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As people suffering from chronic and incurable diseases become disenchanted with Western medicine, they increasingly are turning to natural remedies, including herbal treatments.
"When Western medicine doesn’t offer them an acceptable solution, many people start looking for anything that will help them," says Doug Murray, PharmD, director of pharmacy and clinical services at Kershaw County Medical Center in Camden, SC.
American medical journals have begun to take notice of the trend, Murray notes. The Archives of Internal Medicine published a review article on herbs as medicine in its Nov. 9, 1998, issue, and American Health Consultants, publisher of Homecare Education Management, devotes an entire newsletter, Alternative Medicine Alert, to herbs and other alternative remedies. "Also, there are a lot of Web sites on herbs," he says. (For details, see "Internet Connect" column, p. 56.)
Murray says a great deal of research is available on herbal remedies because for years such medicine has been prescribed by physicians and covered by insurance companies in Germany. "The Germans are the backbones of this. They’ve done the research, and it’s been published, and they have a lot of standard review textbooks that are accepted now in the United States."
Congress has paved the way to ensure herbal remedies do not have to go through expensive and rigorous drug-testing in the United States through passage of the Dietary Supplement and Health Information Act of 1994. While there was some debate over whether herbs were drugs or dietary supplements, the non-drug advocates won.
Murray says he worries about people buying herbs from questionable sources, such as small, fly-by-night manufacturers, because the quality and even the actual ingredients may not be inspected.
A worst-case scenario occurred in 1989, with an epidemic outbreak of eosinophilia-myalgia syndrome (EMS) in the United States that was associated with the use of L-tryptophan, an over-the-counter dietary supplement for weight loss.
Tryptophan is a naturally occurring amino acid that exists in proteins and is essential for human metabolism. More than 1,500 cases of EMS, including 38 deaths, were reported to the Centers for Disease Control and Prevention in Atlanta, according to the U.S. Food and Drug Administration (FDA) in Washington, DC. Some people with EMS experience severe pain and bleeding.
More than 95% of the cases were traced to L-tryptophan supplied by Showa Denka K.K. of Japan. Researchers found some trace-level impurities, suggesting that a contaminated batch contributed to the outbreak. The FDA limited the availability of L-tryptophan supplements and enforced an import alert because of the outbreak. (See "Internet Connect.")
While this type of danger is rarely seen with food supplements and herbal remedies, medical experts still advise people to be cautious in purchasing these products from unfamiliar manufacturers. However, now some major drug manufacturers are beginning to produce herbal remedies, so consumers soon should have some choices that include manufacturers with a proven track record, Murray adds.
• Kathleen Hughes, RN, Director of Home Care, Kershaw County Medical Center Home Health Care, 2001 W. DeKalb St., Camden, SC 29020. Phone: (803) 425-1182. Fax: (803) 432-6351.
• Deanna Lieving, RN, Director of Mental Health, Olsten Health Services, 5700 Cleveland St., Suite 408, Virginia Beach, VA 23462. Phone: (757) 499-9401.
• Doug Murray, PharmD, Director of Pharmacy and Clinical Services, Kershaw County Medical Center, Haile and Roberts Sts., Camden, SC 29020. Phone: (803) 425-6137. Fax: (803) 424-5406.