Monthly Archives: November 2009

Soothing radiotherapy burns

{{de|1=Echte Aloe (Aloe vera)}}
Image via Wikipedia

RELIEVING RADIOTHERAPY BURNS

This was written for those who are still undergoing radiotherapy –

but is also useful as a fantastic stand-by in the kitchen, especially at this time of year when tempers are fraught, and burning pans can cause nasty problems!

Cancer patients are encouraged to spread Aloe Vera gel over their radiotherapy burns – so getting a nasty burn cooking during treatment, I spread some gel on this and the red, painful rash disappeared as if by magic.

The Cromwell Hospital’s Breast care nurse, Mirjana, was a tower of strength – and recommended that I spread Aloe Vera cream on my radiotherapy site every day.  I did this four times a day (no half measures for me!) and didn’t have a single burn – even though Mr. Gui said that the site was still hot two years later.

Then, once I had finished with radiotherapy, the tube sat on my kitchen shelf, and I use it time and time again – reaching for the tube to spread a thin film on burn sites every time I get a burn in the kitchen.  Always, without a change, the day after I have had a burn the site is clear and pain-free, thanks to the Aloe Vera.

Equilibria make an excellent Aloe Vera Dermo-Gel, which is 98% Aloe Vera (it must have a high content to be helpful).  £6.49.

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Follow celebrities and make your face look good in winter time

Michelle Pfeiffer at the 62nd Annual Academy A...
Image via Wikipedia

Surviving cancer makes one more aware of others who are less fortunate, and cancer patients are in the
fore-front of helping others.

Skincare companies add to this by putting profits into schemes, such as Sienzia who have set up Made for Life (see under Events for their pampering days), the Estée Lauder company (who have Clinique,
Prescriptives and of course Estée Lauder in the group) and are staunch supporters of Look Good, Feel Better, and now there is a new kid on the block:  PeaceKeeper Cause-Metics.  They make donations to women’s
health, advocacy and human rights issues, source raw ingredients such as rosemary and spearmint from third world farmers, and give micro-credit loans to the families of those farmers.

So when you next feel like treating yourself to a lipstick, or a complete make-over, it helps to support some of these companies.

When making up, you may find that your previous make-up,. especially if it were heavy, can actually make you look older.  After being on a course of drugs, your skin needs to breath, and following the mantra ‘less is more’ – i.e. using a lighter make-up, can help you look more alive and glowing.

Recently, Joanne Gair, celebrity make-up artist for women like Madonna, Cindy Crawford, Michelle Pfeiffer, Kim Basinger, Christina Aguilera, Celine Dion, etc. came out with some excellent tips to help you achieve a younger, more glowing look:

Before you put on make-up, the skin on your face must be healthy and well-primed.  (See article in this category on website under “How to avoid tired skin”). Take care of your skin on a daily basis and your skin will stay young-looking all your life.

  • Keep your skin (and body) hydrated by drinking lots of water every day.  This is the most
  • natural and nutritional way to feed your skin.
  • Gently exfoliate your skin by keeping it buffed to allow fresh new skin to glow.  This should be done every other day by washing your face with a gentle exfoliate face wash cream.
  • Wipe your face with toner or spray with natural soothing spring water and let it dry naturally.
  • Replenishing moisture in the skin is a must.  Use a nourishing eye cream or gel of your preference, followedby revitalizing day cream or face oil
  • Use moisturiser all over your face, CONTINUE OVER YOUR NECK AND  DOWN TO BREASTBONE.  You would be surprised at the number of women who think moisturiser stops at the jawbone, but the neck is a dead give-away when it comes to age!
  • Before applying any make-up use a substantial protection number sunscreen.  This way you don’t need todisturb your face make-up for the rest of the day.  You may wish to gently pat an open face tissue around your nose and T zone before applying the sun screen.  After application of sunscreen you may again wish to pat the areas that feel a little too oily gently to absorb any overly shiny areas before adding your make-up.

At this point your skin is ready and glowing for your day. Foundation and concealer is applied if needed at this point.

For a sun-kissed glowing face, apply a cream blush to add luster and color to your checks.  Choose a healthy, fresh lip color.  Avoid the ‘heavy’ noir colours – how often to you see a celeb with dark or ‘black’ lipstick?  They know it is ageing.  And no need to buy separate blusher – if you haven’t got any, take a tip from the make-up artists and rub lipstick gently on fingertips, then to your cheeks, smoothing out the colour with your finger tips to create a natural tone on tone look. Now you can lightly dust your face with a transparent powder to set the look.  Use a large head powder brush so it goes on evenly.  Dip the head of the brush in the powder and tap several times
on the side of the container to leave just a gesture of powder on the brush head before applying to your face.

This way you still have a glow and the skin looks radiant.

To learn more about PeaceKeeper Cause-Metics visit them at www.iamapeacekeeper.com.

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Canines sniff out cancer

Coat (dog)
Typical sniffer dog  Wikipedia

DOGS DO THEIR BIT TO HELP CANCER PATIENTS

In Britain and the States, dogs are being trained to help sniff out cancers.

For the moment, this Fido technology is in its early stages – not because of the dogs, but because it is difficult to train humans to identify what the dogs are telling us.

But we are getting there – as you can see on the video : –

httpv://www.youtube.com/watch?v=vNTj400M-kk

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Lymphoedema patients should demand exercise classes

A common utility bicycle
Riding a bike is good exercise  Wikipedia

MANAGING LYMPHOEDEMA

Dr. Jacqueline Todd’s recent talk on Lymphoedema to the Lymphoedema Support Network was packed out.  She kept her audience interested for over 90 minutes, and they were still asking questions when she had to leave.

During her talk she gave out tips

  • Use slow stretches
  • Suitable exercise is good for us
  • Get to know your body and build up exercise gradually
  • Remember PPB – Position, Posture and Breathing
  • Change position frequently, and never sit in same position for any length of time
  • Combine rest and exercise
  • Try to rest with swollen limb higher than the heart, using gravity for draining
  • Important to wear compression garment when exercising
  • Cycling is good exercise
  • So is diving – tight wet suits act like a compression bandage and improve the effect

But if cellulitis appears

  • Treat with anti-biotics
  • Rest – don’t exercise
  • Don’t wear garment

She then showed us a video of the exercise class run at Leeds, and said if we wanted the same it was up to  us to ask the Chief Executive of the hospital where we were treated to start one up.  Ginger up our doctor to do something, and keep on at them.

Most hospitals have the appropriate exercise equipment in their physiotherapy department, but this often lies idle for much of the week.  Lobby for a physio to run a class, and keep on and on.  The Dept. Health constantly repeats the mantra that we have to exercise to combat obesity – so take them at their word and DEMAND exercise classes.  We only have our swellings to lose!

And let Jacqueline know what you are doing.  Contact her via:-

Lymphoedema Support Network, St. Luke’s Crypt, Sydney Street, London, SW3 6NH
020 7351 0990
Email: adminlsn@lymphoedema.freeserve.co.uk

http://www.lymphoedema.org/lsn

STOP PRESS

Dr. Todd would welcome your help with Lymphoedema Research, if you have lymphoedema following cancer or its treatment.

She says  “we are hoping to gain insight into all sorts of experiences – you do not need to have personally experienced social difficulty or appearance concerns to take part.  The main aim is to identify the nature of social difficulty, avoidance and reaction to visible difference in people with lymphoedema after cancer. There are different ways that you can take part that can take an hour or a full day. You will not incur any expense if you want to take part”.

The research is due to start in January 2010, and if you would like to register your interest please email your details to jacquelyne.todd@leedsth.nhs.uk
or you can write to :
Dr Jacquelyne Todd,  Lymphoedema Department, Wharfedale Hospital, Newall Carr Road, Otley, West Yorks

What is actually written in our notes

cartoon24Ever wondered why you aren’t getting better?

Do doctor’s raise their eyebrows when they read your Notes?

Some examples of notes in a Glasgow hospital might explain

Medical or ‘double speak’.

What to do when drugs cause skin lesions, dry patches, itching etc.

Skin cells from burn
When this happens to your skin  Flickr

Information on this website is intended for information purposes only. Nothing is intended to be a substitute for professional medical advice.

DON’T DESPAIR

Our skin is our largest and most important feature – so if you get painful, peeling, dry, itching skin,  during cancer treatment, DON’T think you mustn’t make a fuss.

For those who aren’t having cancer treatment, but have these symptoms – ask if these symptoms could be the result of taking antibiotics, medicinal drugs, etc.

Dermatology (the science of looking after skin) is very badly served in Britain, and far too often there isn’t enough time allocated for patients to discover what causes skin problems, so these are dismissed, or you have to wait months to see a consultant, by which time the condition has driven you nearly mad, or you come off the drugs.  Or doctors blame detergents, pollution, modern life-style or – as in my case “it’s your age”.

DON’T be bullied, or  even think that you are wasting doctor’s time if you have skin problems.   Our skin is our largest organ and needs looking after.

Sadly there are doctors that sniff and murmur “vanity” under their breath when we ask for help.  I came across a horror in my local hospital;  but when I challenged his diagnosis, he swept out defeated.

But it was him and Dr. 30 Second (who didn’t help with my eye problem) that made me start this website – which now has ‘visitors’ from 142 countries – proving that there are others like me who have skin problems!!

So this page is all about nice treatments, well-researched and helpful.  Don’t let nurses put you off.

If you want help with skin problems, don’t let excuses like “we are not allowed to recommend commercial products” put your off.  This is only laziness.  In other countries (with better post-cancer survival rates) it is normal for doctors to prescribe skin products for ‘cancer drug’ skin.  You can ask why is it that the drugs that are possibly causing the problems, are made by the most commercial companies in the world;  if doctors can recommend commercial drugs, then they should be able to recommend commercial products that will help with problems caused by those drugs.

How It all started

About two weeks after starting Tamoxifen, I woke up to find my body was a peeling, bloody mess, covered in lesions.  Cancer side effects had kicked in, and  I really needed a whole lot of advice and TLC.

Peeling off another layer, my (almost never seen) Oncology Nurse said “you do have a problem”, and that was all.  No help from her.

I needed help – fast.  So I went to a Dermatologist – whom I call PD (Pompous Dermatologist).  He was a Professor and in charge at our local Foundation Hospital.  He asked if I minded if he examined me in front of his students – I said I was delighted as I was sure it was drugs that had caused the skin lesions, and therefore students should know the consequences.

After a cursory examination, he told me “it’s your age”.  I started to challenge this – how could my body have erupted with these bloody blisters overnight, if it were age?  I had gone to bed with perfectly normal skin, yet woken up with blood all over me.

He refused to answer – but I could hear the students’ comments, and they were definitely on my side.  He realised this, got up and swept out saying he didn’t have time to answer any more questions.

I since heard that he had treated four friends in exactly the same way.  I HATE BULLIES – and got my own back as I had opted to go privately so I could see him straight away,  and refused to pay his bill.  He never pressed for payment.

After him I went to my private doctor, who spent over an hour talking me through all my symptoms, and eventually put me on a cortisone cream – which cleared everything up – telling me as soon as the skin was healed to come off the cream, start with a good body cream several times a day and go to a Consultant for advice.   I decided to go to France, where I was told they excelled in treating skin problems, but in the meantime would look around for a good body cream.  Having had such a bad experience with a Professor of Dermatology in Britain, I wasn’t going to go back.

What you do

I was lucky – having written articles about skincare, I bombarded the Press Offices of major skincare companies, asking if their research chemists had ever come across cancer skin side effects that might be caused by Tamoxifen.

Back zinged e-mail after e-mail saying they knew all about this.

All the companies mentioned here deserve a big thank you -they saved my skin and helped me stay on drugs.  But I can fully understand and sympathise with the 60% of us who elect to come off these life-prolonging drugs;  after all, who wants painful itching skin day after day, month after month?  With doctors telling you when you ask for help, “its your age”.

But don’t come off drugs – try, try and try recommended skincare products, until you find the one that will sooth and replenish your skin.  And help you stay on the drug.

Doctor’s letter

When I asked companies what they recommended for my skin, quite rightly, none of them would send me anything to help until I could produce a letter from my doctor saying my skin was healed. Once doctors gave me the go-ahead and said I could tolerate creams, etc.

Clinique took over – they make a fabulous Deep Comfort Body Butter. Rubbing that all over my skin three times a day eventually bought my horrible peeling skin under control, and now I only use it once a day (unless I go swimming, and then use again).

I did think I should try to see if the NHS could contribute to the cost, and was given several products to try, including Cetraben and Oilatum Cream; they are OK, but sadly not nearly as effective, so it was back to Clinique!

Daily Routine

Clinique said they were well aware of problems caused by drugs, had developed special creams to help patients and took stands at Dermatology and other medical conferences to tell the medical profession about this – but doctors just weren’t interested. They even have an excellent booklet written for the medical profession which lists every ingredient in their recommended range, so staff can check if anything might produce a reaction to certain drugs.  (I got hold of copies to hand to staff – but they landed in waste paper baskets).

What is it about the British medical profession that it can’t understand that women (and men) today want to keep their skin looking nice? Skin is our largest and one of our most important organs, and if it gets cracked and erupts, this sets up all sorts of problems, not the least germs getting in to the lesions causing havoc.

As I write this, Prof. Sir Magdi Yacoub has written in the The Daily Telegraph “we in the medical profession ……..have to listen more to our patients”.

In France they listen, then you are likely to be prescribed products produced by La Roche Posay (more details in next chapter).  At their medical centre they have a totally different approach, where doctors work WITH the patient, rather than dismissing our concerns.

BME

Sadly, those with dark or black skins tell me they feel left out, and they have even less attention paid to skin problems than we do.  The companies I mention here all make suitable products for BME skin, and their Beauty Consultants (in major stores or chemists) can give advice if you need to use any special creams.

Anthelios (made by La Roche Posay – LRP)  is certainly recommended for people with black skin, those who have vitiligo and is also  for every skin type that is photosensitive or photosensitive as a consequence of photosensitising drugs (chemotherapeutic drugs are known photosensitises).

People with dark or black skin who require camouflage make up post procedure or as a consequence of a skin pathology can use the Unifiance range of make up (available in most countries that stock LRP including Ireland, but not UK, so those in Britain have to order it on the net). They don’t, however, have a range specifically developed for black skin, as Camilla Rummery, their Medical marketing spokeswoman, says “Our range is recommended for all skin colours. We have also done multiethnic studies on the Effaclar range (for acne and oily prone skin) and of course our Lipikar range is suitable for all atopic and dry skin”.

Sadly, when nurses compliment me on my skin, and I start to tell them why it is in such good condition, even though I am on hormonal drugs causing cancer skin side effects – you can see they aren’t paying a blind bit of notice. Their eyes glaze over at the mention of any commercial products – and they live by the NHS mantra “free at the point of delivery”. No matter if you can pay for something that will make your life easier and more comfortable – this dog-in-the-manger attitude is pathetic.

So if you find that nurses just brush aside your questions about what products to use for your skin colour, go to LRP or any of the companies’ Consultants, or go on their websites – you’ll find they are incredibly helpful.

So – unless you are very lucky, if you have peeling skin – blood lesions – itchy skin – etc., it is up to you to sort it out. Or get help from GOOD skincare companies.

Making money

Yes – these companies are in business to make money. But many years ago the major companies realised that if they produced creams that gave customer allergic reactions, consumer groups (particularly in the USA) were so powerful they would be driven out of business by the Courts. So they improved research and development (R & D), employed a whole lot of scientists and doctors who were passionate about skincare – and the result is creams that are almost miracle creams. Not quite – we still can’t believe the ads that promise eternally youthful skin, but if we use good products in the right way, we can do a lot to give ourselves better skin. And women – and men – today realise that good skin makes you feel better.

It is strange that two French and one  US company all launched in Britain in 2008, unless of course they read the Macmillan survey saying we spend so much on ourselves after cancer (upwards of £2,000 – £12,000 pp).

Outdoors

When you go outside, even in winter it makes sense to use a moisturiser of AT LEAST Factor 15 on your face everyday (two lots of Factor 8 are still only Factor 8).

In Summer, the Skin Care Campaign say cancer patients should wear at least Factor 30, and Factor 50 when the sun is bright.

Clarins are another company that takes sun protection very seriously, and make excellent fake tans. They recommend using their exfoliating creams before you apply fake tan for a much more even finish.

And whatever you do – HAVE FUN! I defy anyone to be miserable when there is a gorgeous lavender scent coming from the bathroom, as you slather on a gorgeous cream (and I bet you the men enjoy this too!)

See next posting in this section for more on the Hero Products that help our skin every day.

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Bowel Cancer

This is such an easy test to take, and there is no ’embarrassment’ factor.

If you haven’t already had a test sent to you through the post, ask your GP to get a Bowel Cancer testing kit sent to you.

A dinky little package arrives, with easy-to-read instructions on how to take a sample, which you scrape onto a card and cover with a plastic cover.  It then goes into a Royal Mail approved envelope, off to the laboratory, and you receive the results shortly after.

Don’t worry if you are asked to do another test.  Apparently as the system is so new a certain percentage of patients are being asked automatically to do them again, just to be sure.  However, a warning.  If you still feel there is something wrong, go and see the doctor.

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Examining moles for skin cancer

Melanoma left foot
Typical Melanoma Image

MELANOMA AND SKIN CANCER

Bad news is – once you have had cancer every tiny pimple or mole sends warning signals – is this skin cancer?

Good news is -it is unlikely, but if is kin cancer it is easy to diagnose and treat.

So be skin aware – watch any moles and if they get bigger or inflammed, go to the GP.

Go to My Skin Check and check out your moles.

This is not a self-diagnosis tool, but the interactive information on the website is intended to help you understand the causes and risk factors of skin cancer, whilst telling you about consulting your GP or Dermatologist if you detect any changes. Or if you are worried about the form or size of a mole.

You can check your personal risk and also keep a record of changes on your skin – helpful in identifying when you should go for a check-up.  www.myskincheck.co.uk

More helpful info on http://www.reddingdermatology.com/moles.htm

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How to get Lymphoedema and other treatments when the NHS says no

Normal Lymph Node
Lymph node  Flickr

TEN STEPS ON HOW TO GET LYMPHOEDEMA TREATMENT

If you have Lymphoedema, even if services have been withdrawn in your area, it’s worthwhile making a fuss: read on for information on how you can possibly obtain treatment.

For those of you who would like to go to Europe for treatment that isn’t available here, the same ground rules also apply Steps to take are underlined.

Anita from LSN gave me Step-by-step instructions, which got me superb private treatment, paid for by the NHS!

These steps were:

1. Ask your GP for help and referral to a Consultant – these are usually to be found in specialist cancer hospitals, so it might mean doing some travelling.

2. If the Consultant says treatment will be of benefit, ask if this is available locally.

3. if not…..Contact your local CCG.  Your GP should do this, but if for any reason they won’t, you are entitled to do this.  Find out their address by Googling your area name and,  or look them up in phone book, or ask your Town Hall.

4. If the CCG says treatment is not available (more than likely) get on to your MP, and ask for their support.

5.  Give your MP two weeks to reply. If you have an MP who doesn’t help, then …

6.  Get on to your MEP (Member of European Parliament). These are surprisingly powerful.  You find them by Googling MY MEP.

This is where paths diverge – for Lymphoedema follow steps below.

For treatment ABROAD, if the NHS refuses this let your MEP fight this for you.

7. My MEP happens to be Syed Kamal, who is very interested in health. Incidentally, don’t worry if your MP/MEP is a member of the opposition – whichever party is in power. Often they are more eager to help constituents).  Find address on www.europarl.org

8.  Get the MEP to write a letter to the CCG saying it is your right to have this treatment.

Give the MEP the basic outline (keep it brief).  They will know how to turn the facts you give them into the right letter.

With me, the previous PCT wrote a letter saying they would fund treatment “in an NHS hospital”. This is catch 22 as they have probably closed down the NHS clinics anyway. Your local cancer hospital might have a clinic, but mine wrote to say theirs was for In-patients only.  What a cop-out!

9. So go back to your MEP, explain the situation, and mine sent off a letter saying – in effect – that the PCT HAD to fund this – privately.

10. In my case they caved in almost immediately, and agreed to fund treatment at a private hospital. MEPs have more power than we realise, and here in UK officials seem frightend of them.

Most private hospitals with physio depary tments will offer this, but make sure the physio has been trained in the Vodder method – the best (as far as I know). Currently I had two courses funded – almost all the pain has gone and now I only get limited swelling – and am gearing up to fight for a last course to clear it up completely.

If you feel like it, the Klinic Bad Sulza (see under Spas – Germany) offers excellent treatment, but as you need to take an 18-22 day course, you must be able to pay for that long a stay in this private clinic.

And good luck.  It was surprisingly easy once I had got in touch with my MEP.

verite@greenbee.net

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Herbal remedies can cause harm

HERBAL REMEDIES CAN HARM

Because they are made up of natural herbs, people think remedies made from plants, flowers, leaves, berries, bark etc. must be safe.  But before you take ANY herbal supplement, you MUST check with your medical team that this won’t have any adverse effects on you.

Herbal remedies can be dangerous;  our ancestors knew this, and sometimes used them as poisons.  Some can react – dangerously with drugs and chemo, and no-one should take anything unless they tell their medical team first.

Mint from Project Gutenberg EBook of Culinary ...

Every day I receive e-mails telling me that this herbal supplement is magic – guaranteed to make me live longer, free me from cancer, give me better skin – you know the score!

I love herbs – use them a lot in cooking, but I am very, very careful about any herbal remedies that I swallow. According to the Medicines and Health Care Directorate  (MHRA), these remedies can react in surprising and sometimes dangerous ways, and need to be taken very carefully, under the supervision of a qualified person.

But to ‘mix and match’ remedies can be dangerous, and thousands of people poison themselves each year;  children are especially vulnerable.

Shops and catalogues sell ‘natural foods’ and ‘natural remedies’ to make money.  Drug companies also sell their products to make money, and these are some of the most profitable companies in the world.

However, there is a difference.  Until recently Herbal remedies could be sold without any trials having taken place –  drugs cannot be prescribed unless there have been clinical trials in a controlled environment, rigorously supervised.  Yes, there can be horrendous problems with drugs, but if there is a problem this is flagged up immediately, as I found when I reported to one drug company that I had carpal tunnel syndrome after taking their product.

However, the EU has now taken a stance, much against the wishes of the herbal remedy producers.  To a  certain extent I have sympathy with them, as many have been supplying simple remedies for years, sometimes even centuries, that are relied on by millions.  From 2011, new regulations come in to force, and as with all EU laws, some of the small but good companies will be forced to close, unable to afford the draconian steps that will go towards compliance.

However, the good side is that there should be more transparency and better safety in place.  e.g. Ayurvedic medicine may contain lead, copper, iron, gold, silver, mercury, tin and zinc. Chinese herbal medicine uses Mercury compounds in prescriptions for tranquillizing and anti-convulsant treatment, hypnotic effects and ulcers.  We need to know before we buy.

People combining orthodox drugs with natural remedies could have some very nasty side effects. For instance, I am told  corticosteroids may be included in herbal products without being declared on the label or other product literature.  Even Green Tea, which contains vitamin K, can antagonise Warfarin and increase the risk of heart palpitations and thrombosis.

So before taking any supplement, take advice from

MHRA (THE MEDICINES AND HEALTHCARE PRODUCTS REGULATORY AGENCY), who have issued the following general safety advice to consumers using herbal medicines

  1. Remember that herbal remedies are medicines.
  2. As with any other medicine they should be used with care.
  3. Any medicine – herbal or otherwise – has the potential to have adverse effects.
  4. Before you take any herbal medicine you need to be sure it is the correct product for you.
  5. Remember that natural does not mean safe.
  6. Many plants can be poisonous to humans.
  7. Many pharmaceutical medicines have been developed from plants because of the powerful compounds they contain.
  8. Herbal remedies can interact with other medicines. This could result in the other medicines having reduced or enhanced effects, including side-effects.
  9. When consulting your doctor or pharmacist about your health always tell them about any herbal medicines you are taking.
  10. As with all medicines, keep herbal medicines out of the sight and reach of children.

Are any particular groups at risk?

In many cases the safe use of herbal medicines has not been established in:

  • pregnant women
  • breastfeeding mothers
  • children
  • elderly.

Therefore caution should be taken about use of herbal medicine in pregnancy, when breast feeding or in children/elderly.

If you are due to have a surgical operation always remember to tell your doctor about any herbal medicines you are taking. Some herbal medicines could alter the effects of anaesthetics or other medicines during surgery.

Anyone with a history of liver complaints or any other serious health condition is advised not to take any herbal medicine without speaking to their doctor first.

Which herbal medicines have been assessed by the Regulator?

Look for the PL or THR number on the product labels. Licensed herbal medicines have a Product Licence (PL) number. Under a new scheme products with a Traditional Herbal Registration (THR) number will come on to the UK market in the coming months. Both these kinds of medicines are regulated by the MHRA and meet assured standards. Other herbal medicines on the UK market have not been assessed by the MHRA.

How can I tell if an unlicensed medicine is made to acceptable standards?

Consumers should be aware that unlicensed herbal medicines on the UK market have not been assessed by the MHRA as to their safety, quality or patient information. The MHRA say there is evidence that standards vary considerably in the unlicensed sector. It is likely that some companies manufacture products to good standards. However, there is also evidence of poor or patchy standards in parts of the sector. Information about this is regularly published on the MHRA’s website. www.mhra.gsi.gov.uk

It is not generally possible for consumers to identify which unlicensed medicines are made to acceptable standards. However, there are a number of pointers, in particular from the product information, which may be indicative of poor or unreliable standards.

Advice for consumers when buying unlicensed herbal medicines

Treat with caution claims about safety that are not backed by credible evidence. Be wary of products making claims such as :

  • The herbal remedy is “100% safe”
  • Herbal remedies are “safe because they are natural”
  • This herbal medicine “has no side effects”
  • “Chinese medicines will not interfere with the effects of any western medicine”
  • You can avoid Chinese medicines interfering with other medicines if you take them an hour apart.

Be wary of any unlicensed medicine suggesting the consumer should stop taking, or change the dosage of, a prescribed medicine. The MHRA advise you not to follow such advice – you should always consult your doctor about making changes to your prescribed medication. Treat with caution any unlicensed herbal medicine that makes medicinal claims for the product (that is claims to prevent, treat or cure illnesses). These claims will not have been assessed by the MHRA and could be misleading

Be wary of any product if:

  • It is not labelled in English
  • It does not have information about safe usage
  • The herbal practitioner cannot or will not give a list of ingredients.

Apparently similar unlicensed herbal medicines may be accompanied by different patient information. Do not assume that the medicine with fewer warnings is necessarily safer to use.

Buying herbal medicines over the Internet

  • There is an international trade in poor quality unregulated herbal products. Unlicensed “herbal” products in the UK and elsewhere have been found containing banned pharmaceutical ingredients or heavy metals.
  • Products may contain harmful herbs that are not permitted in the UK. 
  • Be aware that unlicensed herbal medicines manufactured outside the UK may not be subject to any form of effective regulation.
  • If a product refers to licences granted in other countries there may be no guarantees that the product actually complies with requirements or that standards applied in other counties match those that a UK consumer would expect from regulated products.

What to do if you think you have had an adverse reaction to your herbal medicine?

All medicines, including herbal medicines, may cause side effects or unwanted reactions. If you think you have had a reaction to your herbal medicine, you should discontinue use and tell your doctor or pharmacist.

If you think you or someone else has had an unwanted or harmful reaction after taking a herbal medicine (commonly referred to as a suspected adverse drug reaction), the MHRA say they would like to know. This will help us give advice to other patients and healthcare professionals – and will help us make sure herbal medicines in the UK are safe. You can report a reaction yourself directly to us using a system called the Yellow Card Scheme. This can be done online or by filling out a paper yellow form which is available upon request by calling 020 7084 2000. Alternatively, you can ask your doctor or pharmacist to report the reaction us on your behalf.

Herbal Safety News – Current issues
Follow the hyperlink below to all the latest cases that we have received.
http://www.mhra.gov.uk/Howweregulate/Medicines/Herbalandhomoeopathicmedicines/

Herbalmedicines/HerbalSafetyNews/Currentsafetyissues/index.htm

Traditional Herbal Registration Scheme.

Herbal Medicines – What we do

There is a steadily growing body of evidence to show that some unlicensed herbal remedies are not produced to high quality or safety standards, with for example, instances of banned, dangerous or mis-identified ingredients regularly being found and highlighted on the Agency’s Herbal Safety News pages. In October 2005, new regulations (the Traditional Herbal Registration Scheme) were put in place to enable the Agency to assess and authorise traditional herbal products for sale in the UK before they are placed on the market. Purchasing products registered under this scheme will mean that consumers will; have assurance as to the quality and safety of traditional herbal medicines, be able to make an informed choice about which products to use, as registered products will provide full and reliable information on the intended, safe use of the product. No medicine is risk-free. Underpinning all the Agency’s work is fact-based assessments of whether the benefits to patients and the public outweigh any potential risks associated with the use of the medicine.

Background

For many years most herbal remedies on the UK market where sold as unlicensed medicines under section 12 of the Medicines Act 1968. This legislation provided very little in the way of safeguards and meant that the products could be sold with little regard to safety, quality or to the provision of useful patient information. Alongside the unlicensed sector sat several hundred licensed herbal medicines. On the market before the introduction of the medicines licensing system, these products were originally given a product licence of right which was subsequently reviewed and converted into a full product licence.

In recent years, we have seen a substantial growth in the popularity of over-the-counter (OTC) herbal medicinal products; due in part to the public’s belief that herbal and natural products are safer than what are seen as “synthetic” medicines.

Alongside the increased popularity and regular usage of herbal medicines has been an increase in understanding about the possibilities for side effects and interactions between herbal and other medicines; growing concern about the safety and quality of some unlicensed products and about the lack of reliable information; as well as concerns about the professionalism of some practitioners.

Headline catching incidents have highlighted adverse, sometimes life threatening, effects which have resulted from use of OTC herbal medicinal products tainted with anything from microbial contaminants, heavy metals, chemical toxins, or adulterated with pharmaceutical drugs.

In the 1990s a major incident in Belgium prompted increased international awareness of the safety issues surrounding the use of herbal medicines. In this case over a hundred women suffered kidney damage and many went on to develop cancer, following the supply of slimming aids containing the toxic herb Aristolochia.

Evidence, such as this, and the regular cases of products found to contain high levels of heavy metals, and other illegal non-herbal ingredients points to an international trade in low grade herbal medicines. Many such products are sold with illegal medicinal claims whereas the product has not been assessed by a regulatory authority and there is no evidence to show that the product is safe or even contains the stated ingredients.

With the historic lack of a systematic regulatory scheme, requiring specific quality standards it was left up to each manufacture to decide what standards, if any, to follow. Responsible manufacturers found they were being undercut by those operating to very low standards.

The MHRA recognises that many unlicensed herbal medicines on the UK market are manufactured to reasonable standards. But even where this is the case, concerns about the inconsistency in information provided for patients about the safe usage of the product remains a major concern. Herbal medicines, like any other medicines, can have adverse (side) effects and interact adversely with other prescription medicines; this needs to be made clear.

The main problem is that it is impossible for the public to identify which unlicensed herbal medicines are made to acceptable standards.

The EU Directive on traditional herbal medicinal products

The Traditional Herbal Medicinal Products Directive (THMPD) 2004/24/EC establishes a regulatory approval process for herbal medicines in the European Union (EU). It requires each EU Member State to set up a traditional herbal registration scheme, for manufactured traditional herbal medicines that are suitable for use without medical supervision.

The UK Traditional Herbal Medicines Registration Scheme came into force 30 October 2005.

Under these regulations, a company needs to demonstrate the safety of the herbal medicine by providing bibliographic evidence of a minimum of 30 years of traditional use for the product. At least 15 of the 30 years must have been within the EU. This replaces the requirement to demonstrate efficacy and serves as the basis for permitting minor therapeutic claims; regulators can however ask for more data where they have any specific safety concerns. Further, the herbal medicine must now be manufactured under GMP (Good Manufacturing Practice), pharmacovigilance requirements apply as do the normal rigorous quality standards for medicines with a Marketing Authorisation (MA). Patient information is as for any typical over the counter medicine; in addition there is a requirement for a statement on labels and in advertisements that the indication (medicinal claim) is based on traditional usage.

The MHRA will continue to take robust regulatory action against a minority of operators who ignore even the existing limited legislation for unlicensed herbal medicines and so jeopardise public health and the reputation of the sector. The recently established independent expert advisory committee, the Herbal Medicines Advisory Committee, will strengthen MHRA’s capacity to respond to the many challenges ahead.

Herbal products registered under the new scheme

Below is a link to the products which have been registered

http://www.mhra.gov.uk/Publications/PublicAssessmentReports/

PublicAssessmentReportsforherbalmedicines/index.htm

Q: If a new herbal medicine was launched on the market today, would it have to be registered?

Yes, a manufactured over-the-counter herbal medicines would require a product licence – either in the form of a traditional herbal registration or a marketing authorisation.

Q: Do ALL herbal medicines have to register under the new registration scheme?

Yes. As a result of Directive 2004/24/EC, all over-the-counter herbal medicines in the UK, will require either a Traditional Herbal Medicines Registration (THR) or a full Marketing Authorisation (MA). Although products legally on the market prior to 30 April 2004, which complied fully with the requirements of Section 12(2) of the medicines Act 1968, will benefit from transitional protection and can be sold as unlicensed herbal remedies until 30 April 2011.

MHRA 020 7084 2000 (weekdays 0900 -1700);  020 7210 3000 (other times)
Fax: 020 7084 2353 info@mhra.gsi.gov.uk