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Ketamine Treatment Potential For Depression?

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Ketamine has been used as a safe anesthetic for close to 50 years. 8 years after it was produced in 1962, it was approved for use on human beings. The safety margin of ketamine proved important when soldiers were allowed to administer it to their injured comrades during the Vietnam War.

This was done in the field by people who were not necessarily trained anesthetists or even medical professionals. Apart from its anesthetic effects, this drug has been abused as a recreation and club drug.

The use of ketamine as an anesthetic has gone down significantly in many developed countries after more effective anesthetic drugs have been developed. But now there is renewed interest in this drug after researchers found it to be effective in the treatment of depression that is not responding to convention anti-depressant medications.

The journey of ketamine as an antidepressant

The first study group of patients who used ketamine for depression was in the year 2000. The initial study involved only 7 patients. Another study 6 years later found that 71% of patients with treatment-resistant depression improved and reduced symptoms of depression by up to 50%.

These encouraging results occurred within 24 hour of giving a single dose of ketamine infusion. Now compare that with the almost 4 weeks that conventional antidepressant drugs take to start showing any significant improvement. For some patients, no improvement is observed at all with the conventional antidepressant.

What research on ketamine has so far revealed

Compliance

A single low-dose ketamine infusion is given in about 40 minutes. According to The Lancet – Psychiatry, severe depression signs and symptoms reduces for a few hours to up to 14 days after that single dose. Some severely depressed patients may not be very compliant in taking daily medications as is common with many anti-depressants. The Lancet compares this with the 3-4 weeks it would take for conventional antidepressants to offer the same effects.

Still, according to the Lancet, about a third of patients on these antidepressants do not respond to the treatment at all. In this regard, ketamine as an antidepressant is likely to be more convenient for some patients. The only challenge would probably be the need to visit a health facility for the infusion. But for patients whose ketamine antidepressant effects last for up to 14 days, this may not be an issue.

The fast and effective antidepressant effects of ketamine can also be a point in promoting patient’s compliance. This may create a window for counsellors to help the patient gain more insight and positive attitude to help them in the journey out of chronic depression.

Another point to note is that conventional treatment-resistant depression is managed by combining various medications and adjusting treatment regimen. This is likely to confuse the patient and the many different pills are more likely compromise the patient’s compliance to treatment.

Single drug treatments always offer superior compliance than multiple drug therapy.
One of the causes of major depression is chronic pain due to any of the longstanding health conditions. Ketamine has strong analgesic properties. The double effect of pain killing effects and antidepressant properties are further reasons for better patient compliance.
Safety

Ketamine is one of the drugs commonly abused for its dissociative and hallucinogenic effects. This non-medical use creates concern to authorities and for it to be used as an antidepressant calls for effective control measure. Other concerns include:

  • Risk of tolerance. However, unlike the recreational ketamine, preliminary study results indicate that this is not likely to happen with the therapeutic doses used for depression due to the dose and frequency of use. But research is on to consider other routes of administration or prolonged infusions that will ensure small doses are given over a long period of time in an effort to reduce possible undesirable effects on the liver
  • Daily users of ketamine are prone to cystitis. This painful condition can theoretically affect those using the drug for depression. This problem has however, not been seen with the therapeutic doses of ketamine used for pain management and the infrequent use in depression management.
  • Patients with psychosis appear to have their symptoms exacerbated and so should not be given ketamine.

Ketamine and suicidal tendency

A good number of people on the usual antidepressant drugs have a suicidal tendency but this disorder has not been observed with ketamine use.

Ketamine and ECT

The use of conventional antidepressant used in major depression is often combined with electroconvulsive therapy (ECT). The benefits of ketamine are achieved without this unpleasant mode of treatment that requires an anesthetic.

The future of ketamine as an anti-depression agent

There are ethical and social concerns about the use of ketamine. Effective controls have to be in place to minimize its potential for abuse. Currently, its use is largely off-label which means different clinicians use it differently and many recommendations are based on studies.

More research needs to be done and pharmaceutical companies should look into the possibility of promoting it as an antidepressant. There is no doubt that ketamine offers hope for eligible patients with treatment-resistant depression.

References
Radvansky, B. M., Shah, K., Parikh, A., Sifonios, A. N., Le, V., & Eloy, J. D. (2015). Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review. BioMed Research International, 2015, 749837. http://doi.org/10.1155/2015/749837

Cetylev- A Promising New Alternative To An Old Classic

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Cetylev is the new effervescent oral medication recently approved by the FDA for the treatment of acute liver toxicity, following over dosage of the popular drug Acetaminophen (better known as Tylenol).

The drug contained in Cetylev; acetylcysteine, is not new by any means. In fact, it was approved since the 1960’s for use, albeit as injectable intravenous solution. It is also available as an inhalable solution which has to be prepared by the pharmacist prior to use.

The Future- Convenience

In cases of acute poisoning or over dosage of Acetaminophen, the first line or therapy could be at home, as is likely to become the case thanks to the convenience of Cetylev effervescent tablets. The principle behind effervescence is simple; the tablets need to be dissolved in a quantity of water, which liberates the drug into free form, which is flavoured in a lemon-mint vehicle.

The tablets are available in 500mg and 2.5g (2500mg) sizes, and must be dosed according to weight. An initial loading dose of 140mg/kg of bodyweight is advised, followed by 70mg/kg every subsequent 4 hours for a total of 17 oral doses.

At this time, however, the medication will only be available for in-hospital management of over dosage.

Pharmacodynamics (Drug Chemistry)

Following oral ingestion of Cetylev, the drug elicits maximal effect in two hours, with a half-life of 18 hours. Cetylev is extensively metabolized by the liver, where it forms cysteine and sulfide metabolites. Following its metabolism, it is excreted in urine.

In patients suffering from renal impairment, dialysis may be needed to promote clearance from blood.

Possible Adverse Effects

Vomiting frequently occurs in cases of Acetaminophen over dosage, which may be worsened by Cetylev. Gastric bleeding may also follow in predisposed individuals (history of gastric ulcers, gastric valve disorders), so the need for risk-benefit analysis is important.

Allergic Reactions have also been reported in patients receiving oral Acetylcysteine medications, in which event the use should be discontinued unless deemed absolutely necessary.

References:

http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/207916s000lbl.pdf

Zika Virus Developing Into A Global Public Health Emergency- According To WHO

A meeting conducted on 1st February 2016, by the WHO, concluded that the outbreak of the Zika Virus Plaguing large parts of Central and South America, needs to be treated as a major public health emergency, and mandates international co-ordination[i]

This consensus was reached largely based on the strong co-relation between the Zika Virus and the development of microcephaly; a developmental disorder afflicting newborns when the mother is infected during pregnancy

According to the WHO, an international effort is required to minimize the threat presented to the affected countries, and to restrict the free travel of the virus across the globe.

This time, the outbreak of the virus originally appeared in Brazil in 2015, ironically in an area where genetically modified mosquitoes were released to combat malaria and dengue outbreaks.

Currently, more than one million cases have been reported, along with significant increases in reported cases of neonatal microcephaly and Guillain-Barre syndrome.

How Are Affected Countries Handling The Outbreak?

According to the Health Minister of Brazil, the outbreak is serious[ii] and currently difficult to contain, since more and more cases are reported every week, and prevention is difficult

A vaccine for the disease is not available, and not likely before the end of 2016, leaving Brazilian Public Health Authorities no choice but to combat the vector; the aedes aegypti mosquitoes themselves.

Soldiers have been employed to inspect individual premises for possible breeding grounds of the mosquitoes, with the intention of clearing and minimizing their reproduction.

The director general of the WHO, Dr. Margaret Chan, emphasized that at this time the best combative tools available were controlling the population of active vectors, and prevention of bites; especially in pregnant women at high risk of fetal damage.

In spite of the call for a coordinated response, the director general also opined that there was no need to restrict travel or trade, in an attempt to stem trans-global spread.

Skeptics, however, have been questioning the ability of the WHO to manage outbreaks in light of its poor control of the recent Ebola scare across the globe.

[i] http://www.who.int/mediacentre/news/statements/2016/emergency-committee-zika-microcephaly/en/

[ii] http://www.reuters.com/article/health-zika-brazil-exclusive-idUSKCN0VA33F

New Research Shows That Men’s Sexual Health Supplements Are Not As Effective- Or Safe As Claimed

A report published in the Journal of Sexual Medicine had revealed that common over the counter remedies available to enhance men’s sexual health may not be as effective as claimed- or even safe for that matter.

The report comes at a very important time; since as much as 40-70% of men experience symptoms of erectile or sexual dysfunction at some point of their lives, and turn to over the counter products for shame of visiting a physician to have their issue addressed.

Coupled with the fact that the supplement industry is booming- over 200% growth from the period 1999-2007, and the array of available products, it’s not surprising that both consumers and health practitioners alike are confused with what to choose.

The researchers came from Wake Forest Baptist Medical Center[i] in Winston-Salem, NC with the goal of providing a reference of sorts to physicians and urologists who need a guide[ii] for counseling patients that take such products, when presented to them.

Illegal Products Hidden In Plain Sight

Owing to the fact that supplements are rarely or very loosely regulated by the FDA, it was not surprising when the researchers revealed that there was no significant scientific evidence to suggest that various products had any measurable impact on libido, performance or erectile potency.

In fact, many of the so-called natural products were found to be laced with small traces of prescription PDE inhibitors, the class of drugs Viagra belongs to.

PDE inhibitors cannot be legally purchased without a physician’s prescription, since they carry significant risk of harm if used in individuals with certain pre-existing conditions, such as heart disease, liver and kidney disease, or using certain other prescription medications.

Over 81% of the products purchased and tested in the USA contained traces of these prescription only PDE Inhibitors, demonstrating the possible risk to the buying public.

Out of the many popular ingredients analyzed, only L-Arginine showed modest potential for improving erectile function, but could also dangerously lower blood pressure if not used wisely.

[i] http://www.eurekalert.org/pub_releases/2016-01/wfbm-mto011116.php

[ii] http://www.jsm.jsexmed.org/article/S1743-6095(15)34439-8/fulltext

Teenagers Who Use Cannabis At Higher Risk Of Developing Schizophrenia

Research conducted and published in the Journal Cerebral Cortex[i] revealed that exposure to cannabis (marijuana) during the adolescent years contributed to significant schizophrenic-like changes in the brain.

The results from these findings could be particularly troublesome, since according to the National Institute Of Drug Abuse[ii], as much as 15% of kids in the 8th grade have tried cannabis before, with about 1% using it on a daily basis.

Marijuana is normally sought after for its effects of relaxation and euphoria, but can also induce feelings of anxiety, fear or paranoia when taken in high doses, or from the use of new strains with high THC levels.

In adolescents, it can also lead to cognitive impairment, resulting in long term negative changes to the brain which is still in its developmental phase.

Relationship To Psychosis And Schizophrenia

Acute over dosage of cannabis causes symptoms of short term psychoses; which can include loss of spatial awareness and hallucinations. However, more serious long term schizophrenic disorders have also been the result, ultimately affecting that teenager’s quality of life going forward.

Researchers from the Western University in Ontario Canada were able to reveal the long term implications of marijuana use on the developing adolescent brain, following exposure of adolescent rodents to the effects of THC (tetrahydro-cannabinol), the constituent in cannabis that is responsible for its psychoactive effects.

The team investigated the areas of the brain commonly affected by schizophrenia, and its associated symptoms of anxiety, disorganization and public interaction.

The results demonstrated changes that were nearly identical to the disorder schizophrenia; changes such as social withdrawal, anxiety and diminished dopamine levels, all characteristic of schizophrenic disease. These changes also persisted long after the use of cannabis was discontinued, well into adulthood.

It was also noted that no changes were seen in adult rodents, who had already experienced full development of the brain.

[i] http://cercor.oxfordjournals.org/content/early/2016/01/04/cercor.bhv335.abstract

[ii] http://www.drugabuse.gov/drugs-abuse/marijuana

New Study Demonstrates Use Of Light Therapy May Be Very Effective In Treating Year-Round Depressive Illness

In an 8 week trial conduced in Canada[i], it was discovered that the use of light therapy was effective in the treatment of major depressive disorder (MDD), whether it was used alone, or in conjunction with popular anti-depressant medications, the SSRIs (selective serotonin reuptake inhibitors)

The use of light therapy in treating seasonal affective disorder (SAD) was well established, but the study further proved its utility in treating year round depressive illness.

The study was conducted in three major psychiatric outpatient clinics, and stretch over the course of 5 years, primarily as a result of the difficulty in recruiting suitable patients for the trial.

A total of 122 patients were placed into double blind random groups, and were assigned to either daily exposure to light therapy (immediately upon waking) and a placebo pill, a placebo pill and placebo device, fluoxetine and light treatment, or fluoxetine and a placebo device. Their Montgomery-Asberg Depression Rating Scale (MADRS) readings were taken before and after the completion of the trial.

Results

At the end of the trial, the result obtained demonstrated that:

  • The group receiving both light therapy and fluoxetine measured the greatest change in score, with 76% of patients achieving more than a 50% reduction in MADRS number
  • In The group exposed to light only, 50% of patients achieved a 50% reduction in MADRS score
  • The double placebo group had 33% of patients recording 50% or more reduction in MADRS reading
  • Fluoxetine and placebo device group, only 29% of patients achieved a 50% or more reduction in MADRS reading.

Limitations Of The Study

While the results were very promising, the researchers issued the statement that the results must be duplicated, which is probably very likely, before they can positively conclude its efficacy. The reasons for this disclaimer include:

  • Sample Size- at just 122 patients, the researchers explained the difficulty in recruiting candidates for the study, and there was likely not enough room to detect statistically significant differences in response
  • The Dose Exposure- researchers expressed their desire to conduct further studies using higher doses of both fluoxetine and light, as it was likely to bring out greater changes in response

Conclusion

The researchers concluded that the findings are clear enough to show positive benefit, and for medical practitioners to consider the use of light therapy for major depressive disorder, as it is well tolerated and safe. Finally, they are to conduct studies to determine if the exposure for measurable symptom improvement is the same for both SAD and MDD, or if different treatment protocols need to be designed for each illness.

[i] http://archpsyc.jamanetwork.com/article.aspx?articleid=2470681

Use Of Certain Anti-Biotics Linked To Higher Risk Of Cardiac Disease

In a meta-analysis of 33 studies conducted, encompassing over 21 million patients, Chinese researchers, led by Su-Hua Wu, MD identified the positive association of macrolide antibiotic use, and the incidence of cardiovascular death and ventricular arrhythmias[i].

It was revealed that the use of these macrolides was associated with a 242% higher incidence (2.42 fold) of sudden coronary death or ventricular arrhythmias, but did not contribute to the occurrence of heart attacks, or death by other means.

Though the results demonstrated the higher affinity for these conditions, its lack of association to all-cause death was not proven, citing the need for further well designed studies.

Sami Viskin, MD, from Israel who authored an editorial related to this report, emphasized the importance of noting that this association translates to a roughly 1 in 30000 chance of dying from sudden coronary failure, and that hepatitis is a much more frequent, and deadly occurrence following the use of these drugs

Another researcher, iun-Ling Wang, MD from Taiwan, conducted a similar study in Taiwan[ii], explained that while the drugs may be needed, physicians needed to exercise greater caution in avoiding use of the macrolides in patients with known history of heart disease or arrhythmias, and that an alternate antibiotic class needed to be considered.

Though there has been no concrete evidence to suggest that macrolide usage contributes to all-cause death, it necessitates the need for a well-designed study to observe the results in patients who have to use the drugs. At this time, there is reasonable assurance to physicians who need to prescribe the medications to do so.

The Macrolides are a chemical class of drugs that consist primarily of the antibiotics Azithromycin, Clarithromycin, Erythromycin and Telithromycin, which are the most frequently use in clinical practice. The group also consist of two anti-fungal agents, nystatin and Amphotericin B, by virtue of their chemical structure.

[i] http://content.onlinejacc.org/article.aspx?articleID=2468953

[ii] http://cid.oxfordjournals.org/content/60/4/566.abstract

Probiotics – Eat Your Way to Good Health

probiotic-benefitsEver since probiotics and probiotic supplements and foods made an appearance (they have been around since the 1970s officially, tough many cultures have an ancient tradition of using probiotics and naturally fermented foods) there has been news regarding their positive properties. They have been hailed practically as miracle workers for a number of problems and the market for various probiotics has been targeted as $24 billion by 2017, testifying to their growing popularity. Recent research points to different ways that probiotics can be used.

Probiotics can help with obesity in women

A research study led by Professor Angelo Tremblay of the Université Laval in Quebec and Nestle and published on January 28, 2014 in the British Journal of Nutrition says that probiotics may help women lose weight and keep it off. The study followed 125 obese men and women who were put on a weight loss diet for 12 weeks and then a maintenance diet for another 12 weeks. One group also had to take two probiotic pills daily, while the other group took a placebo.

While both groups lost weight, the group on probiotic pills lost an average of 10 pounds while the placebo group lost an average of six pounds during the weight loss period. During the maintenance period, the probiotic group lost an average of 11 pounds, while the other group remained stable and did not lose any further weight. However, there was no difference in weight loss among men who took probiotics and those who took a placebo, so probiotics may help women to lose weight in the long run. The group that took probiotics also had lower levels of leptin, the hormone that regulate appetite as well as intestinal bacteria that is a factor in obesity.

‘We don’t know why the probiotics didn’t have any effect on men. It may be a question of dosage, or the study period may have been too short,’ said Professor Tremblay. The study featured the use of Lactobacillus rhamnosus.

Probiotics can help in the digestive health of infants and reduce healthcare costs

A study published in JAMA Pediatric on January 14, 2014, led by Dr. Flavia Indrio of the Aldo Moro University Baro, Italy, said probiotic use in the first six months of a baby’s life can help reduce health costs as the use mitigates the effects of colic, gastrointestinal disorders, acid reflux and constipation. The research team followed 554 infants who were less than a week old for three months. The infants were divided into two groups, one of which received the probiotic supplement and the other which received a placebo. Parents were told to keep a diary of their bowel movements, vomiting episodes, crying and doctor visits due to these problems.

At the end of the trial period the results were analyzed and it was found that probiotic usage had positive effects on crying, vomiting and colic pains and also resulted in fewer visits to the doctor. On an average the infants using probiotics saved $119 for each family.

While probiotic usage had no harmful or adverse effects, other doctors have warned that more studies are needed and that infants should be studied at a later stage to see that the early probiotic usage had no harmful effects as also study the long term health consequences of such early usage.

Probiotics made with human feces

Typically fermented foods, yoghurt and drinks have different probiotics that are supposed to be good for you. However, a study published in Meat Science in its February 2014 issue talks of using meat as a probiotic. The article titled Nutritionally enhanced fermented sausages as a vehicle for potential probiotic lactobacilli delivery used probiotic bacteria got from baby poop. The study was co-authored by Anna Jofr, a food microbiologist at Catalonia’s Institute of Food and Agricultural Research’s (IRTA) food-safety program in Girona, Spain.

The Spanish scientists used 43 fecal samples from infants up to six months of age and isolated different bacteria from these samples. These were then used to ferment six different batches of sausages. Three batches used commercial bacteria and three used bacteria from infant poop. One of the strains from infant poop multiplied and became dominant enough to have a probiotic effect on the person consuming the sausage.

What is the need for probiotic sausages you may wonder? The author says that for people who cannot take dairy products the sausages would be a way to introduce probiotics in their diet.

Sources:

Science Daily

Fox News

New Treatments for Different Heart Disorders

imagesAccording to statistics collated by the CDC, at least 600,000 people die of heart disease annually. Many more suffer from heart attacks, some for the first time and others for the second. Coronary heart disease costs the country $108.9 billion yearly. What is worse is that some people are not even aware of the risk factors that they may have for heart disease. As many as 50 percent Americans already have risk factors like diabetes, high cholesterol, high blood pressure and smoking that can predispose them towards heart disease, apart from the worrying increase in the incidence of obesity, physical inactivity, alcohol use and more. There are many different kinds of heart disease, not simply coronary artery disease and heart failure because the heart is a muscle with many different parts and mechanisms of action.

Heart valve disease

The American Heart Association says that more than five million people are diagnosed with heart valve problems. The heart has four different valves that work together to allow the smooth flow of blood. If even one valve is damaged or affected in some way, it can lead to cardiac problems. Unfortunately, often heart valve disease may not have any symptoms or may be under-diagnosed.

Different treatment options are used, depending on the medical history, the valves affected and to what degree and other factors. Doctors may prescribe medications alone, heart valve repair or heart valve replacement. Diseased or damaged heart valves may be replaced with natural valves made from animal tissue or artificial valves. Natural valves are better, but they do tend to degrade, leading to repeated surgeries. Artificial valves, on the other, require that blood thinning medicines to prevent the blood from clotting, needs to be taken regularly. Blood thinning medicines like warfarin come with their own side effects and warnings and the patient has to be constantly monitored.

An article published in Nature Communications on February 11, 2014 reported on research done at the University of California and the University of Michigan. The report titled Integration of molecular and enzymatic catalysts on graphene for biomimetic generation of antithrombotic species shows there is a new possible treatment option that can obviate the use of blood thinning medicines by using grapheme coated valves.

The valves can be coated with two catalysts. The first is glucose oxidase, a natural enzyme that changes the glucose in the blood to hydrogen peroxide. The second is an artificial molecule called haemin which promotes the reaction of hydrogen peroxide with L-arginine. These work together and form nitroxyl that mimics the body’s own anti-coagulant properties.

A fragment of grapheme is used and this single-atom layer of carbon holds the catalysts near each other, promoting the blood reaction, making the valve implants easier to use. However, more studies are needed on the preparation and use of this coating and to see whether it is stable and safe over a long period of time or not.

Heart rhythm disorder research leads to startling findings

Long QT syndrome 2 is a heart rhythm disorder that can be fatal if not treated. Caused by a hERG (human ether-a-go-go-related gene) mutation – hERG controls the heart cells’ electrical activity and coordinates the heart’s rhythm, both of which are important for heart and body health. While this condition is usually genetic, occasionally it can be caused by certain medications or some other medical conditions.

Researchers at the National Health Centre, Singapore, were able to completely reverse the conditions leading to this disorder. They used pluripotent human stem cells from the patient and reprogrammed them into heart cells. They then used different drug compounds on these cells in a petri dish and found a drug called ALLN (not normally tested for such a condition) that could reverse the effects of Long QT syndrome 2.

Using this method was easier and, in fact, this method paves the ways for faster drug research and accelerated development instead of the decades current methods take. Another positive of this method is that since it uses the patient’s own cells, there are greater chances that it will work and with fewer or not side effects. The researchers took a year to discover the drug that would work.

The research team was awarded the best poster prize at the prestigious ESC (European Society of Cardiology) Congress on 1 September 2013, the largest international cardiology meeting attended by close to 30,000 participants.

Sources:

American Heart Association

The Strait Times

Are Herbal Medicines All They Are Supposed To Be?

imagesWhile herbal medicines and alternative remedies find favor among users and also among practitioners of such therapies, there is growing concern about the efficacy of herbal medicines. However, many people who suffer from chronic or even acute conditions and those disenchanted with conventional remedies and treatments turn to herbal remedies. According to statistics released by the National Center for Complementary and Alternative Medicine, National Institute of Health, that studied data from the 2007 National Health Survey, as many as 38 percent of adults and 12 percent of children have used complementary and alternative medicines.

The difference between the two is that complementary medicines are used along with conventional remedies and treatments and alternative remedies are used instead of conventional therapies. Some people use them as a holistic remedy and others use them to improve their health and well-being, while still others use them in terminal or acute conditions when conventional medicines and therapies hold out little or no hope.

Are herbal medicines safe – adulteration, contaminations and mislabeling?

According to statistics given in The New York Times, Americans spend close to $5 billion annually for herbal remedies for various ailments. However, a study titled DNA barcoding detects contamination and substitution in North American herbal products published in BMC Medicine on October 11, 2013 showed that many herbal remedies did not have the ingredients that they purportedly contained.

The researchers consisting of Steven G. Newmaster and others from the University of Guelph in Ontario studied samples of herbal remedies procured through mail order from North America and used in Canada. They used a test called DNA barcoding to find out the ingredients in the herbal medicines.

The test results showed that either the products were heavily diluted by cheap fillers like soybean, wheat and rice or they contained only these ingredients and none of the supposed herbal medicines. As many as 44 herbal supplements were studied and one-third of them contained only cheap fillers and no active ingreidnets. Some of them contained another plant or herb, but not the one listed. Only 48 percent of the samples tested were authentic.

While some of the ingredients may be benign, others may cause severe problems in people who unknowing consumer them and who suffer from gluten or nut allergy or allergy or reactions to any of the ingredients these remedies contain. Sometimes herbal remedies can react with conventional remedies, causing even more problems. Then there is the question of misbranding, fraud and lack of quality control.

Herbal therapies are not put through rigorous testing by any regulatory body

Conventional medicines have to undergo a lot of clinical trials before getting regulatory approval. Large double blind studies have to be conducted before the FDA will permit drugs to be sold. However, herbal medicines escape this screening because they come under food and dietary supplements rather than medicines. It may be difficult to test the medicines, too, as they may comprise different chemical compounds in very low doses that may be hard to identify. Another major problem is that many a time these drugs may be individualized for the patient. What will work for one patient may not work for the other.

La Trobe University in Australia has signed a memorandum of understanding in early February 2014 with global wellness company Swisse to establish a Complementary Medicine Evidence Centre that will conduct research into the efficacy of various complementary medicines. The company will be spending $15 million to establish the centre and support the staff that will conduct the trials and research. As this is industry funded research, there is no guarantee that it will be totally unbiased, though the university says that it will walk away from the deal if they are any conditions that are imposed.

If you are a fan of herbal remedies, you should know that you may be putting yourself at risk – some herbal remedies have been found to be toxic with heavy metals in them. In the very least, the manufacturer you are buying from may be scamming you by not giving you a genuine product. And if you have a real ailment and you don’t tell your doctor what herbal remedies you are taking, you may be putting yourself at greater risk. As far as herbal remedies go you are not protected by the FDA or any other regulatory body so the principle of caveat emptor applies.

On the other hand, herbal remedies do have a long history and cultural background and if you take actual herbs rather than pills, powders and potions derived from them, you are probably not doing yourself much harm.