What happens when you blindly take traditional, alternative and otherwise unproven preparations for medical conditions? Prepare for the distinct possibility of irony.
There’s a way of knowing whether a given compound has therapeutic properties and whether it’s safe in general – scientifically controlled clinical studies. Alternative remedies, which include many traditional and regional preparations were not the result of scientific study. A few have been subjected to scientific scrutiny and proven to be worthwhile. When this happens, they stop being “alternative medicine” and become simply “medicine.”
For all the rest, it’s just hit or miss, and more often than not, it’s miss. Guided by old traditions, anecdotes and old wives tales, the actual effect on the body could be just about anything.
Such would seem to be the case with birthwort. Birthwort is a family of plants which have been regarded as medicinally beneficial for centuries, despite complete lack of evidence for this. The exact reason for the belief is unclear, although it might have to do with the fact that some of the compounds in the plant do have antimicrobial properties and thus could be useful as an antiseptic, if only topically. Another reason for the belief that it has useful medical properties is the so-called doctrine of signatures – a discredited belief that herbs are useful in treating a part of the body which they resemble. Birthwort is noted for having a shape that is similar to the human uterus. For this reason, it was believed to be useful for reproductive and genital health and for fertility.
It also has been used for various kidney problems, including kidney stones and urinary tract problems. Again, the reasoning for this is not entirely clear. It may be an extension of the belief that it is helpful for health issues involving the genitals or it could just be that it gained a reputation for being something that people with kidney problems swore by. Whatever the case, it was not science-based. That said, it was accepted for many years.
Like many “alternative” remedies, it remained on shelves, largely unquestioned until people started getting sick and dying enough to catch someone’s attention. This happened in 1991 when a clinic in Brussels, Belgium started offering the herb as part of a weight loss regime. Although it was known for some time that the plant contained potent toxins, it was not until a large number of women in Brussels began to show up at doctors with acute kidney failure that it became evident that the plant was more dangerous than anyone had suspected.
Upon further investigation it turns out that the long trusted, yet untested herb is in fact, a potent carcinogen and that use of the quantities common in traditional preparations can cause kidney damage, amongst other things.
Kidney stones. Snakebites. Head wounds. To the ancients, a weed called birthwort was a wonder drug that treated them all, and more.
Medical detectives, however, are finding that the ancient remedy likely has caused centuries of kidney failure and cancer, as well as being the culprit in a widespread syndrome of kidney disease in some parts of the world.
“The big clue was the plant itself,” says pharmacologist Arthur Grollman of Stony Brook (N.Y.) University. “Once it was appreciated that it contained a potent kidney toxin and human carcinogen, we could get to the bottom of things.”
Grollman and colleagues have unraveled a genetic signature left behind by birthwort in cases of cancers and kidney failure, as reported in the March journal ofKidney International. And in upcoming work, they report signs that use of the drug in Chinese medicines may be responsible for Taiwan’s sky-high rate of kidney disease.
Modern medicine became alarmed by birthwort in 1991, when dozens of young women from a “slimming” clinic in Brussels, Belgium, appeared in doctor’s offices with kidney failure. The case triggered warnings and a 2000 New England Journal of Medicine report noting that about 5% of 1,800 women given the Chinese herb, Aristolochia fangchi (another birthwort species), in a weight-loss treatment at the clinic had developed kidney failure. That triggered a Food and Drug Administration warning about the herb that mentioned 16 weight-loss products then on store shelves, and also offered a clue that only some people suffered from a genetic susceptibility to the herb causing kidney failure, Grollman says.
But it wasn’t until a 2007 Proceedings of the National Academy of Sciences paper that Grollman and his colleagues showed the Balkan and Belgian cases were caused by the same toxin, finding mutations in the genes of Croatian patients that exactly matched those of mice poisoned with aristolochic acid. The mutations were pinpoint changes in a well-known tumor-suppressing gene called p53. The finding “was a breakthrough,” says kidney expert Marc De Broe of Belgium’s University of Antwerp, in a commentary in Kidney International. DeBroe added, “this magic plant turned out to contain a powerful nephrotoxic (kidney-poisoning) substance with an ability to induce urothelial (urinary tract) cancer.”
But the damage from birthwort poisoning may well go beyond clusters of unexplained kidney failure, Grollman suggests. In an upcoming study, he and his colleagues looked at Taiwan, the “Land of Dialysis” in some news reports, where the herb is widely used in traditional medicine. A 2006 survey in The Lancet suggested that nearly 12% of Taiwan’s population suffers chronic kidney disease. Health service statistics there also show that about 1 in 3 patients are prescribed Aristolochia as part of traditional medical treatments delivered at doctor’s offices. And Taiwanese kidney failure patients in the upcoming study widely show the same pinpoint changes in the p53 gene seen in patients in the Balkans and Belgium, Grollman says.
This is a potent example of a basic fact about traditional remedies: The fact that something has been “used for centuries” or that it is common in rural China or that it is natural means absolutely nothing in terms of safety or effectiveness. We can’t know if something is safe or effective unless it is actually subjected to a battery of scientific tests. The fact that something has been considered a valid remedy for a given condition does not mean it works on that condition or even that the claim is based on anecdotal evidence – it could be something as bunk as the fact that the plant looks like a body part.
If you choose to take a traditional or alternative remedy, keep in mind that it may well make your condition worse, or it might do nothing. While it’s possible that it could also have therapeutic benefit, if it has not been subjected to scientific tests and evaluation we just don’t know. It’s a stab in the dark. You may as well go outside, pick up the first random plant you find on the ground and eat it.
This entry was posted on Sunday, April 15th, 2012 at 6:40 pm and is filed under Bad Science, Quackery. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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