Herbal use in patients with steroid-sensitive conditions?

[Guest guest]

No offense taken, Phil. I agree that we need to make our ground on

this issue less shaky, not just expert (thank you, Phil) opinion. At

the same time, we shouldn't swallow speculation and fear to the

opposite about 'estrogenic herbs, either from articles or from studies

that I really wonder about their accuracy. I'd raise the question of

how we perceive herbal medicines to work as opposed to pharmaceutical

drugs, especially when we combine them in prescriptions. There are

presently no mechanisms to study herb interactions in prescriptions,

although we can safely say that there are more complex interactions and

more complex pharmacodyamics in the body that with most medications.

 

Unlike synthetic hormones, the body metabolizes and discharges excess

substances more readily from a natural source, especially one that

doesn't supply the hormone in a direct fashion.

 

Emmanuel, I think I need your help here. I am not so well versed in

pharmacology as you and Phil.

 

 

 

On Wednesday, October 1, 2003, at 11:23 AM, wrote:

 

> Z’ev’ wrote that if a herb/formula really match a carefully Dxed

> Pattern, it should be safe in cancer. However, is OPINION [even

> expert opinion] on that issue sufficient?

>

> No offence intended, Z'ev. But I could see this issue being a aoft-

> target for Quackbuster-types who want to destroy herbal medicine.

> We should be reasonably sure of our ground on this issue.

 

 

[Guest guest]

Unlike synthetic hormones, the body metabolizes and discharges excess

substances more readily from a natural source, especially one that

doesn't supply the hormone in a direct fashion.

>>>>Zev except for this sounding great can you show me any evidence for this

statement?

Alon

[Guest guest]

There is some discussion on how herbs are metabolized differently than

drugs in Simon Mills' text, " Principles and Practice of Phytotherapy " .

 

 

On Wednesday, October 1, 2003, at 01:04 PM, ALON MARCUS wrote:

 

> Unlike synthetic hormones, the body metabolizes and discharges excess

> substances more readily from a natural source, especially one that

> doesn't supply the hormone in a direct fashion.

>>>>> Zev except for this sounding great can you show me any evidence

>>>>> for this

> statement?

> Alon

>

>

>

>

[Guest guest]

Hi Z'ev,

 

I hope this helps. I took the time to post a number of times earlier in the

year regarding the complexity of herb formulas taken orally. Yes, the

thousands of interacting and permutating molecular reactions of CM herbal

formulas is unlike anything that is presented in WM or Western science. My

sense is that CM formulas stimulate, calm or regulate the human physiology

in such a way that tissues, organs, systems secrete (and then respond to)

the body's own molecules in physiologically appropriate dosages. Externally

applied biological end-products like estrogen or cortisol simply shuts down

the homeostatic system while the pharmacological dosage is being metabolized

by the body. From what I've seen in CM research in Taiwanese, Japanese and

mainland Chinese research articles is that CM herbal formulas function in a

variety of ways. Like acupuncture, they do not rely so much on delivering

" biological end molecules " but rather cause the physiology to deliver it's

own internal dosaging of appropriate molecules. I believe many can

appreciate that what I'm describing as " internal dosaging " is of molecules

both known and (perhaps mostly) not yet discovered in dosages that fluctuate

by the second according to homeostatic feedback mechanisms. I personally

view CM (whether acupuncture, herb formulas, tui na or moxa) as being

considerably more subtle, more complex and often more efficacious than the

blunt delivery of molecular medicines. Yes, the molecular medicines require

liver and kidney detoxification in addition to the homeostatic shutdowns or

imbalances that they often cause.

 

That's the " with an explanation " answer. Regarding Phil's Quack-buster

issues, anything that's not in the paradigm of WM can technically be

targeted as quackery by those who wish to ignore efficacy and demand

" mechanisms of action " . However, these days Medline reports thousands of

peer-reviewed papers on CM indicating efficacy and yet noting " mechanism of

action unknown " . If it's okay for Western science, it'll have to be okay

for Western medicine.

 

In gratitude for your patient reading,

Emmanuel Segmen

 

 

-

" " <zrosenbe

 

Wednesday, October 01, 2003 11:40 AM

Re: Herbal use in patients with

steroid-sensitive conditions?

 

 

No offense taken, Phil. I agree that we need to make our ground on

this issue less shaky, not just expert (thank you, Phil) opinion. At

the same time, we shouldn't swallow speculation and fear to the

opposite about 'estrogenic herbs, either from articles or from studies

that I really wonder about their accuracy. I'd raise the question of

how we perceive herbal medicines to work as opposed to pharmaceutical

drugs, especially when we combine them in prescriptions. There are

presently no mechanisms to study herb interactions in prescriptions,

although we can safely say that there are more complex interactions and

more complex pharmacodyamics in the body that with most medications.

 

Unlike synthetic hormones, the body metabolizes and discharges excess

substances more readily from a natural source, especially one that

doesn't supply the hormone in a direct fashion.

 

Emmanuel, I think I need your help here. I am not so well versed in

pharmacology as you and Phil.

 

 

 

On Wednesday, October 1, 2003, at 11:23 AM, wrote:

 

> Z'ev' wrote that if a herb/formula really match a carefully Dxed

> Pattern, it should be safe in cancer. However, is OPINION [even

> expert opinion] on that issue sufficient?

>

> No offence intended, Z'ev. But I could see this issue being a aoft-

> target for Quackbuster-types who want to destroy herbal medicine.

> We should be reasonably sure of our ground on this issue.

 

 

[Guest guest]

Unlike synthetic hormones, the body metabolizes and discharges excess

substances more readily from a natural source, especially one that

doesn't supply the hormone in a direct fashion.

>>>>Zev except for this sounding great can you show me any evidence for this

statement?

Alon

 

Alon,

 

Most of the reference books on pharmaceuticals describe specific pathways of

metabolism and excretion. They're pretty much mostly metabolized as poisons by

the liver and kidney. Is it your impression that Chinese herbs are mostly

delivering poisons that require enormous work by the liver and kidney?

 

Emmanuel Segmen

 

 

 

[Guest guest]

There is some discussion on how herbs are metabolized differently than

drugs in Simon Mills' text, " Principles and Practice of Phytotherapy " .

 

`>>>Is there actual data their or just discussion

Alon

 

 

[Guest guest]

Most of the reference books on pharmaceuticals describe specific pathways of

metabolism and excretion. They're pretty much mostly metabolized as poisons by

the liver and kidney. Is it your impression that Chinese herbs are mostly

delivering poisons that require enormous work by the liver and kidney?

 

>>>>If you look at some the pharm literature on Chinese herbs you can also find

some info on pathways and many are the same enzyme as those for pharm drugs.

There are interactions between herbs and drugs that clearly show herbs to be

affecting many of the same pathways. There are plenty of herbs out there that

cause liver and kidney damage. While i agree that in general CM is less toxic

that is not the same as saying that the mechanisms are totally diffrent. Does

the mechanism of nontoxic drugs then also totally different? I think we have too

much feel good stuff

here

Alon

 

 

[Guest guest]

It is pretty authoritative science. It is not studies, but how this

stuff works from a pharmacological perspective.

 

Shanah Tovah,

 

On Wednesday, October 1, 2003, at 08:39 PM, Alon Marcus wrote:

 

> There is some discussion on how herbs are metabolized differently than

> drugs in Simon Mills' text, " Principles and Practice of Phytotherapy " .

>

> `>>>Is there actual data their or just discussion

> Alon

>

>

[Guest guest]

Alon,

Clearly while there are varying levels of toxicity with many herbal

medicinals, all well documented in the Chinese literature, it is also

true and common sense that herbal medicinals are more complex than

pharmaceuticals, and contain more organic compounds. It is also true

and common sense that combinations of medicinals that have been tested

over centuries neutralize toxicity that would appear if single

medicinal substances were given over extended periods and large doses.

 

 

On Wednesday, October 1, 2003, at 08:57 PM, Alon Marcus wrote:

 

>>>>> While i agree that in general CM is less toxic that is not the

>>>>> same as saying that the mechanisms are totally diffrent. Does the

>>>>> mechanism of nontoxic drugs then also totally different? I think

>>>>> we have too much feel good stuff

 

 

[Guest guest]

It is pretty authoritative science. It is not studies, but how this

stuff works from a pharmacological perspective

>>>I will take a look, however we also know that herbs are processed by the same

enzyme systems as drugs do

Alon

 

 

[Guest guest]

Alon,

 

Only the molecules in the herbs which are identical to or quite similar to the

pharmaceutical molecules would require detoxification similarly by the liver or

kidney. My impression is that herbal formulas function in a manner similar to

acupuncture in that biological systems are regulated or stimulated. In such a

case no toxic chemicals would be delivered. It seems various tonic formulas

seem to work in this manner. The vast research over a decade from the early 80s

to the early 90s sponsored by Min Tong and the Taiwanese government on Bu Zhong

Yi Qi Tang and carried out in Taiwan, Japan and China never looked at molecular

mechanisms of action. It was also assumed that there were no toxic chemicals

that would require liver and kidney cell detoxification. When overdoses were

attempted, the main finding was that it brought on deep and highly effective

sleep. This was an unexpected result and yet a repeatable one according to Dr.

Chiang, prof. of pharmacology at the Chinese medical school in Taichung, Taiwan.

 

Generally if you have to push the liver and kidney to detoxify pharmaceutical

molecules, you've injured the patient and can expect to see side-effects as are

commonly seen with Western pharmaceuticals. Such an action would not at all

result in restful sleep. Quite the opposite. This is one reason, why my

impression is that CM formula use results in few side-effects.

 

BTW, do you really see this as just " feel good " observations. If so, why do you

go to the trouble of being a CM practitioner in America? I'm the skeptical

Western scientist here. It's kind of funny don't you think that I'm trying to

suggest to you, a CM practitioner, that your medicine is less toxic than WM. Of

course, I can understand you are always on the look out for find ways to fend

off the quack-busters.

 

Emmanuel Segmen

-

Alon Marcus

 

 

Z'ev wrote: It is pretty authoritative science. It is not studies, but how

this stuff works from a pharmacological perspective

>>>I will take a look, however we also know that herbs are processed by the

same enzyme systems as drugs do

Alon

 

 

 

[Guest guest]

It is also true

and common sense that combinations of medicinals that have been tested

over centuries neutralize toxicity that would appear if single

medicinal substances were given over extended periods and large doses.

>>>>Well my argument is that you really cant use " common sense " as it is

misleading. While it is obvious that much of herbal medicine is fairly nontoxic

what we do not know is too large to make statements such as neutralize toxicity.

To really understand long term toxicity you need very expensive processes and

studies that have not been done

Alon

 

 

[Guest guest]

My impression is that herbal formulas function in a manner similar to

acupuncture in that biological systems are regulated or stimulated.

>>>>>>What does that mean?

 

Generally if you have to push the liver and kidney to detoxify pharmaceutical

molecules, you've injured the patient and can expect to see side-effects as are

commonly seen with Western pharmaceuticals. Such an action would not at all

result in restful sleep. Quite the opposite. This is one reason, why my

impression is that CM formula use results in few side-effects.

>>>>While bu zhong is one formula there are hundreds of other herbs we use. The

fact that taking herbs can for example alter phamokinetics of drugs clearly show

that they affect the same enzyme systems. For example xiao chi wu as been shown

to do that in many studies.

 

If so, why do you go to the trouble of being a CM practitioner in America? I'm

the skeptical Western scientist here. It's kind of funny don't you think that

I'm trying to suggest to you, a CM practitioner, that your medicine is less

toxic than WM.

 

>>>>>There we go again with generalization. There is no questions that WM has

many highly toxic methodologies and at the same time there are many assumptions

we have about CM that are purely speculative.We are assuming safely often just

because effects are less obvious.With type of attitude we will not find

shortcomings if they exist.

Alon

 

 

 

[Guest guest]

On Wednesday, October 1, 2003, at 10:15 PM, Emmanuel Segmen wrote:

 

> BTW, do you really see this as just " feel good " observations. If so,

> why do you go to the trouble of being a CM practitioner in America?

> I'm the skeptical Western scientist here. It's kind of funny don't

> you think that I'm trying to suggest to you, a CM practitioner, that

> your medicine is less toxic than WM. Of course, I can understand you

> are always on the look out for find ways to fend off the > quack-busters.

 

One of the things that I really respect about Alon is his ability to

question everything regardless of its impact on his belief system. When

we act in order to defend our beliefs, it can be at the expense of What

Is. Alon seems to be more focused on What Is than defending his

beliefs.

 

Now, if we can get him to remove the ambiguities from his email

response formating, we'll REALLY be on to something. : )

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

[Guest guest]

That is not all that is necessary. Long term use in China of

traditional prescriptions sets a precedent for our use, based on

pattern differentiation. If they were harmful to people, they would

have been eliminated. As my chemist friend Dave Weininger says,

Chinese medicine is " a storehouse of three thousand years worth of

clinical trials on more than a billion subjects " . I trust their

experience.

 

 

On Thursday, October 2, 2003, at 09:52 AM, Alon Marcus wrote:

 

>>>>> Well my argument is that you really cant use " common sense " as it

>>>>> is misleading. While it is obvious that much of herbal medicine is

>>>>> fairly nontoxic what we do not know is too large to make

>>>>> statements such as neutralize toxicity. To really understand long

>>>>> term toxicity you need very expensive processes and studies that

>>>>> have not been done

 

 

[Guest guest]

Long term use in China of

traditional prescriptions sets a precedent for our use, based on

pattern differentiation. If they were harmful to people, they would

have been eliminated.

>>>I think that is naive.

Alon

 

 

[Guest guest]

Give me a break, Alon.

 

How can you underestimate the Chinese culture like that?

 

It would appear to me that you only put your trust into clinical trials

and studies, nothing else.

 

Z'ev

On Thursday, October 2, 2003, at 11:35 AM, Alon Marcus wrote:

 

> Long term use in China of

> traditional prescriptions sets a precedent for our use, based on

> pattern differentiation. If they were harmful to people, they would

> have been eliminated.

>>>> I think that is naive.

> Alon

>

>

[Guest guest]

is less toxic than WM.

>

> >>>>>There we go again with generalization. There is no questions

that WM has many highly toxic methodologies and at the same time

there are many assumptions we have about CM that are purely

speculative.We are assuming safely often just because effects are

less obvious.With type of attitude we will not find shortcomings if

they exist.

 

I think that is a good point. Pre-modern understanding of what

is 'toxic' is much different that what we know about today. We have

a much more sophisticated understanding now. So I imagine that there

are many herbs that may be once considered safe found to be toxic

(carcinogen or whatever…) from a modern perspective. We cannot just

discount these findings b/c they may be in combinations and have been

used for 1000's of years. But because of combinations Z'ev is right

that it is not always as cut and dry as one may think... It is a

murky subject which we may need to error on the side of safety...

 

-

[Guest guest]

, " "

<zrosenbe@s...> wrote:

> That is not all that is necessary. Long term use in China of

> traditional prescriptions sets a precedent for our use, based on

> pattern differentiation. If they were harmful to people, they

would

> have been eliminated. As my chemist friend Dave Weininger says,

> Chinese medicine is " a storehouse of three thousand years worth of

> clinical trials on more than a billion subjects " . I trust their

> experience.

>

>

>

 

I am unsure... Blatant disregard for health can easily be noticed and

those Rx's been eliminated... but what about something that causes or

contributes to cancer further along down the road. Well this might

be harder to pick up, but modern science has an ability to identify

substances that are harmful on many different levels.. what do you

think? what about the modern complications that have been found XCHT

in various diseases? I think our health standards are higher than

previous. I also think since we live longer some long-term effects

are able to show up in this older population.

 

 

-

[Guest guest]

How can you underestimate the Chinese culture like that?

 

It would appear to me that you only put your trust into clinical trials

and studies, nothing else.

 

>>>>That is because the chinese were and are not smarter than anybody else. And

unless one has the infrastructure to assess some of the long term effects a

medicine can have one will not see it. And they clearly did not

Alon

 

 

[Guest guest]

But because of combinations Z'ev is right

that it is not always as cut and dry as one may think... It is a

murky subject which we may need to error on the side of safety...

 

>>>That is our challenge. We need to create the infrastructure to deal with this

Alon

 

 

[Guest guest]

How do you know that?

 

Z'ev

On Thursday, October 2, 2003, at 02:48 PM, Alon Marcus wrote:

 

>

>>>>> That is because the chinese were and are not smarter than anybody

>>>>> else. And unless one has the infrastructure to assess some of the

>>>>> long term effects a medicine can have one will not see it. And

>>>>> they clearly did not

 

 

[Guest guest]

Hi All, & Hi Emmanuel

 

Emmanuel wrote:

> Alon, Only molecules identical to or quite similar to the

> pharmaceutical molecules would require detoxification similarly by

> the liver or kidney.

 

Emmanuel, IMO, this is incorrect. Once absorbed, all molecules require

processing of some sort.

 

> My impression is that herbal formulas function in a manner similar

> to acupuncture in that biological systems are regulated or

> stimulated. In such a case no toxic chemicals would be delivered.

> It seems various tonic formulas seem to work in this manner.

 

My gut agrees with that. There is some evidence for herbs & formulas having a

homeostatic effect [working towards the middle, like ST36 in ST spasm, AND in

ST atony]. But we need much more research to be sure of that effect.

 

> The vast research over a decade from the early 80s to the early 90s

> sponsored by Min Tong and the Taiwanese government on Bu Zhong Yi

> Qi Tang and carried out in Taiwan, Japan and China never looked at

> molecular mechanisms of action. It was also assumed that there were

> no toxic chemicals that would require liver and kidney cell

> detoxification.

 

I cannot comment critically on the research on BZYQT (Japanese: Hochu-Ekki-

To) because I do not know the facts. But I feel pretty certain that careful

research would MONITOR for signs of LV or KI stress - for example using

serum/plasma levels of LV enzymes, or BUN.

 

> When overdoses were attempted, the main finding was that it brought

> on deep and highly effective sleep. This was unexpected and yet

> repeatable according to Dr. Chiang, prof. of pharmacology at the

> Chinese medical school in Taichung, Taiwan.

 

BZYQT is one of the most revered and documented formulas. All of its

ingredients [baizhu, Chaihu, Chenpi, Danggui, Gancao, Huangqi, Renshen and

Shengma] are pretty safe in their own right. I would expect, therefore, that the

formula should be safe at normal dose rates. How far above normal were the

overdoses? I have no doubt that if the dose was high enough BZYQT could

poison, or even kill [as water can].

 

> Generally if you have to push the liver and kidney to detoxify

> pharmaceutical molecules, you've injured the patient and can

> expect to see side-effects as are commonly seen with Western

> pharmaceuticals. Such an action would not at all result in

> restful sleep. Quite the opposite. This is one reason, why my

> impression is that CM formula use results in few side-effects.

 

Agreed. Another reason is that many CHMs have antioxidant and organ-

protective actions. They actually ASSIST detoxification in LV and KI.

 

> BTW, do you really see this as just " feel good " observations. If

> so, why do you go to the trouble of being a CM practitioner in

> America? I'm the skeptical Western scientist here. It's kind of

> funny don't you think that I'm trying to suggest to you, a CM

> practitioner, that your medicine is less toxic than WM. Of course,

> I can understand you are always on the look out for ways to fend

> off the quack-busters. Emmanuel Segmen

 

Many of us committed to AP or CHM need the " feel-good " factor! Underpinned

by personal experience, it often is a powerful stimulus to continue to use these

modalities [and to study further] in spite of the scarcity of documented proof

of

safety and efficacy.

 

 

Best regards,

 

Email: <

 

WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

[Guest guest]

I don't know why you, Bob and Alon think I don't respect or draw on

'relevant modern data'. This is not an either-or situation.

 

However, the predominating model of integrative medicine is a

hierarchical one, with biomedicine clearly at the top of the pyramid.

While I may accept this as socio-economic reality, I don't accept its

superiority over Chinese medicine, or Ayurvedic and Tibetan medicine,

for that matter.

 

The point of my discussion isn't that modern methods of analyzing

herbal medicinals is wrong, but that the Chinese did a pretty good job

over the millenia in determining efficacy and toxicity. Whatever

methods can determine this outcome are fine with me.

 

 

On Thursday, October 2, 2003, at 06:57 PM, wrote:

 

> Sure, I respect tradition. But, as a novice with a very high respect

> for the potency of herbal medicine, I also am wary and keep my

> eyes and ears open for relevant modern data.

>

> I do not see CHM as THE medicine, a fixed-in-stone monolith. For

> me, there is ONE medicine - the one that works best, and in the

> safest ways for the most patients. That integrated medicine uses

> methodologies from many different traditions. As data and

> experiences change, so that integrated medicine must change also.

>

> And recognition of weaknesses in any strand of medicine [including

> CHM] is the starting point for improvement. By mistakes we learn,

> but we must recognise AND REPORT the mistakes.

 

 

[Guest guest]

I think this is a very good point, and I cannot answer your question.

Perhaps Bob Flaws or Bob Felt can.

 

I don't think, however, that the tremendous accumulation of data in

China over the centuries neglected toxic reactions to medicinal

substances.

 

Having said that, I think that a computer-based national notification

system is a very good idea.

 

 

On Thursday, October 2, 2003, at 06:57 PM, wrote:

 

>

> Z'ev? Had/has China a national notification system for adverse

> herbal reactions (AHRs)? Is it PC-based? How many Chinese

> practitioners use PCs?

>

> I understand that communication by phone [not to mention PC to

> central server] is very difficullt in China. A Chinese vet researcher,

> who worked with me for some years in Dublin, told me that a phone

> call from his University to Beijing could take as long as 7 hours to

> get through! Although he has a PC, his email does not work!