Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 A while back I called into question the statement in the new Bensky MM that states that ginseng should not be combined with coffee or other stimulants. Despite extensively sifting through every relevant publication in Pubmed, the drug-herb interaction databases of UCSF medical school, the PDR for Herbal Medicine, the Commission E monographs, many Chinese MM texts, Chen & Chen's MM, and numerous other sources, I have been unable to find a single primary reference that supports this claim. Although Eastland never responded to my inquiry for their source, John Chen gave me an excellent and courteous response right away. He was unaware of any direct evidence that supported the claim despite his extensive research of herb-drug interactions. At the end, the only information trail that could be found anywhere via the Web or searches through dozens of physical texts included an unreferenced claim with virtually identical wording in a text by Mills and Bone, and a few sparse references on the internet parroting this claim that pointed to the European ESCOP monographs. Alon similarly directed me to the ESCOP monographs as cited below. The difficulty in finding this expensive text led me to email the ESCOP directly. They were extremely courteous and prompt with their reply, and my inquiry was forwarded to the person in charge of the ginseng monograph. Their reply follows: " I received this from our Scientific Committee Member responsible for the monograph Good afternoon This must be an error. There is no report of interaction between Ginseng and either caffeine or coffee. The only potential reason for this that one can imagine is that one clinical trial assessed the negative influence of night shifts on mood, physical well-being,degree of lethargy and performance in psychophysiological tests and the small but consistent anti-fatigue effect of ginseng. However, neither coffee nor caffeine were included in the study design and there is also no other study on ginseng in conjunction witj coffee or caffeine. The only interactions reported in the monograph are potential interactions of ginseng with warfarine (anticoagulant therapy) and with blood glucose levels which may be slightly reduced by ginseng. Hence diabetics should consult their physician prior to taking ginseng. " This statement about ginseng in the Bensky MM is integrated right in the middle of the otherwise-reliable TCM clinical information. Most students will accept this sweeping statement (that ginseng should not be combined with coffee or other stimulants) at face value without ever investigating the evidence for this claim. To the contrary, ginseng has been reported to reduce the complications of stimulant drugs such as cocaine and methamphetamine in numerous studies. Ginseng and coffee are regularly consumed in combination by literally millions of people, particularly in Korea. Yet there is nothing but a marked absence of any studies reporting negative consequences of this combination. Reporting speculation as fact is just sloppy and puts our profession one step closer to the new-age fantasy world of popular culture while bringing us one step farther away from being seen as accountable medical professionals. Eric , " " <alonmarcus@w...> wrote: > For interaction between coffee and ginseng (Increases stimulation, tachycardia and hypertension) see > 11. European Scientific Cooperative on > > Phytotherapy (ESCOP). ESCOP Monographs > > on the Medicinal Uses of Plant > > Drugs. Exeter, United Kingdom: ESCOP; > > 1997, 1999. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 Eric, Why not ask Mr. Bensky why he stated that? Julie - Eric Brand Wednesday, August 17, 2005 6:13 AM Ginseng and coffee A while back I called into question the statement in the new Bensky MM that states that ginseng should not be combined with coffee or other stimulants. Despite extensively sifting through every relevant publication in Pubmed, the drug-herb interaction databases of UCSF medical school, the PDR for Herbal Medicine, the Commission E monographs, many Chinese MM texts, Chen & Chen's MM, and numerous other sources, I have been unable to find a single primary reference that supports this claim. Although Eastland never responded to my inquiry for their source, John Chen gave me an excellent and courteous response right away. He was unaware of any direct evidence that supported the claim despite his extensive research of herb-drug interactions. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 , JulieJ8 <Juliej8@b...> wrote: > Eric, > > Why not ask Mr. Bensky why he stated that? I did, but I never got a response, unfortunately. The whole thing mystifies me, to be honest. The book as a whole is extremely comprehensive and presents very standard and solid information. I have some issues about the general translation approach and the whole notion that Chinese medicine has few technical terms that require glossing, but I think the text overall is packed with useful and reliable information. I would ideally like to see things like the actions of medicinals be glossed as the technically specific entities that they are, but I understand that a MM cannot be a textbook in theory and other sources need to teach students such issues. Whatever my feelings are about the overall approach to the English transmission of Chinese medicine, I don't think there is much to find fault with in the MM itself. I just personally care about the ginseng and coffee thing because I like both ginseng and coffee. So does my dad and so does my brother. It is an issue that affects a lot of people and I think we should be clear about it if we are going to use ginseng in the modern world. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 Eric, If I remember correctly you are in the process of publishing your own MM. We look forward to seeing it and making comments about it for the years to come. doug , " Eric Brand " <smilinglotus> wrote: > A while back I called into question the statement in the new Bensky MM > that states that ginseng should not be combined with coffee or other > stimulants. Despite extensively sifting through every relevant > publication in Pubmed, the drug-herb interaction databases of UCSF > medical school, the PDR for Herbal Medicine, the Commission E > monographs, many Chinese MM texts, Chen & Chen's MM, and numerous > other sources, I have been unable to find a single primary reference > that supports this claim. Although Eastland never responded to my > inquiry for their source, John Chen gave me an excellent and courteous > response right away. He was unaware of any direct evidence that > supported the claim despite his extensive research of herb-drug > interactions. > > At the end, the only information trail that could be found anywhere > via the Web or searches through dozens of physical texts included an > unreferenced claim with virtually identical wording in a text by Mills > and Bone, and a few sparse references on the internet parroting this > claim that pointed to the European ESCOP monographs. Alon similarly > directed me to the ESCOP monographs as cited below. The difficulty in > finding this expensive text led me to email the ESCOP directly. They > were extremely courteous and prompt with their reply, and my inquiry > was forwarded to the person in charge of the ginseng monograph. Their > reply follows: > > " I received this from our Scientific Committee Member responsible for > the monograph > > Good afternoon > > This must be an error. There is no report of interaction between > Ginseng and either caffeine or coffee. The only potential reason for > this that one can imagine is that one clinical trial assessed the > negative influence of night shifts on mood, physical > well-being,degree of lethargy and performance in psychophysiological > tests and the small but consistent anti-fatigue effect of ginseng. > However, neither coffee nor caffeine were included in the study > design and there is also no other study on ginseng in conjunction > witj coffee or caffeine. > The only interactions reported in the monograph are potential > interactions of ginseng with warfarine (anticoagulant therapy) and > with blood glucose levels which may be slightly reduced by ginseng. > Hence diabetics should consult their physician prior to taking > ginseng. " > > This statement about ginseng in the Bensky MM is integrated right in > the middle of the otherwise-reliable TCM clinical information. Most > students will accept this sweeping statement (that ginseng should not > be combined with coffee or other stimulants) at face value without > ever investigating the evidence for this claim. To the contrary, > ginseng has been reported to reduce the complications of stimulant > drugs such as cocaine and methamphetamine in numerous studies. > Ginseng and coffee are regularly consumed in combination by literally > millions of people, particularly in Korea. Yet there is nothing but a > marked absence of any studies reporting negative consequences of this > combination. Reporting speculation as fact is just sloppy and puts > our profession one step closer to the new-age fantasy world of popular > culture while bringing us one step farther away from being seen as > accountable medical professionals. > > Eric > > > , " " > <alonmarcus@w...> wrote: > > For interaction between coffee and ginseng (Increases stimulation, > tachycardia and hypertension) see > > 11. European Scientific Cooperative on > > > > Phytotherapy (ESCOP). ESCOP Monographs > > > > on the Medicinal Uses of Plant > > > > Drugs. Exeter, United Kingdom: ESCOP; > > > > 1997, 1999. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 This statement about ginseng in the Bensky MM is integrated right in the middle of the otherwise-reliable TCM clinical information. Most students will accept this sweeping statement (that ginseng should not be combined with coffee or other stimulants) at face value without ever investigating the evidence for this claim. >>>>Eric thanks for following through Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 My experience with ginseng... if I take the stuff, regardless how little of it, it gives me a migraine. I obtained a good quality root and soaked it in concag ( how do spell that :-) ) and even if I take 3 drops in water I will react that way. [so looks like I have to find another way to achieve immortality] I had friends over for dinner one night and after dinner I made fresh coffee and gave them half a nip of my ginseng brandy. They said they can normally drink coffee each night after dinner and never have any problems. This time they both had severe insomnia. Was it the ginseng or the combination of coffee and ginseng? I am also a sensative type to coffee so maybe there is a connection. Heiko Lade M.H.Sc.(TCM) Lecturer and clinic supervisor - Thursday, August 18, 2005 5:46 AM Re: Ginseng and coffee This statement about ginseng in the Bensky MM is integrated right in the middle of the otherwise-reliable TCM clinical information. Most students will accept this sweeping statement (that ginseng should not be combined with coffee or other stimulants) at face value without ever investigating the evidence for this claim. >>>>Eric thanks for following through Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 , " Heiko Lade " <heikolade.acnm@x> wrote: > My experience with ginseng... > if I take the stuff, regardless how little of it, it gives me a migraine. Many people are unusually sensitive to particular drugs, herbs, animal products, and minerals. It is very useful for us to be aware of these issues and to be accordingly flexible in our treatments. Similarly, the story of your friend's experience with insomnia after having a ginseng cocktail with coffee gives us useful information. However, anecdotal evidence is not sufficient for textbook-level material. It is easy to create effective human and animal research designs that can evaluate the risk of such combination in a setting that reduces the number of confounding variables and deals with the issue of placebo. A MM is based upon TCM information as it is presented in Chinese source texts, and the supplementary information on issues like herb-drug interactions, botany, and chemistry should be based on modern science. Chen & Chen's MM has done a great job in terms of compiling the modern information on pharmacology, interactions, chemistry, etc. It has also presented TCM information with a high degree of reliability and an extensive glossary. The Bensky/Clavey/Stoger MM has done a similarly great job at compiling a lot of fascinating historical information and botanical information (with an emphasis on correct species identification). Each book offers something that the other does not, and each fills its niche well. One of the main issues that is not extensively addressed in the Bensky, et al. text is the issue of herb-drug interactions. This is understandable and perfectly acceptable because the information is available in other sources and they have dedicated their pages to a different information focus. But I am mystified at why they would leave out warnings against reasonably well-established possible risks yet include a warning against something that thus far cannot be found outside of anecdotal personal experiences. If the wording was just a bit different so that the reader knew that the authors were speculating or noting anecdotal reactions, it would be a totally different matter. I am not concerned about well-educated professionals misconstruing the warning, I am just concerned about students and poorly-read practitioners parroting the information to the public, the press, and future students without evaluating if it is a valid warning or not. Thanks for sharing your experiences. If we build up a large base of anecdotal information, we can more easily select the arenas that require further investigation in the future. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 , " " <alonmarcus@w...> wrote: > >>>>Eric thanks for following through Thank you for the helpful leads. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 , " " wrote: > Eric, If I remember correctly you are in the process of publishing your own MM. We look > forward to seeing it and making comments about it for the years to come. Our book is a relatively straightforward text that compiles the information presented in the PRC core curriculum texts for TCM students. It simply says what the Chinese texts say, nothing more, nothing less, with a consistent and traceable translation methodology. It features extensive chapter introductions that aim to instruct students in clinical concepts relevant to the use of medicinals. All the information in the body of the text is taken directly from primary Chinese sources and all of the terms used may be referenced in the Practical Dictionary of and numerous other works. I am interested in understanding any potential risks between ginseng and coffee because I personally use these substances and I like to be well-educated about any drugs or other medicinals that I use. In addition, since I am compiling a MM intended for clinical use, I am responsible for investigating the literature to make sure that I include information that may affect the safe administration of medicinals. Our text has a minimal amount of information on pharmacology and interactions compared to Chen & Chen's text, but we do try to include appropriate (and referenced) cautions when there is a sufficient evidence base to do so. Warnings based on non-TCM information make up a minimal part of our book and represent the only component that is not taken directly from Chinese sources (Dr. Sabine Wilm's historical introduction notwithstanding). However, if anyone emails me with a question requesting a source for ANY of the information within the text, I will happily and promptly provide them with references so that they don't need to waste hours and hours researching every possible medium to find the information. This is just common professional courtesy. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2005 Report Share Posted August 17, 2005 Eric, Whoever and wherever you are, you are an uncommon pro! As an herb teacher, I thank you. Julie Chambers Warnings based on non-TCM information make up a minimal part of our book and represent the only component that is not taken directly from Chinese sources (Dr. Sabine Wilm's historical introduction notwithstanding). However, if anyone emails me with a question requesting a source for ANY of the information within the text, I will happily and promptly provide them with references so that they don't need to waste hours and hours researching every possible medium to find the information. This is just common professional courtesy. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2005 Report Share Posted August 18, 2005 , JulieJ8 <Juliej8@b...> wrote: > Eric, > > Whoever and wherever you are, you are an uncommon pro! As an herb teacher, I thank you. Uncommon? For responding to emails? I doubt it. John Chen emailed me back right away, as did the representatives at the ESCOP (who in turn emailed the creator of the monograph who also responded right away). Most people respond to emails when someone takes an interest in their work. Pro? In this field, it doesn't matter if we are teachers, writers, or practitioners, we are all eternal students (or should be). Teaching is just a good way to learn the information even better, and writing gives one an excuse to read a lot and study a lot. Practitioners are students also, because our patients are our greatest teachers. Anyone is a pro if they pursue good teachers and don't stop learning. Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2005 Report Share Posted August 18, 2005 Heiko Lade wrote: " I had friends over for dinner one night and after dinner I made fresh coffee and gave them half a nip of my ginseng brandy. They said they can normally drink coffee each night after dinner and never have any problems. This time they both had severe insomnia. Was it the ginseng or the combination of coffee and ginseng? " == Heiko, This seems like a remarkable coincidence. Would you mind giving a little more detail?: Have your friends had ginseng before, and if so, what was their reaction to it? Do these two friends share the same bed? If so, is it possible one kept the other awake? Do they have other sensitivities to ingested substances? Did you discuss the issue of insomnia with them at their visit? Have you offered other friends a nip of your ginseng brandy with their coffee, and they had a different reaction? What has been the reaction of others to your ginseng brandy on its own? Rory Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2005 Report Share Posted August 18, 2005 This whole exchange raised some thoughts for me. First, how the Chinese determined that medicinals work. Yes, we know that the ben cao/materia medica literature is the collected experience of generations of physicians, but do we know their modus operandi for collecting this information? I certainly would be interested in how this data was collected, in some detail. The homeopathic physicians collect their data through a method known as 'proving', where they take a medicinal substance in tincture form and record all of the symptoms experienced from taking it. The consensus is then recorded as the medicinal action of the substance. I am interested in Heiko's experience, because it is similar to the proving methods of the homeopaths, observing reactions of medicines in different people. I also appreciate the criteria you've pointed out. I've always suggested that perhaps we also need to test herbs, supplements and even pharmaceuticals in this manner as well, collected data stored and shared in a data base according to specific CM criteria. On Aug 18, 2005, at 6:01 AM, rorykerr wrote: > Heiko Lade wrote: > " I had friends over for dinner one night and after dinner I made > fresh coffee and gave them half a nip of my ginseng brandy. > They said they can normally drink coffee each night after dinner > and never have any problems. This time they both had severe > insomnia. > Was it the ginseng or the combination of coffee and ginseng? " > == > Heiko, > > This seems like a remarkable coincidence. Would you mind > giving a little more detail?: > Have your friends had ginseng before, and if so, what was their > reaction to it? > Do these two friends share the same bed? If so, is it possible > one kept the other awake? > Do they have other sensitivities to ingested substances? > Did you discuss the issue of insomnia with them at their visit? > Have you offered other friends a nip of your ginseng brandy with > their coffee, and they had a different reaction? > What has been the reaction of others to your ginseng brandy on > its own? > > Rory > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2005 Report Share Posted August 18, 2005 In my personal experience, ginseng and coffee act in a synergistic manner. If coffee tends to make you nervous, the combination with ginseng will make it more so. Both are warming, so the combination is even more so. Excess types tend to get insomnia from taking ginseng too late in the day, so the combination will make it even more likely. Of course, this is personal experience, so it still doesn't explain why the contraindication is in the literature. You might try calling Dan Bensky at his school in Seattle to ask him about the reference. In the past, I had no success at emailing him, but he did respond to a voice mail at his school. I no longer have the number, but it should be easy to find. - Bill Schoenbart, L.Ac. Santa Cruz, CA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2005 Report Share Posted August 18, 2005 Rory yes they have had ginseng before they said, One is Chinese herbalist yes they share the same bed and said that they were both over hyped and coundn't sleep They are both not the sensative types They told me the next morning that they couldn't sleep, we never spoke about it at dinner, they normally never have sleep trouble Other friends have had ginseng brandy without coffee but slept fine Others just like the taste of the brandy , no complaints! Rory what is your address , I will send you a sample and you can experiment. Heiko Lade M.H.Sc.(TCM) Lecturer and clinic supervisor - rorykerr Friday, August 19, 2005 1:01 AM Re: Ginseng and coffee Heiko Lade wrote: " I had friends over for dinner one night and after dinner I made fresh coffee and gave them half a nip of my ginseng brandy. They said they can normally drink coffee each night after dinner and never have any problems. This time they both had severe insomnia. Was it the ginseng or the combination of coffee and ginseng? " == Heiko, This seems like a remarkable coincidence. Would you mind giving a little more detail?: Have your friends had ginseng before, and if so, what was their reaction to it? Do these two friends share the same bed? If so, is it possible one kept the other awake? Do they have other sensitivities to ingested substances? Did you discuss the issue of insomnia with them at their visit? Have you offered other friends a nip of your ginseng brandy with their coffee, and they had a different reaction? What has been the reaction of others to your ginseng brandy on its own? Rory Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2005 Report Share Posted August 19, 2005 Heiko Lade wrote: " Rory what is your address , I will send you a sample and you can experiment " -- Heiko, that is a very kind offer. I'll send you my address. Rory Quote Link to comment Share on other sites More sharing options...
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