[charlielouise1]

I want to do something related to the idea of herbal remedies and their effects, possibly the advantages and disadvantages. Stuff like that

But I have no idea what the actual question should be, and what I should actually investigate?
Please help!

[RxKaren]

If the number of patients I see coming in for surgery with various herbal medicines are anything to go by then it might be interesting to find out what the current trends are, what they're using, why they think they're using it and whether there's any evidence behind it.

I had a vac student audit it last year as a snapshot in a week and we found that there was a lot of milk thistle being bought following something that was published in a tabloid (supposed to protect your liver against Halothane which is something we no longer use...). This year we're seeing a trend towards ginger, ginseng and ginkgo, all of which we stop 2 weeks before surgery because of the risk of increased bleeding. There are a couple of good papers out there - one is produced by UKMi and the other is a journal article called "The surgeon's guide to herbals".

I get quite worried that patients think these are a safer option than conventional medicines. We've had a patient who had a documented sensitivity to statins (deranged LFTs) taking a herbal medicine which contains a naturally occurring statin but it wasn't on the label. A couple of years ago there was a lot of black cohosh coming in - that's fallen out of fashion at the moment.