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Chapter 4. TREATMENT (Alternative Medicine)

There have been few research trials to check the effectiveness of natural therapies, but many people report positive benefits. If you decide to use natural therapies, it’s vital that you see a practitioner who is properly qualified, knowledgeable and well-experienced. It’s also advisable to continue seeing your regular doctor or specialist. If a natural therapist suggests that you stop seeing your medical specialist or doctor, or stop a course of pharmaceutical medicine, consider changing your natural therapist. Ask searching questions of whichever practitioner you go to:

  • is the treatment dangerous if you get the prescription wrong?

  • how have natural therapies helped people with hepatitis C?

  • what are the side effects?

  • is the practitioner a member of a recognized natural therapy organization?

  • how much experience have they had of working with people with hepatitis C?

  • how have they measured the health outcomes of their therapy?

  • how do they aim to help you?

Most typical health insurance will not cover alternative medical procedures, but that’s beginning to change. Many alternative procedures are now covered under medical insurance in the states of Washington and Oregon, and it looks like it’s a trend which is beginning to spread.

Alternative Health Insurance Services of Thousand Oaks, California covers both allopathic and complementary/alternative treatments.

Patients may choose any provider, M.D. or N.D., or D.O. or D.C.

Subscribers must meet a deductible of up to $1000, and the plan pays 80% of the first $5,000 eligible medical expenses in a year, then 100 percent thereafter, with a $2 million maximum. The plan includes prescription drug cards, with a $5 copayment, as well as “named partner” coverage for homosexual or non-married couples and their families. Alternative Health Insurance Services: 1-800-966-8467.)

Another plan is offered by American Western Life Insurance Co. in Foster City California: Prevention Plus. It covers a full range of alternative therapies. Enrollees use a naturopath as their primary care physician, or the gatekeeper who refers to other alternative practitioners. There is a $5 copayment for prescriptions, including herbal medicines. The company also has a 24-hour 800 Wellness Line staffed by naturopathic physicians, saving on doctor visits where possible. (American Western Life: 1-800-925-5323)


Although the area of herb-drug interactions is under-researched, there are some interactions we do know about.

Feverfew: Feverfew is most commonly used for the treatment of migraines. Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen (Motrin, Advil) may reduce the effectiveness of feverfew. It can also inhibit platelet activity and should not be taken together with blood thinners such as Coumadin. Feverfew contains tannin, which has the ability to inhibit iron absorption, and should not be used for longer than four months without medical supervision. The recommended dosage is 125 mg daily; each dosage unit should contain at least 0.2% parthenolide.

Garlic: Most recent uses for garlic focus on its ability to treat high cholesterol and high blood pressure. Garlic can increase the risk of bleeding and should not be used concurrently with blood thinners. It has been reported to induce heartburn and flatulence, sweating, lightheadedness and allergic reactions. The German Commission E (Germany's equivalent to the FDA in the United States) recommends a dosage of 4 g of fresh garlic daily.

Ginger: Ginger is often recommended for motion sickness, nausea and for loss of appetite. It has also been shown to prolong bleeding time and its use with aspirin or Coumadin should be avoided. Excessive consumption of ginger may also interfere with cardiac and anti-diabetic therapy. It is usually well tolerated but may cause stomach upset or heartburn in some people. For motion sickness it is taken one hour before traveling. The total daily dose is 2-4 g.

Ginkgo Biloba: Ginkgo biloba is one of the most popular plant extracts in Europe and has recently received approval in Germany for the treatment of dementia. There have been reports of spontaneous bleeding in people taking ginkgo and again, it should not be used with blood thinners. People who take anti-convulsant medications, such carbamazepine and phenytoin, or phenobarbital should not take gingko without the knowledge of a physician, because it reduces the efficacy of these medications. Ginkgo is generally safe and well tolerated with the most common adverse reactions being stomach upset, headache and dizziness. German Commission E recommends a dosage of 40 mg of ginkgo three times daily with meals for at least four to six weeks. Preparations should be standardized to contain 6% terpene lactones and 24% ginkgo flavone glycosides.

Ginseng: Ginseng is used to combat overall debility, as well as lack of energy and concentration. It has also been used as an aphrodisiac. There is tremendous variation in products labeled as ginseng; in one study, only 25% of the commercially available products actually contained ginseng. Nevertheless, ginseng enjoys widespread popularity. Siberian ginseng has been associated with falsely elevated digoxin levels (a heart drug used to treat congestive heart failure) by interfering with the test used to determine digoxin blood levels. Ginseng may also affect fasting blood glucose levels, so people who need to control their blood glucose levels should take ginseng with caution. Concomitant use with warfarin, heparin, aspirin and NSAID's should be avoided. Additionally, ginseng may cause headache, nervousness, and manic episodes in patients with manic-depressive disorders or psychosis or those on anti-depressants, particularly the monoamine oxidase inhibitors (MAOI) such as phenelzine (Nardil). Side effects include high blood pressure, restlessness, nervousness, insomnia, skin eruptions, edema and diarrhea. German Commission E recommends Asian ginseng be taken as 1-2 g of crude herb daily or as 100-300 mg of ginseng extract three times daily. Commercial products should contain at least 4%-5% ginsenosides.

Kava Kava: Kava Kava is recommended for anxiety, as a sedative and as a relaxant. Excessive sedation may result when Kava Kava is taken with other sedatives (flurazepam, temazepam) or anti-anxiety drugs, particularly alprazolam (Xanax). The toxicity of kava is increased if taken with alcohol. Until the clinical significance of Kava's action on platelet activity is determined, its use with blood thinners should be cautioned. Long-term use is not advised and is characterized by dry, flaking, discolored skin and reddened eyes. The herb is contraindicated in patients with certain types of depression because it may increase the risk of suicide. The daily dosage is the equivalent of 60 mg to 120 mg kava pyrones. Heavy consumption of kava has been associated with increased concentrations of -glutamyltransferase, suggesting potential hepatotoxicity. A case of recurring necrotising hepatitis has been reported

St. John's Wort: St. John's Wort is most widely used to treat mild to moderate depression, anxiety and seasonal affective disorder. Adverse reactions reported include stomach upset, allergic reactions, fatigue and restlessness. Photosensitivity is usually rare and is associated with higher dosages. Fair-skinned people should be particularly cautious. Concomitant use with other photosensitizers, such as piroxicam (Feldene) or tetracycline should be avoided. St. John's Wort should not be used with MAOIs (phenelzine) or selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft or Celexa. St. John's Wort has been reported to prolong narcotic-induced (codeine) sleeping times as well as decreasing barbiturate-induced sleeping times and caution is advised when combining these medications. The herb also contains tannin and may interfere with iron absorption. The usual dosage is 300 mg of standardized extract three times daily or 450 mg twice daily. It may take up to four to six weeks to see desired effect.

Valerian: German Commission E recommends valerian for use in the management of restlessness and nervous disturbances of sleep. Valerian may cause headache, hangover, excitability, insomnia, uneasiness and cardiac disturbances. Given its sedative property it would be wise to avoid barbiturates (phenobarbital), sedatives (flurazepam, temazepam) and alcohol while on valerian. Valerian is also a tannin-containing herb and may interfere with iron absorption. Persons currently taking antidepressants should take valerian only under medical supervision. The usual dosage of the extract is 2-3 g, one to several times per day. Source: When medicine and herbs don't mix by Tammy Chernin, R.Ph. http://www3.healthgate.com

Echinacea , if used for more than eight consecutive weeks, could cause liver toxicity and should not be used with drugs such as anabolic steroids, amiodarone and methotrexate which are toxic to the liver as the affect may be additive.

Feverfew, garlic, ginger, ginseng, and ginkgo biloba all affect bleeding time and should not be taken by patients using warfarin or by patients that have decreased platelet counts.

St. John's Wort should not be taken with monoamine oxidase inhibitors or selective serotonin reuptake inhibitors like Prozac and Paxil until more information is available.

Licorice, plantain, hawthorn and ginseng may interfere with digoxin therapy and valerian root should not be taken when barbiturates are used because it could cause an increase in the barbituate effects.

Evening primrose oil and borage are contraindicated in patients taking anticonvulsants (e.g., clonazepam). lmmunostimulants such as echinacea and zinc should not be given with immuno suppressants such as corticosteroids (like prednisone) and cyclosporine and are contraindicated in patients suffering from rheumatoid arthritis, systemic lupus erythematosus and autoimmune hepatitis. Source: Hans Larsen is a health sciences researcher living in Victoria, British Columbia from Alive Magazine March 1999 with some changes by D. Morrow



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