I was diagnosed with A Fib about 15 months ago and put on Apixaban.
A few weeks ago I contacted a chinese herbalist who had helped me out with a couple of problems some years previously.
Within 6 days of starting on the herbs all of my leg swelling had gone, but after a month it is starting to return. The herbalist seems to be quite optimistic and says he will make adjustments as required, so I've got my fingers crossed.
Has anyone else tried herbs, and if so how did it work out for you ?
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itsok
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If you have not done already, ans assuming you are still taking medication, I suggest you share your herbal treatment experience with your prescribing GP, or at least your pharmacist, to find out his/her opinion on its use ,since they are primarily responsible for your care. Whilst Chinese herbal medicine may have a lot to offer for those who do not take 'conventional' medication, it is possible there could be an adverse reaction if you do take medication, just like some supplements are not recommended with some forms of medication.
I agree with Lowerfield. It is important for you to let your GP know that you have been using a Chinese preparation and which one it is and to let them give you full blood count , kidney function and liver function blood tests before you continue with or increase the combined treatments.
You may also need them to test the level of the prescribed medication you have in your blood.
You also need to ask your Chinese Practitioner the exact name of the preparation , and the ingredients in it, to help you to see if there are any interactions with it and your prescribed medications.
There is one particular Chinese medicine which has been studied for use in combination with regular prescribed medicines and showed good improvement for patients with various cardiac problems within the study when used in combination with standard medications.
I won't name it here , however, because both the Cardiologists and Chinese Practitioners involved in the study warned that this should not be attempted without regular ongoing communication and cooperation between the doctor and Chinese Practitioner, and, regular blood testing to finely tune the doses of each type of drug.
The reason for this is that many Chinese preparations contain various herbal ingredients which interact with beta blockers , anticoagulants and blood thinners.
Both the herbal supplement and the prescribed medication are processed by the same pathway in the liver and do similar functions.
Because the chemicals of both the herbal and prescribed drug are metabolised by the same pathway over time there can be a build up of concentration of the medications and supplements in the blood stream and the liver or kidneys can suffer stress.
This could also be happening if your Chinese preparation is one that is mainly acting like a diuretic and helping to remove fluid or reduce swelling in the legs.
It can also happen when taking other OTC high dose supplements which is why we have to be careful in using anything in combination with prescribed medications.
This could also explain why you have shown some initial improvement but the swelling has started to return.
The two medications , herbal and prescribed , were being processed at first but now they aren't being as efficiently used and removed in your system which could mean neither drug is working as effectively as it should or other salts or hormone imbalance are occurring. Without checking with blood tests it could cause you to be ill or suffer from toxicity at some point.
A good Chinese Practitioner would not just increase or alter the dose of your preparation whilst you are also on prescribed medications without requesting you to have blood tests done just as a good GP does .
They would also be happy to discuss what ingredients are in the preparation and write them down for you so that you can check it against your medications yourself.
If they aren't open or suggesting tests and communication with your GP before making changes (or actually before starting the treatment in the first place ) you should probably find a new Practitioner, just as you would with any other complementary therapist or practitioner whom doesn't follow these good practice rules.
You could still discuss taking both the herbals and prescription medications together after testing if things are confirmed as ok with the GP.
See if the GP will communicate back and forth freely about doses and choices via yourself with the Chinese Practitioner , there is likely to be one Cardiologist or GP in your Practice whom will be happy to take part in this cooperation.
Communication is key to getting things right when using both standard medical care and alternative methods together.
But, if the blood tests are abnormal , or the doses required of your Chinese preparation or prescribed medications would still need increasing , or new drugs have to be added , you may find that you would be better to stop the herbal for the efficiency of the standard drug and your general health.
Which was also the approved choice of action of the Cardiology and Chinese Practitioners in the Chinese herbals study for patients whom had abnormal results or showed no significant improvement by using both at once.
Let us know what you choose and how you get on , it would help add to people's knowledge of patients experience of trying these combined therapies. Take care , Bee
I would like to add the caveat that blood tests don’t necessarily rule out potential issues with herbal/prescription medicine interactions. Obviously raised liver enzymes would be a huge red flag but it may take time for any damage to translate into standard blood test results. Tests should always be evaluated not in isolation but in the context of the other test results and against the patient’s baseline measurements.
The other thing I’m curious about is why was the leg swollen in the first place? Was it fluid retention? Was it an injury? Was it venous insufficiency? All these can produce “swelling” but the causes are very different , as is the treatment/management of the underlying conditions.
I agree 100% that it’s vitally important to know exactly what herbal preparation has been prescribed. If the practitioner does not disclose this, then it’s not someone to trust with your health. Herbal remedies can be potent and should be considered as medicines with potential side effects.
I have to completely agree with Blearyeyed, AutumnLeaves and Lowerfield. A lot of supplements, even those available to buy over the counter, can have very detrimental side effects when taken together with our prescribed medication. You really need to know how they would interact with these. Please consult your GP or pharmacist and ask their advice before taking anything like this in conjunction with your medication.
Thanks for taking the trouble to provide such a comprehensive response to my enquiry Bee.
Many of the precautions that you recommend have been covered. My association with the herbalist began many years ago after I had checked out his credentials thoroughly and my experience since then has shown him to be the genuine article. He is aware of all the relevant medical history and has obviously taken that into account when prescribing the herbs.
I am confident that he would be perfectly happy to compare notes with any of the NHS professionals that you mention, but to suggest that I could persuade GPs, Cardiologists, Path' Labs etc. to provide me with blood tests and consultations in order to measure the effects of a complementary therapy that I have decided to try, is quite honestly 'for the birds'.
Speaking as an NHS patient from it's inception, and an employee for over 20 years, I am convinced that there is total antipathy in the service towards any alternative therapies, but I repeat "thanks for your valuable feedback."
You don't need to persuade anyone for tests, they are your right to request. You can request blood tests from the GP to check your basic levels , and you should really have your liver and kidney function tests done anyway by request from the GP every 3-6 months anyway if you are on prescribed medications or have a chronic health condition and new or recurring symptoms ( like leg swelling ) . This is according to NICE guidelines.In this instance , you are not only requesting to have your liver and kidney function tests and full blood count , and most importantly( if possible) the blood concentration level of your prescribed medication done because you want to see the how your complementary medicine is working and effecting you. You are requesting these tests because you are experiencing a return of leg swelling and have been taking a Chinese medication that may also effect your liver or kidney results.
There is an important medical reason for doing these tests to ensure that there is no current affect occurring in your liver and kidney function. In these circumstances, the GP would be working in contravention of NICE rules if they refused these tests.
They would do the same thing if you were experiencing symptoms on any medications prescribed or otherwise.
Most importantly tests are required, because if your Chinese preparation is one of the varieties which are for diuretic or cardiac treatment they all contain many of the ingredients that do interact with many of our prescribed drugs and are usually contraindicated unless properly supervised for that reason.
All supplements are drug preparations , even the humble vitamins, even if the ingredients are of natural and do cause changes to the human body , and can cause toxicity if too much is taken , interactions occur or they do not suit the individual and their needs. So testing us necessary whatever you take.
I know that there are many therapies and supplements that can be used alongside Western/ Conventional health care , and many good practitioners, but even the best of those can make the odd mistakes ( just as the odd GP and Consultant can) or they need more advice from other professionals that treat you or knowledge of your test results, as well as symptoms , to make their choices properly. This is the true holistic approach, conventional and complementary treatments used hand in hand, not one or the other.
The alternative and ancient health care system isn't infallible just as the conventional one can not be.
It was , from my own knowledge of other therapists that I was a little surprised that your Chinese Practitioner was considering increasing or changing your preparations without first requesting that you had GP tests before those changes.
The NHS is not , as many people seem to believe , against alternative and complementary therapies or appropriate supplements and OTC preparations.
In fact , many of the tested and verified alternatives have slowly become available over the decades on the NHS when they have been shown through enough research to be effective in the treatment of particular conditions. The effectiveness of these things do need to be assessed by NICE and guidelines created for universal application which is why it can take some time for the effective treatments to become available. There can also be a post code lottery based on what is available at your local hospital.
I myself had Hydrotherapy every week for my joint problems ( unfortunately stopping now because the pool is closing). I get Medical Manipulation Massage from my physio to improve my pain and help reduce my autonomic dysfunction.
The NHS offers acupressure, acupuncture and Botox for many conditions . Pacing lessons , chronic pain management , mindfulness and CBT courses can be requested for referral via the GP or you can sign up to many different online courses via NHS Direct.
They , just like people's favourite health influencers , also have links to various accredited other courses and fitness videos , including believe it or not , belly dancing .
Dietitians referrals for those struggling with symptoms that can be linked to diet or digestion can also be arranged via the GP. My daughter is being taken through a carefully supervised FODMAP elimination and assessment at the moment.
The GP will also add you on to the Exercise Referral Scheme which means subsidised or free classes of various types available via checked instructors with sessions appropriate for your illness or conditions , including Tai Chi , Aqua Exercise and Relaxing Yoga to name a few.
I myself also benefit from some of the technology available to assist Chronic Pain and Neurological dysfunction and have a Prescribed Vagal Stimulation Machined, I know many people whom also receive the more standard TENS machines via the Pain Clinic or have had Infra Red therapy to improve wound healing. I have friends whom have had spinal nerve stimulation unit surgery.
And where a supplement or food/ ointment related item has been found to be necessary for the patient and has been recommended as a product to suggest but is not yet available a well read GP, Physio or Nurse will give this guidance.
I don't find apathy by all.
Much like in real life there are some outdated people . Mostly they need more evidence , understandably before they can feel safe or are allowed to offer advice or certain things currently. and some ( especially most overworked surgery GPS) whom just don't realise that the things are available in your area and that they can refer you , or you can self refer for sessions but when they do they are happy to help you get involved.
Even if they think a particular alternative drug or supplement is ' for the birds' and they advise you against it , they certainly need to know you take it and are more than diligent in checking if it is effecting you physically , so that they can discuss with you the options for the future and make adjustments in your medication if they need to if you choose the alternative to prevent the chance of you becoming sick.
At the very least , they do this because they don't want to end up being liable if you become sick or have a crisis that could have been prevented.
And mostly, because they are as committed as any non NHS practitioner to follow their pledge to do know harm and to help heal the patient with the means available , no matter what some people may believe. As an NHS employee I'm sure you realise that .
Thank you once again for taking such an interest in my case Bee.
I think the bottom line here is that, you either live in a world where we have the version of health care that the government tells us we have got, or you are choosing to propagate it.
In my experience very few of the rights and expectations that they tell us we have, are realistically accessible to most of us. Cut backs have obviously made things worse but the system is plagued with a lack of communication problems and buck passing, resulting in unreasonable waiting times for appointments or phone pick ups. There is a very big difference between theory and practice !
in support of the two comment already posted: ALWAYS check any supplements, alternative treatments and other non-prescribed substances with your pharmacist
A good product in my opinion ,the only real option before was warfarin which has very unpleasant side effects. If you are on Apixaban you may be on bisoprolol ,one of the prils and a cholesterol drug. Foot swelling can be a side effect of these and they prescribe Indapamide a diuretic to help ( this may be the chinese type remedy). If you move onto the Amiodorone though for AF the Indap needs to stop as there can be a reaction.
My foot swelling though was vascular not cardio product related. This can confuse the medics as there are two different departments dealing with this and it not joined up in my experience. You need a brachial check and scan which can confirm the venous pressures and system. It is normally treated with pressure socks or surgery depending on the detail and severity. Chinese medicine without imaging is going to be of limited use in my.
Many Chinese medications can put you at risk of bleeding from thinning the blood especially if used in conjunction with Western medicine. Like everyone has already said you must make sure with the pharmacist it is not contraindicated.
Danshen for example is a popular Chinese heart medicine can cause bleeding also angelica a herb for women can interact with blood thinners. Those are the only 2 herbs I know and I just looked them up they both thin the blood.
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