Guest guest Posted October 6, 2006 Report Share Posted October 6, 2006 , Cara Frank <herbbabe wrote: > > This is very upsetting to read. The only wild card is the wu gong. And of > course, the N-nitrosofenfluramine. > Before jumping to any conclusions, it would be worthwhile to find out more about the authors of the original article and their possible motives. I'm saying this because Chris Dhaenens sent me an email this week, with a letter written by an herbalist and addressed to two professors attached. It is Michael McGuffin's reply to an article questioning the safety of black cohosh- reported to cause liver damage in one case report. I will upload the letter to CHA's files section. From my own experience I know that he shou wu can be hard on the liver. My liver gets all prickly when I use that herb. best, Tom. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2006 Report Share Posted October 6, 2006 Somehow we should talk about this article as they seem to have pretty strange ideas about what is hepatotoxic. Listing bo he, jue ming zi, he shoud wu, and da huang as " known to be hepatotoxic " without a citation seems strange to me. We should also see about writing to the editor about issues that we have with this article. Can the article be posted for limited use? Is that an infringement of copyright? -Steve On Oct 6, 2006, at 12:37 PM, Al Stone wrote: > You'll need to upload it to the (CHA) website. However > copywrite issues should be honored as well. Not sure what you should > do > about distributing this article for free... > > -al. > > On 10/6/06, Stephen Bonzak <stephenbonzak wrote: > > > > How do I attach the article in question so we can all review it? > Steve > > > > > > On Oct 6, 2006, at 12:25 PM, Stephen Bonzak wrote: > > > > > > > > On Oct 6, 2006, at 12:07 AM, wrote: > > > > > > > What are we to make out of this > > > > > > > > Traditional Chinese medicine causing hepatotoxicity in patients > with > > > > chronic hepatitis B infection: a 1-year prospective study. > Aliment > > > > Pharmacol Ther. 2006 Oct 15;24(8):1179-86. Background Safety of > > > > traditional Chinese medicine in patients with chronic hepatitis > B is > > > > unknown. Aim To study the clinical outcome of traditional > Chinese > > > > medicine-induced hepatotoxicity in chronic hepatitis B patients. > > > > Patients and methods All chronic hepatitis B patients in 2004 > with > > > > liver dysfunction requiring hospitalization were screened > > > > prospectively for traditional Chinese medicine intake. The > > > > hepatotoxicity of individual traditional Chinese medicine > elements > > > was > > > > determined by extensive search of both English and Chinese > > > > publications. Results Of 45 chronic hepatitis B patients, the > liver > > > > dysfunction in seven (15.6%) was attributable to traditional > Chinese > > > > medicine. All had liver dysfunction pattern resembling those of > > > acute > > > > exacerbation of chronic hepatitis B. Three patients had adverse > > > > outcomes (two deaths, one liver transplantation). One patient > had > > > > accelerated course of cirrhosis now awaiting liver > transplantation. > > > > The identified hepatotoxic components were Polygonum multiflorum > > > > Thunb, Cassia obtusifolia L, Melia toosendan Sieb., Rheum > palmatum > > > L., > > > > Scolopendra subspinipes mutilans L, Alisma orientale Juzepe, > > > > Glycyrrhiza uralensis Fisch. and Mentha haplocalyx Briq. One > > > > traditional Chinese medicine formula was adulterated with a > highly > > > > hepatotoxic agent, N-nitrosofenfluramine. Conclusions > Traditional > > > > Chinese medicine-related hepatotoxicity resulted in high > mortality > > > in > > > > chronic hepatitis B patients. Prospective randomized-controlled > > > trials > > > > with the same stringent criteria as western medicine clinical > trials > > > > are required for Chinese medicines, to document their > efficacies and > > > > safety before they can be advocated for the treatment of > patients. > > > > > > > > > > > > > > > > > > > > Oakland, CA 94609 > > > > > > > > > > > > - > > > > Bill Schoenbart > > > > To: > <%40 > > > > > > Sunday, September 24, 2006 8:01 AM > > > > Re: Organic raw herbs - salvia divinorum > > > > > > > > I think it is a bad idea for acupuncturists to prescribe an herb > > > that > > > > is > > > > also used by people to get high. This could cause serious > negative > > > > publicity > > > > for the profession in the future. It could even affect > malpractice > > > > insurance > > > > rates, which are currently fairly reasonable. > > > > Salvia divinorum is also illegal in some countries and a few > U.S. > > > > states. > > > > People who have smoked it describe the experience as similar to > DMT, > > > > which > > > > is an intense psychedelic. Do we really want to give this to > > > > patients, even > > > > for internal use? What if a patient's kid takes some and smokes > it? > > > > Even if > > > > the herb has a legitimate therapeutic use, prescribing it could > > > bring > > > > serious problems for TCM. Ecstasy (MDMA) also has legitimate > > > > theraputic > > > > potential, as does LSD, but it would be a disaster to prescribe > > > them. > > > > > > > > .................................... > > > > Bill Schoenbart, L.Ac. > > > > PO Box 8099 > > > > Santa Cruz, CA 95061 > > > > > > > > 831-335-3165 > > > > plantmed <plantmed%40earthlink.net> > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2006 Report Share Posted October 7, 2006 I purchased a full text copy of the article and have just glanced over it. At first glance, it looks like junk science. It appears that they did a sloppy literature search and blamed certain herbs for the hepatotoxicity based on this search.The fact that they claim that Gan Cao and Bo He are hepatotoxic indicates that they don't know what they are talking about. I will review it more carefully and confer with AHPA on this. I have forwarded a copy to Michael McGuffin at AHPA, and he and his VP of Science will also examine it. I'll report the findings to the group. - Bill ............................................. Bill Schoenbart, L.Ac. P.O. Box 8099 Santa Cruz, CA 95061 office phone: 831-335-3165 email: plantmed ............................................. >>>>> What are we to make out of this > > Traditional Chinese medicine causing hepatotoxicity in patients with > chronic hepatitis B infection: a 1-year prospective study. Aliment > Pharmacol Ther. 2006 Oct 15;24(8):1179-86. Background Safety of > traditional Chinese medicine in patients with chronic hepatitis B is > unknown. Aim To study the clinical outcome of traditional Chinese > medicine-induced hepatotoxicity in chronic hepatitis B patients. > Patients and methods All chronic hepatitis B patients in 2004 with > liver dysfunction requiring hospitalization were screened > prospectively for traditional Chinese medicine intake. The > hepatotoxicity of individual traditional Chinese medicine elements was > determined by extensive search of both English and Chinese > publications. Results Of 45 chronic hepatitis B patients, the liver > dysfunction in seven (15.6%) was attributable to traditional Chinese > medicine. All had liver dysfunction pattern resembling those of acute > exacerbation of chronic hepatitis B. Three patients had adverse > outcomes (two deaths, one liver transplantation). One patient had > accelerated course of cirrhosis now awaiting liver transplantation. > The identified hepatotoxic components were Polygonum multiflorum > Thunb, Cassia obtusifolia L, Melia toosendan Sieb., Rheum palmatum L., > Scolopendra subspinipes mutilans L, Alisma orientale Juzepe, > Glycyrrhiza uralensis Fisch. and Mentha haplocalyx Briq. One > traditional Chinese medicine formula was adulterated with a highly > hepatotoxic agent, N-nitrosofenfluramine. Conclusions Traditional > Chinese medicine-related hepatotoxicity resulted in high mortality in > chronic hepatitis B patients. Prospective randomized-controlled trials > with the same stringent criteria as western medicine clinical trials > are required for Chinese medicines, to document their efficacies and > safety before they can be advocated for the treatment of patients. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2006 Report Share Posted October 7, 2006 I also looked it over, thank you, Tom. Of the 5 or so cases one patient had been taking N- nitrosofenfluamine. Of Fen fen fame.... back to the Belgium scare. One case was with Ji Gu Cao, an herb I had to look up, hardly common. The case also suggests but is not explicit this herb was taken alone. One fatal case was taking 5 different formulas within one month's time. It is not clear if this meant altother or one after another. This to me suggests 1- an inept doctor or 2- a rapidly deteriating case. However it is a disturbing case because WM tests had shown normality just a month before. And these herbs were rather common, with Wu Gong. This and another fatal case implicates, although not convincingly Chuan Lian Zi, Da Huang and Ze Xie. One case implicates the contamination Abrus Cantonienesis... an herb I am unfamiliar with in the Latin. In the footnotes there are several citations of several Pennyroyal OIL cases. At least one was with infants. I don't doubt that some formulas, given wrongly or not, can at some point cause severe problems. I say this because if your patient, especially a HBV or HBC patient, should be carefully monitored and withdrawn from herbs immediately should problems arise. However, this study definetly does not give a convincing arguement for wholesale condemnation of TCM herbs. If anything it tells us that careful monitoring of patent herbs and prescribing methods is vital. Doug , " Bill Schoenbart " <plantmed2 wrote: > > I purchased a full text copy of the article and have just glanced over it. > At first glance, it looks like junk science. It appears that they did a > sloppy literature search and blamed certain herbs for the hepatotoxicity > based on this search.The fact that they claim that Gan Cao and Bo He are > hepatotoxic indicates that they don't know what they are talking about. > > I will review it more carefully and confer with AHPA on this. I have > forwarded a copy to Michael McGuffin at AHPA, and he and his VP of Science > will also examine it. I'll report the findings to the group. > > - Bill > ............................................ > Bill Schoenbart, L.Ac. > P.O. Box 8099 > Santa Cruz, CA 95061 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2006 Report Share Posted October 7, 2006 About 15 years ago in Sydney there was some similar trouble, there were a bunch of Chinese people taking Chinese herbs that had been in alcohol, very high proof, and had some liver problems The doctors concluded it was the alcohol causing the problems, not the herbs On Behalf Of Friday, October 06, 2006 6:08 PM Re: Re: Toxic herbs What are we to make out of this Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study. Aliment Pharmacol Ther. 2006 Oct 15;24(8):1179-86. Background Safety of traditional Chinese medicine in patients with chronic hepatitis B is unknown. Aim To study the clinical outcome of traditional Chinese medicine-induced hepatotoxicity in chronic hepatitis B patients. Patients and methods All chronic hepatitis B patients in 2004 with liver dysfunction requiring hospitalization were screened prospectively for traditional Chinese medicine intake. The hepatotoxicity of individual traditional Chinese medicine elements was determined by extensive search of both English and Chinese publications. Results Of 45 chronic hepatitis B patients, the liver dysfunction in seven (15.6%) was attributable to traditional Chinese medicine. All had liver dysfunction pattern resembling those of acute exacerbation of chronic hepatitis B. Three patients had adverse outcomes (two deaths, one liver transplantation). One patient had accelerated course of cirrhosis now awaiting liver transplantation. The identified hepatotoxic components were Polygonum multiflorum Thunb, Cassia obtusifolia L, Melia toosendan Sieb., Rheum palmatum L., Scolopendra subspinipes mutilans L, Alisma orientale Juzepe, Glycyrrhiza uralensis Fisch. and Mentha haplocalyx Briq. One traditional Chinese medicine formula was adulterated with a highly hepatotoxic agent, N-nitrosofenfluramine. Conclusions Traditional Chinese medicine-related hepatotoxicity resulted in high mortality in chronic hepatitis B patients. Prospective randomized-controlled trials with the same stringent criteria as western medicine clinical trials are required for Chinese medicines, to document their efficacies and safety before they can be advocated for the treatment of patients. Oakland, CA 94609 - Bill Schoenbart @ <%40> Sunday, September 24, 2006 8:01 AM Re: Organic raw herbs - salvia divinorum I think it is a bad idea for acupuncturists to prescribe an herb that is also used by people to get high. This could cause serious negative publicity for the profession in the future. It could even affect malpractice insurance rates, which are currently fairly reasonable. Salvia divinorum is also illegal in some countries and a few U.S. states. People who have smoked it describe the experience as similar to DMT, which is an intense psychedelic. Do we really want to give this to patients, even for internal use? What if a patient's kid takes some and smokes it? Even if the herb has a legitimate therapeutic use, prescribing it could bring serious problems for TCM. Ecstasy (MDMA) also has legitimate theraputic potential, as does LSD, but it would be a disaster to prescribe them. ..................................... Bill Schoenbart, L.Ac. PO Box 8099 Santa Cruz, CA 95061 831-335-3165 plantmed (AT) earthlink (DOT) <plantmed%40earthlink.net> net Quote Link to comment Share on other sites More sharing options...
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