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Sixteen healthy women who had taken a low dose oral contraceptive (OC) with 20 mcg ethinylestradiol + 0.15 mg desogesterol for at least 3 months participated in this study. A 50% ethanol extract of St. John’s wort 250 mg twice daily standardized to 0.2% hypericin (1 mg/day) and < 0.2%(< 1mg/day) hyperforin was initiated day 7 through day 21 of the of the OC administration. Blood samples were taken on day 7 and 14. The activities of CYP3A4 for the estrogen metabolism, and CYP2C19 and CYP2D6 for the progestin metabolism were used to measure metabolism of the OC and interaction of the OC with St. John’s wort. Results demonstrated that co-medication of the St. John’s wort extract with the oral contraceptive did not elicit any differences in the pharmacokinetic measures of ethinylestradiol in this study.

The pharmacokinetics of the desogestrol was also not affected by co-administration of the St. John’s wort extract. There was a small decrease in ethinylestradiol and 3- ketodesogestrel but it was not considered significant. In addition, there was no break through bleeding induced by the addition of the St. John’s wort extract.[1]

Comments

The results of this study are in contrast to other previous reports and studies. Two reports have shown break-through bleeding and spotting with co-administration of St. John’s wort and OCs.[2],[3]

Three studies indicate an alteration of the pharmacokinetics of the OC with co-administration of St. John’s wort. [4], [5], [6] These studies used a different St. John’s wort preparation (80% methanolic extract) and at a much higher dose (900 mg) containing a much higher amount of hyperforin (20-35 mg) than the current study.

The lower daily total dose and hyperforin intake would appear to be the likely reason for the lack of interaction of the St. John’s wort extract with the OC pharmacokinetics in this current study. Accordingly, using a lower dose St. John’s wort extract with reduced hyperforin content does not appear to interact with OC nor cause breakthrough bleeding (an indication of possible ovulation).

References

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[1] Will-Shahab L, Bauer S, Kunter U. St John’s wort extract (Ze 117) does not alter the pharmacokinetics of a low-dose oral contraceptive. Eur J Clin Pharmacol 2009; 65:287-294.

[2] Ernst E. Second thoughts about safety of St. John’s wort. Lancet 1999;354:2014-2016.

[3] Raetz A, vonMoos M, Drewe J. Johanniskraut: ein Phytopharmakon mit potentiell gefahrlichen Interaktionen. Praxis 2001;90:843-849.

[4] Pfrunder A, Schiesser M, Gerber S, et al. Interaction of St. John’s wort with low-dose oral contraceptive therapy: a randomized controlled trial. Br J Clin Pharmacol 2003;56:683-690

[5] Hall S, Wang Z, Huang S, Hamman M, et al. The interaction between St. John’s wort and an oral contraceptive. Clin Pharmacol Ther 2003; 74:525-535.

[6] Murphy P, Kern S, Stanczyk F, Westhoff C. Interaction of St. John’s wort with oral contraceptives: effects on the pharmacokinetics of norehindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding. Contraception 2005;71:402-408

After the last post on collaborating with your colleagues to help your practice, I thought I’d share the ad we put together. This is a full page newspaper ad that we were able to buy for very little cash since we split it five ways.

If you’re interested in giving your practice and profession a boost by doing something similar, here’s a little more behind-the-scenes info on how the process worked.

First of all, why the newspaper? Our community is reasonably small, so the local paper gets a decent amount of attention. We got a special rate on the full-page size, too, so in terms of value, it was a great way to start off our collaborative efforts. (If you can’t see the ad, you’ll find it here. ) In the end, it was a simple project that we could easily come together on.

The objective was to expand the slice of pie - to increase the percentage of the population actually using naturopathy. All our logos appear, but the ad is really about our profession, not us as individual practitioners. We started out with each practitioner submitting 35 words about what makes their practice unique, but I ended up scrapping the blurbs so we could focus on promoting the profession.

Some of the challenges in expanding the market that we tried to address:

1. Helping people understand the level of training required for ND’s to be licensed in our jurisdiction. Naturopaths make a massive time and financial investment before they even open their doors, but as a rule, the general public isn’t really aware of the level of training and education required.
2. Differentiating an ND in our area from other practitioners who are using the same title without proper licensing
3. Dispelling the misconception that you can’t see both an MD and an ND at the same time. People believe it’s “not allowed,” or that the two professions can’t collaborate.
4. Understanding one of the key differences of the profession, which is that ND’s are heavily focused on finding and treating the root cause of health concerns, not just palliating symptoms.

Working Together: Some Thoughts

I think our process was made easier by me doing the artwork (for better or for worse ). If you’re doing something similar, but working with a designer, I’d say your best bet would be to pick one practitioner to be the contact point for the designer. They’d bring the ideas to the designer, and have the authority to work with them to the point of 1-3 acceptable samples that everyone can comment on. Anything else would be chaotic and cost a lot more.

All told, though, it turns out we’re a surprisingly agreeable bunch. There were a few tweaks to the ad based on everyone’s input, but it was really quite easy to collaborate. The biggest challenge was getting everyone’s logo in the right format for consistency. Other than that, collaborating in this way turned out to be an amazing process. We highly recommend it!

Post from: AlternativeHealthPractice.com

Related posts:

1. Your Alternative Medical Practice as a "Safe" Place for Referrals
2. Alternative Health Practice: The Great Irony
3. Free Naturopathic Community Website: NDUnion

Googled recently did I (that's "Yoga grammar") under spiritual attorney Newport Beach and found Michael H. Cohen pop up....

These lovely April days, when the temperature is getting hot enough to make being outside a pleasure but being inside with the windows open just on the borderline of too stuffy and uncomfortable, I'm choosing more and more often to skip cooking...

[Click on the title to view the complete article in your browser]

A lawyer is a wordsmith who answers complicated questions with diligence and ease....

California's Low Carbon Fuel Standard (LCFS) is a good initiative but it is flawed in its current form. Consider:Ethanol is an alcohol with a fairly simple, universal formula regardless of how it is made. The great thing about all ethanol is that it is miscible in gasoline, oxygenates gasoline so that it burns more cleanly, and it is a renewable fuel whose carbon comes from the atmosphere, not

Eric Lofholm and Arvee Robinson continue to provide value in day 2 of seminar....

How would you go about getting a grant to retrofit your house as a solar model? ---------- Hi Kim, The purpose of your residential solar model

I love the idea of people using animals to take revenge on their enemies. In Japan and India, monkeys are revered and allowed to do as they wish. This old article is a perfect example of 'Who, ME?';

"Monkeys in India are more or less objects of superstitious reverence, and are, consequently, seldom or ever destroyed. In some places they are even fed, encouraged, and allowed to live on the roofs of the houses.

If a man wished to revenge himself for any injury committed upon him, he has only to sprinkle some rice or corn upon the top of his enemy's house, or granary, just before the rains set in, and the monkeys will assemble upon it, eat all they can find outside, and then pull off the tiles to get at that which falls through the crevices.

This, of course, gives access to the torrents which fall in such countries, and house, furniture, and stores are all ruined."

I see people with money so consumed with personal vanity that they dissipate what could help so many others much less fortunate.

Lavish weddings, vacations/trips, jewelry/bling, gadgets, multiple homes, pampering/spoiling kids, etc., etc, AD NAUSEUM.

Mostly to get attention and be noticed as well I suspect as some sick idea that this proves they are better than others.

Every now and then, someone comes along and does something marvelous...they exhibit beneficence without need of thanks or payback.

Such a case I found in an old book where poor and starving people were helped for a few days on the death of a decent man of some means;

"According to the 'Annual Register' for August, 1760, there were expended at the funeral of Farmer Keld, of Whitby, in that year,

one hundred and ten dozen of penny loaves,
eight large hams,
eight legs of veal,
twenty stone of beef (fourteen pounds to the stone),
sixteen stone of mutton,
fifteen stone of Cheshire cheese,
and thirty ankers of ale,

besides what was distributed to about one thousand poor people, who had sixpence each in money given them."