Some Frequently Asked Questions, first published in SAGA Magazine (15)
Professor George Lewith
I’ve been taking red clover supplements for 10 years since I was 50 to ease hot flushes. My mother continued to have these till she was 80 so do I need to stay on the supplements indefinitely?
This is an interesting question and applies to a whole range of herbal and other “natural” products that are used to help the menopause. The evidence for many of the herbals, such as Red Clover and Black Cohosh is minimal as far as randomised trials are concerned, but many women do claim that they are of significant benefit to them during the menopause. These herbal products are all plant derived and contain “natural oestrogens”. The problem with plant based oestrogen and progesterone is that we have no idea how safe they are in the long term. The evidence we have from synthetic and chemically produced and modified oestrogens is that their long term use does marginally increase the risk of breast cancer. We have no adequate information, nor indeed do we have any proper long term safety studies on which to base our opinions with respect to the herbals. At the moment it would seem sensible to consider using herbals for a limited period of time, in the same way that one uses conventional hormone replacement therapy. There is no evidence that one shouldn’t use it till the age of 80, but a practical commonsense approach would be to consider using it for a period of 10 years, perhaps between the ages of 50 and 60, and then stopping it slowly over a couple over 2 or 3 months to see if the symptoms return. In very general terms there is no indication to use any hormone replacement therapy, be it herbal or conventional synthetic medication, to the age of 80. At some point in the future we will hopefully have a much clearer understanding of the potential dangers of long term herbal remedies, but at the moment it would appear best to advise caution based on ignorance. There is no evidence that Red Clover has any long term adverse reactions, from the evidence available.
I always feel bloated and lethargic after the Christmas indulgence and plan to go on a detox diet this year. Do you think this is a good idea?
Christmas is usually a time of excess alcohol, excess fatty food, excess sugar, and very little exercise. However, hopefully, there is lots of laughter and fun, which is great for families, the soul and the spirit, but fairly appalling for your waistline.
I personally think a period of excess alcohol indulgence needs to be followed by a period of restraint, and the same applies to the high calorie food that one tends to consume over the festive season. I don’t think there is any real evidence for that, but it certainly feels much better by the end of January if you have an alcohol free period and try to cut down on the sweets and fats. I feel it has got to be a good idea to balance some excess with a little bit of abstinence. While we would all like to eat healthily all the time that simply doesn’t happen at birthdays, holidays, high days and Christmas so a post Christmas detox seems a good idea to me.Can pills containing pycnogenol really boost the immune system? I understand they’re made with pine tree bark and a friend swears by them.
Pycnogenol is a natural product that is extracted from pine tree bark and it contains a whole host of antioxidants. Antioxidants fundamentally protect against the oxidative damage that occurs in cells as a consequence of “free radicals”. This is supposed to be one of the major functions of vitamin C. What it means is that chemicals that aren’t attached or bound to other chemicals can damage some of the important and very specific cellular functions and proteins that occur within our cells. Pycnogenol is thought to be a powerful antioxidant so it protects against this damage if it can get into the right places ion our cells. There is some evidence it has these effects when you look at the way cells function under the microscope. Unfortunately, there aren’t any really good clinical trials in human beings that show Pycnogenol has a long or short term clinical effect; the trials don’t exist, but the biochemistry suggests that it may fulfil this important function. If we look at the effects that antioxidants have they often are excellent in acute short term illness such as infection. They tend to cut short things like colds or acute flu and in that way they may be seen as “boosting the immune system”. However, when you look critically at herbal remedies that are designed to “boost the immune system”, while they may help in acute infections, they don’t actually do much to prevent those infections happening. This is clearly the case for Echinacea, which has a powerful effect in the very short term, but doesn’t enhance the immune system on a long term continuous basis and does not offer protection against infection. Pycnogenol is a powerful remedy and seems to help some people, but there is no evidence that it should be taken all the time. It also appears to be very safe and have very few side effects.
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