Garden of Healing Articles

Grapefruit-drug interactions and Estrogen Pills

Posted in Q & A Health | Wednesday, March 26th, 2008 | Comments Off

Q & A HEALTH

Grapefruit-drug interactions and Estrogen Pills

By Richard Harkness, Pharm, CDM, Natural Medicines Specialist

March 2008

QUESTION: I read your column on grapefruit-drug interactions and this was the first time I’ve heard about an interaction with estrogen. I take Activella. What are the effects on this drug?

ANSWER: Activella is an estradiol-norethindrone combination prescribed for menopausal symptoms. Estradiol is the estrogen component. Natural compounds in grapefruit block enzymes that normally break down estrogen and certain other drugs for removal from the body.

Most clinical sources rate the grapefruit-estrogen interaction as relatively minor. However, I’d still be wary of this combination.

That’s because orally taken estrogen has high first-past metabolism. This means that most of the drug is broken down in the gut and liver before it reaches the general blood circulation. The recommended dose of estrogen takes this into account.

Grapefruit inhibits drug breakdown in the gut and liver, so it tends to have a more pronounced effect on such drugs. The result is that higher-than-expected amounts of drug make it into the bloodstream. It’s similar to taking an excessive dose.

Increased blood levels of estrogen could boost the risk of harmful blood clots and other adverse effects.

That’s why it’s best to use the lowest effective dose of estrogen.

Grapefruit lovers might consider asking their doctor to prescribe estrogen in the form of a skin patch. In this case, estrogen passes through the skin directly into the bloodstream, bypassing the gut and liver, thus minimizing the grapefruit effect.

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Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books. Write him at 1224 King Henry Drive, Ocean Springs, MS 39564.

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

Email Richard Harkness at: rharkn@aol.com

Osteoporosis & Vitamin D

Posted in Q & A Health | Monday, January 7th, 2008 | Comments Off

Q & A HEALTH

Vitamin D and Osteoporosis in women

By Richard Harkness, Pharm, CDM, Natural Medicines Specialist

January 2008

QUESTION: I’m a 65-year-old female diagnosed with osteoporosis and am at high risk for bone fracture. The doctor found that my vitamin D levels were low. The nurse said I’m to start taking 50,000 IU of vitamin D weekly. I wonder if too many zeros could have been added to the prescription she called to the pharmacy. Wouldn’t this amount be considered toxic?

ANSWER: Not if you’re deficient in vitamin D. The dose you mention is a standard amount used to replenish vitamin D stores and push vitamin D up to optimal levels. Once that’s been done, you could cut back to standard recommended daily doses (600 IU to 1,000 IU), preferably using vitamin D3, the more active form.

__________________

Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books. Write him at 1224 King Henry Drive, Ocean Springs, MS 39564.

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

Email Richard Harkness at: rharkn@aol.com

Lysine for Shingles?

Posted in Q & A Health | Tuesday, October 30th, 2007 | Comments Off

Q & A HEALTH

Lysine beneficial for Shingles?

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

October 2007

QUESTION: I take lysine tablets for cold sores. Would lysine also work against shingles?

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ANSWER: Anecdotal reports suggest that lysine may be beneficial against shingles, but the research has focused on cold sores.

Lysine is an essential amino acid that appears to inhibit the growth of the cold sore virus. It decreases outbreaks and reduces the severity and healing time of cold sores. It’s available in tablet and topical (e.g., cream) form.

__________________

Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books. Write him at 1224 King Henry Drive, Ocean Springs, MS 39564.

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

Email Richard Harkness at: rharkn@aol.com

Suspect Seaweed

Posted in Q & A Health | Tuesday, August 28th, 2007 | Comments Off

Q & A HEALTH

Suspect Seaweed

By C. Claiborne Ray

QUESTION:
I have seen some warnings about hijiki seaweed as a possible source of high levels of arsenic. How alarmed should I be?

ANSWER:
Hijiki, the branched seaweed frequently used in small amounts in salads and garnishes, and other kinds of seaweed do contain more arsenic than other foods, but no arsenic-related health problems have been traced to hijiki in the United States.

But seaweed arsenic is a matter of concern and is under study, along with arsenic levels from known risks like contaminated water and soil. To better assess arsenic levels, the National Exposure Research Laboratory of the Environmental Protection Agency announced plans in 2004 to develop a database of how much of which kinds of arsenic are found in several target foods, including seafood, rice, carrots and apples.

One problem is that food testing efficiency varies widely. For example, for commercially available seaweed and sushi wraps, extraction efficiency ranged from 26 percent to 73 percent, and the testing did not differentiate well between kinds of arsenic found in a sample.

There are many forms of arsenic, both naturally occurring and from mining, industry and pesticides. What is sometimes called fish arsenic has a lower toxicity than other kinds and is rapidly excreted in urine, but seaweed may also contain high levels of more toxic inorganic arsenic.

Source: www.nytimes.com

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Sodium Content: Sea Salt and Table Salt

Posted in Q & A Health | Wednesday, August 1st, 2007 | Comments Off

THE EVERYDAY DIET

Sea Salt and Table Salt; Sodium Content Negligible

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

August 2007

Question: My husband, at age 87, is getting concerned about sodium intake. I would like to know if sea salt has less sodium than processed brands such as Morton table salt.

______________________________

Answer: Both table salt and sea salt are sodium chloride. Though table salt has been refined down to almost pure sodium chloride, any difference in sodium content is likely to be negligible on a weight-for-weight basis.

The key difference between the two might be iodine content.

Table salt is a readily available source of iodine. Manufacturers began adding iodine to table salt in the 1920s to prevent goiter (enlargement of the thyroid gland) caused by iodine deficiency.

Sea salt may have less iodine than table salt, though iodized forms of sea salt might be available.

Iodine deficiency is becoming more common, perhaps because more people are shunning the salt shaker as a way to limit sodium intake. (One researcher hypothesizes that low iodine intake might increase the risk of heart disease.)

Sea salt is a viable alternative to table salt as long as you’re getting adequate iodine from the diet (e.g., iodine-rich seafood) or a multivitamin. The latter generally provides the RDA for iodine (150 mcg).

Be aware that sodium chloride is added to many processed foods as a flavor-enhancer and preservative, particularly if you’re on a low-sodium diet. Note that the sodium chloride used in processed foods is not iodized.

Hypertension (high blood pressure) guidelines typically recommend restricting sodium intake to two to three grams daily.

Don’t get salt (sodium chloride) and sodium confused. For example, five grams of sodium chloride provides two grams of sodium.

A little known factoid:

Higher sodium intake increases your calcium needs. As sodium intake climbs, more calcium is lost in the urine.

Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books. Write him at 1224 King Henry Drive, Ocean Springs, MS 39564.

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

Email Richard Harkness at: rharkn@aol.com.

Bioidentical and Natural is the Debate

Posted in Q & A Health | Friday, December 15th, 2006 | No Comments »

Sorry, Suzanne Somers, ‘bioidentical’ not another word for ’safe’

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

December 15, 2006

QUESTION:

I understand that bioidentical hormones are identical to the hormones the body produces. But aren’t they constructed synthetically? That is, they are not taken from the human body (or is there a ranch somewhere in Montana where they are extracted from humans?).

“Bioidentical” and the word “natural” (as per Suzanne Somers) makes it sound like it’s “safe” estrogen. But if it’s estrogen, it comes with all the possible dangers of excessive estrogen. It seems to be all marketing and driven by the power of the words “bioidentical” and “natural.” No one is saying what they really are and the consumer is misled. Maybe you can do that. Thanks.

ANSWER:

You have good and ample company in your shaky view of bioidentical hormones (and I like your humor about it).

Here’s a stab at clarifying the picture using estrogen as an example.

It may help to use the term “laboratory-manufactured” instead of “synthetic.”

The prescription product Premarin consists of conjugated estrogens extracted from equine sources (pregnant mares). This estrogen is not laboratory-manufactured. It’s “natural” but different from the natural estrogen produced in the human body.

The prescription products Cenestin and Enjuvia are conjugated estrogens that are laboratory-manufactured from plants. This estrogen is derived from natural sources, but is different from the natural estrogen produced in the human body.

Enter “bioidentical” estrogens, which also are laboratory-manufactured from plants (yams and soy), a natural source. In this case, though, the derived estrogen products are identical in chemical structure to the estrogen produced in the body.

For this reason, the body can’t tell any difference between its own estrogen and manufactured bioidentical estrogen.

Your observation is correct: Bioidentical estrogen products would be expected to carry the same risks (and benefits) as the body’s own estrogen. Bioidentical estrogens include estradiol, estrone, and estriol. Bioidentical progesterone is micronized in the laboratory to increase its absorption.

As I noted in a prior column, bioidentical hormones are available in numerous FDA-approved prescription products. An increasingly popular practice is to have bioidentical hormones custom-mixed at a compounding pharmacy. This allows individualized combinations, doses, and preparations.

The interest in bioidentical hormones has surged since 2002. That’s when the Women¹s Health Initiative (WHI) trial was shut down early when Prempro was found to slightly boost the risk of breast cancer, stroke, and blood clots in postmenopausal women.

Prempro is a combination of estrogens and progestin (conjugated equine estrogens and medroxyprogesterone acetate). These hormones are not bioidentical.

There are reasons to hope that bioidentical hormones might pose less risk, but there’s little evidence to support this view currently. Research is needed to compare the various hormone products, doses and forms of administration.

When hormone replacement therapy is prescribed, bioidentical or not, the lowest effective dose should be used and treatment can be stopped once menopausal symptoms subside.

Lastly, it’s important to realize that the body stops making its own estrogen for a reason. To everything there is a season. Menopause is not a disorder, but a natural phase of life.

Richard Harkness is a consultant pharmacist, natural medicines specialist, and author of eight published books.

Richard Harkness, Pharm, CDM, Natural Medicines Specialist

He can be reached at: rharkn@aol.com

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Grapefruit-drug interactions and Estrogen Pills

Osteoporosis & Vitamin D

Lysine for Shingles?

Suspect Seaweed

Sodium Content: Sea Salt and Table Salt

Bioidentical and Natural is the Debate

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