What the doctor didn't order

Herbal medicine Many Australians believe in herbal medicine, whatever the science says. But Dr Ian Musgrave always counsels caution on what remedies to rely on.

“The simple fact that herbal medicines are drugs is underappreciated, or not understood at all, by most people. They include good drugs, bad drugs and completely useless drugs but they are drugs nonetheless, and therein lies a lot of grief,” Dr Musgrave warns.

“As well as being part of traditional remedies, we could very well get new drugs, like antibiotics, from herbs and plants. But we need to be cautious.”

And yet the senior lecturer in pharmacology in the University’s School of Medicine is very interested in the potential of nature for treating degenerative diseases, including Parkinson’s and notably Alzheimer’s disease. But there is no contradiction or even ambivalence inDr Musgrave’s position on medicine from nature. Although herbal medicines can be a source of new drugs, “sometimes the medical effect of what we extract has very little connection with what the herbal medicine is traditionally used for. You have to evaluate it carefully,” he says.

It is what he is doing with colleagues across the University and in other institutions and disciplines as they research nerve function and what degrades it.

He is a part of a promising new research approach to Alzheimer’s. A major cause of brain degeneration is the way proteins fold into the wrong shape and form chains that kill cells. In a process that can start years before the symptomatic impact on a person is obvious, the chains reproduce too fast for the brain to break them down.

Dr Musgrave is focused on ways to stop this “misfolding” from happening, including the use of molecules from plants such as green tea. The same approach also offers opportunities for treating HIV.

But there is a way to go. Dr Musgrave warns that science can’t yet explain why the normally innocuous proteins start misfolding in the brain to become toxic. And he is definitely not ready to contemplate a cure yet. “If the chemicals we are looking at work, we might be able to slow the onset of Alzheimer’s. While a chemical breakthrough might occur, the clinical impact will be incremental. It’s a long road ahead.”

If the research direction is right, that is. He frankly mentions this work might not deliver on its present prodigious promise. “We could be barking up the wrong tree on the processes involved in Alzheimer’s, the disease is known as a graveyard of therapeutic approaches.” But that won’t stop him trying.

If there is a breakthrough it may not come from chemistry. For example, recent research in mice showed ultrasound could break up the protein clumps that do the damage, Dr Musgrave explains. It’s why he is keen to credit his many collaborators. “Without colleagues in chemical and life sciences, I would not be able to do my work,” he says.

His is a clear-eyed assessment of years of hard work but Dr Musgrave is obviously someone who goes only where the evidence takes him. He started his career in science in a laboratory, and after a University of Melbourne PhD in chemistry went onto postdoctoral research in Germany. Since coming home he has focused on Alzheimer’s for 14 years.

He is also known as a prolific science commentator speaking on a range of issues that are dominating current public debate.

And he takes a strong evidence-based approach to herbs in medicine—it is up to scientists to discover what works.

“Science can turn up surprising new things. For example, Rosy Periwinkle, which is used as a traditional herb treatment, also is the source of a chemical compound that is effective against some forms of cancer,” he says.

Certainly he understands why so many Australians have faith in herbal cures, (over 50 per cent, he says). “Taking medicine is a very personal thing. People are attracted by the sense of personal autonomy provided by taking control of their medication.” But, and it is a very big but, people should not take them without telling their GP and should never think that if a herb is good for you, the more you take, the better you will be.

“The old saying is true, ‘it’s the dose that makes the poison,’” Dr Musgrave says.

It’s a problem that alarms the peak government agency, the National Health and Medical Research Council, which last year awarded close to half a million dollars to a cross-university team, including Dr Musgrave, to look at the adulteration and contamination of herbal medicines.

So if natural remedies are a source, not a solution, for research into some of medicine’s biggest challenges, what is he taking for the terrible head cold he has on the day he talks to Adelaidean?

“Tea, just conventional tea—no herbs.”