PHILADELPHIA — The prevention or treatment of some medical conditions, such as cancer-related fatigue, heart disease, infertility and osteoporosis may be complemented with herbs and supplements, according to a speaker at the American College of Physicians Internal Medicine Meeting.
Many patients are interested in non-pharmacologic options for managing or preventing disease, and some are acting based on information found on the internet or other less reliable sources. Some agents have been shown to be beneficial, but clinicians should also advise patients to be cautious and to recognize that not all agents will benefit all patients, according to KaKit Hui, MD, professor of medicine at the Center of East-West Medicine, University of California, Los Angeles Among the agents where there is evidence of benefit:
- reduces cancer-related fatigue and improves the working memory of healthy, young and middle-aged adults and patients with schizophrenia; and
- decreases the severity, frequency and length of colds when consumed as a ginger root extract for 4 months.
- reduces cancer-related fatigue, chemotherapy-induced nausea and vomiting;
- prolongs survival rates in patients with acute myeloid leukemia; and
- possibly protects against gastric, colon, hepatic and ovarian cancers in vitro.
- reduces rates of cardiovascular mortality, all-cause mortality and hospitalizations for heart failure at 2 years vs. those who received placebo;
- may prevent migraine, may increase sperm motility and may modulate expression of insulin, lipid and inflammatory markers in patients with polycystic ovary syndrome; and
- reduces moderate to severe cancer-related fatigue in patients with breast cancer when taken with Lcarnitine.
Fish oil: May reduce the risk for breast and colon cancers and may improve immune response in patients needing colorectal cancer resection.
- reduces chemotherapy-induced nausea and vomiting;
- boosts gastric emptying in healthy volunteers;
- shows moderate effectiveness in treating osteoarthritis, chronic low back pain and exercise-related muscle pain; and
- may treat menstrual cramps at the onset of the menstrual cycle.
Studies have shown green tea lowers fasting glucose and HbA1C levels, according to a presentation at the American College of Physicians Internal Medicine Meeting.
- lowers fasting glucose and HbA1c levels;
- may reduce LDL and total cholesterol and improve BP (especially at levels of 130 mm Hg or higher); and
- effective and well-tolerated against external perianal and genital warts.
- may increase survival in patients with heart failure;
- may improve insulin sensitivity in both healthy adults and those who have diabetes;
- may suppress bone turnover in women who have gone through menopause; and
- improves objective measures of airway resistance and subjective measures of asthma control in adults with asthma.
Red yeast rice: Reduced cholesterol levels in patients with higher lipid counts and lipid proteins.
- produces analgesic and anti-inflammatory effects in clinical trials;
- shows potential as a standalone analgesic or part of an opioid, NSAID- or acetaminophen-sparing strategy; and
- treats osteoarthritis.
Vitamin D is recommended by at least two different medical societies to help prevent falls and fractures.
- recommended by The Endocrine Society for adults older than 65 years to prevent falls and fractures (800 IU/day); and
- recommended by The American Geriatrics Society for adults older than 65 years to prevent falls and fractures (1,000 IU/day).
Hui cautioned that these and other similar products can cause adverse events in some patients.
“Occasionally, taking some of these herbs and supplements with prescription medications can be dangerous, so it is very important for the physician to be open-minded, wary and not ignore patients who take them, because then the patient may not be as forthcoming in the future,” he told Healio Primary Care Today.
Physicians should visit the NIH’s Office of Dietary Supplements webpage for more information on the herbs and supplements before discussing them to their patients. – by Janel Miller
For more information: NIH. Office of Dietary Supplements. https://ods.od.nih.gov/. Accessed April 15, 2019.
Hui K. “Integrating east/west medicine into your practice.” Presented at: American College of Physicians Internal Medicine Meeting; April 11-13, 2019; Philadelphia.
Disclosures: Hui reports no relevant financial disclosures.