Every healthcare practitioner has a very important role to play in ensuring the wellbeing of individuals therefore it is important that we all work together to give patients the best possible care. The current system of healthcare(orthodox medicine) is backed by scientific evidence especially in the area of diagnosis, administration, and prescription of medicines to people. Knowledge about the practice of medicine is important in the provision of alternative medical practices such as Herbal medicine(Phytotherapy), Naturopathy, Homeopathy, etc.
However, the medicines used in the provision of Alternative healthcare are different from that of medical system and this has resulted in a lot of misconceptions mostly by practitioners of orthodox medicine and other individuals. The Herbal medicine practice is the only traditional medicine practice that is subjected to scientific findings or verifications. With increase research into plant medicine, herbal medicines being produced recently in Ghana are just like that of the orthodox (called pharmaceuticals) in terms of dosage forms, packaging, etc thus people think they are pharmaceuticals and should be treated as such.
This misconception is a result of little or no knowledge about Herbs, their nature, and how they work. Unlike pharmaceuticals where an active ingredient or compound is isolated from the plant, animal or mineral sources and made into finished products with a particular strength for a particular disease condition ( e.gNifedipine 20mg and 30mg for hypertension), herbal medicines make use of plant parts that contains a lot of compounds in their inactive state. Some of these compounds have been researched on and include tannins, saponins, flavonoids, glycosides, alkaloids, coumarins, etc.
The listed compounds found in plants are very broad and each type encompasses several subtypes whose activities have been confirmed through research. For instance, Reserpine, a type of alkaloid found in the plant Rawoufiavomitoria (known in twi as Kakapenpen) has been demonstrated to have an antihypertensive effect and thus support the use of the plant in the management of hypertension.
The challenge with herbal medicines however is that not all the components or compounds are known. In the case of Rawoulfia vomitoria, aside from having antihypertensive action, it has also demonstrated antidiabetic and antitumor activities which also suggests its use in the management of diabetes mellitus and cancer respectively. This explains why a single plant or plant part may treat more than one condition.
Most herbal products contain more than one plant (herbal mixture) so one can imagine the range of diseases these products can treat. The Food and Drug Authority (FDA) maintains that producers of herbal medicines should limit the number of disease conditions tackled by their products on the labels before registration and in the advertisement but only a few people adhere to this especially with the advertisement of products which causes people to doubt the credibility of these medicines.
Again some people have a misconception about the dosages of herbal medicines or products. Several factors are considered in determining the dosages of medicines in general. The dosages of medicines with high toxicity (narrow therapeutic index) during studies are carefully regulated as a little increment may cause severe unwanted effects and death.
Most Pharmaceuticals contain compounds in their active forms with narrow therapeutic indexes thus have a strict dosage system as compared to herbal medicines that contain several compounds in their inactive state. i.e Male adults may be required to take two capsules of a pharmaceutical aphrodisiac daily but three to four capsules for a herbal aphrodisiac. Aside from toxicity studies, the bodyweight of humans also play a role in the determination of dosages. This explains why different age groups of people take different dosages of a particular medicinal product.
There is also a misconception that herbal medicines have no contraindications. The indications of a medicine refers to the diseases or conditions tackled by the medicine in specified persons whiles contraindication refers to conditions or persons with which a medicine is not used. Herbal medicines are contraindicated in pregnant women as they contain components that can cause incomplete abortion harming both the developing fetus and mother. They are also contraindicated in children usually below two years as major organs like the liver, kidneys, etc are not well developed hence the body’s ability to breakdown the principles in the medicines is compromised leading to the build-up of toxic waste materials in the blood that may lead to death.
Also in lactating or breastfeeding mothers as principles from the medicines can be passed on to the baby through breast milk which can cause harm to the baby. Some herbal medicines just like their orthodox counterparts are contraindicated in certain situations as in individuals with Glucose-6-phosphate dehydrogenase deficiency, a genetic disorder that affect red blood cells that carry oxygen from the lungs to tissues throughout the body.
Another misconception is the claim that a single herbal therapy or medicine can completely treat a lot of chronic conditions. It’s no doubt that plants have the ability to treat numerous conditions due to their nature and most herbal products are mixtures of plants as earlier discussed. People resort to herbal medicines to treat chronic conditions such as Diabetes mellitus, Stroke, male and female infertility, hypertension, etc and this takes some time to achieve even with the intervention of herbal facilities like hospitals or clinics therefore available products on the market treats limited chronic conditions (at most three)whiles providing support for others but are misinterpreted by advertisers.
There is a general misconception that plants are natural and therefore safe. Not all plants used in the production of herbal medicines are safe because of the toxic nature of some plants. Just as the adage in twi goes: “3ny3 ahaban bia na 3y3 3duro’’ meaning not all leaves are considered to be medicinal. Some plants by virtue of where they grow make them toxic for instance those found growing along roadsides, radioactive waste sites, etc, and should not be used to produce any herbal medicine. Others are toxic by nature.
The fact that safe plants are used to produce medicines does not necessarily mean the finished products will be safe. In the production of herbal products, certain pharmaceutical materials such as solvents, preservatives, amber-colored bottles, etc are recommended according to standard reference books but some producers make use of banned materials that intend to make their products not safe for consumption. This is the reason why consumers of herbal medicinal products are advised to buy from licensed herbal shops or pharmacies and not from vehicles so that any unwanted effects from the products can be effectively traced back to the producers and corrections made (post-market surveillance).
Another misconception is the use of testimonies from people as the only basis for purchasing herbal products. Very often we hear herbal medicine peddlers in vehicles saying all sort of things just to sell their products. Almost all the time the products being sold have not been registered with the FDA so they go to the extent of narrating interesting testimonies of people they claim have had success stories just to convince people to purchase their products. Sometimes these testimonies are very relevant but should not be the only basis used for buying herbal products. Consumers should rather lookout for the FDA registration number and other important information on the product’s label.
People especially advertisers of herbal products have serious misconceptions about the role of herbal medicines in the management of conditions such as inguinal hernias, fibroids, convulsions, etc. The best approach to the correction of hernias is surgery but its associated symptoms are managed with medicines. Hernias are derived from the word herniation which simply means the movement of organs usually in the abdominal cavity from their original location to other locations as a result of increased abdominal pressure, heredity, etc thus the available types: umbilical, inguinal, incisional, hiatal and femoral hernias.
Practitioners often say their medicines melt hernias especially inguinal hernias which is totally incorrect. An inguinal hernia, the intestines, or bladder protrudes through the abdominal wall or into the inguinal canal in the groin therefore they saying their medicines melt hernias suggests that the protruding organ is melted which is not the case. Again with fibroids (noncancerous growth in the muscular walls of the uterus), herbal medicines manage them only at certain sizes but surgical intervention remains the best option in this case.
Lastly some health workers especially medical doctors blame conditions such as kidney and liver disorders on the use of herbal medicines. This is a serious misconception as there is no strong scientific evidence to back this claim. Well prepared Herbal medicines just like pharmaceuticals have side effects and their abuse may affect the liver and kidneys. The hepatotoxic potential of herbal medicines has been recognized for many years and there are no reliable clinical population-based statistics for the incidence of toxicity attributed to herbal medicines in Ghana and places like the United States of America.
However poorly produced herbal medicines may contain banned substances such as heavy metals, microbial products, pharmaceuticals, and pesticides, and these products if consumed will cause serious damage to the liver and kidneys. This claim is fueled by the fact that most people diagnosed to have certain diseases like hepatitis B resort to over-the-counter medicines, self-made herbal preparations, or preparation made by other people without talking to their healthcare providers or visiting a herbal facility first for medical intervention.
These people later report to the hospital when their condition gets worsens and are most of the time reluctant in telling the medical doctors about the herbal medicines they have been on. In some instances, patients do tell their doctors about these medicines but because medical doctors have little or no knowledge about herbal medicines tend to blame the liver or kidney problems on the use of herbal medicines instead of finding out scientifically the cause of the claimed conditions.
Medical practitioners who wish to know more about a particular herbal medicine or herbal medicines, in general, to aid in their diagnosis should not hesitate to contact the herbal medicine department, faculty of pharmacy and pharmaceutical sciences Knust or the Centre for Plant medicine research, practicing Medical Herbalists (MH) across Ghana and myself.
BENTIL EMMANUEL ASARE
bentilemmanuelasare@yahoo.com
+233546678401
