The Self-Treatment Guide

A number of major news outlets have recently picked up on the AP news story
that an herbal supplement called forskolin may help treat recurrent
bladder infections. Here is the
main thrust of the article:

When taken with antibiotics, an herbal extract sold in
health food stores and promoted as an allergy and fat loss aid may
improve treatment of bladder infections, research suggests.

Some 90% of bladder infections are caused by E. coli bacteria. They
affect women four times more often than men, sometimes recurring over
and over.

According to an a recent study in the Journal of Antimicrobial Therapy, urinary tract infection recurs in 12-16% of patients treated, regardless of the antibiotic chosen.

The bladder is lined with small pouches that allow it to
stretch as it fills. Researchers at Duke University reported in
Sunday’s online edition of Nature Medicine that some bacteria were able
to hide in those pouches, escaping the antibiotics used to treat the
infection.

In tests in mice, an extract derived from the Indian coleus plant
can cause the pouches to kick out the bacteria, allowing antibiotics to
kill them, said the lead researcher, microbiologist Soman N. Abraham.

Medical blogger, Dr. Charles cautions that we shouldn’t read too much into this story. He points out that these
small pouches in the bladder are not the only reason urinary tract
infections recur. Among the other factors impacting urinary tract infection:

The largest group of patients with UTI is
adult women. The incidence increases with age and sexual activity.
Rates of infection are high in postmenopausal women because of bladder
or uterine prolapse causing incomplete bladder emptying; loss of
estrogen with attendant changes in vaginal flora; loss of lactobacilli,
which allows periurethral colonization with gram-negative aerobes, such
as E coli; and higher likelihood of concomitant medical illness, such
as diabetes.

Dr Charles goes on to quote more from Dr. Abraham, the lead researcher in this study:

“If we combine this with antibiotics we would be in a very
good position to eradicate urinary tract infection,” he said in a
telephone interview.

In the experiments, the extract forskolin was injected into some
mice and placed directly into the bladders in others, Abraham said.

The extract is available in health food stores and some people take
it by mouth as a supplement, he said. It is promoted as a treatment for
allergies, breathing problems and even fat loss.

That availability does “absolutely not” mean people should attempt to treat themselves for bladder infections,” Abraham said.

Dr. Charles then proceeds to make some very good points:

Much more study is needed to determine whether the addition of
forskolin to antibiotic therapy will make a difference in human UTIs.
It is also a big leap from injecting mice or catheterizing their
bladders to the convenience of a pill (with proven efficacy,
tolerability, safety, etc). It will be interesting to see what
proportion of UTI recurrence is due to these “pouches” and what
proportion is due to other factors such as antimicrobial resistance,
uterine prolapse, diabetes, etc… I would guess more is due to the
combined latter, but maybe I’m just being too hard on this study…

I think Dr. Charle’s conclusions are correct. More study needs to be done into this supplement before anyone decides to rush out and start buying it. Quite often the news media will run with a story just because they need to fill space and give you something to read. It doesn’t mean the item really works.

We consumers need to be very skeptical of any new “health breakthroughs” reported in the media. Investigate everything — gather all the facts — and finally, check with your doctor before adding any of these designer supplements to your diet.

One last note I want to add… there are some interesting comments on Dr. Charles post including this one:

Don’t laugh but I use a supplement called Cranactin, it’s the
concentrate of cranberries. I once ended up in the hospital with a
bladder infection so I’m really careful. As soon as I feel bad, I take
some Cranactin. It works for me so I recommend it. I don’t think it
would hurt you even if it doesn’t work for you.

I’ve also heard of cranberry juice and related products being used for urinary tract infections although I’ve never had the occasion to try them. Just something else to look into.

St. John’s wort (hypericum perforatum) is one of the five best-selling
herbs in the United States. It is used by many to treat the symptoms of
depression, and many prefer it to prescription medications such as
Paxil® and Zoloft.

However, the herb has been the subject of growing
concern about its interaction with birth control pills, the blood
thinner warfarin, and cyclosporin, a medication used with those who
have received organ transplants. A new study examining its effect on
pregnant women and those who are breastfeeding contributes to the
evidence that the product should be used with caution.

A New Study

The new study, entitled “St. John’s Wort (hypericum perforatum):
Is It Safe During Pregnancy, Breastfeeding and With Prescription
Medications? A Systematic Review,” will soon be published in the
Canadian Journal of Clinical Pharmacology. It is one in a series that
systematically reviews the evidence relating to the safety of herbs
commonly used during pregnancy and lactation.

The study was conducted by a team of Canadian researchers consisting of
the principal investigator Jean Jacques Dugoua, ND, MSc (Cand.),
University of Toronto, Sick Kids Hospital, Toronto Western Hospital,
Truestar Health and Wellness Clinic, and the Canadian College of
Naturopathic Medicine, Toronto, CN; and co-investigators Edward Mills,
DPH, MSc., PhD (Cand.), Department of Epidemiology and Biostatistics,
McMaster University, Ontario, CN; Dan Perri, MD, BscPharm, FRCP(C),
Department of Clinical Pharmacology and Toxicology, University of
Toronto, Toronto, CN; and Gideon Koren, MD, The Motherisk Program,
Hospital for Sick Children, University of Toronto, Toronto, CN.

Dr. Dugoua is presenting the team’s findings at the 21st Annual Meeting of the American Association of Naturopathic Physicians (http://www.Naturopathic.org), being held August 9-12, 2006 at the Oregon Convention Center, Portland, OR.

Methodology

The aim of the study was to systematically review the literature for
evidence on the use, safety, and pharmacology of St. John’s wort
focusing on issues pertaining to pregnancy and lactation. The
investigators searched seven databases for reports relating to the
herb. The databases included AMED, CINAHL, Cochrane CENTRAL, Cochrane
Library, MedLine, Natural Database, and Natural Standard. Each database
was examined in duplicate for data from its inception. Unpublished
research and bibliographies were also included. Data were compiled
according to the grade of evidence found.

Results

The researchers found varying levels of scientific evidence on the
efficacy of use for different conditions; low-level evidence of harm
during pregnancy; and strong evidence of side effects during lactation.
As St. John’s wort interacts with a number of medications due to its
effect on cytochrome P450 enzymes, this may account for some of the
findings.

Conclusions

The researchers concluded:

– Caution is warranted when using St. John’s wort during pregnancy and lactation.

– St. John’s wort may interact with medications prescribed during pregnancy.

– During pregnancy, a case study and some animal studies reported lower birth weights with use of St. John’s wort.

– Strong scientific evidence showed that St. John’s wort consumption
during lactation did not affect maternal milk production nor affect
infant weight, but may cause colic, drowsiness or lethargy.

– St. John’s wort showed strong scientific evidence of being an
effective aid in combating mild to moderate depression and low-level
evidence for other conditions.

Recommendations

The authors urge women not to assume that because herbs are labeled
“natural” that they are safe. They recommend all pregnant and lactating
women consult a licensed, health care professional before consuming any
herb or medicine in general, and St. John’s wort in particular.
Finally, they recommend that any woman experiencing depression let
their physician know immediately.

by Dean Moyer

I’ve been a “health nut” my entire life. In fact, I have a whole cupboard full of vitamins, minerals, herbs, essential oils and other products from the health food store to prove it. (Most of which I know I don’t really need.)

I quite literally can’t remember a time when I wasn’t aware of, steeped in, fed upon or indoctrinated with all the latest natural health trends.

But you know what? After years of taking all this stuff for this, that and the other thing… usually with no visible results… it finally started to dawn on me that taking a pill really wasn’t natural.

After all, these pills don’t grow on trees. They’re manufactured in some processing plant by a huge corporation that is no different than any other business except for the fact that they’ve decided to tap into the highly profitable and highly gullible “natural health” marketplace.

Time to Rethink Things

I think it’s time we health nuts stopped kidding ourselves.

I think it’s time we stop letting the multi-billion dollar health food industry pull the wool over our eyes. It’s time we quit swallowing all the hype and publicity found in the books and magazines and TV talk shows… and start to demand real scientific evidence to back up product claims.

It’s time we stopped falling for all the miracle pills and potions that they are literally trying to shove down our throats at $30.00 a bottle.

If we can’t (and I definitely don’t) trust the big drug companies… why do we turn right around and trust the big supplement makers?

After all, the so-called “natural” vitamin manufacturers are huge corporations run by the same type of people who run the giant drug companies. There isn’t a nickels worth of difference between them. They would sell you a worthless bottle of empty promises faster than you can say, “How much?”

And don’t think they wouldn’t.

Still Crazy After All These Years

Make no mistake… I’m still a health nut and a strong advocate for nutrition, exercise and natural, healthy living.

I still get a few products from the health food store — not because they’re “natural” — but simply because it’s the only place I know of to get certain items.

But I’m not as pill crazy as I used to be. I want to see scientific evidence before I shell out my hard-earned money for the latest wonder product. And when I do take something, I do so with the full knowledge that I’m taking a refined, processed chemical… NOT a natural food.

Now I’m not saying you should never take any kind of nutritional supplement… I’ll leave that decision up to you and your doctor.

However, for the most part, instead of pills to supplement my diet, I’ve chosen to do things like juicing and just making sure I eat a well-balanced diet of whole, unprocessed foods.

So far, I seem to be getting along just fine.

Don’t take any wooden nickels,
Dean

The more research I do into so-called natural remedies, the more I run into one common denominator; placebo… placebo… placebo…

I wish it were not so. I wish I could report on scientific studies proving that the alternative treatments actually worked. But unfortunately, that is seldom the case.

Take for example, a recent blog post by Julianne Chickering entitled, Natural Remedies Are Not Inherently Sate, or Effective.

In her post she points to an article published in the July 24 issue of Archives of Internal Medicine, which reviewed no less then 70 studies of alternative therapies currently being used for the treatment of menopausal symptoms:

As more and more women and health care providers shy away from the traditional estrogen treatment because of its possible associated risks, complementary and alternative treatments are becoming increasingly popular.

She then points out that even though these treatments are becoming “popular” that doesn’t have anything to do with how they perform:

It turns out, however, that the efficacy of these treatments relies a great deal on whether or not you believe them to work.

Keep in mind as you read this that it is not nature that failed here. Nature didn’t make a mistake. Science didn’t make a mistake. It is the so-called “alternative treatments” being peddled as “natural” that always turn out to be hoaxes.

Anne Nedrow, M.D. and colleagues reviewed 70 previously completed studies of complementary and alternative therapies used to treat menopause-related symptoms. Their findings… showed that a strong placebo effect was about the only consistent result.

Chickering goes on to write:

Included in the techniques studied were herbal supplements, acupuncture, massage, visualization techniques, and listening to sonic waves. Some of the therapies resulted in an improvement over no treatment when women were asked to rate symptoms such as hot flash frequency, sleep disturbance, sexual dysfunction, and quality-of-life changes; however, often the improvement was almost equivalent to the improvement experienced by the placebo group.

I truly believe that nature holds the key to curing most, if not all, of the diseases that plague mankind.

Whether it’s something as simple as understanding the biomechanics of exercise or as complex as stem-cell research, the more we can learn from nature the better off we’re going to be.

At the same time, there is little question that we consumers need to be more cautious when it comes to choosing alternative therapies. We need to investigate these products thoroughly before putting them into our bodies.

There are far too many people who are just out to sell us something… whether it’s the drug companies, the health food industry or the various quacks that masquerade as healers. We can’t afford to trust something just because it happens to be popular.

Fortunately, the scientific community is doing research into these so-called natural remedies and providing us with a second opinion that we can consider before making a purchase.

Do your homework,
Dean