Friday, 27 February 2009

Grow your own drugs

No, not the good kind, there is a new TV series being heavily trailed, by that title:

...James Wong, a 27-year-old ethnobotanist (a scientist who studies how people use plants), wants to change our minds. He passionately believes that safe, natural remedies can be made from the everyday plants you find in hedgerows, the back garden or local garden centres.

...In Malaysia, where Wong grew up, everyone treated themselves with natural remedies. Food, too, was used as medicine...

The problem, Wong believes, is that there's a big cultural dividing line between conventional medicine, which is thought of as effective, proven and serious, and herbal medicine, which has the reputation of being a bit flaky.

But, as Wong says, up to 50 per cent of over-the-counter medicines are based on chemicals that were first isolated from plants. "Aspirin, for example, is made from the same chemicals that were first isolated from willow, which has been used for thousands of years as a painkiller.

...Wong, who trained at the Royal Botanical Gardens at Kew, is quick to point out that the herbs and plants he recommends all have a long history of use and no record of toxicity.

So, presumably aspirin, which is derived from plants after all, has 'no record of toxicity'? This doesn't bode well.

15 comments:

Dr Aust said...

Joy. The old "chemical bad, natural good" meme.

Being (very) charitable, perhaps he just means that in order to give yourself GI irritation with willow bark, you would have to chew several hundred grams of it?

I guess it SHOULD be possible to calculate, with some reasonable assumptions, how much willow bark you would have to take (chew? stew up in water?) to get a sensibly anti-pyretic dose of aspirin-type natural product. Anyone fancy running the numbers?


half a haIt should be possible

Bob said...

I saw the adverts for this programme too, and the first thing I thought was that it may end up being a good topic for bad science bloggers and skeptics.

pj said...

Funnily enough I managed to miss the programme - ah well.

Anonymous said...

"So, presumably aspirin, which is derived from plants after all, has 'no record of toxicity'? This doesn't bode well."

This is where your presumption is wrong. Willow and meadowsweet both contain the natural compound that is converted into what is in aspirin. This is where the problem lies - altering the molecular structure into something synthetic ensures it does not perform naturally. Like altering a jigsaw piece and finding that it doesn't work properly in the jigsaw puzzle anymore. Plus, don't forget all the other constiuents that are left out of the synthetic aspirin, like the demulcents in meadowsweet that means it can be used for stomach ulcers with aspirin can create!

pj said...

'Natural' does not mean 'good' or 'safe' - that is where you are wrong. Altering something 'natural' into something 'synthetic' can make it safer.

Nature is filled with highly toxic compounds and only the woefully naive think that because something is found in nature it is likely to be either beneficial or safe.

Neil said...

I've not stated that just because something is 'natural' that is it safe, this again is your presumption. Please give examples where converting something that is natural into something synthetic can make it safer. I assure you that largely this is not the case in regards to pharmaceuticals.

The synthetic world is filled with highly toxic compounds and only the woefully naive think that because something is synthetic it is likely to be either beneficial or safe. :-)

pj said...

"I've not stated that just because something is 'natural' that is it safe"

Since you said, in response to my pointing out that a therapeutic dose of aspirin from willow bark is highly likely to be as toxic as synthetic aspirin:

"This is where the problem lies - altering the molecular structure into something synthetic ensures it does not perform naturally."

I can only assume that you either believe that 'natural' aspirin is not toxic and making it 'synthetically' makes it toxic - in which case you are both wrong, and a fool, or you having nothing relevant to say at all.

And that is all I have to say on the matter, this is an old thread and you have little of any interest to add.

Neil said...

"I can only assume that you either believe that 'natural' aspirin is not toxic and making it 'synthetically' makes it toxic - in which case you are both wrong, and a fool, or you having nothing relevant to say at all."

1. I did not say that _all_ natural compounds are save, if I did, please state where.

2. How many people have died this year from taking willow bark or meadowsweet vs how many people die every year from aspirin? The death rate from pharmaceuticals is phenomimal in comparision to herbal medicine. Are you going to refute this?

3. Compare negative effects for aspirin in the BNF to any negative effects in the German government's Commision E monographs or, Prof Kerry Bone books (a research research and industrial chemist, who graduated with first class honours from Melbourne University and won the Masson Memorial Prize as Australia’s top chemistry student).

4. "I can only assume that you either believe that 'natural' aspirin is not toxic and making it 'synthetically' makes it toxic - in which case you are both wrong" Can you back this assertion up?

5. Please, no need for name calling in this debate. Getting emotional and does not change the facts of a rational debate.
Without malice, ill-will or prejudice.

"Condemnation without investigation is the height of ignorance." Albert Einstein

pj said...

1. So you have nothing general to add to the discussion other than the specific claim that willow bark is better than aspirin?

2. How many people take aspirin vs. willow bark moron? The death rate from herbals is, fortunately, low because herbal medicines are not widely used. Any herbal medicine that works has a risk of side effects, just like pharmaceuticals, the only difference being that pharmaceuticals have been tested for efficacy and side-effects and their concentration is fixed and known.

3. Ooh, big fucking deal. Aspirin was developed as a modification of salicylic acid in order to reduce the gastric side-effects i.e. the 'synthetic' drug was less harmful than the 'natural' extract. That you don't even know this tells me all I need to know about the value of your comments.

4. Yes, of course I can, as I state above, willow bark extract, salicin, and salicylic acid were widely used before aspirin was developed. The active ingredient in willow bark is salicin which is metabolised to salicylic acid just like aspirin. The adverse effects of aspirin come from the actions of salicylic acid. Further, aspirin has less gastric side-effects than salicin, which was why it was developed and why it became widely used in preference to salicin.

5. This is my blog, you have turned up on an old post spouting bullshit. I'll insult you if I like. You clearly know fuck all.

Neil said...

1. What I have added ‘in general’ I have in points 2 and 3 above. I have already pointed out in my first post that using the whole herb means that willow or meadowsweet can be used for the VERY thing that aspirin CAUSES ie. Gastric inflammation and ulcers.
Aspirin is a synthetic derivative of salicylic. Salicin containing herbs such as willow bark are primarily used as analgesics, anti-inflammatories and febrifuges...and the well documented tendency to gastric haemorrhage associated with aspirin is NOT a problem in salicin-containing herbs (Bisset 1994). I see where you are coming from in that the you are referring to the 'extract' of the herb. You have, in your comments above, referred to the extract and that actual herb. These do not work the same. I am making the comparison with the whole herb versus the single extract-based synthetic version. Forgive me if I did not make this clear.

2. "The death rate from herbals is, fortunately, low because herbal medicines are not widely used"
I can assure you that herbal medicine is more widely used than you think. See the number of practioners on http://www.nimh.org.uk/ http://www.associationofmasterherbalists.co.uk/practitioners.php?all=1 http://phytotherapists.org/practitioners.php?id=1
There are 1000 plus in addition there are other herbalists, naturopaths and don’t forget all those people that buy herbs over the counter from health stores, Boots, supermarkets and online.

On the other hand, death rates from conventional medicine is the No. 1 biggest killer in the USA:
Death by Medicine: 783,000 (Of which adverse drug reaction is 106,000)
Heart Disease: 699,000
Cancer: 553,000
Death by Medicine, GN Null, PhD et al

"Any herbal medicine that works has a risk of side effects" This is by far less than pharmaceuticals. According to the information gathered by acclaimed researcher and scientist James A Duke, PhD, the statistics on deaths caused by herbs compared by other causes are quite revealing:
Herbs 1 in 1 million
NSAIDS 1 in 10,000
Hospital surgery 1 in 10,000
Alcohol 1 in 500
Properly prescribed medications 1 in 333 (Kuhn and Winston 2008)

Many herbs that have been proven to work in clinical studies have no or extremely rare negative effects. e.g. You can find such papers on sciencedirect
on hawthorn for heart disease, and I'm sure there are papers for garlic and turmeric also. Are you really stating that hawthorn, garlic, turmeric, peppermint, chamomile, fenugreek, lemon balm, sage, oregano, echinacea (the list goes on) are as dangerous as pharmaceuticals?
"the only difference being that pharmaceuticals have been tested for efficacy and side-effects and their concentration is fixed and known." This is not true - refer to scienedirect for clinical trials on herbs or books like A Clinical Guide to Blending Liquid Herbs by Prof. Kerry Bone which states: Meadowsweet - Indications [for use]: Gastric ulcer, dyspepsia, hyperacidity, etc, Side Effects: None known.

3. "Ooh big fucking deal" is not a valid comeback to the points that I have made. "Aspirin was developed as a modification of salicylic acid in order to reduce the gastric side-effects" I do not dispute this but as you have stated aspirin was developed to REDUCE the side effects, not eliminate, whereas in its natural whole herb preparation the tendency to gastric haemorrhage associated with aspirin is NOT a problem with salicin-containing herbs.

4. See above.

5. Yes it is your blog, you have every right to insult and get emotional in a debate but this does not create a valid basis to your arguments, in fact, name-calling detracts from your credibility.

Neil said...

(continued)
References:

Mills, S. and Bone, K. 2000, The Principles and Practices of Phytotherapy, Churchill Livingstone, Edinburgh

Bisset, N. G. (ed) 1994, Herbal Drugs and Phytopharmaceuticals, Medpharm Pubs, Stuttgart

Braun, L. and Cohen, M. 2007 Herbs & Natural Supplements An evidence-based guide 2nd edition, Elsevier, Marrickville

Kuhn, M.A. and Winston, D. 2008 Winston and Kuhn's Herbal Therapy and Supplements: A Scientific and Traditional Approach, Springhouse Publishing Co, U.S

pj said...

Your claims are based entirely pn the unfounded anecdote of herbalists.

Herbalists also claim that salicin has no gastric side-effects, which is blatant nonsense. You are making a more subtle claim that only willow bark (not extracted, but, what, ground up?) lacks the gastric side-effects of aspirin (I presume you are not claiming that it lacks the other side-effects, such as anaphylaxis in those with aspirin allergy, which are well attested).

Claims of deaths caused by modern medicine use largely made up figures - it is certainly not the leading US cause of death. That is simply a lie (in your case I'll accept you just don't know it is a lie).

As to whether raw willow bark contains extra compounds that are gastric protective - you have no evidence for this, purely speculation. Since willow bark extract is generally found to be very much less effective than aspirin (probably due to delivering a lower dose of salicylate) it is at least equally, and rather more likely that the dose is just lower. Fortunately a range of compounds exist to provide alternative analgesia to aspirin or to give gastric protection with aspirin.

Even if there were less gastric side-effects of willow bark over aspirin that would still be utterly irrelevant to my pointing out that willow bark does have side-effects like aspirin precisely because it contains salicylate - these range from anaphylaxis to tinnitus. This was, you may recall, the point of my short post.

Sure, garlic has few side-effects, and it also has few benefits. A whole range of other herbals that do bugger all have few side-effects. But then, some of the few herbals that have some benefit (e.g. peppermint) actually have surprisingly common side-effects. Herbals with reasonably large beneficial effects (e.g St. John's Wort) have massive side-effects that are worse than similarly effective pharmaceuticals.

Look, I really grow weary of arguing with true believers like you. Fundamentally you don't really understand medicine and scientific evidence, herbal medicine seems fluffy and benign to you and therefore 'better', Big Pharma are engaged in an evil conspiracy to suppress these wonderful medicines etc. Your assumption that, for some entirely unclear reason, doctors deliberately ignore herbal medicines which are so very effective and yet have so little in the way of side-effects, is simply a delusion to deal with the cognitive dissonance that the people whose job it is to administer and evaluate medicines - doctors - don't take your little field seriously.

Those of us working in clinical medicine and evidence based medicine fortunately spend rather more of our time evaluating the efficacy and safety of these medicines - herbalists and their friends are mere dilettantes largely operating in a 19th century paradigm - those few forays made into true evidence based studies are adopted into medicine if effective, but largely they prove to be ineffective.

Sometimes I engage the nutters who come to my comments to try and point out the flaws in their reasoning, and sometimes I just tell them to fuck off - neither approach is particularly effective in changing the minds of people who base their opinions on faith rather than evidence.

Since I am a busy man, and since you have nothing interesting to say other than essentially parroting unfounded claims by herbalists, I have no interest in talking to you any further.

Anonymous said...

You insecure turd. I can't believe you'd dismiss a potentially interesting, informative argument just for a chance to lunge at 'Neil'. Nowhere in his posts did he even hint that he was trying to put you down or make fun of you. You really should learn how to have an intelligent discussion. Just because you don't agree with somebody doesn't give you the right to crusade against him and everything you've decided he stands for.

Here you are putting science back up on the pedestal. Science is wonderful, don't get me wrong. But when it goes from mere curiosity about the world around us to some ego trip where whoever knows more wins, there's a problem.

'Neil' pointed out where he thought you made a wrong assumption and told you why he thought so. Instead of taking this as an opportunity to breathe new life into an old post, you indirectly attack him with snide remarks.

All I see is 'Neil' trying to have a valid argument and assuming the poster was more interested in the topic rather than his reputation. He was apparently wrong.

You repeatedly take his posts personally, as if you created Aspirin yourself. Seriously. Step back for a second. Your 'Grand Conclusion' that herbs are basically a crock of shit and don't hold a candle to science is the most well-thought out thing I've read in a while. BULLSHIT. Gee, you're real intelligent, pal. Did you actually take a trip to wikipedia for some inspiration there?

You're claiming you need written evidence and clinical trials presented to you before you'll believe anything, in the same post that you fling shit at all who might dare to oppose you. Get off your high horse. I'll tell you-- for a long time a LOT of this shit wasn't possible. No laboratories, no clinics, no extracts. Isn't that crazy? People had to experiment with what they had to survive. Did you forget about that? Modern science is a BRAND SPANKIN' NEW THING when it comes to history. Throughout MOST of history, people had to have an intimate connection with plants. They were highly tuned to the environment because it was essentially all they had, particularly for medicine. Your posts show your ignorance in short form.

It's funny, how does someone SO close-minded as yourself become a blogger? I thought blogging was about new ideas, communicating with others, and learning. I guess that's not always the case. Sorry for being so close-minded.

pj said...

Fuck off moron.

Anonymous said...

haha good talk. Thanks for at least posting my comment.