Natural Products

Jun 2, 2016

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Children lie. Lying is something to be celebrated! In a wonderful TED talk, Kang Lee explained that lying is developmental step for children just like walking and talking. Lying requires that a child understands everyone in the world doesn't the same knowledge in their head as them. It also requires the child to look at another person and know that person doesn't know what the child knows. These complicated mental gymnastics should be celebrated says Kang Lee. Lying is not a sign your child is going to be a criminal. This made me breathe a sigh of relief for Eric. But what really caught my attention was how poor parents were at catching their own children's lies.

Like lying in children, natural products are not inherently bad. We just seem to be willfully blind to the fact that "natural" does not mean "safe". I'm not against natural products. I just want people to treat them with respect. I also want people to let their doctors and pharmacists know they are taking them.

I hear it all the time. "I just don't want my child to be on drugs." "I'm the type of person who doesn't like medication." "Isn't there a natural option?" I understand the reluctance to take medications. Medications can be scary. Taking medication can mean you are sick and you don't want to be seen as sick. Medications can have scary and serious side effects. I'm usually happy that people treat medications with the respect they deserve because if they aren't used properly, they can be harmful. But if used properly, they can be helpful and even lifesaving.

People seem to have a different mind set about natural products. Natural seems to mean safe to many people. That simply doesn't make sense. If you take a natural product because you want it to change how your body is working, it is a medication. If it changes how your body works, it is doing the same thing as medication does. It can have serious side effects. It should be treated with respect.

Things get even more complicated with people start mixing their conventional medications and natural products. Theoretically lots of natural products have interactions with medications. The problem is no one has done the studies to see if these are real interactions or not. So if you ask me if this natural product interacts with your medication, many times I'm going to have to tell you we just don't know.

St. John's Wort is a natural product that is promoted to treat depression. It can also effect enzymes in the liver that break down other drugs. That means it can reduce the efficacy of certain medications. It can make birth control pills less effective which increases the chance of unintended pregnancies. It can make newer blood thinners like Eliquis and Xarelto less effective which increases the chance of stroke. Interestingly, St. John's Wort can make the blood thinner called clopidogrel or Plavix more effective. That means combining them can lead to excess bleeding problems.

Since St. John's Wort is supposed to work on depression, it is not surprising that if you use St. John's Wort and antidepressents like SSRI's together, it can cause problems. SSRI's have names like paroxetine, and citalopram. Using St. John's Wort and an SSRI is kind of like overdosing on an SSRI. It can lead to a problem called serotonin syndrome. Early symptoms of serotonin syndrome include jitteriness and muscle spasms.

Glucosamine with or without chondroitin is a natural product I actually recommend quite often. There actually is a little science saying glucosamine can help repair the cartilage in the worn-out knees of people with osteoarthritis. I was surprised to learn that there have been cases of people who take glucosamine and the blood thinner warfarin together whose blood gets way too thin. The lab test INR is how we measure how thin the blood gets when someone is on warfarin. Some people who are on glucosamine and warfarin together have their INR go up a lot and we worry those people will bleed too easily. Glucosamine turns out to be similar to a component of heparin which is another blood thinner. We don't know if that is why it interacts with warfarin, though. To be safe, people on warfarin should not use glucosamine products.

Ginkgo is another popular natural product. It is often used to help with memory problems. If someone who is on seizure medications takes ginkgo, unfortunately it can increase the chance of that person getting a seizure. Ginkgo can also make some one who is already on blood thinners bleed more easily.

Kang Lee and his researchers played videos of children lying and telling the truth to social workers, police officers, customs guards and judges. You would think all these professionals who deal with truth and deception would be good at spotting lies. Nope. They all scored about 50%, or no better than chance. The next one really surprised me. Kang Lee showed videos of children lying and telling the truth to their own parents. Again their own parents spotted the lie about 50% of the time, or no better than chance. That means that when Eric tells me he didn't break that window, or when Emily says she didn't go to the drinking party, I won't have any idea if I should believe them or not. This result freaked me out. So here is my new parenting plan. I teach the kids poker and play them for their allowance every week. That way I can learn their tells, and assess their truthfulness. Emily says I should just learn to trust them, and not be a helicopter parent. I think teaching the kids to gamble away their paychecks every week is much more reasonable, right?

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

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Can you tell if a kid is lying - TED Talk:


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