| Herbal medicines and other natural products (including vitamins and
products of animal origin) are becoming more important to health care
professionals as their patients are using them in increasing numbers — and
not only are patients more likely to admit the fact, but they may also
require reassurance on the general advisability (or not) of doing so.
This can put the practitioner in a difficult position if they do not
know enough about these products, and because this omission is now becoming
recognised, new books such as this are springing up to fill the gap.
This book assumes that the reader wishes to know what is available for
treatment of a particular disorder rather than detailing information
on a specific herb or product. It is therefore divided into therapeutic
areas, such as dementia, erectile dysfunction, migraine, osteoporosis
and others. However it focuses almost exclusively on the US situation,
with most references relating to US websites and resources, and omits
some standard texts from the UK and Europe.
This US-centric approach provides some interesting insights to health
care problems there: for example, under “Osteoporosis” there
is a discussion of a situation where a patient cannot afford Actonel
(risedronate sodium) so needs an alternative — which would be unthinkable
in the UK. (In fact it would be just the opposite: the patient would
pay the full cost for the herbal treatment, but receive the risedronate,
subsidised or free, on the NHS.)
Individual products, and the evidence — where available — are
discussed in the therapeutic sections, so for example under “Dementia”,
ginkgo, huperzine A and vitamin E are covered. Under “Osteoarthritis”,
chondroitin, glucosamine, fish oil and others are mentioned, but not
other anti-inflammatory agents such as bromelain, devil’s claw,
turmeric, willow bark or ginger. In the section “Osteoporosis”,
ipriflavone and soya are included, but no mention of other phytoestrogen-containing
herbs such as red clover. There is no chapter on urinary tract infections,
which would include the popular herbs cranberry and bearberry.
There are several other herbs and supplements which are used widely here
but perhaps not in the US, and they have been omitted. These include
chamomile, pelargonium, lemon balm, valerian and (surprisingly, since
it is an American species), goldenseal. More importantly, any real discussion
of issues of quality and herb-drug interactions is missing, and botanical
names are not indexed.
It is a well-written and well-referenced text, and although aimed at
health care professionals, the general tone seems more appropriately
directed to the interested lay person or student. For example, the self-assessment
questionnaire at the end of each section would be useful for students,
but is unlikely to be appreciated by a busy professional who
wants some background information or just needs to know the answer to
his or her questions. Having said that, the book is easy to read and
navigate, and has a refreshingly pragmatic approach, with the key points
being particularly useful.
Elizabeth M. Williamson (professor of pharmacy and director of practice
at
the school of pharmacy, University of Reading)
|
The
Pharmaceutical Journal