21. Supplements & Herbal Remedies supplementary ie. not in text. Working Definition. A dietary supplement is “a product taken by mouth that contains a dietary ingredient” intended to supplement the diet.
21. Supplements & Herbal Remediessupplementary ie. not in text
"Been around for centuries with no reported problems. Should be treated like foods, ie. don't need labels, tests or restrictions on claims. Give me easy access and keep the price down." say proponents(and the producers).
"They contain many potent ingredients. Need lots of tests, warning labels, no unproven claims" say some pharmacists and medical professionals (and the drug companies).
The Rest of the World Knows
Chinese herbal medicine has been practiced pre 0 AD.
In countries of the EU some herbal remedies are covered/ prescribed by government health plans.
Since '78, Germany's Commission E (scientists & health pros) have researched 'herbals' (usefulness & safety); ~200 of 300 have been OK'd. Companies have 2-4 yrs to 'prove their claims'.
USA, 1994 - vitamins/minerals/supplements become in between foods & drugs; many 'hormones' are OTC; benefit claims are eased; little 'quality control'; prices drop; users are happy; but …….
Canada, 1997- started 'thinking about it'; has Office of Natural Health Products and advisory panel to gov't Health Committee; 'promising' new and comprehensive regulations since 2002
www.hc-sc.gc > A-Z index > Natural Health Products
Herbalist - completely unregulated; can get referrals to persons with some courses/experience
Nutritionist - regulated in QC, BC, NS; many are registered dietitians(RD/RDN, with Dietitians of Canada); bachelors degree in nutrition + intern
Naturopathic Doctor(ND) - use a variety of 'alternative therapies'; regulated in BC, MB, ON, SK(AB&NB); should have 4yr program after bachelors; check credentials
Pharmacist - 4/5yrs B.Pharm. + experience(front line); but only relevant courses since ~'95
Conventional + Alternative = Complementary
Complementary Physician often Family Medicine(MD) (bachelor + 4yrs + 1yr resid. + 2yrs specialization); - many 'not on lists‘.!
Don't self-diagnose! Many 'alternative practitioners' also do not have much diagnostic training/experience. Also a certain number of ‘conventional’ doctors are not interested in/ knowledgeable about alternates, but……
For all types of info’ see: www.canadian-health-network.ca
Canadian College of Naturopathic Medicine, 1255 Sheppard Av.,(East) www.ccnm.edu North York, ON, M2K 1E2 1-866-241-2266
Dietitians of Canada, 480 University Av, Suite 604, www.dietitians.ca Toronto, ON, M5G 1V2 (416) 596-0857
Canadian Natural Health Assoc., 439 Wellington St., Suite 5, www.natural-health.org Toronto, ON, M5V 1E7 (416) 977-2642
Canadian Naturopathic Assoc., (see: Can. Coll. of Natur. Med.), 1-800-551-4381 www.naturopathicassoc.ca
Canadian Assoc. of Herbal Practitioners, 1228 Kensington Rd., Apt. 400, Calgary, AB, T2N 4P9 (403) 270-0936
National Institute of Nutrition, 408 Queen St.(3rd floor), www.nin.ca Ottawa, ON, K1R 5A7 (613) 235-3355
Canadian Complementary Medicine Assoc., 8621 104th St., Edmonton, AB, T6E 4G6 (403) 433-7401
In Canada all OTC and prescription drugs, including vitamins & minerals, must show on the label: a) expiry date, b) amt of active ingredient, c) DIN which indicates approval by Health Canada based upon extensive tests of effectiveness and safety.
Traditional herbal medicines(THMs) also can have a DIN based on historical support by 2 recognized herbal compendia and no requirement for proof of safety or efficacy.
Plus: a 'function' claim; address / telephone #
Marketing Hype - Beware!
Clinically Proven Quality Extract Guaranteed Potency Essential Naturally Occurring Pure Highly Concentrated Maximum Absorption Special Extract Scientifically Standardized Nutritionally Comprehensive
Independent testing often indicates up to 30% of products contain little(or no) 'active' ingredients, especially in USA.
The Healing Power of Vitamins, Minerals and Herbs' by Reader's Digest('99); consult. ed. Joe Schwarcz (ISBN 0-88850-678-3) Some interesting health-related websites with lots of archived info and useful web links: 1) www.wellnessletter.com(articles on >70 'herbs') 2) www.tvo.org/yourhealth 3) www.cbc.ca >television>newsworld>healthmatters Also 4) www.canoe.ca/HealthHerbal
In Canada(2007) - $4 billion and growing at ~20%/yr; 40% vitamins, 20% minerals, 20% herbs, 20% others
Out-of-control in some areas, eg. see KidzHerbs (for ages 4 and up) Time Out/ Sweet Lullaby -"to sleep/relax naturally", contains St. John's wort Straight A's - "helps children think straight" contains ginkgo/ginseng Allergy Schmallergy - "to help with allergies" contains echinacea also available in lollipops for your lunch!
OTHERS - not Vitamins, Minerals, Herbs
Acidophilus, bee products(pollen, royal jelly), carotenoids, coenzyme Q, creatine, DHEA & other steroids, evening primrose & other lipoic acids, fish oils, flaxseed, glucosamine, HGH(human growth hormone), 5-HTP(hydroxy tryptophan) & other amino acids, kelp, soy isoflavonoids, shark cartilage
DHEA - the 'Precursor' Hormone
Dihydroepiandrosterone - conc'n drops to ~10% by age 70
Ads: build muscle, immune system, cell damage, relieve stress, reduce fat. Known: rats don't have much and human trials very inconclusive. Prescription only in Canada but OTC in USA. No quality control. Side effects, especially in women when used in excess. Avoid
Melatonin - the 'Fountain of Youth'?
From pineal gland;
regulates body 'biorhythms'; conc’n. with age.
Ads: anti-aging, sleep control, boosts immune system, reduces oxidative cell damage. Known: seems to be effective for 'jet-lag', may assist drugs against cancer, vascular damage, Parkinsons. No apparent side effects. OTC in USA, prescription in Canada.
Glucosamine - it's 'Natural'!
Produced in joints as 'precursor' for cartilage repair
Ads: move again without pain
Known: prescribed in Europe for arthritis relief; slows cartilage deterioration; relieves joint pain; no known serious side effects. It may work for you, try it but inform your doctor; some people need >1g (!) for 'relief'
Herbal Remedies - Remember
These materials contain physiologically active compounds not all of which are known. They are not patentable so there is no incentive by the suppliers to do research. Because of their great popularity there will be good 'studies' over time mainly from medical schools. Meanwhile >>>
• can't cure; only alleviate chronic conditions; NB. frequent use of 'minor effect' and 'may help'
• be aware of 'side effects‘ • avoid if there are 'special conditions', eg. pregnancy • avoid excess dosages and long duration • the species and parts of plant are important • there are many serious interactions with conventional medicines • keep up-to-date
'Herbals' - Something for Everyone
A cornucopia! 121 listings in:
Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies (4th ed), Steven Foster & Varro Tyler
Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicines, J. Roberts & V. Tyler
Aloe Vera(external) - exudate/ gel from leaves, great for minor skin problems; Aloe latex (internal) - juice of crushed leaves, possible 'digestive aid‘ (cramps for many!)
Cranberry - minor urinary tract infections, especially women; recommended 16 oz/day of undiluted juice(~3000 berries!) Echinacea - immune booster don't take constantly; tincture loses potency more quickly but is more effective
………..angustifolia .……….pallida ………. purpurea
the Top Ten– (continued)
Garlic - blood thinner; may cholesterol; 'fights' minor infections; it's the sulfur compounds that do it so raw is best ! Worshipped by the Egyptians and used
by pyramid builders for strength/endurance. Ephedra(Ma Huang) - contains ephedrine(adrenaline – like) for bronchial problems (used in China since 3000BC); potent stimulant, blood pressure(weight loss?); abused in US(28 deaths in '98), illegally peddled in fitness centres. Avoid it!
Ginkgo - aids memory loss in elderly(increase blood flow to the CNS); maybe helps general circulatory disorders BUT doesn't make you smarter Ginseng(panax) - immuno stimulant; affects pituitary/ adrenal glands anti-stress(?); OTC 'tonics' contain more alcohol than ginseng Goldenseal - immuno stimulant + antibiotic qualities (sinus infections, nausea, warts, cold sores/ shingles); 'single' applications not prolonged use Saw palmetto - fatty acids/phytosterols; relieves prostate enlargement and urinary problems.
Truth: does not solve prostate problems!
Supplements+ Drug= Complications
Anticoagulants : avoid before surgery : gingko biloba !!!
Antidepressants - ephedra, ginseng, kava, melatonin, St. John's wort Antihypertensives - ephedra, garlic, ginseng, goldenseal, hawthorn, licorice Diuretics - aloe vera, dandelion, ephedra, ginseng, glucosamine, hawthorn, licorice
Kava kava - ceremonial/social drink in S. Pacific; trendy anti-stress remedy (sedative, muscle relaxant, intoxicant); skin problems; St. John's wort - for mild (NOT major) depression; some side effects (sun sensitivity); many active compounds; with care!
Grape seed extract - popular in Europe; potent anti- oxidant(proanthocyanidins/pycnogenols or PCOs); potential against cardiovascular degeneration; also rheumatoid arthritis, allergies; no side effects; reduces computer eye-strain! Soy isoflavones - phytoestrogens, ie. anti cancer properties, LDL reducers; get 100mg/day flavones in 3 'servings' of soy products. Tofu everyone!
Kava/kava – banned in Germany, Canada, Singapore. Implicated in liver damage.
Ephedra – Banned in USA 2004 Increasing implications for heart attacks/strokes. HC issued ‘voluntary recall’ 2002 .
St. John’s wort – NIH(US) study(double blind) found no more effective than placebo for major depression.
Ginkgo – study in JAMA(US) found no measurable memory improvement. Stay tuned !
Avoid: soft cheeses, smoked fish, all deli meats, raw milk
Heating kills it-pasteurization of milk, cooking meats thoroughly
Keep food out of the danger zone (4-60oC).
2 Meat slicing machines in processing plant
Typical of this bacteria-can hide in “nooks and crannies” of equipment
19 deaths in Canada
Prime Minister orders “public inquiry”