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Suzanne Harrison

Everyone knows that when it comes to  health problems, seeking professional advice  is highly recommended. 
For some, however, the urge to self-prescribe - whether for western or traditional Chinese medicine - is  too great to resist.
The result, however, can be fatal, or at the least, make you  ill. 
In Hong Kong, a female  patient was recently  admitted  to  hospital with hypoglycaemia  (low blood sugar) after taking a  proprietary product she bought  on the mainland.
The Hospital Authority (HA) has since sent out a warning about the product to  health-care professionals in TCM and western medical circles.  
'The product  was found to contain 4.9mg of glibenclamide   per capsule by the HA Toxicology Services; the recommended dosage is six to nine capsules daily. If one followed the  instructions, the daily dosage would be 29 to 44mg, which is potentially fatal,' the HA says in the warning.
The product, glibenclamide,   also known as glyburide,  is an  anti-diabetic drug in a class of medications known as sulfonylureas.  It is sold in doses  of 1.25mg, 2.5mg and 5mg,  under the trade names Diabeta,  Glynase  and Micronase  in the  US and Daonil,  Semi-Daonil  and Euglucon  in Britain.
'This product claimed to be herbal in origin and indicated  for the treatment of diabetes.  Similar problems involving another proprietary Chinese medicine  occurred on the mainland  two months ago, causing two deaths,' the HA says.
TCM and western  doctors agree  these kinds of problems occur for various reasons, the most likely being that over-the-counter products are unsuitable for treating illnesses or conditions.  
They suggest visiting a Hong Kong Medical Council-licensed TCM practitioner for professional advice, and avoiding purchasing these products on the mainland.
'A lot of people   are taking one ingredient and using it in higher dosages,  believing it will work well,' says John Fung,  a licensed TCM practitioner with    a clinic in Causeway Bay.  
'TCM practitioners don't prescribe medicine like this.   Always seek out a licensed  TCM  doctor  via the Chinese  Medicine Council of Hong Kong.  You should not take over-the-counter Chinese medicine.'
Eugene Kwan,  a general practitioner with Central  Health Medical Practice,  says consumers may not know what  is in  many TCM  products  without  a formal consultation.
'First of all, this   [glibenclamide]  had a chemical in it which is a diabetes medication and  a western chemical,' Kwan says. He says  he asks patients if they are taking products such as TCM to avoid negative interactions with western medicines he may prescribe. 
Kwan says while it's not certain the patient mentioned in the HA's report bought the medication over the counter, the lack of formal accreditation on the part of many doctors on the mainland makes purchases there risky.  
'The problem is  you have  unregistered doctors peddling their family potions and drugs from China,' he says.  'I would  not get anything over the counter. I would go to a licensed practitioner.'
As Fung says, if you have a headache, you can buy   paracetamol, but if you are suffering from  a disease, using over-the-counter medications would be inadvisable.  
So how do TCM proponents find reliable  practitioners?
As with choosing a western doctor, it is often about word of mouth and checking  credentials. 
TCM has been a saving grace for Hongkonger Kat Mayers, who is in her late 30s and the mother of an  11-month-old baby.  
But she would never visit just  any TCM practitioner, nor buy any product over the counter here.  She has also taken her  daughter to  consult a TCM practitioner for  minor ailments. 
'People don't realise TCM is  very effective and it's dangerous to self-prescribe,' Mayers says.
'People think it's just herbs,  but it's strong and  combining medications or increasing dosages can be dangerous.  Anybody  can say, 'I'm a Chinese doctor'. You do need a good practitioner and a reliable source [to find one].' 
Mayers had struggled for some time with digestive problems, and had every western medical test available.  Visiting specialists  shook their heads and said she would need to take strong  pills daily.
In desperation, she sought out alternative health measures and was introduced to TCM and her doctor in Causeway Bay. She no longer has the digestive problems.
'He is the only one I go to. I saw him through my entire pregnancy and I would only ever get medicine from him,' Mayers says.    She says  the cost  was covered by her private health insurance.
 The Chinese Medicine Council  of Hong Kong was established  under the Chinese Medicine Ordinance  in 1999. It  is responsible for implementing regulatory measures for Chinese medicine practitioners and medicines. 
The main purpose  of  regulation is to protect public health and consumers' rights, and to ensure the professional standard of Chinese medicine practitioners and the trade of Chinese medicines through  self-regulation.
 According to the Chinese Medicine Ordinance,   TCM practitioners who were practising in January 2000 can  apply for registration  under  transitional arrangements.
 However, last month it was reported that about 900 of the people whose names appear on  the official list of Chinese medicine practitioners had failed the licensing examination over the past six years. Figures  reported in  Legislative Council show  that only 40 per cent of the 1,565 listed practitioners taking the exam  between 2003 and 2008 had passed. 
The government launched the exam in 2000 to create a regulatory system for the profession. People who were already practising Chinese medicine at that time were included on the list of practitioners, allowing them to continue practising, although they had to take the  exam. Those who pass  become registered practitioners. 
The goal is for all practitioners to become fully registered, though there is no time frame. Some 1,832 listed practitioners have still not applied to take the exam, according to the government. 
So before  taking any medicine, consult your doctor, ask your  friends and don't buy mysterious over-the-counter products to treat serious ailments.



Dose of reality