MU professor to test interaction of herbal supplements and prescribed medications

Monday, August 15, 2011 | 12:01 a.m. CDT; updated 5:22 p.m. CDT, Wednesday, August 17, 2011

COLUMBIA – An MU biochemistry professor is working on a test that will tell people if the medicines they're taking are interacting negatively with something else in their system.

Bill Folk's  experiences in South Africa sparked his idea for the test. He has been to South Africa multiple times to test plants used to treat symptoms of AIDS and other diseases. Many people in Africa use traditional remedies in addition to western medicine, and Folk became concerned about how the traditional plants might be interacting with the western medicines. The test Folk and other researchers and students are helping to develop would determine just that.

Folk is the principal investigator and co-director of the International Center for Indigenous Phytotherapy Studies. It's an organization led by MU and the University of the Western Cape in South Africa that is investigating the safety of a native plant called sutherlandia as part of a long-term study on the interaction of the plant with western medicine.

These kinds of interactions are the focus of the center's research, but it could be a long time before the results are known. Tests on sutherlandia alone will likely take years to complete, and it's one of thousands of plants used across Africa to treat some diseases and their symptoms. It is also used to treat stress.

Folk thinks that testing all of the plants would be the best option, but it would simply take too long to do enough research to have a large impact.

"We need an alternative to doing all this good science," Folk said.

The potential for a test that checks if treatments are interfering with each other extends far beyond Africa, though. In America, natural remedies are becoming increasingly popular. They're already widespread in Europe, and people taking them often don't mention them to their doctors, either out of embarrassment or absentmindedness, Folk said. He also said that doctors aren't trained to ask if patients are taking them.

According to the American Botanical Council, the sale of herbal supplements in America totaled $5.2 billion in 2010, up 21.1 percent from 10 years earlier and 3.3 percent from the year before.

These supplements, which can be obtained without a prescription, can interfere with the body's drug metabolizing systems, causing drugs to be metabolized differently by the body, resulting in greater or lesser effect — or no effect at all.

This can cause doctors to prescribe different drugs, sometimes more expensive ones, when the real problem is something else the patient is taking.

One example Folk cited is Saint-John's-wort, a common herbal treatment for depression. The plant stimulates some of the body's eight drug metabolizing systems, which limits the effect of prescribed medications, including some anti-retrovirals used to treat AIDS, hormonal contraceptives and some immunosuppressants.

If someone were taking Saint-John's-wort in addition to one of those other medications, it might become less effective – and that could be fatal, particularly with anti-retrovirals.

Gina Butler, an acupuncturist and Chinese herbalist for the Women's Wellness Center in Columbia, said she always checks to make sure the herbs she recommends don't conflict with medications her patients are taking. She also makes a list of what herbs they're taking available to the patients and their doctors so they can head off interactions.

Folk's test uses a sample of a body fluid and checks it for a natural hormone. If the chemical is outside a certain level, the metabolizing system of a drug is being affected. The idea is to make it as easy and simple to use as a pregnancy test.

But the test is still several years from being finished. The hormone the test looks for is similar to another hormone that is often present in the body, and the researchers need to ensure that the test measures the right one.

"It's possible, but it's going to take a fair amount of work," Folk said.

When it's ready, Folk said, it could affect millions worldwide, especially if it's as cheap as he hopes to make it. He said it will give people the ability to manage their medications more effectively, eliminating the need for doctors to determine if any treatments, traditional or otherwise, are counteracting each other.

It would be a lifesaver in developing countries, where doctors are often too few and far between for most people to see one when they need one.

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