Doctors warn on mixing herbs with prescription drugs

Medical experts have expressed concern over high usage of herbal medicines by patients being treated in hospital.

In a recent study at the Mama Lucy Kibaki Hospital, Nairobi, a team of doctors found that most diabetic patients were using herbal medicines.

More than half of the patients, the team found, were experiencing complications related to usage of herbal medicines.   

Doctors Joseph Mutai of the Kenya Medical Research Institute (Kemri), and Evans Ochoki and Daniel Nyamongo of Jomo Kenyatta University of Agriculture and Technology suggest herbalists be involved in managing such patients.

“This will ensure their practises support rather than interfere with treatment,” they recommended.

The three were investigating how diabetic patients attending Mama Lucy Kibaki Hospital are faring. The hospital attends to 80 cases in its outpatient diabetes clinic weekly. There are 700 registered diabetic patients at the facility.

In the study appearing in the current issue of the Pharmaceutical Journal of Kenya, the researchers involved 266 adult diabetes patients.

The team reports that despite being in treatment, almost 60 per cent of the patients had developed complications.

The three common complications with these patients are hypertension, eye disease and heart problems in that order.

Other complications in order of prevalence include nerve damage, joint and foot problems, skin infections and kidney problems.

“We went further to inquire into why and who was most likely to report complications, and the results were quite telling,” said the team.

Three factors stood out as the major cause of complications -- older persons, those using herbal medicines and the obese.

It has been widely documented that older and/ or obese persons with diabetes are at high risk of developing complications. However, recent evidence points to herbal medicines as an emerging risk factor.

About a quarter, 27 per cent, of those with complications in the Mama Lucy Kibaki Hospital study, reported using herbal medicine. However, less than five per cent of patients not using herbal medicines had complications.

A similar but earlier study at the outpatient diabetes clinic at Kenyatta National Hospital (KNH) also reported high use of herbal medicine among the patients.

The research found almost 40 per cent of the 251 participating patients use herbal medicines for various reasons. 

“The total prevalence of use of herbs among the diabetic outpatients was 39.5 per cent,” the researchers reported.

However, the research published in 2017 revealed that seven per cent of the patients used herbal medicines specifically to treat diabetes.

“The commonest herbs used were ginger and Aloe Vera by 50 per cent of the herbal users,” wrote a team from the Ministry of Health and the University of Nairobi. Led by Elsa Okoth, this group of researchers said about half of the herb users did not regard it important to inform the doctor about their use of herbs.

About one in five of the herbal users in the KNH study reported that they did not regard it important for the doctor to know that they were on herbal medications.

The majority feared that the doctor would ask them to withdraw from the herbs since they were worried about the negative attitude of doctors towards herbs.

“The doctors have never asked me whether I use herbal or any other medicines,” says Priscilla, 65, who attends diabetes clinic at Mama Lucy Hospital.

Okoth suggests that health care providers should encourage diabetic patients to talk about the use of herbs as it may affect the outcome and the management of their disease.

The main reason for herbal medicine usage by diabetics, the KNH study says, was mainly due to easy accessibility and perceived faster relief of symptoms

In addition, the researchers say herbs were affordable to many of the study participants. Priscilla, who gets her diabetes herbs from roadside hawkers, says she can buy as little as she can afford unlike in health facilities.

Herbalists, the researchers found, can also be paid in kind. For instance, one can give out a chicken in exchange for the services, making them more affordable compared to the medical professionals.

The use of ginger and Aloe Vera, the KNH research says, may not be a wild guess. The two, the study found, have been found to play a role in lowering blood sugar levels.

Healthcare workers, Okoth suggests, should encourage diabetic patients to talk about the use of herbs as it may affect the outcome and the management of their disease.

“Healthcare workers and researchers should find ways of harmonising the utilisation of herbal and conventional medicines amongst diabetic patients.”

Efforts to harmonise the safe use of herbal medicines in Kenya were first suggested in 2002 by the then Minister for Health and now Kisii Senator Dr Sam Ongeri.

But almost two decades later, and coming to effect of the Health Act 2017 which directs the formalisation of the safe use of herbal medicines, this is yet to be addressed.