Prescribing drugs is a tricky science, requiring physicians to carefully consider many factors. Your doctor can measure or otherwise determine many of these factors, such as weight and diet. But another key factor is drug interactions. You already know that every time you go to the doctor, he or she will ask whether you are taking any other drugs and whether you have any drug allergies or unusual reactions to any medicines.
Interactions between different drugs in the body, and between drugs and foods or dietary supplements, can have a significant influence, sometimes "fooling" your body into thinking you have taken more or less of a drug than you actually have taken.
By measuring the amounts of a drug in blood or urine, clinical pharmacologists can calculate how a person is processing a drug. Usually, this important analysis involves mathematical equations, which take into account many different variables. Some of the variables include the physical and chemical properties of the drug, the total amount of blood in a person's body, the individual's age and body mass, the health of the person's liver and kidneys, and what other medicines the person is taking. Clinical pharmacologists also measure drug metabolites to gauge how much drug is in a person's body. Sometimes, doctors give patients a "loading dose" (a large amount) first, followed by smaller doses at later times. This approach works by getting enough drug into the body before it is metabolized (broken down) into inactive parts, giving the drug the best chance to do its job.
Feverfew for migraines, garlic for heart disease, St. John's wort for depression. These are just a few of the many "natural" substances ingested by millions of Americans to treat a variety of health conditions. The use of so-called alternative medicines is widespread, but you may be surprised to learn that researchers do not know in most cases how herbs work—or if they work at all—inside the human body.
Herbs are not regulated by the Food and Drug Administration, and scientists have not performed careful studies to evaluate their safety and effectiveness. Unlike many prescription (or even over-the-counter) medicines, herbs contain many—sometimes thousands—of ingredients. While some small studies have confirmed the usefulness of certain herbs, like feverfew, other herbal products have proved ineffective or harmful. For example, recent studies suggest that St. John's wort is of no benefit in treating major depression. What's more, because herbs are complicated concoctions containing many active components, they can interfere with the body's metabolism of other drugs, such as certain HIV treatments and birth control pills.