|Tawa-tawa photo by Nasty|
My son was diagnosed with Dengue fever a couple of weeks ago. With normal results for platelet count being 140,000 - 400,000 per microliter (mcL), his was at 131,000 on the second day of his fever.
Before panic could rise, I got reassuring advice from friends and kasambahays to try out this herb known as tawa-tawa. They said that tea made from this common plant had been featured in the news as a promising cure for dengue.
When we went home to pack for my son’s confinement in the hospital, I snuck in a quick internet search. From the website of the Philippine Council for Health Research and Development (PCHRD), I learned that in 2012, students of the University of Santo Tomas (UST) – Faculty of Pharmacy had conducted a study entitled “Investigation of the anti-thrombocytopenic property of euphorbia hirta linn (Tawa-Tawa) decoction in rat models.” In layman’s terms, they used a cocktail of chemicals to duplicate dengue hemorrhagic fever in rats. It was to test widespread anecdotal evidence of tawa-tawa’s ability to heal people with dengue, thus turning into it the Philippines’ most popular folkloric treatment against this life-threatening disease.
In a nutshell, the study proved that tawa-tawa can increase platelet count, reduce bleeding time and decrease blood clotting time. The UST students’ conclusion: Tawa-tawa can, indeed, help improve the healing mechanism. At least, among rodents.
On the other hand, GMA News Online reported in a post dated Sept. 2010 that Dr. Eric Tayag of the National Epidemiology Center of The Department of Health (DOH) had cautioned that drinking tawa-tawa could “potentially aggravate” the condition by inducing peeing which could lead to further dehydration.
But a year later, in Aug. 2011, Philippine Daily Inquirer reported that, according to Health Secretary Enrique Ona, “very preliminary” results from initial research work show that tawa-tawa “appears” to have “some effects” on rehydration. But he made it clear that the DOH was not making any official recommendations and stressed the importance of immediately seeing a doctor. “Don’t depend on tawa-tawa,” Ona had said.
I Googled further and found an even more recent post, also from GMA News Online dated Feb 2013, saying DOH had stated that although the tawa-tawa herb has not been proven to cure dengue, it may be taken along with effective medication and had been evaluated free of toxic substances, so it was deemed safe. In addition, Dr. Lyndon Lee Suy, DOH manager for the Dengue Control and Prevention Program had explained that drinking steeped tawa-tawa is “fluid replacement, which is basically the thrust for dengue [medication].” In another article on the PCHRD website, Ona said that the DOH does not endorse tawa-tawa “but at the same time we are not prohibiting it”.
All right, so with a gap of three years, the herb had gone from “potentially aggravating dehydration” to “fluid replacement”. And the DOH was neither endorsing nor prohibiting.
I sighed and looked up from my computer and realized it was time to leave for the hospital. As I rushed towards the door, concerned kasambahays stood by, thermos in hand. At their own initiative, they had gathered tawa-tawa from our backyard and made my son enough infusion for a day. My husband and I took the thermos gratefully.
At the hospital, I asked a resident about the use of tawa-tawa and the response was pretty much seated on the fence right next to DOH. They see no harm in us having our son drink it, if it will make us feel better. On-going studies, she said, had deemed it to be safe. (But not exactly helpful, I believe, was her unspoken last sentence.)
Before my son’s first drink of tawa-tawa could take effect, medical personnel took another CBC. His platelet count had gone down to 101,000. For the rest of the day, my son finished the contents of his thermos. The next day, his platelet count went down to 100,000, a drop of only 1,000! We continued with the tawa-tawa, and on the next day, his platelet count even went up to 110,000. I was convinced the tawa-tawa was working. But later, I realized, I was looking at the wrong factor.
Keeping a “platelet count watch” is not the point of dengue treatment. What matters is his hematocrit count, which, in essence gives the doctors a reading of the patient’s dehydration level. Dengue is a disease of dehydration. Metaphorically, it’s “diarrhea of the blood vessels”.Fluids are not lost visibly, as with vomiting or LBM, but rather through insensible plasma leakage. And based on the blood tests, my son’s hematocrit level was not looking good. His blood was getting too thick.
For the first three days, I had my son drink the herbal infusion several times a day. But this was done only as additional fluid replacement, on top of the IV, oral rehydration solution, and lots of water. On the fourth day, his platelet count went down again and, despite massive intake of fluid, his hematocrit level didn’t improve.
On the fourth day, his nose bled. By the fifth day, when we were all expecting the fever to break, I stopped the tawa-tawa and let his body take over. But the fever didn’t break, and his CBC showed that things were not improving. He was moved to ICU. By the eve of the seventh day, his fever finally ended. But by then, it had affected his heart.
The official diagnosis: Dengue Hemorrhagic Fever, Grade 2, with myocarditis. Thankfully, there would be no lifelong after-effects of the disease. His heart will fully recover.
What is my personal, unscientifically-backed conclusion from this experience? I believe the tawa-tawa was working wonders in preventing platelet destruction. But like I said, that should not have been the point. These days, doctors don’t consider blood transfusions for dengue anymore, even if the platelet count plummets to 10,000, provided there is no excessive bleeding. I think that even though the tawa-tawa tea was somehow assisting with fluid replacement, it was also masking the greater damage being wrought. For all I know, it might have actually been stimulating increased urination, as Dr. Tayag had suspected back in 2010. My son may have been more dehydrated than was suspected and the “good results” being generated by the tawa-tawa might have made the doctors less aggressive in managing his dehydration in the first few days.