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Herbal medicines – how do we know what works?

Chair: Thandi Haruperi, UKC

Facilitator: Simon Hincks

Rapporteur: Simon Hincks

This workshop was attended by 50 people and began with an introduction to the subject.

What is herbal medicine?

Simon explained that this is the use of plant remedies in the treatment of disease. Common approaches include:

Western Medical Herbalism

Traditional Chinese Medicine

Ayurveda

Herbal medicine is the most widely practiced form of medicine worldwide and it is estimated that 80% of the world’s population rely on herbs for health

Herbalists’ approach

The first thing is to seek the underlying cause of the problem. Once identified it is this which is treated, rather than the symptoms alone. Treatment or suppression of symptoms will not rid the body of the disease itself. Herbalists use remedies to restore the balance of the body thus enabling it to mobilise its own healing powers.

Healing is a matter of teamwork with patient, practitioner and the prescribed treatment all working together to restore the body to health. Treatment may include advice about diet and lifestyle as well as herbal medicine.

How do herbs work?

Plants with a particular affinity for certain organs or systems of the body are used to ‘feed’ and restore to health those parts, which have become weakened. As the body is strengthened so is its power and ability to fight off disease. When balance and harmony are restored health will be regained.

Differences between pharmaceutical and herbal medicine

Herbal – extracts from part of whole plant and contain 100s to 1000s of active constituents. Herbalists believe these are balanced within the plant and are made more (or less) powerful by numerous other substances present.

Herbalists do not simply dispense remedies – they are trained to identify the underlying cause of disease and will treat each person (not health problem) very specifically.

Participants were then asked to raise any issues that they wanted to address in the workshop, as follows:

Share experiences

Risk of interactions with conventional treatments

Risks of herbal medicine

Where to go to obtain herbal medicine

Views of the scientific community in respect of Herbal Medicine

How do we know what works?

How can we evaluate if what we are taking works?

People then split into four groups and recorded their discussion on flip charts (see below)

Group 1. The advantages of taking herbal medicine

Used for the treatment of toxic side effects of conventional medicines

Easier and safer for the body to handle herbal medicines

The long history/experience with some herbal medicines, e.g. Traditional Chinese Medicine (some have been used for 3,000 years)

More accessible in areas of the world with no access to conventional medicines e.g. Africa and Asia

Cost saving benefits of growing certain herbs yourself as well as the experience of growing them (connection to nature etc.)

Herbal medicines are natural remedies

Some herbs boost the immune system

Gives people a feeling of self control over their treatment

It is a holistic approach

It can help people manage their symptoms

Group 2. The disadvantages of taking herbal medicine

Possibility of poisoning

Lack of specific measurements e.g. dose

Lack of information evaluating effectiveness

Difficulty accessing herbalist

Interactions with conventional medicines e.g. St John’s Wort and Evening Primrose Oil

Is there a recognized and enforced professional code of conduct for herbal practitioners?

Cost – not generally available on the NHS (includes cost of seeing practitioner and/or cost of herbs themselves)

Difficulty of accessing quality herbs especially if being shipped in from abroad

Difficulty of finding reliable information

Group 3. How do we evaluate the effectiveness of herbal medicine?

Keeping a diary

Monitoring side effects

Use conventional medical tests to monitor progress

Listen to other people’s experiences of taking herbal medicine including any concerns they might have

Need to move to more subjective assessment of health and well being rather than being informed purely objectively e.g. by doctor or results of blood tests etc.

Group 4. How do we share information?

Share information via a website using discussion forums (could be an add on to one of the national organisations’ websites)

Writing to HIV publications about our experiences

Having people with specialist knowledge available at conferences and seminars (rather than just ‘Ask the Doctor’ what about ‘Ask the Herbalist’, ‘Ask the Traditional Chinese Medicine Practitioner’ etc)

Leaving notices up on boards in clinics

Informing and asking doctors

Ordinary people discussing our opinions at conferences as we are doing today

Existing Resources:

National Institute of Medical Herbalists www.nimh.org.uk. They have a Register of members, information sheets and Information line manned by a Medical Herbalist

The Herb Society www.herbsociety.co.uk The UK's leading society for increasing the understanding, use and appreciation of herbs and their benefits to health

British Herbal Medicine Association www.bhma.info/

Ayurveda See BBC Website

Specific to HIV:

NAM Guide on Complementary Medicine

www.hiv-druginteractions.org This website shows the potential interactions of some common herbal medicines with antiretroviral drugs

The Gateway Clinic NHS Clinic that uses Traditional Chinese Medicine including Chinese herbs. People with HIV can self refer, just ring up for an appointment. 108 Landor Road, London SWP 9NT Tel 020 7411 6151

KEY POINTS

Herbal medicines can be used alongside pharmaceutical medicines for a more holistic approach to HIV treatment

There is little evidence based information about the use of herbal medicine in relation to HIV

Individuals can play a role in evaluating their own experience of herbal medicines and sharing this information with other people, their doctors and other healthcare practitioners

RECOMMENDATIONS

A toolkit is needed to guide people through using herbal medicine as an approach

There should be a facility to share information via a website (using discussion forums)

‘Ask the Herbalist’ or ‘Ask the Traditional Chinese Medicine Practitioner’ sessions at conferences as well as the more traditional ‘Ask the Doctor’

EVALUATION

This workshop was evaluated by 36 people. There was a wide age range, the youngest participant being 24 and oldest 64. The average age was 43

Gender

23 male, 12 female, 1 not stated

Ethnicity

20 white, 9 black African, 4 not stated, 3 other non-white

Sexuality

16 heterosexual, 17 gay, 2 not stated, 1 bisexual

Usefulness

Very useful

Useful

Not useful

44%(16)

31% (11)

25% (9)

19 people set themselves action points.

Finding out more (53%)

Check websites and other health services

Find out about Ayurveda medicines

More research/info leading to personal strategy

Taking specific action (47%)

Maybe see a herbalist

Follow up with clinic

Ask UKC for more space on the item

 

Move on to HIV and Hepatitis Co-infection

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