One of the most common complaints from people about trying botanical medicines is that synthetic meds are stronger. People looking for relief are afraid they’ll take an herb or supplement and not immediately feel something, to be able to know that the medicine is working. Internet “skeptics” and medical providers alike say that pharmaceutical medications are superior because they are concentrations of active ingredients. It’s true that when a medication is created, a substance is chosen and often chemically altered, resulting in a concentration of that substance. We know what’s in the medicine and the medicine is strong.

In contrast, when we use botanical medicines, we take parts of the whole plant. Sometimes the part of the plant containing active ingredients will be the leaves, the roots, or the flowers. But whichever it is, we take that part and dry it for capsules or extract the substances in alcohol. We end up with a wide range of substances that the plant contains, some of which have medicinal effects and some of which likely do nothing at all (known as “inert” substances). I’ve talked before about advantages of this combination of substances, but another major pro to this is that the medicine is less concentrated.

You may be thinking, “Wait, that’s a pro?” How is stronger anything but good? Stronger equals “works better,” right? Well, yes and no. Medicines push our biology in a specific direction, and concentrated substances push harder. Sometimes this is good, like if we really, really need something strong to fix an acute problem right now before it permanently damages us in some way. Like the time my husband’s leg got so infected he spent a week in the hospital. The strong IV antibiotics pushed hard and had some definite damaging effects to his gut and microbiome, but they were needed. But we see this same concentrated push off our biology’s center being used without a second thought for every minor ailment and many people have no idea why it matters.

Playing Biological Dominoes

Drugs work by taking advantage of different aspects of our biology. The problem with this is that there’s no way to target one specific biological mechanism without affecting others. Since all our body’s processes are inseparably wired together,  our medications inevitably wind up having handy effects as well as not-so-handy effects. We call the ones we don’t like “side effects,” but that kind of misses the point. They’re all just effects of the drug, none necessarily more major or minor than the others.

The best way to see this in action is to take a look at a specific class of medications. We’ll pick one that’s over-the-counter and incredibly common – NSAIDs. Most people know that NSAIDs like Advil and Ibuprofen work by decreasing inflammation – that’s why we call them anti-inflammatories. More specifically, they block the body from making as much of the hormone called prostaglandins that trigger inflammation. Sounds good so far, but prostaglandins aren’t bad. They’re also responsible for a ton of vital bodily processes. This one effect of the drug – less prostaglandins – has a bunch of downstream effects, kind of like a trail of falling dominoes.

First off, less prostaglandins means lower inflammation. This is what we’re going for when we pop an Advil because lower inflammation can reduce pain and swelling. Goodbye, headache! The lower levels of prostaglandin also mean there are less available for one of its other jobs – triggering the secretion of the mucous that protects the lining of the stomach and intestines. NSAIDS are commonly known to irritate our intestinal lining and putting prostaglandin out of commission compounds this problem because our bodies can’t even protect it normally. What does this get us in real-world terms? Up to 60 percent of NSAID users with gastrointestinal complaints, and 14-25% of users with ulcers. 1

Another effect of low prostaglandins is that it can cause our blood vessels to constrict and our bodies to retain sodium, which can both lead to high blood pressure. This is why the FDA strengthened warnings in 2015 that even a few weeks’ use of NSAIDS increases risk of heart attack and stroke in healthy individuals. 2 Another recent finding was that regular short-term use of NSAIDs prevents many women from ovulating, thereby affecting their hormonal health and causing infertility. This is thought to likely be a result of the drug’s inhibiting effect on certain enzymes which synthesize prostaglandin.3 A 2015 study found that taking NSAIDs for as little as 10 consecutive days had this affect, reducing ovulation by 75-93%.4

To a More Balanced and Gentle Medicine

As the case of anti-inflammatories shows, one substance doesn’t cause just one effect in our bodies.  Tipping an area of our biology starts a cascade effect and the extent of the resulting damage is going to correspond to how severely our bodies were tipped to begin with. As I was looking through the scientific literature, I happened upon a study about the ulcer effects of NSAIDs. The researchers casually noted the standard for dealing with this problem – adding a proton pump inhibitor drug! As you can probably guess by now, this additional drug is going to have a ton of strong effects all its own. And these are just the over-the-counter drugs we consider less potent.

Of course, all this doesn’t mean we have to have a blanket no-meds stance. There are life-saving medications and treatments, and sometimes strong meds are needed for damage control so that we can begin to rebuild our health. Other times, they are needed in the short-term (thyroid stimulating hormone can be an example of this) or even long-term as a last resort. But too often, the concession is made that sometimes meds are needed in cases when meds aren’t needed. I think this is because knowing the difference is tricky, particularly when our conventional providers routinely err on the side of over-prescribing. Making that judgment call requires a decent grounding in physiology and a willingness to question norms, which is where finding a trusted integrative or functional medicine provider comes in.

Such providers may look at the body in an entirely different way, with a philosophy that  the body is always trying to reach homeostasis and achieve better health, though there may be obstacles in the way. This philosophy can help us to see potential harms of intervention where modern medicine often does not. Without the idea that the body is capable of doing well with minimal intervention and that this is actually preferable, we’re far more likely to have a mechanistic view of the body that misses these points altogether. When we see the body as a machine, we may tackle healing from a perspective of mechanical man-handling. On the other hand, when we see the body as more akin to a plant, we can fuss over it gently, understanding that when we give it what it needs and take away what it doesn’t, it will do what it does best – grow and thrive.

It’s totally counter-intuitive to everything we’ve been taught, but “bigger, stronger, more”? It isn’t always better.

 


Sources:


1. Russell, R. (2001). Non-steroidal anti-inflammatory drugs and gastrointestinal damage—problems and solutions. BMJ Postgraduate Medical Journal, 77(904). Retrieved from ttps://pmj.bmj.com/content/77/904/82


2. Curfman, G. (2017, August 22). FDA strengthens warning that NSAIDs increase heart attack and stroke risk. Retrieved from https://www.health.harvard.edu/blog/fda-strengthens-warning-that-nsaids-increase-heart-attack-and-stroke-risk-201507138138


3. Hulisz, D., PharmD. (2015, December 23). Nonsteroidal Anti-inflammatory Drugs and Infertility. Retrieved from https://www.medscape.com/viewarticle/856186


4. Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days. (2015, June 11). Retrieved from https://www.sciencedaily.com/releases/2015/06/150611082124.htm

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