Complementary Therapies Warning

stickywicket

Docs at St Barts have warned against using complementary therapies with children after a little boy developed a potentially fatal condition and his parents didn't initially tell the hospital about the supplements because they didn't think it relevant. http://www.bbc.co.uk/news/health-37572771

I think a lot of people come here looking for 'safe' alternatives to what they perceive as dangerous DMARDS. Unfortunately, because the industry is largely unregulated, supplements do not legally have to contain warnings of side effects or dangerous interactions. I wonder how appealing they would be if they did have to.

daffy2

The report's authors are recommending that it becomes routine practice to gather information about any complementary treatments being used as part of the history-taking process for all patients.

Two things struck me about this bit in the report. Firstly, I thought it was already routine practice, in so far as a routine question is 'Are you taking anything else' so is this another casualty of too many patients to see,too little time?
Or is it part of a more difficult situation where doctors are not explicit about needing to know about all non-prescribed treatments/remedies, so the patient limits information supplied, and /or doesn't supply the information because of concerns the doctor will react negatively.
In view of the fact that medics often disagree among themselves as to the efficacy of 'approved' treatments, they would do well to avoid overt disapproval of what their patients may have decided to do on their own initiative. Better to listen, get the whole picture, sort out what has known contra-indications(overdose of VitD in the case the article deals with) and engage the patients in a constructive discussion.
Even though I am more positive about 'alternatives' in general than many on this forum due to personal experience, I am also only too well aware of the downsides and risks.But I have also been on the receiving end of doctors' opinions being presented as facts and used to try and coerce( or even frighten me) me into compliance with their view. The most recent occurred earlier this year when I was treated to a lecture by a consultant about why my request(supported by my GP) for a particular osteoporosis drug was ill-informed and unadvisable. She was basing that opinion on out of date facts about the drug trials, but when I tried to show her the info I had printed out from the relevant advisory body(European Medicines Agency, which NICE uses to inform its decisions, and the Medicines and Healthcare products Regulatory Agency, which among other things administers the yellow card reporting of side effects) , she dismissed it.
Effective communication and building a good workable patient-doctor relationship will do far more to prevent the sort of problems the article raises than simply a knee-jerk 'ban it all' approach.

hileena111

Hi Sticky
I think its a matter of teaching people to tell their GP's EVERYTHING they take rather than warn them against complimentary medicines

Love
Hileena

dreamdaisy

People assume that 'natural' equals harmless not necessarily realising (because they are not medicos) that 'conventional' meds are often based on the same sources. Belladonna is a natural substance, as is opium and we all know what can result if one overdoes them. Then factor in the individual response to individual or combined medications of any kind plus the age of the patient - the potential variables in responses are endless. We all know on here that one man's miracle drug is another's poison.

I think the onus has to lie upon the doctor asking the questions, rather than 'Are you taking anything else?' they should ask if the patient is taking homeopathy pills, St John's Wort, Echinacea, etc., that way they might elicit a (for want of a better word) more honest reply DD

stickywicket

I've thought about this a lot. I don't know the answer but I do know that, if asked this question, more than one person of my acquaintance would not report herbal supplements as they would regard them as completely safe in all circumstances. This might be why the child's parents took 'several days' to give the docs the required info.

Given people's misconceptions, and that such supplements come in a variety of quantities of the active ingredients, would it not be be more advantageous to simply make all supplements bear a warning on the packet on the lines of 'Please let your GP or pharmacist know that you take this product if you are prescribed medication or buying over the counter pills.'

I guess I'm just pre-disposed to dislike an industry which, in my more gullible arthritic years, happily took my money in exchange for empty promises. At least it didn't nearly kill me as it did this little boy but it did grind me down and I'd already been ground down quite sufficiently by the disease.

daffy2

Given people's misconceptions, and that such supplements come in a variety of quantities of the active ingredients, would it not be be more advantageous to simply make all supplements bear a warning on the packet on the lines of 'Please let your GP or pharmacist know that you take this product if you are prescribed medication or buying over the counter pills.'

At present it seems to be a voluntary situation so yes, tightening that up would certainly be a help. The 2 Vit supplements I have both have that advice on, but they are High Street brands, rather than 'niche' brands. The other remedies I have also give that advice but again they are well known brands.
There may still be a communication/opinion issue for the patient with such disclosure if it brings censure as well as straightforward factual advice about toxicity or incompatibility, and GPs in particular may be slow(for perfectly understandable reasons) to pick up revised thinking e.g.on nutritional matters and supplements. I know that osteoporosis patients are still facing problems getting initial blood tests for VitD levels done for instance, and that can push them into self-medicating especially in the early panic-stricken days following diagnosis.