26 April 2008

Natural remedies - upsides and downsides

For obvious reasons there is a lot of interest in finding new sources for antimicrobial compounds that work against MRSA, and in finding non-drug remedies as well. There's been a small upsurge in reports of such research recently, which may be coincidence or may simply be due to the timing of certain scientific meetings.

Notably there was the report of "four or five super-active peptides" found in the blood of alligators and reported at the American Chemical Society's annual meeting a few weeks ago (first author Lancia Darville. Louisiana State University; Science News' take on the story is here), and another report at the same meeting of antimicrobial compounds in clay (authors Lynda Williams and Shelley Haydel of Arizona State University; press release here).

And just a few days ago, the journal Clinical Infectious Diseases posted ahead-of-print a study from the Netherlands on a "medical-grade honey" named Revamil that reduced skin colonization by resistant bacteria 100-fold.

That study's authors raise a red flag: that while honey has an antibacterial reputation that reaches back into prehistory, most investigations of honey as an antimicrobial have tripped up on the lack of product standardization, with batches from different areas, or even the same area at different times, showing significant variations in antibacterial activity. (Standardization of active ingredient is a long-standing problem for herbal remedies as well; regulatory authorities in Europe, where herbal preparations are more mainstream, are far ahead of the US on tackling this.)

It's important to remember that, naturally-sourced or not, antimicrobials are antimicrobials and must be handled with care, or they may invoke the sort of unintended consequences that brought us resistant organisms in the first place. For an excellent example of this, see a little-noticed paper from Irish researchers published last year in the the Journal of Antimicrobial Chemistry. That group found problems with the well-researched natural antimicrobial tea tree oil (Melaleuca alternifolia), which is commonly used in "natural" toiletries and cleaning products (and which I have in my own medicine cabinet). When tea tree oil was applied to bacterial colonies at a lower-than-lethal dose, the surviving bacteria developed resistance not only against the oil's active ingredient, but also against a range of antibiotics including vancomycin.

4 comments:

Robyn said...

Substituting a natural product for a synthetic drug without changing the underlying paradigm (reductionistic inhibition or suppression) does not make a natural product a better choice. It just makes another drug, especially if used as a pure compound instead of a mixture (the form it is found in nature).

That's not how nature employs their antibiotic defense systems. 3 billion years of experience has taught plants that super strong antibiotic are a dumb idea. Resistance is the response. So instead, plants use a myriad of approaches. Synergy. Taming the beast not challenging it. THAT is what we can learn from nature. But we STILL haven't got a clue. We want simple, financially rewardable, and painless.

Throw all the disinfectants and antibiotics you want at these bugs. But until we change our BEHAVIOR and learn to wash our hands, stay home when we are sick, wash surfaces sick people touch, stop sharing our drinking glasses...stop giving antibiotics to cattle to make them grow bigger, stuffing as many chickens in a pen as possible...well, dah.

And you suggest standardization is the problem? Oh please. Nature doesn't use standardization. Standardization serves a corporate system, not a natural one. Maybe there's a reason why nature doesn't make chemical mixes the same way each time.

Maryn McKenna said...

I absolutely agree with this: "[U]ntil we change our BEHAVIOR and learn to wash our hands, stay home when we are sick, wash surfaces sick people touch..." — the simplest actions are the most protective, but they also seem to be the hardest for people to do. When was the last time you saw someone wash their hands properly — getting all the surfaces down to the wrists, for the appropriate amount of time?

But about standardization: I don't understand why that would be problematic. Not everyone can wildcraft what they need; if they want to use a natural product but their choice is a tincture or extract, shouldn't there be some assurance that it contains what the label says? Also, what about the problem raised by the (pro-natural products) Dutch researchers, that the same substance harvested from the same place can have different degrees of effectiveness?

Robyn said...

The insistence that every herbal product should be standardized is believed by people who think that herbs are drugs. Herbs are only drugs when you purify specific compounds or if you use an herb in the manner you use drugs. Drugs are used to inhibit and suppress. Herbs are used in traditional medical models to tonify, strengthen and balance.

Standardization of which compound or what set of compounds? Who sets that standard? There is no standardization authority. It’s a sham to make you believe the product is better. Standardized products are expensive and out of reach of many who cannot afford $20 for an ounce.

The bioactivity of herb extracts whether water infusion or alcohol and water is based on a mixture of chemicals, sometimes hundreds of them. Which of those chemicals are released into the extract? In what ratio? Is the alkaloid or glycoside or tannin by itself the only biologically active chemical?

Hundreds of research papers now suggest that a synergistic effect IS the biological activity. Berberine does not kill Staph aureus by itself. But it can in combination with other compounds in the plant.

Meaningful standardization is a fantasy.

Withania standardized to contain exactly the “right” amount of withanolides is 20x more expensive than Withania tea which contains the same amount of withanolides as the standardized version. Who sets the standards for Withania? There exists no standardization authority for Withania or any other herb.

Plants are not standardized and neither are people. Each is unique. That is why we have so many side effects and deaths from properly prescribed drugs. Traditional medicine around the world understands this. That is why traditional models almost always include a system of diagnosis by pulse, tongue and urine. The energetics of the disease and the energetics of the herbs is crucial. It is understood that there are weak or poor quality herbs, but traditional practices suggest which herbs to use and which ones to discard. Quality is not the same as standardization, but corporations want you to believe that.

Standardization is good for corporations. It is not good for people.

Robyn said...

>When tea tree oil was applied to bacterial colonies at a lower-than-lethal dose, the surviving bacteria developed resistance not only against the oil's active ingredient, but also against a range of antibiotics including vancomycin.

It is important to remember that tea tree oil is a pure product, and is not found in nature in that form.