Guest guest Posted December 11, 2008 Report Share Posted December 11, 2008 Hi Gursewa Strachan was using some shortly before she retired. She wasn't able to source any, so she grew it. I'd love to be able to get hold of some, so perhaps what we should be doing is asking our suppliers to get people growing it. One of those things of supply meeting demand. And along with that night blooming cactus. For years Bryonia was unavailable but now we can get it. That happened because people kept asking for it. So the answer may be to extend the repertoire of herbs we use, go back to what our forefathers were using and look at why, and then place polite demands on our suppliers to meet the demands we have to meet our patients requirements. Gout is something I think we see a fair bit of, and could treat so much better with Colchicum. heck, if people can tear down the Berlin wall surely someone can manage to grow a little crocus. I have a patient who has gunk oozing out of her toes her gout is so bad. best wishes ======================================== Message Received: Dec 11 2008, 06:29 PM From: herbalist@... To: ukherbal-list Cc: Subject: Colchicum Hi, I was wondering if anyone still uses Colchicum and where I could get some from (other than in homeopathic form - unless its a mother tincture of course). Most of the things I've tried for a particularly severe gout attack my father is going through at the moment are barely making a difference. Â His g.p. was relcuctant to prescribe colchicine (probably more through inexperience than anything else in my opinion) even though based on the rest of his medical picture, colchicine is the recommended course of action (according to the BNF) rather than the NSAIDs she sent him off with (which are actually contraindicated for him!). thanks, gursewa harrad. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2008 Report Share Posted December 11, 2008 Hi , I have been thinking about trying to grow a number of older (not in favour anymore) and endangered herbs, including trillium and colchicum that are quite easy to grow and cypripedium which is available cultivated from tissue culture.  But, we only have so much space and aren't all as talented as the likes of Church in cramming so many species into his garden!  As far as the suppliers are concerned, the few times I have tried to request things not in their catalogues (or even things in the catalogues sometimes!), I have either got an immediate 'no we can't get that', without  even making an effort to look into it, or a lecture on why we should not use the requested herb!  I think in the short term, I'm gonna try and get organised and go with the 'grow it yourself' idea - only problem is, this still doesn't help when you need something now! Back to colchicum; apparently, the colchicine content of the bulb can be quite variable, especially if collected at anytime other than during or just after flowering and according to King's, 'the bruised seeds yield the strongest tincture. Their properties are similar with those of the bulb, and, as they are considered more uniform in strength than the bulb, they are usually preferred'.  I have seen some sources state that the seed can contain almost twice as much colchicine as the bulb.  King's also suggests that the alkalis make the extract less harsh with a milder action, hence some practitioners prefer the vinegar to the ethanolic tincture. I'm going to try and contact some seed suppliers and see if I can get a reasonable bulk price on non-treated seeds - i'll let you know if I have any luck. regards, gursewa.  Hi Gursewa Strachan was using some shortly before she retired. She wasn't able to source any, so she grew it. I'd love to be able to get hold of some, so perhaps what we should be doing is asking our suppliers to get people growing it. One of those things of supply meeting demand. And along with that night blooming cactus. For years Bryonia was unavailable but now we can get it. That happened because people kept asking for it. So the answer may be to extend the repertoire of herbs we use, go back to what our forefathers were using and look at why, and then place polite demands on our suppliers to meet the demands we have to meet our patients requirements. Gout is something I think we see a fair bit of, and could treat so much better with Colchicum. heck, if people can tear down the Berlin wall surely someone can manage to grow a little crocus. I have a patient who has gunk oozing out of her toes her gout is so bad. best wishes ======================================== Message Received: Dec 11 2008, 06:29 PM From: herbalist@... To: ukherbal-list Cc: Subject: Colchicum Hi, I was wondering if anyone still uses Colchicum and where I could get some from (other than in homeopathic form - unless its a mother tincture of course). Most of the things I've tried for a particularly severe gout attack my father is going through at the moment are barely making a difference.  His g.p. was relcuctant to prescribe colchicine (probably more through inexperience than anything else in my opinion) even though based on the rest of his medical picture, colchicine is the recommended course of action (according to the BNF) rather than the NSAIDs she sent him off with (which are actually contraindicated for him!). thanks, gursewa harrad. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2008 Report Share Posted December 11, 2008 Isn't Colchicum on the list of currently " banned " herbs? Subject: RE: Colchicum To: ukherbal-list Date: Thursday, 11 December, 2008, 6:44 PM Hi Gursewa Strachan was using some shortly before she retired. She wasn't able to source any, so she grew it. I'd love to be able to get hold of some, so perhaps what we should be doing is asking our suppliers to get people growing it. One of those things of supply meeting demand. And along with that night blooming cactus. For years Bryonia was unavailable but now we can get it. That happened because people kept asking for it. So the answer may be to extend the repertoire of herbs we use, go back to what our forefathers were using and look at why, and then place polite demands on our suppliers to meet the demands we have to meet our patients requirements. Gout is something I think we see a fair bit of, and could treat so much better with Colchicum. heck, if people can tear down the Berlin wall surely someone can manage to grow a little crocus. I have a patient who has gunk oozing out of her toes her gout is so bad. best wishes ============ ========= ========= ========= = Message Received: Dec 11 2008, 06:29 PM From: herbalistmedherb (DOT) co.uk To: ukherbal-list@ yahoogroups. com Cc: Subject: Colchicum Hi, I was wondering if anyone still uses Colchicum and where I could get some from (other than in homeopathic form - unless its a mother tincture of course). Most of the things I've tried for a particularly severe gout attack my father is going through at the moment are barely making a difference. Â His g.p. was relcuctant to prescribe colchicine (probably more through inexperience than anything else in my opinion) even though based on the rest of his medical picture, colchicine is the recommended course of action (according to the BNF) rather than the NSAIDs she sent him off with (which are actually contraindicated for him!). thanks, gursewa harrad. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 Hi Maybe you just overlooked it because it's basically impossible to use due to no sources? When you've never seen something, unless it comes up in conversation on reasonably regular basis or you have a particular need for it, it's easy to forget. It's definitely on S3 list - corn only, as Gursewa says. You should have Fred Fletcher Hyde's guide to the Medicines Act somewhere, but if not you can find it on the S3 herbs 'course' I created on CAMLIS VLE. Off the top of my head I can't remember if it is on NIMH website as well - I expect it is. Gursewa - if you're short of space have you thought of getting an allotment? Best wishes ======================================== Message Received: Dec 12 2008, 10:46 AM From: anna.newton@... To: ukherbal-list Cc: Subject: RE: Colchicum That is interesting, cause it don't think it was on my schedule III list (School of Phytotherapy). Thanks, Gursewa. From: Stannard <lauraartemisia (DOT) freeserve. co.uk> Subject: RE: Colchicum To: ukherbal-list@ yahoogroups. com Date: Thursday, 11 December, 2008, 6:44 PM Hi Gursewa Strachan was using some shortly before she retired. She wasn't able to source any, so she grew it. I'd love to be able to get hold of some, so perhaps what we should be doing is asking our suppliers to get people growing it. One of those things of supply meeting demand. And along with that night blooming cactus. For years Bryonia was unavailable but now we can get it. That happened because people kept asking for it. So the answer may be to extend the repertoire of herbs we use, go back to what our forefathers were using and look at why, and then place polite demands on our suppliers to meet the demands we have to meet our patients requirements. Gout is something I think we see a fair bit of, and could treat so much better with Colchicum. heck, if people can tear down the Berlin wall surely someone can manage to grow a little crocus. I have a patient who has gunk oozing out of her toes her gout is so bad. best wishes ============ ========= ========= ========= = Message Received: Dec 11 2008, 06:29 PM From: herbalistmedherb (DOT) co.uk To: ukherbal-list@ yahoogroups. com Cc: Subject: Colchicum Hi, I was wondering if anyone still uses Colchicum and where I could get some from (other than in homeopathic form - unless its a mother tincture of course). Most of the things I've tried for a particularly severe gout attack my father is going through at the moment are barely making a difference.  His g.p. was relcuctant to prescribe colchicine (probably more through inexperience than anything else in my opinion) even though based on the rest of his medical picture, colchicine is the recommended course of action (according to the BNF) rather than the NSAIDs she sent him off with (which are actually contraindicated for him!). thanks, gursewa harrad. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 Hi , yes, it is on the offcial schedule III list (impossible to find on internet, but found it in the end). Well, I suppose we must have been given a slightly " reduced " list from the college - I don't recollect for instance learning about Senecio or Rhux, which are on schedule III. You live and learn, I wonder why our list was not complete? And then I found an unpowdered slippery elm on schedule I - why? Thanks From: Stannard <lauraartemisia (DOT) freeserve. co.uk> Subject: RE: Colchicum To: ukherbal-list@ yahoogroups. com Date: Thursday, 11 December, 2008, 6:44 PM Hi Gursewa Strachan was using some shortly before she retired. She wasn't able to source any, so she grew it. I'd love to be able to get hold of some, so perhaps what we should be doing is asking our suppliers to get people growing it. One of those things of supply meeting demand. And along with that night blooming cactus. For years Bryonia was unavailable but now we can get it. That happened because people kept asking for it. So the answer may be to extend the repertoire of herbs we use, go back to what our forefathers were using and look at why, and then place polite demands on our suppliers to meet the demands we have to meet our patients requirements. Gout is something I think we see a fair bit of, and could treat so much better with Colchicum. heck, if people can tear down the Berlin wall surely someone can manage to grow a little crocus. I have a patient who has gunk oozing out of her toes her gout is so bad. best wishes ============ ========= ========= ========= = Message Received: Dec 11 2008, 06:29 PM From: herbalistmedherb (DOT) co.uk To: ukherbal-list@ yahoogroups. com Cc: Subject: Colchicum Hi, I was wondering if anyone still uses Colchicum and where I could get some from (other than in homeopathic form - unless its a mother tincture of course). Most of the things I've tried for a particularly severe gout attack my father is going through at the moment are barely making a difference.  His g.p. was relcuctant to prescribe colchicine (probably more through inexperience than anything else in my opinion) even though based on the rest of his medical picture, colchicine is the recommended course of action (according to the BNF) rather than the NSAIDs she sent him off with (which are actually contraindicated for him!). thanks, gursewa harrad. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 This is because long strips of ulmus bark were historically inserted through the cervix into the uterus by native american women in order to procure abortion. (When the pharmicist l;obby first suggested that herbal medicine should be restricted to pharmacist only sales, many years ago, they picked on ulmus to demonstrate how dangerous herbs could be in pregnancy, and did not draw a distinction between powdered and unpowdered. (this is most likely the source of some still surviving concerns about the drinking of ulmus by pregnant women.) Sally O > Hi , > yes, it is on the offcial schedule III list (impossible to find on > internet, but found it in the end). Well, I suppose we must have > been given a slightly " reduced " list from the college - I don't > recollect for instance learning about Senecio or Rhux, which are on > schedule III. You live and learn, I wonder why our list was not > complete? And then I found an unpowdered slippery elm on schedule I > - why? > Thanks > > > > From: Stannard <lauraartemisia (DOT) freeserve. co.uk> > > Subject: RE: Colchicum > > To: ukherbal-list@ yahoogroups. com > > Date: Thursday, 11 December, 2008, 6:44 PM > > Hi Gursewa > > Strachan was using some shortly before she retired. > > She wasn't able to source any, so she grew it. > > I'd love to be able to get hold of some, so perhaps what we should > be doing is asking our suppliers to get people growing it. One of > those things of supply meeting demand. > > And along with that night blooming cactus. > > For years Bryonia was unavailable but now we can get it. > > That happened because people kept asking for it. > > So the answer may be to extend the repertoire of herbs we use, go > back to what our forefathers were using and look at why, and then > place polite demands on our suppliers to meet the demands we have > to meet our patients requirements. > > Gout is something I think we see a fair bit of, and could treat so > much better with Colchicum. > > heck, if people can tear down the Berlin wall surely someone can > manage to grow a little crocus. > > I have a patient who has gunk oozing out of her toes her gout is so > bad. > > best wishes > > > > ============ ========= ========= ========= = > > Message Received: Dec 11 2008, 06:29 PM > > From: herbalistmedherb (DOT) co.uk > > To: ukherbal-list@ yahoogroups. com > > Cc: > > Subject: Colchicum > > Hi, > > I was wondering if anyone still uses Colchicum and where I could > get some from (other than in homeopathic form - unless its a mother > tincture of course). > > Most of the things I've tried for a particularly severe gout attack > my father is going through at the moment are barely making a > difference. His g.p. was relcuctant to prescribe colchicine > (probably more through inexperience than anything else in my > opinion) even though based on the rest of his medical picture, > colchicine is the recommended course of action (according to the > BNF) rather than the NSAIDs she sent him off with (which are > actually contraindicated for him!). > > thanks, > > gursewa harrad. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 It is on my list from the College of Phytotherapy compiled by Vicky Ridley. Chris J Etheridge PhD MCPP MRSC CChem DoIC ARCS BSc(Hons) Chem BSc(Hons) Phyto Medical Herbalist Cheshunt Clinic of Herbal Medicine 62 Roundmoor Drive Cheshunt Hertfordshire EN8 9HQ M: 0 www.drchrisetheridge.co.uk _____ From: ukherbal-list [mailto:ukherbal-list ] On Behalf Of anna.newton@... Sent: Friday, December 12, 2008 10:46 AM To: ukherbal-list Subject: RE: Colchicum That is interesting, cause it don't think it was on my schedule III list (School of Phytotherapy). Thanks, Gursewa. From: Stannard <lauraartemisia (DOT) freeserve. co.uk> Subject: RE: Colchicum To: ukherbal-list@ yahoogroups. com Date: Thursday, 11 December, 2008, 6:44 PM Hi Gursewa Strachan was using some shortly before she retired. She wasn't able to source any, so she grew it. I'd love to be able to get hold of some, so perhaps what we should be doing is asking our suppliers to get people growing it. One of those things of supply meeting demand. And along with that night blooming cactus. For years Bryonia was unavailable but now we can get it. That happened because people kept asking for it. So the answer may be to extend the repertoire of herbs we use, go back to what our forefathers were using and look at why, and then place polite demands on our suppliers to meet the demands we have to meet our patients requirements. Gout is something I think we see a fair bit of, and could treat so much better with Colchicum. heck, if people can tear down the Berlin wall surely someone can manage to grow a little crocus. I have a patient who has gunk oozing out of her toes her gout is so bad. best wishes ============ ========= ========= ========= = Message Received: Dec 11 2008, 06:29 PM From: herbalistmedherb (DOT) co.uk To: ukherbal-list@ yahoogroups. com Cc: Subject: Colchicum Hi, I was wondering if anyone still uses Colchicum and where I could get some from (other than in homeopathic form - unless its a mother tincture of course). Most of the things I've tried for a particularly severe gout attack my father is going through at the moment are barely making a difference. His g.p. was relcuctant to prescribe colchicine (probably more through inexperience than anything else in my opinion) even though based on the rest of his medical picture, colchicine is the recommended course of action (according to the BNF) rather than the NSAIDs she sent him off with (which are actually contraindicated for him!). thanks, gursewa harrad. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 Hi laura, I certainly have thought about an allotment, but as is the case in many areas, there is a huge waiting list to get one.  Also, i'm not sure I would have the time to do it justice, so would not want to take the opportunity away from someone who did, until I was certain i could devote the time and energy needed. On the colchicum, considering the Sch III only mentions the corm, presumably the seed is therefore (technically) not regulated even though it is stronger!  This is certainly the case for other herbs where the part of the plant is stated e.g. Ulmus whole/bark/twigs are regulated (due to prior use in abortions) but the powder is not. regards, g.  Hi Maybe you just overlooked it because it's basically impossible to use due to no sources? When you've never seen something, unless it comes up in conversation on reasonably regular basis or you have a particular need for it, it's easy to forget. It's definitely on S3 list - corn only, as Gursewa says. You should have Fred Fletcher Hyde's guide to the Medicines Act somewhere, but if not you can find it on the S3 herbs 'course' I created on CAMLIS VLE. Off the top of my head I can't remember if it is on NIMH website as well - I expect it is. Gursewa - if you're short of space have you thought of getting an allotment? Best wishes ======================================== Message Received: Dec 12 2008, 10:46 AM From: anna.newton@... To: ukherbal-list Cc: Subject: RE: Colchicum That is interesting, cause it don't think it was on my schedule III list (School of Phytotherapy). Thanks, Gursewa. From: Stannard <lauraartemisia (DOT) freeserve. co.uk> Subject: RE: Colchicum To: ukherbal-list@ yahoogroups. com Date: Thursday, 11 December, 2008, 6:44 PM Hi Gursewa Strachan was using some shortly before she retired. She wasn't able to source any, so she grew it. I'd love to be able to get hold of some, so perhaps what we should be doing is asking our suppliers to get people growing it. One of those things of supply meeting demand. And along with that night blooming cactus. For years Bryonia was unavailable but now we can get it. That happened because people kept asking for it. So the answer may be to extend the repertoire of herbs we use, go back to what our forefathers were using and look at why, and then place polite demands on our suppliers to meet the demands we have to meet our patients requirements. Gout is something I think we see a fair bit of, and could treat so much better with Colchicum. heck, if people can tear down the Berlin wall surely someone can manage to grow a little crocus. I have a patient who has gunk oozing out of her toes her gout is so bad. best wishes ============ ========= ========= ========= = Message Received: Dec 11 2008, 06:29 PM From: herbalistmedherb (DOT) co.uk To: ukherbal-list@ yahoogroups. com Cc: Subject: Colchicum Hi, I was wondering if anyone still uses Colchicum and where I could get some from (other than in homeopathic form - unless its a mother tincture of course). Most of the things I've tried for a particularly severe gout attack my father is going through at the moment are barely making a difference.  His g.p. was relcuctant to prescribe colchicine (probably more through inexperience than anything else in my opinion) even though based on the rest of his medical picture, colchicine is the recommended course of action (according to the BNF) rather than the NSAIDs she sent him off with (which are actually contraindicated for him!). thanks, gursewa harrad. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 Hear Hear ! I would love to see some GMP produced Colchicum. It would be interesting to see what the demand for a quality produced Colchicum product would be to the U.K. market, it might get one of the producers interested in this time of economic slowdown... Best regards & a Merry Christmas to everyone, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 yes, of course. I used to have one when nobody wanted them. I once knew someone who had a patch in someone else's garden and grew veg there. Maybe somewhere like an old people's home where the ground would be reasonably well tended, and you could create a herb garden for them? No idea about the other parts actually. I'll ask someone who might know and get back to you. not instantly as I know she's not well. ATb Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 Knitting needles, ? Used to be used quite frequently I understand. Sally is spot on. I've had people ask me about Ulmus and pregnancy when giving talks - the joys of being able to explain to them. ATB ======================================== Message Received: Dec 12 2008, 01:46 PM From: anna.newton@... To: ukherbal-list Cc: Subject: Re: Colchicum Thanks, Sally. Yes, I have heard about the abortive use before, but did not think it would be the reason to put it on the schedule I with highly toxic plants - crazy, isn't it? They should ban the sale of wires, twigs, or any long thin objects really etc by the same token... Best wishes > > From: Stannard <lauraartemisia (DOT) freeserve. co.uk> > > Subject: RE: Colchicum > > To: ukherbal-list@ yahoogroups. com > > Date: Thursday, 11 December, 2008, 6:44 PM > > Hi Gursewa > > Strachan was using some shortly before she retired. > > She wasn't able to source any, so she grew it. > > I'd love to be able to get hold of some, so perhaps what we should > be doing is asking our suppliers to get people growing it. One of > those things of supply meeting demand. > > And along with that night blooming cactus. > > For years Bryonia was unavailable but now we can get it. > > That happened because people kept asking for it. > > So the answer may be to extend the repertoire of herbs we use, go > back to what our forefathers were using and look at why, and then > place polite demands on our suppliers to meet the demands we have > to meet our patients requirements. > > Gout is something I think we see a fair bit of, and could treat so > much better with Colchicum. > > heck, if people can tear down the Berlin wall surely someone can > manage to grow a little crocus. > > I have a patient who has gunk oozing out of her toes her gout is so > bad. > > best wishes > > > > ============ ========= ========= ========= = > > Message Received: Dec 11 2008, 06:29 PM > > From: herbalistmedherb (DOT) co.uk > > To: ukherbal-list@ yahoogroups. com > > Cc: > > Subject: Colchicum > > Hi, > > I was wondering if anyone still uses Colchicum and where I could > get some from (other than in homeopathic form - unless its a mother > tincture of course). > > Most of the things I've tried for a particularly severe gout attack > my father is going through at the moment are barely making a > difference. His g.p. was relcuctant to prescribe colchicine > (probably more through inexperience than anything else in my > opinion) even though based on the rest of his medical picture, > colchicine is the recommended course of action (according to the > BNF) rather than the NSAIDs she sent him off with (which are > actually contraindicated for him!). > > thanks, > > gursewa harrad. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 12, 2008 Report Share Posted December 12, 2008 Dear Gursewa There is a useful but largely unreferenced chapter in Ebadi's book (Pharmacodynamic Basis of Herbal Medicine) on colchicine and gout. Personally, I wouldn't touch Colchicum autumnale with a barge pole until I knew much more about it. Acute colchicine poisoning carries the risk of vascular damage, GI haemorrhage and CNS toxicity, and using uncharacterised preparations of Colchicum would be extremely risky. I believe that the future safe use of schedule III herbs in general will depend on herbalists being able to source reliable, well-characterised preparations. I don't think that most of us are geared up to make them. We should now be putting pressure on the herbal suppliers to offer products that have been assayed for their content of toxic constituent(s) rather than to make a wider range of herbs available. This will give us a rational basis for choosing safe doses. Another question is how frequently to dose. After a single iv dose, colchicine can apparently be detected in the urine for at least 9 days, which would make frequent, and certainly t.i.d. dosing, dangerous in terms of cumulative toxicity. In any case, intravenous dosing (which, of course, we wouldn't attempt) might be preferable to oral dosing to minimise GI side effects such as abdominal pain. Rodney Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2008 Report Share Posted December 14, 2008 Just a note on cholchicum: a patient came to me a long time ago for herbal treatment to prevent gout attacks. He was prescribed cholchicine by his GP, which he found very effective for acute episodes. According to the BMA New Guide to Medicine & Drugs, Cholchicine is used together with NSAIDs, urosuric drugs and allopurinol, to ease Sx of acute gout. Because cholchicine is specific for releaving pain and infl. of gout (mechanism not understood), GPs use it to confirm diagnosis before prescribing NSAIDs. In long-term treatment of gout with urosuric drugs or allopurinol, cholcicine is added for a few month to counteract their side effects (attacks of gout (!), especially at beginning of treatment. I don't know, but I assume, that cholchicum whole plant extracts have also been used traditionally for short term treatment of gout only. Elsa > > Dear Gursewa > > There is a useful but largely unreferenced chapter in Ebadi's book > (Pharmacodynamic Basis of Herbal Medicine) on colchicine and gout. Personally, I > wouldn't touch Colchicum autumnale with a barge pole until I knew much more about > it. Acute colchicine poisoning carries the risk of vascular damage, GI > haemorrhage and CNS toxicity, and using uncharacterised preparations of Colchicum > would be extremely risky. I believe that the future safe use of schedule III > herbs in general will depend on herbalists being able to source reliable, > well-characterised preparations. I don't think that most of us are geared up to > make them. We should now be putting pressure on the herbal suppliers to offer > products that have been assayed for their content of toxic constituent(s) > rather than to make a wider range of herbs available. This will give us a > rational basis for choosing safe doses. > > Another question is how frequently to dose. After a single iv dose, > colchicine can apparently be detected in the urine for at least 9 days, which would > make frequent, and certainly t.i.d. dosing, dangerous in terms of cumulative > toxicity. In any case, intravenous dosing (which, of course, we wouldn't > attempt) might be preferable to oral dosing to minimise GI side effects such as > abdominal pain. > > Rodney > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 15, 2008 Report Share Posted December 15, 2008 Dear Rodney I understand your concern here but I am equally concerned that what you say and the impression that can make could seriously limit the scope of herbal practice. If we start from a basis of fear we could end up just being able to give a few people chamomile tea as long as they are not allergic to compositae. We have a duty of care to our patients - yes not to poison them, but we are meant to do all in our power to relieve their suffering. When I have someone writhing in pain if I so much as disturb the air around them, how frustrating it is to know there is something that would most likely help them but it is just not available. Colchicum is not the same as colchicine in the same way that methylsalycilate is not synonymous with Filipendula. There is a widely held but arguably false view that isolating active ingredients leads to better medicine (consider older doctors views on digitalis v digoxin). There has to be a reason why colchicine was developed and I very much doubt it was to do with safety and had a lot more to do with patents and therefore money. As herbalists we have to be careful not to be drawn into thinking isolated active constituents have identical effects to those same chemicals in a plant. If they have then we may as well pack up shop and becomes doctors. Colchicum is traditionally used to treat acute gout, emphasis on acute – therefore its use is time limited. If you look at the data you will find: The maximum dosage permitted, dried corm Colchicum,is 10O mg (1½ grains), thrice daily. This is equivalent to 1 ml (15 minims)Tincture Colchicum B.P.1 : 10. Maximum 3 ml daily in divided doses. Now no-one is going to administer the maximum dose, and most certainly not straight up. With anything you start at a low dose and increase as necessary, if necessary, until you reach an effective dose. You are looking for the minimum effective dose. Why give 50 mls of valerian if 5 will do the trick? Granted the range for Colchicum might be small but the range for a number of herbs is small – it doesn’t mean we don’t use them. Cimicifuga has a low dose range, and people get headaches from it if it is given in large doses – but we use it daily. The precautions for Colchicum are given in Fred Fletcher Hyde’s document – restricted to acute episode of gout and symptoms should subside in 48 hours. Toxic effects are indicated along with how to treat them. He drew up that guidance after discussion with professional colleagues and based on professional practice, not a lab report. If you go to Bartram you’ll find he recommends 2- 5 drops every 2 hours. In Kings you’ll find that large doses may cause gastric upset as may continued dosing which may also cause diarrhoea and it says large doses should never be used. Note large doses, and continued use. At some point we have to value the experience of our elders and forefathers and learn from the extensive experience they have accumulated through years of treating patients. They know/knew what is safe. None of us is going to give an iv dose – well first of all everything from Disocorides to Bartram indicates oral administration and secondly that would be breaking the law – the 1968 medicines act. You say a single dose of colchicine iv can be detected for at least 9 days, so you are presumably looking at the half life. The problem with looking at half lives only in terms of cumulative effects is that you risk overlooking the therapeutic effect and that a certain amount is needed in the body to have the desired effect. We very rarely give single doses – if we were giving Colchicum, it would be small doses, very small in fact, and for a very limited time. We would also be monitoring the patient closely. Contrary to what you suggest about iv being a safer route for administration, it is in fact known to be less safe and that was why the FDA withdrew injectable colchicines recently (I know, it’s not Colchicum but in this case I think we can extrapolate). http://www.fda.gov/Cder/drug/unapproved_drugs/colchicine_qa.htm In case the link doesn’t work this is what it says. “Why is the FDA taking the injectable form of colchicine off the market at this time but not the oral forms? There is an increased likelihood of colchicine toxicity when the drug is administered intravenously. For oral dosing in the treatment of acute gout, the dose is usually titrated by administering the drug over time until symptoms resolve or the patient begins to experience side effects, which are typically gastrointestinal. This emergence of side effects when the drug is taken orally provides a margin of safety that often prevents serious and fatal overdoses. In the case of intravenous administration, side effects are generally not experienced until the patient has already received toxic levels of colchicine. Therefore, extreme care must be exercised when colchicine is administered by this route.†I also found evidence that colchicine (not Colchicum) through iv is likely to have caused deaths – administered over long time by naturopath in USA, and that deaths from that in 2000 were actually due to the manufacturer making a batch that was 10 times more concentrated than stated on the label. None of these are what a herbalist does or would do if we had a supply available to us. We’d more than likely have a lot of happy patients. We have an excellent safety record, as had our forerunners and we should not be looking to limit our practice in any way. Best wishes Quote Link to comment Share on other sites More sharing options...
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