Before You Take That Chinese Medicine … ; MEDICAL NOTES BY DR MARK PORTER Health Fitness

THE Committee on Safety of Medicines (CSM) has written to every doctor in the country warning them about the potential dangers of traditional Chinese medicines after some have been found to contain potentially lethal toxins and banned, prescription-only drugs.

Chinese medicine has become increasingly popular in the UK in recent years and clinics are now a familiar sight on most high streets.

Treatments are typically dispensed as a collection of unlabelled mixed herbs, to be brewed in water and drunk as “tea”, with most patients having no idea what they are actually taking – an ignorance that all too often appears to be shared by the practitioner.

Here is a list of some of the concerns highlighted by the CSM.

. Use of the wrong herb.

Aristolochia can cause cancer and kidney failure and is sometimes confused with other, safer herbs. At least 70 cases of kidney failure occurred in Belgium when aristolochia was accidentally substituted for stephania in a herbal slimming preparation. Since then, the herb has been banned, but there is plenty of evidence that it is still being used, and UK authorities seized 90,000 aristolochia tablets earlier this year.

. In March, the Medicines and Healthcare Products Regulatory Agency (MHRA) was notified about a case of liver failure in a patient who had taken a remedy dispensed from a Chinese clinic in the West Midlands. The investigation is ongoing but the liver damage is thought to have been due to a derivative of a prescription-only slimming drug (Fenfluramine) that was withdrawn globally in 1997 due to safety fears. And the MHRA believes that the product is included in at least four other “natural” herbal slimming remedies available in the UK.

. In December 2003, analysis of the Chinese herbal product, fufang luhui jiaonang, found that it contained very high levels of mercury – more than 10 per cent, by weight. The product was available from 36 Chinese medicine clinics across the country, and there is evidence to suggest that it was still being dispensed as recently as April this year.

Since 2002, the MHRA has investigated 17 suspected cases of illegal inclusion of prescription-only steroids in “herbal” eczema creams.

Other remedies have been found to contain potentially infective ingredients, such as bats’ droppings and human placenta, plus worrying levels of arsenic.

To be fair, these incidents pale into insignificance when compared to the number of adverse reactions to orthodox medicines that the CSM and MHRA have to deal with on a weekly basis, but they are likely to be the tip of the iceberg. If you are considering using herbal remedies, then follow the tips below.

. Consult a properly qualified herbalist – preferably a member of the National Institute of Medical Herbalists. Visit www.nimh.org.uk to find your nearest practitioner.

. If you want to try traditional Chinese medicine, insist on any remedy being fully labelled, with a list of all ingredients and accompanied by proper instructions (in English).

. Walk away from any clinic or practitioner that claims its remedies are natural and, therefore, completely safe – no herb is 100 per cent safe.

. Some herbs can interact with prescribed medicines, so always check with your pharmacist if you are on regular medication.

. If you suspect an adverse reaction to a herbal remedy, report it to your doctor so that he or she can pass the information on to the authorities.

. If you have a liver problem or a history of liver trouble, think twice before taking any herb, and seek medical advice first.

Fears allayed over folic acid

I’VE HAD a number of letters following reports of a link between breast cancer and folic acid. This stems from a study in the British Medical Journal which found that women taking high-dose supplements of the vitamin during pregnancy were more likely to develop breast cancer later in life.

Current advice is that every woman trying to conceive should take a daily folic acid supplement up to the 12th week of pregnancy, in order to reduce the chances of spina bifida and related conditions.

So, should those women who are taking it worry? No, they should not. The dose of the supplements used in the study was more than 12 times that recommended for most women (5 mg, versus 0.4 mg), and the increase in deaths from breast cancer was so marginal that it could well have been due to a statistical anomaly.

Keep taking the pills: the protection far outweighs the risks of a theoretical and unproven link to breast cancer.

Skin lotions as effective as antibiotics

OVER-THE-COUNTER acne treatments are often just as effective as high-dose, long term antibiotics, according to research published in the latest edition of The Lancet.

Researchers from Nottingham and Leeds universities randomly allocated 650 acne sufferers to a number of different treatments and discovered that those using benzoyl peroxide lotion showed similar improvements to those given antibiotics (Oxytetracycline or Minocycline).

Antibiotics are still an important tool in treating acne – particularly in severe cases when there is a risk of scarring – but the study results suggest that we are underusing simpler, safer treatments.

Benzoyl peroxide has a dual action: it removes the top layer of skin, preventing the blockage of oil-producing glands, and it kills surface bacteria. Side-effects include soreness, dry skin and peeling. Ask your pharmacist for more details.

. For more advice and information on acne and its treatment visit www.stopspots.org

So, arthritis bands do work after all

WE DOCTORS are not famed for humility, but it’s time for me to eat some humble pie.

For years, I have refused to believe that magnets help people with arthritis, or that the Pounds 2.5 billion spent worldwide every year on magnetic bracelets does anything other than fatten the wallets of the people peddling them. But the latest evidence suggests that I am wrong.

A study, commissioned by the Arthritis Research Campaign and published in this week’s British Medical Journal, has found that magnets do help alleviate pain from arthritic hips and knees and that it’s not just all in the mind – real ones appear to work better than dummy bracelets (placebos) and the stronger the magnet, the more pronounced the benefit.

The researchers are at a loss to explain their findings – as am I – but, as this is the season of goodwill, I feel duty bound to pass them on.

And that’s as a humble as I get!

. For further details visit www.bmj.com

Home-testing for chlamydia

WOMEN can now buy a home-test kit to find out if they are carrying chlamydia, the sexually transmitted infection. As many as one in 10 British women under the age of 30 now carry chlamydia, most of whom will show no symptoms and are unaware that they have an infection which, if left untreated, could irreversibly damage their fertility.

HomeChec’s new test involves inserting a small swab in the vagina.

Results are given in less than 15 minutes. It costs Pounds 19.99 and you can avoid the embarrassment of a queue in your local pharmacy by ordering it online at www.homechec.co.uk Anyone testing positive should contact their local sexual health clinic and avoid intercourse until both they and their partner(s) have been treated (normally by a single large dose of antibiotics).

Can you stomach the festive season?

IF your stomach is already protesting at the excesses of the festive season, then you are not alone – more people will suffer from indigestion and heartburn in the next week than at any other time of the year. Fortunately, the choice of over-the-counter remedies has never been better, but which ones should you go for?

If you want rapid relief from occasional symptoms, simple antacid tablets and liquids work well enough, but if your symptoms recur with depressing regularity, you need something stronger.

And they don’t come any stronger than Omeprazole – a drug that was only available on prescription until earlier this year. It is much more expensive than other remedies but, as in most aspects of life, you get what you pay for.