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(Text for a lecture Oct. 11. Herbal
Therapies (Botanical, Herbal, or Phytochemical Alternatives)
Continuing Education for Toledo Physicians. Contact Nancy Merriam
419-471-4649.)
First I summarize for you the herbs that are
selling most in the US, according to figures published in the September 23
issue of Chemical and Engineering News. Echinacea leads herbal medicine
sales in the US, commanding 9.9% of the American herbal sales (costing
$24-42 a pound wholesale for the roots, 4.40 for the leaves), followed by
garlic, 9.8% ($2.60 per pound), goldenseal, 7.0% ($50.00), ginseng , 5.9%
($28-219) ginkgo 4.5 ($5.50); saw palmetto 4.4 ($22), aloe 4.3 ($10.50),
ephedra 3.5 ($4.50, siberian ginseng 3.1 ($7.50), and cranberry 3.0%.
Therefore I include all these in my discussion. Originally I had agreed to
introduce you to some 30 of the most frequently used herbs.
Other top sellers listed by Peggy Brevort in Herbalgram include:
Scientific Name Common Name $ Per Lb. (Wholesale)
Capsicum spp Cayenne 3.20
Cassia senna Senna OTC
Centella asiatica Gotu Kola 3.50
Crataegus oxyacantha Hawthorn 3.60
Glycyrrhiza glabra Licorice 5.25
Hamamelis virginiana Witch Hazel OTC
Humulus lupulus Hops 6.00
Matricaria recutita Camomile 4.70
Mentha piperrita Peppermint 2.95
Plantago ovata Psyllium OTC
Rhamnus purshiana Cascara sagrada OTC
Salix alba White Willow 2.70
Silybum marianum Milk Thistle 8.00
Tabebuia impetiginosa Pau d'arco 4.25
Tanacetum parthenium Feverfew 9.75
Trifolium pratense Red Clover 14.00
Ulmus fulva Slippery Elm OTC
Uncaria tomentosa Cat's Claw
Valeriana officinalis Valerian 2.90
The tops among Chinese herbs are:
Scientific Name Common Name $ Per Lb. (Wholesale)
Angelica sinensis Dong Quai 8.75
Astragalus sinensis Huang Qi 7.50
Eleutherococcus senticosus Tsu Wujia 7.50
Ephedra sinica Ma Huang 4.50
Ginkgo biloba Ginkgo 5.50
Glycyrrhiza uralensis Licorice 3.25
Paeonia obovata Peony 4.00
Panax ginseng Ren Shen 79.00
Polygonum multiflorum Fo Ti 6.58
Rehmannia glutinosa Rehmannia 5.92
Schizandra chinensis Schizandra 7.89
Zingiber officinale Ginger 3.75
Ziziphus jujube Jujube 4.00
MOST FREQUENTLY SOLD CHINESE DRUGS
(MODIFIED FROM BREVOORT, HERBALGRAM, 1996)
Here I list what I view as the major
physiological activities, which herbalists may think they can legally
label, the most promising indications, which they still cannot label, but
ones for which I candidly think there are valid claims. Then,
hyperconservatively, I have gone thru rather alarmist a/o very
conservative views of potential side effects and/or caveats (SE)
applicable to these herbs. I am, in most cases, rather convinced of the
efficacy, and less convinced of the alleged side effects and caveats that
I have included, as promised in my syllabus for this CE course. Look at
the ads for pharmaceuticals in a pop journal or in JAMA and you'll see
that much more verbiage is dedicated to side effects than to indications,
with 10-1,000 times more words addressing caveats, counterindications, and
side effects. Remember that as you address the side effects of these
herbal concoctions.
I like the albeit arbitrary safety scoring I
gave herbs in my CRC Handbook of Medicinal Plants (1985), no pluses if I
feared for my daughter to drink a single cup of tea therefrom, 1 + as more
dangerous than coffee ( meaning I'd not fear her drinking one cup but
discourage more), 2 ++ about as safe (ca in the toxicity range) of coffee,
two cups of which I think are OK (except maybe if you're pregnant), and 3
+++ as safer than coffee ( I would not be alarmed at my daughter's
ingesting three cups). I did not consult that CRC book when developing the
scores I report here. These scores are gut feeling scores a dozen years
later with much holy water over the dam. In the following table
ACT=Activities; IND=Indications; POS = Posology, and SEC=Side effects and
caveats , mostly from the literature. OTC = Over the Counter or approved
for sale in Europe. STX=Standardized Extract;. TCM=Traditional Chinese
Medicine; PNC=Potter's New Cyclopaedia ( Williamson & Evans, 1988);
SF=Steven Foster NH=personal communication, Barbara Grant, Natures Herbs.
Most data in the posology columns were derived from these sources, and
they do not necessarily correspond to OTC doses. To avoid clutter on these
slides, these sources are not always cited on the busier slides.
ALFALFA (Medicago sativa) +
ACT: Aperitif; Bactericide; Cardiotonic; Diuretic; Estrogenic; Stomachic; Tonic
IND: Arthritis; Cancer; Coughs; Dysuria; Gravel Fever; Halitosis; Peptic Ulcers
POS: 1-2 500-mg Capsules/Day; 3-4 375-mg capsules 3x/day
SEC: Abortion; Diarrhea; Dyspepsia; Hemolysis; Lupus, Pancytopenia
Seeds a/o sprouts may contain 13,000 ppm canavanine which may be
implicated in hypocomplementenemia, lupus, and pancytopenia. Stachydrine
and l-homostachydrine in the seeds may be emmenagogue and lactogenic. One
patient died from listeriosis after ingesting contaminated alfalfa
tablets. (LRNP, Mar. 1991) May cause stomach upset and diarrhea. Believed
by some herbalists to be helpful in delaying absorption of cholesterol and
dissolving plaque deposits on arterial walls. (TMA, 1996)
ALOE (Aloe vera) ( Gel) ++ OTC
ACT: Anesthetic; Antiinflammatory; Antiseptic; Moisturizer; Tissue restorative
IND: Abrasions; Alcoholic Ulcers; Bugbites; Burns; Dermatitis
POS: Apply Topically; or 1 Tsp juice after meals; 25 mg in 1,185 mg soybean oil
3-6 capsules daily (Not an OTC dosage)
SEC: Dermatitis; Diarrhea; Intestinal Cramps; Ulcers
ALOE (Aloe vera) (Inner leaf) + OTC
ACT: Anthelminthic; Cathartic; Laxative
IND: Constipation
POS: 1 Tsp juice after meals; 1 250 mg capsule at bedtime
SEC: Dermatitis; Diarrhea; Intestinal Cramps; Ulcers; Commission E
reports counter indications, adverse effects, and interactions of
anthranoid laxatives. (AEHD). Naturopaths Yarnell and Meserole (1996)
state that people allergic to aloe may develop a severe rash following its
application.
ASHWAGANDHA (Withania somniferum) +
ACT: Adaptogenic; ?Aphrodisiac?; Hypotensive; Sedative; Spasmolytic
IND: Cramps; High Blood Pressure; Immune Dysfunction; Impotence; Insomnia
POS: Two 300 mg capsules/day
SEC: Gastritis; Intestinal Cramps; While many herbalists praise this,
even attributing ginseng like magic to it, I think of it as a poorly known
nightshade relative with a few toxic medicinal compounds.
BEARBERRY (Arctostaphylos uva-ursi) + OTC
ACT: Astringent; Urinary Antiseptic
IND: Cystitis; Urethritis
POS: 10 g dry leaf in one quart cold water; 1-3 500 mg capsules/3x/day
SEC: Hepatitis; Nausea; Nephrosis; Stomachache;Vomiting. Use no more
than one week, unless otherwise directed by physician. Not recommended for
children, pregnant or nephritic patients;
BILBERRY (Vaccinium myrtillus) +++ OTC
ACT: Antiaggregant; Antiinflammatory; Antioxidant; Antiseptic; Astringent; Capillary-strengthener; Circulatory-stimulant
IND: Cataracts; Diabetic Retinopathy; Diarrhea; Fragile Capillaries; Impaired Vision (esp. at night); Maculitis; Sore Throat;Varicose Veins
POS: 20-60 g dry fuit/day; 240-480 mg STX/day; 2 500 mg capsules 2x/day
SEC: Fresh berries may cause diarrhea. Leaves can be poisonous consumed
over a long period of time. (TMA, 1996) Commission E reports leaf not
permitted for therapeutic use; higher doses or prolonged use can produce
chronic poisoning; chronic administration of 1.5 g/kg/day is lethal in
animals. (AEHD)
BLACK COHOSH (Cimicifuga racemosa) +
ACT: Analgesic; Antiinflammatory; Antirheumatic; Diuretic; Emmenagogue; Expectorant; Nervine; Sedative
IND: Arthritis, Dysmenorrhea; High Blood Pressure; Menopause; Menstrual Problems; PMS; Whooping Cough
POS: 300-2,000 mg dry root; 40 mg herb in 40-60% ethanol; one 550 mg capsule 3x/day
SEC: I got a nasty letter from some Germans apparently with an economic
interest in cohosh, asking where I got the cautionary remarks from by 1985
CRC book. They must really be irritated by what follows Commission E
reports occasional gastric complaints. Not to be used for more than 6
months. (AEHD) With prolonged use, may irritate the uterus, cause
dizziness, diarrhea, nausea, vomiting, abdominal pain, headaches, joint
pains, and lowered heart rate. Can contribute to abnormal blood clotting
and liver problems. Can encourage breast tumors. Should not be used by
anyone with any type of heart disease or by anyone advised not to take
oral contraceptives. Can cause premature labor. Should be used only under
medical supervision. (TMA, 1996)
BOSWELLIA (Boswellia commiphora) ++
ACT: Analgesic; Antiinflammatory; Antirheumatic
IND: Arthritis; Inflammation; Rheumatism; Sports Injuries
POS: Three 195 mg capsules boswellin/day
SEC: This johnny-come-lately hasn't been among us occidentals long
enough to accumulate much negative or positive folklore.
BURDOCK (Arctium lappa) +++ OTC
ACT: Antipyretic; Antitumor; Diaphoretic; Hypoglycemic; Immunomodulator
IND: Arthritis; Degenerative Diseases; Diabetes (NIDM); Lymphoma; Urethritis
POS: Liquid Root Extract 2-8 ml; Liquid Seed Extract 0.5-2 ml; three 475 mg capsules 3x/day
SEC: Physicians in Burgos Spain report 3 1995 cases of contact
dermatitis caused by burdock root poultices. Herbs for Health (Nov./Dec.).
p. 68., reviewing Rodriguez, P. et al. 1995. Allergic contact dermatitis
due to burdock. Contact Dermatitis 33(2): 134-5.
CALENDULA (Calendula officinalis) +++ OTC
ACT: Antiinflammatory; Antiseptic; Antiviral; Carminative; Immunostimulant; Vulnerary
IND: Abrasions; Burns; Indigestion; Menstrual Distress; Stomach Distress
POS: 1-5 g herb per cup tea, 3 x daily; 5-40 drops tincture 3 x/day
SEC: I think it safer than coffee, discounting a report of anaphylactic
shock in one Russian who gargled with the infusion (it's kin to ragweed)
(LRNP, Aug. 1992)
CASCARA SAGRADA (Rhamnus purshiana) OTC +
ACT: Diuretic; Emetic; Fungicide; Laxative; Peristaltic; Purgative
IND: Constipation; Hemorrhoids; Ringworm
POS: 1 ml (ca 10 drops) STX (fluid); two 450 capsules/bedtime
SEC: While widely used, anthranoid-containing laxatives can be
habit-forming; some contain compounds suspected of being cytotoxic,
genotoxic, mutagenic and even tumorigenic; epidemiological studies in
Germany reveal that abusers of anthranoid laxatives have three times
higher rate of colon carcinoma
CAT'S CLAW (Uncaria tomentosa) ++
ACT: Antiinflammatory; Antiviral; Immunostimulant
IND: Arthritis; Gout; Immune Dysfunction; Indigestion; Inflammation;
POS: 20-60 mg STX; 1 Tsp Decoction; 1-2 500 mg capsules 3x/day; two 505 mg STX capsules/day
SEC: Too new to have much toxicity data, I think it as innocuous as
coffee. But only time will tell. Foster cautions that, like other
immunostimulants, including his favorite echinacea, cat's calw should be
avoided in such immune disorders as HIV, multiple sclerosis, and
tuberculosis. Not shown safe in children and lactating or pregnant women.
CAYENNE (Capsicum spp.) ++ OTC
ACT: Analgesic; Carminative; Circulatory Stimulant; Diaphoretic; Spasmolytic
IND: Arthritis (Pain); Herpes Zoster; Indigestion; Pain; Tennis Elbow; Varicose Veins
POS: Topical STX usually contain 0.25-0.75% capsaicin; 0.5-1 tsp dry
fruit/cup water; 2-3 155 mg capsules 3x/day; 1 STX 450 mg capsule 3x/day
SEC: Commission E reports counter
indications of damaged skin, hypersensitivity and adverse effects of
irritant properties; rarely allergic reactions. Not to be used for more
than 2 days.
CHAMOMILE (Matricaria recutita) +++ OTC
ACT: Antiinflammatory; Antispasmodic; Carminative; Diuretic; Expectorant; Sedative
IND: Dermatitis; Eczema; GI Distress; Gingivitis; Indigestion; Insomnia; Ulcers; Varicose Veins
POS: 2-3 g per cup, 3-4x/day; 10-40 drops tincture 3 x/day; 2-3 355mg capsules 3 x/day
SEC: Some people advise, perhaps over advise, that sensitive people may have an allergic
reaction to this. I don't take camomile daily but almost daily I ingest a whole lot of peanuts,
which are more dangerous, anaphylactically killing two people a year in the US.
CHASTEBERRY (Vitex agnus-castus) ++
ACT: Emmenagogue; Stimulant; Vulnerary
IND: Acne; Breast Pain; Cramps; Irregular Cycles; Menopause; Menstrual Distress; PMS
POS:30-40 mg dry fruit/day; 40 drops STX tincture; two 565 mg capsules 2x/day
SEC: Commission E reports no counter indications or interactions for the fruit. Adverse effects:
skin reactions.
CRANBERRY (Vaccinium macrocarpum) +++ OTC
ACT: Antiseptic; Bactericide
IND: Bladder & Kidney Infections; Cystitis; Gout; Urethritis
POS: 5-20 oz/day; 800 mg capsules; 2-4 505 mg capsules 3x/day; 2-3 505 mg capsules STX w meals
SEC: Ingestion of ridiculous amounts (3-4 liters a day may cause diarrhea and other GI
disorders.
DAMIANA (Turnera diffusa) ++
ACT: Antidepressant; ?Aphrodisiac?; Diuretic; Stimulant; Tonic (aphrodisiaca)
IND: Anxiety; Depression; Frigidity; Impotence
POS: 2-4 ml Liquid Extract; Damiana Extract BPC 0.3-0.6g PNC
SEC: "No significant adverse effects . . . Persons claiming to experience damiana-induced
hallucinations should be monitored closely."
DANDELION (Taraxacum officinale) +++ OTC
ACT: Antiinflammatory; Aperitif; Bitter; Cholagogue; Diuretic; Natriuretic
IND: Cirrhosis; Improper Bile Secretion; Hepatitis; Indigestion; Jaundice
POS: 4-10 g dry lf 3x/day; 1-2 tsp root/cup/ AM & PM; three 515 mg capsules 3x/day
SEC: Commission E reports counter indications: biliary obstruction, empyema of gall-bladder,
ileus; adverse effects: gastric complaints. Other counter indications reported: biliary
inflammation.
DONG QUAI (Angelica sinensis) +
ACT: Analgesic; Antiallergic; Antiinflammatory; Antiseptic; Antispasmodic; Female Tonic; Hypotensive
IND: Dysmenorrhea; Hot Flashes; Menstrual Pain; Muscular Cramps; PMS
POS:1-3 tsp tsp root/day; 5.5-12 g root/day; three 535 mg capsules 3x/day; two 630 mg STX capsules 2 x daily
SEC: Psoralens can be phototoxic and carcinogenic. The aqueous extract inhibits experimentally
induced IgE titers, suggesting immunosuppressive potential. "Its use cannot be recommended."
Pregnant and nursing women, or patinets with diarrhea, should not take except under a doctor's
instruction.
ECHINACEA (Echinacea spp.) +++
ACT: Antibacterial; Antiviral; Immunostimulant
IND: Bronchitis; Cold; Earache; Eczema; Flu; Immune Dysfunction; Infections; Wounds
POS: 60 drops root tincture 3x/day; 2-3 425 mg capsules 2-3x/day; two 505 mg STX capsules 2-3x/day
SEC: I don't worry about levels of PA's as low as 60 ppms; isotussilagine and tussilagine have
been reported at levels of up to 60 ppms in pallid and purple coneflower (These PA's are
unlikely to cause any liver damage. Commission E reports counter indications: progressive
systemic diseases (e.g., tuberculosis, multiple sclerosis). Should not be used for more than 6
weeks. Other sources report counter indications: inclination to hypersensitivity, pregnancy;
adverse effects: metabolic worsening in diabetic patients; dose-dependent chills, fever, nausea,
vomiting; acute allergic reactions. Not to be used for more than 3 weeks. According to Parnham
(1996) doses 1,000 times greater than normally used may be immunosuppressive.
ELDERBERRY (Sambucus canadensis) +++ OTC
ACT: Antiviral
IND: Bronchitis; Cold; Cough; Fever; Flu; Sorethroat
POS: 2-4 g dry flower PNC; 2-10 g dry fruit; 2-3 485 mg capsules 2-3x/day; one 485 mg STX capsule, 3x/day
SEC: Parts of the plant may contain dangerous levels of HCN. Several cases of severe poisoning
from several glasses of juice involved dizziness, nausea, numbness, stupor, vomiting and
weakness.
EPHEDRA (Ephedra spp.) + OTC
ACT: Anorexic; Antiinflammatory; CNS-Stimulant; Diuretic
IND: Asthma; Lethargy; Nasal Congestion; Obesity; Sinusitis
POS: 1.5-6 g/cup/day
SEC: The herb and/or its ephedrine can cause dizziness, flushing, hypertension, palpitations and
utero contraction (Green Farmacy). Commission E reports counter indications, adverse effects,
and interactions of the major alkaloid, ephedrine. Not to be used for prolonged period. Not to be
taken with MAOI's.
EVENING PRIMROSE (Oenothera biennis) +++ OTC
ACT: Antiaggregant; Antiinflammatory; Nutritive (Essential Oil Deficiencies)
IND: Arthritis; Dermatitis; Eczema; Hyperactivity; Mastalgia; Menstrual Distress; PMS
POS: 3-12 500-mg capsules EPO/day; two 1300 mg capsules/day
SEC: The literature looks clean. I've heard from two separate personal cases of women taking it
satisfactorily for PMS that it caused migraine-like headaches which they did not experience
before taking EPO. Anecdotal but credible. As my best source of tryptophan which leads to
cerebral serotonin, it can alter brain levels of serotonin which is involved in some migraine
cases. Enteralgia, headache, and nausea may occur in a small percentage of subjects.
FENUGREEK (Trigonella foenum-graecum) +++ OTC
ACT: Antiinflammatory; Estrogenic, Hypocholesterolemic, Hypoglycemic; Steroid Precursor;
IND: Arthritis; Diabetes (NIDM), High Blood Pressure, High Cholesterol; Indigestion; Sore Throat
POS: 50-100 g/day; one 625 mg capsule 2-3 x/day
SEC: Commission E reports no counter indications or interactions for oral use of the seed.
Adverse effects: skin reactions to repeated external use. An idiosyncratic gastroenteritis was
fingered on fenugreek in LRNP (July, 1987). One micromastic female complained of mastogenic
activity following ingestion of fenugreek sprouts.
FEVERFEW (Tanacetum parthenium) ++ OTC
ACT: Analgesic; Antiinflammatory; Emmenagogue; Serotonin-Reuptake-Inhibitor
IND: Arthritis; Cluster Headache; Fever; Menstrual Pain; Migraine
POS: 125 mg dry lf/day with at least 0.2% parthenolide; two 400 mg capsules, 3 x/day
SEC: Oral feverfew may cause mouth ulcers in ca 10% of patients. Should not be taken by
pregnant women as the leaves have emmenagogue activity. No serious side effects have been
noticed in those taking feverfew over years as a preventive. Ulcerations of the mouth, sore
tongue, inflammation of the oral mucosa and tongue, swelling of the lips, unpleasant taste, loss
of taste, urinary problems, headache, diarrhea, flatulence, nausea, and vomiting are side effects
(most were apparent only in the first week) reported by those using feverfew. Cases of contact
dermatitis are rare. Mild tranquillizing and sedative effects have been reported. Chewing the
leaves for extended periods may lead to abdominal pains and indigestion. Has shown
abortifacient effects. Sesquiterpene lactones (SL), are aromatic compounds widely distributed in
certain plant families, with highest concentrations generally found in leaves and flowers. Sheep
and cattle poisonings due to SL-containing species have been reported. Cases of allergic contact
dermatitis in humans have also been reported.
FLAX (Linum usitatissimum) +++ OTC
ACT: Demulcent; Laxative
IND: Colitis, Constipation; Diverticulitis; Enteritis; Gastritis
POS: 1 tsp ( 5-6 g alpha-linolenic-acid)/day; one 300 mg STX softgel
SEC: Under pessimal conditions, 100 g linseed can liberate up to 50 mg HCN, enough to bring
about symptoms of poisoning. But these conditions rarely if ever maintain. Most HCN is
metabolized via the enzyme rhodanase which can convert 30-60 mg HCN per hour into the
relatively toxic thiocyanate. Even doses of 300 g ground linseed evoked no symptoms of
poisoning in volunteer. Single doses of 100 g to not cause significant rise in blood hydrocyanic
acid and thiocyanate levels. Taking 15 g linseed thrice daily for 3 to 4 weeks raised thiocyanate
levels in blood and urine. May adversely affect absorption of drugs (as with any mucilaginous
preparation).
FO-TI (Polygonum multiflorum) +++
ACT: Antiatherosclerotic; Antioxidant; Hypocholesterolemic; Immunostimulant; Laxative
IND: Bronchitis; Cardiopathy; High Cholesterol
POS: 6-15 g dry root; 2-3 575 mg capsules; 3 x/day
SEC: May cause diarrhea, enteralgia, nausea; numbness of the extremeties; skin rashes.
GARLIC (Allium sativum) +++ OTC
ACT: Antiaggregant; Antioxidant; Antiseptic; Diaphoretic; Hypocholesterolemic; Hypotensive
IND: Cold; Flu; High Bloodpressure; High Cholesterol; Infections; Yeast
POS: 4 g garlic or one average clove; 5,000 ug allicin/day; one 400 mg STX/day; 3-4 550 mg capsule 3 x/day
SEC: Some thiol-bearing compounds in garlic and onion and their relatives can cause
acantholysis in vitro and possibly pemphigus in vivo. "More than 5 cloves a day may induce
flatulence and heartburn (Castleman, 1996) and "thin blood" (people taking blood thinners may
over thin their blood thereby. Some people (including a long-term director of the Missouri
Botanical Garden) are very allergic to garlic. Commission E reports foul breath, rare
GI-disturbances, and allergic reactions.
GINGER (Zingiber officinale) +++ OTC
ACT: Antiemetic; Antiinflammatory; Carminative; Spasmolytic
IND: Arthritis; Cramps; Dizziness; Indigestion; Morning & Motion Sickness; Nausea
POS: 3-10 g fresh ginger; or 2-4 g dry ginger/day; three 550 mg capsules 3 x day (NH); one 480mg STX 2x/day
SEC: Perhaps erring on the side of caution, Reichert cautions that ginger may raise the
bloodpressure, may amplify blood-thinning drug's activities, and might be counter indicated in
pregnancy. The Lawrence Review says overdoses may cause cardiac arrhythmias and
CNS-depression. Due to ginger's strong antiaggregant activity, "experts recommend it not be
used by people with blood-clotting disorders. Many ... chemotherapy patients experience periods
when their blood platelet counts drop dramatically....Doctors will warn patients to avoid aspirin
when their platelet counts are low ... We feel that patients should also avoid ginger when their
platelet count drops, while continuing use of ginger for patients with normal platelet counts."
(Block, 1996) Less conservatively, Commission E reports rhizome should not be used for
vomiting in pregnancy.
GINKGO (Ginkgo biloba) ++ OTC
ACT: Antioxidant; Cerebral-Stimulant; Circulatory-Stimulant; Peripheral-Stimulant; Vasodilator
IND: Alzheimer's; Impotence; Intermittent Claudication; Maculitis; Poor Circulation; Raynaud's Syndrome; Senile Dementia; Tinnitus
POS: 40-80 mg STX 3x/day; three 400 mg capsules/day
SEC: Though regarded by many as a poisonous plant, ginkgo, selling at 500 million a year in
Europe, has not accumulated much data in the alarmists journals. According to (LRNP Feb '94)
mild adverse effects include GI upset and headache. Bilobin and ginkgolic acid are similar to
poison ivy's allergen (LRNP Feb '88). In my CRC Handbook of Nuts, I don't discuss the leaves
(extracts of which are sold as medicine). Fruits are allergenic (and disgustingly malodorous) and
too many of the edible seeds can cause serious problems, even death.
GINSENG (Oriental) (Panax ginseng) +++ OTC
ACT: Adaptogenic; Hypoglycemic; Stimulant; Tonic
IND: Cold; Diabetes; Fatigue; Immune Dysfunction; Impotence; Slow Thinking
POS: 0.33-0.66 g root 3x/day; 1-9 g; 100 mg STX (4-7% ginsenosides) 1-2x/day; three 550 mg capsules 3x/day (Korean); one 535 mg STX 2x/day (Korean)
SEC: The worst and most erroneous studies of ginseng were reported in JAMA, which accepted
no corrections from the herbal industry, trying to get the reports straight. I regard as erroneous
these studies. "Most commonly reported side effects of ginseng are nervousness and excitation,
which usually diminish" (LRNP Sep '90) Foster (1996) reports GI distress; overstimulation;
breast tenderness; dysmenorrhea. Avoid if hypertensive or pregnant.
GOLDENSEAL (Hydrastis canadensis) +
ACT: Antiinflammatory; Antiseptic; Astringent; Digestive
IND: Dermatitis; Earache; Eczema; Gastritis; Gingivitis; Laryngitis; Ringworm; Sore Throat
POS: 2-4 ml (20-40 drops) tincture; 150-350 mg root 3x/day; 1-2 540 mg capsules 3x/day; one 470 mg STX 2x/day
SEC: "goldenseal should not be taken for long periods of time" (Barney, 1996). The LRNP (June '87) is a bit stronger. Large doses of the plant may irritate the mouth and throat, and cause diarrhea, nausea, parathesia, and vomiting. "CNS stimulation and respiratory failure induced by the plant can be fatal." In higher doses hydrastine can cause convulsions, exaggerated reflexes, hypertension, and death from respiratory failure. (LRNP, but quoting an old old book). "No recent reports of toxicity...in the literature" (SF). May alter intestinal flora.
GOTU KOLA (Centella asiatica) +++
ACT: Antiedemic; Antiinflammatory; Diuretic; Sedative; Tonic; Vulnerary
IND: Burns; Edema; Failing Memory; Phlebitis; Psoriasis; Varicose Veins; Wounds
POS: 1 tsp dry herb/cup; 600 mg powdered leaf/day
SEC: LRNP (Dec '88) says that, despite claims of non-allergenicity, dermatitis has been reported
in some patients taking the gotu kola. Reading their account, I'd not be any more afraid of gotu
kola than wild lettuce.
HAWTHORN (Crataegus monogyna) +++ OTC
ACT: Antianginal; Antiarrhythmic; Cardiotonic; Coronary Vasodilator; Preventative
IND: Angina; Arrhythmia; Cardiovascular Insufficiency;; High Blood Pressure
POS: 4-5 g fruit/cup; 80-160 mg STX 3x/day; 2-3 550 mg capsules 2-3 x/day; one 500 mg STX 2-3x/day
SEC: LRNP (Jan '94), admitting that low doses, are usually devoid of adverse effects, says that
high doses may induce hypotension (that can be good in hypertensives) and sedation (which can
be good in insomniacs). Acute parenteral LD50's range from 18-34 ml/kg while LD50's of
individual components range from 50-2,600 mg/kg. Acute oral toxicity reportedly ranges from
18.5-33.8 ml/kg.
HONEYSUCKLE (Lonicera japonica) ++
ACT: Antiinflammatory; Antiseptic, Antiviral
IND: Cavities, Cold, Conjunctivitis; Flu; Infection
POS: 10 g flower/cup water
SEC: Though flowers are reported as foods in the orient, I think of it as more medicine than
food, but damn good antibiotic medicine (JAD).
HOPS (Humulus lupulus) +++ OTC
ACT: Estrogenic; Sedative; Tranquiulizer
IND: Anxiety; Depression; Insomnia; Unrest
POS: 500 mg/day (SF)
SEC: Mild Allergies or Dermatitis may result from contact.
HORSE CHESTNUT (Aesculus hippocastanum) ++ OTC
ACT: Astringent
IND: Diarrhea; Hemorrhoids; Varicosities
POS: 0.5-1.2 ml Liquid Fruit Extract; 2-4 ml Liquid Bark Extract
SEC: Commission E reports rare GI-disturbances. Aesculin has caused contact dermatitis.
HORSETAIL (Equisetum arvense) +
ACT: Astringent; Siliceous
IND: Arthritis; Poor Bone Development; Poor Hair; Poor Skin
POS: 2-4 ml Liquid Extract; three 355 mg capsules 3 x day; one 505 mg STX 2 x day
SEC: Despite reported benefits of silicon, it seems prudent that infants, young children and pregnant women not ingest horsetail for extended periods, unless its thiaminase enzyme has been deactivated. Said to induce seborrheic dermatitis.
HORSE CHESTNUT (Aesculus hippocastanum) ++ OTC
ACT: Astringent
IND: Diarrhea; Hemorrhoids; Varicosities
POS: 0.5-1.2 ml Liquid Fruit Extract; 2-4 ml Liquid Bark Extract
SEC: Commission E reports rare GI-disturbances. Aesculin has caused contact dermatitis.
HORSETAIL (Equisetum arvense) +
ACT: Astringent; Siliceous
IND: Arthritis; Poor Bone Development; Poor Hair; Poor Skin
POS: 2-4 ml Liquid Extract; three 355 mg capsules 3 x day; one 505 mg STX 2 x day
SEC: Despite reported benefits of silicon, it seems prudent that infants, young children and
pregnant women not ingest horsetail for extended periods, unless its thiaminase enzyme has
been deactivated. Said to induce seborrheic dermatitis.
HUANG QI (Astragalus membranaceous) ++
ACT: Antibacterial, Antiinflammatory; Antipyretic; Antiviral; Diuretic; Immunostimulant; Tonic
IND: Cancer; Cold; Fatigue; Flu; HIV; Other Infections; Immune Dysfunction
POS: 9-15 g sliced root; six 500- mg capsules/day; two 400 mg capsules 3 x day
SEC: No side effects reported but "pregnant women should check with their practitioners before
using." No botanist knows all the species of Astragalus, and some very toxic ones look pretty
much like the innocuous ones.
KAVA (Piper methysticum) ++
ACT: Analgesic, Anticonvulsant; Antidepressant; Antirheumatic; Antiseptic; Muscle Relaxant; Sedative
IND: Anxiety; Depression; Headache; Insomnia; Menstrual Cramps; Prostatitis; Stress
POS: 1 tsp cup/nite; 35 mg STX (70% kavalactone) 3x/day; 1-2 455 mg capsules 2-3x/day; 1-2 530 mg STX capsules 1-2 x/day
SEC: Commission E reports counter indications: esophageal and gastrointestinal stenoses;
adverse effects: allergic reactions (rarely). Other sources report counter indications: intestinal
obstruction. Many reports suggest a yellowing of the skin in chronic users. "Chronic ingestion
may lead to 'kawism' characterized by dry, flaking, discolored skin and reddened eyes."
Persistent rumors suggest that overdoses can cause intoxication.. Commission E warns against
the concomitant use of kava with barbituates, antidepressant medications, and CNS agents.
Lactating or pregnant women should not use kava.
LEMONBALM (Melissa officinalis) +++ OCT
ACT: Antiherpetic, Antispasmodic; Antiviral; Sedative
IND: Enterospasms; Gastrospasm; Herpes, Insomnia
POS: 1.5-4.5 g/cup
SEC: Safer than coffee in my book.
LICORICE (Glycyrrhiza glabra) ++ OTC
ACT: Adrenal-Stimulant; Antiasthmatic; Antiinflammatory; Antitussive; Antiviral; Demulcent; Diuretic; Expectorant
IND: Adrenal Insufficiency; Asthma; Bronchitis; Cough; Herpes; Indigestion; Ulcers; Virus
POS: 5-15 g root/day; 200-600 mg glycyrrhizin/day
SEC: Too much (>50 g/day) can raise the blood pressure, cause sodium and water retention, and
lower potassium levels to far. May result in pseudoaldosterianism. Adverse effects reported in
M30 (amenorrhea, cardiac arrest, congestive heart failure, headache, hyperprolactinemia,
hypertension, hypokalemia, muscle weakness, myoglobinuria, myopathy, and paralysis,
Commission E reports counter indications: cholestatic liver diseases, liver cirrhosis,
hypertension, hypokalaemia, severe renal insufficiency, pregnancy. As prolonged use/higher
doses may give mineralocorticoid adverse effects/interactions, the root should not be used for
more than 4-6 weeks without consulting physician. The use to correct taste in doses providing
maximum 100 mg of glycyrrhizin per day is also allowed. Cantelli-Forti et al (1994) note that
"serious side effects related to glycyrrhizin ingestion, including headaches, edema, body weight
increase, and disturbances in body-electrolyte balance were observed either after daily high LE
personal consumption or in clinical use." "Continuous consumption of licorice root extract in
daily use as food or for therapeutic purposes is safer than the use of glycyrrhizin alone (or when
the latter is added to man-made products {chewing gums, drinks, drugs, sweets etc.}). I would
extend that into a generality for whole herbal extracts rather than silver bullets: "Continuous
consumption of whole plants or plant extracts is safer than the use of their major active
ingredient alone (or purified and added to drugs)"
MARSHMALLOW (Althaea officinalis) +++OTC
ACT: Demulcent, Emollient; Hypoglycemic; Immune-Stimulant; Vulnerary
IND: Asthma; Bronchitis; Cough; Diabetes; Sore Throat; Stomatitis
POS: 5-15 g root/day; 200-600 mg glycyrrhizin/day
SEC: Safer than coffee in my book. Remote chance of gossypol. High pectin/mucilage content
may interfere with uptake of other pharmaceuticals.
MELATONIN (+)-N.A.
ACT: Antiaging; Antidepressant; Antioxidant; Synchronizer
IND: Insomnia; Jetlag; Seasonal Affective Disorder
POS: 0.5-3 mg melatonin at bedtime
SEC: Doses < 8 mg have reportedly induced heavy head, headache, and transient depression.
May aggravate depression in psychiatric patients. JAMA cautions that "some studies suggest
melatonin may deepen depression in those who have it or induce it in those susceptible to it.
Melatonin in physiological doses caused vasoconstriction. Melatonin also constricts cerebral
arteries." (in rats). Melatonin has no LD50...Additional possible adverse effects mentioned in the
NIH workshop included inhibition of fertility, suppression of male sexual drive, hypothermia,
and retinal and retinal damage. " (Possibilities of gynaecomastia and low sperm count
disappeared in one man when he discontinued melatonin.) Some people taking as little as 3 mg
tell me it's too much and gets them wired, reporting better insomnia protection with smaller
doses.
MILK THISTLE (Silybum marianum) +++ OTC
ACT: Antidotal; Antioxidant; Antitoxic; Cholagogue; Hepatoprotective
IND: Cirrhosis; Hepatitis; Indigestion; Intoxication; Mushroom Poisoning; Psoriasis
POS: 12-15 g whole or powdered seed; STX 420 mg silymarin day; 1-2 540 mg capsules 3 x/day
SEC: Commission E reports no counter indications or interactions for the fruit. Occasional mild
laxative effects are reported. "The long term safety and the advisability of the use of these
extracts in pregnant or women of potential childbearing remain to be established.
NETTLE (Urtica dioica) +++ OTC
ACT: Antiasthmatic; Astringent; CNS-Depressant; Diuretic; Histaminic; Hypotensive; Nutritive; Tonic
IND: Arthritis; Asthma; Diarrhea; Hayfever; Nephrosis; Osteoporosis; Prostatitis; Rheumatism
POS: 8-10 g dry herb/day; 4-6 g root/day; 1-2 480 mg capsules 2-3x/day; 1-2 480 STX capsules 1-2 x/day
SEC: Occasional mild GI-complaints after root ingestion. The urtication can be painful and
long-lasting, in some inducing a black-and-blue reaction. No fatalities are reported in the US.
PASSION FLOWER (Passiflora incarnata) ++ OTC
ACT: Analgesic; Antispasmodic; Monoamine-Oxidase Inhibitor; Sedative; Tranquilizer
IND: Addiction; Anxiety; Depression; Hyperactivity; Insomnia
POS: 1-3 g herb 3x/day
SEC: Large doses may result in CNS depression (LRNP, May 1989). The same precautions
suggested for MAO inhibitors might be indicated here.
PAU D'ARCO (Tabebuia spp.) +++
ACT: Antibacterial; Antiinflammatory; Antifungal; Antitumor; Candidicide
IND: Immune Dysfunction; Fungal Infections; Yeast Infections
POS: 15-20 g inner bark/pint/day; three 505 mg capsules 3 x/day
SEC: Side effect may include GI distress and nausea. Guiraud et al (1994) note that lapachol and
beta-lapachone, though active against Candida, could be harmful). Multiple doses of oral
lapachol at 500 mg/kg caused death with severe histopathological changes. In clinical trials, oral
lapachol induced anticoagulant effects, nausea and vomiting. After 6 doses at 9 mg/kg.
Beta-lapachone caused death, following anorexia, diarrhea and weight loss.
PEPPERMINT (Mentha piperita) +++ OTC
ACT: Analgesic; Antipruritic; Antispasmodic; Carminative
IND: Colitis; Diverticulitis; Gingivitis; Heartburn; Indigestion; Irritable Bowel Syndrome; Itch; Menstrual Cramps
POS:1-2 g leaf/cup 3x/day; 1-2 enteric coated peppermint oil pills 3 x daily
SEC: Not to be used in patinets with achlorhydria, biliary or gall-bladder obstruction.
Menthol-containing ointments applied to an infants nostrils have produced immediate collapse.
Rats receiving 100mg/day peppermint oil develop dose-related brain lesions. Because of it
ability to relax GI smooth muscles, peppermint oil may sometimes worsen symptoms of hiatal
hernia. "Peppermint tea should not be given to infants of very young children because the
pungent fragrance can cause gagging." (Castleman, 1996) Coated pills opening too soon (in
stomach) may cause gastralgia and heartburn.
PSYLLIUM (Plantago psyllium) +++ OTC
ACT: Demulcent; Laxative; Pectiniferous
IND: Colitis; Constipation; Diarrhea; Hemorrhoids; Ulcers; Stress
POS: 10-20 g powdered seed; 4-20 g husks; 3-4 565 mg capsules 3 x/day
SEC: Physicians and other health care professionals are developing increasingly allergic
reactions to psyllium powder. Hulbert et al (1995) report a fatal bronchospasm after oral
ingestion of isphagula, identical with or closely related to psyllium. Commission E reports
counter indications for seed and seed-shell: GI-obstruction (ileus), diabetes which is hard to
control (as insulin need may be reduced); adverse effects: allergic reactions; interactions:
absorption of other drugs taken simultaneously. Other counter indications: intestinal obstruction.
RED CLOVER (Trifolium pratense) +++
ACT: Antiangiogenic; Antiinflammatory; Diuretic; Estrogenic; Expectorant
IND: Asthma; Bronchitis; Cancer Prevention; Indigestion; Menopause; Whooping Cough
POS: 3-6 g dry flowers; three 355mg capsules 3x/day
SEC: Safe at levels normally consumed by humans, clovers have so much estrogenic activity that
when pregnant animals graze heavily on them, they may suffer miscarriage. Apparently healthy
clovers may be fungally infected with much higher levels of estrogens, rarely even slaframine, a
toxic fungal metabolite.
ROSEMARY (Rosmarinus officinalis) +++ OTC
ACT: Anticholinesterase, Antioxidant, Antiseptic; Antispasmodic; CNS-Stimulant
IND: Alzheimer's; Arthritis; Drowsiness; Lethargy; Myalgia; Neuralgia; Rheumatism;
POS: 3-1.2 ml Rosemary Spirit (?tincture?)
SEC: Like any essential oil, that of rosemary can be toxic in large quantities, causing irritations
to the intestines, kidneys, skin and stomach. Michael Castleman is apparently talking about the
herb, not the more dangerous essential oil, when he says, "Like most other herbs, rosemary
should be used in large amount only in consultation with your health care provider. If you are
pregnant, you should avoid such amounts because they can cause uterine contractions."
(Castleman, 1996)
SARSAPARILLA (Smilax aristolochiifolia) +++
ACT: Antiinflammatory; Antirheumatic; Diuretic; Steroid-Precursor Starter material for progesterone, testosterone and other steroids
IND: Psoriasis; Steroids used for arthritis, dysmenorrhea, menopause PMS
POS: 1-4 g powdered root; two 455mg capsules 2-3x/day. I'd feel safe with 10-30 g dry root in 3 cups tea or sarsaparilla per day.
SEC: Commission E reports for the root that gastric and renal toxicity as well as drug
interactions are possible.
SAW PALMETTO (Seronoa repens) +++ OTC
ACT: Antiinflammatory; Diuretic
IND: Impotence; Inflamed Prostate; Male Pattern Baldness; Polyuria
POS: One 320 mg softgel STX/day; 1-2 g dry fruit; 2-3 600 mg capsules 3x/day
SEC: Commission E reports no counter indications or interactions for the fruit. Adverse effects:
gastric complaints (rarely). As improvement is symptomatic without eliminating prostatic
hypertrophy, a physician should be consulted regularly.
SENNA (Cassia senna) + OTC
ACT: Cathartic; Fungicide; Laxative
IND: Constipation; Ringworm
POS: 0.5-2 g dry leaf; two 25 mg capsules/day
SEC: Anthranoid-containing laxatives can be habit-forming; some contain compounds suspected
of being cytotoxic, genotoxic, mutagenic and even tumorigenic; epidemiological studies in
Germany reveal that abusers of anthranoid laxatives have three times higher rate of colon
carcinoma. One woman developed clubbing of her digits and hypertrophic osteoarthropathy after
taking at least 3 senna tablets daily for 3 years for weight loss. She also experienced several
months of secondary amenorrhea.
SIBERIAN GINSENG (Eleutherococcus senticosus) +++
ACT: Adaptogenic; Antistress; Immune-Stimulant; Tonic
IND: Cold; Depression; Fatigue; Flu; Mental and Physical Dysfunction; Stress
POS: 2-16 ml STX 1-3x/day for 1-2 mos.; two 500 mg capsules 3x/day; 2-3 400 mg capsules 3x/day; two 400 mg STX capsules 2-3x/day
SEC: Commission E reports counter indications for hypertension. (AEHD) Though generally
regarded as safe by non-FDA types, use is not recommended "for patients in febrile states,
hypertonic crisis or myocardial infarction."
SKULLCAP (Scutellaria laterifolia) ++
ACT: Antispasmodic; Astringent; Bitter; Demulcent; Hypotensive; Nervine; Sedative; Tonic
IND: Headache; Insomnia; Nervous Tension; Stress
POS: 3-9 g root
SEC: "There is no evidence to indicate the Scutellaria is toxic when ingested at normal doses."
The FDA has suggested that overdose of the tincture causes confusion, convulsions, giddiness,
pulsar irregularities, and twitching. Reported fatality in Norway possibly Scutellaria; possibly
Teucrium, a frequent adulterant.
SLIPPERY ELM (Ulmus rubra) +++ OTC
ACT: Demulcent; Emollient
IND: Cough; Cuts; Gastritis; Sore Throat; Stomach Distress
POS: 0.5-2 g powdered bark/cup, 2-3x/day; two 340 mg capsules as needed
SEC: While I consider slippery elm safer than coffee, LRNP (Mar, 1991) says "preparations of
slippery elm had been used as abortifacients." Oleoresins from several elm species can cause
dermatitis. Pollen is allergenic.
ST. JOHN'S-WORT (Hypericum perforatum) +++ OTC
ACT: Antidepressant, Antiinflammatory, Antiviral; Monoamine-Oxidase-Inhibitor; Tranquilizer
IND: Burns; Depression, HIV; Insomnia, Stress
POS: 2-4 g dry herb (0.2-1 mg hypericin)/day; 300 mg STX (0.3% hypericin) 3x/day ; one 425 mg STX 2x/day
SEC: active ingredients may be photoactive, especially in fair-skinned people. Reichert takes it
even more seriously. Although hypericum is not as strong as synthetic MAO inhibitors, patients
should still avoid the things usually avoided when taking MAO's: high tyramine foods (smoked
or pickled), alcoholic beverages; amphetamines, cold and hay fever remedies, narcotics,
tryptophan, tyrosine. Do not take during pregnancy or intense sun exposure. Foster (1996) is
moderate. St. John's-wort should not be mixed with synthetic antidepressants. Because it may
inhibit MAO, taking it with selective serotonin reuptake inhibitors such as Prozac could cause
serious health damage... Although side effects have not been reported in clinical studies, range
animals eating the plant and then standing in bright sunlight have experienced sunburn or
blindness from photosensitization. . .This treatment option should be discussed with your
health-care provider.
TEATREE OIL (Melaleuca spp.) ++ OTC
ACT: Antiseptic; Fungicide
IND: Candidiasis; Fungi; Infections; Onychiosis
POS: Topical as directed STX (>30% terpinen-4-ol; <15% cineole); 0.05-0.2 ml Cajuput Oil
SEC: Topical and vaginal irritation have been reported, but the "topical use of the oil has not
generally been associated with toxicity." Still, "the topical use...cannot be recommended at this
time" (LRNP-Jan 91) As with most essential oils, this one may induce dermatitis in sensitive
individuals.
TURMERIC (Curcuma longa) +++ OTC
ACT: Antiinflammatory; Antilymphomic; Antitumor
IND: Arthritis, Lymph Gland Dysfunction; Rheumatism
POS: 1,200 mg curcumin; one 445 mg STX capsule 2-3 x/day
SEC: While in moderate doses, turmeric is said to inhibit cancers, lymphomas and ulcers,
overdoses of curcuminoids may possibly be cytotoxic and ulcerogenic and may lead to
dimunition of red and white corpuscles. Still Comm. E approves 1.5-3 g/day, not nearly enough
to provide 1,200 mg curcumin. Commission E also reports counterindications: biliary
obstruction, adverse effects: GI-irritation from continued use.
VALERIAN (Valeriana officinalis) +++
ACT: Antispasmodic; Carminative; Nervine; Sedative; Stomachic; Tranquilizer
IND: Anxiety; Insomnia; Menstrual Cramps; Nervous Tension; Stress
POS: 2-3 g/day; 300-400 mg STX (0.5% essential oil)/day; three 475 mg capsules 3 x/day; 3-6 475 mg/capsules ½ hr before bed
SEC: No counter indications, adverse effects, or interactions except for the effect of the tincture
on driving ability.
WHITE WILLOW (Salix alba) ++OTC
ACT: Analgesic; Antitinflammatory; Antipyretic; Astringent
IND: Arthritis; Fever; Gout; Headache; Pain; Rheumatism; Toothache
POS: 1-2 g bark (20-40 mg salicin), 1-3x/day; 2-3 380 mg/capsules every 3 hrs
SEC: Commission E reports for oral use of bark, counter indications, adverse effects, and
interactions: on theoretical grounds similar to those of the salicylates.
WILD YAM (Dioscorea villosa) +++
ACT: Antiinflammatory; Starter material for progesterone, testosterone and other steroids
IND: Steroids used for arthritis, dysmenorrhea, menopause, PMS
POS: 2-4 ml Liquid Extract; two 505 mg capsules/day; one 505 mg STX capsule/day
SEC: While the medicinal yams are so rich in saponins as to be distasteful, over consumption is
not to be recommended. Reichert (1996) reports GI distress in volunteers taking high doses of
wild yam, after saying that the investigators (Araghiniknam et al, 1996) he was reviewing "noted
no adverse effects".
WITCH HAZEL (Hamamelis virginiana) ++ OTC
ACT: Astringent
IND: Bruises; Dermatitis; Diarrhea; Gingivitis; Hemorrhoids; Varicose Veins
POS: Topical
SEC: "It is not recommended that these extracts be taken internally because the toxicity of the
tannins has not been well defined ... Doses of 1 g of witch hazel will cause nausea, vomiting or
constipation." (LRNP, Sep, 1990)
YUCCA (Yucca elata) +++
ACT: Antiinflammatory; Starter Material for Steroids
IND: Steroids used for arthritis, dysmenorrhea, menopause, PMS
POS: Three 490 mg capsules 3x/day
SEC: Though large doses of saponins can be hemolytic and problematic, "little is known about
the toxicity of yucca saponins." (LRNP, Mar, 1994)
SOURCES
Anon. 1986. Feverfew: A Folk Migraine Remedy for Migraine? Harvard Med. School Health
Letter 2(6): 6-7.
Araghiniknam, M., Chung, S., Nelson-White, T., et al. Antioxidant activity of Dioscorea and
dehydroepiandrosterone (DHEA) in older humans. Life Sci 1996; 59:147-57. Rev. by Reichert
R., QRNM (Winter 1996) p. 257-58.
Barney, D.P. 1996. The Cranberry Cure. Herbs for Health (Nov-Dec) 45-47.
Bisset, N.G., ed. 1994. Herbal Drugs and Phytopharmaceuticals. (English translation of Wichtl,
1984, 1989). CRC Press. Boca Raton, FL. 566 pp.
Cantelli-Forti, G.F., et al. 1994. Interaction of licorice on glycyrrhizin pharmacokinetics. Envir.
Health Pers. 102 (Suppl. 9): 65-8.
Castleman, M. 1996. Spice-Rack Remedies - Turn to your kitchen for health care. Herbs for
Health (Nov-Dec) 22-29.
De Smet, et al., eds. 1992. Adverse Effects of Herbal Drugs.
Foster, S. 1996. Fighting depression the herbal way. Herbs for Health (Nov-Dec) 51-52.
Foster, S. 1996. Herbs for your health - a handy guide for knowing and using 50 common herbs.
Interweave Press, Loveland CO 80537-5655.
Lamberg, L. 1996. Melatonin potentially useful but safety, efficacy remain uncertain. J.
American Medical Association 276(13):1011-14 (reviewed by JAD).
LRNP=Lawrence Review of Natural Products
QRNM=Quarterly Review of Natural Medicine.
Reichert, R. Treatment of anxiety with kava-kava. Quarterly Review of Natural Medicine;
Winter: 249-50. 1996. (Review of Lehmann paper.)
Reichet, R. Yam and DHEA. Quarterly Review of Natural Medicine Winter:257-58. 1996.
(Review of Araghiniknam et al. paper.)
Time-Life, editors. 1996. The Medical Advisor. The Complete Guide to Alternative &
Conventional Treatments. Time Life, Inc., Alexandria Va. 1152 pp.
Tyler, V.E. 1994. Herbs of Choice - The Therapeutic Use of Phytomedicinals. Pharmaceutical
Products Press, New York. 209 pp. 1994.
Williamson, E.M. and Evans, F.J., Potter's New Cyclopaedia of Botanical Drugs and
Preparations, Revised Ed., Saffron Walden, the C. W. Daniel Co., Ltd., Essex UK, 362 pp,
1988, reprint 1989.
Yarnell, E. and Meserole, L. 1996. Topical applications of botanical medicine. Alt. & Comp.
Ther. 2(4):241-4.
Herbal Alternative Indication Physician's
"Farmaceutical" Pharmaceutical
Aloe Burns Silvadene cream
Aloe Ulcers Abx (Antibiotics)
Bearberry Cystitis Bactrim; Pyridium
Bilberry Diarrhea Imodium, Lomotil; Kaopectate
Bilberry Nyctalopia Vitamin A derivatives (NH)
Bilberry Retinopathy
Bilberry Varicosities ASA, Motrin; Dcleral Therapy
Bugleweed Graves Disease Iodine, PTU, Beta-Blocker
Calendula Acne Retin-A; Tetracycline
Calendula Sprain NSAIDS
Camomile Allergy Corticosteroids; Antihistamines
Camomile Dyspepsia Pepcid; Antacids; Reglan
Camomile Eczema Hydrocortisone cream
Camomile IBS Librax, Donnogel-PG; Donnatal
Capsicum Arthritic Pain Tylenol, NSAIDS
Capsicum Myalgia NSAIDS, Cyclobenzabrene
Capsicum Shingles Acyclovir; Famcyclovir
Celery Seed Arthritis NSAIDs
Celery Seed Hyperiuricemia Allopurinol
Chaste Tree Mastodynia NSAIDS
Chaste Tree PMS NSAIDS: SSRI; diuretics; analgesics
Clove Toothache Ibuprofen; Aspirin
Clover Cancer Taxol; Chemotherapy
Coca Leaves Altitude Sickness O2; Diamox
Comfrey Decubitis Proshield
Comfrey Diabetic Ulcers Antibiotics, if infected
Cranberry Cystitis Bactrim; Antibiotics
Echinacea Adenoids See Allergy Treatment
Echinacea Bronchitis Abx; Atropine,Codeine; Dextromethorphan
Echinacea Cold Decongestants; OTCs; Tylenol
Echinacea Earache Abx, Decongestants
Echinacea Flu Tylenol, OTCs
Echinacea HIV Indinavir: Ritonavir; Lamuvidine
Echinacea Rhinitis Cromalyn; Varcenase; Phenylpropolamine
Eggplant/Willow B-Cell Carcinoma Chemotx
Ephedra Narcolepsy Modafinil; Tricyclics
Evening Primrose Alcoholism Antabuse, Prozac
Evening Primrose Atopic eczema Steroids
Evening Primrose Att. Def. Disorder Ritalin; Some antidepressants
Evening Primrose Insomnia Halcion; Valium
Evening Primrose Mastodynia Ambien; NSAIDS; Progesterone
Evening Primrose Obesity Fen/Phen; Prozac; Redux
Evening Primrose PMS NSAIDS, Diuretics ; Analgesics
Faba Bean Parkinsonianism Amantadine; L-Dopa; Sinemet
Faba Beans Tardive dyskinesia Sinemet, Amantadine; Cosentrin
Fennel Gas Mylanta/Gaviscon; Simethicone
Fennel Oligolactea Prolactin
Fenugreek Hypercholesterolemia Mevacor, Niacin; Zocar
Fenugreek Micromastia Silicon
Feverfew Migraine Cafergot; Sumatriptan, Verapamil
Garlic Arteriosclerosis (Vasodilators) Hydralazine
Garlic/beans Diabetes II Diabeta, Metformin; Sulfuryurea
Garlic Encephalitis Interferon; Vidarabine
Garlic/beans Hypertension HCTE, Beta blockers, ACE-inhibitor
Garlic Yeast Lotrimin, Nystatin
Ginger Arthritis Tylenol, NSAIDS; Steroids
Ginger Dyspepsia Pepsid, antacids (NH)
Ginger Morning Sickness Vit. B6, Ginger, OTCs
Ginger Motion Sickness Scopolamine, Dramamine
Ginger Vertigo Miclizine, Antihistam.; Antiemetics
Ginkgo Alzheimer's Tacrine (Cognex)
Ginkgo Cerebral Circ. None
Ginkgo Interm. Claudication Trental
Ginkgo Tinnitus Steroids (rarely work)
Ginkgo Vertigo Meclizine, Antihist;Benzquidamide
Gobo/Tumeric Lymphoma Cortisone; Prednisone
Goldenseal Cankers Ambesol
Goldenseal Giardia Flagyl, Chloraquine
Goldenseal Gingivitis Abx; Peridex
Goldenseal Tonsilitis Abx
Goldenseal Vaginitis Clindamycin; Flagyl
Goldenseal Yeast Clotrimazole; Femstat; Monostat
Hawthorn Angina Beta-blocker; Nitroglycerin
Hawthorn Cardiomyopathy (Prev.) ACE-Inhib.; Vasodilators
Honeysuckle/Forsythia Incipient Flu No equivalent treatment
Hops Anxiety Ativan, Xanax, Klonopin, Paxil
Hops Insomnia Ativan, Halcion, Klonopin, Paxil
Horsebalm Alzheimer's Cognex (Tacrine)
Horse Chestnut Varicosities Heat/ASA
Horse Chestnut Ulcus cruris (Decubitus)
Hypericum Depression Prozac, Elavil, Trazadone, Zoloft
Jewelweed Poison Ivy Hydrocortisone cream
Jewelweed Urticaria Benadryl/Atarax; Antihist.
Kava/kava Anxiety Ativan, Klonopin; Paxil; Xanax
Kava/kava Dysmenorrhea Naprosyn
Kava/kava Stress Diazepam
Kudzu Alcoholism Antabuse
Lemonbalm Herpes Acyclovir, Zovirax
Lemonbalm Insomnia Ativan; Halcion;Klonopin; Paxil;
Licorice Ulcers Abx; Antacids; Beta-Block;Zantac
Marijuana Glaucoma Pilocarpine, Betophic, Timoptic
Milk Thistle Hepatitis (Prev.) Interferon
Milk Thistle Cirrhosis No Effective Treatment
Milk Thistle Mushroom Intoxication No Effective Treatment
Mountain Mint Tick Repellant Deet
Passionflower Anxiety Adapin; Librium; Valium
Pectin Hypercholsterolemia Mevacor, Niacin; Zocar;
Peppermint Colitis Sulfalasalazine
Peppermint Diverticulitis Abx
Peppermint IBS Librax, Donnogel-PG; Donnatal Prickly Ash Toothache NSAIDS; Analgesics
Quinidine Arrhythmia Beta-Block; Digoxin; Procainamide;
Raspberry Diarrhea Imodium
Raspberry Dysmenorrhea NSAIDS
Rosemary Alzheimer's Cognex (Tacrine)
Rutin Telangectasia Laser
Saw Palmetto BPH Hytrin, Proscar
Saw Palmetto Male Pattern Baldness Rogaine
Senna Irregularity Metamucil
Stinging Nettle Hayfever Antihist.; Decong.; Pseudoephedrine
Stinging Nettle Osteoporosis Caleiferrin, ERT, Fosomax
Stinging Nettle Prostatic Dysuria Abx; Hytrin; Proscar
Sweet Annie Malaria Chloroquine; Daraprim; Lariam;
Sweet Annie Virus Acyclovir, Zovirax
Sweet Annie Yeast Clotrimazole; Femstat; Monostat Teatree Athlete's Foot Griseofulvin
Teatree Boils Erythromycin; Other Abx
Teatree Infection Erythromycin; Other Abx
Teatree Onychyosis Sporonox; Ketoconazole
Thymol/Carvacrol Low Back Pain NSAIDS, Analgesics; Myorelax
Turmeric Arthritis Amalgesics; NSAIDS; Tylenol
Turmeric Lymphoma Chemotherapy
Valerian Anxiety Xanax, Valium Adapin ; Librium
Valerian Insomnia Xanax, Seconal
Willow Angina Nitroglycerin
Willow Arthritis NSAIDS, Tylenol, Analgesics
Willow Toothache Ibuprofen; Aspirin
Wintergreen Myalgia NSAIDS, Cyclobenzabrene
Yohimbe Impotence Yohimbine; Testosterone
Yohimbe Narcolepsy Modafinil; Tricyclics