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Primary Care: PAs Need Vigilance with Herbals

Posted By Barbara Cortright, PA-C, Wednesday, April 4, 2018

With complementary and alternative medicine grabbing larger market share each year, physician assistants often increasingly find themselves learning more about herbal remedies from their patients before they hear about it in continuing-education courses.

But if a clinic’s patient panel includes a large number of Hispanic and Latino populations, the list of supplements can be substantial thanks to the increasing popularity of neighborhood herbal shops called yerberías that cater to this clientele.

Also known as botanicas, these retail stores sell herbs, creams, tinctures and teas. They may also carry talismans to ward off evil spirits and votive candles for events or ceremonies. Patients whose ancestral roots come from rural parts of Latin America may lean more heavily on the yerberías for help than the local pharmacy.

Many of these substances pose little threat to the patient’s overall health. Manzanilla, for example, is the Spanish word for “chamomile” and is often formulated into a soothing tea for bedtime. Other substances often focus on treating the common cold or aching joints. They may include extracts from creosote, arnica, and chiles (think modern medicine’s capsaicin cream), and anti-inflammatory extracts like turmeric, ginger, black pepper and nettle leaves.

However, products from yerberías lack FDA studies and approval. A 2013 study found that many of the substances patients receive from yerberías for the common cold may contain excessive amounts of lead, arsenic or mercury. 

And then there is the occasional rogue yerbería, like the one Mesa Police raided five years ago and found Viagra, Valium, amoxicillin and Pentrexyl, which are prescription-grade pharmaceuticals. (Pentrexyl contains ampicillin.)

PAs practicing in Arizona often ask for a list of all medications and supplements. But in the right patient, it’s also worth asking, “¿Cuál botanicas usa Usted?” or “Which botanicals do you use?”

– Barbara Cortright, PA-C

Tags:  botanicals  complimentary  herbal  supplements  yerberia 

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