A forensic pathologist from the University of Adelaide has issued a warning to users of herbal medicines who take these medicines in large quantities, injected, or combination with prescription drugs.

Professor Roger Byard, the pathologist, issued this warning that appeared in the US-based Journal of Forensic Sciences outlining the highly toxic nature of many herbal substances considered to be safe.

From Sciencedaily.com:

In his paper he cites the case of an epileptic patient on prescription medicine who had also ingested a Chinese herbal preparation and lapsed into a coma. Cushing’s syndrome, a hormonal disorder, has also been linked to the ingestion of steroids and herbal cures mixed together.

Some herbal medicines may also have a variety of effects on standard drugs, according to Professor Byard. St John’s Wort can reduce the effects of warfarin and cause intermenstrual bleeding in women taking the oral contraceptive pill.

Gingko and garlic also increase the risk of bleeding with anticoagulants and certain herbal remedies such as Borage Oil and Evening Primrose Oil lower the seizure threshold in epileptics.

Professor Byard says the American Society of Anesthesiologists has recommended its patients discontinue using herbal medicines at least two weeks before surgery because of the risks of herbal and drug interaction, including an increased chance of hemorrhaging.

Professor Byard said that the safe-considered herbal substances may cause serious illnesses, exacerbate pre-existing health problems or even death when taken in excess or injected rather than ingested.

The odds of developing heart damage in children with Kawasaki’s disease are reduced to a significant extent when steroids are added to the standard treatment.

The finding was revealed during a study in an issue of Pediatrics and highlights a gap in knowledge. It was emphasized by this study that the benefits of steroid treatment for Kawasaki’s disease are good enough to provide relief to the children with this complication.

From News-Medical.Net:

Current guidelines from the American Academy of Pediatrics state that the evidence for steroid treatment is lacking and recommend the standard treatment for Kawasaki’s, which is aspirin and intravenous immunoglobulin (IVIG).

“This gap in knowledge led us to examine the benefits of steroids more closely. We looked at research worldwide and were surprised to find eight solid clinical trials showing the value of steroids in significantly reducing heart damage in children with Kawasaki’s disease. Steroids, when combined with aspirin and IVGB, reduced the odds of developing inflammation of the heart blood vessels by half,” said Stephen Aronoff, MD, lead author of the meta-analysis and Temple University School of Medicine professor and chair of pediatrics.

Kawasaki’s disease is one of the leading causes of acquired heart disease in children. The complication is treatable and the symptoms are red eyes, palms and foot soles, and swollen lymph nodes.

Children administered with steroids to treat chicken pox are at a higher risk of a more severe case of the virus leading to death.

The finding was revealed by pediatric oncologists at the Brenner Children’s Hospital, part of Wake Forest University Baptist Medical Center.

From News-Medical.Net:

“Steroids are used to treat leukemia and they suppress the immune system,” said Thomas McLean, a pediatric oncologist at Brenner Children’s Hospital. “When a child is exposed to the varicella virus (the virus that causes chicken pox) around the time they are receiving steroid treatment, they are more likely to contract a more severe case of chicken pox.”

McLean and his colleagues studied 697 patients with acute leukemia over a nine-year period. About 16 percent or 110 patients contracted chicken pox. Of those 110 patients, 54 had severe disease, including two deaths. Of the patients whose chicken pox was diagnosed within three weeks of taking steroids, 70 percent had severe infection whereas only 44 percent of those who had not received steroid therapy within three weeks had severe infection. Although the study was limited to patients with leukemia, the findings may apply to other conditions for which steroids are used, McLean said.

“One of the things we need to remember to ask before we prescribe steroid treatment is whether the child has had a recent exposure to chicken pox,” McLean said. “If so, we recommend waiting until the incubation period has passed before beginning steroid therapy.”

It was noted that chicken pox, though mild in nature, can result in fatal complications. It is worth noting here that there were approximately 12,000 deaths from chicken pox on a yearly basis before the discovery of varicella vaccine.

According to Lung disease experts at Johns Hopkins, medical practitioners must observe a high sense of care before recommending corticosteroids to patients suffering from COPD (chronic obstructive pulmonary disease).

It is believed that COPD is a complication affecting more than 11 million people in the United States alone and a big part of this affected population belongs to the category of past or present-day smokers.

From News-Medical.Net:

Despite the increased pneumonia risk, the team found no clear evidence that the drug therapy also pushes up rates for other steroid-related problems, such as bone fractures, nor was there an increase in deaths.

Senior study investigator and critical care specialist Eddy Fan, M.D., says the results of the analysis should not alarm patients or cause them to stop taking their medications but should spur physicians to screen and monitor their patients to find the lowest possible steroid dose that works, especially in the elderly, people with immune system problems, and people who have had multiple bouts of pneumonia and for whom repeat bacterial infection might be a life-threatening complication.

“Inhaled corticosteroids are not of equal benefit to all, and what we are seeing is that the treatment may be more harmful and pose a greater risk of harm to some,” says Fan, an instructor at the Johns Hopkins University School of Medicine.

Lead author and pulmonologist M. Brad Drummond, M.D., M.H.S., said the finding is nothing but a reminder for prevention of pneumonia, which can double the risk of death.

The use of growth hormone (GH) in an injectable form for the purpose of building solid muscle mass is irrelevant, according to a dissertation from the Sahlgrenska Academy at Göteborg University in Sweden.

Growth hormone does not offer benefits on the same lines as anabolic steroids, which are used by sportsmen for enhancing performance and building muscle mass. It was noted that the use of growth hormone may even lead to health complications such as damage to the heart and blood vessels.

From News-Medical.Net:

“Many of those who abuse anabolic steroids regard growth hormone as the Rolls Royce of doping agents: it is significantly more expensive to use than anabolic steroids. There is, however, no scientific evidence that it increases performance when used alone as a doping agent”, says Dr. Christer Ehrnborg.

Christer Ehrnborg has studied 30 well-trained people living in Göteborg. Twenty of these injected large doses of growth hormone each day for a month, while the other 10 believed that they also were receiving growth hormone but received injections of harmless saline solution instead. Tests of the participants’ physical performance on an exercise cycle showed that the participants receiving growth hormone did not perform better than those receiving saline solution.

“It has been a matter of controversy whether growth hormone actually causes an effect or whether it is a matter involving mass psychology. Both our study and studies carried out by others suggest that taking growth hormone will not make you a better athlete”, says Christer Ehrnborg.

Christer Ehrnborg, who was involved in this dissertation, said that some sportsmen may sense a sudden change in the body (perceived as benefit) after using GH but there is no benefit such as increased muscle mass of GH.

A recent study has found that administration of injectable teriparatide (foreto) results in improvement of bone mineral density (BMD) by as much as two percent when compared to oral alendronate (fosamax) in a head-to-head comparison.

It was remarked by Kenneth Saag, M.D., of the University of Alabama at Birmingham and his colleagues, that teriparatide is better than alendronate for promoting improvements in the BMD level at the spine and hip.

From Medpagetoday.com:

“In our study, teriparatide was associated with greater increases in [BMD] at the spine and hip and with significantly fewer new vertebral fractures,” Dr. Saag’s group wrote. But the dropout rate for adverse effects was twice as high for those taking teriparatide.

Only one out of 171 evaluable patients receiving teriparatide had radiographic evidence of a vertebral fracture, while 10 of 165 evaluable patients on alendronate had such fractures (P=0.004).

Nonvertebral fractures occurred at similar rates with the two treatments (5.6% versus 3.7%, P=0.36). BMD in the total hip increased with both drugs, though less dramatically than in the lumbar spine. Teriparatide increased hip BMD by 3.8% while it rose 2.4% in the alendronate group. The advantage for teriparatide was significant (P<0.01). Significantly more patients in the teriparatide group had at least one elevated serum calcium measurement > 10.5 mg/dL (18% versus 5.7%, P<0.001) and there was a tendency toward more patients with at least one measurement > 11 mg/dL (3.8% versus 1%, P=0.06).

Teriparatide is a recombinant peptide drug, based on a portion of the parathyroid hormone protein. Earlier studies had indicated that it leads to increased BMD.

Philip N. Sambrook, M.D., of the University of Sydney, said that teriparatide can be considered as an effective form of treatment and may even be taken as a potential first-line therapy for steroid-Induced osteoporosis as per the findings of Saag and his colleagues.

The benefits of anabolic steroids have always impressed one and all but a paper presented at the American Society of Nephrology’s 42nd Annual Meeting and Scientific Exposition in San Diego, CA has suggested that athletes using steroids can suffer from kidney damage.

This complication was previously unrecognized and can happen when steroids are used on a habitual basis.

From Sciencedaily.com:

Reports of professional athletes who abuse anabolic steroids are increasingly common. Most people know that using steroids is not good for your health, but until now, their effects on the kidneys have not been known. Leal Herlitz, MD (Columbia University Medical Center) and her colleagues recently conducted the first study describing injury to the kidneys following long-term abuse of anabolic steroids. The investigators studied a group of 10 bodybuilders who used steroids for many years and developed protein leakage into the urine and severe reductions in kidney function. Kidney tests revealed that nine of the ten bodybuilders developed a condition called focal segmental glomerulosclerosis, a type of scarring within the kidneys. This disease typically occurs when the kidneys are overworked. The kidney damage in the bodybuilders has similarities to that seen in morbidly obese patients, but appears to be even more severe.

The study was conducted in the lab of Dr. Vivette D’Agati, MD at Columbia Univeristy Medical Center. Study co-authors included Glen Markowitz, MD, Joshua Schwimmer, MD, Michael Stokes, MD, Cheryl Kunis, MD, Vivette D’Agati, MD, (Columbia University Medical Center); Alton Farris, MD, and Robert Colvin, MD (Massachusetts General Hospital).