MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

I have often pointed out that, in contrast to ‘rational phytotherapy’, traditional herbalism of various types (e. g. Western, Chinese, Kampo, etc.) – characterised by the prescription of an individualised mixture of herbs by a herbalist – is likely to do more harm than good. This recent paper provides new and interesting information about the phenomenon.

Specifically, it explores the prevalence with which Australian Western herbalists treat menstrual problems and their related treatment, experiences, perceptions, and inter-referral practices with other health practitioners. Members of the Practitioner Research and Collaboration Initiative practice-based research network identifying as Western Herbalists (WHs) completed a specifically developed, online questionnaire.

Western Herbalists regularly treat menstrual problems, perceiving high, though differential, levels of effectiveness. For menstrual problems, WHs predominantly prescribe individualised formulas including core herbs, such as Vitex agnus-castus (VAC), and problem-specific herbs. Estimated clients’ weekly cost (median = $25.00) and treatment duration (median = 4-6 months) covering this Western herbal medicine treatment appears relatively low. Urban-based women are more likely than those rurally based to have used conventional treatment for their menstrual problems before consulting WHs. Only 19% of WHs indicated direct contact by conventional medical practitioners regarding treatment of clients’ menstrual problems despite 42% indicating clients’ conventional practitioners recommended consultation with WH.

The authors concluded that Western herbal medicine may be a substantially prevalent, cost-effective treatment option amongst women with menstrual problems. A detailed examination of the behaviour of women with menstrual problems who seek and use Western herbal medicine warrants attention to ensure this healthcare option is safe, effective, and appropriately co-ordinated within women’s wider healthcare use.

Apart from the fact, that I don’t see how the researchers could possibly draw conclusions about the cost-effectiveness of Western herbalism, I feel that this survey requires further comments.

There is no reason to assume that individualised herbalism is effective and plenty of reason to fear that it might cause harm (the larger the amount of herbal ingredients in one prescription, the higher the chances for toxicity and interactions). The only systematic review on the subject concluded that there is a sparsity of evidence regarding the effectiveness of individualised herbal medicine and no convincing evidence to support the use of individualised herbal medicine in any indication.

Moreover, VAC (the ‘core herb’ for menstrual problems) is hardly a herb that is solidly supported by evidence either. A systematic review concluded that, although meta-analysis shows a large pooled effect of VAC in placebo-controlled trials, the high risk of bias, high heterogeneity, and risk of publication bias of the included studies preclude a definitive conclusion. The pooled treatment effects should be viewed as merely explorative and, at best, overestimating the real treatment effect of VAC for premenstrual syndrome symptoms. There is a clear need for high-quality trials of appropriate size examining the effect of standardized extracts of VAC in comparison to placebo, selective serotonin reuptake inhibitors, and oral contraceptives to establish relative efficacy.

And finally, VAC is by no means free of adverse effects; our review concluded that frequent adverse events include nausea, headache, gastrointestinal disturbances, menstrual disorders, acne, pruritus and erythematous rash. No drug interactions were reported. Use of VAC should be avoided during pregnancy or lactation. Theoretically, VAC might also interfere with dopaminergic antagonists.

So, to me, this survey suggests that the practice of Western herbalists is:

  1. not evidence-based;
  2. potentially harmful;
  3. and costly.

In a nutshell: IT IS BEST AVOIDED.

45 Responses to Individualised (traditional) herbalism: best avoided, in my view

  • Good day to you, Dr. Ernst!

    I think that you have cherry-picked a paper in order to condemn a natural therapy, i.e. herbalism, which may not work in every instance with every illness, but which works effectively nonetheless. Type in “Herbs” at http://www.nutritionfacts.org for research papers to this effect.

    I use herbal mixtures in certain instances when a doctor would prescribe a Western medicine, and they may take as little as 15 minutes to deal with the (minor) problem.

    It would be easy to use the same strategy you have used of choosing an instance where a Western medicine does not work and then state at the end as you have above: “In a nutshell: IT (i.e. Western Medicine) IS BEST AVOIDED.”

    The more you go after every kind of natural medicine, the more you run the danger of being seen as a corporate defender of Big Pharma.

    I think I hear the thunderous roar of your now upset supporters approaching, so I’ll leave quickly now.

    My warmest regards,

    Peter

    • please show us the trials of individualised herbal therapy that support what you are stating.
      I linked my post to the evidence that I am quoting, so please do the same, if you think I cherry-picked.

    • I cited 3 systematic reviews; FYI these are papers based on the totality of the evidence; and you accuse me of ‘choosing an instance’ – makes no sense at all.

    • and they [herbal mixtures] may take as little as 15 minutes to deal with the (minor) problem.

      The only plant-derived substance that I know of that takes effect within 15 minutes of ingestion is ethanol – although I doubt that sobriety comes under your definition of ‘a minor problem’.
      Unless, of course, you’re talking about this all too common problem of hyperpecuniosis, something that alternative practitioners are always on the lookout for. In that case, providing the patient with a herbal remedy from your own apothecary may have an even faster effect, particularly on the leathery structure known as ‘the wallet’.

  • Peter:
    Logical fallacies:
    (i) Red herring: There is no such thing as ‘Western medicine’ – only medicine (drugs in this context) which have been demonstrated to work by plausible reproducible scientific methods.
    Those which do not meet this criterion are not ‘medicine’ by definition.

    (ii) Straw man: ‘Big Pharma’. Some firms which use pharmacological methods may be crooks and frauds, and many are deserving of critique (which they receive from many doctors and commentators) – but modern firms have moved on from anachronistic methodologies, embraced science and advanced the development of drugs with as many beneficial effects, and as few side-effects as possible.

    None of ‘us’ defend bad practice.
    ‘Big Quacka’ offers no reputable practice at all.

    (iii) False dichotomy:
    Of course herbs have effects – they contain powerful compounds from which modern preparations have been derived – but the question is not black and white, but is: “To what extent does the preparation in question contain known compounds of known effects (beneficial or harmful)?”
    ‘Herbal preparations’ have yet to answer this question – which is why they are not medicines.

    (iv) False belief that there exists in the immanent universe ‘vital forces’ which, though unidentified, have an effect on the health of living things.

    More work needed Peter.
    It is a tough road I acknowledge, but worth it as the alternative is, well, alternative.

  • On a day when there is serious debate in the UK at the highest levels as to how quickly the law can be changed to allow medical cannabis to help those with epilepsy where this *might* be the most appropriate treatment, this article- saying nothing in particular apart from predictably AVOID!- seems rather outdated & totally out of touch with the incredible possibilities that herbal medicine *might* provide.

    • are you sure you have understood it?
      had the epileptic boy fallen into the hands of a traditional herbalist, he could well be dead by now.

  • I’m someone who has suffered epilepsy since I was 2 and have trailed most pharma prescriptions with varying effectiveness but the side effects outweighed the results as one of them made me deeply depressed and considering suicide since I did not understand what was happening to me. Through meeting a naturopath by chance who also made cbd oil in addition to tinctures and performed Chinese therapy on me such as acupuncture I was able to come off that horrible medication slowly and now on only one medication supported by this plant medicine and alternative therapies I have a higher quality of life and fewer seizures than before.
    I cannot speak for all people who have leaned towards plants after being disillusioned by pharmaceutical medication regarding effectiveness but I can speak from personal experience and say that she has change my life….medical cannabis works, herbs work and alternative therapies help with the management of my life-long condition.

    I’m not here to convince anybody of anything just to share my story as the statement above felt ill informed and personally offensive.

    • Sorry if you’re offended by good evidence.

      • Alan

        You are the one Sir, with your eyes and ears closed.

        When you refute somebodys personal testimony, you are calling them a liar.

        Emily said:
        “the side effects outweighed the results as one of them made me deeply depressed and considering suicide”

        “I was able to come off that horrible medication slowly and now on only one medication supported by this plant medicine and alternative therapies”

        “I have a higher quality of life and fewer seizures than before.”

        “say that she has change my life….medical cannabis works, herbs work and alternative therapies help with the management of my life-long condition.”

        So do you actually recommend Emily accepting some other “evidence” than what has already proved NOT to work for her ? In fact to be detrimenta to her life.

        Would you choose for yourself failure over success ? I don’t think so.

        • @RG

          Noone is claiming the woman is a liar. She may well be one of the sadly few who benefits from ingredient(s) in the CBD oil but acupuncture is difinitely not helping ayone.
          Most likely other factors are behind the improvement she experiences.
          Please try to read this article and understand how anecdotal evidence is useless.

          • Bjorn

            Ahhh yes, how convienient. If a pateint benefits from alllpathic medicine, it gets accepted, and it proves the science. If someone benefits from homeopathy, the healing gets explained away as a result of “other factors”.

            Pure BS

            Emily stated that ” herbs work and alternative therapies help with the management of my life-long condition.” … she has been verifying the “science” of homeopathy vs. modern medicne since she was an infant…. PLEASE !

            Don’t attempt to say that she is an anomaly, There are thousands and thousands of such testimonies.

          • the plural of anecdote is, however, still not evidence

          • As clever and useful as the “the plural of…” phrase is, evidence from studies is only one tool amongst (hopefully) many. Collecting multiple (plural) anecdotes is another tool…sometimes more useful than well done studies.

            As dangerous as it is to confuse anecdotes with evidence, it’s possibly more dangerous to confuse evidence with the skillful practice of medicine.

          • “Collecting multiple (plural) anecdotes is another tool…sometimes more useful than well done studies.”
            give us an example where this has proven to yield more helpful results for finding effective therapeutic solutions.

          • Mr Edzard and friends

            What you call “science based evidence” is actually farce. You pound the table here everday as though you have something so real and factual…. in reality, the joke is on you. You science based studies mean little to the paitent. I don’t care what the studies show, in a large way, many meds won’t work any better than placepos, and many millions of foks like me have expereneced this fact. Yes, there are some that function to assist the patient in a beneficial way.

            This is your Scinece Based Medicine (in a nutshell)
            https://scholarlycommons.law.wlu.edu/cgi/viewcontent.cgi?article=4358&context=wlulr

            “In short, there is no legal efficacy standard. Although the need
            for statistical significance might imply that new drugs must at
            least be better than nothing (zero efficacy), there is no minimum
            quantum of difference from zero that is required, making the
            standard illusory in a way reminiscent of how mathematics
            describes .9¯ (point nine repeating) as exactly equal to 1. The
            influencing of trial results by drug sponsors, suggested by studies
            that demonstrate inconsistent comparative efficacy results that
            correlate with the study sponsor, can make whatever tiny
            quantum of efficacy difference that may be required entirely
            disappear. Making highly effective drugs may be complex,
            expensive, and difficult, and the law must be sensitive to the
            significant technical challenges drug companies face. At the same
            time, greater awareness of the illusory efficacy standard is badly
            needed in order to enable physicians, patients, governments, and
            society at large to make rational choices about the risks they are willing to undertake and the medicines for which they are willing
            to pay. “

          • I know you don’t care what studies show. luckily there are many people who are not quite as regressive as you.

          • “give us an example where this has proven to yield more helpful results for finding effective therapeutic solutions.”

            Certainly. In your post about fibromyalgia and massage therapy: https://edzardernst.com/2014/03/is-massage-therapy-effective-for-fibromyalgia/,
            “The authors conclude that ‘massage therapy with duration ≥5 weeks had beneficial immediate effects on improving pain, anxiety, and depression in patients with FM.’”

            You conclude the post with “Therefore the conclusion for those who suffer from FM might well be that massage therapy is worth a try.”

            ‘Massage therapy’ is a pretty broad term, and a blanket recommendation for massage therapy can do a lot more harm than good. The nine trials were different in many respects, including the type of massage employed. A meta-analysis usually has to lump fairly diverse studies together and therefore will not give a massage therapist the type of specific information they would need to treat fibro patients. The nine individual trials didn’t provide the specific information either.

            Based on multiple anecdotes, massage therapists get information about how fibro patients respond to different types of massage, pressure, duration, specific techniques, etc – the specific information needed to work with fibro patients. In this case, the anecdotes are much more useful.

          • “Collecting multiple (plural) anecdotes is another tool…sometimes more useful than well done studies.”
            give us an example where this has proven to yield more helpful results for finding effective therapeutic solutions.
            AND YOU GIVE ME THE EXAMPLE OF A SYSTEMATIC REVIEW OF RCTs?
            you are kidding me, aren’t you?

          • I think you’re kidding me, Edzard. It included nine individual trials. None of the nine individual trials didn’t provide useful specific information. Which is why I said “The nine individual trials didn’t provide the specific information either.”

          • “Collecting multiple (plural) anecdotes is another tool…sometimes more useful than well done studies.”
            give us an example where this has proven to yield more helpful results for finding effective therapeutic solutions.

          • Well, there’s always massage therapy for fibromyalgia patients. I read a blog post a while back that linked to 9 different studies. None were as useful as anecdotes collected from bodyworkers all over the world who treat fibro patients.

            In that particular case, the studies aren’t therapeutically useful. But the collected anecdotes are quite helpful.

          • “Collecting multiple (plural) anecdotes is another tool…sometimes more useful than well done studies.”
            give us an example where this has proven to yield more helpful results for finding effective therapeutic solutions.

          • @jm

            Forgive me for horning in on a near-private jm/Edzard conversation. But I regard you, jm, as this blog’s resident gadfly, and you usually manage to say something that makes good sense. But on this occasion, I just can’t understand where you’re coming from.

            this comment prompted Edzard to respond “give us an example where [multiple anecdotes] has proven to yield more helpful results for finding effective therapeutic solutions.” You answered by referring to an earlier blog post which described a systematic review of RCTs of “massage therapy” for fibromyalgia.

            I’ll translate Edzard’s first response for brevity: systematic reviews are not multiple anecdotes.

            But you persisted that “The nine individual trials [in the systematic review] didn’t provide the specific information either.” Well, the nine individual trials (Column 7 in Table 1 of the systematic review) were characterized as follows: (1) Swedish massage (30 min/10 sessions), (2) Connective tissue massage (15 sessions), (3) Swedish massage (45 min/10 seconds), (4) Swedish massage and Shiatsu (30 min/10 session), (5) Massage Therapy (30 min/12 sessions), (6) Therapeutic touch (25 min/1 session), (7) Connective tissue massage (20 min/15 sessions), (8) Chinese traditional massage (60 min/20 sessions) and (9) Massage myofascial therapy (90 min/20 sessions). I agree that’s a lot of different massage types, durations and sessions; and it’s up to the reader to know what each type of massage consists of in specific terms.

            But the bottom line is the Forest plot (Fig. 3) in which, with two exceptions,all of the massage therapies had a small degree of positive effect on all four outcome measures (not all the outcomes were measured in all of the trials). So, despite your contention that “a blanket recommendation for massage therapy can do a lot more harm than good”, the paper surely indicates that any kind of attention involving massage of any kind can have a positive effect on patients suffering from fibromyalgia.

            (I’m sorry, but I can’t resist commenting: in other studies a very high level of adherence to the Catholic faith was observed among successive Popes and undergrowth sampling in woods revealed considerable amounts of faecal material from bears.)

            Do you honestly not comprehend what Edzard means when he repeats his response:

            “Collecting multiple (plural) anecdotes is another tool…sometimes more useful than well done studies.”
            give us an example where this has proven to yield more helpful results for finding effective therapeutic solutions.

            If not, you’re not the blog gadfly I thought you were.

          • @RG

            The evidence is mounting

            Evidence of what? The medical ignorance of those who wrote the silly and in many cases erroneous listicles you refer to. The only evidence your link provides is of your own ignorance. Or are you trying to give us a good laugh perhaps?

          • Correction: In my remark above, I omitted a ?-mark after “…listicles you refer to”.

          • Frank,

            No worries about horning in – we’ve quickly reached the copy/paste stage. So forgive me if I’m telling you things you already know – I’m not sure how familiar you are with massage and fibromyalgia. If you’re familiar, skip to the last paragraph.

            You listed off the different types of massage used in the nine trials, and said “and it’s up to the reader to know what each type of massage consists of in specific terms.” Here’s the problem with that:

            These two are incredibly vague categories that could include a lot of different things, possibly the same things, possibly not. No way to know unless they tell us:
            – Connective tissue massage
            – Massage myofascial therapy

            And then of course one was the even more vague:
            – Massage Therapy

            And one that I’m not really familiar with:
            – Therapeutic touch

            That leaves us with the remainders:
            – Swedish massage
            – Swedish massage and Shiatsu
            – Chinese traditional massage

            The three remainders have almost infinite variables (amount of pressure, how & how long one particular area would be worked, direction, etc). You could get a massage that focused on muscle. Or sinew. Or fluid. And still fall under the category of ‘Swedish massage’, or ‘Chinese traditional massage’. All of these things are left unmentioned in the trials, yet quite relevant to treating fibro patients.

            Please correct me if I’m wrong – I would love those relevant details regarding those trials. But as far as I can tell, the info from the trials: various unspecified, but accurately categorized, massage was done. Some of it may have helped. That’s nice. It really is. But it’s not a lot of help if you’re a massage therapist.

            On the other hand, massage therapists actually share information about treating fibro patients. And of course they are anecdotes. Thousands of them. Fibro folks are tricky to work on, so massage therapists actually share info on how fibro patients respond to specifics like pressure, time, frequency, tissue, techniques, etc. And of course ‘fibro patients’ are quite variable as well. For instance, fibro folks who flare up with mild exercise require different specifics (in terms of bodywork) than fibro folks who flare up with too much inactivity. Bodywork that works well for one type can flare up the other type, and vice versa. That type of thing.

            If you’re not familiar with fibro patients, a flare up can range from mild flu-like symptoms to being bedridden with pain for a couple of weeks or more. The wrong kind of bodywork for the particular fibro patient can trigger a flare up. That’s partly what I mean by ‘can do a lot more harm than good’. And why I disagree with the whole “any kind of attention involving massage of any kind can have a positive effect on patients suffering from fibromyalgia” thing. I hope you can see why.

            You asked “Do you honestly not comprehend what Edzard means when he repeats his response:” Nope, I honestly don’t. It seems pretty straightforward to me: the nine trials – not very useful for finding effective therapeutic solutions. Thousands of anecdotes from massage therapists working with fibro patients and attempting to avoid flare ups – useful. For example.

          • Sorry, jm, you’re completely missing my point. Please re-read my paragraph about the Forest plot. It didn’t matter what massage technique was used: they all had at least small positive effects on the four outcome measures, with just two exceptions, regardless of the massage details.

            Richard Rawlins has commented a few times that we all enjoy benefit from a ‘good massage’. By implication, that’s regardless of “amount of pressure, how & how long one particular area would be worked, direction, etc”. The detail may be of great interest to those of you who take the specific effects and benefits of massage seriously; but even for fibromyalgia, where you assert that “The wrong kind of bodywork for the particular fibro patient can trigger a flare up” the systematic review suggests otherwise.

            The data in the review possibly confirm that benefits of any kind of massage probably come more from the personal attention and TLC the masseur offers than from the details you and your fellow “therapists” share anecdotally. With ‘tricky’ patients like those suffering from fibromyalgia, the design of rigorous trials to explore the impact of massage details on outcome, thus confirming your conviction of their importance, ought to be straightforward. Why don’t you and your colleagues put together a convincing application for funding to undertake a proper study instead of relying on anecdote?

          • @Bjorn

            You said:
            “Evidence of what? The medical ignorance of those who wrote the silly and in many cases erroneous listicles you refer to. The only evidence your link provides is of your own ignorance. Or are you trying to give us a good laugh perhaps? ”

            On the contrary, If you don’t believe pharma pills have serious side effects, the laugh is on you.

            No Bjorn, the link I provided is no real evidence. We all know anyone can write anything and post it on the WWW,there is not standard of truth or reality. The link is just some EVIDENCE that the media and the public are becoming more aware of the dangers. The evidence is in the factual scientific, AND anecdotal evidence compiled over years of study by pharma, practitioners and patients.

            It was over twenty years ago that my MD was the one that informed me that HE wanted to withdraw my blood to look for adverse effects of Motrin/Ibuprofin use. Had he not, and I continued prolonged use, it is likey that eventually my anecdotal evidence would have led me back to my doctor with a real life disease from the medicaton usage. You see how that works ? The problem is that sometimes, once the evidence is anecdotal, the damage has already been done and can’t be reversed.

            https://www.sciencedaily.com/releases/2005/01/050111123706.htm
            “Everyday more than 30 million people take over-the-counter and prescription NSAIDs for pain relief, headaches and arthritis. Currently, there are about 20 NSAIDs available by prescription only. Many, including ibuprofen, naproxen, aspirin and ketoprofen are available over the counter.* Although NSAIDs and aspirin provide great benefit in terms of pain relief and cardioprotective effects, there is an increased risk of gastrointestinal complications ranging from stomach pain to ulcers. Moreover, these drugs are responsible for severe and potentially deadly gastrointestinal problems. Each year, the side effects of long-term NSAID use cause nearly 103,000 hospitalizations and 16,500 deaths. More people die each year from NSAIDs-related complications than from AIDS and cervical cancer in the United States.” READ THAT STATEMENT AGAIN !
            Stats are in the USA only. Yes, deaths are both factual and scientific evidence, the ancedote remains for the family to tell. They say that a dead man can not give an anecdote. Wrong, a dead person is an anecdote.

            Other reading:
            http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.886.2020&rep=rep1&type=pdf

          • Frank,

            Yikes. You’re right, I completely missed your point. I really expected better of you.

            “It didn’t matter what massage technique was used: they all had at least small positive effects…”
            I guess if you’re after small positive effects, this study is quite useful :). Way back in grade school sciene classes, we were taught to eliminate or control as many variables as possible when doing any kind of experiment. I see that you don’t subscribe to that theory.

            “The wrong kind of bodywork for the particular fibro patient can trigger a flare up” the systematic review suggests otherwise.”
            The suggestion of the systematic review doesn’t match reality. Don’t take my word for it. Ask around. There’s no shortage of fibro folks.

            “The detail may be of great interest to those of you who take the specific effects and benefits of massage seriously”
            Yes, I have a weird interest in not causing folks to be bedridden with pain for a couple of weeks. Go figure – everybody needs a hobby.

            And speaking of hobbies, keep in mind that Richard’s hobby is studying how people can be fooled. “Richard Rawlins has commented a few times that we all enjoy benefit from a ‘good massage’.” Richard also thinks that acupressure involves needles, because ‘acu’ is part of the term (https://edzardernst.com/2018/05/exeter-university-offers-bogus-treatments-but-is-not-in-a-position-to-actively-condone-the-effectiveness-of-such-treatments/#comment-102343).

            “Why don’t you and your colleagues put together a convincing application for funding to undertake a proper study instead of relying on anecdote?”
            And what would the benefit of that be? How would that be more useful than thousands of conversations about treatment details over the past 20 years? Over that time period, the understanding of fibro has changed quite a bit, meds are different, treatment strategies have evolved…seriously, how would a proper study be more than just a nostalgic snapshot on an ever changing timeline?

            Again, this is an example of how anecdotes yield more helpful results for finding effective therapeutic solutions.

          • Your attempts at smartly vilifying medicine are painfully inept, RG. Of course medicines have side effects, everyone knows that. They have side effects because they work and doctors know that and take it into account. Homeopathic remedies for example, have no side effects because they have no effects. The fools who collected scare stories about medicines are not revealing any secrets and many of the claims are pure nonsense.
            And you should look up the meaning of the word ‘anecdote’, you are evidently not understanding that either.

          • My attempts at vilifying medicine are NOT inept, they are true, and you know it. On the contrary, pharma medicine is worthy of being vilified. Neither Physicians nor pharmaceuticals inform patients correctly that the meds they prescribe long term are slowly killing them.

            “The fools who collected scare stories about medicines are not revealing any secrets and many of the claims are pure nonsense.”
            Bjorn, I already informed you that it was my physician that alerted me to the dangers of pills, so why is it nonsense ? Meds that are presumed by millions to be safe, yet Motrin is killing people by the thousands. What do you think is happening with prescription meds that are more toxic and more dangerous than Motrin ?

            People are dying daily in the name of allopathic medicine, and the pills are only on of the causes.

          • @RG

            As so often, the fact that people die in aircraft accidents does not validate a belief in magic carpets.

          • Lenny

            That is not a defense. You continue to resort to the cliche when you don’t have a better answer.

            The truth is that you can not die from flying if you don’t get in the airplane. Don’t eat the meds.

          • are you competing for the stupidest comment of the month?

          • @RG

            Tell that to the people on the ground who have been killed when aircraft have crashed. Hasn’t happened with magic carpets.

          • I already informed you that it was my physician that alerted me to the dangers of pills, so why is it nonsense

            Good doctor. Tell her from me to continue taking good care of you. I hope you won’t give her too hard time when she needs to prescribe powerful medicine for you with many side effects. As we all know, most medicines (real ones that is) are dangerous, not the least when they are used wrongly. Good doctors know how to use medicines with care, when to look for those risks and when and how to monitor the patient for signs of danger when needed. They also know how to inform and advise their patients.

          • Bjorn

            “Good doctors know how to use medicines with care, when to look for those risks and when and how to monitor the patient for signs of danger when needed. They also know how to inform and advise their patients.”

            That’s laughable in my case. My physician changed my prescription from Motrin to Vioxx, which gave me a severe heart attack. Fortunately for me, I stopped taking it before I even realized it was the Vioxx responsible for my change. Regardless, most all NASID have similar effects on the digestive system…. don’t they. So what was he really doing checking my blood ?…just poking around. Changing one NASID for another was no good solution to any problem possibly revealed in my blood. He was looking for a reason to prescribe the latest med that carried a significanly higher cost. He never gave me any results, informed me of anything, nor advised me of anything… just changed the prescription to a much more expensive one. Whatta great guy ! The point is, doctors know this stuff is deadly, it’s a business Bjorn… and you know it.

          • @RG: “It’s a business”
            So is the totality of quackery. That includes herbalism and homeopathy of course.

            Your anecdote[sic] tells an unfortunate story, I am sure, but is in no way generalisable to medicine and doctors in general, especially medicine in the “first world” outside the USA. There is also no way of telling whether your heart problem was due to the drug, Vioxx was discontinued because the producer was dishonest, not because of the well known AE’s of NSAID’s. I am trying to tell you that ALL drugs have inherited risks and potential adverse effects. That does not mean they should not be used!
            Homeopathy and many other forms of quackery have no side effects because they have no effects, whatsoever. That does not mean their use is without risks. It also means they should not be encouraged or sold.

            I can tell you two anecdotes that in some ways counteract your anecdote.
            1.
            I have taken an NSAID for decades. It has made my life bearable and kept me working. I am well looked after and monitored and I am not worried about the risk/benefit ratio of taking an NSAID. I know medicine and my doctors have also been careful to discuss risks vs. benefit. I have tried being without NSAID’s, I have tried other means, including all the food supplements supposed to help OA. Useless stuff and research has not shown otherwise. I can add that I have even tried acupuncture, in the form of frequent phlebotomies that did not help any with the arthritis 😉 .

            2.
            My grandfather died healthy at 92. he took an even more dangerous NSAID for a large part of his life and often “overdosed” on the stuff because. He was a farmer with severe osteoarthritis. His knees were bone-to bone. The NSAID made it possible for him to work hard well into his old age.

            I win, 2 anecdotes to 1
            😀

    • Dear Emily,

      You have my full sympathy for your life blighted by epilepsy. I’m pleased for you that you’re now much improved.

      When you say “medical cannabis works, herbs work and alternative therapies help with the management of my life-long condition”, you presumably realize that epilepsy, particularly when its onset is in early childhood, often tends to become less severe in adulthood? So how do you know for sure that the things you sincerely believe have helped you really did anything special? I agree they might have done, but demonstrating for sure that these things ‘worked’ takes something more than personal testimony.

  • Information often spreads around based on personal testimony and recommendation. That isn’t great I agree but many of us have given up on your precious evidence based medicine after bitter experience and disillusionment. When the anecdote is mine then that becomes my personal evidence. Relentless of bleating of ‘evidence good anecdotes bad’ from people on here can’t change anything.
    Plenty agree with me otherwise there wouldn’t be any demand for CAM would there?

  • How does a herbalist assess disease for evidence based studies.. That sounds like taking an astrologer out at night and asking them what tide it is.

    Someone please rub my back.

  • Lenny

    You’re way off topic, and saying just stupid things

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