What Can we use in Place of Over-the-counter Medications like Zantac

September 20, 2019/in News/by David Shaw

Herbal Medicines that can help support GERD before, during and after using Zantac.

Some interesting news has come out this week from the FDA in the United States regarding Zantac containing a chemical that is possibly carcinogenic. These types of stories are eye-catching and tend to make the headlines of major news outlets. It is always important to look further into claims made by any organization, including the FDA. Zantac, also known as Ranitidine, was put on the market in 1981 and was the top-selling prescription drug that year. Since then the drug has been available as an over-the-counter medication at many grocery and drug stores.

According to a FOX news report a carcinogenic constituent known as N-nitrosodimethylamine (NDMA), is labelled as a probable human carcinogen. The reason for this claim is based on studies showing that this chemical causes cancer in animals (Fox News, 2019). As of right now, no recalls are being recommended by the Food and Drug Administration since the amount of NDMA inside of the drug Zantac is in such small amounts. According to the US Environmental Protection Agency or the EPA, NDMA was formerly used in the production of rocket fuel (Foxnews, 2019). Many Pharmaceuticals that have been developed since World War II are a product of the petroleum industry, and NDMA is no exception.

Zantac is commonly prescribed for GERD, peptic ulcer disease, and for high stomach acid production that is often associated with heartburn. According to a professional resource out of the UK patient.Info.com heartburn and other discomforts in the upper abdomen were formerly classified as dyspepsia prior to 1991 (Patient, 2019). The term has evolved into the acronym GERD which stands for gastroesophageal reflux disease. One Belgian population study reported the prevalence of GERD in their population. They found that about 20% of their population exhibited symptoms of GERD (Patient,2019). It’s easy to see why Zantac would be so popular and prescribed as an over-the-counter medication across the world.

What is GERD?

So what is GERD specifically? Most often there are many different symptoms and can include:

Bloating
Nausea
Pain inside the chest near the heart mistaken as a heart attack (epigastric discomfort)
Fatty food intolerance (Patient, 2019)

There are many other conditions that can mimic the symptoms so it’s important to check with your healthcare provider to rule out any alarming conditions. Other conditions with similar symptoms include:

irritable bowel syndrome
gallstones or pain in the gallbladder
esophageal spasm
and peptic ulcers (Patient, 2019)

Herbal medicine is a great ally for people with GERD and can help with pain management and even reduction of symptoms – without the same side effects as conventional pharmaceuticals. It has been shown that long term use of Ranitidine decreases the absorption of nutrients like magnesium, calcium, B12 and Vitamin C. This is the result of long-term suppression of stomach acid (Heidelbaugh, 2013). This doesn’t mean that short term use of proton pump inhibitors (PPI) like Ranitidine shouldn’t be used but rather should be used appropriately. It is important to weigh the benefits and risks as you would with any other medication when applying it for any length of time.

So where does Herbal medicine come in?

We have different approaches to getting to the underlying causes of GERD or dyspepsia. We also have different approaches to protecting the stomach and the small intestine with plants that create a protective barrier of plant mucilage and that are anti-inflammatory.

Plants that we would use to help reduce stomach acid include Meadowsweet (Filipendula ulmaria) and to some extent chamomile (Matricaria recutita).

To help with protecting the stomach we would use anti-inflammatories like the resins found in calendula (Calendula off.) and the anti-inflammatory properties of licorice (Glycyrrhiza glabra).

For short and long-term GERD symptoms we would almost always address diet and lifestyle. Herbal medicine can help with returning the body to its normal way of functioning but diet and lifestyle are so foundational that we would need to make any adjustments needed rather than just throwing a plant at the problem. This should also be true when applying drugs like Zantac

Filipendula ulmaria:

Meadowsweet is also known by its Latin name Filipendula is one of the few plants we would consider an antacid. This plant also acts as an anti-inflammatory, astringent, antiseptic and is protective of the mucosal barrier (Bone, 2007). Specific indications for Meadowsweet include:

dyspepsia
IBS
soothing the mucous membranes (Bone, 2007)
gastrointestinal inflammation
muscle and joint pain
and urinary tract inflammation (PRC, 2018)

Some of the active constituents inside of Filipendula include quercetin and salicylic acid. Both have been highly researched. This plant should be taken with caution for people who have a sensitivity to salicylates, like Asprin

Matricaria recutita:

One of the most underrated herbs used around the US and Canada would be Chamomile. This plant has a relaxing/sedating effect and is also anti-inflammatory and anti-ulcer. Chamomile is also mildly bitter and acts as a carminative to help break down and expel gas (PRC, 2018). Some specific applications for chamomile include:

IBS
flatulent colic
colitis
gastritis
mouth ulcers and
wounds (Bone, 2007)

Calendula officinalis:

One of the most common plants found in a medical herbalist dispensary is the beautiful Calendula. We use the flower of this plant. The active constituents that help reduce inflammation include the resins, triterpenoid saponins and the flavonoids: kaempferol and quercetin (PRC, 2018).

This plant is very versatile and is commonly used for many topical applications including but not limited to diaper rash, cradle cap, eczema, cuts and scrapes. More specifically we also take Calendula internally for digestive inflammation and ulcers as well as inflammation in the small and large intestine. There is also a use for the calendula in the cases of eczema and acne as it has depurative properties.

Glycyrrhiza glabra:

Another versatile herb that we use to help with many different symptoms and conditions is Licorice. Licorice is:

anti-inflammatory
protective to the stomach and the intestinal lining
demulcent
anti-ulcer
it is expectorant
mildly laxative.

Gastrointestinal issues we tend to use licorice for are: ulcers, GERD, gastritis and to reduce inflammation of the gastric mucosa (PRC,2018). Since Licorice is mildly laxative, we would also use it to stimulate bile flow and to help with constipation.

Some non-gastrointestinal applications that we would use Licorice for include: chronic fatigue syndrome, eczema, respiratory problems, and topically for viral infections like shingles and chickenpox.

Though Licorice is widely popular there are some specific contraindications to be aware of. Licorice is not recommended for people who have edema, who are dealing with high blood pressure or congestive heart failure (Bone, 2007).

Herbal medicine can be used to help with symptoms for many different varieties of gastrointestinal issues. If there are any questions or comments please feel free to reach out and speak with an herbalist near you or through this blog.

David is a Medical Herbalist practicing on Vancouver Island. His holistic health path has led him to work with many different people operating a general practice at Apotheka Herbal Boutique with access to over 150 plants. He has a special interest and focuses his study working with families, including children, athletes and men’s health. If you are interested please message for a free 15-minute phone consult to see how herbal medicine might be helpful for you.

References:

Rettner, R Sept. 16^th, 2017; Zantac found to contain traces of cancer-causing chemical; https://www.foxnews.com/health/zantac-found-to-contain-traces-of-cancer-causing-chemical

Knott, L Oct. 2017; Dyspepsia https://patient.info/doctor/dyspepsia-pro

Heidelbaugh, J June 2013; University of Michigan; Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110863/

PRC Monograph Sept. 2018, Pacific Rim College, Victoria, BC

Bone, K July 2007, Warwick Queensland-Phytotherapy press The Ultimate Herbal Compendium

Photos complimentary Pacific Rim College Monographs.

What is the Difference Between a Naturopath (ND) and a Medical Herbalist (RHT)?

September 16, 2019/in News/by David Shaw

Do You Need a Naturopath or a Medical Herbalist?
By David Shaw

The holistic health world has always been with us to some extent or another. Speaking with seasoned herbalists and older patients, they both mention that the options for a more natural approach in health care have been there; although elusive. A compounding effect seems to have taken place over the past 15 years in the holistic world. More people are venturing away from conventional medicine with more education around preventative care like diet and lifestyle choices. This is where the newest profession of Naturopathic Doctor (ND) in the health field has been developed and the colleges of Holistic Medicine have sprung up in North America. Working with patients over the past 3 years I have come across very specific differences between ND’s and Medical Herbalists (RHT)/Holistic Nutritionist (HNC), not just in our approach and “prescriptions” but also training.

Comparing ND and RHT side by side:

Below is a table breaking down the training provided by two different colleges, one an ND curriculum and the other an RHT/HNC program. The table below has been condensed to their specific categories. More information explaining the naturopathic therapeutics is below the table.

ND Training RHT; HNC
Biomedical/Western Diagnosis: ND -3742hrs.    RHT -525hrs
Nutrition:    ND-144hrs.     RHT -675hrs.
Herbal Medicine, Ayurveda/TCM: ND()    RHT -1080hrs.
Clinical Practice:    ND~1200 hrs.        RHT~860 hrs.
Naturopathic Therapeutics: 588hrs.*
** N/A

***Naturopathic Therapeutics total of 588 hours includes Herbal medicine, Homeopathy, TCM, Hydrotherapy, ND Manipulative therapy, Ayurveda, Case analysis, ND Philosophy. (See references for resources)

The two biggest differences between the two health professions is the study in Biomedical studies and then Holistic therapeutics.

The course content for ND’s in the biomedical/Western Diagnosis is very extensive and detailed (list of courses are in the notes). This is the training that specifically qualifies them to practice within the conventional medicine world. On top of that training, they can also opt-in for additional training to be able to prescribe pharmaceuticals. The RHT/HNC are taught the fundamentals of Biomedical/western diagnosis introducing the student to anatomy, physiology, pathophysiology, all diagnostic tests and results, western pharmacology and more. A lot of the same topics are covered within the Biomedical sciences comparing the two programs- with the ND spending more time on each topic.

Medical herbalist training:

The time spent training a Medical Herbalist on Materia Medica – an in-depth study of each individual plant is extraordinary. This time is spent learning the properties of more than180 plants that would be in a dispensary including therapeutic applications, specific applications to conditions, contra-indications, dosage and the current scientific research. The therapeutic application is further explored in a separate curriculum learning how to apply plant medicine to a specific disease. In comparison to an ND, the time spent is not proportionate. The same can be said with the difference in time spent in studying nutrition and the therapeutic application.
The HNC studies holistic nutrition in-depth:
– Proper diet
– Therapeutic application
– Supplemental advice
– Diet analysis
– Meal planning

Clinic hours comparison:

The clinical practice acquired while in college is fairly similar. The ND college provides about 300 more hours. This time is spent gaining experience working with patients, learning constitution differences, applying integrative physical examination and ethical patient communication.

Regulating bodies and government oversight:

There is quite a difference between a Medical Herbalist and Naturopathic Doctor and both are viewed differently in the eyes of the government and overseen by different regulating bodies. Naturopathic Doctors must complete a board exam coming out of college to meet the standards of their regulating body, The College of Naturopathic Physicians of British Columbia. Similarly, to complete the Medical Herbalist programs some colleges will require a live observation of a new herbalist in front of a medical doctor and other herbalists.
Medical Herbalists also have a Regulating Body in British Columbia known as the Canadian Herbalist’s Association of British Columbia. This is where the designation of Registered Herbal Therapist or RHT is obtained. Standards are set and overseen by this organization so that a person who attends a two-week intensive course on herbal medicine is held to the same standard as a person who spent 3 years in training.
Another difference between the two regulating bodies is that one is recognized by the Canadian federal government and one is not. This is how ND’s are able to direct bill insurance for the patient who has extended coverage and the care provided by a Medical Herbalist is always out of pocket for the patient.

Speak to an Herbalist

The right practitioner for your approach:

It is important to find a health care provider that appeals to your goals. For a lot of people, the conventional model using pharmaceuticals is the right approach. People are making a turn towards preventative care and alternative approaches to healing and that’s where the Naturopathic Doctor and Medical Herbalist come in. The ND and RHT are bringing both worlds together being able to bridge conventional medications and alternative therapies. The ND has a wide range of training in a lot of different fields with some deciding to specialize in one field or another. A Medical Herbalist is the specialist in applying herbal medicine to a diagnosed and/or suspected condition. A lot of times ND’s and RHT’s work together for the benefit of the patient and to provide comprehensive care. In the holistic health world, the bottom line is and should always be the patient, nothing more.

What to expect from a Herbal Medicine consultation?

Medical Herbalists are outside of the conventional bubble. When it is necessary, we like to work directly with other health care providers to have a comprehensive approach. We are able to use the tools and diagnosis provided from conventional medicine and apply specific and appropriate plants to facilitate healing. Our environment and the food we eat are so fundamental that a health picture wouldn’t be complete without looking in these areas for each individual person.

Inside an Herbal Medicine consultation, you can expect:

60 – 90-minute consultation
Complete health background and health concern intake
Diet review and adjustments as you feel necessary
Diet analysis and meal planning to fit your goals (optional)
A comprehensive exploration of each body system: everything from the cardiovascular, respiratory, nervous and digestive systems, et
Complete review and understanding of all conventional diagnostic tools like lab work
Supplement analysis and adjustment where you/we feel necessary.
Specific herbal remedy(s) recommendations

References:

Naturopathic Medical Education Comparative Curricula – National College of Naturopathic Medicine PDF – https://www.bcna.ca/documents/comparativecurriculacombined.pdf

Pacific Rim College 2019 – Website; Dual Diploma of Phytotherapy and Holistic Nutrition Course Overview and Curriculum

Dual Diplomas of Phytotherapy and Holistic Nutrition

Naturopathic Medicine – Regulating Body Province of British Columbia – https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/professional-regulation/naturopathic-medicine