The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Herbs used to treat liver toxicity due to tuberculosis therapy

    Drugs to protect the liver are prescribed in some countries as a routine part of tuberculosis treatment.

    But do they work?

    First, the details.

    • 85 research articles were included in the review.
    • Studies were carried out in China (77), India (2), Russia (4), and Ukraine (2).
    • These studies were not limited to testing herbals, but also included vitamins and other drugs.
    • It was difficult to keep the patients from knowing their treatment because the herbals have distinct odors — blinding was often not done.

    And, the results.

    • Different combinations of ingredients were often given even in the same study based on the perceived needs of the patients.
    • 30 different liver protection drugs or mixtures of herbs, vitamins, and prescription drugs were identified.
    • Herbals included in the Chinese studies:
      • Extract of milk thistle (silymarin) most frequently
      • Oleanic acid (extract of swertia)
      • Glycyrrhizin (extract of liquorice)
    • Products in the Indian studies:
      • Stimuliv tablets
      • Optiliv capsules

    The bottom line?
    Drug-induced liver injury during anti-tuberculosis therapy ranges from 5% to 33% according to the American Thoracic Society. But it was impossible to determine if anything helped prevent liver toxicity in these tuberculosis patients.

    The studies reviewed were mainly small and poorly conducted. Study designs were sometimes mislabeled. For example, retrospective studies were sometimes actually case reports. The research methods were not defined. Little information about safety was included in the results. Outcome measures and endpoints were often omitted.

    Goodness gracious!

    10/22/08 19:24 JR

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