Use of herbals associated with lower quality of life in asthma patients

Proponents of CAM often claim that one major advantage to their methods is the absence of side effects seen with conventional medical treatments. This makes little sense since there is no “free lunch” in physiology, and an intervention that affects one part of the system is going to have effects on other parts as well. Those practitioners who claim a “holistic” approach ought to realize this. If the treatment has absolutely no side effects, it’s probably because it isn’t doing anything at all.

And there is plenty of evidence that some CAM treatments can be harmful. While certain therapies, like homeopathy or reiki, may have little direct harm, they can still discourage patients from seeking and complying with more effective, evidence-based therapies. And the very CAM therapies most likely to turn out to have real benefits, herbal preparations, are also the most likely to cause unintended harmful effects, which is why they need to be properly studied before being used in practice.

A recent article in the Annals of Allergy, Asthma and Immunology surveyed primarily low-income inner city patients with chronic asthma to identify use of herbal treatments and any apparent association with how well their disease was controlled. What they found was that a moderate number of patients (25%) used herbal remedies for their asthma. Only about 39% of these people told their doctors about the use or herbal remedies, which raises the concern for unanticipated drug interactions. And about 20% of the herbal medicine users (about 5% of the total number of patients) used herbal treatments in place of their prescribed therapies.

Not surprisingly, the folks who used herbal preparations had a lower quality of life score and were significantly less likely to be complaint with their prescribed treatment regime than those patients who did not use herbal products. The authors also reported a trend towards poorer asthma control scores among herbal users. but this did not achieve statistical significance so it may not be a real finding.

The authors were careful to point out, correctly, that the association cannot identify a causal connection between quality of life and herbal remedy use. The poorer compliance with prescribed therapy can reasonably be suspected to be the causal factor, but it is impossible from this study to rule out a direct harmful effect from the herbal remedies or the possibility that people are seeking these remedies because they are not having an acceptable response to conventional therapy and that their poor compliance came after turning towards the CAM therapy.

However, there was also a correlation between use of herbal treatments and certain beliefs about conventional therapy, including concern about possible side effects and difficulty in following the prescribed treatment regime. This suggests that anxiety about the conventional treatment might be associated with susceptibility to the promises of safe and easy relief often used to market herbal therapies. This paper illustrates the dangers of such marketing strategies, which play into patient concerns which may be perfectly legitimate but which then offer alternatives which do not provide the relief the patient is seeking.

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8 Responses to Use of herbals associated with lower quality of life in asthma patients

  1. Bartimaeus says:

    This is the type of thing that particularly concerns me when CAM is used in pets. Combine the human ability for self-delusion and the pet’s inability to complain and the potential for unnecessary suffering on the animal’s part goes up. It’s bad enough when people do this to themselves, but even worse when they do it to a pet or even a child.

  2. Ceridwen says:

    I share Bartimaeus’ concern. When I owned a severely asthmatic cat I was constantly berated by other pet owners for refusing to use herbal and homeopathic treatments instead of the “evil” steroids he needed to survive (and I was spending no small amount of money to use inhaled medication so as to avoid the major side effects of steroids, not that it mattered to these people). I always hate to think about all the crazy, unhelpful, and potentially dangerous stuff these people are subjecting their own animals to.

  3. skeptvet says:

    Yes, it’s all well and good to point to subjective measures that improve as part of placebo effect in humans and claim that even when it isn’t really doing anything physiologically at least CAM offers some sort of perceived relief. But even that dubious benefit isn’t available to veterinary patients. And as this study illustrates, even in humans such methods can easily do more harm than good.

    And the self-righteousness of true believers is sometimes truly astounding. That they would feel justified in berating others for using scientific medicine would be unbelievable if I hadn’t seen it so many times.

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  7. Science and Reason says:

    “. The authors also reported a trend towards poorer asthma control scores among herbal users. but this did not achieve statistical significance so it may not be a real finding.” Direct quote from your article.

  8. skeptvet says:

    I’m not sure I see your point. The other findings were significant, and while associations do not prove causation they are one factor in assessing it. The general point is that there is not only a lack of evidence to show these treatments work, there is actually some evidence suggesting they may make things worse, and that should be factored into any decision about using them.

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