WITH extensive APPENDICES ON pHASE i, ii & iii
METABOLISM
NEW APPENDIX –
BENEFITS OF INTEGRATINg botanicals WITH conventional therapies
by Francis Brinker, N.D.
Copyright 2008
All rights reserved
Last update: April 14, 2008
Combining herbal use with
prescribed medication should only be done after consultation with the
prescribing physician. Information
provided in the book and at this site is not intended to take the place of
instructions provided by one’s doctor, pharmacist or other health care
provider.
The content on this site is presented to supplement
the information found in the third edition of the book. By this means the database can be enlarged,
enhanced and updated without the user having to annually purchase a new printed
edition largely containing information already provided in the previous edition
or subscribing to an online updating service.
The format for this site is consistent with that found in the book, so
that herbs and appendix categories can be easily accessed by the same
arrangement as in the printed text. The page numbers for the updates indicate
where in the book the associated information can be found, while additions are
identified as "NEW." The added reference citations begin with
1100. Citations for lower reference
numbers are found in the book. Changes in scientific binomials and standardized
common names used here are now based on the second edition of Herbs of
Commerce (2000).
Since the information on
this site presupposes familiarity with the content in the book, it must be
understood in that context. The content on this site must be recognized as
inadequate without access to what has been published in the 3rd
edition. However, abbreviated versions
of prior referenced statements about the contraindications or the drug
interactions are included at the beginning of an addition to identify the
context of the addition. Listed below are important terms, abbreviations, and
symbols used in the book and/or on this site, followed by a Table of those
herbs and appendix sections to which additions have been made.
Regarding herbal
contraindications, many bridge the empirical vs. speculative designations, with
greater evidence provided by one or the other, though a combination of factors
often contribute. The method of determining such designations is imprecise, and
what is described as a speculative contraindication for self-prescribing by the
general public (the method employed for this text and web site) may in some
cases be more accurately described as a precaution for an expert prescriber
educated in botanical medicine (as indicated in other texts primarily intended
for professional use).
When herbal influence on
drug pharmacokinetics is discussed, the term “bioavailability” is often used as
a short-hand term to describe the total Area Under the concentration-time Curve
(AUC). Though the total time that the drug concentration is monitored may vary
from a few hours to to a few days depending upon the study, this general term
is applied to conveniently indicate that the overall average circulating serum
level of the drug has been significantly altered.
The
following terms are used to describe the different means of determining
botanical effects.
The
categorization of I, II, III and IV is used to rank potential herb-drug
interactions according to their probable pertinence based on the strongest
degree of evidence available.
Where
contradicting data exists for a particular item in any category, this is noted
by an indentation, and the sentence will begin with the word, “However.”
I. human studies –
published research done on healthy individuals
human
clinical studies – published research from therapeutic trials on patients
being treated for a condition
empirical – traditional knowledge or consensus based on
experience from extensive use
human
case reports – published individual responses to using herbs
II. in animals (types listed) – laboratory tests using live animals (in vivo