Additional Information
Book Details
Abstract
Herbs and Natural Supplements, 4th Edition: An evidence-based guide is an authoritative, evidence-based reference. This two volume resource is essential to the safe and effective use of herbal, nutritional and food supplements.
The first volume provides a foundation of knowledge in the clinical practice of complementary medicine.
It emphasises safe practice with strategies to prevent adverse drug reactions, guidelines in assessing benefit, risk and harm and the evaluation of research.
- Comprehensive review of herbal medicine, clinical nutrition, aromatherapy, and food as medicine
- Patient safety and wellness
- Considerations in preoperative care and pregnancy
- Use in the treatment of cancer
- Herb/nutrient – drug interactions.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Herbs and Natural Supplements | i | ||
| Copyright page | iv | ||
| Table of Contents | v | ||
| Organisation of this Book | vi | ||
| Acknowledgments | vii | ||
| About the Authors | viii | ||
| Contributors | ix | ||
| Reviewers | x | ||
| Preface | xi | ||
| Herbal and natural supplements | 1 | ||
| 1 Introduction to Complementary Medicine | 1 | ||
| What is Complementary Medicine? | 1 | ||
| Complementary Medicine in Australia | 2 | ||
| Greater acceptance | 3 | ||
| Why is it still popular? | 5 | ||
| Complementary Medicine in New Zealand | 5 | ||
| The Medical Spectrum | 6 | ||
| Integrative and holistic medicine | 7 | ||
| Herbal Medicines and Natural Supplements | 8 | ||
| Product quality and regulation | 8 | ||
| Government actions: the PAN Pharmaceuticals recall in Australia | 9 | ||
| National Institute of Complementary Medicine | 10 | ||
| Evidence-Based Complementary Medicine — the burgeoning scientific evidence base | 11 | ||
| Where is the Scientific Evidence Created? | 12 | ||
| In vitro studies | 12 | ||
| In vivo studies | 12 | ||
| Human studies | 12 | ||
| Case reports | 12 | ||
| Randomised controlled trials | 13 | ||
| Systematic reviews and meta-analyses | 13 | ||
| Whole system practice research | 14 | ||
| Assessing evidence | 14 | ||
| Limitations of evidence | 14 | ||
| Applying evidence | 15 | ||
| Finding evidence | 15 | ||
| Misleading headlines | 16 | ||
| Factors to Consider in Decision Making | 16 | ||
| References | 17 | ||
| 2 Introduction to Herbal Medicine | 19 | ||
| Herbs, Drugs and Phytochemicals | 20 | ||
| Pharmacognosy | 20 | ||
| Chemical Complexity | 20 | ||
| Synergistic Interactions | 21 | ||
| Key Constituent Groups | 22 | ||
| Flavonoids | 22 | ||
| Tannins | 22 | ||
| Coumarins | 22 | ||
| Alkaloids | 23 | ||
| Terpenes | 23 | ||
| Glycosides | 24 | ||
| Chemotherapeutics Versus Herbalism | 24 | ||
| Product Variation and Standardisation | 25 | ||
| Standardisation | 25 | ||
| Limitations | 26 | ||
| Herbal Safety | 27 | ||
| Interactions with Pharmaceutical Drugs | 27 | ||
| References | 27 | ||
| 3 Introduction to Clinical Nutrition | 29 | ||
| Consequences of Poor Nutrition | 29 | ||
| Mortality risk: cardiovascular disease and cancer | 29 | ||
| Food Under the Microscope | 30 | ||
| Macronutrients | 31 | ||
| Carbohydrates | 31 | ||
| Lipids | 31 | ||
| Protein | 31 | ||
| Minerals | 31 | ||
| Micronutrients | 31 | ||
| Vitamins | 31 | ||
| Essential trace minerals | 32 | ||
| Phytochemicals | 32 | ||
| Food labels | 32 | ||
| Nutritional Deficiencies | 32 | ||
| Primary deficiency | 32 | ||
| Inadequate dietary intake | 32 | ||
| Evidence of deficiency in Australia and New Zealand | 33 | ||
| Barriers to good nutrition | 34 | ||
| Secondary deficiency | 34 | ||
| RDA and RDI reference values for Australia and New Zealand | 35 | ||
| RDI and nutritional deficiencies | 36 | ||
| Serious deficiencies of reference values | 36 | ||
| Optimal nutrition: a state beyond RDI | 37 | ||
| Redefining an essential nutrient | 38 | ||
| Nutritional Genomics | 38 | ||
| Nutritional deficiency, genome damage and clinical practice | 39 | ||
| Nutritional supplementation | 39 | ||
| Safety issues | 39 | ||
| Adverse reactions and interactions | 40 | ||
| Toxicity | 40 | ||
| Natural versus synthetic | 40 | ||
| Rational use of supplements | 40 | ||
| References | 41 | ||
| 4 Introduction to Aromatherapy | 42 | ||
| Historical overview | 42 | ||
| Aromatherapy Practice Models | 43 | ||
| Medical aromatherapy | 43 | ||
| Subtle aromatherapy or aromacology | 43 | ||
| Popular, or traditional, aromatherapy | 43 | ||
| Essential Oils | 44 | ||
| Chemistry | 44 | ||
| Carrier substances | 46 | ||
| Hydrosols | 46 | ||
| Pharmacokinetics and pharmacodynamics | 46 | ||
| Safe use | 47 | ||
| Potentially carcinogenic essential oils | 47 | ||
| Use in pregnancy | 47 | ||
| Interactions | 48 | ||
| Safety Precautions | 51 | ||
| Storage | 51 | ||
| Aromatherapy in Practice | 52 | ||
| Choosing an Aromatherapist | 52 | ||
| Education and competence | 52 | ||
| Professional courtesy | 52 | ||
| Safety | 52 | ||
| Clarity of outcome | 52 | ||
| References | 52 | ||
| 5 Introduction to Food as Medicine | 54 | ||
| Functional Foods | 54 | ||
| Supplements Versus Food | 59 | ||
| Individualising Food | 60 | ||
| Food Quality Issues | 61 | ||
| Pesticide residues | 61 | ||
| Genetic modification (transgenic foods) | 62 | ||
| Antibiotic resistance | 63 | ||
| Food additives and irradiation | 64 | ||
| Processing and preparation | 64 | ||
| Glycaemic index | 65 | ||
| Social, cultural and environmental aspects | 65 | ||
| Principles of Using Food as Medicine | 67 | ||
| Therapeutic potential of common foods | 67 | ||
| Blueberries (and other berries) | 67 | ||
| Broccoli (and cruciferous vegetables) | 68 | ||
| Single-cell foods | 69 | ||
| Medicinal mushrooms (reishi, shiitake) | 71 | ||
| Future Directions | 73 | ||
| References | 73 | ||
| Clinical practice | 78 | ||
| 6 Introduction to the Practice of Integrative Medicine | 78 | ||
| Holism and the Individual | 79 | ||
| Therapeutic Relationships | 80 | ||
| Practitioner Wellbeing | 80 | ||
| Intuition, Bedside Manner and Placebo | 81 | ||
| Bias in Medical Decision Making | 81 | ||
| Complementary Medicine Products | 82 | ||
| Cost Effectiveness of CAM | 82 | ||
| Dispensing Products | 84 | ||
| Ethical conduct | 84 | ||
| Informed Consent | 85 | ||
| Evidence-Based Medicine | 85 | ||
| Evidence in Practice | 85 | ||
| A Multidisciplinary, Collaborative Approach | 87 | ||
| Open Communication | 87 | ||
| Interdisciplinary Collaboration | 88 | ||
| Referral letters | 88 | ||
| Patients’ responsibility | 89 | ||
| Personal and Professional Satisfaction | 89 | ||
| Summary Points | 90 | ||
| References | 90 | ||
| 7 Safety of Complementary Medicines | 92 | ||
| A Brief History of Medication Safety | 92 | ||
| What is Safety? | 94 | ||
| Benefits, risk and harm | 95 | ||
| Adverse drug reactions (ADRs) | 96 | ||
| Type A reactions | 96 | ||
| Type B reactions | 97 | ||
| Extrinsic factors | 97 | ||
| Regulation and Product Information | 97 | ||
| Reliable information sources | 98 | ||
| Medical databases and texts: inconsistency | 100 | ||
| ADR Incidence | 100 | ||
| Case reports and post-marketing surveillance systems | 102 | ||
| Black cohosh | 102 | ||
| Kava kava | 103 | ||
| Factors that make an ADR more likely | 104 | ||
| Patient-related factors | 104 | ||
| Therapeutic factors | 105 | ||
| Strategies for preventing and limiting ADRs | 105 | ||
| Strategies for clinicians | 105 | ||
| Strategies for patients | 106 | ||
| The Rational Use of Herbal and Natural Medicines | 106 | ||
| References | 107 | ||
| 8 Interactions with Herbal and Natural Medicines | 109 | ||
| Interaction Mechanisms | 109 | ||
| Pharmacokinetic interactions | 110 | ||
| Factors affecting absorption | 110 | ||
| Changes in relative rate of absorption | 110 | ||
| Changes in extent of absorption | 110 | ||
| Mucilaginous herbs | 110 | ||
| Nutrients | 110 | ||
| Intrinsic drug transporters | 111 | ||
| Herbal and natural medicines affecting P-gp | 111 | ||
| Factors affecting metabolism | 112 | ||
| Cytochromes | 113 | ||
| Enzyme inhibition | 115 | ||
| Enzyme induction | 115 | ||
| Lack of in vitro–in vivo correlation | 116 | ||
| Factors affecting excretion | 116 | ||
| Pharmacodynamic interactions | 116 | ||
| Physicochemical interactions | 117 | ||
| Reduced absorption | 117 | ||
| Tannins | 117 | ||
| Chelation | 117 | ||
| Increased absorption | 118 | ||
| Synergy herbal research | 118 | ||
| Interaction screening tools | 118 | ||
| In vitro tests | 118 | ||
| Animal studies | 119 | ||
| Clinical studies | 119 | ||
| Putting Theory Into Practice | 120 | ||
| Interaction mechanisms | 120 | ||
| Medicine factors | 120 | ||
| Individual patient factors | 121 | ||
| Problems and pitfalls interpreting the evidence | 121 | ||
| A predictive algorithm | 121 | ||
| Medication and mechanisms | 121 | ||
| Evidence available? | 121 | ||
| Timing and dose — introducing which, when and for how long? | 121 | ||
| Outcomes possible | 121 | ||
| Practitioner considerations | 121 | ||
| Individual considerations | 121 | ||
| Action required | 121 | ||
| Assessing the likelihood of an adverse drug–herb interaction | 122 | ||
| Patient evaluation | 122 | ||
| Causality and probability | 122 | ||
| Next steps if interaction is likely | 122 | ||
| Analysis of the medicine | 122 | ||
| Case reporting | 122 | ||
| Two Medicines Requiring Special Attention | 122 | ||
| Digoxin | 122 | ||
| Potassium changes | 124 | ||
| P-gp and changes to metabolism | 124 | ||
| Pharmacodynamic interactions | 124 | ||
| Interference with therapeutic drug monitoring for digoxin | 124 | ||
| Warfarin | 125 | ||
| Pharmacodynamic interactions | 125 | ||
| Pharmacokinetic interactions | 125 | ||
| The Rational Use of Herbal and Natural Medicines | 125 | ||
| References | 126 | ||
| 9 Preoperative Care: | 129 | ||
| Extent of CM Use | 129 | ||
| Assessing Potential for Adverse Effects | 130 | ||
| Safety, Side Effects and Interactions with Other Medicines | 130 | ||
| Bleeding risk | 131 | ||
| Herbal medicines and food supplements | 131 | ||
| Glucosamine | 131 | ||
| Ginkgo biloba | 132 | ||
| Fish oils | 132 | ||
| Salicylate-containing herbs | 133 | ||
| Coumarin-containing herbs | 133 | ||
| Nutritional supplements | 133 | ||
| Electrolyte status and blood-pressure effects | 134 | ||
| Glycyrrhiza glabra | 134 | ||
| Paullinia cupana | 134 | ||
| Panax ginseng | 134 | ||
| Tissue perfusion and reperfusion injury | 134 | ||
| Coenzyme Q10 pretreatment | 134 | ||
| Interactions with Medicines Commonly Used during Surgery | 136 | ||
| Analgesics and anti-inflammatories | 136 | ||
| Anaesthetics | 137 | ||
| Valeriana officinalis | 137 | ||
| Kava kava | 137 | ||
| St John’s wort | 138 | ||
| Recommendations before High-Risk Surgery | 138 | ||
| Patient-Centred Assessment and Management during Perioperative Care | 138 | ||
| Quality use of medicines | 138 | ||
| Australian hospitals: policies and problems | 139 | ||
| Recommendations | 139 | ||
| Unmanaged integrated healthcare | 139 | ||
| References | 141 | ||
| 10 Cancer and the Safety of Complementary Medicines | 143 | ||
| Why Do People with Cancer Use Complementary Therapies? | 144 | ||
| Poor disclosure | 144 | ||
| Cm in the Oncology Setting | 145 | ||
| Benefits of cm in oncology | 146 | ||
| Supportive measures | 147 | ||
| Cm to improve survival | 147 | ||
| Research Approaches and Constraints | 150 | ||
| Whole systems research (WSR) | 150 | ||
| Outcomes research | 151 | ||
| Exploring exceptional patients | 151 | ||
| Limited funding | 151 | ||
| Adverse Reactions and Interactions | 152 | ||
| Adverse reactions | 153 | ||
| Vitamin A | 153 | ||
| Selenium | 153 | ||
| Zinc | 153 | ||
| Interactions | 153 | ||
| Pharmacodynamic interactions | 154 | ||
| Antioxidants and chemotherapy | 154 | ||
| A historical perspective | 154 | ||
| The evidence today | 155 | ||
| Cisplatin and antioxidants | 156 | ||
| Neurotoxic protection | 156 | ||
| Nephrotoxic protection | 157 | ||
| Antioxidants and radiation therapy | 157 | ||
| Increased risk of bruising and bleeding | 158 | ||
| Hormonally responsive tumours | 158 | ||
| Soy and isoflavones | 159 | ||
| Drug inactivation — chemical incompatibility | 159 | ||
| Pharmacokinetic interactions | 160 | ||
| P-glycoprotein | 160 | ||
| Herbal and natural medicines affecting P-gp | 160 | ||
| Cytochromes and metabolism | 161 | ||
| Herbal and natural supplements affecting CYP enzymes | 161 | ||
| Elimination | 161 | ||
| Clinical Implications of Integrative Medicine | 161 | ||
| Shared decision making | 162 | ||
| 1. General safety issues | 162 | ||
| 2. Availability of credible information sources | 162 | ||
| 3. Evidence of efficacy and safety | 163 | ||
| 4. Intent behind using CM treatment | 163 | ||
| 5. Severity of disease | 163 | ||
| Highly curable cancers | 163 | ||
| Difficult-to-cure cancers | 166 | ||
| Prevention and enhancing quality of life in cancer survivors | 166 | ||
| Palliative care | 167 | ||
| Communicating with patients | 167 | ||
| References | 169 | ||
| 11 Herbs and Natural Supplements in Pregnancy | 172 | ||
| Introduction | 172 | ||
| Part 1 — Herbs and Natural Supplements Used in Pregnancy | 172 | ||
| Nutritional medicine | 173 | ||
| Long-term impact of maternal nutrition | 173 | ||
| Herbal medicine | 174 | ||
| A traditional approach | 174 | ||
| Abortifacients | 174 | ||
| Emmenagogues | 174 | ||
| Historical perspectives | 174 | ||
| Contemporary use by Western herbalists | 176 | ||
| Part Two — Safety in Pregnancy | 177 | ||
| Critical periods in human development | 177 | ||
| Teratogenesis | 177 | ||
| Neonatal withdrawal | 178 | ||
| How is safety evaluated in pregnancy? | 178 | ||
| Epidemiological studies | 178 | ||
| Animal studies | 178 | ||
| Post-marketing surveillance systems | 178 | ||
| Adverse event case reports | 179 | ||
| Examples of case reports: | 179 | ||
| Clinical studies | 179 | ||
| Example: echinacea | 180 | ||
| Long-term use | 180 | ||
| Weighing up the evidence | 180 | ||
| Proposing a different system for complementary medicines | 180 | ||
| Using the safety matrix | 181 | ||
| Echinacea spp. (Echinacea) | 181 | ||
| Zingiber officinalis (Ginger) | 183 | ||
| Rubus idaeus (raspberry leaf) | 184 | ||
| Cimicifuga racemosa (Black cohosh) | 185 | ||
| Vitex agnus castus (Chaste tree) | 185 | ||
| Part Three — Advising Patients in Clinical Practice | 185 | ||
| Factors to consider in practice | 186 | ||
| Individual prescribing | 186 | ||
| Timing of the intervention | 186 | ||
| Informed consent | 186 | ||
| Appendix 11.1: Nutrients during pregnancy | 188 | ||
| Appendix 11.2: NHMRC dosage recommendations for pregnancy | 196 | ||
| References | 196 | ||
| 12 Introduction to Wellness | 202 | ||
| A New Academic Discipline — Wellness Online | 202 | ||
| What is ‘wellness’? | 202 | ||
| The World in Crisis | 204 | ||
| In Search of Wellness | 204 | ||
| The thermodynamics of wellness | 205 | ||
| Wellness and flow | 205 | ||
| Wellness Metrics | 207 | ||
| The Wellness Revolution | 207 | ||
| The wellness industry | 208 | ||
| Conscious consumption | 209 | ||
| Towards a Wellness Policy Agenda | 209 | ||
| Government initiatives | 210 | ||
| Working towards wellness | 210 | ||
| Lifestyle Medicine | 210 | ||
| A New Academic Discipline | 211 | ||
| Wellness Online | 212 | ||
| The Future of Wellness | 213 | ||
| References | 213 | ||
| Index | 215 | ||
| A | 215 | ||
| B | 216 | ||
| C | 216 | ||
| D | 218 | ||
| E | 218 | ||
| F | 218 | ||
| G | 219 | ||
| H | 219 | ||
| I | 219 | ||
| J | 220 | ||
| K | 220 | ||
| L | 220 | ||
| M | 220 | ||
| N | 220 | ||
| O | 221 | ||
| P | 221 | ||
| Q | 222 | ||
| R | 223 | ||
| S | 223 | ||
| T | 223 | ||
| U | 223 | ||
| V | 224 | ||
| W | 224 | ||
| X | 224 | ||
| Y | 224 | ||
| Z | 224 |