Last week, on a beautiful walk along the river here in Missoula, I had a good talk with another Mom. We talked about life, kids, and Dr. Google. My new friend conveyed her thoughts on how helpful Google has been, and how she has found many more answers on the internet than in her doctors office. I’ve had hit and (many) miss experiences looking things up for Annika in the early months after she was born, so we talked about that a little as well. While we were talking I thought to myself, I should really write a blog post about the potential dangers of Doctor Google. Then I promptly forgot about it.
Until Friday. On Friday I found an article on Twitter that piqued my interest, it was titled: “Natural Birth Control Using Herbs“. Hmmm, I thought, as a naturopath I don’t know of any herbs that can be safely used to prevent pregnancy. (That’s the thing about natural medicine, it tends to promote fertility rather than prevent it.) Sure enough, the author listed a half dozen herbs to “promote sterility” or prevent implantation. The sterility promoting herbs included Stoneseed and Jack-in-the-pulpit roots, which are known to be toxic. (Conventional medical sources recommend calling poison control center if ingested). The implantation preventing herbs are what we usually call “abortifacients,” since they do, in fact, trigger spontaneous abortion. All abortifacients carry risk of hemorrhage or incomplete abortion. They are also teratogenic, and should the pregnancy fail to terminate they could result in significant birth defects.
I didn’t sleep Friday night.
I had dreams of women hemorrhaging. Under the comments section of this page I saw several women ask if these (toxic!) herbs were safe to take while breastfeeding. Then I had nightmares of women breastfeeding, passing toxic herbs through their breastmilk to their tiny infants. (Everything is more dramatic in the middle of the night.)
On Saturday I decided to start doing some research for this blog post. Under the same blog I found advice to not take antibiotics for strep throat because strep throat will go away on its own “with or without treatment.” (True, however, antibiotics are given to prevent the negative sequelae of rheumatic fever, rheumatic heart disease and post-streptococcal glomerulonephritis*). She also believes that she passed on strep immunity to her children because she didn’t take antibiotics.
Saturday night I had dreams of rheumatic fever.
After more digging on Sunday I found more blog posts by multiple authors. One on why you should not immunize against tetanus and how, by exposure to dirt, you can create natural immunity**. Another on why herd immunity doesn’t exist. Another on herbs for birth control – this one promoting the use of Conium maculatum (poison hemlock) to reduce fertility.
I had a bad weekend.
This afternoon I checked back in on the herbal birth control post, and left the following comment (and a longer reply about the dangers of abortifacient herbs):
My number one priority as a physician is to protect the safety of my patients – but how can I shield people from the internet? From Dr. Google? There is no accountability for what Dr. Google can prescribe. There is no medical license to be revoked, no health department to oversee, no medical community to connect with.
Maybe I am over-reacting. Ever since Annika was born I am hyper sensitive to anything that could cause harm, especially to mothers and children. Then again, maybe not – since a study found 25% of British women misdiagnosed themselves on the internet. Another study showed that Google searches may lead to a correct diagnosis a little more than half the time. (Actually – that’s not too bad!)
Then again, again, another study showed that Googling before heading into the physician’s office may actually improve patient-doctor relationships. This study showed that many patients who had previously Googled their condition thought that their visit to the doctor was more productive.
So what’s the take home message? Please, please, use Dr. Google carefully. Always look at the credentials of the author, and watch for the “this is not medical advice” disclaimer. Ask your doctor (the one you see in person) before you jump on any health-kick bandwagon. And if your doctor doesn’t have time to sit down and answer your questions – go find a new one.
Kim, et al. Rheumatic Fever. First Consult. Web. 2 March 2011 [http://www.mdconsult.com/das/pdxmd/body/377082501-3/1373734046?type=med&eid=9-u1.0-_1_mt_1014245]
Tetanus, Puerto Rico 2002. MMWR weekly. Web. 19 July 2002 [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5128a1.htm] 28 October 2012.
Prevots R, Sutter RW, Strebel PM, Cochi SL, Hadler S. Tetanus surveillance—United States, 1989–1990. In: CDC Surveillance Summaries (December 11). MMWR 1992;41(No. SS-8).
Verma R, Khanna P. Tetanus toxoid vaccine; elimination of neonatal tetanus in selected states of India. Hum Vaccin Immunother. 2012 Oct 1;8(10).
Woldeamanuel YW. Tetanus in Ethiopia: unveiling the blight of an entirely vaccine-preventable disease. Curr Neurol Neurosci Rep. 2012 Sep 21.
Tang H, Hwee Kwoon Ng J. Googling for a diagnosis – use of Google as a diagnostic aid: internet based study. BMJ 2006:333:1143.
Tibazarwa KB et al. Incidence of Rheumatic Fever in the world: a systematic review of population-based studies. Heart. 2008 Dec;94(12):1534-40.
* I have searched and searched for good data regarding the actual incidence of rheumatic fever, rheumatic heart disease and post-streptococcal glomerulonephritis. Much of the data is old and lists the actual incidence of rheumatic fever at 0.3-3% in untreated persons. Newer data suggests a rate of <10/100,000 persons in Western Europe and United States, with higher rates (>10/100,000) in Eastern Europe, the Middle East and Australasia. This includes treated and untreated persons, however. The medical community generally attributes declines in rheumatic fever to the use of antibiotics, but this has never been completely substantiated. In this sense, the above-mentioned author is correct. However, I still personally believe that cases of strep should be managed appropriately by a physician to carefully monitor for signs of rheumatic fever if the patient, given that knowledge, refuses antibiotics. Though some herbal methods have shown antimicrobial activity against group A streptococcus, they have never been shown to reduce the incidence of rheumatic fever (i.e., no study has been done).
** On this, the research is pretty clear: vaccination campaigns in developing nations significantly decrease the incidence of tetanus. Where there are vaccines the incidence is low, where there are not the incidence is high. (Coincidence?) The blogger cites a few studies, but as far as I can tell these have not been replicated. Personally, I am happy to support families who decline vaccinations, even tetanus (though of all vaccines, this is the one most families tend to choose first, in my experience). However, I think it is unwise to assume that natural immunity is likely.
Phew. I’ve spent all day scouring Pubmed looking for journal articles for you, my loyal readers. I need a break.