Wednesday, October 14, 2009

New Study Shows Pharmacological Foundation of Chinese Herbal Medicines

As documented in Wild Health, a book suggested to me by Todd Hargraves, a frequent commenter on this blog, not only humans, but many other species have used herbal medicine for literally millions of years. I call herbal medicine Paleolithic or primal because it originated long before even the advent of agriculture, let alone the emergence of modern allopathic medicine.

Anyway, researchers at The University of Texas Health Science Center at Houston have found that ancient Chinese herbal formulas used primarily for cardiovascular indications including heart disease may produce large amounts of artery-widening nitric oxide.

Science Daily reported on this study:

"The results from this study reveal that ancient Chinese herbal formulas 'have profound nitric oxide bioactivity primarily through the enhancement of nitric oxide in the inner walls of blood vessels, but also through their ability to convert nitrite and nitrate into nitric oxide,' said Nathan S. Bryan, Ph.D., the study's senior author and an IMM assistant professor."


Traditional Chinese medicines (TCMs) used primarily for cardiovascular indications commonly contain three to 25 herbs, administered as tablets, elixirs, soups and teas. In this study, the researchers tested DanShen (salvia root), GuaLou (trichosanthis fruit) and other herbs purchased at a Houston store to determine their ability to produce nitric oxide.

They also tested the capacity of the store-bought TCMs to widen blood vessels in an animal model. They found that each of the TCMs tested relaxed vessels to various degrees.

Allopathic medical practitioners commonly assert that herbal medicine "doesn't work" or suggest it is mere "folklore." Worse, they often assert that modern pharmaceuticals are "safer" than "untested" herbs. Packaged with this comes the belief that our ancestors were stupid for believing that plants provided medicines.

Allopathic physicians learned these beliefs in medical schools funded by the pharmaceutical industry. Since herbs are non-patentable competitors for patented drugs produced by the pharmaceutical industry, the industry has done everything possible to prevent, suppress, and eliminate the practice of herbal medicine in the U.S., and internationally, including telling lies about herbs and getting licensing laws passed that effectively outlawed the practice of herbal medicine.

For example, consider how the FDA demonized Ephedra. Ephedra is an excellent bronchodilator that Chinese physicians traditionally used to treat asthma. The FDA removed Ephedra from the market after collecting 100 cases where people had died while voluntarily using it. All Ephedra-related deaths in America occurred among people using the herb improperly, without the guidance of a trained herbalist, and for purposes not endorsed by traditional OM herbalists (energy-enhancement, weight loss). Moreover, in none of the cases did the evidence clearly show that the Ephedra caused the deaths.

Aside from this being another sure-to-fail attempt at prohibition, comparatively, aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) have much worse safety records than Ephedra. According to James Fries, M.D., of the Stanford University School of Medicine, about 76,000 Americans are hospitalized and 7,600 die each year from gastrointestinal bleeding caused by aspirin and other NSAIDs. Yet these remain on the market, approved by the FDA.

Moreover, the FDA still allows OTC sales of psuedoephedrine, the patented copy of the natural compound. I wonder who this benefits.....

Shows how you can always count on the wisdom and benevolence of the government. I believe that if we did not have the government (FDA, state medical licensing boards, FCC, etc.) protecting NSAIDs from competitive market forces by suppressing natural alternatives (FCC suppresses information about alternatives), we would have far fewer deaths from NSAIDs because people would naturally seek the safer alternatives.

And since herbal medicines are not protected by profit-generating patents (another way the government increases costs of drugs, etc.), and anyone can grow herbs, the cost of medical care would go down.

But then the Statist economists would start complaining about deflation, since you know that it would kill our economy if the cost of living declined, resulting in a decline of the GDP. Or so they believe.

Anyway, as this study of TCMs shows, the continuing denigration of our ancestors and diatribe against Paleolithic medicine that forms part of conventional "wisdom" does not stand up to critical analysis.

20 comments:

Aaron Blaisdell said...

I bet another reason the government outlawed ephedren but not asprin is because if someone is hospitalized from taking asprin, they can sue the company, but if someone is hospitalized for taking ephedren, there is no one to sue (especially if grown in their own garden). To not be able to sue is anti-American!

Dyea said...

Nice post! Anytime substantial amounts of money are involved you can count on people doing whatever it takes to kill the competition and promote their pockets.

Can you point us to effective natural alternatives to NSAIDs? Specifically I am looking for something to relieve pain caused by malformed cartilage in the knee. Something present since birth and causing a lot of aching and throbbing at night and very easy to irritate when exercise involves flexion of the knee. Hence no squats, rowing, etc... Even kick turns during swimming will sometimes flare it.

Thanks,
Ward

madMUHHH said...

That's just oh so true. It's really a god damn shame.

Dennis Mangan said...

Pseudoephedrine is no longer patented; generic versions exist. Not that that takes away from your main point.

Don said...

Ward,

Have you tried:

1) Glucosamine sulfate

2) Turmeric extract (curcumin)


For herbs, the best thing to do: Consult a local Chinese herbal medicine practitioner. S/he can give you the formula most appropriate for your specific condition. Acupuncture often helps also.

Don said...

Dennis,

Thanks, you are right it is no longer patent protected, but it is a pharmaceutical product.

Don said...

Aaron,

If a person purchased Ephedra in a bottle at a Whole Foods, they might try suing the company that produced the product. But then they would have to prove that they had not abused the product. Most of the cases associated with Ephedrine involved abuse. So I guess we should outlaw alcohol also since people die from abusing it as well. (sarcasm)

But you're right, if they grew it in their own backyard, they'd have no one to blame but themselves.

mogey said...

Allopathic medical practitioners commonly assert that herbal medicine "doesn't work" or suggest it is mere "folklore." Worse, they often assert that modern pharmaceuticals are "safer" than "untested" herbs. Packaged with this comes the belief that our ancestors were stupid for believing that plants provided medicines.

I think you don't really understand what people mean when they say that traditional medicine doesn't work. You seem to define "work" as "to have a beneficial effect on one's health." This is an understandable interpretation, but it is not appropriate for this discussion. Sugar pills "work." If you mean that traditional medicine works in a properly controlled experiment, and especially if you mean that you can show, biologically, how that medicine works, than the medicine is by definition adopted by allopathy. Medicine can be both traditional and allopathic. Furthermore, this idea that defenders of modern medicine believe that plants cannot be medicinal is just preposterous. The opposite is true. The history of modern medicine is in many respects the history of our efforts to accurately describe and then make use of the amazing healing powers contained within plants (with the key word being 'accurate').

Don said...

Mogey,

"Furthermore, this idea that defenders of modern medicine believe that plants cannot be medicinal is just preposterous. The opposite is true. The history of modern medicine is in many respects the history of our efforts to accurately describe and then make use of the amazing healing powers contained within plants (with the key word being 'accurate')."

I hear from people often, their physicians tell them to avoid herbs because they aren't effective medicines, because their unsafe, etc. I subscribe to Medscape, and they definitely show an anti-herbal medicine stance. Your statement suggests I could go to any current medical journal and find "efforts to accurately describe and then make use of the amazing healing powers contained within plants." Sorry I have missed those articles...and how many herbal medicines are in the PDR? Not many the last time I looked.

And you emphasize "accurately"--are you suggesting that only allopathy can "accurately describe" the healing powers of plants?

The idea that Western science gives an "accurate" picture of the world superceding all other world views is hilarious to me. I'm sure that Aristotelians also thought they had the final word as well. I've got news: No conceptual framework accurately describes the world, and the tighter the framework, the less accurate it is. The current Western scientific view is one tight/narrow view, and it has been crumbling for a while now. The map is never accurate to the actual territory.

mogey said...

The medicinal properties of various herbs and the like is an established scientific fact, and a lot of modern medicine comes, ultimately, from natural sources like herbs. Doctors might advise you to avoid herbal remedies, but it is not because they think that our flora can't be medicinal. Instead, it is because we have come up with better delivery systems (better meaning more accurate doses, standardized results, safety testing, etc.)

As for accuracy and western science, I agree with the sentiment you are expressing (for the most part) but you are making a general statement. I'm talking about what you can see under a microscope. It's quite nice to be able to say, "our people have been taking this here herb for centuries when we have such and such an illness, and we have seen that it relieves symptoms," but surely you will concede that it is also nice to be able to describe how the process works with a little more specificity. Modern medicine is capable of describing ,how plants heal us with a level of detail that blows traditional medicine out of the water. Are you really going to contest that idea? This is different than saying that Western medicine, because of it's limited framework, is ignoring the healing powers of traditional remedies. That is an idea that I can get behind, but as they say, don't throw out the baby with the bathwater.

mogey said...

http://pubs.acs.org/doi/pdfplus/10.1021/np068054v

You might find this interesting.

Don said...

mogey,

yes, I will contest that idea. Unless you are completely trained in Chinese medicine, how can you claim that the "detail" offered by the allopathic framework is greater than that of Chinese medicine?

I use herbal medicines in clinical practice, and I use them according to the traditional Chinese description of "how" they work, and I get results for people that they don't get from conventional medicine. The "how" we get from conventional research doesn't improve results, in fact, from a Chinese medicine perspective it can easily cause harm. For example, according to conventional modern medicine, ginger has some anti-inflammatory properties, so someone might use it to treat inflammation. But according to Chinese description, ginger is hot, and will make hot conditions (most inflammation) worse. The so-called "scientific" perspective - reductionism - oversimplifies it.

BTW I don't mean that my herbal treatment only have a vague "benefit to health." I treat skin diseases, for example, as a specialty. By using the traditional explanation for "how" herbs work, I can differentially diagnose acne with a detail unknown to Western medicine. The diagnosis differs based on the appearance of the lesions, location, and background condition of the patient, and when I prescribe herbs according to their Chinese medical functions (e.g. clear heat, vitalize blood, purge toxins, resolve nodules, etc.) I watch the herbs cure it; I have done the same with psoriasis and eczema. To a Western mind, psoriasis [or acne] is one disease, but to me, although almost all psoriasis patients have heat in the blood, some have blood stagnation, some damp-heat, some blood deficiency dryness, etc. The therapy varies from patient to patient depending on the differential diagnosis.

So the assumption that the Western medical system provides a more "detailed" understanding of disease simply does not wash with me. I could as easily say the opposite.

Don said...

Mogey,

I was well aware that chemists mine the plant world for new drugs. This is not the same as using herbs as medicines. Drug chemists approach herbs afflicted by reductionitis and "magic bullet" thinking. They want to isolate a single molecule. They rationalize this by make the claim you wrote: "....we have come up with better delivery systems (better meaning more accurate doses, standardized results, safety testing, etc.)"

It doesn't occur to them that their version of greater accuracy of dosing, standardization, etc. might actually reduce the therapeutic efficacy or safety. They assume that Platonizing medicine makes it better. They assume that what they do know about a plant's constituents is greater than what they don't know. They assume that isolating a chemical makes it safer than leaving it in its natural context.

They are like the physicians who in the 1960s decided we knew everything about mother's milk and so we could replace it with synthetic formula with no adverse effects and a "better" delivery system (bottles, standardized "doses" of protein, fat, carbohydrate, vitamins, etc.). In practice this proved to be a failure, we now know that mother's milk has components unimagined at that time, and even now we don't know why it does things formula doesn't do, like protect against various adult diseases, increase intelligence and visual acuity, etc..

Humans evolved in an environment that was not "standardized," and paleo people used non-standardized herbal medicines. So we are adapted to an approach the opposite of what modern medicine tries to implement.

Well, if you think the chemists know it all, good luck. I for one remain a skeptic of claims that we, with our limited intelligence and knowledge, can improve on what we adapted to through evolution.

mogey said...

"I was well aware that chemists mine the plant world for new drugs. This is not the same as using herbs as medicines."

As a distinction, this is a bit of a stretch, and seeing as you specifically said that you think that modern medicine does not believe that plants can provide medicine, I have a hard time seeing how this isn't backtracking.

"It doesn't occur to them that their version of greater accuracy of dosing, standardization, etc. might actually reduce the therapeutic efficacy or safety. They assume that Platonizing medicine makes it better. They assume that what they do know about a plant's constituents is greater than what they don't know. They assume that isolating a chemical makes it safer than leaving it in its natural context."

Again, in general I don't disagree, but if you look at what scientists have done with specific plants and specific drugs, you can easily see that while they sometimes can't see the forest for the trees, they also have frequently succeeded in their attempts at isolation, improvement and mass production. You talk about "assumptions" but there are real results backing up my assertion that you are unjustifiably rejecting modern medicine.

"They are like the physicians who in the 1960s decided we knew everything about mother's milk and so we could replace it with synthetic formula with no adverse effects and a "better" delivery system (bottles, standardized "doses" of protein, fat, carbohydrate, vitamins, etc.). In practice this proved to be a failure, we now know that mother's milk has components unimagined at that time, and even now we don't know why it does things formula doesn't do, like protect against various adult diseases, increase intelligence and visual acuity, etc..

So? You're correct about mother's milk, obviously, and there are plenty more examples like this, but we shouldn't let these failures make us totally numb to the idea that we should study how and why our food/medicine effects us. The scientists who thought they could replicate mother's milk overestimated what they knew, but I think you are underestimating what modern medicine is capable of.


"Well, if you think the chemists know it all, good luck. I for one remain a skeptic of claims that we, with our limited intelligence and knowledge, can improve on what we adapted to through evolution."

That's the thing though. I don't think that chemists know it all, and I fully accept that they never will. The difference, and the main area where we disagree, is that I think that we ought to try our best nonetheless, and what's more I urge you to accept that western science has done a lot of good through its attempts, even if at times scientists overreach.

Don said...

Mogey,

You claim this:

"seeing as you specifically said that you think that modern medicine does not believe that plants can provide medicine, I have a hard time seeing how this isn't backtracking."

I would like you to show me where I said this. As I recall, all I said was that allopathic practitioners commonly state that herbs either don't work or aren't safe.

"Modern medicine," and abstraction, doesn't believe anything. Individuals hold beliefs, and I refered to a specific class of individuals. I am willing to change it thus:

"Some allopathic practitioners make statements suggesting that they believe, and prefer to have their patients believe, that whole herbs either have no significant therapeutic effect, or are more dangerous than isolated chemicals."

I can think of so many examples of how isolating chemicals creates harm compared to the original whole source. Aspirin and similar drugs kill 100K+ people every year. Aspirin is acetylsalicilic acid, originally from salicin in plants, a rich source being white willow bark (Salix alba) after which it is named. People get large amounts of salicin from eating fruits and vegetables, but no one has shown that people die from intestinal bleeding as a result.

Using whole herbs is vastly different from using isolated chemicals, the same way that using compost is vastly different from using isolated N-P-K fertilizer. A person using aspirin is NOT using herbal medicine, he is using a chemical extracted from an herb; just as a person using whey protein isolate is NOT using milk, and a person using sucrose is not using sugar cane.

mogey said...

"I use herbal medicines in clinical practice, and I use them according to the traditional Chinese description of "how" they work, and I get results for people that they don't get from conventional medicine. The "how" we get from conventional research doesn't improve results, in fact, from a Chinese medicine perspective it can easily cause harm."

Like I said, it's a question of how you define "results," because sugar pills can give results too. And the idea that the "how" in western medicine doesn't do any good is ridiculous. While there are obviously instances where the "how" is apparently not of great importance (although I would point out that sometimes what appears of no consequence can turn out to be quite useful later on), and while it may indeed be the case that the "how" sometimes hinders rather than helps, the fact remains that there are so many examples of the "how" being of utmost importance that your statement is essentially a denial of reality.

"So the assumption that the Western medical system provides a more "detailed" understanding of disease simply does not wash with me. I could as easily say the opposite."

Clearly TCM is elaborate, I wouldn't argue about that. I haven't studied it to practice it, but I have lived in Singapore and I've talked to people who use it, and it is obviously very detailed in its own way, as your description of how you treat skin conditions shows. However, the method you describe is still incapable of zooming in like modern science does. You might say that this zooming is unnecessary, or even harmful (and you do say this), but can't you at least admit that it gives us access to objective, directly observable information in a way that no traditional system does?

mogey said...

I would like you to show me where I said this. As I recall, all I said was that allopathic practitioners commonly state that herbs either don't work or aren't safe.

I was responding to this: "Packaged with this comes the belief that our ancestors were stupid for believing that plants provided medicines."

"Some allopathic practitioners make statements suggesting that they believe, and prefer to have their patients believe, that whole herbs either have no significant therapeutic effect, or are more dangerous than isolated chemicals."

Okay.

I can think of so many examples of how isolating chemicals creates harm compared to the original whole source. Aspirin and similar drugs kill 100K+ people every year. Aspirin is acetylsalicilic acid, originally from salicin in plants, a rich source being white willow bark (Salix alba) after which it is named. People get large amounts of salicin from eating fruits and vegetables, but no one has shown that people die from intestinal bleeding as a result.

That example does not show that it was the isolation itself that caused the harm, nor does it show that there is something inherent in isolation that causes harm in general. Anyway, it's irrelevant. My point is not that there are no examples of whole herbs beating isolated-compound based drugs. You won't find me singing the praises of drug companies, don't worry. I am merely asking you to acknowledge the successes that exist next to the failures, and to in turn acknowledge that the method, while not 100% reliable, is valuable in many cases.

Don said...

Mogey,

Why do you keep bringing up sugar pills? Are you suggesting that my patients would get similar results if I gave them sugar pills? If so, how does that fit with your admission that herbs are not sugar pills, i.e. contain pharmacological agents?

You keep taking my words out of context. When I said that the western info does not improve results I was talking in context of my practice. I don't need to know what chemicals in the herbs I use perform the actions I see them perform, or how they perform those actions, in order to know that they work. Moreover, I did not deny "reality," I denied that it is necessary to know "how" an herb works (from a chemical perspective) in order to use it effectively. You can use another understanding of how it works instead -- like Chinese medicine. You are stuck in believing that you can't know "how" something works without describing that "how" in western scientific terms. Questioning the veracity or efficacy of western scientific explanations is NOT denial of reality, it is questioning a particular STORY about the world.

Of course western experimental science reveals dimensions of experience not revealed by naked eye, ear, nose, hand, etc. I don't beleive I denied that. Again, I question the STORY told about those observations, not the observations. The STORY might include claims like that the isolated chemicals are the "real" actors in herbs, that herbs act like sugar pills but their constituents are medicines (?), that isolated chemicals are safer than whole herbs, that this story describes reality more faithfully than all other stories (or is reality itself), or similar claims.

mogey said...

"Why do you keep bringing up sugar pills? Are you suggesting that my patients would get similar results if I gave them sugar pills?
If so, how does that fit with your admission that herbs are not sugar pills, i.e. contain pharmacological agents?"


Basically I am saying that some traditional remedies (many, even) actually have pharmacological agents, and thus would be able to beat a placebo in a controlled test, but until you are able to show this, you can't expect the fact that a given treatment produces results to be of great significance.

"You keep taking my words out of context. When I said that the western info does not improve results I was talking in context of my practice. I don't need to know what chemicals in the herbs I use perform the actions I see them perform, or how they perform those actions, in order to know that they work."

You don't have to do anything you don't want to, but if you would like me to believe that TCM is real medicine, instead of just a placebo, you have to at the very least show me evidence that it can beat one in a test.

"Moreover, I did not deny "reality," I denied that it is necessary to know "how" an herb works (from a chemical perspective) in order to use it effectively."

Like I said, sometimes it is unnecessary, but oftentimes it is very necessary and very important to know these things. Your words: "The "how" we get from conventional research doesn't improve results, in fact, from a Chinese medicine perspective it can easily cause harm." That kind of blanket statement is primarily what I'm objecting to.

"You are stuck in believing that you can't know "how" something works without describing that "how" in western scientific terms. Questioning the veracity or efficacy of western scientific explanations is NOT denial of reality, it is questioning a particular STORY about the world."

It sounds like, rather than denying reality, you are denying that there is a reality to deny. I say this because the "particular stories" I was referring to are specific historical instances where our understanding of the how led to improved care. You keep retreating into generality land. Again, I will freely join you in saying to hell with positivism. But the devil is in the details. Many of the "stories" you reject, I also reject. I think that people have this inflated idea of the current state of medical knowledge, but to me that doesn't mean that we should just stop trying. The existence of competing explanations is the bread and butter of western science (even if it doesn't seem like it sometimes), but the key is to test the theories. You can't just throw up your hands and say, "you have your medicine, I have mine."

Don said...

How about comparing herbs directly with drugs (since drugs also have a placebo effect)? Cochrane database studies:

Chinese herbal medicine comparable or better effects to gestrinone or danazol for endometriosis

http://www.ncbi.nlm.nih.gov/pubmed/19588398?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

Chinese herbal medicine for primary dysmenorrhoea: "The review found promising evidence supporting the use of Chinese herbal medicine for primary dysmenorrhoea.."

http://www.ncbi.nlm.nih.gov/pubmed/18425916?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedreviews&logdbfrom=pubmed

Chinese medicinal herbs for influenza: "..traditional Chinese medicinal herbs as a whole seem to be comparatively or more effective compared to different chemical drugs."

http://www.ncbi.nlm.nih.gov/pubmed/15674953?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=17

Just a few quick examples. More on pubmed. All suggest larger trials, but there's little economic incentive to test unpatentable mixtures in large trials.

Among my patients, most have tried a variety of remedies (often including drugs - I usually am a last rather than first resort) before coming to me, with no results. Placebo effect was present for the things they tried before they got to me, but it didn't change their conditions. Patients act as their own controls.

I'm going to let this rest.