Herbal Medications and the Vascular System

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These headlines from mailings and ads make it seem like the only way to be healthy is to take herbs, vitamins, or food supplements. Not true. The optimal nutrition is through a balanced, reasonable diet. However, there are times when it is difficult to maintain a balance diet. If you are one of the 60% of Americans who have tried or are taking herbal remedies, or food supplements, you should know some important facts about them and how they differ from traditional medicines. (For the purpose of this article, all herbal and natural medications as well as food supplements will be referred to as "herbals.")

In the United States, medical drugs must be tested and approved by the Food and Drug Administration (FDA) for safety and efficacy. They are also tested for purity, consistency (same amount of drug in each pill), and stability, and what they are intended to treat, diagnose, or cure must all be checked. On the other hand, herbal medications and food supplements are not tested by the FDA. Herbal or all natural does not necessarily mean safe. Dirt is all natural and organic, but one wouldn't want to eat it. Few studies have been conducted on herbals, and those which have been conducted have shown that the amount of the amount of the herbal contained in the bottle you buy is not the same for all brands, or even within the same batch of herbal. This means you don't know how much or how little you are getting when you take a dose. The herbals also may be contaminated. Some studies have found many bacteria, fungi, and other substances in the herbals.

Most importantly, it is essential to know that herbals can interact with prescription medications. Some of the interactions are known, but not all drugs or doses of herbals have been studied. Therefore, you may be risking bad side effects, or ineffectiveness of your medications, if you take herbals with your medications. This is particularly true for people on medications for vascular disease.

People with vascular disease often are on many medications. It is important to tell your health care provider about each and every herbal, natural or vitamin supplement, or drug that you are taking. If unaware, he or she may prescribe a medication that has an action that is either increased (potentiated) or decreased when combined with the herbal. There are no warning labels or pharmacy notes that will tell you that you may have an interaction. This applies for both the prescription and the herbal.

One common drug affected by herbals is warfarin (Coumedin®), used to help prevent blood clotting. Some herbals make warfarin work more – increasing the risk of bleeding. Others make warfarin work less – increasing the risk of clotting. Either of these could cause a dangerous result. Look at chart 1, which shows a few of the herbals that interact with warfarin. Make sure you use care and check with your health care provider before adding any herbal when you take warfarin. When taking warfarin, avoid common herbals beginning with the letter G – ginseng, green tea, garlic, ginger, and ginkgo – because all of these affect the action of warfarin.

Other drugs taken for blood thinning such as aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), ticlopidine (Ticlid®), or clopidogrel (Plavix®), may be affected by the same herbals as warfarin. Check with your health care provider before adding herbals with these drugs.

Many people who have vascular disease also have diabetes or hypertension. Blood sugar control can be affected by herbals. Garlic, ginger, ginseng, hawthorn, Ma Huang, and nettle all may cause your blood sugar to become out of control. Hypertensive drugs of many types can be affected by black cohosh, devil's claw, ginseng, goldenseal, hawthorn, licorice, Ma Huang, and yohimbe. These herbals may be used for many reasons. Their bottle labels will not mention that they interact with drugs you may be taking. This is a partial list of interactions and should not be considered as the only or a comprehensive list of herbals that affects drugs.

Just remember, herbal or all natural does not necessarily mean safe. Make sure your health care provider is given a complete list of every medication, herbal, and dietary supplement you are taking. It may make the difference between having a bad reaction and being safe.