Trick or Treatment (31 page)

The most infamous case of herbal medicine contamination concerned PC-SPES, a remedy that was supposedly based on a mix of Chinese herbs. It was promoted as being beneficial to prostate health and as a treatment for prostate cancer – PC is an abbreviation of prostate cancer and SPES is Latin for
hope
. Men began using it in the mid-1990s as an apparently safe and natural alternative to hormone treatment. By 2001, however, it became clear that PC-SPES had been doubly contaminated. The first contaminant was
diethylstilbestrol
, an artificial substitute foroestrogen, which had fallen out of favour in the 1970s due to its numerous adverse reactions, including blood clots. In hindsight, this explained both the effectiveness of PC-SPES and the fact that some users had died of thrombosis.

The second contaminant was
warfarin
, a blood-thinning agent used both in medicine and as a rat poison. This had presumably been introduced to counter the adverse effects of the artificial oestrogen. Unfortunately, the addition of warfarin caused other problems, namely excessive bleeding. A sixty-two-year-old man who used PC-SPES to combat prostate cancer arrived at a hospital in Seattle with uncontrolled bleeding. According to Dr R. Bruce Montgomery, one of the doctors who documented the case, ‘He developed spontaneous bleeding from many places. He had a rapid heartbeat from the large amount of bleeding and low blood pressure.’

So far, we have focused on how the herbal-medicine industry can harm humans, and we will return to this issue shortly. First, however, it is worth briefly noting that the industry in natural remedies can also damage nature itself. This may come as a surprise to some users of herbal treatments, but the harvesting of wild plants for medicines is a genuine threat to the survival of some species. According to Chen Shilin of China’s Institute of Medicinal Plant Development, 3,000 of the country’s threatened plant species are used in traditional medicine. This number is in line with a study by Alan Hamilton from the World Wildlife Fund, who estimated that between 4,000 and 10,000 medical plants are under threat due to harvesting from the wild.

For example, the herb goldenseal was already under threat due to the destruction of its hardwood forest habitats, but its reputation as a treatment for a variety of conditions has led to widespread harvesting and has placed it at even greater risk. The absurdity is that there is no good evidence that goldenseal is effective for anything at all. By contrast, echinacea is not under threat because it is being cultivated. But it has a similar appearance to the Tennessee purple coneflower and smooth coneflower, which are endangered species and which are often gathered by mistake. One journalist called this the herbal-medicine equivalent of ‘collateral damage’.

Some traditional herbal healers also offer remedies that contain animal products, such as tiger bone or rhino horn, and in these cases the trade is pushing species to the brink of extinction. It is ironic that those who seek natural herbal cures often do so because they have a love of nature, and yet their desire to be at one with nature might be destroying it.

Before ending this section, we will return to the subject of how herbal medicines can harm humans and summarize some of the key issues. In particular, we will offer some important advice to help you protect yourself against the three potential dangers posed by herbal medicines:

1. Direct toxicity from the herbal medicine.
   
 

2. Indirect reactions caused by interactions with other medicines.
   
 

3. The risk due to contaminants and adulterants.
   
 

Before embarking on taking a particular herbal remedy, it is crucial that you reassure yourself that it is safe. To help you do this, we have drawn up Table 2, which shows the main risks associated with the most popular herbal medicines. Unfortunately, we cannot offer you a complete guide to the dangers of such remedies, as the list would run to dozens of pages. Moreover, new risks are discovered virtually every month. For example, in 2007 the
New England Journal of Medicine
reported the cases of three boys who developed breast tissue after their mothers had rubbed lavender or tea tree oil products on their chests. It seems that lavender and tea tree oils can mimic female hormones and inhibit male hormones, thereby giving rise to this condition.

Having looked at Tables 1 and 2 and other sources of reliable information, you may feel that a particular herbal medicine could help you, because it appears to be both relatively safe and reasonably effective. However, you still need to consider whether the remedy in question is safer and more effective than the conventional drug option. There is no point in taking a herbal medicine if there is a safer and more effective conventional treatment, especially bearing in mind that conventional drugs have generally undergone a higher degree of testing for both safety and efficacy. If the herbal remedy remains your preferred option, then we would urge you take on board the following points before embarking on your treatment:

1. Obtain your herbal medicine from a mainstream pharmacy, where you are likely to find the highest-quality products, which are probably free of contaminants and adulterants. You are also more likely to receive responsible advice regarding your particular condition and its treatment.
   
 

2. Take herbal medicines in pill form, rather than in the form of a powdered leaf, tea or concoction obtained from a herbalist. This is the best way to have some confidence that you are receiving the correct dosage.
   
 

3. Do not take individualized herbal mixtures from a traditional herbal practitioner. They could be contaminated or adulterated. Also, the more herbs you take, the higher the likelihood of adverse effects. Moreover, there is no evidence that the approach of individualizing herbal medicines is effective.
   
 

4. Be particularly careful about using herbal medicines if you are pregnant or if the treatment is intended for a child or an elderly person.
   
 

5. If you are already taking a conventional drug, then be aware that there is the risk of interactions between the conventional drug and your herbal remedy.
   
 

6. Inform your GP and your entire healthcare team about any decision to take herbal medicines.
   
 

7. Last, but certainly not least, under no circumstances abandon your conventional medicine unless you have first discussed this at length with your GP.
   
 

This final point is crucial. Perhaps the most dangerous aspect of herbal medicines is that they often displace effective conventional medicines. If ineffective herbs replace an effective conventional treatment, then it is almost inevitable that the patient’s condition will deteriorate. Worse still, if the patient is no longer being seen by a specialist in conventional medicine, then this deterioration might not be halted before it is too late.

For example, cancer patients are often confronted by the intimidating prospects of surgery, radiation and chemotherapy, sometimes referred to as ‘slash, burn and poison’ by critics of conventional medicine. Hence, the offer of a herbal medicine is tempting, because it is often marketed as a natural alternative, which is both safer and more effective. The key issue, however, is whether or not the herbal alternative is really safer and more effective.

One such natural treatment promoted as an anti-cancer agent is
laetrile
. It is an extract derived from various natural sources, often apricot pits, and it has been in use since the nineteenth century. Early proponents argued that laetrile could attack tumours by entering cancer cells, where it decomposed into cyanide, thus destroying the cells. Another hypothesis was that laetrile was a vitamin (even though it is not), and that cancers were due to a laetrile deficiency. Few doctors, however, took laetrile seriously and it remained on the fringes of medicine until the early 1970s, when it was cleverly promoted and marketed, thus persuading many cancer patients to see it as their only hope for survival.