Re: PCOS - drug/herb interactions?

[Guest guest]

I'll need to check those particular drug interactions, but I presume you've got the necessary references yourself?However consider this:Occasionally with new patients I've had reports of untoward effects. On re-examining the case and double checking that they've not done anything extra they didn't initially tell me of I advise:Stop herbs for 2-3 days. If symptoms relieved start back on half dose (or less) and watch carefully. If okay gradually increase to full dose.CAUTION: IF YOU SUSPECT A POSSIBLE ANAPHYLACTIC REACTION YOU SHOULD NEVER ADVISE RESTARTING BUT THAT MEDICAL ADVICE IS SOUGHT. Also if any liver signs present.In most cases the above has worked. Frequently there will also be a back story that emerges that an unfamiliar food/infection/situation has coincided with herbal treatment.Sometimes mild transient GI disturbance can be normal with especially raw TCM herbs. However its always best to advise stopping immediately and investigating.I believe there can be up a five fold difference in the way people react so it might just be them!However incidents are rare, all the more necessary to take care in handling it.LorraineLorraine Hodgkinson AHG MRCHMHERBS AND HELPERS6, Butts Fold, Cockermouth,Cumbria, CA13 9HY. UK.Tel: +44 (0) 1900 826392Mobile: 07761 489838 (O2)www.herbalmedicineuk.comOn 21 Jun 2012, at 11:17, "ruth" wrote:

I have a new patient with diagnosed PCOS. She is on 2 grams of metformin per day, the maximum dose, and is also taking Fersaday iron supplement, and the progestogen-only contraceptive Cerazette. Her initial prescription includes Paeonia lactiflora and Glycyrrhiza glabra.

After one week she has stopped the herbal medicine because she says she has tummy upsets. I would be most grateful for any advice on treating a patient for PCOS who is on prescribed medication from the GP. I have prepared a letter for her GP but have not sent it yet. Obviously, I cannot suggest that she reduce her dose of prescribed medication.

Thanks,

Ruth

[Guest guest]

Hi Ruth,

What else was in her herbal prescription?

Was she also on any supplements?

I have seen px who cannot tolerate Glycyrrhiza as it made them

gag... found this out by testing each herb in the prescription

separately. Also, many people have issues with B vitamins if taken

away from food...

Just a couple of thoughts,

Kerry

I have a new patient with diagnosed PCOS. She is on 2

grams of metformin per day, the maximum dose, and is also

taking Fersaday iron supplement, and the progestogen-only

contraceptive Cerazette. Her initial prescription includes

Paeonia lactiflora and Glycyrrhiza glabra.

After one week she has stopped the herbal medicine because

she says she has tummy upsets. I would be most grateful

for any advice on treating a patient for PCOS who is on

prescribed medication from the GP. I have prepared a

letter for her GP but have not sent it yet. Obviously, I

cannot suggest that she reduce her dose of prescribed

medication.

Thanks,

Ruth

-- Kerry Hackett, MNIMH, AHG, OHA

Medical Herbalist

www.kerryhackett.ca

[Guest guest]

Hi

Medscape do a great app that has medical information and drug effects including

interactions. They don't list any problems with those meds and licorice. Peony

is on webmd.com and lists potential problems with anticoagulants and

anticonvulsants. Is this white or red peony and what part of the plant?

Regards

Dr Gascoigne

Medical doctor, acupuncturist, herbalist

+44 (0) 79 88 05 92 01 ( UK)

+353 (0) 87 9266234 (Ireland)

Web: www.drgascoigne.com

> Paeonia lactiflora

[Guest guest]

Hi Dr Gascoigne,

Thank you for your email. I have heard about the Medscape app but my phone is

too old to support it. I did not find Paeonia lactiflora on webmd. It's the

root.

Regards,

Ruth

>

> > Paeonia lactiflora

>

[Guest guest]

HiAnd is it red or white peony?This is the link to Webmd - http://www.webmd.com/vitamins-supplements/ingredientmono-32-Peony.aspx?activeIngredientId=32 & activeIngredientName=Peony & source=1RegardsDr GascoigneMedical doctor, acupuncturist, herbalistClinics in Bath & Tetbury, UKTel: +44 (0) 79 88 05 92 01Also, Bandon, Co. Cork, IrelandTel: +353 (0) 87 9266234Website: www.drgascoigne.comOn 23 Jun 2012, at 19:21, "ruth" wrote:

Hi Dr Gascoigne,

Thank you for your email. I have heard about the Medscape app but my phone is too old to support it. I did not find Paeonia lactiflora on webmd. It's the root.

Regards,

Ruth

>

> > Paeonia lactiflora

>

[Guest guest]

Hi Lorraine,

Thanks very much for your helpful reply. I have not found any information on

drug/herb interactions for this case, but presume that any herb having a similar

action to a drug is going to enhance that effect, i.e. gymnema and metformin.

I did suggest she had a break of a few days and then started at a lower dose.

Best wishes,

Ruth

>

> > I have a new patient with diagnosed PCOS. She is on 2 grams of metformin per

day, the maximum dose, and is also taking Fersaday iron supplement, and the

progestogen-only contraceptive Cerazette. Her initial prescription includes

Paeonia lactiflora and Glycyrrhiza glabra.

> >

> > After one week she has stopped the herbal medicine because she says she has

tummy upsets. I would be most grateful for any advice on treating a patient for

PCOS who is on prescribed medication from the GP. I have prepared a letter for

her GP but have not sent it yet. Obviously, I cannot suggest that she reduce her

dose of prescribed medication.

> >

> > Thanks,

> > Ruth

> >

> >

>

[Guest guest]

Hi Kerry,

Thanks for your email and helpful suggestion. I also gave her Verbena

officinalis, Cinnamon and Eleuthero. I did get her to try the formula, and she

liked it, but I shall do as you suggest and get her to test each herb. She is

also on B complex, magnesium zinc & chromium - recommended by Verity, the PCOS

charity.

> >

> > I have a new patient with diagnosed PCOS. She is on 2 grams of

> > metformin per day, the maximum dose, and is also taking Fersaday iron

> > supplement, and the progestogen-only contraceptive Cerazette. Her

> > initial prescription includes Paeonia lactiflora and Glycyrrhiza glabra.

> >

> > After one week she has stopped the herbal medicine because she says

> > she has tummy upsets. I would be most grateful for any advice on

> > treating a patient for PCOS who is on prescribed medication from the

> > GP. I have prepared a letter for her GP but have not sent it yet.

> > Obviously, I cannot suggest that she reduce her dose of prescribed

> > medication.

> >

> > Thanks,

> > Ruth

> >

> >

>

>

> --

> Kerry Hackett, MNIMH, AHG, OHA

> Medical Herbalist

> www.kerryhackett.ca

>

[Guest guest]

Thanks for reply and link. Assume it's white peony, and it's the root.

Ruth

> >

> > > Paeonia lactiflora

> >

>

[Guest guest]

Glad it's been helpful!A lot of the time when I check drug interactions there are many things mentioned a lot of it speculative/theoretical. I think it's a case of a judgment call. If someone is on a lot of medication then usually on the invoice I tend to list all the herbs and nutrients that may cause problems just for safety!Can't really think of any issues that have arisen though besides lots of conversations about it!THR stuff should have it on, a glaring error!Lorraine Lorraine Hodgkinson AHG MRCHMHERBS AND HELPERS6, Butts Fold, Cockermouth,Cumbria, CA13 9HY. UK.Tel: +44 (0) 1900 826392Mobile: 07761 489838 (O2)www.herbalmedicineuk.comOn 25 Jun 2012, at 12:18, "ruth" wrote:

Hi Lorraine,

Thanks very much for your helpful reply. I have not found any information on drug/herb interactions for this case, but presume that any herb having a similar action to a drug is going to enhance that effect, i.e. gymnema and metformin.

I did suggest she had a break of a few days and then started at a lower dose.

Best wishes,

Ruth

>

> > I have a new patient with diagnosed PCOS. She is on 2 grams of metformin per day, the maximum dose, and is also taking Fersaday iron supplement, and the progestogen-only contraceptive Cerazette. Her initial prescription includes Paeonia lactiflora and Glycyrrhiza glabra.

> >

> > After one week she has stopped the herbal medicine because she says she has tummy upsets. I would be most grateful for any advice on treating a patient for PCOS who is on prescribed medication from the GP. I have prepared a letter for her GP but have not sent it yet. Obviously, I cannot suggest that she reduce her dose of prescribed medication.

> >

> > Thanks,

> > Ruth

> >

> >

>

[Guest guest]

HiIt is presumably red peony root that has been 'flagged up' on WebMD in relation to anticoagulants as its function is to regulate Blood whilst white peony root is a Blood tonic - all Chinese medicine terms. The thing with white peony is that it is energetically cold so if a patient has, say, bowel problems due to cold - and female sex hormones are cold in nature, the white peony could conceivably make that worse, it depends on what the white peony is combined with.Polycystic ovaries are often rooted in a digestive imbalance which is why metformin has an effect. So, I find that treating the digestion is paramount in such cases,Regards GascoigneLDr GascoigneMedical doctor, acupuncturist, herbalistClinics in Bath & Tetbury, UKTel: +44 (0) 79 88 05 92 01Also, Bandon, Co. Cork, IrelandTel: +353 (0) 87 9266234Website: www.drgascoigne.comOn 25 Jun 2012, at 12:25, "ruth" wrote:

Thanks for reply and link. Assume it's white peony, and it's the root.

Ruth

> >

> > > Paeonia lactiflora

> >

>

[Guest guest]

hello Ruthcinnamon is a likely culprit - I have found quite a lot of people react to cinnamon in a formula. I check it with kinesiology, then remove it from the formula and every time they are fine afterwards. I should think I have seen  2 - 5% of patients react to cinnamon.

regards

 

Hi Kerry,

Thanks for your email and helpful suggestion. I also gave her Verbena officinalis, Cinnamon and Eleuthero. I did get her to try the formula, and she liked it, but I shall do as you suggest and get her to test each herb. She is also on B complex, magnesium zinc & chromium - recommended by Verity, the PCOS charity.

-- Herbert Herbalist and allergy therapist15 Queens StSpooner RowNorfolk NR18 9JU01953 603056www.christineherbert.co.uk

[Guest guest]

Thanks to everyone for their interesting and helpful suggestions. Strange that

white peony root should be recommended for PCOS if they are both cold

energetically. I think the advice on digestion is good, and I shall also try

taking out the cinnamon.

Ruth

>

> > **

> >

> >

> > Hi Kerry,

> > Thanks for your email and helpful suggestion. I also gave her Verbena

> > officinalis, Cinnamon and Eleuthero. I did get her to try the formula, and

> > she liked it, but I shall do as you suggest and get her to test each herb.

> > She is also on B complex, magnesium zinc & chromium - recommended by

> > Verity, the PCOS charity.

> >

>

>

> --

> Herbert

> Herbalist and allergy therapist

> 15 Queens St

> Spooner Row

> Norfolk NR18 9JU

> 01953 603056

> www.christineherbert.co.uk

>

[Guest guest]

This I think arises from the clash of two traditions! Bai Shao Yao (White peony) and Dang GUI ( sinensis) have been 'adopted' by western Herbalists and used in different formats and contexts. I freely admit to enhancing some of my western tincture prescriptions with a few choice granules of TCM magic.If you're comfortable with the herbs then don't sweat it. They're all herbs after all! However if you're expecting TCM herbs to behave in Western way and vice versa then I understand that without the full picture it may get rather confusing!Lorraine Lorraine Hodgkinson AHG MRCHMHERBS AND HELPERS6, Butts Fold, Cockermouth,Cumbria, CA13 9HY. UK.Tel: +44 (0) 1900 826392Mobile: 07761 489838 (O2)www.herbalmedicineuk.comOn 26 Jun 2012, at 13:06, "ruth" wrote:

Thanks to everyone for their interesting and helpful suggestions. Strange that white peony root should be recommended for PCOS if they are both cold energetically. I think the advice on digestion is good, and I shall also try taking out the cinnamon.

Ruth

>

> > **

> >

> >

> > Hi Kerry,

> > Thanks for your email and helpful suggestion. I also gave her Verbena

> > officinalis, Cinnamon and Eleuthero. I did get her to try the formula, and

> > she liked it, but I shall do as you suggest and get her to test each herb.

> > She is also on B complex, magnesium zinc & chromium - recommended by

> > Verity, the PCOS charity.

> >

>

>

> --

> Herbert

> Herbalist and allergy therapist

> 15 Queens St

> Spooner Row

> Norfolk NR18 9JU

> 01953 603056

> www.christineherbert.co.uk

>