Agnus Castus and PMS: Don’t buy it from Boots or Holland & Barrett if you actually want it to work

agnus castus flowerDear Juliet,

I ended up on your blog  while looking for information about agnus castus and PMS.

A few months ago a counsellor asked me whether the episodes of anger or low self worth were happening at any particular time. For the first time in more than 10 years of counselling, therapy, CBT etc I realised that there might be a connection between me feeling like not me and PMS. I started looking into it and a set of completely new ideas opened in front of me. First, is the idea that the emotional pain I carry with me could actually be triggered from something different than my mind. Second is the idea that there are remedies.

It is so great to receive an email like that, however, the writer of the email is finding it difficult to get the correct dosage of Agnus Castus and more importantly ascertain what the correct dosage is, as each supplier seems to calculate the active ingredients completely differently.

For example:

Nature’s Best sell 100mg tablets, equivalent to 100omg of fruit, ratio 10:1 (this old stock*).

Prime Health, advertise (although you can’t actually purchase it) 20mg standardised extract tablets, equivalent to 24omg dried fruit, ration 12:1. This is the dosage described in the clinical data, and the only one I understand.

Herbs sell Agnus Castus Tincture 1ml equivalent to 500mg, ratio 1:2 (again this is advertised as old stock.*)  This is the response I received to information on dosage. “Our dose equivalence is 1ml (ie 10 drops) to 500mg of dried herb.  So to get close to your current tablet equivalence you would take 0.4ml or 0.5ml (4 or 5 drops) three times a day.” (remember this is old stock, so you would have to take 5 times that, once new stock carries the THR logo.)

*The reason these companies are pointing out they are selling old stock is because the new regulations of herbal medicines has restricted the amount of active ingredient per tablet/ ml. What that means is the recommended dosage is no longer based on data from clinical trials, but rather is based on the restrictions of selling herbal remedies under the Traditional Herbal Registration license (THR).

In short, up until 2011 herbal medicines were unlicensed (meaning dosage was not restricted). Since 2011 all suppliers of herbal remedies must apply for a license. In the case of Agnus Castus there are two sorts of licenses. The Traditional Herbal Registration (THR), which restricts dosage to 4mg per tablet, or the Marketing Authorization (MA), which would allow dosage of 20mg (based on Well Established Use). The information on dosage allowed under each type of license can be found in the EMA Community Monograph, which is the document to which member states should refer to when deciding on whether to an issue a license or not.

Unfortunately, most high street and online stores have applied and been granted a Traditional Herbal Registration (THR), which means they can’t sell any Agnus Castus with a dosage higher than 4mg.

If it has this logo, then the dosage can be no more than 4mg per tablet.
If it has this logo, then the dosage can be no more than 4mg per tablet.

So where you see the THR symbol on herbal remedies, it is a guarantee the dosage will be too low to have an effect. This means products from Boots, Kira and Holland & Barrett are not worth buying (unless you’re can afford and are prepared to take 5 tablets each day.) They are selling 4mg tablets at the same price they used to sell 2omg tablets.

Why has the EMA interfered? I hear you ask.

It seems there is a grave fear in Europe that herbal medicines are dangerous and in particular they interact with prescribed drugs leading to undesirable effects. To protect the (silly) public all herbs must have a license in order to be sold. THR license is based on traditional use for thirty years, and doesn’t require rigorous clinical trials to be granted (even though there are rigorous clinical trials accepted by the EMA for Agnus Castus).  Because of the lower requirements for THR, that means the dosage is set at a level where it is unlikely to have any effect (adverse of therapeutic). Which makes you wonder why Boots would bother selling the products at all (I have emailed Boots this very question and will post their response). They are in fact cheating their customers, by implying the drug will work at the lower dosage, despite overwhelming clinical evidence to the contrary.

So where can you get the correct dosage of Agnus Castus from?

1) Not from any supplier who has a THR license. If it’s got the THR logo, then it is going to be too low to be effective. You will need 5 times the dosage suggested. Products from Boots, Holland & Barrett, Healthspan, Kira all carry the THR logo.

2) Some companies are still selling old stock, this is likely to be at higher dosage. If it doesn’t have the THR logo it is likely to be old stock. Nature’s Best, mentioned above, wrote to me about their dosage, and the problems they are experiencing in restocking:

“The Natures Best Vitex Agnus Castus currently provides 100mg of Vitex Agnus Castus fruit extract at a one a day dose.  This is a 10:1 extract which means the starting material is 1000mg (dried fruit).  Vitex contains the flavonoid casticin and we ensure that that our extract contains not less than 0.4% casticin per tablet which is an excellent marker of potency. At the time of formulating this herb we did review all of the data referring to tincture, traditional use and extracts that were available.  This was launched 14 years ago and we have received excellent feed-back from
customer who have used it.

In April 2011 the status of this herb changed from food supplement to medicine.  We have applied for a medicinal licence but we are struggling to get the potency to match our current product.  Nothing has been finalised yet and once we sell through our stock of food supplements, we will have to wait for our licensed product to become available.   We are close (weeks away) from running out and although this may appear like a hard sell, I am really only telling you so you have the choice.”

3) If the product has a PL code (product license required for all medicines), which means the supplier has obtained Marketing Authorisation. Although I have not as yet found any supplier that has got an MA, I do have an email from one, who is attempting to get this (and will give you their details as soon as I can). I have also emailed the MRHA (UK regulatory body for medicines) to ask them if they have a list of suppliers who have applied for the Market Authorisation. I await their reply.

4) Finding a supplier outside of the EU (possibly US or Canada).

I wish the news was better, but the EU regulations have, in effect, decimated the herbal medicines industry, rendering the herbs ineffective, by restricting dosage to levels too low to be effective (this hasn’t just affected Agnus Castus). For more on the herbal industry’s take on the regulations, click here.

Something is very wrong here. You have to wonder who really benefits from these regulations (the public or the drug companies), because as one herbal company, who emailed me this morning said:

“The pharmacists at the MHRA will have their way with regard to recommended doses, their is nothing that can be done to prevent that. As you cannot patent a herb, it is highly unlikely a company would go to the expense of trials to justify market authorisation. So it is most likely once current stocks are are sold through and the MHRA has attacked the sale of agnus castus food supplements that agnus castus will only be sold at very low doses.”

Link to fees for Market Authorisation and Traditional Herbal Registration.

The main medical treatments offered for PMT are anti-depressants and hormonal treatments (with the well documented side effects), despite the overwhelming evidence that Agnus Castus works (with minimal side effects). Doctors cannot prescribe Agnus Castus in the UK because it is not listed in the BNF (the British National Formulary).

All I want is somewhere I can buy the correct dose of Agnus Castus and continue to be free of the debilitating PMT I suffered for years under the ‘care’ of a gynaecologist. Is that too much to ask?

If anyone else finds old stock of Agnus Castus, post a link here. Or if you find a supplier that has a PL code, please let us know.

Six for writers: Show don’t tell – what’s all the fuss about?

The Betterware catalogue is sat on the kitchen table all innocent looking. For flip’s sake, either you are morphing into a boomerang when my back is turned, or else someone is bringing you back in. For the third time that day, I put it back out on the front porch. I never buy anything from it. I have the internet.

My son and husband are talking (loudly) in the next room. Since he has got taller than his father, every conversation they have is loud, and to my ears, competitively edged.

“Who brought the catalogue in from the porch?” I shouted three times.

“I did,” my nearly grown son said, filling the kitchen doorway, momentarily startling me – where did the boy go?

“Well don’t.”

“Why? What is it?”

It’s a catalogue of house stuff, but I never buy anything from it. Just leave it on the porch and they will pick it up again in a few days.”

He screwed up his nose. “Why don’t you just throw it away? If you don’t want it and didn’t ask for it?”

“Because it is someone’s business – how they make money – and I am not trying to hurt them, I just don’t want anything myself.”

His face smoothed into a wry smile.  Looking down on me, he said: “You’re such an inspiration. Do you know that Mum.”

My eyebrows lifted, waiting for the sarcastic punch-line.

“I really mean it.”

And I learnt a major lesson in how to be a parent (slightly too late as my youngest is almost eighteen) and the parallels in writing emotionally connecting fiction.

You can tell your kids until the polar ice-caps melt that they must be kind and respectful, but showing them is likely to have more power and impact. I am not a perfect mother, but I am ‘good enough’ and my son is kind and respectful not because I told him to be, but because I showed him how to be.

Just as it is in your writing.

When you want to convey an abstract idea, like respect or hate, you must show it through a concrete action if you want the reader to feel it rather than merely hear it.

I could say:

Roger was filled with hate.

Or,

I could show you:

Roger placed the air-rifle on the windowsill to steady it. The window was already ajar; the day had been the hottest one yet. The squeals from the playground were deafening.  The One Show was about to start and Monty Don was going to be on talking about his new Gardening programme. In Roger’s day, children were sent to bed straight after tea. There was no point talking to the parents, if anything they were more ignorant than their offspring. Some bright spark, no doubt the flashy lawyer from no. 45, with the four blond-haired boys ranging from downright evil to obnoxious, had filled a large paddling pool and placed it not more than ten feet from Roger’s back fence.

He heard the News coming to an end and lined up his sight. The eldest of the four boys had dragged a plastic slide over the paddling pool and was standing at the top of it, crowing about the splash he was going to make.

Roger aimed for his thigh and pressed the trigger. The gun popped. He swung it around and aimed at a squirrel running along the edge of the fence – rats with bushy tails was all they were. The squirrel and the boy fell down together.

The screaming started. He went upstairs and stood at his bedroom window as children ran into and over each other, scrambling for their back gates, like the savages they really were. Soon all would be quiet. He plumped up his pillows and sat on the bed, remote in his hand.

Of course, it doesn’t have to be all ‘show’ – sometimes ‘tell’ is good enough, for example, when you have to cover a lot of time quickly. Not everything you write needs to have emotional resonance, sometimes characters just have to get places or complete an action, but never forget showing is where the power is.

So make sure, when the reader needs to feel, you show them how to.

Do you think unpublished writers make too much fuss about writing ‘rules’? Is show and tell one of those ‘rules’ that you get fed up hearing about?

On Education: Those who can’t, teach – and thank goodness for them

Wilshaw and Gove seem intent on denigrating teachers, for whatever political/ economic agenda they are currently pushing.

gove terminator

Sir Michael said regional chiefs were being given orders to root out poor-performing schools, chains of academies and local authorities in each region.

In particular, they will be told to crackdown on schools that:

• Fail to stretch the brightest and weakest pupils by placing them in mixed-ability lessons;

• Enter large numbers of pupils early for GCSEs simply to bank a pass-mark before moving pupils on to other courses;

• Consistently mislabel poorly-performing pupils as suffering from special educational needs to disguise weak teaching;

Critics have warned that many schools are failing to place children into ability bands because of “ideological” opposition to the system by teachers.

I could blog about the lack evidence they have for their spurious assertions, in particular the idea that teachers are against ‘setting’ for ideological reasons, and the unsubstantiated assumption that mixed ability classes damage the most able.

The view that, at least for certain subjects, learning is best when pupils are grouped by ability seems to be widely held by teachers and others, as is evident from the setting that takes place within comprehensive schools. […] We may also note that despite widespread belief in the benefits of setting, it is not a view that is really supported by research evidence (Mosteller et al, 1996). Evidence of the effects of Selective Educational Systems.

I could rage on about how unfair it is, and how teachers (me included) are seriously considering why we work in a profession that is Wilshawseen as an easy route for lazy,whinging people, who can’t do anything else. I could give you a run down of my typical day and the variety of roles I must simultaneously fulfill – but my job is no more difficult than many other jobs that involve dealing with emotions, expectations and hopes (nursing, policing, social work, childminding, youth workers, probation officers and on and on).

Instead I want to tell you about my teacher, Mr Hallet, who worked at Bushmead Primary School in Luton in the late 1970’s and earlydanny_champion_of_the_world_pic 80’s. I guess I was around 9 or 10 when he became our form tutor. I do remember it was love at first sight. His front teeth slanted backwards and when he spoke, a line of spittle would extend from his top lip to his bottom lip. I loved that line of spittle. I loved watching it break and reform as he shared another exciting fact about the world. He had dark hair, I think he was tall, though I was very, very short (kinda like a munchkin) – I didn’t get much taller as it happens. Whenever I remember Mr Hallet it is summer (why is it when we think of our childhoods it is always summer?) He read us Roald Dahl’s  ‘Danny Champion of the World’ under a broad oak tree on the grass border that surrounded the playground every afternoon, until the bell went for home time. I remember lying on my back on the cool grass and looking through the leaves, while plump pheasants drunk on hand sewn alcohol-laced raisins plopped on the ground around me. His mellifluous voice wove pictures  in my head. I do wonder if he is one of the reasons I love reading and writing. I cried when I left primary school. I swore I would never forget him. I never have.

On a side note, he was also partly responsible for the one and only broken bone of my childhood. A greenstick fracture of my right wrist. On a residential field trip, he offered aeroplane rides on his feet. I couldn’t wait for my turn and possibly pushed myself to the front of the queue. To be in his gaze was to be in heaven. His soles pressed against my tummy, gently, as he lifted me up in the air, grasping my hands in his and flying me around. Over-excited me, shouted; more, harder, Greenstick_fracturefaster – and then all I remember is flying over his head and thinking, I am really flying, before the grass came up suddenly and I realised, too late, I had let go of his hands. The rest is history. I didn’t cry. I didn’t want him to think I was a baby. My wrist looked wonky. It hurt a lot. He took me to hospital. I came back to the outdoor centre with a white plaster cast. He cuddled me and bought me an ice-cream. My parents came to collect me (once they had been found in the time of BMP -before mobile phones). I made them take me straight back there the next day and stayed for the rest of the week. He was the first to sign my cast. He was my first love. He may also have been the reason I became a teacher.

He made each and everyone of us feel special, important, unique and loved. I am so glad whatever it is Mr Hallet couldn’t do, meant he chose to teach.

In this little corner of the blogosphere, let’s celebrate those teachers who made going to school an adventure. Who made a difference in our lives. Who chose teaching, not because of what they couldn’t do, but because of what they could.

we salute you
We salute you!

And I salute you, Mr Hallet, Teacher at Bushmead Primary School, Luton, and I probably still love you too. love

Got a teacher you want to salute. Remember them here. Share your stories. Let’s remind all those beleaguered teachers (including me) why it is one of the best jobs in the world. And Mr Hallet, if you read this, thank you.

Please do share.

A review: My top ten for 2013

Time to review my list for 2013, one month in:

  1. Get an agent- well, I jumped. MS is sent.
  2. Get a publisher – depends on 1.
  3. Fast twice a week – yup, still doing it. Still feel great. Husband starts it tomorrow.
  4. Meditate regularly- not once. I really must start doing it again. Make time.
  5. Enjoy the moment (live in the present) – always trying, but would help if I meditated.
  6. Worry less (see no. 5) – nuff said.
  7. Read more books – reading two at once, currently. Spent a great train journey, immersed in Sadie Jones, Small Wars.
  8. Write more (instead of procrastinating on the internet) – well I’ve sent the MS and my friend and I are challenging ourselves to write something new each month and put it in our shared dropbox.
  9. Keep blogging- love my blog.
  10. Accept change is part of being alive and embrace it – I’m getting on a plane to Honduras! And looking forward to it.