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Combinations of Natural Products Opportunities and Dangers

Combinations of Natural Products Opportunities and Dangers. Dr. Paul F. Davis Bioactivity Investigation Group (BIG) Wellington School of Medicine and Health Sciences Wellington New Zealand. Natural Products. Long History Prevention Therapeutics. In Early Times Achieved Via Food.

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Combinations of Natural Products Opportunities and Dangers

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  1. Combinations of Natural ProductsOpportunities and Dangers Dr. Paul F. Davis Bioactivity Investigation Group (BIG) Wellington School of Medicine and Health Sciences Wellington New Zealand

  2. Natural Products • Long History • Prevention • Therapeutics

  3. In Early Times Achieved Via Food • Derived preparations from: • Animal • Plants • Fish • Birds Becomes a tradition

  4. Traditional Chinese Medicine • 3,500 years ago-origins • 2,700 years ago (Zhou Dynasty)-regularly prescribed

  5. Arabian Medicine • 1,800 years ago • Drugs • Many conditions • 1,100 years ago • Samanids • Muhamad Zakariyya Razu • Abu Ali Ibn Sina • Records kept

  6. South American Medicine • Incas • Bolivia • Kallaways (1500 years at least)

  7. Long history suggests efficacyRecognised by current consumers

  8. Currently • Increasing use of Natural Products • Preventative • Therapeutic • Nutraceuticals • Functional Food • Food Supplements • Medicinal Food • US Market-$18 billion in 2001- 20% per annum growth

  9. Tendency to use multiple products, multiple conditionsAnecdotal Information Basis

  10. Combinations • Natural Products-Natural Products • Natural Products-Prescription medicines

  11. Examples • Garlic –used for hypertension, cardiovascular conditions, neoplasms and infections • Cod Liver Oil- used for B-cell lymphoma, prostate cancer, breast cancer, hypertension, hypertryglycerdemia, arthritis, cardio vascular conditions • Garlic +Cod Liver Oil- used for anti-coagulant (andecdotal)

  12. Examples • Ginger • Has over 30 uses including inhibition of platlet aggregation • Regarded as safe • Potential Risks • Concurrent use with anti-coagulant prescriptions or natural products • When combined with angelica, garlic, ginseg panax, red clover, tumeric

  13. Risks for: • Individuals • Producers • Marketers (international sales)

  14. Risks occur when: • Consumer does the combining • Marketer does the combining

  15. Beneficial or Detrimental Product available in Korea, Japan, and China • Oil derived from shark • Anti-angiogenic • Anti-inflammatory • Mushroom Extract (b-glucan rich) • Immune enhancing

  16. Beneficial or Detrimental • Shark Oil +Mushroom extract • Reduction in proliferation of primary tumours • Reduction in metastases • Effect of combination is synergistic • Neither of them or combination is anti-tumour

  17. Beneficial or Detrimental • Echinachea-Immune enhancing (Cichoric acid) • Echinachea+Herbal Supplements-No reported adverse effect • Echinachea+Other Immune Stimulants-Additive effect • Echinachea+Other Immune Stimulants-Suppresseive effect Examples of these are commercially available

  18. Examples From BIG Research • Lipid-rich extract from sharks is anti-angiogenic • Potency meant dilution required • Cooking oil (olive oil)-inactive • Combination • 2x more active invitro • 6x more active invivo Synergistic Activity-Beneficial Outcome

  19. Risks of Prescription Pharmaceutical • Widely Publicised • Recent publicity on Cox-2 inhibitors • Also risk of combining 2 pharmaceuticals (regulatory authority requirment) • Frequently these combinations are for chronic conditions-Elderly often have several medical conditions

  20. Possible that Patients are Taking: • Over the counter remedies + Prescribed therapies • Combination often not revealed at time of prescribing • Non-prescription item commenced subsequent to prescription • Risky • Little research information

  21. Example-Warfarin • An anti-thrombotic, anti-coagulant • Activity decreased by: • American Ginseng • St John`s Wort • CoQ10 • No data on ginseng (Siberian)

  22. Example-Warfarin • Not all combinations are detrimental • Activity increased by combining with: • Garlic • Ginger • Ginkgo Biloba • Fish Oils • 60 other products

  23. Summary All Natural Products: • Biologically active • Can interact with cells, pathways, like drugs • Modulate other activities • Own activities altered Care and caution needed Similar approach to that with pharmaceuticals Significant lack of data and information Need for Research is Urgent

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