Chinese herb seems effective in rheumatoid arthritis (RA)

Screen Shot 2014-04-16 at 2.05.11 PMSome people believe that the herbs and botanicals they use as supplements are not drugs, but rather, natural substances. Some believe that prescription drugs are merely synthetic chemicals.

Both groups are wrong.

In fact, a huge number of prescription drugs are derived from natural products, often plants. Some drug companies have a separate discovery area where the scientists do nothing except test crude extracts from multiple plants and other organisms and look for a biological effect. Then, the active ingredient is identified and purified. If all goes well, this could subsequently become a new drug.

Here are some common examples of drugs derived from plants:

Vincristine (cancer)

L-DOPA (Parkinson s)

Morphine (pain)

Pseudoephedrine (decongestant)

Digoxin (heart drug)

There are many more. So, it is not a surprising that extracts from a chinese herb, Tripterygium wilfordii Hook F (the Thunder God Vine), would show some sort of biological activity. It is now in the news and a potential treatment for rheumatoid arthritis (RA), but one of the active chemical components there appear to be several called (5R)-5-hydroxytriptolide has been studied as a potential therapy for ovarian and prostate cancers, and multiple autoimmune and inflammatory conditions, such as lupus, psoriasis and prevention of organ rejection following transplants. Thus, it is not surprising that it might have an effect on RA.

And, it did. The extract was found to reduce symptoms of RA, especially when combined with methotrexate one of the standard therapies. It is difficult to quantify the efficacy of the extract vs. methotrexate, because a number of studies have been conducted using different protocols and drug combinations. But, depending on dose, length of study and the dose of methotrexate used, anti-RA effects to various degrees were seen in all of the trials.

Does this mean you should go online and buy the pills to treat your RA?

No, says ACSH s Dr. Josh Bloom. He explains:When crude extracts of plants are tested, they typically contain multiple chemical compounds. It is often very difficult to purify each compound. This can be crucial, because different chemical compounds from the same plant can have very different properties. It is not unusual for a crude extract to contain one active component and dozens of other compounds, which may be ineffective, toxic, or both.

He continues, It is far safer to wait until the scientists have sorted out which of the components is/are responsible for the therapeutic properties and get rid of the ones that are not. Also, the dose of the active component is critical, since there is inherent toxicity in almost all plant extracts (and this one is no exception). When you take a crude extract, it is nearly impossible to determine the composition of what you re actually taking.

The take home message here is that drugs from plants aren t inherently different from synthetic drugs. They all have efficacy and toxicity at certain doses. All of this is determined during the approval process required by the FDA. Just another reason to be wary of untested supplements.