A Patient with Natural Supplements 2

When I first reported the prevalence of Calendula in natural products recommended for skin conditions, I pointed out that calendula was a derivative of marigold flowers.  Marigold is a sibling to ragweed, the most common allergen in North America.  So it seemed particularly shocking to me that the natural products industry has somehow targeted all those kids with eczema to get this product that will often make their skin much worse, even if they avoid the emergency room for the asthma attack.

I noticed that my patient had some nasal allergies.  I didn’t make anything of it—I have some of these too.  But I spent a couple of hours making sure that the medication I was prescribing didn’t have some kind of interaction with the 8 nutritional supplements recommended by her chiropractor.  I wasn’t too concerned about the vitamins, whether they came from algae or a Swiss pharmaceutical company.  Deep down on the list of one of the products—mostly vitamins and minerals in this one—was a quick mention in the ‘other ingredients’ section:  barley grass.  I wondered if it could be triggering her grass allergies in the middle of winter.

And there was another product with Globe Artichoke as an ingredient.  It’s in the same flower family as marigolds and ragweed.

Yet another product contained Milk Thistle.  It’s in the same plant family as, sure enough, marigolds and ragweed and artichoke.

But it probably didn’t help that buried in the long list of ingredients in another product was dandelion. Lots of people are allergic to that, too. She wasn’t taking antibiotics, so I wasn’t worried about the dandelion lowering the levels of antibiotics in her blood.

She was taking a product I often recommend:  Fenugreek.  It’s a common spice in Indian recipes, but that’s not the way I prescribe it.  I use it with new mothers struggling to develop their milk supply.  Not with all, and not with whatever dose they want.  I write down for them exactly how many milligrams, how many times a day, what they should expect, and what side effects they should look out for.  Just like any medication I prescribe. 

Because I was very experienced with the use and dosage of this product, I don’t expect—though that doesn’t mean it’s not possible—that this teenage girl will start leaking in an embarrassing way during 2nd-period geometry.  Should I warn her that it can increase uterine cramping? 

I found out that many of the product ingredients interfere with blood clotting.  Some have effects on blood pressure.

I’m happy to admit that somebody with high blood pressure might do quite well on Reishi Mushroom.  Maybe better than on conventional drugs.  But it’s still a drug.  Some studies show that it decreases platelet activity.  That’s generally a good thing in heart-disease patients.  And anything that lowers your blood pressure increases the risk of fainting, sometimes not at the most convenient moment. 

What is so annoying is the obvious elephant in this room.  It’s a supplement when I try to supplement my diet with some extra fruit and vegetables.  But these are drugs.

The natural medicine folks want to have it both ways.  If the plant products actually work medically, they are better because they work ‘naturally.’  But if they work medically, and do all the things claimed—like serious changes to bleeding, blood pressure, or the immune system—why aren’t they drugs?  If they don’t work medically, why are they recommended?