Orthopedic
Docs Boost Complementary Medicine Awareness
Excerpt
By Nancy
A. Melville, HealthScoutNews
(HealthScoutNews) -- With more people turning to alternative
therapies to treat everything from aching joints to the common
cold, doctors are finding they need to educate themselves on potential
interactions with conventional drugs.
In one such effort to increase awareness, the American Academy of
Orthopaedic Surgeons recently created a Complementary and Alternative
Medicine section on its Web site.
Among information found on the site is a listing of popular
alternative remedies that could have adverse reactions when used
with common conventional drugs.
For instance, St. John's Wort, commonly taken as treatment for
mild depression, can have potentially harmful interactions with
anti-coagulants, and can enhance bleeding and hasten the metabolic
breakdown of drugs. The therapy is particularly discouraged for
organ transplant patients.
Other alternative treatments that pose a risk of increasing
bleeding include everything from ginkgo biloba and ginseng to
ginger and garlic.
The herbal supplement kava kava may have adverse reactions with
anesthetics and golden seal, which eases cold symptoms, and it
can mix badly with diuretics and hypertensive drugs.
The primary goal of the site is not to encourage or discourage
the use of any particular remedy, but to increase dialogue between
doctors and patients, says Dr. Harris Gellman, a professor of
orthopedics at the University of Miami and a member of the committee
that put the site together.
"The purpose of the site is to try to give information,
and say to both doctors and patients that this is what's available
and these are the risks and complications," he says.
"In addition, it's to inform doctors of the specific reasons
why it's so important to ask their patients if they are taking
any of these things, especially when scheduling for surgery,"
Gellman says.
Otherwise, he says, there's a good chance patients won't volunteer
the information: "Many patients may think of herbal therapies
along the same lines as food supplements, and don't realize that
it's nevertheless important to tell their doctor they're taking
something."
The U.S. Food and Drug Administration reports that sales of
herbal and botanical products alone increased a full 20 percent
from 1995 to 1999, with the products representing a $3 billion
industry by the year 1999.
In proper doses and when not in conflict with other medications,
many alternative remedies are not only endorsed, but even recommended
by some orthopedic surgeons.
The dietary supplement glucosamine, for instance, is widely
regarded by conventional doctors as an effective treatment for
osteoarthritis.
"Glucosamine actually looks like something that is very
healthy for cartilage, and may be an alternative medicine remedy
that could become mainstream," explains Dr. Julie Dodds,
an orthopedic surgeon at Michigan State University.
But even with that, she adds, relaying the information to one's
doctor is important: "People hear the word natural and they
think that translates to safe, so they don't mention it and physicians
don't think to ask about it."
"But surgeons in particular need to be aware that a large
percentage of their patients may be taking some of these supplements
and that, especially with anesthetic medications, there are some
potentially serious interactions," she says.
Joseph Betz, vice president for scientific and technical affairs
for the American Herbal Products Association, argues that research
on potential problems from products such as garlic is sketchy,
but he agrees a cautionary approach is always wise when mixing
any kinds of drugs or alternative supplements.
"Some have published warnings on potential risks based
on very weak reviews of the literature and the recommendations
are unjustified," he says. "But it's clear that physicians
have to be conservative, and anesthesiologists generally recommend
discontinuing all herbal therapies two weeks before your surgery.
That's probably justified, based on the lack of knowledge we have
on some herbs."
"The bottom line is that physicians need to know what herbs
patients are taking so they can have a good working knowledge
of what's going on," Betz says.
What To Do
For more on alternative medicine, visit the American
Academy of Orthopaedic Surgeons.
The National Institute of Health's National
Center for Complementary and Alternative Medicine offers information
on alternative therapies and safety issues.
The U.S. Food and Drug Administration offers extensive information
on dietary
supplements.
Reference
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