HRF OPINION PIECE
by Rob McCaleb
JAMA bashes herbs for surgical patients
No one has ever accused the Journal of the American Medical
Association (JAMA) of being overly objective about the topic
of "alternative medicine." The article "Herbal
Medicines and Perioperative Care," which appeared in the
July 11 issue of JAMA, offers further proof that the Journal
is willing to compromise its editorial integrity to attack herbs.
The article speculates on potential problems that could arise
for surgical patients using common herbal dietary supplements,
including ginkgo, St. John's wort, garlic, ginseng, echinacea,
kava, and others. However, the authors discredit themselves by
making sweeping generalizations and warnings based on minimal
evidence and outright speculation. It's unlikely that the editors
of JAMA would accept such a flimsy article if it were about
pharmaceuticals instead of herbs.
For example, the authors make warnings about the use of garlic
supplements for surgery patients based on a single case that did
not even involve the use of a garlic supplement, but rather extreme
consumption of a food. One elderly man ate 15 grams of raw garlic-or
about five medium-sized cloves-per day for an extended period
of time, and subsequently experienced bleeding problems during
surgery, possibly but not necessarily connected with the garlic.
This one incident, more than a decade old, is the only case on
record that supports the authors' argument against garlic. The
JAMA article warns against using ginseng before surgery
because of its blood sugar lowering effects based on a flawed
study that failed to account for the sugar content of ginseng
itself. The authors also advise patients not to use echinacea
around the time of surgery, but offer no evidence whatsoever to
support the recommendation.
In short, it is hard to understand how an article that runs from
single case report to flawed study to no evidence at all was accepted
for publication in a widely read, peer-reviewed medical journal.