By: MSF
Staff and reviewed by the MSF Medical Advisory Board
Herbal medicine
is nothing new. In fact, it’s been around for tens of thousands of years. From
1820 to 1920, herbal medicine was particularly popular in the U.S. Then, in the
mid-1920s, conventional medicine began to replace the herbal remedies of old.
“There has
been a recent revival of interest in herbal medicine, and herbs are currently
one of the most frequently used forms of CAM (complementary and alternative
medicine),” writes Allen C. Bowling, M.D., Ph.D., in his book Alternative Medicine and Multiple
Sclerosis. “The use of herbs by Americans nearly
quadrupled between 1990 and 1997.”
The most
important difference between drugs and herbs is that the majority of drugs
consist of a single chemical compound, but herbs consist of many different
ones. Some may be beneficial, some may be harmful, and some have unknown
effects on the human body.
This is because
herbs have not been studied as extensively as drugs and it is still unknown
which chemicals in herbs are the active ingredients. There is also a lot to be
learned about the side effects of herbs and their interaction with conventional
drugs.
“Herbs
should be used with caution by people with MS. There are many herbs with no
well-documented benefits that may potentially worsen MS or interact with MS
medications. If a therapy is strong enough to produce beneficial effects, it
usually is also strong enough to produce harmful effects,” said Dr.
Bowling.
This does not
mean that herbs are off limits. What it does mean is that you need to be informed.
Do some research, talk to your doctor and pharmacist, and weigh the risks and
the benefits before using herbal medicine.
SYMPTOM
INTERACTIONS
The medications
often prescribed for those with MS, such as Baclofen®, Valium®, Klonopin® and
Zanaflex®, can produce fatigue or other sedating side effects. So it is
important to be aware of any herbs that could cause even more sedation. Some of
the more common ones include chamomile, goldenseal, kava kava, St. John’s wort,
valerian, Siberian ginseng and Asian ginseng.
Some herbs may
irritate the urinary tract or worsen the effects of a urinary tract infection.
Frequent or high doses of these herbs may irritate the urinary tract even when
no infection exists. Coffee is the leading culprit. Other herbs include cinnamon,
eucalyptus, myrrh gum, and sassafras.
If you’ve
experienced depression, you may be familiar with the older class of
antidepressants known as tricyclic antidepressants. These include amitriptyline
(Elavil®), nortriptyline (Pamelor®), and others. If you are taking one of the
tricyclic antidepressants, St. John’s wort, henbane, belladonna, mistletoe and
scopolia should be avoided. If you are taking one of the newer antidepressants
known as SSRIs, (Prozac®, Zoloft® or Paxil®) steer clear of St. John’s wort as
well. It may decrease the levels of these and other prescription medications in
the bloodstream.
DRUG
INTERACTIONS
Amantadine is
frequently prescribed to treat fatigue. Sedation or confusion may result if
amantadine is taken along with certain herbs. These include belladonna,
pheasant’s eye, scopolia or henbane.
Steroids are
sometimes used to treat MS attacks. Therefore, it is important to be aware of
those herbs that may worsen steroid side effects, such as increased blood sugar
or decreased blood potassium. Other herbs may actually increase the potency of
the steroids. The more common ones include Asian ginseng, ephedra (ma huang),
senna and licorice.
Methotrexate, a
chemotherapy drug, is sometimes used to treat MS. If combined with aspirin-like
chemicals known as salicylates, adverse effects may occur. Certain herbs
contain salicylates and should be avoided when taking methotrexate. These
include meadowsweet, poplar, sweet birch, black cohosh, willow and wintergreen.
Another herb, echinacea, may produce liver toxicity when combined with
methotrexate.
Consumption of
echinacea, popular for its long history of treating infections, may aggravate
MS by stimulating the immune cells (macrophages and T cells) and impairing the
activity of MS medications, such as the ABCR drugs. Regardless, echinacea is
sometimes recommended for people with MS and continues to be used by a large
number of people with the disease.
Many herbs,
despite limited toxicity evaluations and significant toxic effects, are still
available in the U.S. Some potentially dangerous herbs that are sometimes
recommended for MS include borage seed oil, yohimbe, lobelia, chaparral and
comfrey. These may produce high blood pressure, psychiatric problems, rapid
heart rate, seizure, and other serious complications.
For more
information, read Dr. Bowling’s book, Alternative Medicine and Multiple
Sclerosis. It is available through the MSF lending library.
.