Category Archives: medicine

Natural Does Not Imply Safety or Efficacy

I’ve been thinking a lot lately about the safety of various natural pharmaceuticals* such as homeopathics, herbs, and essential oils. People tend to act like natural pharmaceuticals don’t have any risks and are completely effective and entirely unsusceptible to the problems experienced by allopathic pharmaceuticals. But that’s not necessarily true.

Here are three basic points I came up with.

 

  1. The Desired Therapeutic Effect can Result in Undesired Side Effects

Most people who have a family member over 50 with heart disease are familiar with the therapeutic effects and side effects of aspirin. Aspirin is a blood thinner, which reduces the risk of blood clots that can cause heart attack and stroke. However, it can also prevent your blood from

white_willow_bark-product_2x-1439419453

white willow bark

clotting when it needs to, resulting in excessive, even dangerous, bleeding. However, what few people seem to know is that aspirin was originally made from powdered white willow bark. Like aspirin, white willow bark is an effective treatment for fever, pain, and inflammation. It is also effective as a blood thinner. They discovered the active ingredient of willow extract was salicylic acid and subsequently began manufacturing acetylsalicylic acid in 1899. (In fact, if you are allergic to aspirin, you should also not take white willow because you will almost certainly be allergic to white willow as well [1].) Like aspirin, white willow bark poses a risk of excessive bleeding. Other blood thinning herbs, such as garlic and gingko, also pose the same risk of excessive bleeding.

In other words, the desired therapeutic effect can also have undesired side effects.

 

  1. The Desired Effect in Certain Circumstances May Be Undesired in Others

Misoprostol (Cytotec) is a synthetic prostaglandin used to prevent or treat stomach ulcers. However, the fact that it is a prostaglandin also means that it causes uterine contractions. It was initially approved for use as an ulcer preventive/treatment and pregnancy was listed as an cytotecabsolute contraindication to its use. After some experimentation with Cytotec during pregnancy to induce labor, pregnancy was removed as a contraindication. However, Cytotec still should not be used in early pregnancy, when it can cause miscarriage (and, in fact, it is standard to use it alongside methotrexate for the purpose of inducing an abortion) [2].

Similarly, the essential oil Clary Sage can cause uterine contractions. In fact, my fellow midwives often use it to induce or augment labor and, for the same reason, prohibit its use in early pregnancy (since this may result in a miscarriage). I’ve discovered that other naturally-minded

Clarysage

clary sage

groups typically offer the same warning [e.g., 3].

People tend to believe that homeopathics have no risks because, after all, they’re so very, very diluted. However, a particular homeopathic has the same potential issue as the Clary Sage essential oil… Like Clary Sage oil, homeopathic Caulophyllum can cause uterine contractions [e.g., 4]. To be safe, it should therefore be avoided in early pregnancy so as to prevent miscarriage.

Salicylates such as aspirin can cause birth defects in animals, which is why it is not recommended in pregnancy for humans (though the ethical barrier means that it hasn’t been studied in humans) [5]. In fact, salicylates have been specifically used to induce birth defects in animals for research purposes since at least the 1950s [6]. You know what natural product contains salicylates? Wintergreen essential oil, which is composed of a whopping 98% methyl

methyl salycilate

methyl salycilate

salicylate [7]. So does Birch essential oil, at over 95% salicylate [8]. I completely understand being skeptical of claims that a given natural product is unsafe in pregnancy. However, simple reason seems to dictate that a skeptic of the “unsafe” claims would at least fact-check it to be absolutely certain it is safe for their unborn child before using it. Sadly, my experience has been that “oily” people are often rigidly religious about their opinions on essential oils and unlikely to change their opinions in the face of scientific evidence.

In other words, a pharmaceutical that is safe in some circumstances is not always safe in all circumstances.

 

  1. Being Natural Doesn’t Mean it’s 100% Safe

There’s a heart drug called digoxin that is fairly widely used. It helps to slow down one’s heart rate, but this means that if your heart rate is under 60 bpm, you shouldn’t take digoxin because it can slow your heart rate down to an unsafe rate. Furthermore, even when the heart rate is normal, digoxin toxicity can occur. One of the symptoms of digoxin (or digitalis) toxicity is the appearance of yellow haloes around lights.

starry night

Van Gogh’s Starry Night

Have you ever seen Vincent Van Gogh’s Starry Night? Notice the yellow haloes around the stars? It is widely believed that Van Gogh was suffering from digitalis toxicity—except that digoxin didn’t exist yet. Rather, he was taking the plant from which we first extracted digoxin: foxglove. While foxglove presumably had the desired therapeutic effect on Van Gogh’s health, it poses the risk of toxicity, just as digoxin does today, and the result was Van Gogh’s Starry Night with yellow haloes around the stars [9].

In other words, just because it’s the “natural” version of the drug we use today doesn’t mean it is entirely safe and without risk.

 

  1. The Efficacy Risks of Allopathic Pharmaceuticals are Often Also True of Natural Pharmaceuticals

Penicillin is still used today, though bacteria are widely antibiotic-resistant to penicillin in only 70 short years of use, making penicillin not entirely worthless but nearly so. Another problem is that penicillin kills “good” bacteria as well as “bad” bacteria. The fact that penicillin was originally purified from a mold and was therefore “natural” doesn’t change the fact that it kills (and has always killed)

penicillium

Penicillium mold

both “good” and “bad” bacteria and that bacterial resistance eventually develops, making the product useless. In fact, I recently discovered that herbal-resistance among bacteria have been discovered just like antibiotic resistance. In China, where they widely use both allopathic medicine and Traditional Chinese Medicine (TCM, which is largely herbs), they have done some research on herbal resistance and found that, in some cases, herbal resistance is sadly very widespread [10, 11].

In other words, just because it’s a natural antibacterial doesn’t mean it only kills bad bacteria or that bacterial resistance will not develop.

 

Final Thoughts

The very fact that allopathic pharmaceuticals are effective is what makes them, at times or in certain situations, risky. Some allopathics are just not safe or effective at all. However, many that are effective are simultaneously risky precisely because they are effective. Aspirin is effective at thinning your blood, which is precisely why it poses a risk of excessive bleeding. If a natural pharmaceutical is effective at thinning your blood, it will also pose a risk of excessive bleeding. It doesn’t matter whether it’s natural or synthetic. Health-Welness-BusinessesAnd if a given chemical (e.g., methyl salicylate) causes a specific problem (e.g., birth defects), any product containing that chemical in sufficiently large quantities (e.g., Wintergreen and Birch essential oils) may have the same effect and should be presumed to have the same effect until proven otherwise.

I do believe that natural products can be safer than allopathic products in many cases, and I reach for my essential oils, homeopathics, and herbal tinctures before I reach for the allopathic solutions like Tylenol, ibuprofen, and antibiotics. However, it is clearly to the detriment of our and our children’s health when we are uninformed of the risks posed by these wonderful products and therefore use them unsafely.

It’s impossible for everyone to become a homeopath, a master herbalist, and an aromatherapist purely for use in their own homes. However, at the very least, we can make use of the lists of safe and unsafe natural pharmaceuticals, safe and unsafe uses of natural pharmaceuticals, and contraindications and precautions to natural pharmaceuticals that have been prepared by people who actually are the experts. Remember that ego helps no one, especially in the areas of pharmacology and medicine.

 

Footnotes

* “Pharmaceutical”: This term comes ultimately from Ancient Greek φαρμακευτικός (pharmakeutikós), meaning “drug maker.” The first drugs included essential oils and herbals. Thus, “pharmaceutical” or “pharmacotherapeutic” can mean natural products just as accurately as when it refers to allopathic products.

 

Selected References

[1] http://www.umm.edu/health/medical/altmed/herb/willow-bark

[2] Allen, R., & O’Brien, B. M. (2009). Uses of misoprostol in obstetrics and gynecology. Reviews in Obstetrics and Gynecology, 2(3):159-168. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760893/

[3] http://fertilitypregnancyacupunctureclinic.com.au/clary-sage-oil-to-induce-labour-naturally/

[4] http://www.britishhomeopathic.org/charity/how-we-can-help/articles/womens-health/labour-and-childbirth/

[5] Alsaad, A. M. S., Fox, C., & Koren, G. (2015). Toxicology and teratology of the active ingredients of professional therapy MuscleCare products during pregnancy and lactation: A systematic review. BMC Complementary and Alternative Medicine, 15:40. doi: 10.1186/s12906-015-0585-8. https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-015-0585-8

[6] Warkany, J., & Takacs, E. (1959). Experimental production of congenital malformations in rats by salicylate poisoning. American Journal of Pathology, 35(2):315-331. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1934858/

[7] http://essentialoils.co.za/toxic-oils.htm

[8] http://authorscott.com/salicylate-sensitivities-essential-oils-need-know/

[9] Lee, T. C. (1981). Van Gogh’s vision: Digitalis intoxication? JAMA, 245(7):727-729. doi: 10.1001/jama.1981.03310320049025

[10] Tong, Y. Q., Jia, S. L., & Han, B. (2013). Chinese herb-resistant clinical isolates of Escherichia coli. The Journal of Alternative and Complementary Medicine, 19(4):387-388. doi: 10.1089/acm.2011.0955.

[11] Tong, Y. Q., Xin, B., & Zhu, L. (2014). Transfer of herb-resistance plasmid from Eschirichia coli to Staphylococcus aureas residing in the human urinary tract. Jundishapur Journal of Microbiology, 7(3):e15056. doi: 10.5812/jjm.15056. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138649/