The Immune System

The Immune System

Boosting Immunity With Herbs

Caisse-ACT - for life-threatening illness and HerbShield

A potential herbal cure for HIV/AIDs

A potential herbal cure for HIV/AIDs is being investigated and developed by researchers at the University of Airlangga in Surabaya.
Nasronudin, an academic who heads the university’s Institute of Tropical Disease, said that the research has already taken two years and that the project team hopes the final product will be ready sometime next year.
He said several active substances from a number of plants have been studied, and substances from two plants have been found, based on invitro laboratory tests, as having the ability to reduce the count of human immunodeficiency viruses.
The two plants currently undergoing tests are the Justicia gendarussa and the Camelia sinesis.
Due to the positive results, Nasronudin explained, the next step was to commence tests on “living beings, from animals to humans.”
He added that the final research results will provide clues for a possible cure and that the actual production would be handed over to a pharmaceutical company for mass production.
Nasronudin said the treatment would be an antiretroviral (ARV) medicine, a treatment that assists HIV/AIDS patients to lower the virus count in their blood.
“Hopefully, Indonesia can produce HIV/AIDS medicine on its own, so that we do not need to continue to import it. If we create the medication ourselves, the price can be cheaper and therefore the coverage wider. That way all those who need this cure can access it.”

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Strengthening the exterior

For over 4000 years, research confirms that all the ancient civilizations including the Chinese have used certain herbs to prevent common diseases. The ancient Chinese knew nothing of bacteria or viruses, yet some of these herbs were said to "strengthen the exterior" of the "shield." Modern scientific research is confirming that they were right. Thousands of years later and 60 years after the discovery of penicillin, the study of herbs that affect the immune system is one of the hottest topics in pharmacological research. Can herbs really strengthen our resistance and help us lead healthier lives? Both the wisdom of centuries of observation and the scrutiny of the scientific laboratory support the view that they can.

How the Immune System Works

Our immune system recognizes and destroys anything foreign to the body, including cells (such as bacteria and other microbes), foreign particles, and toxic compounds. This recognition and destruction is performed by cells in the circulatory and the lymphatic systems. These cells are produced in the bone marrow and lymphatic tissue (thymus, lymph nodes, spleen and tonsils, respectively).

Stem Cells

The cells begin their lives as "stem cells." The stem cells are so featureless that there is no way to determine what type of blood cell they will ultimately become. They may develop into any of a number of different kinds of cells, for instance, red blood cells and various types of white blood cells. These cells are then released into the blood stream and are carried to all parts of the body.

Memory Cells

There are essentially two types of cells, one of which is called "memory cells." As the name implies, memory cells remember specific foreign cells or chemicals to which they have been exposed and react immediately when they are next exposed to those compounds. Drugs that affect the memory cells stimulate immunity only to one disease or antigen. Vaccines are an example of drugs that effect memory cells. Most herbs for the immune system don't affect memory cells but are general immune system stimulators (immunostimulants).

Effector Cells

The herbs increase the activity of the immune system but are not specific to a particular disease or "antigen" (a protein against which immune cells act). Rather, they increase resistance by mobilizing "effector cells," which act against all foreign particles rather than just one specific type (e.g., a measles virus).
Remarkably, since the discovery of penicillin, our scientists, in search of drugs against infectious disease, have looked only for chemicals that kill bacteria or viruses. Finally, scientists are coming to realize that it is possible to boost the immune system, which can then fight naturally against infectious agents, without the drawbacks of antibiotic therapy. While immunostimulants cannot replace antibiotics in some cases, they have proven far superior in others. Here are two of the best researched immune boosters available in natural food stores.

Chinese Astragalus Root

Astragalus membranaceus is widely used throughout the orient as a tonic food and medicinal plant. It is sold as dried slices of root, six to twelve inches long. The roots are frequently boiled, along with other herb ingredients -- and frequently some chicken broth -- to produce a tonic/medicinal soup. Research has shown that this root and its extracts are powerful stimulators of the immune system.
Astragalus has been used for thousands of years in China. First mentioned in the Divine Husbandman's Classic of the Materia Medica, an ancient Chinese medicinal text, Astragalus is said to "Tonify the Spleen, Blood and Qi," and is used for "wasting and thirsting syndrome." Some specific Chinese uses hint at a stimulant effect on the immune system. For example, the root is used as a tonic for the lungs, for frequent colds, or for shortness of breath. The Chinese also use it internally for chronic ulcerations and for persistent external infections.
Astragalus stimulates virtually every phase of immune system activity. It increases the number of "stem cells" in the marrow and lymph tissue, and it stimulates their development into active immune cells that are released into the body. Research documenting this has also demonstrated that Astragalus could promote or trigger immune cells from the resting state into heightened activity. Another study on an Astragalus-based Chinese remedy demonstrated "the tendency to stimulate immune response" without suppressive effects. Long-term use (35 days) heightened the activity of spleen cells. The remedy also decreased negative side effects of steroid therapy on the immune system. The author recommended using it in combination with steroid therapy "to alleviate the adverse effects" of the steroid.
Perhaps the best evidence to date for the powerful immunostimulant effects of Astragalus come from the University of Texas Medical Center in Houston. There scientists tested damaged immune system cells from cancer patients, comparing them against cells from the blood of non-cancerous human subjects. Astragalus extracts were able to completely restore the function of cancer patients' immune cells. In some cases, the compromised cells were stimulated to greater activity than those from non-cancerous human subjects. The study concluded that "a complete immune restoration can be achieved by using a fractionated extract of Astragalus membranaceus, a traditional Chinese medicinal herb found to possess immune restorative activity in vitro."
Astragalus has also been found to stimulate the production of interferon and increase its effects in fighting disease. The combined effect of interferon and Astragalus root "resulted not only in decreased common cold incidence but also in shortening the course of illness." The average course of illness of the patients in the combined treatment group was 2.6 days, as compared to 4.6 days in the control group. In the same study, the astragalus root was found to increase the life span of human cells in culture. The authors report no toxicity to human cells. "On the contrary, cell counts indicated that the vital cells in cultures treated with this drug for three weeks were markedly more numerous than those without treatment." The treated cells also became resistant to a common virus, and astragalus promoted regeneration of cells in the bronchi of virus-infected mice. Most consumers probably use Astragalus to prevent and treat colds and other minor diseases.
As if this weren't impressive enough, another study probed the activity of macrophages, one of the major cells responsible for consuming invading microbes. The activity of the macrophages was significantly enhanced within six hours of treatment, and the enhancement persisted for at least 72 hours. The extract also significantly inhibited the growth of tumor cells in mice, especially when combined with the extract Ligustrum lucidum (privet). The authors remark that Astragalus extract "may thus restore immunocompetence; potentially beneficial as a preventative against cancer as well as AIDS."

Echinacea

Echinacea is a very popular American wildflower and garden plant, the purple coneflower. It is also one of America's most popular herbal products, used to prevent and treat the common cold, influenza, and infections. Echinacea is the best known and one of the most researched of immunostimulants.
Echinacea was among the most popular herbs used by Native American Indians. At least 14 Indian nations used Echinacea for coughs, colds, sore throats, infections, toothaches, inflammations, tonsillitis, and snake bites, among other uses. It was used by the Dakota as a veterinary medicine for their horses. By the early 20th century, Echinacea had become the best-selling medicinal tincture in America, used for a variety of internal and external conditions. But by 1910 it had been dismissed as worthless by the AMA. Not until the 1930s did it fall into disuse in this country. However, Europeans, especially Germans, began growing and using Echinacea, and to this day they have produced the best scientific documentation of its value.
The extract's popularity in the U.S. grew rapidly during the 1980s, and the plant is now again among America's best-selling herb extracts. The most common anecdotal reports about the use of Echinacea are from people who begin taking the extract at the first sign of a cold. Often to their surprise, they find the cold has disappeared, usually within 24 hours, and sometimes after taking the extract only once. Anecdotal evidence carries little weight in scientific circles, but plant drug researchers have conducted over 350 scientific studies about Echinacea. Here's what some of those studies say:
The most consistently proven effect of Echinacea is in stimulating phagocytosis, or the consumption of invading organisms by white blood cells and lymphocytes. To prove this, scientists incubate human white blood cells, yeast cells, and Echinacea extract. They examine the blood cells microscopically and count the number of yeast cells gobbled up by the blood cells. Extracts of Echinacea can increase phagocytosis by 20-40%.
Another test called "the carbon clearance" test measures the speed with which injected carbon particles are removed from the bloodstream of a mouse. The quicker the mouse can remove the injected foreign particles, the more its immune system has been stimulated. In this test, too, Echinacea extracts excel, confirming the fact that this remarkable plant increases the activity of immune system cells so they can more quickly eliminate invading organisms and foreign particles.

Cancer
As with Astragalus, Echinacea causes an increase in the number of immune cells, further enhancing the overall activity of the immune system. Echinacea also stimulates the production of interferon as well as other important products of the immune system, including "tumor necrosis factor," which is important to the body's response against cancer. Acts as a preventative against cancer.

Yeasts
Echinacea also inhibits an enzyme (hyaluronidase) which is secreted by bacteria, and helps it gain access to healthy cells. Research in the early 1950s showed that Echinacea could completely counteract the effect of this enzyme, and this could help prevent infection when the herb is used to treat wounds. While Echinacea is usually used internally for the treatment of viruses and bacteria, it is now being used more for the treatment of external wounds. It also kills yeast and slows or stops the growth of bacteria and helps to stimulate the growth of new tissue. It also combats inflammation, further supporting its use in the treatment of wounds.

Inflammation
Research in 1957 showed that an extract of Echinacea caused a 22% reduction of inflammation among arthritis sufferers. Although it is only about half as effective as steroids, steroids have serious side effects. Steroids also strongly suppress the immune system, making them a poor choice for any treatment in which infection is likely. Echinacea, on the other hand, is non-toxic and adds immune-stimulating properties to its anti-inflammatory effect.

Dose
Most people use Echinacea for warding off colds and influenza. Extracts, either alcoholic or non-alcoholic, are the most commonly used form, and the usual dose is one dropperful (15-25 drops). This is taken at the first sign of a cold and is repeated two or three times a day. European clinics do not use continuous doses of Echinacea but rather alternate three days on and three days off. This is because some testing shows that the immune system in healthy subjects can only be stimulated briefly before returning to its normal state. After several days without stimulation, immunostimulants can again be effective.

No Toxicity
Echinacea has an excellent safety record. After hundreds of years of use, no toxicity or side-effects have been reported except rare allergic reactions in sensitive individuals. The purple coneflower is a truly American contribution to world health care through herbs. This safe and effective immune stimulant was discovered and first used by the Native Americans and is now a major medicinal plant used throughout Europe and the U.S.
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Original text by Rob McCaleb, Herb Research Foundation (HRF) President, to whom we give special thanks and acknowledgement.
Astragalus References:
Bensky, D., and Gamble, A., (1986), Chinese Herbal Medicine, Eastland Press.
Rou, M., and R. Fu-Xie, (1983), Journal of Traditional Chinese Medicine 3(3): 199-204.
Iwama, H., et al., (1986), Planta Medica: 247-50.
Mavligit, G. M., et al., (1979), J. Immunology 123: 2185-88.
Sun, Y., Cancer, (1983: 7/3), 52(1): 70-3.
Chu, D., et al., (1987), Clin. Immuno. and Immunopathology 45: 48-57.
Chu, D., et al., (1988), J. Clin. Lab. Immunol. 25: 25-29.
Yunde, H., (1981), Chinese Medical Journal 94(1): 35-40.
Lau, B. et al., (1989), Phytotherapy Research, 3(4): 148-53.

HERBACTIVE HERBALIST'S
Guide to the most useful immunostimulants

Immunostimulant Herbs:
Caisse - for life-threatening illness - FORMULA

PRICES OF Caisse-ACT - for life-threatening illness HERBS

1 oz £ lasts 1 week
2 oz £
3 oz £
4 oz £ lasts 1 month
8 oz £ lasts 2 months
1 lb £ lasts 4 months

for current prices see click here

(Patients with serious conditions require double dose - lasts half the time). 1 oz makes 2 pints. But to see our Caisse - for life-threatening illness - Organic Concentrated Tincture, and its convenience and benefits.

Dose
80 ml twice a day (an hour before breakfast and 2 hours after last meal at night).
160 ml twice daily for patients with serious conditions taken as above.

To make
Add 1 oz Caisse to 2¼ pints boiling spring water for 10 minutes
(you can make 2 weeks supply at a time: 2 oz to 4¼ pints)
Let stand for 6 hours
Stir, and allow to stand for another 6 hours
Bring to the boil again
Allow to cool; strain, bottle, store in refrigerator.

Caisse-ACT - for life-threatening illness - Organic Concentrated Tincture is also available. By taking just 10ml twice a day it is exactly equivalent to the 160ml twice daily of the decoction. This makes is very easy to take, it is better than the decoction in that it is made as a cold extract (no loss of constituents due to heat), it is a better extract than the decoction made from water (tincture extraction draws out more of the essential constituents and phytochemicals), it is easier to store (no space consuming in your fridge), the tincture does not need to be stored in the fridge, it does not degrade, it has long life (due to the tincture) and it is more efficiently absorbed directly into the blood stream.

Price for the Concentrated tincture is less than the 8oz pack of the dried mix of herbs: £see current Prices ​here (incl VAT, plus postage). This will last 1 month at the 10ml twice daily for those on abnormal cell formation treatment; and 2 months supply as preventative or post-chemo treatment (5ml twice daily). More information about Caisse-ACT - for life-threatening illness click here

HerbShield is a supreme combination of anti-abnormal cell formation herbs and immunostimulating herbs. This is recommended be taken when you take Caisse-ACT - for life-threatening illness - . See more about this on my Tonics page. For more about HerbShield click here

ORDERS
To order Caisse-ACT - for life-threatening illness - and HerbShield please  go to the Mail Order and Prices page
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SOME OF THE HERBS USEFUL TO THE IMMUNE SYSTEM
 

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Alan Hopking MA MNIMH has written an article, a double-page centre-spread fully illustrated with colour pictures of each herb in the latest Journal of ICON (Integrative Cancer and Oncology) Volume 9 Issue 3 (2013) called:

20 Natural Herbs that Can Help Act as a Preventative Against Cancer

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1. Commiphora molmol (Myrrh) - anti-microbial, astringent, carminative, anti-catarrhal, expectorant, vulnerary, immunostimulant. Increases WBC and defences, infections, mouth ulcers, pyorrhoea, pharyngitis, sinusitis, boils, glandular fever, brucellosis. Ext. healing and anti-septic for wounds and abrasions. Dose: Tincture BPC 1973 1-2.5ml. Tincture Myrrh Comp. (Thompsons) 1 part Tincture Capsicum BPC 1973 to 4 parts Tincture Myrrh - BPC 1973 Dose: 1-2.5ml. Commiphora myrrha (Mo Yao) Chinese Herb - analgesic, traumatic pain and swelling; to promote the healing of wounds. Pharmacological Action: bronchial secretion - reduces, uterus - reduces secretion from, anti-bacterial, anti-fungal, weight - decreases, mouth-wash, peristalsis - increases; bitter, neutral; HE LIV SP; C/I pregnancy.

2. Eleutherococcus senticosus (Siberian Ginseng) - adaptogen, circulatory stimulant, vasodilator; stress, depletion, (mental and physical), depression, immune stimulant.

3. Rubus ideus (Raspberry leaves) - astringent, tonic, refrigerant, parturient. Use in pregnancy to strengthen and tone womb; haemorrhage, diarrhoea, leucorrhoea, birth preparer, stomatitis, tonsillitis, conjunctivitis (eye lotion). Has been shown to induce ovulation, relax the uterus, stimulate immunity, kill viruses (incl herpes), high blood sugar, increase insulin (diabetes), anti-fungal and anti-viral. (Michael Weiner)

4. Uncaria tormentosa (Cat’s Claw, Peru; inner bark) - adaptogen; immunostimulant, digestive tonic. Enhances phagocytosis. Crohn’s disease, ulcers, asthma, arthritis, iritis, shingles, dysbiosis and chronic fatigue syndrome. enhance overall immunity while increasing stamina; viral infections; enhance emotional stability - even in the midst of extreme stress, fight infections in AIDS patients and decrease the visible size of some skin tumours and cysts within two weeks; reduction in the side-effects of radiation and chemotherapy in patients with life-threatening illness; fibromyalgia; adaptogen, anti-oxidant, anti-tumour, anti-microbial and anti-inflammatory properties; powerful cellular reconstructor; abnormal cell formation, arthritis, gastritis, female hormonal imbalances.

5. Curcuma longa (Tumeric root, Jiang Huang) - Anti-inflammatory for RA, eczema, psoriasis, CVS disease (lowers cholesterol), dissolves clots, thrombosis; lowers cancer risk (smokers, farmers), increased gastric and hepatic function; haemostatic, amenorrhoea, dysmenorrhoea, pain in chest and abdomen, traumatic injury, bleeding in lungs, bladder and nose; RA pain, semi-conscious states, hysteria; jaundice. Ext: RA, inflamed skin, psoriasis, infections of skin. Pungent, bitter, cold. HE, LU, LIV. (Best made as 1:1 45% 35-100ml per week.)

6. Oldenlandia diffusa (Bai Hua She She Cao, whole herb) - anti-bacterial, anti-inflammatory, asthma, bronchitis, laryngitis, lymphatitis, acute gastro-enteritis, septicaemia, pneumonia, urinary tract infection, tonsillitis, appendicitis, abnormal cell formation in GIT; sweet, bitter, cold; HE LIV SP. C/I pregnancy.

7. Scutellaria barbata (Barbat Skullcap whole herb, Ban Zhi Lian) - anti-pyretic, haemostatic, boils, diuretic, reduces swellings; liver disease, detoxification; hepatitis, cirrhosis, ascites, abscesses, ulcers in stomach and lungs; abnormal cell formation in lungs, stomach and intestines; bitter, cold; LIV ST. C/I pregnancy.

8. Symphytum officinale (Comfrey leaves) 1:10 - vulnerary, demulcent, astringent, expectorant; wound healing (allantoin), gastric/duodenal ulcers, hiatus hernia, colitis, ulcerative colitis, haemorrhages, abnormal cell formation.

9. Tabebuia impeteginosa (Pau D’Arco, Taheebo bark. 1:4 45%) Antiabnormal cell formation. Increases energy and endurance. Has lapachol (active against lymphocytic leukaemia), a naphthoquinone, lapachone and xyloidone (quinoids). Anti-candida (thrush), anti-fungal, intestinal parasites.

10. Thuja occidentalis (Thuja, Arbor-Vitae leaves and stems) - haemostatic (all forms of haemorrhage), astringent, refrigerant to blood; stimulates uterus and heart, emmenagogue, amenorrhoea, abnormal cell formation of uterus, anti-pyretic, expectorant, stimulant to smooth muscle, alterative - psoriasis; bronchial catarrh, heart weakness, urinary incontinence, cystitis. Ext.: with Hamamelis Water in exudative eczema. - bitter, sour, slightly sour; LU, LIV, LI. C/I pregnancy. Dose: 1:10 60% 1-2ml. NB: The seeds are used as sedative in insomnia, heart palpitation and nervous disorders; the fresh leaves steeped in 60% alcohol for 7 days rubbed on baldness 3 times/day to promote hair growth.

11. Trifolium pratense (Red Clover flowers) - alterative, expectorant, anti-spasmodic, anti-neoplastic; skin problems in children, eczema, psoriasis, coughs, bronchitis, whooping cough, abnormal cell formation.1:10 45% 1-2ml.

12. Viola odorata (Sweet Violet leaves and flowers) - expectorant, alterative, anti-neoplastic; coughs and bronchitis, upper respiratory catarrh, abnormal cell formation (breast or alimentary canal), naso-pharyngeal catarrh.

All these herbs and more are in the HerbShield Herbal Medicine

Drinking smoothies will also help your condition - find out more about smoothies

Order your tonics here

 

 

 


Prescriptions

Our herbal tonic medicines are carefully prepared on a personal and individual basis for your healing by medical herbalist Alan Hopking MA MNIMH FINEH.

Only whole herbs are used in our herbal medicines. Nothing else is added. If you have symptoms which you consider might be helped with herbal medicine please contact herbal practitioner Alan Hopking for a friendly confidential professional consultation. See terms and fees.

Once you have received your herbal prescription you can contact Alan Hopking at any time for more free advice (preferably by email). When you have completed your bottle of herbal medicine and if you want a repeat prescription you are requested to phone or email so that your progress can be assessed and adjustments made if necessary so that there is no break in your treatment. To order or re-order, click here.

MRCHM - see Alan Hopking's statement about renouncing his association with membership of this organisation

HERBACTIVE Centre of Herbal Medicine, England, UK. Freephone 0800 0834436

General advice to consumers on the use of herbal remedies from the Medicines Healthcare products Regulatory Agency

From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK

• Remember that herbal remedies are medicines. As with any other medicine they are likely to have an effect on the body and should be used with care. • Herbal remedies may sometimes interact with other medicines. This makes it particularly important to tell your doctor or pharmacist if you are taking a herbal remedy with other medicines such as prescribed medicines (those provided through your doctor or dentist). • Treat with caution any suggestion that a herbal remedy is '100% safe' or is 'safe because it is natural'. Many plants, trees, fungi and algae can be poisonous to humans. It is worth remembering that many pharmaceuticals have been developed or derived from these sources because of the powerful compounds they contain. Any medicine, including herbal remedies, which have an effect on the body should be used with care. • Treat with caution any herbalist or other person who supplies herbal remedies if they are unwilling or unable to provide written information, in English, listing the ingredients of the herbal remedy they are providing. • If you are due to have a surgical operation you should always remember to tell your doctor about any herbal remedy that you are taking. • Anyone who has previously experienced any liver complaint, or any other serious health complaint is advised not to take any herbal remedy without speaking to their doctor first.

PRECAUTIONS:

Pregnant/Breast-feeding mothers

Few conventional medicines have been established as safe to take during pregnancy and it is generally recognised that no medicine should be taken unless the benefit to the mother outweighs any possible risk to the foetus. This rule should also be applied to herbal medicinal products. However, herbal products are often promoted to the public as being “natural” and completely “safe” alternatives to conventional medicines. Some herbal ingredients that specifically should be avoided or used with caution during pregnancy. As with conventional medicines, no herbal products should be taken during pregnancy unless the benefit outweighs the potential risk.

Volatile Oils

Many herbs are traditionally reputed to be abortifacient and for some this reputation can be attributed to their volatile oil component.(6) A number of volatile oils are irritant to the genito-urinary tract if ingested and may induce uterine contractions. Herbs that contain irritant volatile oils include ground ivy, juniper, parsley, pennyroyal, sage, tansy and yarrow. Some of these oils contain the terpenoid constituent, thujone, which is known to be abortifacient. Pennyroyal oil also contains the hepatotoxic terpenoid constituent, pulegone. A case of liver failure in a woman who ingested pennyroyal oil as an abortifacient has been documented.

Uteroactivity

A stimulant or spasmolytic action on uterine muscle has been documented for some herbal ingredients including blue cohosh, burdock, fenugreek, golden seal, hawthorn, jamaica dogwood, motherwort, nettle, raspberry, and vervain. Herbal Teas Increased awareness of the harmful effects associated with excessive tea and coffee consumption has prompted many individuals to switch to herbal teas. Whilst some herbal teas may offer pleasant alternatives to tea and coffee, some contain pharmacologically active herbal ingredients, which may have unpredictable effects depending on the quantity of tea consumed and strength of the brew. Some herbal teas contain laxative herbal ingredients such as senna, frangula, and cascara. In general stimulant laxative preparations are not recommended during pregnancy and the use of unstandardised laxative preparations is particularly unsuitable. A case of hepatotoxicity in a newborn baby has been documented in which the mother consumed a herbal tea during pregnancy as an expectorant. Following analysis the herbal tea was reported to contain pyrrolizidine alkaloids which are known to be hepatotoxic.

Breast-feeding mothers

A drug substance taken by a breast-feeding mother presents a hazard if it is transferred to the breast milk in pharmacologically or toxicologically significant amounts. Limited information is available regarding the safety of conventional medicines taken during breast-feeding. Much less information exists for herbal ingredients, and generally the use of herbal remedies is not recommended during lactation.

Paediatric Use

Herbal remedies have traditionally been used to treat both adults and children. Herbal remedies may offer a milder alternative to some conventional medicines, although the suitability of a herbal remedy needs to be considered with respect to quality, safety and efficacy. Herbal remedies should be used with caution in children and medical advice should be sought if in doubt. Chamomile is a popular remedy used to treat teething pains in babies. However, chamomile is known to contain allergenic sesquiterpene lactones and should therefore be used with caution. The administration of herbal teas to children needs to be considered carefully and professional advice may be needed.

Perioperative use

The need for patients to discontinue herbal medicinal products prior to surgery has recently been proposed. The authors considered eight commonly used herbal medicinal products (echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John’s Wort, valerian). On the evidence available they concluded that the potential existed for direct pharmacological effects, pharmacodynamic interactions and pharmacokinetic interactions. The need for physicians to have a clear understanding of the herbal medicinal products being used by patients and to take a detailed history was highlighted. The American Society of Anaesthesiologists (ASA) has advised patients to tell their doctor if they are taking herbal products before surgery and has reported that a number of anaesthesiologists have reported significant changes in heart rate or blood pressure in some patients who have been taking herbal medicinal products including St John’s Wort, ginkgo and ginseng. MCA is currently investigating a serious adverse reaction associated with the use of ginkgo prior to surgery. In this case, the patient who was undergoing hip replacement experienced uncontrolled bleeding thought to be related to the use of ginkgo.

From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK

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