Herbal & Homeopathic Medicines Quiz

Herbal & Homeopathic Medicines

• Herbal and homeopathic medicines are used alongside conventional medicine
• Current legislation and professional issues concerning the manufacturing and supply of complementary and alternative medicines (CAM) are important - including Traditional Herbal Registration Scheme (THR)
• Herbal and Homeopathic medicines need to be differentiated
• CAM covers over 700 types of therapies, including acupuncture, Ayurveda, chiropractic, diet/dietary supplements, herbal medicines, homeopathy, massage, osteopathy, reflexology, reiki, traditional Chinese medicine (TCM) and yoga
• Ayurveda is a holistic, natural system of medicine that originated in India over 5,000 years ago. The name comes from Sanskrit words ayur (life) and veda (knowledge)
• Five elements make up Ayurveda's view of the world - space (ether), air, fire, water and earth
• Doshas (vata, pitta, and kapha) are life forces that influence health and personality and are assessed via physical and mental characteristics
• Ayurvedic medicine suggests imbalances in doshas can lead to illness and lifestyle changes, nutrition, and natural treatments can help restore balance
• Traditional Chinese Medicine (TCM) includes acupuncture, herbal medicine, moxibustion, cupping therapy, Tui Na, Qi Gong, Tai Chi, and dietary therapy
• Chi is regarded as a vital life force permeating the body. Balanced chi is indicative of health and vitality.
• A study by Royal Marsden (2004) found 50% of participants did not tell their doctor about using herbal medicines
• A study by Bhamra et al. (2017) found 69% of participants did not tell their doctor about using herbal medicines, and even more didn't tell their pharmacist

Herbal Medicines

• A herbal medicinal product is a medicinal product whose only active ingredients are herbal substances or herbal preparations (HMR 2012)
• Herbal substances are mainly whole, fragmented or cut plants, plant parts, algae, fungi, lichen, in unprocessed/usually dried, form but sometimes fresh
• Herbal preparations are obtained by subjecting herbal substances to treatments like extraction, distillation, expression, fractionation, purification, concentration or fermentation (Directive 2004/24/EC)
• In the UK, 20% of adults use herbal medicines
• The use of CAM in cancer patients is high
• There is a potential risk of adverse effects if herbal and conventional medicines are taken together
• Examples of potential drug interactions include garlic, ginger, turmeric, aspirin, Clopidogrel, Warfarin. This can result in an increased risk of bleeding
• There are other herb-conventional medicine interactions: St. John's wort with Ciclosporin, Amlodipine, Citalopram,and Digoxin; Garlic with Antiplatelet drugs and Warfarin; and Ginseng with Warfarin
• Herbal medicines, while having advantages such as being effective for health conditions, being natural, and potentially cheaper than conventional medicines, have disadvantages such as not being well-regulated, variable dosing, lack of clinical evidence.

Homeopathic Medicines

• Homeopathy is a complementary discipline based on the law of similars, involving administration of ultra-dilute medicines prepared according to methods specified in homeopathic pharmacopoeias, aiming at stimulating a person's own healing capacity.
• Homeopathic medicinal product is a medicinal product prepared from homeopathic stocks in accordance with a homeopathic manufacturing procedure.
• Homeopathic medicines are based on the principles of "like cures like," minimal dose, and single medicine
• Developed by German doctor Samuel Hahnemann in the 1700s.
• Homeopathic medicines are prepared from various sources like plants, animals/insects, biological material, and chemical material.
• Mother tinctures are made from extracting the source material (plant or herb) in alcohol and water.
• Homeopathic medicines are often diluted using a serial dilution and succussion method
• Formulations of homeopathic medicine include oral preparations (tablets, pills, granules, powders), liquid preparations (drops), topical preparations (cream, gel, ointment, paste)
• Absorption may be affected by food (usually a 30-minute gap is recommended)
• Patients should avoid smoking or strongly flavoured products (e.g. peppermint toothpaste) and not touch the product with their hands
• Homeopathic medicines can be supplied on the NHS or via a private prescription.
• There are disadvantages of homeopathic medicines including lack of clinical evidence, effects compared to a placebo effect, and that they are not always evidence based.

Legislation

• Regulation of herbal medicines in the UK passed through several phases, with early 1970s requirements for a product license for medicinal claims.
• Section 12.2 of the 1968 Medicines Act allowed exemption from licensing for herbal remedies that contained only herbal substances and no medicinal claims.
• Human Medicines Regulations (HMRs) 2012 requires that herbal medicines making a medicinal claim either be registered under the Traditional Herbal Registration Scheme (THR) or licensed with marketing authorisation.
• Unregistered products cannot make any therapeutic claim.
• Traditional Herbal Medicinal Products Directive (THMPD) was passed in 2004 to regulate the use of HMs.
• The legislation required herbal medicinal products to have at least 30 years of evidence of traditional use in the EU, or 15 years within the EU and 15 years elsewhere.
• Safety data, quality, and pharmacovigilance were also required.
• There are various details about registrations, validity, and conditions for homeopathic medicines which were granted by the MHRA

Risk of Buying Herbal Medicines Online

• Fake, substandard, unlicensed contaminated or adulterated products may contain banned ingredients or substances.
• Products may be made in unlicensed factories with no Quality Assurance
• Claims such as "100% safe," "Safe because they are natural," and "Has no side effects" should be avoided.

Herbal Medicines vs. Conventional Medicines

• Herbal medicines are alternative, with a poor evidence base, and are natural. Traditional use is not well documented
• Herbal medicines are not well regulated, marketing authorisation is not always necessary, and there is a lack of clinical evidence that proves their efficiency
• Conventional medicines are conventional, evidence based, synthetic/manufactured/purified and regulated which has well established use. Necessary product licenses or marketing authorisation is required.