Research on the Health Benefits of Herbs and Nutrients

Compiled by John G. Connor, M.Ac., L.Ac. Edited by Barbara Connor, M.Ac., L.Ac.

 (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.)

TABLE OF CONTENTS
1.   Introduction
2.   Herbs and their Common Uses
3.   Nutrients and their Common Uses
4.  Conditions that are Treated by Herbs and Nutrients
5.   Safety Issues with Herbs and Nutrients
6.  Dangerous Herbs
7.   Systematic Reviews On The Efficacy And Safety Of Herbs
8.  Towards A Better Understanding Of Herbs And Nutrients
9.  References

INTRODUCTION
Barbara and I hope that the eventual completion of this data base will help give a deeper appreciation of the healing properties and therapeutic uses of the many wonderful herbs and supplements that we use and are being used around the world today. In the meantime we hope that you find the information useful and helpful in your quest for optimal health. In the extracts of the reviews on herbs and supplements that follow we have endeavored to list only uses for which there have been clinical or animal studies done.  In a few instances we cite cases in which herbs or supplements are being investigated for use in specific conditions.  We decided not to include anecdotally based information in this data base — although more and more of the traditional uses of herbs and supplements are being confirmed by scientific studies as interest in the health applications of herbal and nutritional medicine continues to grow.

Key to main references consulted:
§  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

HERBS 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.

American Ginseng 
see Ginseng

Andrographis
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)

Artichoke Leaf
o    Artichoke is used to lower cholesterol levels; and it may protect the liver from harmful effects (Kraft, 1997)(S 56) 
In a systematic review done by Thompson-Coon and Ernst (2003) they found that artichoke (Cynara scolymus) demonstrated reductions in total serum cholesterol levels of between 10% and 33%.

Astragalus
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)

Atractylodes 
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)

Berberine (Barberry) (Berberis aquifolium)
Several studies have found barberry to be effective against a wide variety of fungi, protozoans, helminths, viruses and bacteria including Chlamydia, Bacillus spp., Candida spp, Corynebacterium diphtheriae, E. coli, Entamoeba histolytica, Giardia lamblia, Klebsiella pneumoniae, Leishmaniasis spp., Mycobacterium tuberculosis, Shigella boydii, Staphlyococcus spp., Streptococcus pyogenes, Trichomonas vaginalis and Vibrio cholerae. (Altern, 2000; Amin; 1969; Nakamoto, 1990; Subbaiah, 1967; Gupte, 1975)(S 71)
It can also suppress premature ventricular contractions without serious side effects. (Huang 1990)(S 71)

Betel Palm (Areca catechu) (pan parag)
Chewing betel decreases symptomatology in schizophrenia. (Sullivan, 2000)(S 97)
It has an antidepressant action (Dar, 1997; Van der Hyden, 1987), lowers the heart rate and induces euphoria. And it has been shown to produce inhibitory as well as stimulatory effects on thyroid function. (Panda, 1998)(S 97)

Bilberry
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)
Bilberry extracts appear to reduce capillary leakage in venous insufficiency. (Morazzoni et al 1996)(B 393)

Bitter Melon
Bitter melon may improve glucose control in type 2 diabetes. (Srivastava et al 1993)(B 399)
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 bitter melon (Momordica charantia).

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)

Black pepper One study has shown the antibacterial effect of black pepper against Staphylococcus aureus growth (Nakatani, 1986) and other studies have shown a chemoprotective effect in the colon. (Nalini, 1998)(S)

Borage
Two studies have shown that in doses of 1.1 to 1.4 GLA in borage seed oil reduces joint inflammation significantly (Pullman-Mooar, 1990; Leventhal, 1993)
One study has shown that the high levels of GLA in borage oil are responsible for its ability to decrease hypertension. (Engler, 1998) (S)

Boswellia
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)

Preliminary research suggests that Boswellia may protect cartilage from damage (Reddy, 1989)(B)

Bupleurum Preliminary research shows that active components found in bupleurum possess anti-hypercholesterolemic effects, hepatoprotective and antioxidant effects as well as exhibiting potent cytotoxic actions against human hepatocellular carcinoma cells. (Cheng et al 2004; Wang et al 2004; Chiang et al 2003)

Burdock 
Preliminary studies have shown that burdock root has hypoglycemic, antibacterial, antitumor and hepatoprotective effects. (S)

Butcher’s Broom
 Several studies have confirmed the use of butcher’s broom in treating chronic venous insufficiency (Cappelli, 1988; Facino, 1995; Bouskela, 1994 and Vanscheidt, 2002)(S)

Butterbur
A double-blind, placebo-controlled study showed that the total number of days of migraine pain were significantly reduced by butterbur compared to the placebo group. (Grossmann, 2000)(B)
Another study showed a 56% reduction in migraines. (Eaton 1998)(S)
A 2 week double-blind study on patients suffering from allergic rhinitis comparing butterbur extract to cetirizine found that both treatments were equally effective. (Schapowal, 2002)(B & L)

Capsaicin (Capsicum, Cayenne)
Research has shown that capsaicin cream is an effective and safe treatment for relief of the pain associated with diabetic neuropathy. (Tandan, 1992)(S)
The FDA has approved a capsaicin cream for the treatment of post herpetic neuralgia. There is also evidence that capsaicin cream may be helpful for relieving various types of arthritis as well as fibromyalgia. (B)
Capsaicin was found to protect against H pylori-associated gastrointestinal disease. (Jones, 1997)(S)

Cat’s claw (Una de gato) (Uncaria) A poorly designed study found suggestive evidence that cat’s claw might reduce osteoarthritis symptoms. (Piscoya, 2001)(B)

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

Cinnamon
Cinnamon bark has been shown to be effective against Candida albicans, Aspergillus spp., Histoplasma and Cryptococcus neoformans. (Viollon, 1994 (S)
Cinnamon extract has shown an inhibitory effect on Helicobacter pylori. (Tabek, 1999) (S)

Cramp Bark (Black Haw) There is reference to one study done on animals on its ability to reduce uterine excitability. (Reynolds, 1996) (S)

Cranberry
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)

Curcumin (Turmeric)
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)

Dandelion root may have potential use as an anti-inflammatory agent in osteoarthritis, rheumatoid arthritis and other inflammatory conditions. (Tito et al, 1993 & Mascolo et al, 1987) (B 507)
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)

Devil’s Claw There are mixed results using devil’s claw in the treatment of joint conditions. (S 356 & B 511)
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)

A 2 month, double-blind, placebo-controlled study of devil’s claw following 89 individuals with various rheumatoid disorders found a significant decrease in joint pain intensity and an improvement in mobility.  Another double-blind study of devil’s claw in 50 individuals with various types of arthritis showed that 10-day treatment provided significant pain relief. (ESCOP 1996-1997)(B294)

Dioscorea (Wild yam)

Dong Quai (Angelica) when combined with peony, alisma and cnidium increased progesterone secretion by means of its action in the corpora lutea (Usuki, 1991) (S 358)
Dong Quai has been shown to decrease intraocular pressure (Yoshihiro, 1985) (S358)

Dong Quai has been shown to decrease blood pressure (Yoshihiro, 1985) (S 358)

Dong Quai has been shown to decrease premature ventricular contractions (Zhuang, 1991) (S 358)

Dong Quai has been shown to increase tumor necrosis factor (TNF) (Haranaka, 1985) (For more information on TNF we invite you to read about it in our Immune System Enhancement article.)

Echinacea
o    Individuals with recent onset of a respiratory infection showed significant benefit from Echinacea.  (Brinkeborn et al, 1999) (B527)
Echinacea if taken during pregnancy may promote spontaneous abortions.  Therefore Echinacea is contra-indicated for pregnant women. (Chow et al 2006) (Barcz et al 2007)
Echinacea significantly reduced the length of the upper respiratory tract infection. (Dorn et al, 1997) (B 527)
Echinacea was found effective at reducing the duration and severity of recent-onset respiratory infection. (Lindemuth et al, 2000) (B 527)
Echinacea resulted in a statistically significant decrease in progression to a “real cold” in the treated group as compared to the placebo group, as well as symptomatic benefit in individuals that did develop colds. (Hoheisel et al, 1997) (B 527)

Elderberry Flower (Sambucus nigra) 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)

Eleutherococcus (Siberian Ginseng)
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)
In a human trial, Eleutherococcus increased the absolute number of immunocompetent cells, especially T-lymphocytes of the helper/inducer type (Breum et al 1994) (B536)
Eleutherococcus has been found to normalize biologic functioning in a variety of body organs and systems, including the adrenal gland, thyroid, kidneys, white and red blood cells, and blood pressure. (Brekham, 1969) (S872)
Eleutherococcus has exhibited protective and therapeutic effects when laboratory animals are exposed to x-ray radiation. (Ben-Hur, 1981) (S872)
Eleutherococcus has decreased thyroid tumors, lung adenomas and myeloid leukemia in animals. (Wagner, 1985) (S872)
Preliminary evidence suggests that Eleutherococcus may prove valuable in the long-term management of various disease of the immune system, including HIV infection and chronic fatigue syndrome. (Bohn, 1987) (L420)

Ephedra (Ma huang) (For news on the FDA’s Final Ruling on Ephedra and how it relates to Chinese medicine go to www.acupuncturetoday.com )

Fenugreek
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%. Use of 1 g of fenugreek per day of a standardized extract significantly improved some measures of blood sugar control and insulin response compared to placebo.  Levels of triglycerides decreased and HDL cholesterol levels increased. (Gupta et al, 2001) (B547)
Many studies have confirmed the anti-diabetic effects of fenugreek: (Abdel-Barry, 1997; Abdel-Barry, 2000; Ghafghazi, 1977; Gupta, 1999; Khosla, 1995; Ribes, 1986 and Vats, 2002) (S398)

Feverfew
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)

Fo-ti
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)

Garlic
     In a 4-year study of 280 individuals it was found that standardized garlic powder at a dose of 900 mg/day significantly slowed the development of atherosclerosis. (Koscielny et al 1999) (B577)
      One study of 432 patients who had suffered myocardial infarction showed significant reductions in reinfarction rate (35%) and mortality (45%) through the use of garlic oil extract over a period of 3 years. (Bordia 1989) (B577)
        A meta-analysis involving 13 trials found evidence of cholesterol reduction in the range of 5% compared to placebo. (Stevinson et al 2000) (B577)
          In a study published in 2001 participants receiving garlic were almost two-thirds less likely to develop an upper respiratory infection than those who received placebo.  Furthermore, those who did develop an upper respiratory infection recovered about one day faster in the garlic group as compared to the placebo group. (Morcos & Camilo 2001) (B578)
            According to two small, double-blind, placebo-controlled trials of hypertensives, garlic may reduce blood pressure mildly, in the average range of 10 mm Hg for systolic blood pressure and 5 mm Hg for diastolic blood pressure, compared to placebo. (Auer et al 1990; Silagy & Neil 1994) (B578)
              In a 4-week, double-blind, controlled trial, 64 individuals with consistently increased spontaneous platelet aggregation were treated with either placebo or 900 mg of standardized garlic powder daily.  A significant decrease in spontaneous platelet aggregation was seen in the treated group.  (Kiesewetter et al 1991) (B578)
                Several retrospective and prospective epidemiological studies have shown that individuals whose diet includes relatively large amounts of garlic tend to develop cancer less frequently. (Agarwal 1996; Dausch & Nixon 1990; Lau et al 1990; You et al 1989) (B579)
                  One of the best epidemiological studies on garlic, the Iowa Women’s Study, found that participants whose diet included significant quantities of garlic were about 30% less likely to develop colon cancer. (Steinmetz et al 1994) (B579)
                    A study using aqueous extracts of garlic in vitro showed that garlic inhibits both gram-positive and gram-negative organisms. (Emma 1983; Sovova 2002) (S427)
                      Studies have demonstrated the antimicrobial action of garlic against Mycobacterium tuberculosis (Hughes 1991) (S427)
                        One study demonstrated the cholesterol-lowering action of garlic to be equal to that of bezafibrate, a prescription drug available in Germany. (Holzgartner, 1992) (S427)
                          Several investigations have demonstrated the ability of garlic to reduce platelet aggregation and cyclooxygenase resulting in improved circulation, decreased atherosclerosis and improved intermittent claudication. (Bordia, 1996; Ali, 1995; Apitz-Castro, 1994) (S428)
                            One study showed a decrease in the development of gastric cancer when garlic was added to the diet. (Buiatti, 1989) (S428)
                              Another study has shown that the addition of vegetables in the Allium family (onions, leeks, garlic) to the diet prevents gastric cancer. (Dorant, 1996) (S428)
                                Garlic has been shown to inhibit free radicals, which may be responsible for cancer proliferation, and to decrease lipid peroxidation. (Reitz, 1995) (S428)
                                Ginger
                                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)

                                Gingko
                                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)

                                Ginseng (Oriental Ginseng or Panax ginseng and American Ginseng or Panax quinquefolium)
                                  In a systematic review by Yeh et al (2003) on herbs and dietary supplements for glycemic control in diabetes they concluded that the best evidence for efficacy is available for ivy gourd (Coccinia indica) and American ginseng.
                                    A 1996 study using ginseng to treat fatigue found significant improvement in fatigue with the use of ginseng as compared to the placebo. (LeGal, 1996) (S448)
                                      A study in 1990 using ginseng to treat cancer found that those subjects taking ginseng had a lower cancer risk than those in the control group. (Yun, 1990) (S448)
                                        A study in 1983 found that long-term administration of ginseng inhibits tumor growth. (Yun, 1983)(S448)
                                          A double-blind, placebo-controlled study of 227 persons using 100 mg daily of Panax ginseng showed a statistically significant decline in the frequency of colds and flus in the treated group as compared to the placebo group from week 4 to 12. Antibody titers and measure of NK cell activity were also higher in the treated group.  All participants received flu vaccine. (Scaglione et al, 1996) (B603)
                                            A double-blind, placebo-controlled trial of 60 elderly individuals found that 50 or 100 days of treatment with Panax ginseng produced improvements in memory, attention, concentration and ability to cope.  (Siegl & Siegl, 1979) (B604)
                                              A double-blind, placebo-controlled study performed in China reported evidence that Panax ginseng can improve symptoms of male sexual dysfunction. (Choi et al, 1995) (B607)

                                              Guggul (Myrrh)
                                              In a systematic review done by Thompson-Coon and Ernst (2003) they found that Guggul (Commiphora mukul) demonstrated reductions in total serum cholesterol levels of between 10% and 33%.
                                                In a study published in 2004 by Wang et al it was found that guggul significantly inhibits LDL oxidation.  The authors concluded that the combination of antioxidant and lipid-lowering properties of guggul and guggulsterone makes them especially beneficial against atherogenesis.

                                                Gymnema 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 Gymnema sylvestre.

                                                Ivy gourd (Coccinia indicaIn a systematic review by Yeh et al (2003) on herbs and dietary supplements for glycemic control in diabetes they concluded that the best evidence for efficacy is available for ivy gourd (Coccinia indica) and American ginseng.

                                                Rhubarb (Chinese rhubarb) contains anthraquinones which possess purgative properties, and tannins and bitters which posses antidiarrheal properties.  Therefore small doses have a tightening, drying effect and larger doses cause a laxative or purgative effect (Weiss, 1988; Yim, 1999) (S)

                                                Trichosanthes kirilowii (Chinese cucumber)  
                                                Trichosanthes has exhibited antitumor action due to the action of a chemical in it called trichokirin (Thatte, 2000) (S) 
                                                  Another study revealed compounds in trichosanthes that showed inhibition of the Epstein-Barr virus, early antigen (EBV-EA). (Akihisa, 2001) (S)

                                                  Zizyphus There have been two animal studies on the effects of zizyphus with the most recent study suggesting that it has inhibitory effects on excitatory signal pathways in the hippocampus of the brain. (Zhang et al 2003)

                                                  NUTRIENTS AND THEIR COMMON USES

                                                  5-HTP5 -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)
                                                  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)
                                                  A 1 month, double-blind, placebo controlled study of 50 fibromyalgia patients found significant improvement in all symptom categories with 5-HTP treatment. (Caruso et al 1990)(B360)

                                                  Alpha-Lipoic Acid

                                                  A study published in 2001 found that alpha-lipoic acid is effective in the prevention of early diabetic glomerular injury and suggests that it may have advantages over high doses of either vitamin E or C. (Melham et al 2001)
                                                    A study published in 2000 demonstrated that in patients with diabetic polyneuropathy alpha-lipoic acid improves microcirculation. (Haak et al 2000)
                                                      See meta-analysis in Alt Med Rev Vol 9 No. 2

                                                      Antioxidants
                                                      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)

                                                      Due to the continual bombardment of DNA and other tissues by free radicals, the body must obtain ample antioxidant supplies through the diet.  These include vitamins, flavonoidsand other compounds found in fresh fruits and vegetables. Epidemiological studies consistently report that populations who consume inadequate amounts of these foods are at higher risk for heart disease, cancer and other degenerative disease. (Boik 1996)

                                                      Arginine 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, 374)

                                                      Beta-Sitosterol produced significant benefits in men with benign prostatic hyperplasia. (Wilt et al, 1999; Klippel et al, 1997; Kadow et al, 1986; Berges et al, 1995) (B, 389)

                                                      Biotin may help reduce blood glucose levels in individuals with either type 1 or type 2 diabetes. (Maebashi et al, 1993) and (Coggeshall et al, 1985) (B, 395)

                                                      Borage  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)

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

                                                      Bromelain There are mixed studies showing benefit as well as no benefit when using bromelain for post-surgical recovery.  However there are three positive studies showing the benefits of using bromelain in individuals suffering from sinusitis. (B, 419)

                                                      Calcium
                                                      Numerous well-designed studies indicate that calcium supplementation at recommended dosages has been found to help prevent and slow nonvertebral bone loss in postmenopausal women. (Cumming, 1990; Dawson-Hughes et al, 1990)(B, 431) 

                                                      1200 mg daily of calcium carbonate reduced PMS symptoms by half over a period of 3 menstrual cycles.(Thys-Jacobs, 1989) (B, 433)

                                                      Carnitine
                                                      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) 
                                                      Carnitine has also sown positive results in Alzheimer’s disease and other dementias (Bonavita, 1986 and Calvani, 1992) (S, 211) 
                                                      A 1 year study using carnitine for Alzheimer’s was negative. (Thal, 1996)(B, 443) 
                                                      A 6 month double-bind study showed that L-carnitine reduced standard symptoms of hyperthyroidism. (Benvenga, 2000) (B, 444)

                                                      Chondroitin sulfate
                                                      According to a review by Reginster et al preliminary results obtained in patients with osteoarthritis of the hands suggests that chondroitin sulfate could be used for inhibiting the structural progression of osteoarthritis. (Reginster et al 2003)
                                                      A review by Volpi found that Chondroitin sulfate produces a slow but gradual decrease of the clinical symptoms of osteoarthritis and these benefits last for a long period after the end of treatment.  Literature data shows that Chondroitin sulfate could have an anti-inflammatory activity and a chondroprotective action by modifying the structure of cartilage. (Volpi 2004)

                                                      A meta-analysis published in 2000 in JAMA concluded that trials of Glucosamine and chondroitin preparations for osteoarthritis symptoms demonstrate moderate to large effects. (McAlindon et al 2000)

                                                      Clinical findings have revealed that glucosamine sulfate and chondroitin sulfate are effect and safer alternatives than NSAIDs to alleviate the symptoms of osteoarthritis.  Experimental evidence indicates that these compounds and their low molecular weight derivatives have a particular tropism for cartilage where they serve as substrates in the biosynthesis of component building blocks. (de los Reyes et al 2000)

                                                      In published studies glucosamine used in a dosage of 1.5 grams daily is, after a period of 2 to 4 weeks, just as effective as low doses of NSAIDs in alleviating the pain of osteoarthritis.  Chondroitin sulphate has been less well investigated; but there are indications that it affects the symptoms of osteoarthritis, even though this effect only occurs after a longer period of time. (Bijlsma 2002)

                                                      Data suggest that the ability to retard progression of cartilage degeneration is more efficacious if one uses a mixture of glucosamine, chondroitin sulfate and manganese ascorbate together rather than using one single agent alone. (Lippiello 2000)

                                                      Clinical trials of glucosamine and chondroitin sulfate showed substantial benefit in the treatment of osteoarthritis. (Deal & Moskowitz 1999)

                                                      Chondroitin apparently works by attracting essential fluid into the joints, which thereby acts as a shock absorber.  It also attracts needed nutrients into cartilage. (Benedikt, 1997)(S)

                                                      Chromium has been shown to increase the number of insulin receptors in peripheral tissues; to increase the binding of the insulin to receptors and to decrease fasting glucose and serum lipids.  It may also increase HDL cholesterol. (Anderson, 1998)(S, 272)

                                                      Citrus bioflavonoids (Diosmin/Hesperidin)
                                                      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)

                                                      Diosmin/Hesperidin significantly improved symptoms of severe chronic venous insufficiency (Laurent et al, 1988)(B 520)

                                                      Diosmin/Hesperidin significantly improved the rate of healing with non-healing venous stasis ulcers (Guilhou et al, 1997) (B 520)

                                                      Diosmin/Hesperidin showed decreased tendency toward capillary rupture in individuals with fragile capillaries (Galley et al, 1993)(B 520)

                                                      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)

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

                                                      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)
                                                      Significant improvements in systolic and diastolic blood pressure were found using CoQ10 in a small 10 week study on 18 persons. (Digiesi et al, 1990)(B476)

                                                      A study published in 2002 concluded that CoQ10 appears to slow the progressive deterioration of function in Parkinson disease, but these results need to be confirmed in a larger study. (Shults et al 2002)

                                                      CoQ10 has shown promise as a migraine preventive agent. (Rozen, 2000) (S 289)

                                                      DHEA was found to improve general feelings of well being, mood and energy level in patients suffering from adrenal insufficiency. (Hunt et al, 2000) (B 516)
                                                      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)

                                                      Evening Primrose Oil A study of 111 patients with mild diabetic neuropathy given 6 g of Evening Primrose Oil for one year found demonstrated improvement in diabetic neuropathy symptoms without change in serum glucose levels. (Keen et al 1993) (B572)
                                                      o    A study using a combination of evening primrose oil and borage oil showed positive results in rheumatologic conditions. (Belch 2000) (S162)

                                                      Fish Oil  
                                                      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)

                                                      According to many but not all studies, fish oil reduces serum triglycerides and may also modestly raise HDL levels. (Yam et al 2001; Harris et al 1996 & 1997; Cobiac et al 1991 and Nenseter et al 2000) (B554)

                                                      A study of 42 young women in 1996 found that supplementation with 6 g of fish oil daily (providing 1080 mg of EPA and 720 mg of DHA) resulted in significantly reduced menstrual pain (Harel et al 1996) (B555)

                                                      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)

                                                      Preliminary controlled studies suggest that fish oil may be of benefit in Raynaud’s phenomenon. (DiGiacomo et al 1989; Ringer et al 1989) (B556)

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

                                                      Flaxseed

                                                      In a study of 55 individuals with chronic constipation related to irritable bowel syndrome the group receiving ground flaxseed experienced fewer problems with constipation, abdominal pain and bloating than the group taking psyllium. (Tarpila 1997) (B560)
                                                      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)

                                                      Folate (Folic Acid)

                                                      Very strong evidence indicates that regular use of folate by pregnant women can reduce the risk of neural tube defects by 50%. (Werler et al 1993) (B567)
                                                      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)

                                                      Gamma-Linolenic Acid (GLA)
                                                       In a double-blind study of 56 patients with rheumatoid arthritis, 16 of 21 patients treated with 2.8 g/day of GLA for 1 year significantly improved compared to those in the placebo group. (Zurier et al 1996) (B572)
                                                      GLA may be beneficial for Raynaud’s phenomenon. (Belch et al, 1985) (B574)

                                                      Glucosamine
                                                      A meta-analysis published in 2000 in JAMA concluded that trials of glucosamine and chondroitin preparations for osteoarthritis symptoms demonstrate moderate to large effects. (McAlindon et al 2000)

                                                      Clinical findings have revealed that glucosamine sulfate and chondroitin sulfate are effect and safer alternatives than NSAIDs to alleviate the symptoms of osteoarthritis.  Experimental evidence indicates that these compounds and their low molecular weight derivatives have a particular tropism for cartilage where they serve as substrates in the biosynthesis of component building blocks. (de los Reyes et al 2000)

                                                      In published studies glucosamine used in a dosage of 1.5 grams daily is, after a period of 2 to 4 weeks, just as effective as low doses of NSAIDs in alleviating the pain of osteoarthritis.  Chondroitin sulphate has been less well investigated; but there are indications that it affects the symptoms of osteoarthritis, even though this effect only occurs after a longer period of time. (Bijlsma 2002)

                                                      Data suggest that the ability to retard progression of cartilage degeneration is more efficacious if one uses a mixture of glucosamine, chondroitin sulfate and manganese ascorbate together rather than using one single agent alone. (Lippiello 2000)

                                                      In a review published in 2003 it was concluded that in short-term clinical trials, glucosamine provided effective symptomatic relief for patients with osteoarthritis of the knee. In addition, glucosamine has shown promising results in modifying the progression of arthritis over a 3-year period.  Glucosamine may therefore prove to be a useful treatment option for osteoarthritis. (Matheson & Perry 2003)
                                                      Clinical trials of glucosamine and chondroitin sulfate showed substantial benefit in the treatment of osteoarthritis. (Deal & Moskowitz 1999)
                                                      In a study using 500 mg three times daily of glucosamine sulfate or placebo it was found that osteoarthritic severity significantly improved in the treated group as compared to the placebo. (Noack et al, 1994) (B611)

                                                      In a study comparing 1200 mg/day of ibuprofen to glucosamine sulfate in treating osteoarthritis of the knee it was found that although ibuprofen produced faster results, both groups experienced comparable relief at the end of 4 weeks.  In addition, although 35% of the ibuprofen-treated group complained of side effects only 6% of the glucosamine group did so. (Muller-Fassbender et al, 1994) (B611)  Essentially equivalent results were seen in a similar 4 week, double-blind trial of 178 patients with knee osteoarthritis. (Qiu et al, 1998) (B611)

                                                      One double-blind, placebo-controlled study of 212 individuals over 3 years found radiologic evidence of reduced cartilage loss in the treated group, suggesting glucosamine is a disease-modifying drug in osteoarthritis. (Reginster et al 2001) (B612)

                                                      Supplemental glucosamine may stimulate the synthesis of proteoglycans and collagen by cartilage cells and reduce phospholipase A2 activity, as well as inhibit enzymatic degradation of collagen. (Crolle & D’Este, 1980; Setnikar, 1992) (B612)
                                                      Glucosamine is believed to exert a weak anti-inflammatory effect unrelated to prostaglandins, but does not produce direct analgesia. (Crolle & D’Este, 1980; Rovati et al, 1994) (B612)

                                                      Grape Seed Extract (OPCs) 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)

                                                      Omega 3 Fatty Acids
                                                      ○    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)

                                                      Evidence from some but not all observational trials suggests that higher dietary intake of omega-3 essential fatty acids may reduce incidence of cardiovascular disease: (Guallar et al 1995; Iso et al 2001; Kromhout et al 1985; Shekelle et al 1985; Dolecek & Grandits 1991; Kromhout et al 1995; Vollset et al 1985 and Curb & Reed 1985) (B554)

                                                      Red yeast rice
                                                      In a study published in 1999 examining the cholesterol-lowering effects of red yeast rice it was found that total cholesterol concentrations decreased significantly compared with the placebo-treated group.  LDL cholesterol and total triacylcglycerol were also reduced, but HDL cholesterol did not change significantly. (Heber et al 1999)

                                                      In a systematic review done by Thompson-Coon and Ernst (2003) they found that red yeast rice demonstrated reductions in total serum cholesterol levels of between 10% and 33%.

                                                      Soy isoflavones 
                                                      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 NUTRIENTS

                                                      Adaptogen 
                                                      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)

                                                      Eleutherococcus has been found to normalize biologic functioning in a variety of body organs and systems, including the adrenal gland, thyroid, kidneys, white and red blood cells, and blood pressure. (Brekham, 1969) (S872)

                                                      Adrenal Insufficiency DHEA was found to improve general feelings of well-being, mood and energy level in patients suffering from adrenal insufficiency. (Hunt et al, 2000) (B 516)

                                                      Allergic Rhinitis A 2 week double-blind study on patients suffering from allergic rhinitis comparing butterbur extract to cetirizine found that both treatments were equally effective. (Schapowal, 2002)(B)

                                                      Alzheimer’s Disease 
                                                      Carnitine
                                                       has also sown positive results in Alzheimer’s disease and other dementias (Bonavita, 1986 and Calvani, 1992) (S) However one 1 year study using carnitine for Alzheimer’s was negative. (Thal, 1996)(B)
                                                      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 double-blind, placebo-controlled trial of 60 elderly individuals found that 50 or 100 days of treatment with Panax ginseng produced improvements in memory, attention, concentration and ability to cope.  (Siegl & Siegl, 1979) (B604)

                                                      Anxiety 5-HTP is useful for anxiety (Kahn et al, 1987) (B)

                                                      Asthma
                                                        Tylophora – In a double-blind, placebo-controlled study of 195 individuals with asthma, participants given 40 mg of tylophora alcohol extract daily for 6 days showed significant improvement in symptoms as compared with placebo. (Shivpuri et al 1972)(B38)
                                                           Boswellia – In a 6-week, double-blind, placebo-controlled study of 80 persons with relatively mild asthma it was found that treatment with 300 mg of boswellia three times daily reduced the frequency of asthma attacks and improved objective measurements of breathing capacity.  (Gupta et al 1998)(B38)
                                                            Quercetin – In vitro studies suggest that quercetin may inhibit the release of pro-inflammatory substances from mast cells.  (Ogasawara & Middleton 1985; Pearce et al 1984)(B38)
                                                              In clinical trials of Boswellia, promising results were observed in patients with bronchial asthma. (Ammon 2002)
                                                                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)
                                                                  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 asthma. (McDermott 2000)

                                                                  Atherosclerosis
                                                                   In a 4-year study of 280 individuals it was found that standardized garlic powder at a dose of 900 mg/day significantly slowed the development of atherosclerosis. (Koscielny et al 1999)

                                                                  In a study published in 2004 by Wang et al it was found that guggul significantly inhibits LDL oxidation.  The authors concluded that the combination of antioxidant and lipid-lowering properties of guggul and guggulsterone makes them especially beneficial against atherogenesis.

                                                                  Several investigations have demonstrated the ability of garlic to reduce platelet aggregation and cyclooxygenase resulting in improved circulation, decreased atherosclerosis and improved intermittent claudication. (Bordia, 1996; Ali, 1995; Apitz-Castro, 1994) (S428)

                                                                  Autoimmune Disease 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)

                                                                  BPH (Benign Prostatic Hyperplasia
                                                                  Beta-Sitosterol
                                                                   produced significant benefits in men with benign prostatic hyperplasia. (Wilt et al, 1999; Klippel et al, 1997; Kadow et al, 1986; Berges et al, 1995) (B)

                                                                  Cancer
                                                                  Medicinal plants that have exhibited antitumor action due to modulation of programmed cell death and arrested proliferation are trichosanthes, soy, garlic, ginger and green tea(Thatte, 2000) (S)
                                                                    Eleutherococcus has decreased thyroid tumors, lung adenomas and myeloid leukemia in animals. (Wagner, 1985) (S872)
                                                                      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)
                                                                        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)

                                                                        ○    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)

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

                                                                        Dong Quai has been shown to increase tumor necrosis factor (TNF) (Haranaka, 1985) (For more information on TNF we invite you to read about it in our Immune System Enhancement article.)

                                                                        Several retrospective and prospective epidemiological studies have shown that individuals whose diet includes relatively large amounts of garlic tend to develop cancer less frequently. (Agarwal 1996; Dausch & Nixon 1990; Lau et al 1990; You et al 1989) (B579)

                                                                        One of the best epidemiological studies on garlic, the Iowa Women’s Study, found that participants whose diet included significant quantities of garlic were about 30% less likely to develop colon cancer. (Steinmetz et al 1994) (B579)

                                                                        One study showed a decrease in the development of gastric cancer when garlic was added to the diet. (Buiatti, 1989) (S428)
                                                                        Another study has shown that the addition of vegetables in the Allium family (onions, leeks, garlic) to the diet prevents gastric cancer. (Dorant, 1996) (S428)
                                                                        Garlic has been shown to inhibit free radicals, which may be responsible for cancer proliferation, and to decrease lipid peroxidation. (Reitz, 1995) (S428)

                                                                        A study in 1990 using ginseng to treat cancer found that those subjects taking ginseng had a lower cancer risk than those in the control group. (Yun, 1990) (S448)

                                                                        A study in 1983 found that long-term administration of ginseng inhibits tumor growth. (Yun, 1983)(S448)

                                                                        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)

                                                                        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)

                                                                        Cardiovascular Disease
                                                                         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 cardiovascular disease. (McDermott 2000)

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

                                                                        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)

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

                                                                        One study of 432 patients who had suffered myocardial infarction showed significant reductions in reinfarction rate (35%) and mortality (45%) through the use of garlic oil extract over a period of 3 years. (Bordia 1989)

                                                                        Several investigations have demonstrated the ability of garlic to reduce platelet aggregation and cyclooxygenase resulting in improved circulation, decreased atherosclerosis and improved intermittent claudication. (Bordia, 1996; Ali, 1995; Apitz-Castro, 1994) (S428)

                                                                        In a 4-week, double-blind, controlled trial, 64 individuals with consistently increased spontaneous platelet aggregation were treated with either placebo or 900 mg of standardizedgarlic powder daily.  A significant decrease in spontaneous platelet aggregation was seen in the treated group.  (Kiesewetter et al 1991) (B578)

                                                                        Evidence from some but not all observational trials suggests that higher dietary intake of omega-3 essential fatty acids may reduce incidence of cardiovascular disease: (Guallar et al 1995; Iso et al 2001; Kromhout et al 1985; Shekelle et al 1985; Dolecek & Grandits 1991; Kromhout et al 1995; Vollset et al 1985; Curb & Reed 1985) (B554)

                                                                        Cataracts
                                                                        Bilberry may be useful for the prevention and treatment of cataracts. (Bravetti, 1989) (S106)
                                                                          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 cataracts. (McDermott 2000)

                                                                          Central Nervous System Disorders A study published in 2000 demonstrated the anti-cancer and antioxidant actions of 3 chemical components of turmeric on CNS disorders. (Ramsewak, 2000) (S 909)

                                                                          Cerebral Insufficiency 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)

                                                                          Chronic Fatigue Highly preliminary evidence suggests that DHEA might be helpful for chronic fatigue syndrome. (Himmel et al, 1999) (B 517)
                                                                          Preliminary evidence suggests that Eleutherococcus may prove valuable in the long-term management of various disease of the immune system, including chronic fatigue syndrome. (Bohn, 1987) (L420)
                                                                          A 1996 study using ginseng to treat fatigue found significant improvement in fatigue with the use of ginseng as compared to the placebo. (LeGal, 1996) (S448)

                                                                          Colitis
                                                                          In clinical trials of Boswellia, promising results were observed in patients with chronic colitis. (Ammon 2002)
                                                                            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)

                                                                            Common Cold & Flu
                                                                            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)

                                                                            Echinacea significantly reduced the length of the upper respiratory tract infection. (Dorn et al, 1997) (B 527)

                                                                            Echinacea was found effective at reducing the duration and severity of recent-onset respiratory infection. (Lindemuth et al, 2000) (B 527)

                                                                            Echinacea resulted in a statistically significant decrease in progression to a “real cold” in the treated group as compared to the placebo group, as well as symptomatic benefit in individuals that did develop colds. (Hoheisel et al, 1997) (B 527)

                                                                            A double-blind, placebo-controlled study of 227 persons using 100 mg daily of Panax ginseng showed a statistically significant decline in the frequency of colds and flus in the treated group as compared to the placebo group from week 4 to 12. Antibody titers and measure of NK cell activity were also higher in the treated group.  All participants received flu vaccine. (Scaglione et al, 1996) (B603)

                                                                            Congestive Heart Failure
                                                                            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)

                                                                            Constipation In a study of 55 individuals with chronic constipation related to irritable bowel syndrome the group receiving ground flaxseed experienced fewer problems with constipation, abdominal pain and bloating than the group taking psyllium. (Tarpila 1997) (B560)

                                                                            Crohn’s Disease In clinical trials of Boswellia, promising results were observed in patients with Crohn’s disease. (Ammon 2002)

                                                                            Depression (Mild to Moderate)
                                                                            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)

                                                                            Diabetes
                                                                            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)

                                                                            A study published in 2001 found that alpha-lipoic acid is effective in the prevention of early diabetic glomerular injury and suggests that it may have advantages over high doses of either vitamin E or C. (Melham et al 2001)

                                                                            Biotin may help reduce blood glucose levels in individuals with either type 1 or type 2 diabetes. (Maebashi et al, 1993) and (Coggeshall et al, 1985) (B)

                                                                            Bitter Melon may improve glucose control in type 2 diabetes. (Srivastava et al 1993)(B 399)

                                                                            Chromium has been shown to increase the number of insulin receptors in peripheral tissues; to increase the binding of the insulin to receptors and to decrease fasting glucose and serum lipids.  It may also increase HDL cholesterol. (Anderson, 1998)(S)

                                                                            Many studies have confirmed the anti-diabetic effects of fenugreek: (Abdel-Barry, 1997; Abdel-Barry, 2000; Ghafghazi, 1977; Gupta, 1999; Khosla, 1995; Ribes, 1986 and Vats, 2002) (S398)

                                                                            Use of 1 g of fenugreek per day of a standardized extract significantly improved some measures of blood sugar control and insulin response compared to placebo.  Levels of triglycerides decreased and HDL cholesterol levels increased. (Gupta et al, 2001) (B547)

                                                                            In a systematic review by Yeh et al (2003) on herbs and dietary supplements for glycemic control in diabetes 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 sylvestreAloe veravanadium, bitter melon (Momordica charantia) and prickly pear cactus (nopal).

                                                                            Dysmenorrhea
                                                                             A study of 42 young women in 1996 found that supplementation with 6 g of fish oil daily (providing 1080 mg of EPA and 720 mg of DHA) resulted in significantly reduced menstrual pain (Harel et al 1996) (B555)

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

                                                                            Fibromyalgia There is evidence that capsaicin cream may be helpful for relieving pain due to fibromyalgia. (B)

                                                                            5-HTP is useful for fibromyalgia. A 1 month, double-blind, placebo controlled study of 50 fibromyalgia patients found significant improvement in all symptom categories with 5-HTP treatment. (Caruso et al 1990)(B360)

                                                                            Gastrointestinal Disease Capsaicin was found to protect against H. pylori-associated gastrointestinal disease. (Jones, 1997) (S); although a study done by Graham in 1999 disputes this result. (B)

                                                                            Genital Herpes
                                                                            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)

                                                                            Glaucoma Bilberry may be useful for the prevention and treatment of glaucoma. (Bravetti, 1989) (S106)


                                                                            Headaches 5-HTP is useful for tension headache prophylaxis (Songo et al, 1984) B)

                                                                            Hemorrhoids ) 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)


                                                                            Herpes Zoster The FDA has approved a capsaicin cream for the treatment of post herpetic neuralgia.(B)

                                                                            HIV Support Preliminary evidence suggests that Eleutherococcus may prove valuable in the long-term management of various disease of the immune system, including HIV infection. (Bohn, 1987) (L420)

                                                                            Hyperlipidemia 
                                                                            In a study published in 1999 examining the cholesterol-lowering effects of red yeast rice it was found that total cholesterol concentrations decreased significantly compared with the placebo-treated group.  LDL cholesterol and total triacylcglycerol were also reduced, but HDL cholesterol did not change significantly. (Heber et al 1999)

                                                                            According to many but not all studies, fish oil reduces serum triglycerides and may also modestly raise HDL levels. (Yam et al 2001; Harris et al 1996 & 1997; Cobiac et al 1991 and Nenseter et al 2000) (B554)

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

                                                                            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)

                                                                            One study demonstrated the cholesterol-lowering action of garlic to be equal to that of bezafibrate, a prescription drug available in Germany. (Holzgartner, 1992) (S427)

                                                                            Garlic has been shown to inhibit free radicals, which may be responsible for cancer proliferation, and to decrease lipid peroxidation. (Reitz, 1995) (S428)

                                                                            In a systematic review done by Thompson-Coon and Ernst (2003) they found that guggul (Commiphora mukul), fenugreek (Trigonella foenum-graecum), red yeast rice andartichoke (Cynara scolymus) have demonstrated reductions in total serum cholesterol levels of between 10% and 33%.

                                                                            Turmeric extracts were found to lower LDL and total cholesterol in one human study. (Soni, 1992) (B 502)
                                                                            The root of fo-ti has been shown to lower triglyceride accumulations in animal livers. (Liu 1992) (S413)

                                                                            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)

                                                                            Hypertension One study has shown that the high levels of GLA in borage oil are responsible for its ability to decrease hypertension. (Engler, 1998) (S)

                                                                            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)

                                                                            Significant improvements in systolic and diastolic blood pressure were found using CoQ10 in a small 10 week study on 18 persons. (Digiesi et al, 1990)(B476)

                                                                            Dong Quai has been shown to decrease blood pressure (Yoshihiro, 1985) (S 358)

                                                                            According to two small, double-blind, placebo-controlled trials of hypertensives, garlic may reduce blood pressure mildly, in the average range of 10 mm Hg for systolic blood pressure and 5 mm Hg for diastolic blood pressure, compared to placebo. (Auer et al 1990; Silagy & Neil 1994) (B578)

                                                                            Hyperthyroidism A 6 month double-bind study showed that L-carnitine reduced standard symptoms of hyperthyroidism. (Benvenga, 2000) (B)

                                                                            Immune Enhancement 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 may enhance immune function. (McDermott 2000)

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

                                                                            In a human trial, Eleutherococcus increased the absolute number of immunocompetent cells, especially T-lymphocytes of the helper/inducer type (Breum et al 1994) (B536)

                                                                            Inflammation
                                                                            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)
                                                                              Boswellia decreases leukotriene synthesis that is responsible for maintaining inflammation and edema. (Bruneton, 1995; Gupta et al, 1997) (S)
                                                                                Dandelion root may have potential use as an anti-inflammatory agent in inflammatory conditions. (Tito et al, 1993 & Mascolo et al, 1987) (B 507)
                                                                                ○    Feverfew inhibits arachidonate metabolism in leukocytes that may increase inflammation. (Williams, 1995) (S402)

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

                                                                                Joint Inflammation 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)

                                                                                Liver Support Preliminary research shows that active components found in bupleurum possess anti-hypercholesterolemic effects, hepatoprotective and antioxidant effects as well as exhibiting potent cytotoxic actions against human hepatocellular carcinoma cells. (Cheng et al, 2004; Wang et al, 2004; Chiang et al, 2003)

                                                                                Macular Degeneration 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 macular degeneration. (McDermott 2000)

                                                                                Bilberry may be useful for the prevention and treatment of macular degeneration of the eye (Bravetti, 1989) (S106)

                                                                                Menopausal Syndrome  Dong Quai (Angelica) when combined with peony, alisma and cnidium increased progesterone secretion by means of its action in the corpora lutea (Usuki, 1991) (S 358)

                                                                                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)

                                                                                Migraines
                                                                                A double-blind, placebo-controlled study showed that the total number of days of migraine pain were significantly reduced by butterbur compared to the placebo group. (Grossmann, 2000)(B)
                                                                                  Another study showed a 56% reduction in migraines using butterbur. (Eaton 1998) (S 192)
                                                                                    In a systematic review by Ernst & Pittler (2000) they concluded that feverfew is likely to be effective in the prevention of migraine and that there are no major safety problems.
                                                                                      5-HTP is useful for migraine headache prophylaxis (Titus et al, 1986).(B)
                                                                                        CoQ10 has shown promise as a migraine preventive agent. (Rozen, 2000) (S 289)

                                                                                        Multiple Sclerosis
                                                                                        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)

                                                                                        Neural Tube Defects Very strong evidence indicates that regular use of folate by pregnant women can reduce the risk of neural tube defects by 50%. (Werler et al 1993) (B567)

                                                                                        Night Vision Bilberry significantly improves night vision. (Sala 1979; Caselli 1985) (S106)

                                                                                        Obesity 5-HTP is useful for obesity (Cangiano et al, 1992).(B)

                                                                                        Osteoarthritis
                                                                                        A poorly designed study found suggestive evidence that cat’s claw might reduce osteoarthritis symptoms. (Piscoya, 2001)(B)
                                                                                          There is evidence that capsaicin cream may be helpful for relieving pain due to various types of arthritis. (B)
                                                                                            In a review published in 2003 it was concluded that in short-term clinical trials, glucosamine provided effective symptomatic relief for patients with osteoarthritis of the knee. In addition, glucosamine has shown promising results in modifying the progression of arthritis over a 3-year period.  Glucosamine may therefore prove to be a useful treatment option for osteoarthritis. (Matheson & Perry 2003)

                                                                                            Clinical findings have revealed that glucosamine sulfate and chondroitin sulfate are effect and safer alternatives than NSAIDs to alleviate the symptoms of osteoarthritis.  Experimental evidence indicates that these compounds and their low molecular weight derivatives have a particular tropism for cartilage where they serve as substrates in the biosynthesis of component building blocks. (de los Reyes et al 2000)

                                                                                            According to a review by Reginster et al preliminary results obtained in patients with osteoarthritis of the hands suggests that chondroitin sulfate could be used for inhibiting the structural progression of osteoarthritis. (Reginster et al 2003)

                                                                                            A review by Volpi found that chondroitin sulfate produces a slow but gradual decrease of the clinical symptoms of osteoarthritis and these benefits last for a long period after the end of treatment.  Literature data shows that chondroitin sulfate could have an anti-inflammatory activity and a chondroprotective action by modifying the structure of cartilage. (Volpi 2004)

                                                                                            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)

                                                                                            A meta-analysis published in 2000 in JAMA concluded that trials of glucosamine and chondroitin preparations for osteoarthritis symptoms demonstrate moderate to large effects. (McAlindon et al 2000)

                                                                                            In published studies glucosamine used in a dosage of 1.5 grams daily is, after a period of 2 to 4 weeks, just as effective as low doses of NSAIDs in alleviating the pain of osteoarthritis.  Chondroitin sulphate has been less well investigated; but there are indications that it affects the symptoms of osteoarthritis, even though this effect only occurs after a longer period of time. (Bijlsma 2002)

                                                                                            Clinical trials of glucosamine and chondroitin sulfate showed substantial benefit in the treatment of osteoarthritis. (Deal & Moskowitz, 1999)

                                                                                            Chondroitin apparently works by attracting essential fluid into the joints, which thereby acts as a shock absorber.  It also attracts needed nutrients into cartilage. (Benedikt, 1997)(S)

                                                                                            In a study using 500 mg three times daily of glucosamine sulfate or placebo it was found that osteoarthritic severity significantly improved in the treated group as compared to the placebo. (Noack et al, 1994) (B611)

                                                                                            In a study comparing 1200 mg/day of ibuprofen to glucosamine sulfate in treating osteoarthritis of the knee it was found that although ibuprofen produced faster results, both groups experienced comparable relief at the end of 4 weeks.  In addition, although 35% of the ibuprofen-treated group complained of side effects only 6% of the glucosamine group did so. (Muller-Fassbender et al, 1994) (B611)  Essentially equivalent results were seen in a similar 4 week, double-blind trial of 178 patients treated with glucosamine sulfate for knee osteoarthritis. (Qiu et al, 1998) (B611)

                                                                                            One double-blind, placebo-controlled study of 212 individuals over 3 years found radiologic evidence of reduced cartilage loss in the treated group, suggesting glucosamine is a disease-modifying drug in osteoarthritis. (Reginster et al 2001) (B612)

                                                                                            Dandelion root may have potential use as an anti-inflammatory agent in osteoarthritis. (Tito et al, 1993 & Mascolo et al, 1987) (B 507)

                                                                                            Osteoporosis Numerous well-designed studies indicate that calcium supplementation at recommended dosages has been found to help prevent and slow nonvertebral bone loss in postmenopausal women. (Cumming, 1990; Dawson-Hughes et al, 1990)(B)

                                                                                            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)

                                                                                            Parkinson Disease A study published in 2002 concluded that CoQ10 appears to slow the progressive deterioration of function in Parkinson disease, but these results need to be confirmed in a larger study.

                                                                                            Periodontal Disease 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)

                                                                                            Peripheral Neuropathy
                                                                                            Research has shown that capsaicin cream is an effective and safe treatment for relief of the pain associated with diabetic neuropathy. (Tandan, 1992) (S)
                                                                                              A study of 111 patients with mild diabetic neuropathy given 6 g of evening primrose oil for one year found demonstrated improvement in diabetic neuropathy symptoms without change in serum glucose levels. (Keen et al 1993) (B572)
                                                                                                A study published in 2000 demonstrated that in patients with diabetic polyneuropathy alpha-lipoic acid improves microcirculation. (Haak et al, 2000)

                                                                                                PMS 1200 mg daily of calcium carbonate reduced PMS symptoms by half over a period of 3 menstrual cycles. (Thys-Jacobs, 1989) (B) 

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

                                                                                                Premature Ventricular Contractions 
                                                                                                Berberine can suppress premature ventricular contractions without serious side effects. (S)

                                                                                                Dong Quai has been shown to decrease premature ventricular contractions (Zhuang, 1991) (S 358)
                                                                                                ·  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)

                                                                                                Raynaud’s 
                                                                                                GLA may be beneficial for Raynaud’s phenomenon. (Belch et al, 1985) (B574)

                                                                                                Preliminary controlled studies suggest that fish oil may be of benefit in Raynaud’s phenomenon. (DiGiacomo et al 1989; Ringer et al 1989) (B556)

                                                                                                Rheumatoid Arthritis
                                                                                                Boswellia decreases leukotriene synthesis that is responsible for maintaining inflammation and edema. (Bruneton, 1995; Gupta et al, 1997) (S)
                                                                                                o    In clinical trials of Boswellia, promising results were observed in patients with rheumatoid arthritis. (Ammon, 2002)
                                                                                                Preliminary research suggests that boswellia may protect cartilage from damage (Reddy, 1989) (B)

                                                                                                There is evidence that capsaicin cream may be helpful for relieving pain due to various types of arthritis. (B)

                                                                                                Dandelion root may have potential use as an anti-inflammatory agent rheumatoid arthritis. (Tito et al, 1993 & Mascolo et al, 1987) (B 507)

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

                                                                                                Fish oil – 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)(B294)

                                                                                                Gamma-Linolenic Acid (GLA) – In a double-blind study of 56 patients with rheumatoid arthritis, 16 of 21 patients treated with 2.8 g/day of GLA for 1 year significantly improved compared to those in the placebo group. (Zurier et al 1996)(B294)

                                                                                                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)

                                                                                                Devil’s claw – A 2 month, double-blind, placebo-controlled study of devil’s claw following 89 individuals with various rheumatoid disorders found a significant decrease in joint pain intensity and an improvement in mobility.  Another double-blind study of devil’s claw in 50 individuals with various types of arthritis showed that 10-day treatment provided significant pain relief. (ESCOP 1996-1997)(B294)

                                                                                                Schizophrenia Chewing betel decreases symptomatology in schizophrenia. (Sullivan, 2000) (S)

                                                                                                Seborrhea 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)

                                                                                                SLE (Systemic Lupus Erythematosus) 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) (B 515)
                                                                                                Preliminary controlled studies suggest that fish oil may be of benefit in systemic lupus erythematosus. (Walton et al 1991)(B556)

                                                                                                Ulcerative Colitis In clinical trials of Boswellia, promising results were observed in patients with ulcerative colitis. (Ammon, 2002)

                                                                                                Upper Respiratory Tract Infection Prevention In a study published in 2001 participants receiving garlic were almost two-thirds less likely to develop an upper respiratory infection than those who received placebo.  Furthermore, those who did develop an upper respiratory infection recovered about one day faster in the garlic group as compared to the placebo group. (Morcos & Camilo 2001) (B578)

                                                                                                Urinary Tract Infection Prevention

                                                                                                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 urinary tact infections. (Jackson, 1997; Jepson, 2000) (S 324)

                                                                                                Venous Insufficiency (Chronic)
                                                                                                Bilberry extracts appear to reduce capillary leakage in venous insufficiency. (Morazzoni et al 1996) (B)
                                                                                                   Several studies have confirmed the use of butcher’s broom in treating chronic venous insufficiency (Cappelli, 1988; Facino, 1995; Bouskela, 1994 and Vanscheidt, 2002) (S)
                                                                                                    Diosmin/Hesperidin significantly improved symptoms of severe chronic venous insufficiency (Laurent et al, 1988)(B 520)

                                                                                                    Vertigo 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)

                                                                                                    SAFETY ISSUES WITH HERBS AND NUTRIENTS

                                                                                                    (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:
                                                                                                    Akebia
                                                                                                    Aristolochia
                                                                                                    Asarum
                                                                                                    Belladonna
                                                                                                    Bloodroot (internally)
                                                                                                    Calamus
                                                                                                    Chien-li-kuang
                                                                                                    Clematis
                                                                                                    Dictamnus
                                                                                                    Digitalis
                                                                                                    Echinacea if taken during pregnancy may promote spontaneous abortions.  Therefore Echinacea is contra-indicated for pregnant women. (Chow et al 2006) (Barcz et al 2007)
                                                                                                    Eupatorium
                                                                                                    Henbane
                                                                                                    Lithospermum
                                                                                                    Lobelia
                                                                                                    Mandrake
                                                                                                    Mo dou lin
                                                                                                    Pei-lan
                                                                                                    Pennyroyal essential oil (internally)
                                                                                                    Pomegranate peel
                                                                                                    Stephania
                                                                                                    Tansy
                                                                                                    Virginia snakeroot
                                                                                                    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 sylvestreAloe 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 NUTRIENTS
                                                                                                    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.

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