Glucose-6-phosphate dehydrogenase deficiency and Chinese herbs

[Guest guest]

Hi all,

Anyone with experience treating patients with a G6PD defiency

(allergy to sulfa drugs). I am treating her for fertility, but I have

not introduced chinese herbs yet till I can be assured that they are

safe for her.

Any comments?

 

Thanks

Trevor

[Guest guest]

Hi Trevor & All,

 

As I'm sure everyone remembers G6PD (or glucose-6-hosphate dehydrogenase) is

the first enzyme used in the Pentose Phosphate Pathway, I'm being factious here!

I am very grateful to you Trevor for asking this question because I had to

memorize this pathway as a biochemistry major at UCSD and this is the first time

in 15 years that I have ever had an opportunity to use this information. I'm

glad that it finally would come in handy!

 

The Pentose Phosphate Pathway is an alternative pathway of carbohydrate

metabolism.

G6PD is an enzyme that converts Glucose-6-phosphate (G6P into

6-Phosphoglucono-¦Ä-lactone). This is an oxidative reaction producing NADPH

(the reduced form of nicotinamide adenine dinucleotide phosphate) involved in

the production of ribose-5-phosphate the sugar precursor of the nucleic acids

(DNA & RNA).

 

Why is this important? Approximately 400 Million people worldwide are

affected by this enzymopathy and are at risk for several pathologies which can

be potentially serious (even causing death) if they are not properly treated.

 

So, the first thing that I like to do is to qualify the initial statement; how

was the Glucose-6-phosphatase dehydrogenase (G6PD) Deficiency diagnosis made?

Then I would like to make sure that you are not referring to

Glucose-6-phosphatase (G6P) Deficiency (von Gierke¡¯s Disease). Next I would

like respectfully mention that G6PD Deficiency is not synonymous with allergy to

sulfur drugs. How was the allergy to sulfur drugs diagnosed?

 

If I interpret your question to read that the patient has G6PD Deficiency and

is also allergic to sulfa drugs then the first thought that comes to mind is a

concern about sulfites. Some herbal supplies use sulfites as a preservative. A

patient with an allergy to sulfa drugs could have cross reactivity to Sulfites

see the following link:

http://www.druginformation.co.nz/Bulletins/SulphurAllergy.pdf

Therefore it makes sense to make sure if you do use herbs that they are

sulfite free.

 

Raw broad beans (fava beans) contain vicine and covicine, which can induce

hemolytic anemia with the hereditary condition G6PD Deficiency. This

potentially fatal condition, which is quite common in certain ethnic groups, is

called " favism " after the fava bean.

For more on this topic see the following link:

http://en.wikipedia.org/wiki/Vicia_faba

 

G6PD Deficiency is a X-linked genetic defect in the gene that expresses the

G6PD enzyme resulting in an abnormality in the structure of the enzyme that

causes it to not be fully active.

G6PD deficiency resulting in decreased NADPH levels can affect erythrocyte

membrane integrity because membrane integrity requires a plentiful supply of

reduced glutathione (GSH).

 

For more information on see the following link:

http://www.rialto.com/g6pd/

 

NADPH is also used to keep the tri-peptide glutathione in its reduced form.

Reduced glutathione acts as a scavenger for dangerous oxidative metabolites in

the cell; it converts harmful hydrogen peroxide to water with the help of the

enzyme, glutathione peroxidase.

There are other metabolic pathways that can generate NADPH in all cells,

except in red blood cells where other NADPH-producing enzymes are lacking. This

has a profound effect on the stability of red blood cells since they are

especially sensitive to oxidative stresses in addition to having only one

NADPH-producing enzyme to remove these harmful oxidants. This is why G6PD

deficient individuals are not prescribed oxidative drugs (including sulfa drugs,

ascorbic acid, Vit-K, even aspirin) because the red blood cells in these

individuals are not able to handle this stress and consequently hemolysis

ensues. Although not necessarily an allergic reaction sulfa drugs should not be

used.

This being said we probably would want to be mindful of any herbs that could

potentially behave as oxidative drugs and produce similar harmful consequences.

The first rule is physician do no harm.

 

Although not classical Chinese medicine you might look into the possible

affects of taking supplemental nucleic acids & /or glutathione. The thinking

here that supplemental nucleic acids might possibly help compensate for the

decreased ribose-5-phosphate sugar production. The supplemental glutathione

might possibly cause a Le Chatlier shift to the right that might possibly result

in an increase in increased levels of reduced glutathione (G-SH) but, this

contains sulfur so ¡­ I would want to do more research before making any

recommendations. In acute hemolytic anemia, patients are administered folic

acid (Vit-B9). Perhaps folic acid could be used prophylactically?

 

I would probably avoid the use of all herbs that contain sulfur for one thing.

The book Chinese Medical Herbology and Pharmacology by John K.Chen has molecular

structure of the major constituents in the Chinese herbs but The Chemical

Constituents of Oriental Herbal Drugs published by Oriental Healing Arts

Institute) is much more comprehensive. The Herbal PDR might also be useful.

 

There could be & probably are other concerns as well in using Chinese herbal

medicine with this patient. I would urge that you exercise caution! This being

said, what is the chief complaint, the presenting symptoms (tongue, coating,

pulse, etc.) and how do they relate to the pattern differentiation for

infertility?

 

Keep me posted,

Steve

 

 

Hi all,

Anyone with experience treating patients with a G6PD defiency

(allergy to sulfa drugs). I am treating her for fertility, but I have

not introduced chinese herbs yet till I can be assured that they are

safe for her.

Any comments?

 

Thanks

Trevor

 

 

 

 

 

 

 

Be a better Globetrotter. Get better travel answers from someone who knows.

Answers - Check it out.

 

 

[Guest guest]

Trevor,

 

Subhuti Dharmananda of ITM wrote a very comprehensive article about

Sulfur and all the substances that contain it. It was in the last

couple years. Perhaps it would be on the website for Institute of

Traditional Medicine. If you can't find it, get in touch with me off

list.

Marian

 

www.iaomb.com

mb

 

 

, " Trevor Erikson "

<trevor_erikson wrote:

>

> Hi all,

> Anyone with experience treating patients with a G6PD defiency

> (allergy to sulfa drugs). I am treating her for fertility, but I have

> not introduced chinese herbs yet till I can be assured that they are

> safe for her.

> Any comments?

>

> Thanks

> Trevor

>

[Guest guest]

/ Hi all,

Anyone with experience treating patients with a G6PD defiency

(allergy to sulfa drugs). I am treating her for fertility, but I have

not introduced chinese herbs yet till I can be assured that they are

safe for her.

Any comments?

 

Thanks

Trevor/

 

Hi Trevor,

 

Avoid ban lan gen, da qing ye and qing dai. Sulfa drugs come from the

isatis plants.

 

--

Karen Vaughan, MSTOM

Licensed Acupuncturist, and Herbalist

253 Garfield Place

Brooklyn, NY 11215

 

(718) 622-6755

 

Co-Conspirator to Make the World A Better Place: Visit

http://www.heroicstories.com/ and join the conspiracy

See my Acupuncture and Herbalism website

at:http://www.byregion.net/profiles/ksvaughan2.html

 

 

" When you are in doubt, be still, and wait. When doubt no longer exists for you,

then go forward with courage. So long as mists envelop you, be still. Be still

until the sunlight pours through and dispels the mists -- as it surely will.

Then act with courage " White Eagle