Herbal remedies

HERBAL REMEDIES:

• Regarding herbal and complementary treatments, although some patients find these helpful, the quality, purity, constituents and safety of these products may be unknown.
• Examples of herbal treatments include St John's wort, pollen extract, black cohosh, wild yam, dong quai, evening primrose, maca, ginseng, red clover, isoflavanes, ashwaghanda, chasteberry and milk thistle.
• The BMS recommends that if a herbal treatment is chosen, a patient should look for the Traditional Herbal Registration (THR) stamp which shows that the product has been registered by the MHRA.

CAUTIONS:

• Black Cohosh can be associated with major adverse effects such as liver injury, constipation, arrhythmia, weight gain and abdominal cramps. Black Cohosh interferes with Tamoxifen activity.
• Isoflavones, red clover and black cohosh are not recommended for breast cancer survivors by any of the International bodies.
• NICE says do not offer soy (isoflavane), red clover, black cohosh, vitamin E or magnetic devices to treat vasomotor symptoms in women with breast cancer.
• St Johns Wort has the potential for drug interactions, including to Tamoxifen, anticoagulants and anticonvulsants. In addition, NICE says that although there is some evidence that St Johns Wort may help relieve vasomotor symptoms, there is uncertainty about the appropriate dose, persistence of effect and variation in the nature and potency of preparations.
• Cannabinoids are not recommended.

PHYTOESTROGENS:

• Phytoestrogens can form a large part of dietary intake in certain ethnic groups, and these patients can be advised to continue what is considered to be normal levels of dietary intake.
• Most studies evaluating effectiveness of phytoestrogens are of poor quality.
• Data on phytoestrogen safety and survival benefits in breast cancer patients are inconsistent and as they are known to have oestrogen like activities, herbal supplements containing phytoestrogens are not recommended.