to a BAD product
There have been a handful of cases in the news where people have reacted badly to herbal/nutritional products purchased… or products that simply don’t work. These are often purchased from dubious companies selling ‘Natural’ products – usually online. The reactions or lack of efficacy is due to a poor quality product – or worse… contaminated or substituted products. This is why it is important to visit a qualified naturopath/herbalist/nutritionist who will prescribe high quality brands with a good safety rating.
Not adhering to the recommended Dose! Naughty Naughty…
The old issue of dose – anything can be toxic in the wrong dose– including over the counter drugs such as paracetamol or even table salt or sugar! Again, if you follow the guidelines provided by the practitioner this should not be an issue. Listen to the professional advice given to you! Please.
Individual Reactions to a Normally Safe Product
Allergic reactions (which can occur to anything- including foods) and individual adverse effects are random, unexpected events. The same happens in the medical world where an individual can react badly to a certain drug – sometimes there is no way of knowing who will react to what. Luckily this is rare. If you develop a reaction when taking a natural supplements/herb then stop and consult with the practitioner who prescribed it or the company you purchased it from.
Natural vs Pharmaceutical
‘Dangerous’ Herbs and Supplements? Well what about Drugs?
So the media loves to report on ‘dangerous’ herbs and supplements, but for some perspective on ‘safety’ in comparison to pharmaceutical medicines, consider this… Each year, prescription meds cause hundreds of thousands of deaths – and that is when they are properly prescribed- not to forget the many more deaths related to improper prescribing. The overall number runs into the millions per year! This also does not even include serious adverse side effects caused by drugs, which may not result in death but do cause serious long lasting damage. Compare this to vitamins or professionally prescribed herbs and you will see that the track record is pretty good! I would struggle to find a death by vitamin case. Similarly, adverse effects due to herbal medicine are extremely rare and usually due to contamination/adulterated sources, improper use or rare individual reactions (as can occur with anything- including food or pharmaceuticals)
Is ‘Evidence Based Medicine’ really the gold standard?
The medical profession love the term ‘Evidence Based Medicine’ and reject natural therapies because of the so called ‘lack of evidence’, but scientific evidence is not the holy grail of medicine and simply disregarding thousands of years of traditional knowledge is supremely ignorant. In fact around 50% of medicines are recalled in the first decade– after they are approved as safe, due to previously unknown side effects – it obviously isn’t such good ‘evidence’ after all. It is common that the side effects of the drug can end up being worse than the initial condition for which it is intended to treat.
Well take the drug Vioxx as one example, this anti-inflammatory drug was prescribed to millions from 1999-2004 and was withdrawn because it caused heart disease in 90 000-140 000 people and killed nearly 60 000. Now that was supposedly ‘evidence based’ and was approved as safe. Another more recent case is Valproate, a commonly prescribed epilepsy drug which is now under investigation for causing severe birth defects though this has been known for years. Can you imagine the consequences if this was a ‘natural remedy’? So it seems to me that the obsession with ‘dangerous herbs and nutrients’ is a bit like a modern day witch hunt. I agree that more research needs to be done- this can only be a good thing in helping us to understand more about how the herbs/foods/nutrients work and highlight any possible dangers, however laboratory trials alone should not govern the use of natural medicines. Traditional knowledge is equally important, sometimes more.
Pharmaceutical Giants and the ££££ machine…. No You Can’t Patent Nature! (for now)
Money makes the world go round… this is the #1 reason Pharmaceutical companies dumb down the remarkable effects of lifestyle interventions, food, herbs and other natural substances. Why? Because they can’t make money from them (they would if the law allowed!) Just imagine what would happen to the profits of the big drug companies, if a food/herb or simple lifestyle change turns out to be more effective and safer than the standard drug prescribed (as is often the case!) Hence the vendetta and increasing control over ‘natural’ therapies. Drugs make money. Plants not so much. Sadly the drug companies are so big, they have a remarkable amount of power and leverage when it comes to legislation, clinical trials, education and the media. Sad but true. We natural therapists have to fight our corner!
Like I said, I’m certainly not ‘anti-drugs’, they (like natural remedies) have their place and there are times when I would choose a drug over a herbal treatment program and vice versa – but we should have a choice.
So why is there not more safety data for Herbs/Foods/Supplements?
Simple… there is a gross lack of funding for natural therapies and a strong bias towards Pharmaceuticals. Granted, the pile of clinical trials on natural products and lifestyle interventions is growing – slowly. However, this is still nothing compared to the trials being dedicated to drugs. A big issue with natural therapies and scientific evidence is that clinical trials are so expensive that usually only the multi-billion drug companies are able to fund them. As I mentioned, you can’t patent and make money from food or herbs, so the incentive to fund trials on these natural substances is just not there. Small-scale herbal medicine manufacturers simply do not have the funds to pay for costly trials. This is a totally unrealistic and unfair condition (which unfortunately due to recent regulation has become a reality and many quality herbal manufacturers in Europe have had to close). Scientific research is also heavily biased towards pharmaceuticals (universities being heavily funded by the Pharmaceutical Companies). Though a little more research on Natural Therapies is being done now but it still is not able to compete in terms of the quantity of quality trials- there simply isn’t the money to do them. It’s a catch 22.
Lastly, a large number of the ‘alternative medicine’ trial that have been done to date are not entirely valid– they are done on animals, or using unrealistic doses, poor quality herbs and synthetic vitamins or even the wrong species or part of a plant! In addition, there is no input from nutritionists or herbal experts. More research is needed, but it can only be a good thing if done properly (without vested interests). Professional Herbalists and Nutritionists need to be involved in research, much more than they currently are – for it to be truly valid.
To Conclude: Food and Plants – A Human trial lasting Millennia!
The beauty about Nutrition and Herbal Medicine is that they have a long history of use, spanning hundreds or even thousands of years – this speaks volumes about safety and efficacy. You want a clinical trial- here are mass human trials that have lasted generations! Though it may not be double-blind, placebo controlled! 😉 So the conclusion- I assure you that herbs and nutrition are generally very safe, especially when prescribed by a knowledgeable practitioner!
Now I hope reading this has answered some of your concerns about Natural Therapies, for more info on foods/nutrients/plants and how they work … do take a look under the tabs of ‘Nutrition’ and ‘Herbal Medicine’ in this section.