Medical hypocrisy, or somthing else?

[Cryozombie]

I was listening to a medical call in show on the radio, and I heard somthing interesting. Following this, in a medical advice column in the local paper, I heard something similar. It got me thinking.

Ask most doctors, and they will mainly agree with the effects of Marijuana/THC... dry mouth, intoxication, rapid heartbeat, blood vessel expansion, etc. And basically it makes you high.

Ask most doctors and they will mainly agree with the effects of MaHuang/Ephedra... bronchialdialation, hypertension, vasodialation... and basically it acts like speed.

Two examples, I can think of several more...

Why is it, with "herbs" like this, they are in agreement... they have effects on the human body... and they are bad, so stay away from them.

But in the case of "Herbal" or "Natural" treatments for other things... (in the case of the radio call in show, it was an "herbal" anti fungal remedy for athletes foot) doctors insist that herbs are nothing more than Placebos that have no real effects, and "Any effect you saw from that was purley coincidental" (again, the radio call in show)

Another example is Dr Drew from "Loveline"... he always swore up and down that herbs did nothing... but he was always all over the effects of pot, which is, basically an herb.

I guess I am confused by these positions... are they real? Are they Placebos?

I can suppose that in the case of things like Ma Huang, and Marijuana, we have simply studied them more, so we KNOW what they do... but does that mean that we just need to STUDY what these other herbs do, instead of discounting them as witchcraft? Or is this about the fact that the Drug Companies cant regulate the growth and sale of these herbs, so they teach the doctors they are bullstuff... when in fact they may or may not be?

I guess I'm just confused? What do you guys think?

 

[Xue Sheng]

The problem with Herbal remedies are that many people self medicate by what they hear or read and, to be blunt, they are clueless.

Some go to herbalists that are, also to be blunt, charlatans

Also many who prescribe herbal remedies, although what they are prescribing will cure what they prescribe them for, do not have the knowledge to actually mix the entire herbal remedy. This is not their fault; they simply did not get the full training because the school they went to does not know they complete prescriptions either.

In Beijing University of Traditional Chinese medicine horology is much like a pharmacist’s degree. Also you can't just run out and by any old herb you think will work. For many you need a doctor’s prescription.

I use to think herbs were just a lot of garbage that can potentially be dangerous, I was half right. They can be dangerous in the wrong hands.


Since I meant my wife and used the herbal she prescribes me now that they work rather well, they generally taste awful, but they work.

She has had patients come to her with prescriptions from other people and those prescriptions were incomplete based on her TCM training. She has said that the prescription will work, but not very fast. She generally changes the prescription to what her training says and in most cases they work rather well.

Herbal in combination with Acupuncture or acupressure is also used in certain cases. If you use just the acupuncture or acupressure in these cases it may take longer to work or not work at all. Same goes for some cases with herbal. Without the acupressure or acupuncture it will take longer to cure the particular problem or not work at all.

Also in some cases Western Doctors refuse to accept that TCM, if administered by a properly trained person works rather well and sometimes better for certain conditions. But that is ok you get the same thing in China, some doctors there think Western medicine is a load of garbage too.

 

[Nomad]

I guess I am confused by these positions... are they real? Are they Placebos?

I can suppose that in the case of things like Ma Huang, and Marijuana, we have simply studied them more, so we KNOW what they do... but does that mean that we just need to STUDY what these other herbs do, instead of discounting them as witchcraft? Or is this about the fact that the Drug Companies cant regulate the growth and sale of these herbs, so they teach the doctors they are bullstuff... when in fact they may or may not be?

I guess I'm just confused? What do you guys think?

As a scientist working in pharmaceuticals, I often see the opposite... people talking about how bad pharmaceuticals are (side effects, etc.) and how much better the "natural" herbals are instead.

Basically, both points of view are badly skewed.

Many traditional herbal medications have been found to be efficacious and a large number of these have become marketted pharmaceutical products (eg. digitoxin from foxglove, taxol from yew trees, etc.) In these cases, the scientists have identified the active ingredient(s) and produced them in a pure form as the medication. Frequently, these are better tolerated than the bulk herbals because they are pure (and dosage is much easier to control)... often the side effects in herbal medications may come from other biologically active ingredients in the mixture. Rarely, the pure substances are actually less effective; in these cases it is likely that several components in the herbal mixture are playing a role in it's overall activity.

On the other side of the coin, many other herbal remedies have been shown in double blind clinical trials to not have any statistically relevant effect on the conditions they are supposed to treat. In this case, what you're seeing is a simple placebo effect. These herbals continue to be marketted because there is no oversight body (equivalent to the FDA for pharmaceuticals) and because they remain profitable.

The other big problem with the lack of oversight of herbals and nutraceuticals has been highlighted in several scientific studies. Currently the manufacturers don't have to adhere to any quality standards, and testing across different brands and even from batch to batch shows that the quantity of the "active" ingredients varies greatly. In other words, some batches of XYZ nutraceutical may contain upwards of 500 mg of "active" ingredient, others will have none, or any amount in between.

Just because something is natural does not mean it is safe! (please recall that cocaine and curare are both natural!) Doctors and scientists are just now starting to understand how many herbal products (St. John's Wort is a famous example) interact with other medications that someone may be taking, occasionally with fatal results. In the development of a new pharmaceutical product, drug-drug interactions are something that must be considered, and have stopped the production of some very promising medications over the years.

Nutraceuticals are a multi-billion dollar a year industry, not the powerless cottage industries people often envision. Many of the producers of herbal supplements and medications are taking their lead from the pharmaceutical industry in terms of quality control and proof of efficacy; others are not.

As for the drug companies not being able to regulate the growth and sale of these herbs, thereby leading to them badmouthing them to doctors... I honestly don't think this is the case. Why? Because many of the big pharmaceutical companies ARE making and distributing these herbals as a side business or under a subsidiary.

Over the years, doctors and scientists have seen far too many Snake Oil salesmen hawking stuff that will "cure" everything from depression to cancer. Most now want the salespeople to put their money where their mouth is... if it works, prove it (see double blind clinical trial). If they can't or won't, doctors are unlikely to recommend it.

 

[Xue Sheng]

One more very important point.

In many states, possibly all, you do not need a license or certification to give out herbal, so you may be getting herbal form a self-proclaimed expert that know less than you do about it and that can be dangerous.

There are herbal remedies, like western medications, that where once used that were later found to be harmful so a professional no longer uses it in any herbal prescription. Were Joe self-proclaimed will know nothing about this.

 

[MA-Caver]

The problem I have with it is that both the medical profession (not all of it's members) and the pharmicutical companies that manufacture the drugs are prescribing the quick fix.
Example: Myself personally. I was diagnosed a few years ago with severe clinical depression. I went into therapy and had initially (thought) I had an agreement with the therapist and the organization (state run) "NO DRUGS!" I was/am after all a drug addict/alcoholic (recovering for the last 17 years.
After the first 30 days I was finally given an appointment to see the clinic's psychiractist. He was reputed to be the leading one in the state.
Wow, he must've been THAT good. Because after sitting down with him for five minutes and ONE question ("are you suicidal?" ... me thinking... geez as if I'm going to tell HIM? I answered "No, because I'd done it already." ) He prescribed zoloft.
Every month I was to see him (we were supposed to be scheduled for half hour visits (he was such a busy man) but only saw me for at most 10 to 15. Each subsquent visit he kept upping the dosage of the zoloft. Dispite that I was reporting that I was feeling better each time, (mostly in part because of the therapy sessions I was going through which were helping me sort all the crap in my head that was causing the depression in the first place). But he kept upping the dosage. By 250 mgs a day I dropped out and found my own path out of the funk I was in.
Oh, guess what?... I - did - NOT - take - ONE - pill... PERIOD!
They didn't even bother to check. I have a copy of the "Physician's Guide To Prescription Medicines. Zoloft has well over 83 side-effects. Prozac has well over 200. What are side-effects by the way? Simply put... they are EFFECTS of the drug. Maybe not with everyone but definitely with enough to warrant putting it down on record. I didn't take the zoloft because I didn't feel like taking a chance on growing breasts. I prefer them where they're normally found... on women.
Basically I saw it as a means of justifying receiving state funds per patient.
Malarky, bullcrap and greed.

Doctors are sent samples, along with coupons for free dinners at posh resturants, free frequent flyer miles, and so forth. I've a friend who was a former doctor who became disgusted with the whole affair. The more samples and full blown prescriptions he gave out the bigger were his incentives from the pharm companies.
Not feeling well? Ok just take a couple of these and come back to see me when they run out. NEXT!

As I've seen/read/heard physicians tend to shy away from herbal meds because they're cheap, and actually WORK! If done correctly. Now of course many pharm drugs help out too... but they should be administered when all other treatments fail.

I've a bitter taste in my mouth on this subject (obviously ) and probably biased but I stand firm on my position that drugs are not always needed. Particularly on mental illness. As far as stomach-aches, headaches/migraines, muscle, back, and the like, there are (cheaper) alternatives than just a quick pop of a little ole' pill.
If the pharm companies truly believed in their product then they would/should LOWER the prices of their wares so that EVERYONE can benefit from them. Not those with hefty insurance policies.

 

[Xue Sheng]

I guess I'm just confused? What do you guys think?

OK, now that I am done with the Herbal rant I can give my opinion on the question.

Many Western MDs do not understand it, nor do they want to. And they point to failed remedies by poorly trained or not trained people as examples of proof. Also if it does work and it does, it cuts seriously into the pharmaceutical market and MDs have to retrain and many do not want to nor feel they need to.

 

[Nomad]

As I've seen/read/heard physicians tend to shy away from herbal meds because they're cheap, and actually WORK! If done correctly. Now of course many pharm drugs help out too... but they should be administered when all other treatments fail.

I think most doctors shy away from herbal remedies because they don't know enough about them. These are not in their medical training, and as previously stated while many may work, lots of others do not. Doctors tend to put their trust in treatments which have proven results, which all pharmaceuticals need to have before they can make it to market. Side-effects, while always a problem, are at least known for most pharmaceuticals (as seen by the extensive warnings on the label). If you don't think that herbals have side-effects, you're fooling yourself... the difference is that many of them won't have been so meticulously documented.

I've a bitter taste in my mouth on this subject (obviously ) and probably biased but I stand firm on my position that drugs are not always needed. Particularly on mental illness.

This I agree with 100%. Clearly a number of conditions or diseases, especially those such as depression which do not have clear clinical markers (ie. something measurable in blood, etc.) are WAY overdiagnosed and thus overprescribed.

If the pharm companies truly believed in their product then they would/should LOWER the prices of their wares so that EVERYONE can benefit from them. Not those with hefty insurance policies.

Sales of pharmaceuticals are what allows research for new drugs. Period. If you cut the costs of all pharmaceuticals, you kill the research pipeline and you will not have new drugs being developed. The average drug costs roughly $800 million dollars to develop and takes around 10 years to get to market. Over the last 20 years or so, these costs have been steadily rising (stiffer requirements from FDA, longer clinical trials, etc).

Pharmaceutical companies are not supported by the government or taxpayers; the only way they stay in business to provide new and old drugs is by remaining profitable.

That said, most pharmaceutical companies are providing a number of medications such as AIDS and tuberculosis drugs way below cost to many severely afflicted nations (especially in Africa). Why? Because they're trying to make a difference in a horrible situation.

Corporations like these are WAY too easy to demonize. The vast majority of them are doing a very difficult job well, to the benefit of mankind (eliminating polio, nearly eradicating tuberculosis before the bugs got smarter... they're now taking a second stab at this one, turning HIV from a fatal disease into a chronic treatable disease, greatly reducing cancer mortalities, etc.).

OK, enough ranting for now. Back to work on my diabetes project.

 

[Xue Sheng]

I think most doctors shy away from herbal remedies because they don't know enough about them. These are not in their medical training, and as previously stated while many may work, lots of others do not. Doctors tend to put their trust in treatments which have proven results, which all pharmaceuticals need to have before they can make it to market. Side-effects, while always a problem, are at least known for most pharmaceuticals (as seen by the extensive warnings on the label). If you don't think that herbals have side-effects, you're fooling yourself... the difference is that many of them won't have been so meticulously documented.

Actually all Herbals work well if administered by a trained person. A trained person knows what herbals to use for what ailment. However not all ailments can be treated by herbal, this too a trained person knows. As to Side effects, once again there are fewer side effects from herbal if a trained person is administering them. As for meticulous documentation, Chinese hospitals are very meticulous about this.

The problem occurs with herbals in the west when people self-medicate or get herbal medication from an untrained or poorly trained individual...or an ice tea company. Westerners think; Oh this is natural so it is safe".... nope. Rocks are natural too but you wouldn’t want to eat one. You need a well trained herbalist to administer herbal.

And most pharmaceuticals in the west know little or nothing about herbal. In China there are pharmacies dedicated to herbal with highly skilled people AND you need a doctor's prescription to get them.

There are also reputable companies in the West that sell herbal and in order to buy from them you have to at least be a licensed acupuncturist. However being an acupuncturist does not mean you know anything about herbal.

And you are correct Western Medical Doctors are not trained in using them.

 

[Cryozombie]

Corporations like these are WAY too easy to demonize. The vast majority of them are doing a very difficult job well, to the benefit of mankind (eliminating polio, nearly eradicating tuberculosis before the bugs got smarter... they're now taking a second stab at this one, turning HIV from a fatal disease into a chronic treatable disease, greatly reducing cancer mortalities, etc.).

OK, enough ranting for now. Back to work on my diabetes project.

I dunno man... it seems like I can get many of the same drugs out of Europe, Canada or Mexico for often 1/2 of what they cost here... why would that be, if not insurance coverage?

 

[Blotan Hunka]

Whats the "effectiveness" difference between western drugs and herbal remedies? Which has saved the most lives?

 

[Xue Sheng]

Whats the "effectiveness" difference between western drugs and herbal remedies? Which has saved the most lives?

Hard to say, they are not always used to treat the same problem. There are problems that western Medicine is much better are dealing with and there are problems Eastern medicine is much better at dealing with.

In China it is not a competition it is cooperation, its not a this is better than that, it is a this is better for that problem than that.

 

[Nomad]

Actually all Herbals work well if administered by a trained person. A trained person knows what herbals to use for what ailment. However not all ailments can be treated by herbal, this too a trained person knows. As to Side effects, once again there are fewer side effects from herbal if a trained person is administering them. As for meticulous documentation, Chinese hospitals are very meticulous about this.

The problem occurs with herbals in the west when people self-medicate or get herbal medication from an untrained or poorly trained individual...or an ice tea company. Westerners think; Oh this is natural so it is safe".... nope. Rocks are natural too but you wouldn’t want to eat one. You need a well trained herbalist to administer herbal.

And most pharmaceuticals in the west know little or nothing about herbal. In China there are pharmacies dedicated to herbal with highly skilled people AND you need a doctor's prescription to get them.

There are also reputable companies in the West that sell herbal and in order to buy from them you have to at least be a licensed acupuncturist. However being an acupuncturist does not mean you know anything about herbal.

And you are correct Western Medical Doctors are not trained in using them.

Sorry if the last post confused. I was definitely talking about Western MD's and their relationship with herbals. I don't have the experience to talk about Chinese doctors or how things work there. Thanks for the information.

 

[Xue Sheng]

Sorry if the last post confused. I was definitely talking about Western MD's and their relationship with herbals. I don't have the experience to talk about Chinese doctors or how things work there. Thanks for the information.

No problem.

In most cases it is the lack of experience and or training that makes herbals dangerous. Exactly the same as if soemone decided to be a pharmacist and never went to school for it or took only a couple of chemistry classes.

I do not mean to sound upset, if I do I apologize. My main point is you need to have someone trained in herbal before you start taking them and right now you are not required to have any type of certification in most or all of the US to call yourself an herbalist and start dolling out herbs.

 

[Nomad]

I dunno man... it seems like I can get many of the same drugs out of Europe, Canada or Mexico for often 1/2 of what they cost here... why would that be, if not insurance coverage?

I don't know the reasons drugs are more expensive in the US than Canada or other developed nations, other than that the companies will price them differently based on market (size, structure, ability to pay, etc.). Some countries do negotiate prices or new drugs directly with pharmaceutical companies.

In the US, the potential for very costly litigation (justified or not) likely plays a role in the higher prices of prescription drugs. Certainly the multi-tiered medical and insurance system in the US also plays a role, but I'd hesitate to claim which was the cause and which the effect.

 

[Phoenix44]

Well, there's an awful lot of generalization going on, about what doctors think and whether herbs are "bad" or "good" or whether drugs are bad or good.

The main difference between pharmaceuticals and herbs is the testing. Pharmaceuticals must be tested according to strict protocols and must be evaluated and approved by the FDA. Herbs and nutritionals do not. It doesn't mean either one is bad or good. Obviously, either one can be either one depending on the circumstances. But if I want to read about a pharmaceutical--benefits, risks, potential side effects, doses, double-blind studies--I can do that. I can't necessarily do so with an herbal.

At varying times I use pharmaceuticals, nutritional products, and herbals. But I wouldn't think of using any of those if I couldn't read about them first.

Again, you can read about the efficacy and side effects of Prozac or Zoloft. Just because you may not be find any, or many, side effects to an herbal doesn't mean it doesn't have side effects, it just means that appropriate testing may not have been done in the first place. Geez, aspirin probably wouldn't be approved by the FDA now.

As for the idea of doctors prescribing drugs because of really great perks from drug companies: that went out years in 1990 when the AMA adopted strict ethics standards. Gifts to doctors have to primarily benefit patients, not doctors.

And if you want to know why drugs in America are so much more expensive than elsewhere, you might want to investigate the campaign contributions made by the pharmaceutical industry.

 

[Xue Sheng]

Well, there's an awful lot of generalization going on, about what doctors think and whether herbs are "bad" or "good" or whether drugs are bad or good.

The main difference between pharmaceuticals and herbs is the testing. Pharmaceuticals must be tested according to strict protocols and must be evaluated and approved by the FDA. Herbs and nutritionals do not. It doesn't mean either one is bad or good. Obviously, either one can be either one depending on the circumstances. But if I want to read about a pharmaceutical--benefits, risks, potential side effects, doses, double-blind studies--I can do that. I can't necessarily do so with an herbal.

At varying times I use pharmaceuticals, nutritional products, and herbals. But I wouldn't think of using any of those if I couldn't read about them first.

Again, you can read about the efficacy and side effects of Prozac or Zoloft. Just because you may not be find any, or many, side effects to an herbal doesn't mean it doesn't have side effects, it just means that appropriate testing may not have been done in the first place. Geez, aspirin probably wouldn't be approved by the FDA now.

As for the idea of doctors prescribing drugs because of really great perks from drug companies: that went out years in 1990 when the AMA adopted strict ethics standards. Gifts to doctors have to primarily benefit patients, not doctors.

And if you want to know why drugs in America are so much more expensive than elsewhere, you might want to investigate the campaign contributions made by the pharmaceutical industry.

A lot of documented herbal testing exists in China. That is why I am saying do not take herbal from someone that is not highly trained.

Note on the documentation in China. Reading that here may not be an option since the majority of it is in Chinese. Also there are books about it that are, for lack of a better word, fake. Once again it goes back to needing a well-trained herbalist.

But I admittedly am only speaking about Chinese herbal that is all I use. There are obviously other herbals and experts in use of those herbals. But there’s that word expert that infers well trained.