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RESEARCH ON THE HEALTH BENEFITS OF HERBS & SUPPLEMENTS

(This data base is a work in progress and even though it is unfinished it is being presented here for the purpose

of disseminating scientific studies on the health benefits of herbs and supplements.)

 

John G. Connor, M.Ac., L.Ac.

June 2010

TABLE OF CONTENTS

1.      Introduction

2.      Herbs and their Common Uses

3.      Supplements and their Common Uses

4.      Conditions that are Treated by Herbs and Supplements

5.      Safety Issues with Herbs and Supplements

6.      Dangerous Herbs

7.      Systematic Reviews On The Efficacy And Safety Of Herbs

8.      Towards A Better Understanding Of Herbs And Supplements

9.      References

 

INTRODUCTION

 

§         B = Bratman, Steven, MD & Andrea M. Girman, MD MPH, Mosby’s Handbook of Herbs and Supplements and their Therapeutic Uses, St Louis: Mosby, 2003

§         L = Lininger, Schuyler W, Jr. DC, Editor in-Chief, The Natural Pharmacy, Rocklin, CA: Prima Publishing, 1999

§         S = Skidmore-Roth, Linda, Mosby’s Handbook of Herbs & Natural Supplements, 2nd edition, St. Louis: Mosby, Inc., 2004

§         W = Werbach, Melvyn R., M.D., Nutritional Influences on Illness, Tarzana, CA: Third Line Press, 1996

§         Y = Yance, Donald R, Jr., C.N., M.H., A.H.G., Herbal Medicine, Healing & Cancer, Chicago: Keats Publishing, 1999

 

HERB AND THEIR COMMON USES

·        Aloe

o       Aloe is useful when applied topically for genital herpes. In one double-blind, placebo-controlled study use of aloe cream resulted in a reduced mean time to healing and increased total number of healed patients. (Syed et al 1997) (B 363)

o       Aloe is useful when applied topically for psoriasis.  In one double-blind, placebo-controlled study aloe cream produced significant improvement compared to placebo. (Syed et al 1996) (B 363)

o       Aloe is useful when applied topically for seborrhea.  In one double-blind, placebo-controlled study aloe ointment could significantly reduce symptoms of seborrhea. (Vardy et al 1999) (B 363)

o       Aloe is useful when taken orally for diabetes.  In a single-blind, placebo-controlled study those taking glibenclamide and aloe showed improvements in blood glucose levels over a six week period that compared to those taking glibenclamide and placebo. (Bunyapraphatsara et al 1996) ( (B 363)

o       In a systematic review by Yeh et al (2003) on herbs and dietary supplements for glycemic control in diabetes they concluded that other supplements with positive preliminary results include Aloe vera.

o       Andrographis can be used to treat symptoms of the common cold. In a double-blind placebo-controlled study158 persons with colds received 1200 mg daily of an andrographis extract (standardized to contain 5% andrographolide) or placebo for 4 days.  By day 2 of treatment, and even more, by day 4, persons given andrographis extract experienced significant improvements in symptoms compared to the placebo group.  The greatest response was seen in earache, sleeplessness, nasal drainage and sore throat. (Caceres et al, 1999) (B 369)

o       Andrographis can be used for prevention of the common cold.  A 3-month, double-blind, placebo-controlled study of 107 persons found that prophylactic treatment with andrographis at the low dose of 200 mg/day significantly reduced the risk of infection. (Caceres et al, 1997) (B369)

o       Artichoke is used to lower cholesterol levels; and it may protect the liver from harmful effects (Kraft, 1997)(S 56) 

o       Astragalus improves immune function in a number of ways: it increases the numbers of both macrophages and white blood cells, it increases immunoglobulins A, G and M; it increases the functioning of B-cells and T-cells; and it may intensify phagocytosis, stimulate pituitary-adrenal activity and stimulate production of interferon.  These research studies provide evidence of the use of astragalus to treat cancer and other conditions with decreased immune response such as HIV/AIDS. (Kajimura et al 1997) (S 62)

o       In a study using an extract of Atractylodes lancea which contained 80% galacturonic acid it was shown to play a major role in the protective activity against Candida-infected mice. (Inagaki et al 2001)

o       Bilberry significantly improves night vision; in addition it may be useful for the prevention and treatment of glaucoma, cataracts and macular degeneration of the eye (Bravetti, 1989)(S 106)

Black cohosh Studies by Stolze (1982), Warnecke (1985) and Stoll (1987) provide adequate evidence to support the use of black cohosh as an alternative to estrogen therapy in menopausal women.  Unlike estrogens, black cohosh does not affect the secretion of prolactin, FSH or LH (Freudenstein, 2002)(S)

o       A study published in 1998 found 70% of patients suffering from bronchial asthma improved when treated with Boswellia serrata gum resin. (Gupta et al 1998)

o       A study published in 2001 found that gum resin preparation from Boswellia serrata could be effective in the treatment of chronic colitis with minimal side effects. (Gupta et al 2001)

o       In clinical trials of Boswellia, promising results were observed in patients with rheumatoid arthritis, chronic colitis, ulcerative colitis, Crohn’s disease, bronchial asthma and peritumoral brain edemas. (Ammon 2002)

o       Boswellia decreases leukotriene synthesis that is responsible for maintaining inflammation and edema. (Bruneton, 1995; Gupta et al, 1997)(S)

Chasteberry (Chaste tree)(Vitex agnus castus) Three studies have shown that chaste tree significantly reduces PMS symptoms. (Lauritzen, 1997; Berger, 2000; Loch, 2000)(S)

o       An unpublished trial presented at the June 2001 American Urological Assn. found that both cranberry juice and cranberry tablets significantly reduced the number of episodes of symptomatic urinary tract infections. (Stothers, 2001) (B 490)

o       Two studies found that cranberry juice is useful in the prevention (but not the treatment of) of urinary tact infections. (Jackson, 1997; Jepson, 2000) (S 324)

o       One study found that the proanthocyanidins in cranberry juice altered subgingival microbes and therefore would be able to control periodontal disease. (Weiss, 1998) (S 325 & B 491)

o       Turmeric extracts were found to lower LDL and total cholesterol in one human study. (Soni, 1992) (B 502)

o       One study using 500 mg curcumin four times daily found clinically significant benefits in 116 patients being treated for dyspepsia. (Thamlikitkul, 1989) (B 501)

o       A study published in 2000 demonstrated the anti-cancer and antioxidant actions of 3 chemical components of turmeric on leukemia, CNS disorders, renal cancer, breast cancer, colon cancer and melanoma. (Ramsewak, 2000) (S 909)

o       One study in mice showed restoration of suppressed immune function with dandelion (Luo, 1993) (S 343)

o       The bitter principles in the leaves and roots of dandelion increase bile production in the gallbladder and bile flow from the liver. (Behm, 1959)(L 416)

o       One animal study using devil’s claw demonstrated that it exerts a protective action in hyperkinetic ventricular arrhythmias (Costa De Pasquale, 1985) (S 347)

o       Dong Quai has been shown to decrease intraocular pressure (Yoshihiro, 1985) (S358)

o       Individuals with recent onset of a respiratory infection showed significant benefit from Echinacea.  (Brinkeborn et al, 1999) (B527)

o       A study found that Eleutherococcus (2 g daily) reduced the frequency of infections by approximately 50% in a group of 93 men and women suffering from recurrent herpes infections. (Williams 1995) (B535)

o       A review of Russian studies showed that Eleutherococcus resulted in general improvement in physical performance and mental agility, adaptation to temperature fluctuations, resistance to immune insults and strengthening of cardiovascular parameters. (Farnsworth et al 1985) (B535)

o       In a systematic review done by Thompson-Coon and Ernst (2003) they found fenugreek (Trigonella foenum-graecum) demonstrated reductions in total serum cholesterol levels of between 10% and 33%.

o       Ernst & Pittler (2000) conducted an update of a systematic review on the efficacy and safety of feverfew (Tanacetum parthenium L.) they concluded that feverfew is likely to be effective in the prevention of migraine and that there are no major safety problems.

o       In a study of 57 patients with severe migraine headaches, use of feverfew significantly reduced pain intensity, vomiting, and noise sensitivity (Palevitch, 1997) (S401)

o       A study on migraine sufferers demonstrated that feverfew acts as a significant preventive when taken for 4 months. (Murphy, 1988) (S402)

○       Feverfew may decrease the release of polymorphonuclear leukocytes in joints that are arthritic and inflamed (Heptinstall, 1998) (S402)

○       Feverfew inhibits arachidonate metabolism in leukocytes that may increase inflammation. (Williams, 1995) (S402)

o       The root of fo-ti has been shown to lower triglyceride accumulations in animal livers. (Liu 1992)  (S413)

o       One study has shown fo-ti extract to provide myocardial protective action against ischemia-reperfusion injury. (Yim 2000) (S413)

o       A double-blind, placebo-controlled trial of 70 pregnant women with morning sickness found that ginger significantly reduced nausea and the number of vomiting episodes. (Vutyavanich et al, 2001) (B589) 

o       Benefits of using ginger in treating the nausea and vomiting of pregnancy were seen in a double-blind crossover trial of 27 women. (Fischer-Rasmussen et al 1991) (B589)

o       In a study involving 56 patients (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort) who used powdered ginger against their afflictions.  Amongst the arthritis patients more than 75% experienced, to varying degrees, relief in pain and swelling.  All the patients with muscular discomfort experienced pain relief. It is suggested that at least one of the mechanisms by which ginger shows its ameliorative effects could be related to inhibition of prostaglandin and leukotriene biosynthesis, i.e., it works as a dual inhibitor of eicosanoid biosynthesis. (Srivastava & Mustafa, 1992)

o       According to a study done on rats ginger is as effective as aspirin in reducing yeast-induced fever. (Mascolo, 1989) (S 437)

o       A well-regarded double-blind, placebo-controlled study of Ginkgo in dementia (primarily Alzheimer’s) found significant improvement in a performance-based test of memory and language. (LeBars et al, 1997) (B594)

o       The results of six double-blind studies suggest that ginkgo might be useful for ordinary age-related memory loss. (Allain et al, 1993; Rigney et al, 1999; Winther et al, 1998; Brautigam et al, 1998; Mix & Crews, 2000 and Rai et al, 1991) (B595)

o       A 3 month, double-blind study of 70 persons with a variety of vertiginous syndromes found that ginkgo extract given at a dose of 160 mg twice daily produced results superior to placebo. (Haguenauer et al, 1986) (B597)

o       Approximately 50 controlled studies between 1975 and 1997 have demonstrated the positive effects of ginkgo in the treatment of cerebral insufficiency.  All studies incorporated various dosages and varying lengths of treatment, and all results were positive. (Hadjiivanova, 2002; Schulz, 1997) (S442)

Licorice

Milk thistle (silymarin) (silibinin)

White willow

 

SUPPLEMENTS AND THEIR COMMON USES

o       5 -HTP is useful for anxiety (Kahn et al, 1987), obesity (Cangiano et al, 1992), tension headache prophylaxis (Longo et al, 1984) and migraine headache prophylaxis. (Titus et al, 1986) (B, 359)

o       5-HTP is useful for depression.  A 6 week, double-blind trial of 63 individuals given either 5-HTP (100 mg three times daily) or fluvoxamine (50 mg three times daily) showed equivalent improvements in depressive symptomatology. (Byerley et al, 1987) (B359)

o       A review done at UNC and published in 2000 found that overall it appears that antioxidant nutrients (vitamin C, vitamin E, selenium and carotenoids) especially those from food sources, have important roles in preventing pathogenic processes related to cancer, cardiovascular disease, macular degeneration, cataracts and asthma and may enhance immune function. (McDermott 2000)

o       Two studies have shown that doses of 1.1 to 1.4 g GLA in borage seed oil reduces joint inflammation significantly (Pullman-Mooar, 1990; Leventhal, 1993) (S, 162)

o       Several studies have shown the positive effects of carnitine in post myocardial infarction recovery, intermittent claudication, angina and congestive heart failure. (Davini, 1992; Illicento, 1995 and Singh, 1996) (S, 211) 

o        Bioflavonoids, particularly diosmin and herperidin have demonstrated efficacy in the treatment of hemorrhoids and varicose veins. (Cospite, 1994)

o       Diosmin/Hesperidin supplementation has been shown to be beneficial for significantly reducing the frequency and severity of hemorrhoidal exacerbations (Godeberge, 1994) and with bleeding hemorrhoids (Misra et al, 2000)(B 520)

o       A study of 59 hypertensive men found that 120 mg of CoQ10 daily reduced the average systolic blood pressure by 10% and the diastolic blood pressure by about 9%. (Singh et al, 1999) (B 476)

o       A study done on 83 persons with isolated systolic hypertension found improvements using 60mg per day of CoQ10. (Burke et al, 2001) (B 476)

o       Highly preliminary evidence suggests that DHEA might be helpful for chronic fatigue syndrome. (Himmel et al, 1999) (B 517)

o       DHEA was found to reduce many symptoms in patients suffering from systemic lupus erythematosus.  However it was found to adversely affect the ratio of total cholesterol to HDL and to raise levels of testosterone. (Mease et al, 2000) (van Vollenhoven et al, 1999)(B 515)

o       DHEA may have an anti-osteoporotic effect especially in women over 70, but probably not in men. (Labrie et al, 1997) (B 515)

o       A study using a combination of evening primrose oil and borage oil showed positive results in rheumatologic conditions. (Belch 2000) (S162)

o       Thirteen double-blind, placebo-controlled studies involving a total of more than 500 individuals found that omega-3 fatty acids in fish oil can reduce the symptoms of rheumatoid arthritis. (James & Cleland 1997; Volker et al 2000)

o       A meta-analysis of all published trials suggests that high intake of fish or fish oil can reduce overall mortality, heart disease mortality and sudden cardiac death. (Bucher et al 2002) (B554)

o       Preliminary controlled studies suggest that fish oil may be of benefit in systemic lupus erythematosus. (Walton et al 1991)(B556)

o       Small human trials suggest that flaxseed can improve lipid profiles. (Jenkins et al 1999; Tarpila et al 1997; Lucas et al 2002) (B561)

o       Observational studies suggest that lignan-containing foods (such as flaxseed) are associated with a lower incidence of breast and perhaps colon cancer. (Adlercreutz & Mazur 1997) (B561)

o       One study showed a significantly reduced incidence of breast cancer when women consumed high levels of phytoestrogens such as the lignans found in flax products. (Ingram 1997) (S410)

o       In one study 38 postmenopausal women with elevated cholesterol were given whole flaxseed and sunflower seed.  In the experimental group, cholesterol dropped by nearly 15%. (Arjmandi 1999) (S410)

o       Observational studies suggest that a high intake of folate may decrease the risk of cardiovascular disease by 50%, possibly by reducing homocysteine levels. (Rimm et al 1998) (B567)

Ipriflavone

Iron

○       Animal experiments and clinical intervention studies indicate that omega-3 fatty acids have anti-inflammatory properties and, therefore, might be useful in the management of inflammatory and autoimmune disease.  Many of the placebo-controlled trials of fish oil in chronic inflammatory disease reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs. (Simopoulus 2002)

o       A review of 38 controlled studies on soy and heart disease concluded that soy is definitely effective at reducing total cholesterol, LDL levels, and triglycerides. (Anderson et al, 1995) (B681)  One double-blind study involving 66 older women taking soy protein found improvements in HDL levels as well. (Baum et al 1998) (B681)

o       A double-blind, placebo controlled study involving 104 women with menopausal symptoms found that soy protein provided significant relief as compared to placebo. (Albertazzi et al, 1998) (B681)  Similarly, after 3 weeks, participants taking daily doses of 60 g of soy protein were having 26% fewer hot flashes, and by week 12, the reduction was 45%. (Albertazzi et al, 1998) (B681)

o       In one study, that evaluated the benefits of soy isoflavones in osteoporosis, a total of 66 postmenopausal women took either placebo (soy protein with isoflavones removed) or soy protein containing 56 or 90 mg of soy isoflavones daily for 6 months.  The group that took the higher dosage of isoflavones showed significant gains in spinal bone density. (Knight et al, 1999) (B682) 

o       Unlike estrogen, which inhibits bone resorption, the soy isoflavone genistein may enhance new bone formation. (Fanti et al 1998) (B683)

o       Soy isoflavones may exert preventive effects in some forms of cancer, primarily hormone-dependent cancers. (Messina et al 1994; Goodman et al 1997; Ingram et al, 1997) (B683)

o       A recent study shows that bone loss in the spine decreases with the addition of soy-rich products to the diets of perimenopausal women. (Alekel, 2000) (S884)

o       A recent study postulates that the isoflavones and other chemical constituents of soy may lower the cancer risk of postmenopausal women by altering estrogen metabolism such that genotoxic metabolites are converted to inactive metabolites. (Xu, 2000) (S884)

○       Genistein has been shown to decrease prostatic cancer and to increase the immune response in laboratory animals. (Zhang, 1997) (S884)

○       A group of 58 menopausal women, who experienced an average of 14 hot flashes per week, supplemented their diets with either wheat flour or soy flour every day for 3 months; the women taking the soy reduced their hot flashes by 40%. (Murkies et al, 1995) (L332)

 

CONDITIONS  THAT ARE TREATED BY HERBS AND SUPPLEMENTS

o       A well-regarded double-blind, placebo-controlled study of Ginkgo in dementia (primarily Alzheimer’s) found significant improvement in a performance-based test of memory and language. (LeBars et al, 1997) (B594)

○       A study published in 2000 found that grape seed proanthocyanidin extract (GSPE) is highly bioavailable and provides significantly greater protection against free radicals and free radical-induced lipid peroxidation and DNA damage than vitamins C, E and beta-carotene.  GSPE was also shown to demonstrate cytotoxicity towards human breast, lung and gastric adenocarcinoma cells, while enhancing the growth and viability of normal human gastric mucosal cells. (Bagchi et al 2000)

○       A review done at UNC and published in 2000 found that overall it appears that antioxidant nutrients (vitamin C, vitamin E, selenium and carotenoids) especially those from food sources, have important roles in preventing pathogenic processes related to cancer. (McDermott 2000)

o       Andrographis can be used to treat symptoms of the common cold. In a double-blind placebo-controlled study158 persons with colds received 1200 mg daily of an andrographis extract (standardized to contain 5% andrographolide) or placebo for 4 days.  By day 2 of treatment, and even more, by day 4, persons given andrographis extract experienced significant improvements in symptoms compared to the placebo group.  The greatest response was seen in earache, sleeplessness, nasal drainage and sore throat. (Caceres et al, 1999) (B 369)

o       Andrographis can be used for prevention of the common cold.  A 3-month, double-blind, placebo-controlled study of 107 persons found that prophylactic treatment with andrographis at the low dose of 200 mg/day significantly reduced the risk of infection. (Caceres et al, 1997) (B369)

o       Sambucol, a product containing elderberry flower as well as small amounts of echinacea and bee propolis, was shown in a preliminary double-blind study to reduce the recovery time from a particular strain of epidemic influenza by almost one-half. (Zakay-Rones et al 1995) (B532)

o       Individuals with recent onset of a respiratory infection showed significant benefit from Echinacea.  (Brinkeborn et al, 1999) (B527)

o       Several studies have shown the positive effects of carnitine in post myocardial infarction recovery, angina and congestive heart failure. (Davini, 1992; Illicento, 1995 and Singh, 1996) (S)

o       Several studies using arginine have shown improvement in cases of congestive heart failure and angina. (Rector et al, 1996; Bednarz et al, 2000; Blum et al, 1999 and Maxwell et al, 2002) (S)

o       Coenzyme Q10 in a dosage of 30 mg/day significantly reduced overall symptoms in a study on patients with heart failure. (Hashiba et al 1972) (B 475)

o       Another study on patients with CHF also found that CoQ10 significantly reduced overall symptoms. (Hofman-Bang et al, 1999)(B 475)

o        5-HTP is useful for depression.  A 6 week, double-blind trial of 63 individuals given either 5-HTP (100 mg three times daily) or fluvoxamine (50 mg three times daily) showed equivalent improvements in depressive symptomatology. (Byerley et al, 1987) (B)

o       A study of 20 individuals with recurrent depression found that use of fish oil improved depression-index scores significantly compared to placebo. (Nemets 2002) (B556)

o       Aloe is useful when taken orally for diabetes.  In a single-blind, placebo-controlled study those taking glibenclamide and aloe showed improvements in blood glucose levels over a six week period that compared to those taking glibenclamide and placebo. (Bunyapraphatsara et al 1996) (B 363)

o       Aloe is useful when applied topically for genital herpes. In one double-blind, placebo-controlled study use of aloe cream resulted in a reduced mean time to healing and increased total number of healed patients. (Syed et al 1997) (B 363)

o       A study found that Eleutherococcus (2 g daily) reduced the frequency of infections by approximately 50% in a group of 93 men and women suffering from recurrent herpes infections. (Williams 1995) (B535)

o       Diosmin/Hesperidin supplementation has been shown to be beneficial for significantly reducing the frequency and severity of hemorrhoidal exacerbations (Godeberge, 1994) and with bleeding hemorrhoids (Misra et al, 2000)(B 520)

o       A review of 38 controlled studies on soy and heart disease concluded that soy is definitely effective at reducing total cholesterol, LDL levels, and triglycerides. (Anderson et al, 1995) (B681)  One double-blind study involving 66 older women taking soy protein found improvements in HDL levels as well. (Baum et al 1998) (B681)

o       A study of 59 hypertensive men found that 120 mg of CoQ10 daily reduced the average systolic blood pressure by 10% and the diastolic blood pressure by about 9%. (Singh et al, 1999) (B 476)

o       A study done on 83 persons with isolated systolic hypertension found improvements using 60mg per day of CoQ10. (Burke et al, 2001) (B 476)

○       Feverfew inhibits arachidonate metabolism in leukocytes that may increase inflammation. (Williams, 1995) (S402)

o       A double-blind, placebo controlled study involving 104 women with menopausal symptoms found that soy protein provided significant relief as compared to placebo. (Albertazzi et al, 1998) (B681)  Similarly, after 3 weeks, participants taking daily doses of 60 g of soy protein were having 26% fewer hot flashes, and by week 12, the reduction was 45%. (Albertazzi et al, 1998) (B681)

○       A group of 58 menopausal women, who experienced an average of 14 hot flashes per week, supplemented their diets with either wheat flour or soy flour every day for 3 months; the women taking the soy reduced their hot flashes by 40%. (Murkies et al, 1995) (L332)

o       A double-blind, placebo-controlled trial of 70 pregnant women with morning sickness found that ginger significantly reduced nausea and the number of vomiting episodes. (Vutyavanich et al, 2001) (B589) 

o       Benefits of using ginger in treating the nausea and vomiting of pregnancy were seen in a double-blind crossover trial of 27 women. (Fischer-Rasmussen et al 1991) (B589)

o       In a study involving 56 patients (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort) who used powdered ginger against their afflictions.  Amongst the arthritis patients more than 75% experienced, to varying degrees, relief in pain and swelling.  All the patients with muscular discomfort experienced pain relief. (Srivastava & Mustafa, 1992)

o       DHEA may have an anti-osteoporotic effect especially in women over 70, but probably not in men. (Labrie et al, 1997) (B 515)

o       In one study, that evaluated the benefits of soy isoflavones in osteoporosis, a total of 66 postmenopausal women took either placebo (soy protein with isoflavones removed) or soy protein containing 56 or 90 mg of soy isoflavones daily for 6 months.  The group that took the higher dosage of isoflavones showed significant gains in spinal bone density. (Knight et al, 1999) (B682) 

o       Unlike estrogen, which inhibits bone resorption, the soy isoflavone genistein may enhance new bone formation. (Fanti et al 1998) (B683)

o       A recent study shows that bone loss in the spine decreases with the addition of soy-rich products to the diets of perimenopausal women. (Alekel, 2000) (S884)

·     Psoriasis Aloe is useful when applied topically for psoriasis.  In one double-blind, placebo-controlled study aloe cream produced significant improvement compared to placebo. (Syed et al 1996) (B 363)

o       In clinical trials of Boswellia, promising results were observed in patients with rheumatoid arthritis. (Ammon, 2002)

o        In a study involving 56 patients (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort) who used powdered ginger against their afflictions.  Amongst the arthritis patients more than 75% experienced, to varying degrees, relief in pain and swelling.  All the patients with muscular discomfort experienced pain relief. (Srivastava & Mustafa, 1992)

o       Two studies found that cranberry juice is useful in the prevention (but not the treatment) of urinary tact infections. (Jackson, 1997; Jepson, 2000) (S 324)

 

SAFETY ISSUES WITH HERBS AND SUPPLEMENTS

(This section is still in the process of being written up.)

 

DANGEROUS HERBS

The following herbs are highly toxic and we do not recommend their use:

 

Selected references for the above: (Dharmananda, Bag of Pearls, 2002 & 2004; Dharmananda, Aug. 2000; Dharmananda, Apr. 2003; Dharmananda, May 2001; Lenz & Baugh-Meyer, 2000)

 

SYSTEMATIC REVIEWS ON THE EFFICACY AND SAFETY OF HERBS

·        In order to appreciate how modern science is approaching the question of herbal efficacy and safety we thought it would be good to include some scientific studies to see how scientists are tackling these issues.  The gold standards for assessing efficacy and safety are large, well-designed, randomized controlled trials and systematic reviews.  Systematic reviews require that all trials which meet specified criteria must be included in the review, regardless of the trial results.  In the midst of the information explosion clinicians rank reviews as their most preferred source of new information. (Stux & Hammerschlag, 2001)  With this in mind we would like to cite some systematic reviews that have been done on herbs.

 

·        Coon and Ernst (2002) conducted a systematic review on the adverse effects and drug interactions of Panax ginseng.  Systematic searches were performed in five electronic databases and the reference lists of all papers located were checked for further relevant publications.  Data from the clinical trials suggest that the incidence of adverse events with ginseng monopreparations is similar to that with placebo.  The most commonly experienced adverse events are headache, sleep and gastrointestinal disorders.  Combination products containing ginseng as one of several constituents have been associated with serious adverse events and even fatalities.  Interpretation of these cases is difficult, as ingredients other than P. ginseng may have caused the problems.  Possible drug interactions have been reported between P. ginseng and warfarin, phenelzine and alcohol.  Collectively, these data suggest that P. ginseng monopreparations are rarely associated with adverse events or drug interactions.

 

·        In another systematic review done by Thompson-Coon and Ernst (2003) on herbs for serum cholesterol reduction 25 randomized clinical trials involving 11 herbal medicinal products were identified.  They found that Guggul (Commiphora mukul), fenugreek (Trigonella foenum-graecum), red yeast rice and artichoke (Cynara scolymus) have been most extensively studied and have demonstrated reductions in total serum cholesterol levels of between 10% and 33%.   They concluded that further research is warranted to establish the value of these extracts in the treatment of hypercholesterolemia.

 

·        In a systematic review done by Yeh et al (2003) on herbs and dietary supplements for glycemic control in diabetes they found that the evidence for improved glucose control was positive in 76% out of 58 trials; and that very few adverse effects were reported.  They concluded that the best evidence for efficacy is available for ivy gourd (Coccinia indica) and American ginseng.  Other supplements with positive preliminary results include Gymnema sylvestre, Aloe vera, vanadium, bitter melon (Momordica charantia) and prickly pear cactus (nopal).

 

·        Ernst & Pittler (2000) conducted an update of a systematic review on the efficacy and safety of feverfew (Tanacetum parthenium L.).  They conducted literature searches using Medline, Embase, Biosis, CISCOM and the Cochrane Library and only six trials mete their inclusion/exclusion criteria.  The majority favour feverfew over placebo.  Yet important caveats exist.  The data also suggest that feverfew is associated with only mild and transient adverse effects and few other safety concerns.  They conclude that feverfew is likely to be effective in the prevention of migraine and that there are no major safety problems.

 

·        A systematic review of the safety of black cohosh was conducted by Huntley and Ernst (2003).   In this review systematic literature searches were conducted in seven electronic databases and the reference lists of all papers located were checked for further relevant publications.  Information was also sought from WHO and national drug safety bodies.  The data from the clinical studies and spontaneous reporting programs suggest that adverse events with black cohosh are rare, mild and reversible.  Gastrointestinal upsets and rashes are the most common adverse events.  They concluded that if black cohosh products are taken for a limited length of time, there seems to be a slight risk of mild, transient adverse effects.  More serious adverse effects seem to be rare, and it is impossible to ascertain causality with black cohosh with the limited data available.  Thus, although definitive evidence is not available, it would seem that black cohosh is a safe herbal medicine.

 

TOWARDS A BETTER UNDERSTANDING OF HERBS AND SUPPLEMENTS

Where to find out more about information on Herbs and Supplements

·        For detailed information and studies on Chinese herbs we recommend consulting the excellent websites of the Institute of Traditional Medicine at www.itmonline.org and Natura Health Products website at: www.naturahealthproducts.com.

·        For a well researched herbal database with links to PubMed abstracts we recommend Herbmed.org .

·        For information on herbal safety and quality Steven Foster, the lead editorial adviser of Herbs for Health, recommends several websites including the American Botanical Council website at www.herbalgram.org and the American Herbal Products Association website at www.ahpa.org. (McCullough 2000)

·        For information on the latest published systematic reviews and studies on herbs we recommend consulting the vast database of Medline at http://www.ncbi.nlm.nih.gov/PubMed/.

·        For information on the side effects of drugs as well as drug-drug interactions we find the following website useful: www.drugs.com.

REFERENCES

 

Ammon, HP (Article in German) “Boswellic acids (components of frankincense) as the active principle in treatment of chronic inflammatory disease” Wien Med Wochenschr 2002;152(15-16):378-8

 

Bagchi D et al, “Free radicals and grape seed proanthocyanidin extract: importance in human health and disease prevention” Toxicology 2000 Aug 7;148(2-3):187-97

 

Barnes, P.M. & Eve Powell-Griner, “Complementary and Alternative Medicine Use Among Adults: United States, 2002” CDC Advance Data Report #343, May 27, 2004 www.nccam.nih.gov/news/camsurvey.htm

 

Bensky, Dan & Randall Barolet, Chinese Herbal Medicine Formulas & Strategies, Seattle: Eastland Press, 1990

 

Bensky, Dan & Andrew Gamble, Chinese Herbal Medicine: Materia Medica, Seattle: Eastland Press, 1986

 

Bijlsma, JW, [“Glucosamine and chondroitin sulfate as a possible treatment for osteoarthritis”] [Article in Dutch] Ned Tijdschr Geneeskd 2002 Sep 28;146(39):1819-23

 

Boik, John, Cancer & Natural Medicine, Princeton, MN: Oregon Medical Press 1996

 

Bratman, Steven, MD & Andrea M. Girman, MD MPH, Mosby’s Handbook of Herbs and Supplements and their Therapeutic Uses, St Louis: Mosby, 2003

 

Calixto, J.B. “Efficacy, safety, quality control, marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents), Brazilian Journal of Medical and Biological Research, (2000) 33:179-189

 

Caron, M.F. & C.M. White, “Evaluation of the antihyperlipidemic properties of dietary supplements” Pharmacotherapy 2001 Apr;21(4):281-7

 

Cheng BJ et al, “Preventive effect of traditional herbal formulae against experimental hypercholesterolemia in rats with special reference to blood lipoprotein cholesterol levels, “ J Ethnopharmacol. 2004 Oct;94(2-3):275-8

 

Chiang, LC et al, “Cytotoxicity and anti-hepatitis B virus activities of saikosaponin from Bupleurum species.” Plant Med 2003 Aug;69(8):705-9

 

Coon, JT & E Ernst, “Panax ginseng: a systematic review of adverse effects and drug interactions” Drug Saf 2002;25(5):323-44

 

Cospite M. “Double –blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids.” Angiology 1994;45:566-573

 

Cupp, MJ, “Herbal remedies: adverse effects and drug interactions” Am Fam Physician 1999 Mar 1;59(5):1239-45

 

de los Reyes, GC et al “Glucosamine and chondroitin sulfates in the treatment of osteoarthritis: a survey” Prog Drug Res 2000;55:81-103

 

Deal CL and RW Moskowitz, “Nutraceuticals as therapeutic agents in osteoarthritis.  The role of glucosamine, chondroitin sulfate and collagen hydrolysate.” Rheum Dis Clin North Am 1999 May;25(2):379-95

 

Dharmananda, Subhuti, Ph.D., “A Bag of Pearls” Portland, OR: Institute for Traditional Medicine, 2002 & 2004

 

Dharmananda, Subhuti, Ph.D., “Are Aristolochia Plants Dangerous?” Portland, OR: Institute for Traditional Medicine, May 2001

 

Dharmananda, Subhuti, Ph.D., “Controlled Clinical Trials of Chinese Herbal Medicines: A Review” Portland, OR: Institute for Traditional Medicine,

Dec. 1997

 

Dharmananda, Subhuti, Ph.D., “Did the Herbs Cause That” Portland, OR: Institute for Traditional Medicine, May 2001

 

Dharmananda, Subhuti, Ph.D., “Do Herbs, Vitamins and Antioxidants Adversely Affect Cancer Therapies?” Portland, OR: Institute for Traditional Medicine, Dec. 2002

 

Dharmananda, Subhuti, Ph.D., “Drugs in Imported Chinese Herb Products” Portland, OR: Institute for Traditional Medicine, Nov. 1996

 

Dharmananda, Subhuti, Ph.D., “How Clean and Pure are Chinese Herbs?” Portland, OR: Institute for Traditional Medicine, March 2002

 

Dharmananda, Subhuti, Ph.D., “Safety Issues Affecting Chinese Herbs: (6 articles) “Magnolia alkaloids” (2000); “The Case of Asarum” (Aug. 2000);  “The Case of Ma-huang” (Dec. 2000); “The Case of Xanthium” (Dec. 2002); “The Case of Dictamnus and Herbs for Skin Diseases” (April 2003); “Herbs That May Increase Blood Pressure” (Sept. 2003) 

 

Dharmananda, Subhuti, Ph.D., “Safety Issues Affecting Herbs: (3 articles) “Pyrrolizidine Alkaloids” (Nov. 2001); “How Long can Stimulant Laxatives be Used?” (March 2002); “Herbs That May Increase Blood Pressure” (Sept. 2003)

 

Dharmananda, Subhuti, Ph.D., “The Methods of Preparation of Herb Formulas: Decoctions, Dried Decoctions, Powders, Pills, Tablets and Tinctures” Portland, OR: Institute for Traditional Medicine, May 1997

 

Duke, James A, Ph.D., The Green Pharmacy Herbal Handbook, Rodale, 2000

 

Entrez-PubMed (Medline) website: http://www.ncbi.nlm.nih.gov/PubMed/

 

Ernst, E & MH Pittler, “The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review” Public Health Nutr 2000 Dec;3(4A):509-14

 

Fetrow, Charles W., Pharm D. & Juan R. Avila, Pharm D, The Complete Guide to Herbal Medicine, New York: Simon & Schuster, 2000

 

Fetrow, Charles W., Pharm D. & Juan R. Avila, Pharm D, Professional’s Handbook of Complementary & Alternative Medicines, Philadelphia: Lippincott Williams & Wilkins, 2004

 

Goldman, Peter, MD, “Herbal Medicines Today and the Roots of Modern Pharmacology” Ann Intern Med 2001 Oct.;135(8 Pt 1):594-600

 

Gupta I et al, “Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study” Eur J Med Res 1998 Nov 17;3(11):%11-4

 

Gupta I, et al, “Effects of gum resin of Boswellia serrata in patients with chronic colitis” Planta Med, 2001 Jul;67(5):391-5

 

Haak E et al, “Effects of alpha-lipoic acid on microcirculation in patients with peripheral diabetic neuropathy” Exp Clin Endocrinol Diabetes 2000;108(3):168-74

 

Harkey, MR et al, “Variability in commercial ginseng products: an analysis of 25 preparations” Am J Clin Nutr 2001 Jun;73(6):1101-6

 

Harkness, Richard, Pharm., FASCP & Steven Bratman, M.D. Drug-Herb Interactions Bible, Prima Publishing, 2000

 

Harvey, Richard A. and Pamela C. Champe (Editors) Lippincott’s Illustrated Reviews: Pharmacology, Philadelphia: J. B. Lippincott Co., 1992

 

Hashiba et al, “Coenzyme-Q10 for treatment of aneurysm” (In Japanese) Heart (Japanese)1972;4:1579-1589

 

Heber D et al, “Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement” Am J Clin Nutr 1999 Feb;69(2):231-6

 

Huang, Kee Chang, The Pharmacology of Chinese Herbs, Boca Raton: CRC Press1993

 

Huntley, A & E Ernst, “A systematic review of the safety of black cohosh” Menopause, 2003 Jan-Feb;10(1):58-64

 

Kajimura K et al, “Polysaccharide of Astragali radix enhances IgM antibody production in aged mice.” Biol Pharm Bull 1997 Nov;20(11):1178-82

 

Inagaki N et al, “Acidic polysaccharides from rhizomes of Atractylodes lancea as protective principle in Candida-Infected mice” Planta Med 2001 Jul;67(5):428-31

 

Lenz, Erika & Amy Baugh-Meyer, “Trust your herbs”, Herbs for Health, July/August 2000: 46-51

 

Lininger, Schuyler W, Jr. DC, Editor in-Chief, The Natural Pharmacy, Rocklin, CA: Prima Publishing, 1999

 

Lippiello L, “In vivo chondroprotection and metabolic synergy of glucosamine and chondroitin sulfate” Clin Orthop 2000 Dec;(381):229-40

 

Lust, John, N.D., D.B.M., The Herb Book, Simi Valley, CA: Benedict Lust Publications, 1974

 

Maciocia, Giovanni, The Practice of Chinese Medicine, Edinburgh: Churchill Livingstone, 1994

 

Martin, J. & J. Dusek, “The Baikal skullcap (Scutellaria baicalensis Georgi) – a potential source of new drugs” (Article in Czech) Ceska Slov Farm. 2002 Nov;51(6):277-83

 

Matheson, AJ & CM Perry, “Glucosamine: a review of its use in the manag4ement of osteoarthritis” Drugs Aging 2003;20:1041-1060

 

Mayo Clinic Drug and Supplement Information Website: http://www.mayoclinic.com/findinformation/druginformation/index.cfm

 

McAlindon TE et al, “Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis” JAMA 2000 Mar 15;283(11):1469-75

 

McCullough, Lynda, “Find the best herbal research” Herbs for Health, May/June 2000: 12

 

McDermott JH “Antioxidant nutrients: current dietary recommendations and research update” J Am Pharm Assoc(Wash) 2000 Nov-Dec;40(6):785-99

 

Melham MF et al, “Effects of Dietary Supplementation of alpha-Lipoic Acid on Early Glomerular Injury in Diabetes Mellitus” j Am Soc Nephrolv2001 Jan;12(1):124-133

 

Mindell, Earl, R.Ph, Ph.D., & Virginia Hopkins, Prescription Alternatives, New Canaan, CT: Keats Publ, 1998

 

Murray, Michael, N.N. and Joseph Pizzorno, N.D., Encyclopedia of Natural Medicine, Rocklin, CA: Prima Publishing, 1991

 

Naeser, Margaret A, Ph.D., Outline Guide to Chinese Herbal Patent Medicines in Pill Form, Boston: Boston Chinese Medicine, 1992

 

Pierce, Andrea The American Pharmaceutical Association Practical Guide to Natural Medicines, New York: Wm. Morrow & Co., 1999

 

Reginster JY et al, “Naturocetic (Glucosamine and Chondroitin sulfate) compounds as structure-modifying drugs in the treatment of osteoarthritis” Curr Opin Rheumatol 2003   Sep;15(5):651-5

 

Shou C et al, “The inhibitory effects of jujuboside A on rat hippocampus in vivo and in vitro” Planta Med 2002 Sep;68(9):799-803

 

Shults et al, “Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline: Arch Neurol 2002;59:1541-1550

 

Simopoulus, AP, “Omega-3 fatty acids in inflammation and autoimmune diseases” j Am Coll Nutr 2002 Dec;21(6):495-505

 

Skidmore-Roth, Linda, Mosby’s Handbook of Herbs & Natural Supplements, 2nd edition, St. Louis: Mosby, Inc., 2004

 

Srivastava KC, Mustafa T., “Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders” Med Hypotheses, 1992 Dec;39(4):342-8

 

Stux, G and R. Hammerschlag (Eds.) Clinical Acupuncture:  Scientific Basis, Berlin: Springer-Verlag, 2001

 

Tesch, BJ, “Herbs commonly used by women: an evidence-based review” Dis Mon 2002 Oct;48(10):671-96

 

Thompson-Coon JS & E Ernst, “Herbs for serum cholesterol reduction: a systematic review” J Fam Pract. 2003 Jun;52(6):468-78

 

Tierra, Michael, C.A., N.D., The Way of Herbs, New York: Simon & Schuster, 1990

 

Volpi, N, “The pathobiology of osteoarthritis and the rationale for using the chondroitin sulfate for its treatment” Curr Drug Targets Immune Endocr Metabol Disord2004 June;4(2):119-27

 

Vuksan, V. et al, “American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals”, Am J Clin Nutr 2001;73:753-8

 

Vuksan, V. et al “American Ginseng Improves Glycemia in Individuals with Normal Glucose Tolerance; Effect of Dose and Time Escalation” J Am Coll Nutr 2000 Nov-Dec;19(6):738-44

 

Wang X et al, “The hypolipidemic natural product Commiphora mukul and its component guggulsterone inhibit oxidative modification of LDL” Atherosclerosis 2004 Feb; 172(2):239-46

 

Weiss, Rudolf Fritz, M.D. & Volker Fintelmann, M.D., Herbal Medicine, Stuttgart, Germany: Thieme, 2000

 

Werbach, Melvyn R., M.D., Nutritional Influences on Illness, Tarzana, CA: Third Line Press, 1996

 

Yance, Donald R, Jr., C.N., M.H., A.H.G., Herbal Medicine, Healing & Cancer, Chicago: Keats Publishing, 1999

 

Yeh, Gloria Y et al, “Systematic Review of Herbs and Dietary Supplements for Glycemic Control in Diabetes” Diabetes Care, Vol 26, No. 4, April 2003 1277-1294

 

Yeung, Him-che, O.M.D., Ph.D., Handbook of Chinese Herbal Formulas, Rosemead: Institute of Chinese Medicine, 1995

 

Yeung, Him-che, O.M.D., Ph.D., Handbook of Chinese Herbs, Rosemead: Institute of Chinese Medicine, 1996

 

Zhang M et al, “Inhibitory effect of jujuboside A on glutamate-mediated excitatory signal pathway in hippocampus” Planta Med 2003 Aug;69:692-5

 

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