"Herbal Medicine & Acupuncture- What's the Point?"

Many of us "flock" to alternative therapies and remedies to help
in our quest for optimal health. The intake of over- the-
counter supplements has reached critical mass. In 1997,
Americans spent an estimated $12 billion for vitamins and
minerals and herbal products. Sales are up nearly 30 percent
from 1995, says the Nutrition Business Journal, an industry
newsletter. Also growing is the number of doctors and
pharmacists adding prestige to these products.

As I have cautioned earlier in these newsletters, we should
proceed only with a very health dose of caution, as many of
these therapies are unproven, unregulated, and may even
be unsafe.

Yes, unsafe and even harmful.

As more and more studies are done on alternative health
modalities and products, we are be able to separate the "truths"
from the "myths". Recently, another wave of information has
come forth, reinforcing this "healthy" and cautious approach to
alternative health.

An article in the Aug/Sept 1999 Food Testing & Analysis
described some of the problems facing the industry. There are
few standard methods for analyzing herbal materials, and this
means results vary greatly between laboratories and in different
countries. For example, the ginsenoside content of ginseng
giving an 80% content by the method used in China shows only a
50-60% level with the method used in the U.S.

Another major factor that effects herbal potency is natural
variation. For example, there are 72 strains of kava with a
range of active ingredient from 3% to 20%. The hypericin
content of St. John's Wort varies due to ambient temperature,
altitude, flowering status, age of the plant, and which part of
the plant is extracted.

Also, the term "standardization" is not legally defined in the
U.S. or many other countries. As is often the case, you are
on your own if you buy these products.

Some herbal "good news, bad news"...

The good news......

A recent company has been attempting to "self regulate" the
industry and test the potency of many herbs. The companies
mission is "to provide consumers and healthcare professionals
with results of independent tests of products that effect health
and well being". By year-end, the company, ConsumerLab.com
will have tested most of the popular dietary supplements sold in
the U.S.

The bad news.......

Out of 27 major brands of dietary supplements purporting to
contain saw palmetto for treating symptoms of prostate
enlargement, only 17 appeared to have ingredients similar to
those found in published clinical studies.

Saw palmetto is a type of dwarf palm whose berries are used
medicinally, most often in the form of an extract. Among
clinically tested saw palmetto extract products, at least 85% of
the extract's weight have been attributable to specific fatty
acids and sterols. To evaluate products against this standard,
ConsumerLab.com purchased 27 leading brands of saw palmetto
supplements through retail stores, on-line retailers, and direct
sales or multi-level marketing companies. Five saw palmetto
extract products were immediately eliminated from testing
because their labels indicated that they had been standardized
to levels of fatty acids and sterols that were below 85%. A
sixth product was eliminated as it had incomplete labeling to
determine the amount of saw palmetto per serving.

Among the 21 remaining products that then underwent laboratory
analysis, four were found not to contain the minimum amounts of
specific fatty acids and/or sterols commonly found in the saw
palmetto products used in published clinical trials. These four
products all had fatty acid levels that were accordingly too low
and two of these products also had inadequate sterol levels. The
list of products that passed ConsumerLab.com's independent
testing, as well as more information about the testing, are
available at www.consumerlab.com.

Also, to assess the quality of Ginkgo products on the market,
ConsumerLab.com purchased 30 Gingko Biloba products in August at
retail stores, online, and through direct and multi-level
marketing companies. The contents of these products were tested
against international standards for the quality and
concentration of clinically tested Ginkgo Biloba. Among the
thirty leading brands tested of Ginkgo Biloba tested, one in
four (25%), failed quality testing.

What is most interesting in this is that while the company is
trying to do some legitimate testing, the level they are setting
as "acceptable" is highly questionable. To pass their quality
test, a product must contain within 20% of the amount stated on
the label. This is far below the level established by drug
manufacturers. Pharmaceutical drugs are held to a higher
standard and must contain within 10% of what they state on their
labels. Herbal products should be held to the same standards.

While some of you may be shocked at the results of these tests,
other independent tests have resulted in similar findings.

When Consumers Union (the company that publishes the magazine
Consumers Reports) tested ten brands of ginseng in 1995, they
found substantial brand-to-brand variation in the total
concentration of ginsenosides, the supposed active ingredients.

When the Good Housekeeping Institute tested nine brands of St.
John's wort, they found a 17-fold difference in the amount of
the suspected active ingredient. When the Los Angeles Times
tested St. John's wort last September, it found that seven of
ten brands came up short.

Consumers Union also recently tested ginko, and echinacea and
their tests of ginkgo biloba and echinacea products showed
variations in active ingredients or in compounds that indicate
the presence of the active ingredient.

Their results on echinacea...

CU said that Americans spend more than $300 million a year for
this "cold remedy." Are they getting what they pay for? CU
tested 12 brands for the phenolic compounds caffeoyl-tartaric
acid, chlorogenic acid, cichoric acid, and echinacoside. Most
products cite the amount of echinacea per pill (50 to 500
milligrams), instead of phenolic compounds. But by a guideline
some products use, those compounds should make up at least 4
percent of the echinacea claimed for each pill.

CU found that the total percentage of the four compounds per
pill varied from brand to brand. Of the two products that
promised at least 4 percent total phenolic compounds (and
confirmed that those were the same four we looked for), one,
Sunsource Echinex, came close to 4 percent, on average. (Two
other products also met that level, though they didn't claim
to.) Even within a brand, pills in different bottles had
different percentages.

The amount of those compounds PER PILL also varied, from an
average of 2 milligrams, in Nature Made, to more than 10
milligrams, in Nature's Herbs. Given the different dosages among
products, someone taking the recommended dose of One-A-Day could
consume about 2 milligrams of phenolic compounds per day, while
someone taking Nature's Herbs could consume more than 90
milligrams.

In respect to gingko.....

CU said that ginkgo biloba has been used for thousands of years
in China and is widely used in Europe. Ginkgo's rise to herbal
superstar status in the U.S. began in 1997 with a study
published by the nonprofit New York Institute for Medical
Research. Researchers said that ginkgo biloba extract helped
stabilize and even partially improve--for six months to a
year--the cognitive performance and social functioning of
patients with dementia from Alzheimer's disease or multiple
ministrokes. Results were modest, however, and we there are no
long-term studies of ginkgo's effects on people with no signs of
memory loss.

The active ingredients in ginkgo biloba are thought to be
flavone glycosides and terpene lactones. Flavone glycosides make
up 24 percent of the ginkgo biloba product used in the New York
Institute study; terpene lactones, 6 percent. The same
percentages are claimed by many products sold in the U.S.

CU found that on average, the brands tested came within 2
percentage points of meeting those amounts. As with echinacea,
however, the percentage in individual bottles often varied.
Concentrations of flavone glycosides in individual samples of
Nature Made, for instance, ranged from about 24 percent to 35
percent; in Nature's Resource, terpene lactones ranged from 7
percent to about 13 percent.

Another issue that CU found was that prices vary widely on these
products. You may pay $5 for 100 pills--or $10 for 50.

Getting less then you pay for certainly isn't a good idea. But
is getting more then you pay for a good idea when it comes to
herbals? And besides, what's the big deal really? Even if
these products don't contain EXACTLY what they say they
contain, could they do any real harm?

The answer, my friends, is a resounding yes!!

Here are some very serious warnings on herbal products...

From January 1993 to October 1998, the Food and Drug
Administration (FDA) received 2,621 reports of serious
problems--including 101 deaths--linked to supplements. Reports
like these, recently led the editors of The New England Journal
of Medicine to emphatically state.."It is time for the
scientific community to stop giving alternative medicine a
free ride," and they called for more-rigorous testing

And now, the FDA is warning diabetics to avoid five brands of
Chinese herbal products because the herbs illegally contain
prescription drugs that could cause dangerous drops in blood
sugar. (This is no joking matter)

Makers of these products say they contain only natural Chinese
herbs. But after a diabetic herb user had several episodes of
hypoglycemia, California investigators discovered the products
also contain the prescription diabetes drugs glyburide and
phenformin.

Consumers can receive a dangerously high amount of the drugs
from the affected herbs, California's health department
concluded - and herb users particularly are at risk if they also
take regular diabetes medicine.

``People with diabetes should avoid these products and consult
their physician if they've been taking them,'' the FDA warned
Thursday.

In particular, people who suffer fatigue, excessive hunger,
profuse sweating or numbness after taking the herbs should call
a doctor.

Affected products are:

-Diabetes Hypoglucose Capsules, sold by Chinese Angel Health
Products of Santa Monica, Calif.

-Pearl Hypoglycemic Capsules, imported by Sino American Health
Products Inc. of Torrance, Calif., but also sold by Chinese
Angel.

-Tongyitang Diabetes Angel Pearl Hypoglycemic Capsules and
Tongyitang Diabetes Angel Hypoglycemic Capsules, sold by Sino
American.

-Zhen Qi Capsules, sold by Sino American.

The FDA has stopped imports of the products and is investigating
how the drugs were added to the herbs and whether any other
herbal products are contaminated.

Chinese Angel and Sino American have agreed to recall the
products, which may be returned to the place of purchase for a
refund

Also.....

Another report has found that certain Chinese herbs may cause
kidney failure . Remember, just because a remedy or nutritional
supplement is 'herbal,' that does not make it harmless. A team
of doctors from Taiwan report the cases of 12 patients with
kidney failure apparently caused by taking Chinese herbs.

'The risk of using uncontrolled herbal medicines warrants our
urgent attention,' stated the group of physicians from Cathay
General Hospital in Taipei, led by Dr. Chwei-Shiun Yang.
'Obviously; the incidence of herbal medicine-induced (kidney
damage) is more common than previously perceived.'

The doctors describe 12 Chinese patients seen over a 3-year
period, all of whom had unexplained kidney failure. Tests showed
that these patients had interstitial nephritis (inflammation of
the kidney tissues) and severe damage to the kidney tubules. The
only thing these patients had in common was that they had each
taken Chinese herbs for some reason: for weight control, as a
nutritional supplement, or to treat a non-kidney disease.

The patients had taken Chinese herbs of various kinds and from
various sources, for periods of time ranging from 3 to 18
months, although several patients did not know how long they'd
taken the herbs. The doctors diagnosed all 12 patients with
Chinese herbs nephropathy, a condition first identified in
Belgium in 1992 when over 100 patients taking 'slimming herbs'
at a weight loss clinic experienced similar unexplained kidney
failure. The harmful ingredient in the herbal preparation in
these cases was thought to be aristolochic acid.

But Yang and colleagues note that the role of aristolochic acid,
the substance thought to cause the Belgian kidney failures, was
never definitely proved. In the Taiwanese patients, no one
ingredient common to all 12 patients could be identified. The
doctors suggest that 'unidentified phytotoxins (plant-derived
poisons) other than aristolochic acid might induce this unique
toxic (kidney disease).'

Writing in the February issue of the American Journal of Kidney
Diseases (2000;35:313-318, 330-332), Yang and colleagues suggest
that 'it is crucial to investigate the possible role of herbal
remedies when faced with an interstitial nephritis of unknown
origin.'

In an editorial in the same issue, Dr. Jean-Louis Vanherweghem
of the Universite Libre de Bruxelles in Brussels, Belgium,
observes that 'numerous myths have grown around medicinal herbs
and their healing powers.' But, he warns, 'many plants contain
substances toxic to humans and therefore -- not surprisingly --
to the human kidney.' Vanherweghem calls for herbal substances
to be 'subjected to the same stringent scrutiny and controls as
common drugs.'

Also....

The same issue of the American Journal of Kidney Diseases
(2000;35:310-312) also reports that a type of fruit juice sold
in health food stores can be a hidden source of potassium and
thus could be hazardous for patients with kidney disease.

Noni juice is sold as an herbal remedy and its users claim (on
numerous websites) that it can help reduce high blood pressure,
menstrual cramps, arthritis, ulcers, sprains, depression, sexual
dysfunction, senility, heart disease and chronic fatigue
syndrome, among other ailments. The juice is derived from the
fruit of the noni tree (Morinda citrifolia).

However, the juice also contains potassium, but does not include
this information on the label, according to a report in the
February issue of the American Journal of Kidney Diseases. While
potassium alone is not hazardous (and is found in many fruit
juices), it can be harmful for patients with kidney disease who
cannot excrete the substance. If blood levels of potassium are
too high, patients can suffer irregular heart rhythms and heart
attack.

'Patients with kidney disease and unexplained hyperkalemia (high
potassium levels) should be queried about their ingestion of
herbal remedies and alternative medicine products because they
may be a hidden source of potassium,' report Dr. Bruce A.
Mueller, of Purdue University in Indianapolis, Indiana, and
colleagues.

The researchers report the case of a man with kidney disease who
visited his doctor for a routine checkup. Blood tests indicated
that potassium and other markers of kidney disease were
dangerously high.

The patient denied consuming any potassium-rich foods such as
bananas and orange juice but admitted that he had begun to drink
a shot of noni juice before each meal. The juice, he claimed,
had cured a relative of cancer.

The patient continued to drink the juice despite warnings that
it may contain potassium and at his next visit, potassium
remained elevated. The patient insisted that he would never stop
drinking the juice and said the doctors 'did not understand the
power of noni juice,' according to the report. The patient never
returned to the clinic.

The doctors purchased a bottle of noni juice from a health food
store and had it analyzed in a lab. The potassium content of the
juice was found to be similar to that of orange juice and tomato
juice, which are generally restricted in the diets of patients
with kidney disease.

According to the researchers, the case illustrates the potential
dangers of herbal products, which, despite a lack of federal
oversight, are becoming increasingly popular in the US.

'The use of herbal products by patients continues to grow, and
(patients) often do not tell their healthcare providers about
the use of these alternative therapies,' Mueller and colleagues
write. The researchers tested noni juice manufactured by Body
Systems Technology, Inc. of Casselberry, Florida.

And still more....

Another report, appearing this same week in the Lancet (2000;
355:547-548) warns that one of the most commonly used herbal
remedies, St. John's wort, substantially reduces blood levels of
the HIV-fighting drug indinavir, and may cause treatment failure
in some HIV-infected patients.

Although St. John's wort (Hypericum perforatum), is marketed as
a treatment for mild depression, little is known about its
potential drug interactions.

Past studies had suggested that St. John's wort and protease
inhibitors -- a particularly effective class of HIV-fighting
drugs -- share the same metabolic pathway in the body.

To further investigate, researchers at the National Institutes
of Health in Bethesda, Maryland, gave St. John's wort and
indinavir alone and together to 8 healthy, HIV-free volunteers.

The investigators found that St. John's wort substantially
reduced blood levels of the protease inhibitor. After taking St.
John's wort, the level of indinavir dropped by an average of
nearly 60% compared with the level seen without the herbal
remedy.

Almost all important HIV drug combinations contain at least one
medication that is metabolized through the same pathway used by
the herbal remedy, noted senior investigator Dr. Judith Falloon
of the National Institute of Allergy and Infectious Diseases in
Bethesda.

Therefore, St. John's wort should be avoided by patients taking
these drugs, 'at least until it's figured out how to correct for
any potential interactions.' Falloon told Reuters Health.

After completing the study, the researchers immediately checked
to see if they had any patients in their clinic who were taking
the herbal remedy.

'We did have patients who were taking St. John's wort who were
on indinavir,' Falloon said. 'We promptly called them and told
them to stop.'

It is possible that some patients who have failed indinavir
therapy may have done so because they were taking St. John's
wort, according to Falloon.

Many AIDS drug trials have permitted patients to also take
supplements, which fall under the category of nutrition, she
added. 'So these substances would not necessarily have been
controlled by clinical trial design.'

'I'm certain there are plenty of other... herbal remedies out
there that people use that affect their drug concentrations,'
she continued. 'It's not uncommon for people to take four or
five supplements.' And it's not just a question of drug
interactions, there may well be other unrecognized toxicities,
she said.

And even more on another alternative health practice,
acupuncture.....

Another recent study in Tobacco Control (1999;8:393-397)
evaluated the claim that acupuncture can help smokers kick the
habit and found that smokers planning to 'kick the habit' should
not depend on acupuncture for help.

'Acupuncture is like a placebo, it's better than doing nothing,
(but) it's not a specific effective treatment,' said lead author
Dr. Adrian R. White, a general practitioner and acupuncturist
from the University of Exeter, UK. (Note that this lead author
was himself an acupuncturist)

White and his colleagues reviewed 14 studies involving one of
two acupuncture techniques: inserting needles in the ear or face
for 10 to 20 minutes; or inserting needles into the ear and
leaving them there for 1 to 2 weeks.

The studies were of poor quality, but even the best studies did
not find that either technique was more effective than a sham
acupuncture in helping to stop smoking. In addition, many of
the study authors failed to confirm that the subjects had indeed
quit smoking (a minor but important endpoint of the study). :)

'The subjects weren't measured for carbon monoxide to test
whether they've stopped smoking or not,' said White in an
interview with Reuters Health. The studies also were small and
were not particularly well conducted, White told Reuters Health.

'If further research into acupuncture for smoking cessation is
conducted, this should be to a much higher standard of quality
than previously,' the investigators write.

'The conclusion from the study is that patients are welcome to
carry on using acupuncture. It works by expectation of the
patient, expectation of the practitioner (as well as) other
factors like... the physical distraction of actually placing the
needles in the body,' said White. However, there may be more
effective methods to quit smoking, he said.

Some other news reports on herbs from last year.....

Stop herbal medicines before surgery
NEW YORK, May 07 -- Herbal medicines can interfere with
anesthesia or cardiovascular function, increasing the risks of
complications during surgery, according to experts at the
American Society of Anesthesiologists (ASA). The organization
cautions patients to stop taking herbal remedies such as ginko
biloba and ginseng at least 2 to 3 weeks before surgery, and to
tell anesthesiologists if they have been using alternative
remedies.

Herb supplements may impair fertility
NEW YORK, Feb 23 -- Some of the most commonly used herbal
supplements may have adverse effects on fertility, according to
California researchers who conducted tests on eggs and sperm in
laboratory culture dishes. Echinacea purpura, ginkgo biloba,
and St. John's wort appear to interfere with the sperm's ability
to penetrate an egg, reported Dr. Richard R. Ondrizek and
colleagues at the Loma Linda University School of Medicine,
California, in the March issue of the journal Fertility and
Sterility.

Herbal remedy linked to kidney failure
NEW YORK, Aug 06 -- Chinese herbal remedies used to treat eczema
appear to be the cause of rapidly progressive kidney failure in
two British women. The cases are described in the August 7th
issue of The Lancet.

Herbal teas linked to Parkinson's symptoms
NEW YORK, Jul 23 -- Toxins in herbal teas may be at least partly
to blame for the 'unexpectedly high' rate of Parkinson's
disease-like ailments seen in Guadeloupe, French West Indies,
report an international team of researchers.

St. John's wort toxic in AIDS patients
NEW YORK, Mar 16 -- Hypericin, the active ingredient in St.
John's wort, may trigger severe skin reactions in AIDS patients,
researchers conclude.

Some herbs sold as food supplements undoubtedly have health
benefits - as yet, we have little evidence for this however.
And in the meantime, most of you who are experimenting
with them , are in fact doing just that, taking part in the
largest uncontrolled experimental study ever done on
herbs and supplements.

Herbs are natural and from plants, but this doesn't mean that
they are inherently safe and healthy.

Remember, true health can't be bought, it has to be built.
Health doesn't come from a pill, potion or herb. Health is a
result of healthful living. Don't be swayed by all the slick
promoters these days of "health in a bottle". If you want high
level health, then you have to do those things that are known to
build health....

...eat right, exercise regularly, get plenty of sleep, rest and
relaxation, and find a meaningful purpose to life.

Have another great week, and remember...

Your Health Is Your Greatest Wealth!

In Health,
Chef Jeff