The Herb Drug Mix

The herbs and drugs that you shouldn't mix

| July/August 1999

There’s been a lot of confusing news lately about mixing botanicals and pharmaceuticals. What’s safe, what’s not? Here, Herbs for Health kicks off a regular column by medical doctor Robert Rountree, who will clear up the confusion and offer guidelines for safely ­combining medicine of both the botanical and pharmaceutical kind. This issue’s topic: the impact of herbs on blood-thinning drugs such as aspirin and warfarin.

Cautious doctors have chosen to avoid herbs, but is this rational?

Maggie, a patient in my ­family practice, has a dilemma. One of the valves in her heart was ravaged by rheumatic fever when she was a child. Now, at age sixty-eight, Maggie has just had the valve replaced with an artificial one.

Before the surgery, she had done her best to achieve a healthy lifestyle and ate a diet rich in fresh fruits, vegetables, and many herbs, including ginkgo and garlic. But after surgery, her doctor started her on a drug called warfarin (its brand name is Coumadin), intending to thin her blood so that it would take longer to clot. Along with the drug, he gave her two recommendations: Stop eating green, leafy vegetables, and stop taking ginkgo and garlic supplements.

On the one hand, Maggie trusts her surgeon. On the other, she has noticed that her memory has improved from taking ginkgo, and she counts on the green, leafy vegetables to provide her with rich sources of vitamins such as folic acid and carotenes. But she has to wonder—is it safe to discount her surgeon’s advice?

Maggie is not alone. Millions of people regularly take blood-thinning drugs such as warfarin, and even more take aspirin and similar medications to prevent heart attacks and strokes. At the same time, with the use of herbal medicines more popular now than ever, surveys show that most people don’t tell their physicians about their use of herbs or vitamin supplements.

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