Herb-Drug Interactions

Disclaimer:  I am not a licensed health practitioner.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care.  A qualified, licensed physician or other medical provider should be consulted before beginning any herbal or conventional treatment.

After decreasing in practice for most of the 1900s, the use of herbs as medicine began a resurgence in this country in the mid-1970s.  While initially employed instead of pharmaceuticals, many are now being used in addition to pharmaceuticals, or being used to self-treat one condition while a physician is conventionally treating another with pharmaceuticals.  Accordingly, the potential for interactions is escalating.  Preppers need to be aware of what herbal and conventional medicines they are currently using, what they may use in the future, and what the potential for interactions is.

And for purposes of this blog post, herb also refers to food.

The first thing to emphasize is the importance of telling your doctor absolutely everything you are taking--vitamins, mineral supplements, herbals, OTC meds--in addition to whatever prescriptions you are on.  And even if you are eating a lot of something, as may happen in collapse and you've got a boatload of whatever that need to be eaten because you can't waste the nutrition and calories and you have no refrigeration or other means of cooling or preserving. 

Secondly, just because something is an herb does not necessarily mean it is beneficial nor harmless.  Monkshood (used historically to make poison arrows), foxglove (digitalis--heart medicine), opium poppies (no explanation needed) are not harmless, though they may have beneficial uses in the right situation. 

The greatest concern as far as individuals go is for those drugs that are used continuously, like for heart conditions or depression, and for drugs that treat infections. 

The first modern study to bring this issue to the attention of medical practitioners used grapefruit juice as a control in a drug trial.  However, it totally messed with the research because, rather than being the control it was supposed to be, the grapefruit juice actually potentiated the drug being researched, increasing the blood concentration almost three-fold.  In the time since that first study, grapefruit juice has been found to inhibit the drug metabolism (meaning the drug remains in the bloodstream and keeps circulating and working) of calcium antagonists (which are used for lowering blood pressure), some benzodiazepines (for depression), and terfenadine (an anti-allergy antihistamine).

Several months ago, long before I ever thought of starting this blog so I didn't note the websites, I stumbled across blogs and forums and such detailing the use of grapefruit juice to potentiate opioids.  Some were addiction center sites and some were obviously forums run by druggies; all were basically sharing the how-to's of maximizing the high.  They absolutely creeped me out.  But I thought the idea of being able to extend a limited supply of percocet might have merit.  Maybe stocking up on some grapefruit juice for such a situation warrants consideration.  You'll have to research it yourself.

What is more likely to happen is that an herb (or food) will reduce the efficacy of a given drug.  The foods increase drug metabolism, which thus reduces the bioavailability, or the amount of the drug able to get to the tissue to do its work.  St. John's wort inhibits indinavir, a drug used by HIV patients.  It also inhibits cyclosporine, an anti-rejection drug used by organ transplant recipients.  Of course, patients in both of these groups may not do so well post-collapse; however, it is really important to understand that herb-drug interactions are real and are not without consequences.  We need to learn about them now, because opportunities for research are going to limited later.

Tetracycline absorption is significantly (50-90%) impaired by milk and milk products.  The issue arises not from the milk itself, but rather the antibiotic binding with calcium.  Tetracyclines also bind with iron, zinc, and magnesium.  So antacids like Tums and supplements of these minerals would also inhibit tetracyclines, as would any other foods rich in these minerals, like oysters, dried figs, and raisins.

Warfarin, a blood thinner, is potentiated by bilberry, Angelica (dong quai), celery, chamomile, ginger, onion, cranberry, willow,  and inhibited by green tea, dandelion, CoQ-10, yarrow, vitamin E, and St John's wort.  Vitamin K-rich foods like Brussels sprouts, broccoli, and spinach antagonize the effect of warfarin.  Basically, there are a whole lot of foods that affect warfarin in a variety of ways.  If you're on it, you better research it and know everything about it.

As I have spent the last three hours working on this one post (why the heck am I doing this?!?!), it's becoming clear to me that if we are stocking a drug, we really need to research everything about it, and especially the herb-drug interactions.  No one else can really do this for us.  Even post-collapse if we happen to end up in a group with a competent physician, is s/he really going to know or remember much about potential interactions?  Maybe if that doctor is a family or ER doc, but what if your physician was a cardiologist or an orthopedist or neonatologist?  All the handy devices they use now to supplement their brains may not be an option later. We've got to know what we have, how to use it, and how not to use it.  And perhaps in the case of pharmaceuticals that we cannot replace, how to potentiate them, if possible.  

For more information:
http://www.itmonline.org/arts/herbdrug.htm (accessed on 7 January 2019)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976951/ (accessed on 7 January 2019)
https://nccih.nih.gov/health/providers/digest/herb-drug  (accessed on 7 January 2019)
https://www.drugs.com/slideshow/herb-drug-interactions-1069 (access on 7 January 2019)
https://www.standardprocess.com/MediHerb-Document-Library/Catalog-Files/herb-drug-interaction-chart.pdf (accessed on 7 January 2019--chart you may wish to print and put in your files for future reference)
https://www.nursebuff.com/herb-drug-interactions/ (accessed on 7 January 2019--another helpful, shorter chart)
https://www.aafp.org/afp/2017/0715/p101.pdf (accessed on 7 January 2019)
https://www.greenhousetreatment.com/opiate/potentiating/ (accessed on 7 January 2019)