An increasing number of parents and adolescents ask me about the use of herbs when it comes to promoting health and preventing illnesses. I am glad to notice this trend in my practise. Why? Because a few years ago, a study published in the New England Journal of Medicine showed the minority of patients inform their physicians about herbal use in promoting wellness. This lack of communication is now less often seen, mostly because some doctors actually ask their patients about it and in doing so, open the door for further discussion.
Dr. Kathi Kemper, MD, Associate Professor of Pediatrics at Harvard and Director of the Center for Holistic Pediatric Education and Research at Children’s Hospital Boston, makes the excellent point that many of our most well known medications, aspirin and atropine among others, were derived from herbs. Many physicians themselves use at least one herb every day: coffee.
In 1998, herbs and other dietary supplements were a $3.5 billion industry in the USA. Almost 75% of teenagers who use complementary and alternative medicines use herbs.
Of course not all physicians share the same level of enthusiasm toward the use of herbs. One can see why: never before has the medical establishment had such an appetite for what is commonly referred to as “evidence-based medicine.” Some feel, correctly, that more studies need to be done to ensure the safety of herbal use in children. The McMaster Medical School in
Hamilton has pioneered this concept of evidence-based medicine and infected the rest of North America with its enthusiasm for practising this way. Similar to its counterpart at Harvard, McMaster Medical School has provided leadership in establishing extensive studies in the areas of using alternative and complimentary medicines.
What concerns many physicians is that many herbal products are marketed as pills and capsules and they are not subjected to the same rigorous standards and testing as traditional medications. Drug controlling bodies such as the FDA in the US and the Health Protection Branch in Canada, do not have to approve packaging or marketing before a product reaches the market. This leaves the potential of less protection for patients, particularly the young ones, against misleading and fraudulent claims made by some manufacturers. Recent studies also raised the issue that some herbal products may be inconsistent in the quantities of its content.
The New England Journal of Medicine reported last month that a natural product used in promoting weight loss did in fact cause kidney cancer if used long-term. It illustrates two very important concepts: firstly, the word ‘natural’ does not always imply the safety of a product; secondly, for some products – not all – short-term use may be safe but long-term use may be akin to sailing into unchartered waters.
Where does this leave well-meaning parents who want to do what is best for their children? How do they navigate their thinking through the stormy seas created by the deep and often acrimonious debates between orthodox and less traditional practitioners? My suggestion is the answer lies in education and research.
Both parents and physicians can do better in leaving often opposing biases at the door. Instead, more and more medical schools across North America are including information on alternative medications and complementary medicine in their teaching curriculum. For paediatricians in particular, the American Academy of Pediatrics offers education in the form of publications on this topic. In February 2000, authors Paula Gardiner and Kathi Kemper, from the prestigious medical schools at Tufts and Harvard, wrote an Academy publication about the use of herbs in children. It is a very complete and detailed review and available to the public at www.pedsinreview.org.
Other resources include:
The Herb Research Foundation – www.herbs.org
Herbmed – www.amfoundation.org/_vti_bin/shtml.exe/herbmed.htm
American Botanical Council – www.herbalgram.org
McMaster University Health Care Information – www.hsl.mcmaster.ca/tomflem/altmed.html
Center for Holistic Pediatric Education – www.childrenshospital.org/holistic
Meanwhile, remember it is in your child’s best interest to inform his or her doctor if you use herbal medication. It is the doctor’s responsibility to practise without bias and rely on evidence-based medicine.
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