Re: Taking St. John's Wort

Posted By CCF Cardio MD-SGM on May 15, 1998 at 08:58:13:

In Reply to: Taking St. John's Wort posted by Char on May 10, 1998 at 22:58:04:






I have MVP and take Inderal. I tried taking St. John's Wort a few times, but
felt more flutters than usual. So is there typically a problem with this herb and
MVP or was this an isolated incident? In other words, do you recommend this
or not for me?



___


Dear Char,
Patients with MVP sometimes experience palpitations that are most often benign in nature.  Such
palpitations can be investigated using tests such as the electrocardiogram, and possibly a holter monitor that records the ECG for 24-48hours.  Treatment is usually supportive, i.e. reassurance, although occasionally patients benefit from therapy with medications such as beta blockers.  More aggressive therapy for palpitations using "anti-arrhythmic" drugs is not helpful, and has proven to be harmful in some cases.
Many herbal remedies have been promoted, throughout history, to cure one ailment or another.   Marketers who produce and package these products have typically avoided the scrutiny that is placed on mainstream pharmaceuticals by insisting that "natural",  herbal products  must be safe and thus can't cause harm.  This may or may not be accurate, but the fact remains that the great majority of these products-- with rare exception-- have not been shown to be useful when studied in large groups of patients.  The benefit of supra-physiologic doses of certain vitamins and minerals such as Vitamin C, Vitamin E, and even garlic has been demonstrated, but such proof of efficacy is rare.  
In contrast, randomized, controlled studies of the prescription medications serve to carefully assess both risks and benfits of different compounds.  In this manner, we gain a much more thorough understanding not only of potential ill-effects, but also of the magnitude of benefit.  Try not to be fooled by slick advertising on the labels of herbal remedies.  This is a largely unregulated industry, in that objective evidence of efficacy  (whether a promoted treatment actually helps to improve the condition for which it's used)  is not required to market a product.  
Thus, the various makers of St. John's Wort can claim everything they like on the label.  This week it helps palpitations in MVP,  perhaps next week it will promote hair growth in balding men, etc....   I don't know whether St. John's Wort is effective for palpitations in MVP because no carefully controlled research has been done on this subject.  Most likely, potential harm from a herbal remedy taken in small doses is limited-- I can't be certain.    However, the damage to your pocketbook may be more severe.  
Information in the Heart Forum is for general purposes.  Specific diagnoses and therapies can only be provided by your physician.