To clear up some misconceptions: First, comfrey does not have proven efficacy against tooth decay, either as a preventative or to reverse decay that's already underway. Safety as a mouth rinse is probably not a major concern apart from possible local irritation, if one is careful not to swallow any. Many responsible herbalists recommend against any internal use of comfrey because of the risk of pyrrolizidine alkaloid toxicity, implicated in some cases of acute liver failure and a concern for possible carcinogenicity. Oral formulations are banned in most countries for this reason. Young children are especially susceptible to toxicity from comfrey (even a few days of taking comfrey internally can be fatal). Contrary to what's been stated, acute liver failure is not a significant consideration when it comes to use of NSAIDS (non-steroidal anti-inflammatory drugs). Tylenol (acetominophen, which can be hepatotoxic) is not an NSAID (non-steroidal anti-inflammatory drug) like aspirin or Motrin. Tylenol is not an anti-inflammatory agent - it works by a different mechanism than NSAIDS to reduce pain and fever. Used in proper dosage and not combined with other things that can damage the liver (i.e alcohol) it is a generally safe as well as effective drug. The real problem is when people take too much, which may happen when they combine or otherwise overdose on over-the-counter cold meds. The big difference between Tylenol and comfrey is that Tylenol is a proven effective drug. Comfrey may have limited value in topical pain control (when applied for limited periods on unbroken skin), but in general the claims made for it have not been backed by quality studies (something to consider when weighing a decision whether to ingest it). You cannot count on drying to significantly reduce the harmful alkaloids. Unfortunately, you also can't count on comfrey sellers to be knowledgeable and upfront about the composition of their products in our current, largely unregulated supplement market. I rarely take acetominophen, but feel a lot more confident about its safety than I do comfrey. And based on what we've seen already, if Americans began to ingest comfrey as commonly as they do acetominophen, it's extremely likely that comfrey would quickly pass acetominophen as the leading cause of acute liver failure in the U.S.

>> I think enough has been posted already about the FDA's warning on kava (they have not established its safety or recommended it for any potential users) ... As a rule, the FDA does not recommend herbs - the fact that they do not specifically recommend kava means nothing. The FDA can ban an herb if there is clear evidence that it is unsafe. Since the 2002 advisory, the FDA has monitored the situation, but has not seen real evidence that this herb is clearly dangerous. By implying that no one should use an herb unless recommended by the FDA, aren't you really saying that herbalism should be avoided altogether? >> I'm surprised, then, that you aren't attacking the "biases" of the authors of the American Academy of Family Physicians article that you triumphantly cited on kava. After all, the authors of that article pooh-poohed a host of other herbal remedies and supplements that you recommended earlier in this thread, such as chamomile, hops, valerian, skullcap and passionflower. They do have their biases - they take a conservative approach and tend not to endorse something unless there is overwhelming proof (in the form of double-blind placebo controlled trials). That's fine for them, and in the case of kava, the evidence took them past their threshold and they do suggest doctors recommend it. The fact that there is not an adequate number of such studies for every other herb does not mean that none of these are effective - it merely means that it remains unknown according to their framework. I personally believe that there are other ways of knowing - the clinical experience of doctors or herbalists can lead to useful knowledge. And while many people dismiss personal experience as 'unscientific' I do not always do so. Many researchers believe that anxiety is a condition where people can monitor themselves and adjust their regimen, and I agree with this. Studies can tell us that a particular approach is better than placebo, but they generally cannot predict individual response. I have taken a variety of prescription and non-prescription therapies for anxiety, and can say that kava can have dramatic, rapid beneficial effects. I also seen benefits from passiflora. Chamomile has not resulted in any noticeable changes for me - maybe some people benefit, but I do not consider it to be that effective. Hops are used more for insomnia than for anxiety - so an article on herbal approaches to anxiety might not recommend hops, even if it was written by a herbalist. Ashwagandha I have find helpful, though there is almost no research on it with regards to anxiety; many people with anxiety have tried it and found benefit, but the FDA hasn't gotten around to looking into it (and they probably won't, so looking to the FDA probably won't answer that question). >> In searching for publications on kava you may have overlooked another new report. This one (in the Journal of Psychopharmacology) looked at 21 different double-blind clinical trials of anxiety treatments, incorporating two complementary/alternative medicine (CAM) therapies (including kava) and found that: "Subjects taking CAM had worse outcomes than placebo". No, I am aware of that study. It reviewed 21 different studies on 7 different types of medications (8 different types if kava and homeopathy are not lumped together - unlike other categories, they are not chemically related, and do not share a common mechanism). It is not clear how many studies were actually on kava (my guess is one or two). And lumping kava in with homeopathy doesn't tell us much about kava - I don't consider homeopathy to be effective, so I am not surprised that it would bring down the score of what they define as CAM. The idea that outcomes for kava are worse than placebo is at variance with a much larger number of other studies, and is not supported by the facts. To cherry-pick one review that has a dubious design and considers only a fraction of the research on kava is shoddy science. >> I was encouraged recently to see that you'd apparently forsaken personal attacks in this forum. I regret that you're resuming this tactic, I think your being too sensitive. Noting or criticizing apparent bias is not necessarily an unfair ad hominem attack. You have repeatedly mischaracterized my arguments as an appeal to folklore, you have insinuated that financial interests are behind the kava research that doesn't find it to be massively toxic, and you have invoked irrational fear over rare idiosyncratic reactions in kava while ignoring such risk from other commonly consumed medicines. You refuse to acknowledge well known limits to predicting liver toxicity using cell culture models, and dismissively suggest that I don't know how such research is done. For me to point out that you do in fact have biases and values that can color your interpretations of the research is not an unfair personal attack on you. You have consistently done the same to me.

So a follow up... I didn't have Monkey tested in July like I was supposed to but he's been acting just fine. Yesterday I took him into the vet for a check up and I brought the lab results and asked the vet about them. The ALT from 12-2010 was 104 (100 maximum) and the Jan-2011 ALT was 112. That was the only liver enzyme that was high. The vet said it was just barely above and he only really worries when it's two or three times the maximum range. Monkey has also lost 3 pounds in the last year. I believe it's because I moved him from a free-freeding dry food diet to a strict canned food only diet so he's slimmed down. He was 17 pounds and now he's just under 14, which is good for his size. But between that and the ALT levels, the vet wanted to do another panel. He just called me with the results. Now, there are four affected liver enzymes (he didn't tell me specifically which ones) that are high, but he said they are just barely above normal. He also said that the blood was clumpy (he gave a more scientific word for it - can't remember the name, something that started with an h and ended in -sis, lol) and that there was some fat in it from eating so he thinks that may have caused some of the elevations instead of it being a true elevation. He's calling the lab to find out. I should say the other two blood tests last year also had a note about the clumpy blood and how it might affect the ALT levels. The thing is, Monkey didn't eat before he came in. He gets food at 6 am when I wake up, and then again when I get home. When I got home to take him to the vet, I didn't feed him beforehand. The vet did give him treats in the office but he said that wouldn't have affected it. So I don't know where this fat came from. I told the vet he didn't eat but he didn't seem that concerned. Oh, and the night before, Monkey got into a bag of those candy melts and ate some and threw it up. I brought the bag with me to show the dr. It's full of sugar and oils and milk derivatives and it's not something I would have dreamed he'd get into but I wonder if that had an affect. He's been snacking on a lot of bad foods as I've been making holiday treats (I don't give them to him but sometimes he'll snatch something I drip in the kitchen before I can get it). So what I'm taking away from this is that: 1. it might be a lab issue because of Monkey's blood and he might not have higher elevations at all 2. It's been a year between tests and his elevation is still just slightly high. I tend to think that active liver damage would be more progressed in a year, right? 3. There are three other high enzymes now but just slightly above and they may be inflated because of the blood 4. All other blood levels were fine and I did the full senior panel so they looked at everything He said he doesn't think it's anything to worry about but he recommended supplementing with milk thistle and samE just in case there's mild damage of some sort. I'm trying not to worry about it. All things considered, I think this is good news. Not the best possible news but much better than high numbers! Any thoughts?

My almost 16 year old cat Maud was diagnosed with melanoma on the tip of her nose after a biopsy. We went to an oncologist who said surgery to remove her nose was the best shot at removing the cancer, and we would follow up with a series of cancer vaccines. She just had the surgery less than a week ago and is doing AMAZINGLY well! The surgeon was an artist and she was running around the day she came home. She stayed one night in the hospital and the techs told us she was asking for petting that night! We are so hopeful this has cleared the cancer and the surgery has not been a huge deal for our senior cat at all. She is on pain meds every 8 hours, which make her sleepy right after. The surgeon said he wished more owners considered nose removal rather than be upset by a cosmetic issue when the animal could care less how it looks. I am sharing in hopes that people will consider surgery for an older cat, depending on the type of cancer of course. My girl has amazed me with her will to live and resilience.