Herbal Supplements vs Immunosuppressants 

By: Cheryl Wagoner Monti, PharmD.

      To enhancing the immune system, herbal supplements have been safely used for centuries as a holistic approach to medicine. These supplements can be cultivated from plants or other natural sources, or synthetically produced. However, for a patient that has received a transplant, the effects of these supplements can be detrimental to their health and the health of the new organ.

     To avoid rejection of the new organ, the transplant patient's immune system is suppressed by the use of anti-rejection medications, also called immunosuppressants.  However, when a patient takes a non-prescribed supplement, it can activate or enhance their immune system, weakening the response of the immunosuppressants which could possibly cause rejection.

     On average, a transplant patient takes eight or more medications, including the prescribed and necessary immunosuppressants.  Anytime that there are multiple drugs being prescribed to a patient, there is a chance for a drug interaction.  Such an interaction can be severe, including rejection of the transplanted organ or other life-threatening effects.  Herbal supplements or any other drug, be they prescribed or not, can create and multiply a potential negative interaction - hence the critical importance for the transplant patient; along with their doctors, coordinators, and pharmacist to have a clear and complete understanding of what the patient should and should not take.

     One popular herbal supplement is green tea. Green tea contains approximately 65 mg of caffeine per a 6 ounce cup.  As with most teas, the more tea used and the longer it is steeped, the higher the caffeine content.  This increase in caffeine can cause a directly related increase in blood pressure and heart rate, therefore possibly creating a need for an increase in medication.  It can also affect the amount and rate of absorption of some medications used for blood pressure and can have a diuretic effect. In addition, green tea can increase the amount of stomach acid, making a less than desirable environment for Proton Pump Inhibitors such as Protonix, Nexium, Omeprazole, deeming them ineffective. Green tea can also enhance the immune system by detoxing the body and eliminating transplant drugs, which can increase the risk of acute rejection. 

     A few of the popular herbal supplements are St. John's Wart, ginkgo, ginseng, ground flax seed, Echinacea, licorice, and rosemary - these all may interfere with immunosuppressant levels.  While not considered an herbal supplement, grapefruit and pomegranate should be avoided to prevent potential drug toxicity - juices from these two popular fruits have been proven via studies to show variable and unpredictable levels in drug strengths and effectiveness.  Keep in mind that too little or too much drug in a person's system can be dangerous for the organ. 

     While they can be safe, homeopathic supplements are not regulated by the FDA and therefore have no official standards as to strength, additives, or purity.  It is extremely important for the transplant recipient to avoid herbal supplements to prevent acute rejection.  Also, the medical professionals, including the doctors, coordinators and pharmacists, must advise the transplant patients of the potential risks associated with using herbal supplements and transplant medications together.  The patient must be diligent, always informing their transplant team of any and all other medications, be they over the counter or even prescribed by another doctor. The success of the organ transplant and the satisfactory health and life of the patient depend on this.

Treasurer's Report

By: Peter Nicastro

March Transplant Anniversaries 

     February and March can be so humbug.  On and off cold (mostly on), biting wind, snow and ice one day then sun to put us back on the path to Spring.  We had a poem sent to us shortly after Larry's transplant that will keep some of this in perspective and is worth sharing.

Happiness keeps you Sweet,

Trials keep you Strong,

Sorrows keep you Human,

Failures keep you Humble,

Success keeps you Glowing,

But only God keeps you Going!

Friends like you are special hugs from God!

     Hugs and happiness to the following who are celebrating their March transplant anniversary.

CALENDAR 

     The St. Louis Chapter of Second Wind Lung Transplant Association meets the second sunday of each month. Following please find the meeting schedule for the remainder of the year.

March 13, April 10, May 8, June 12, July 10, August 14, September 11, October 9, November 13 and December 11.

     Please mark your calendar and plan to join us at Chris' Pancake and Dining at 2:00 pm.