Herbal Remedies: Solution or Problem?

by Paul Engstrom, Aviation Writer and IFA Member

At least once in the course of flight training, pilots are cautioned to 'expect the unexpected' and 'keep an alternative in mind.'

If an engine conks out, an alternate airport could save lives. So could an alternate route if bad weather develops.

But there's one alternative that may be bad medicine for aviators: herbal remedies, sold as treatments for everything from gastrointestinal distress to sexual dysfunction and memory loss.

These nonprescription, natural substances can cause side effects'or interact with mainstream drugs to produce other side effects'that just don't mix with flying.

For example:

• Among the side effects of yohimbine, an herb for impotence, are anxiety and panic attacks, increased heart rate and blood pressure, tremors, hallucinations and dizziness.
  
• Ephedrine, an ingredient in weight-loss products, can boost heart rate and blood pressure, and cause skipping heartbeats, anxiety and vomiting.
  
• Gingko, danshen, dong quai, papaya and even garlic can interfere with the function of blood platelets, which promote coagulation. This is especially important for people who have clotting disorders, are awaiting surgery or are taking anticoagulant drugs.
  

After Charles Fisher and colleagues at the U.S. Air Force School of Aerospace Medicine in Texas studied toxicological samples from 3,177 pilots who died in crashes between 1989 and 1997, they concluded that the number of aviators using potentially risky botanical products is growing.

Indeed, surveys indicate that around 20 percent of all Americans'including, presumably, those in the general aviation community'now use them.

Yet the impact herbal remedies have on health and physiology is far from clear. That's partly because most haven't undergone rigorous scientific tests to determine if they are safe and effective, according to Stephen H. Goodman, MD, the Federal Aviation Administration's regional flight surgeon in Los Angeles.

Moreover, the Food and Drug Administration has little or no authority to regulate herbal medications.

From pilots' perspective, there are other reasons why this issue isn't easily sliced and diced. One is that the use of herbal treatments needn't be disclosed on medical-certificate applications. Nor are medical examiners obliged to ask any questions in that regard.

Such use also raises the question of whether an underlying'and possibly disqualifying'medical condition exists. If a pilot takes goldenseal as a bowel antiseptic, for instance, could it mean he's suffering from an undiagnosed case of acute gastroenteritis?

Recognizing that 'legal' doesn't necessarily mean 'safe' in the realm of herbal remedies, experts offer these tips to pilots:

• Before taking any medication, natural or otherwise, consult a physician about side effects and interactions with other drugs.
  
• Thoroughly research a remedy before consuming it.
  
• As with any medication, don't experiment while flying. Try a remedy and gauge your response well before climbing into the cockpit.
  
• More doesn't mean better. Stick to recommended doses.
  
• Buy herbal medications from large manufacturers, as they tend to be more quality-minded.
  

When he isn't flying, Paul Engstrom writes and edits from Sebastopol, Calif.