Studies presented at the North American Research Conference on Complementary and Integrative Medicine point to the medical establishment's growing interest in alternative therapies. I personally believe they have few remaining options in the matter. They have tried to deride and to undermine and have attempted to usurp control. With the medical establishment's credibility at quite low levels and countless satisfied consumers of alternative medicine, their attempts have all failed. They are not yet ready to let go of tactics that seek to undermine or control but they increasingly seem to recognize that a more successful future rests in embracing alternative therapies, at least at some level.
The conference was primarily hosted by a group of 32 medical schools called the Academic Consortium for Complementary and Alternative Health Care. The public is the motivation behind the conference and not the medical establishment itself, according to one of the organizers of the conference.
Four studies related to herbal and dietary supplements and functional foods included: pharmacists' attitudes to natural health products, the potential deterioration of probiotic supplements before they reach shelves, herb-drug interaction in patients with osteoperosis and green tea as an aid for immunity disorders.
One study presented suggested many pharmacists are encountering reportable adverse events in patients using natural health products, but are not reporting these events. In the survey, 47 percent of 132 pharmacists indicated they had seen a potential natural health product-drug interaction or adverse event. Of these, only 2 respondents reported the interaction to Health Canada and about half discussed it with the patient.
Something that should be remembered is that only a limited number of adverse reactions involving approved pharmaceuticals are actually reported. It would be good to see a reporting system for alternative medicines and therapies but I would not be happy to see such a system be rigorously implemented unless and until a similar reporting standard could actually be made to work for regular drugs and treatments.
A second study, conducted as part of the Canadian multicenter osteoporosis study, found few potential drug-herb interactions in patients with osteoporosis. The patients were divided between those taking cardiovascular agents and those taking neuroleptic agents. Researchers assessed whether or not herbal therapies patients were taking, such as St.John's wort, were adversely interacting with these drugs.
“In this randomly selected, population-based sample we found a relatively low rate of potential drug-herb interactions, most of which were among subjects using specific cardiovascular medications,” the authors concluded. Of the 514 subjects on one of the cardiovascular medications, 2.5 percent were using a contraindicated herb. Only one of the 514 subjects taking a neuroleptic agent was identified as at-risk for a potential drug-herb interaction (lithium and psyllium). Frankly, this surprises me. I would have expected a finding of more potential interctions with a small number of herbs in particular, including St John's wort.
The third relevant study presented at the conference looked at quality assurance and lactobacillus-containing dietary supplements commercially available in Washington State. The authors showed that while probiotic supplements contain so-called 'friendly' bacteria, they also contain live microorganisms that make them susceptible to contamination and loss of effectiveness during shipping and storage.
The investigators concluded most Lactobacillus supplement products in Washington State were viable, but found a large discrepancy existed between labeling and actual contents. The most commonly identified labeling discrepancy was at the species level rather than the genus level. “Many products contained organisms not listed on the label,” the authors noted. “Some of these could act as human pathogens, posing risk if used by susceptible consumers,” they added.
Of the 94 samples analyzed, investigators found 88 percent were viable. Of these, manufacturer labeling exactly matched only 8 percent of the products, while 51 percent contained at least one organism that matched labeling at both genus and species level. Disturbingly, seventy-one percent of the supplements contained at least one organism not listed on the label, and ten percent had more than one potentially pathogenic organism. This is a valuable finding and should hopefully be followed up to ensure improvement in manufacturing quality control.
The only ingredient-based study presented at the conference was done on green tea and its potential to help with impaired immunity in HIV infection. The study found that the green tea component epigallocatechin gallate (EGCG) binds to the CD4 molecule on immune cells, inhibiting HIV from attaching to host cells.
“We have demonstrated clear evidence of high affinity binding of EGCG to the CD4 molecule. EGCG at concentrations equivalent to those obtainable by the consumption of green tea is able to significantly reduce the attachment of gp120 to CD4,” the authors concluded. Naturally however, the authors pointed out that while EGCG may be effective against HIV in laboratory cells, much more research is needed to determine if it has potential in infected humans.