References

Acute ethanol poisoning and the ethanol withdrawal syndrome. Med Toxicol Adverse Drug Exp 3.3 (1988) 172-96. Alguire PC. Rapid evaluation of comatose patients. Postgrad Med 87.6 (1990) 223-8, 233. Beers MH, Berkow R (eds). The Merck Manual of Diagnosis and Therapy, 17th edn. Whitehouse, NJ Merck and Co. Inc, 2003. Blanc P, Boussuges A. Is thiamin supplementation necessary in patients with cardiac insufficiency Abstract . Ann Cardiol Angeiol 50.3 (2001) 160-8. Blass JP et al....

Lipidlowering Activity

Although the mechanism of action is yet to be fully explained, studies show that chromium supplementation may decrease triglyceride levels, total and LDL-cholesterol and modestly increase HDL-cholesterol (Bahijri 2000, Lee & Reasner 1994, Press et al 1990, Preuss etal 2000). ANTIDEPRESSANT NEUROTRANSMITTER EFFECTS Depression is often associated with insulin resistance, owing to Cortisol overproduction (McCarty 1994). The reputed antidepressant effects of chromium may be explained by...

Premenstrual Syndrome

Magnesium deficiency may contribute to the symptomology of PMS, which may be improved by chocolate or cocoa powder, which contain a high concentration of magnesium ( 100 mg 100 g in chocolate and 520 mg 100 g in cocoa powder). There is also some evidence to suggest that serotonin levels are low premenstrually, and it is possible that premenstrual chocolate cravings are the body's attempt to raise CNS concentrations of serotonin (Bruinsma & Taren 1999).

Glossary And Abbreviations

Abortifacient - Substance used to terminate a pregnancy. ACE - angiotensin-converting enzyme ACTH - adrenocorticotropic hormone Active constituents - Chemical components that exhibit pharmacological activity and contribute to the agent's overall therapeutic effects. Acute - Beginning abruptly sharp and intense subsiding after a short period. Adaptogen - Innocuous agent, non-specifically increasing resistance to physical, chemical, environmental, emotional or biological factors ('stressors') and...

Contraindications And Precautions

In patients who are sensitive to iron overload, vitamin C supplementation may exacerbate iron toxicity by mobilising iron reserves. As such, vitamin C supplementation should be used with caution by people with erythrocyte glucose-6-phosphate dehydrogenase deficiency, haemochromatosis, thalassaemia major or sideroblastic anaemia. Supplemental vitamin C can affect the results of numerous laboratory tests and n , i j i j. j Vitamin C 1296 urine 17-hydroxy corticosteroids Clinical note Is the...

Impotence

In men, zinc deficiency may lead to impaired testosterone synthesis, resulting in hypogonadism and impotency. One placebo-controlled study has investigated whether oral zinc supplementation improves erectile dysfunction. The study involved 20 uraemic haemodialysis patients and showed that 6 months treatment with oral zinc acetate (25 mg elemental zinc) taken twice daily 1-2 hours before meals resulted in greater libido, improved potency and more frequent intercourse compared to placebo (Mahajan...

Chemical Components

Green-lipped mussel contains minerals, mucopolysaccharides and numerous other constituents however, the protein and lipid content is considered the most important for pharmacological activity. Virtually all of the protein content is comprised of pernin, a self-aggregating glycoprotein rich in histidine and aspartic acid (Scotti et al 2001). A Iipid-rich extract, prepared by supercritical fluid (C02) extraction of freeze-dried stabilised NZ green-lipped mussel, is commercially available as...

Antiretroviral And Antibacterial

Although in vitro and studies in animal models have identified antiretroviral activity for hypericin and pseudohypericin (Meruelo et al 1988), two clinical trials could not confirm these effects, even when larger doses of hypericin were administered (Gulick et al 1999, Jacobson et al 2001). The mechanism involved is not known however, it is suspected to involve direct inactivation of the virus or prevention of virus shedding, budding or assembly at the cell membrane (Meruelo et al 1988). The...

Adverse Reactions

The safety of curcumin is demonstrated by the fact that it has been consumed for centuries at levels of up to 10 mg day by people in certain countries (Ammon & Wahl 1991). Curcumin was not toxic to humans in doses up to 8000 mg day when taken by mouth for 3 months (Cheng et al 2001). Multiple other human trials have also found it to be safe with no alteration of liver or renal function tests (Chainani-Wu 2003, Prucksunand et al 2001, Ramirez-Bosca et al 1995, Ramirez et al 1997, Sharma etal...

Antibacterial Activity

Green tea extract has moderate and wide-spectrum inhibitory effects on the growth of many types of pathogenic bacteria, according to in vitro tests, including seven strains of Staphylococcus spp., seven strains of Streptococcus spp., one strain of Corynebacterlum suls, 19 strains of Escherichia coll and 26 strains of Salmonella spp. (Ishihara et al 2001). Green tea has also been found to inhibit Helicobacter pylori in an animal model (Matsubara et al 2003). According to one study, which...

Chamomile

Historical note Chamomiles have been used as medicines since antiquity and traditionally grouped in botanical texts under the same general heading. They were probably used interchangeably. Roman chamomile was reportedly used to embalm the Egyptian Pharaoh, Ramses II, and is thought to have been introduced into Britain bythe Romans during their conquests. The Anglo-Saxons used chamomile, presumably the Roman chamomile, as one of their nine sacred herbs. Culpeper lists numerous ailments for which...

Ginseng Korean

Historical note Gin refers to man and seng to essence in Chinese, whereas Panax is derived from the Greek word pan (all) and akos (cure), referring to its use as a cure-all. Ginseng is a perennial herb native to Korea and China and has been used as a herbal remedy in eastern Asia for thousands of years. It is considered to be the most potent Qi or energy tonic in TCM. Modern indications include low vitality, poor immunity, cancer, cardiovascular disease and enhancement of physical performance...

Quality Of Life

An 8-week, randomised, double-blind study found that 200 mg day ginseng (n 1 5, placebo n 1 5) improved aspects of mental health and social functioning after 4 weeks' therapy but that these differences disappeared with continued use (Ellis & Reddy 2002). A review of eight clinical studies with ginseng found some improve- Ginseng_Korean 561 ment in QOL scores. However, the findings were equivocal. Despite some positive results, Improvement In overall health-related QOL cannot, given the...

Cardiovascular Effects

According to in vitro and animal studies ginseng may benefit the cardiovascular system 'through diverse mechanisms, including antioxidant, modifying vasomotor > 2007 Elsevier Australia function, reducing platelet adhesion, influencing ion channels, altering autonomic neurotransmitters release, improving lipid profiles', and glycaemic control (Zhou et al 2004). Antihypertensive Red ginseng has been used as an antihypertensive agent in Korea, but its clinical effect is unclear despite several...

Antihypertensive

In the 1970s Yamagami et al observed a deficiency in CoQ10 in patients with hypertension (1975, 1976) and suggested that correction of the deficiency could result in hypertensive effects. Small studies were initially conducted with hypertensive patients identified as CoQ10 deficient. Since then, significant antihypertensive activity has been observed in several clinical studies (Burke et al 2001, Digiesi et al 1994, Langsjoen et al 1994), however, not all have identified the subjects' baseline...

Elevated Triglyceride Levels

DHA and EPA supplementation significantly reduces triglyceride levels and is used as sole therapy in cases of elevation or as adjunctive therapy with cholesterol-lowering medication when indicated. According to Din et al, omega-3 fatty acids reduce triglyceride concentrations in a dose-dependent manner, with intakes of about 4 g day lowering serum triglycerides by 25-30 (Din et al 2004). Overall, it appears that the smallest amount of omega-3 PUFA needed to lower serum triglyceride levels...

Anticarcinogenic Activity

Observational epidemiological studies have consistently shown a relationship between dietary beta-carotene intake and low risk of various cancers (Cooper et al 1999b, Pryor et al 2000). In animal studies beta-carotene has been found to be chemoprotective, with inhibition of spontaneous mammary tumours (Fujii et al 1993, Nagasawa et al 1991), as well as prevention of skin carcinoma formation (Ponnamperuma et al 2000), UV-induced carcinogenesis in mice (Epstein 1977, Mathews-Roth 1982) and oral...

Primary Deficiency

Iodine deficiency results when iodide intake is < 20 fjg day (Kasper et al 2005). In situations of moderate deficiency, TSH induces thyroid hypertrophy in order to concentrate iodide, resulting in a goitre. Most of these cases remain euthyroid, but in cases of severe iodine deficiency, myxoedema may result in adults and cretinism in infants, both of which are serious conditions. Myxoedema is characterised by swelling of the hands, face, feet and peri-orbital tissues and can lead to coma and...

Plant Part Used Chemical Components

Baical skullcap contains numerous flavonoids and their glycosides. The main flavonoids are baicalin and its aglycone, baicalein and wogonin. Resin and tannins are also present. Baical also contains melatonin. It has been shown that dietary melatonin directly contributes to the circulating level of the hormone. The clinical effects of plant-derived melatonin remains to be investigated (Hardeland & Poeggeler 2003). Baicalin itself is poorly absorbed from the gut, but is hydrolysed to its...

Significant Interactions

Calcium carbonate when taken as an antacid alters the absorption and excretion of a wide range of drugs. Please refer to a drug interaction guide for specific concerns. Only those interactions encountered with oral administration of calcium supplements will be included in this section. ZINC Calcium supplementation has been shown in some studies to increase faecal losses of zinc (McKenna et al 1997) ensure adequate zinc intake and monitor for signs and symptoms of deficiency.

Inhibit Platelet Function

Numerous dietary intervention studies in humans and animals indicate that flavanol-rich foods and beverages might exert cardioprotective effects with respect to vascular function and platelet reactivity (Keen et al 2005). Acute doses of flavanols and oligomeric procyanidins from cocoa have been observed to inhibit platelet activation (Pearson et al 2002, Rein et al 2000b) and have an aspirin-like effect on primary hemostasis 2 and 6 hours after consumption (Hermann et al 2006, Pearson et al...

Dermatological Uses

Vitamin C is used as an oral supplement or topical application in a number of dermatological conditions. Wound healing Vitamin C is important for effective wound healing, as deficiency contributes to fragile granulation tissue and therefore impairs the wound-healing process (Russell 2001). In vitro studies with skin graft samples have demonstrated that vitamin C extends cellular viability, promotes formation of epidermal barrier and promotes engraftment (Boyce et a I 2002). In this way, vitamin...

Elevated Lipid Levels

Several clinical studies conducted in people with and without diabetes have identified significant lipid-lowering activity with different fenugreek preparations, such as defatted fenugreek, germinated seed and hydro-alcoholic extracts (Bordia et al 1997, Gupta et al 2001, Sharma et al 1990, Sowmya & Rajyalakshmi 1999). As can be expected, the dose used and type of preparation tested has an influence over results. An open study using a daily dose of 18.0 g germinated fenugreek seed in healthy...

Enhanced Cognition

Therapeutically, tyrosine supplements are used to enhance levels of its derivatives and, therefore, improve cognitive function. One randomised, placebo-controlled study investigated the effects of L-tyrosine (1 50 mg kg) on cognitive performance following one night's sleep loss. Supplementation was found to significantly reduce performance decline, with cognitive improvements lasting approximately 3 hours (Neri et al 1995). RCTs comparing the effects of a balanced amino acid drink with one...

Sweet Taste Suppression

The constituent, gymnemic acid, inhibits the ability to taste sweetness in animal models (Fushiki et al 1992, Harada & Kasahara 2000, Kurihara 1969, 1992) and humans (Frank et al 1992). In humans, the administration of 5 mmol L gurmarin to the tongue raised the threshold ability to taste sucrose from 0.01 mol L to 1 mol L for several hours. It is suggested that gurmarin acts on the apical side of the taste cell, possibly by binding to the sweet taste receptor protein (Miyasaka & Imoto...

Heart Disease

Elevated homocysteine levels Elevated fasting plasma concentrations of homocysteine have a high prevalence in subjects with cardiovascular disease and have also been associated with an increased risk of atherothrombosis in most, but not all, prospective studies (van Guldener & Stehouwer 2001). Clinical studies have found that supplementation with vitamin B6 significantly reduces plasma homocysteine concentrations (Lakshmi & Ramalakshmi 1998). In practice, pyridoxine is typically...

Herpes Infection

Based on the herb's antiviral activity against HSV-1 in vitro, it is also used in the treatment of herpes infections. Genital herpes A prospective, double-blind, placebo-controlled crossover trial conducted over 1 year investigated the effects of an extract of the plant and root of E. purpurea (Echinaforce 800 mg twice daily) on the incidence and severity of genital herpes outbreaks in 50 patients (Vonau et al 2001 ). The study found no statistically significant benefit compared with placebo...

Olive

Historical note The olive tree is among the oldest known cultivated trees in the world. Several biblical references to olive suggest its use dates back to ancient times and victors in the early Olympic Games were crowned with its leaves. Olives and its associated products have been used widely as folk medicines in countries such as Spain, Italy, France, Greece, Israel, Morocco, Tunisia, Turkey and the Mediterranean islands. Today, the olive plant is most well known for its fruit crop and oil....

Antioxidant

Quercetin is a phenolic antioxidant and has been shown to inhibit lipid peroxidation, protecting the lens of the eye (Cornish et al 2002) and renal tubular epithelial cells from oxidant-induced injury (Pietruck et al 2003). The antioxidant activity may be the result of free radical scavenging, metal chelation, enzyme inhibition or the induction of protective enzymes (Erlund 2004). Quercetin treatment for short periods exerts an antioxidant effect whereas long-term treatment may produce an...

Answers To Patients Frequently Asked Questions

Astragalus appears to have numerous biological effects, such as digestive and immune system stimulation and heart muscle stimulation. Early research suggests that it may have a role in the treatment of asthma, memory deficits, elevated cholesterol levels and as an adjunct to chemotherapy treatment for cancer. When will it start working This will depend on the indication and dose some studies have shown that effects can begin within 2 weeks. Are there any safety issues Overall the herb appears...

Congestive Heart Failure

Muscle fatigue due to loss of skeletal muscle mass and strength, decreased oxidative capacity and other abnormalities of muscle metabolism have been associated with congestive heart failure. As a result, creatine supplementation has been suggested as a possible therapeutic agent in this condition. A dose of 10 g creatine daily for 7 days significantly increased exercise capacity and muscle strength compared to placebo in a double-blind study involving 17 men with congestive heart failure...

Antiinflammatory

Chondroitin exerts an anti-inflammatory action with an inhibitory effect over complement (Pipitone 1991). In an in vitro study of bovine cartilage, chondroitin alone and in combination with glucosamine was found to regulate gene expression and synthesis of NO and PGE2, suggesting a basis for its anti-inflammatory properties (Chan et al 2005). Chondroitin sulfate has been found to increase the levels of antioxidant enzymes and reduce inflammation and cirrhosis of liver tissue in an...

Pregnancy Use

Ginseng is traditionally used in Korea as a tonic during pregnancy. The Commission E Ginseng Korean 566 does not list any restrictions (Blumenthal 2001). However, due to the potential teratogenicity of some compounds (ginsenoside Rb1 ) observed under experimental conditions, ginseng should be used cautiously during the first trimester of pregnancy (Chan et al 2003). In a two-generation rat study, a ginseng extract fed at doses as high as 1 5 mg kg day did not produce adverse effects on...

Hypoglycaemic

The hypoglycaemic effect of fenugreek seeds has been demonstrated in numerous studies involving experimentally induced diabetes (both type 1 and type 2) in rats, Fenugreek 407 dogs, mice, rabbits and humans (Alarcon-Aguilara et al 1998, Madar et al 1988, Raju 2007 Elsevier Australia et al 2001, Ribes et al 1984, 1986, Riyad et al 1988, Sharma et al 1990, Vats et al 2002), and the effect has been described as slow but sustained (Puri et al 2002). Interestingly, no reduction of fasting or...

Benign Prostatic Hypertrophy

Isoflavone-containing supplements are widely used in patients with BPH. Recently, an in vivo study using mice showed that red clover-derived isoflavones have a significant effect on prostatic growth, and are capable of reducing the tendency to enlarged non-malignant prostate, by acting as anti-androgenic agents rather than weak oestrogenic substances (Jarred et al 2003). A case series (n 29) presented at the Endocrine Society's 82nd Annual Meeting in 2000 suggested that 3 months of Red clover...

Secondary Deficiency

This may develop in conditions associated with diarrhoea, cirrhosis or malabsorption, as well as after extensive postoperative use of parenteral nutrition lacking adequate niacin. Pellagra may occur during prolonged isoniazid therapy (the drug replaces niacinamide in NAD), in malignant carcinoid tumour (tryptophan is diverted to form 5-hydroxytryptamine), and in Hartnup disease, an autosomal recessive disorder in which there is defective conversion of tryptophan to niacin (Beers & Berkow...

Cancer Treatment

Overall, the current evidence does not support the use of green tea as a cancer treatment however, there are some exceptions, which suggest an adjunctive role. Green tea increased the survival rate of patients with epithelial ovarian cancer in a cohort of 309 Chinese women (Zhang et al 2004). Most (77.9 ) of the women in the treatment group were alive at the 3-year follow-up as compared with 47.9 of the control group. In a RCT, 90 patients with cervical lesions infected with human papilloma...

Improved Physical Performance And Preservation Of Muscle Mass

BC has been used by athletes mainly as a natural source of IGF-I because it has an anabolic effect and is involved in the regulatory feedback of growth hormone. It is taken in the belief that protein catabolism will be reduced during intense training periods and physical performance will improve. A double-blind crossover study of nine male athletes confirmed that ingestion of BC (125 miyday Bioenervie, Viable Byproducts) resulted in elevated concentrations of IGF-I however, no significant...

Cancer Prevention

Epidemiological studies have generally shown a decreased occurrence of cancer in those individuals who drink green tea regularly, although this has not been observed in all studies. A 2003 prospective cohort study using 13-year follow-up data found increased green tea consumption was associated with an apparent delay of cancer onset and death, and all cause deaths (Nakachi et al 2003). A phase 2 RCT evaluated the effects of green tea on oxidative DNA damage in 143 heavy smokers over 4 months...

Hepatoprotection

Dong quai is said to improve abnormal protein metabolism in people with chronic hepatitis or hepatic cirrhosis. Evidence comes from an in vivo study in which 5 dong quai was added to the daily diet of rats, resulting in enhanced metabolism, increased hepatic oxygen utilisation, and increased glutamic acid and cysteine oxidation (Micromedex 2003). Dong quai has been found to have antioxidant activity (Wu et al 2004), as well as antiproliferative and pro-apoptotic activities in hepatic stellate...

Dermatological Conditions

Vitamin E is used both as an oral supplement and as a topical preparation in a variety of dermatological conditions. It is a popular ingredient in many moisturising preparations used to alleviate dry and cracked skin, assist in the repair of abrasions, burns, grazes and skin lesions, prevent stretch marks and diminish scar tissue. Vitamin E oil is used as a stand-alone preparation or incorporated into a cream or ointment base for these purposes. Sunburn protection Topical application of 1...

Prevention Of Cardiovascular Disease

The association between vitamin C and cardiovascular disease prevention is still unclear, although several themes are emerging as evidence accumulates. In general, laboratory, epidemiological and observational follow-up studies suggest that vitamin C is associated with reduced incidence of cardiovascular disease although not all studies are positive (Houston 2005). Studies have looked at blood levels, dietary intake and supplemental vitamin C and in some studies, vitamin C is co-administered...

Recommendations

Avoid there may be insufficient information available to be able to advise using the two substances safely together, so avoid until more is known. The drug may have a narrow therapeutic index and there is sufficient evidence to suggest that the interaction may be clinically significant. Consider an alternative treatment that is unlikely to produce an undesirable interaction. Avoid use unless under medical supervision harmful effects of the potential interaction can be avoided if doses are...

Cardioprotective

During inflammation, circulating conjugates of quercetin pass through the endothelium to reach vascular smooth muscle cells where they exert their biological effects and are then deconjugated (Mochizuki et al 2004). The cardioprotective effects of quercetin may be related to its vasorelaxant (Ke Chen & Pace-Asciak 1996, Roghani et al 2004), anti-inflammatory and antioxidant properties and inhibition of vascular smooth muscle cell proliferation and migration Quercetin 976 (Alcocer et al 2002,...

Cardiac Surgery

The use of CoQ10 supplementation before cardiac surgery has been studied since the early 1980s. Since that time, growing evidence suggests that CoQ10 can reduce reperfusion injury after coronary artery bypass surgery, reduce surgical complications, accelerate recovery times and possibly shorten hospital stays (Chello et al 1996, Chen et al 1994, Judy et al 1993, Rosenfeldt et al 2002, Taggart et al 1996, Tanaka et al 1982, Zhou et al 1999). In general, the studies that achieved positive results...

Dosage Range

Powdered turmeric 1.5-3 g day in water or cooking. Liquid extract (1 1) in 45 ethanol 5-1 5 miyday. Powdered extract standardised to 95 curcumin 100-300 mg day. Higher doses used for arthritis and cancer. Turmeric powder of standardised powdered extract applied as a paste or poultice half cup of turmeric combined with 1 teaspoon of carbonate of soda and then mixed with hot water to make a paste spread on gauze and apply to affected area.

Mild Inflammation Of The Mouth And Throat

The considerable astringent, anti-inflammatory and anti-oedema activity of bilberry provides a theoretical basis for its use as a topical application in these indications. Commission E approved for this indication (Blumenthal et al 2000). HAEMORRHOIDS, VARICOSE VEINS, VENOUS INSUFFICIENCY The considerable astringent, anti-inflammatory and anti-oedema activity of bilberry provides a theoretical basis for its use in these conditions. Several human case series and a single-blind trial report...

Seasonal Affective Disorder

Wheatley found that people with mild to moderate SAD experienced significant improvements with anxiety, loss of libido and insomnia after 8 weeks' treatment with SJW (Wheatley 1999). The test group receiving SJW extract (Kira 300 mg) three times St John's wort 1028 daily plus light therapy experienced superior sleep compared with the group receiving SJW as stand-alone treatment.

Protective Effects Against Cancer

A 2001 critical review of the epidemiological evidence suggests a preventive effect for garlic consumption in stomach and colorectal cancers, but not other cancers (Fleischauer & Arab 2001). In regard to gastric cancer protection, case-control studies suggested a protective effect for raw and or cooked garlic when eaten at least once a week whereas protective effects against colorectal cancer seem to require at least two servings of garlic per week. A similar view was reported in a 2003...

According To Clinical Studies

Asthma 100-200 g day of sodium selenlte. Cancer prophylaxis 200 g day selenium (supplied as 500 mg brewer's yeast). Mood disturbances 100 g day. Post myocardial infarction selenium-rich yeast 100 g day. Rheumatoid arthritis 200 g day. Autoimmune thyroiditis 200 g day sodium selenite. HIV positive status 80 g day has been used but it is most likely that higher doses are required.

Diabetes

Vitamin C has several actions that provide a basis for its use in diabetes. It has been reported to lower erythrocyte sorbitol concentrations (important for preventing 2007 Elsevier Australia complications in type 1 diabetes), improve endothelial function (important for slowing atherosclerosis) and reduce blood pressure (Beckman et al 2001, Cunningham 1998). Plasma vitamin C levels seem to play a role in the modulation of insulin activity in aged healthy or diabetic subjects (Paolisso et al...

Alertness

Although clinical studies using guarana are not available, anecdotal evidence has suggested that it may produce similar effects to caffeine on subjective feelings of Guarana 666 wellbeing, energy, motivation and self-confidence (Mumford etal 1994). Guarana may exert a mild antidepressant effect as demonstrated in forced-swimming and open field tests in mice (Campos et al 2005)

Deficiency Signs And Symptoms

When reduced intakes or increased losses of magnesium, potassium or phosphorus occur (the three major intracellular elements), losses of the others generally follow. As such, many deficiency symptoms are also due to alterations in potassium and or phosphorus status and manifest as neurological or neuromuscular symptoms. Symptoms of deficiency include muscular weakness and spasms mental confusion and decreased attention span hyper-irritability and excitability cardiac arrhythmia, tetany and...

Chemopreventative

Chemoprotective effects of selenium have been indicated by an epidemiological relationship, RCTs and by experimental studies of selenium and known carcinogens in the development of specific cell lines. Overall, it appears that selenium works by inhibiting important early steps in carcinogenesis. Several mechanisms have been postulated to explain the chemopreventative effect of selenium, including protection against oxidative damage, alterations to immune and metabolic systems, alterations to...

Background And Relevant Pharmacokinetics

Chitosan is a form of poorly soluble fibre, chemically derived from chitin, which is extracted from the exoskeletons of crustaceans or squid. It is a cationic polysaccharide and is in itself a major source of the nutritional supplement glucosamine. Similar to other forms of fibre, such as oatbran, chitosan is thought to bind bile acids and dietary lipids. The solubility, biocompatibility and immunological activity and physicochemical properties of chitosan are altered by its molecular weight...

Other Uses

Traditionally, a juice made from the leaves has been used Internally to treat night blindness. The bark and seeds have been used to relieve diarrhoea, dysentery and treat haemorrhoids, most likely because of their astringent activity. The flowers have been used as an emollient to soothe eruptions, swellings, boils and carbuncles. In Ayurvedic medicine, it is used to treat bronchitis, asthma, allergy and inflammation.

Anticoagulants

According to one case report, l-carnitine 1 g day may potentiate the anticoagulant effects of acenocoumarol (also known as nicoumalone or acenocumarin) (Martinez et al 1993). Use this combination with caution. Monitor bleeding time and signs and symptoms of excessive bleeding. ANTICONVULSANTS (INCLUDING VALPROATE, PHENOBARBITAL, PHENYTOIN, CARBAMAZEPINE) Trials with children and adults have shown a reduction in carnitine levels during anticonvulsant therapy (Hug et al 1991, Rodriguez-Segade et...

Ginkgo biloba

Historical note Ginkgo biloba is one of the world's oldest living tree species, earning it the name 'living fossil'. Its existence can be traced back more than 200 million years and it was commonly found in North America and Europe before the Ice Age. Ginkgo was first introduced into Europe in 1 690 by the botanist Engelbert Kaempfer, who described it as the 'tree with duck feet'. Ginkgo has been used medicinally for many centuries and is now one of the most popular therapeutic agents...

Syndrome X

Syndrome X, also known as metabolic syndrome or insulin resistance syndrome, is a highly prevalent condition that significantly increases the risk of coronary heart disease and is associated with elevated triglycerides, low HDL-cholesterol, and LDL-cholesterol. As niacin raises HDL-cholesterol, lowers triglycerides and increases LDL-cholesterol particle size, it may be considered a useful therapeutic option for the treatment of dyslipidaemia in such cases (Ito 2004). The potential for niacin to...

Food Sources

Vitamin C is found in many different fruits and vegetables. The most concentrated food sources are blackcurrants, sweet green and red peppers, hot red peppers, green chilli peppers, oranges and its fresh juice, and strawberries. Other good sources are watermelon, papaya, citrus fruits, cantaloupe, mango, cabbage, cauliflower, broccoli and tomato juice. In practice, vegetables may be a more important source of vitamin C than fruits because the vegetable supply often extends for longer periods...

Photoprotection

Excessive exposure to solar radiation, especially UVA (320-400 nm) and UVB (290-320 nm), may induce UV-carcinogenesis and erythema in the skin (Lee et al 2000). There have been a number of controlled clinical trials that have demonstrated that supplementation with beta-carotene alone, or in combination with other antioxidants, can reduce UV-induced erythema (Gollnick et al 1996, Heinrich et al 1998, 2003, Lee et al 2000, Mathews-Roth et al 1972, Sies & Stahl 2004, Stahl et al 2000). These...

Hiv And Tryptophan Depletion

A pellagra-like state can develop in malnourished patients with HIV and this may be due to impaired niacin status (Monteiro et al 2004) and result in tryptophan depletion. As tryptophan is preferentially converted to vitamin B3 (if B3 is depleted), a trial was conducted using high-dose niacin for 2 months in HIV patients and it was found that the high-dose niacin increased plasma tryptophan levels by 40 (Murray et al 2001). An open, prospective trial has also concluded that extended-release...

Cholinergic

Lemon balm exhibits CNS acetylcholine receptor activity, with both nicotinic and muscarinic binding properties (Wake et al 2000). In vitro data has demonstrated that lemon balm is a weak inhibitor of acetylcholinesterase and has a moderate affinity to the GABA-A benzodiazepine receptor site (Salah & Jager 2005). This indicates that lemon balm may have a role to play in the treatment of Alzheimer's disease and epilepsy. However, a 2003 randomised, double-blind, placebo-controlled, crossover...

Chemopreventative Role

Epidemiological, animal and human studies all suggest that folate status affects the risk of developing cancers in selected tissues. The exact nature of this relationship continues to elude researchers (Bollheimer et al 2005, Powers 2005). Previously, high folate intake was purported to have a protective effect, although there were some anomalies. An extensive review of the role of the MTHFR C677T polymorphism in cancer risk concluded that, in spite of the poor folate status and activity...

Antiinflammatory And Antipyretic Activity

Potent anti-inflammatory activity was demonstrated in an animal model for both single-dose and ch ronic-dose applications of a dried leaf decoction of fenugreek Fenugreek 408 (Ahmad iani et a I 2001). The effectiveness of the 1000 mg kg dose of the extract was relatively equal to 300 mg kg sodium salicylate for single dosing however, chronic administration was more effective than sodium salicylate. Additionally, the fenugreek decoction demonstrated stronger antipyretic activity than that of...

Neurotransmitter And Hormone Production

Many of the pharmacological actions of tyrosine relate to its role as a precursor for a number of neurotransmitters and hormones. Elevating tyrosine concentrations in brain catecholamine neurons (particularly dopamine and noradrenaline neurons) can stimulate neurotransmitter production in actively firing neurones but not in those that are quiescent or firing slowly (Fernstrom 2000). It plays an essential role in the body as a precursor to the catecholamine neurotransmitters as illustrated...

Neuroprotective

Many in vitro and in vivo trials have demonstrated the neuroprotective effects of flavonoids derived from baical skullcap (Cho & Lee 2004, Heo et al 2004, Piao et al 2004, Shang et al 2006, Son et al 2004). Cerebral ischaemia can cause a significant elevation in the concentrations of amino acid neurotransmitters in the cerebral cortex. Baical in administration can attenuate the elevations of glutamic acid and aspartic acid induced by cerebral ischaemia. This research demonstrates that...

Anticancer

Twenty patients with various end-stage cancers were given 500 mg twice daily for 6 months. After 6 months 16 patients were still alive with a statistically significant increase in both NK function and TNF-alpha levels. Haemoglobin, haematocrit and glutathione levels were all greatly increased (See et al 2002). Although these results are interesting it is difficult to examine the direct effect of Andrographis paniculata as many other nutritional supplements were given concurrently. In vitro...

Main Actions

The pharmacological actions of slippery elm have not been significantly investigated in clinical studies. Therefore, information is generally based on what is known about key constituents found within the herb. SOOTHES IRRITATED AND INFLAMED TISSUE The large amount of mucilage found in slippery elm bark will coat the surface of mucous membranes or wounds and sores when it comes in contact with water, and form a gel-like layer. Laboratory research has shown that mucilaginous medicinal plants,...

Dong quai

Historical note Dong quai is an aromatic herb commonly used in TCM. Its reputation is second to that of ginseng and is regarded as a 'female' remedy, or women's ginseng. Used in combination with other herbs, dong quai is used to treat numerous menstrual disorders and menopausal symptoms, as well as abdominal pain, migraine headache, rheumatism and anaemia (Murray 1995). Dong quai (Angelica sinensis) is closely related to the European Angelica archangelica, a common garden herb and the...

Dopaminergic

It Is suggested that the effects of A. racemosa may be due to dopaminergic activity, because black cohosh extract BNO 1055 displayed dopaminergic activity with a D(2)-receptor assay (Jarry et al 2003). Considering that dopaminergic drugs reduce some symptoms (e.g. hot flushes) associated with menopause, this theory is feasible however, further studies are required to explain why black cohosh is devoid of the typical side-effects associated with dopaminergic drugs (Borelli & Ernst 2002).

Haemorrhoids

Horse chestnut is also used both orally and topically for the treatment of haemorrhoids. Although it has not been investigated for this indication, escin has been shown to significantly improve signs and symptoms according to a placebo-controlled double-blind study of 72 volunteers with haemorrhoids. Symptom relief was experienced by 82 of subjects compared with 32 for placebo, and swelling improved in 87 compared with 38 for placebo (Sirtori 2001). Symptom improvement required at least 6 days...

Astringent

The tannin content of the herb is chiefly responsible for its astringent activity. ANTHELMINTIC Thymol possesses anthelmintic activity, demonstrated in vitro (Newell et al 1996). OTHER ACTIONS Anti-inflammatory due to thymol and carvacrol. CLINICAL USE Thyme has not been significantly investigated in controlled studies, therefore information is generally derived from evidence of activity and traditional use and the clinical significance is unknown. RESPIRATORY TRACT INFECTIONS Thyme extract has...

Autoimmune Thyroiditis

Selenium supplementation may improve inflammatory activity in chronic autoimmune thyroiditis patients, as evidenced by a significant reduction in the concentration of thyroid peroxidase antibodies (TPO-Ab) to 63.8 in selenium-supplemented subjects versus 88 (P 0.95) in placebo subjects (Gartner et al 2002). The randomised study of 70 females (mean age 47.5 years) compared 200 jg sodium selenium daily orally for 90 days to placebo. A follow-up crossover study of 47 patients from the initial 70...

Digestive Processes

The gut bacteria carry out a number of biochemical functions, including deconjugation and dehydroylation of bile acids, the conversion of bilirubin to urobilinogen, the metabolism of cholesterol to coprostanol, production of vitamins K, B1, B2, B6, B12 and generation of short-chain fatty acids. Probiotics are involved in balancing colonic microbiota and aid in the treatment of diarrhoea associated with travel and antibiotic therapy, and control of rotavirus and Clostridium difficile-induced...

Antihypertensives

High-dose GL taken long term can lead to increased blood pressure, thereby reducing drug efficacy. Caution monitor blood pressure when high-dose licorice preparations are taken for longer than 2 weeks. CHEMOTHERAPY (PACLITAXEL AND VINBLASTINE) A constituent of licorice has demonstrated significant potentiation of paclitaxel and vinblastine chemotherapy in vitro (Rafi et al 2000). Observe beneficial interaction is theoretically possible under medical supervision.

Cardiovascular Diseases

Hypertension A double-blind, placebo-controlled study with a crossover design found that the combination of EPO and fish oils significantly lowered blood pressure in 25 non-obese black patients with mild-moderate uncomplicated essential hypertension after 8-12 weeks compared with placebo (sunflower and linseed oil) (Venter et al 1988). Other smaller studies have found a similar beneficial effect in hypertensive patients. A combination of 4 g GLA and DHA daily for 6 weeks reduced blood pressure...

Maintenance Of Connective Tissue

Vitamin C maintains the body's connective tissue and is essential for the formation of collagen, the major fibrous element of blood vessels, skin, tendon, cartilage and teeth (Morton et al 2001). If collagen is produced in the absence of vitamin C, it is unstable and cannot form the triple helix required for normal tissue structure. Vitamin C is involved in the biosynthesis of other substances important for connective tissue such as elastin, proteoglycans, bone matrix, fibronectin and...

Cardiovascular Disease

Epidemiological studies support the idea that a diet rich in high carotenoid containing foods is associated with a reduced risk of heart disease (Kritchevsky 1999). A review of observational and intervention studies on beta-carotene and the risk of coronary heart disease found that seven cohort studies (Gaziano et al 1995b, Gey et al 1993, Knekt etal 1994, Manson etal 1991, Morris et al 1994, Rimm et al 1993, Street et al 1994) reported relative risks between 0.27 and 0.78 for high serum...

Internal

German chamomile is used either as a tea made from the dried flower heads, or as an extract. Dried flower heads 2-8 g three times daily by infusion. . Fluid extract (1 2) 3-6 m day. Chamomile 210 Tincture (1 5) 3-10 ml_ three times daily. The quality of chamomile varies greatly. For maximum efficacy, use high-grade chamomile (high in alpha-bisabolol). Standardised extracts are usually standardised to either bisabolol or apigenin.

Clinical Use

Overall, W. somn fera has not undergone significant scientific investigation in humans, therefore much of its use is based on pharmacological effects demonstrated in experimental models or traditional usage. In practice, it is often used in herbal combination treatments. stress adaptation The pharmacological effects of the herb, which have been well established in animal studies, provide a theoretical basis for its use in situations characterised by stress (Archana & Namasivayam 1999...

Male Fertility

A placebo-controlled, double-blind crossover trial of 100 infertile males (aged 20-40 years) found that l-carnitine therapy (2 g day) was effective in increasing semen quality, sperm concentration and total and forward sperm motility, especially in groups with lower baseline levels (Lenzi et al 2003). The positive effects on sperm motility have also been shown in previous trials using l-carnitine 3 g day (Costa et al 1994, Vita I i et al 1995). In a later trial, improvements in sperm motility...

Lipidlowering

The role of carnitine in fatty acid metabolism suggests a potential role in hyperlipidaemia. Several studies have indicated that oral l-carnitine significantly reduces lipoprotein-a levels however, effects on other lipids are inconsistent, l-Carnitine (2 g day) significantly reduced serum lipoprotein-a levels in 77.8 of subjects receiving active treatment after 12 weeks, according to one placebo-controlled, double-blind randomised study. No significant change was observed in other lipid...

Arthritic Conditions

Traditionally, nettle herb and leaf have been used to treat painful joint diseases, and scientific investigation now shows there is a demonstrable benefit with its use. One randomised, double-blind crossover study involving 27 patients with OA pain at the base of the thumb or index finger compared topical applications of stinging nettle leaf with placebo, used daily for 1 week. After a 5-week washout period, treatments were then reversed. Nettle application used for 1 week showed reduction in...

Reducing Morbidity And Mortality Of Pregnant Women

Vitamin A supplements have been recommended in pregnancy to improve outcomes, including maternal mortality and morbidity. There is a Cochrane review of five trials involving 23,426 women that investigated the effects of vitamin A supplementation during pregnancy, alone or in combination with other supplements (Van et al 2002). Trials were heterogeneous and difficult to pool however, two trials from Nepal and Indonesia suggested beneficial effects of vitamin A supplementation. In addition, daily...

Sex Hormones

Testosterone Whether licorice consumption affects testosterone levels is still unknown, as conflicting results have been obtained from clinical studies. Armanini et al have conducted a series of trials investigating the effects of licorice on testosterone levels in males with mixed results (Armanini et al 1999, 2003a). One study showed that licorice (7 g day equivalent to 0.5 g GA) was able to reversibly reduce testosterone levels within 7 days, by inhibiting 17,20-lyase (involved in the...

Vancomycin

In animal studies the combination of ginseng polysaccharides with vancomycin resulted in a 100 survival rate for animals treated for Staphylococcus aureus compared to only 67 or 50 survival in animals treated with ginseng polysaccharides or vancomycin alone (Lim et al 2002b). A beneficial additive effect is possible but clinical use in humans has not yet been established. No affects on the pharmacokinetics or pharmacodynamics of either S-warfarin or R-warfarin were revealed in an open-label,...

Acne And Other Skin Conditions

Over the past 2-3 decades, tetracyclines and macrolide antibiotics have been widely prescribed for the treatment of acne however, resistance has been reported, especially to erythromycin and clindamycin with cross-resistance being widespread among strains of Propionibacterium acnes. As a result, non-antibiotic treatments such as topical and oral zinc preparations have been investigated as both alternatives and adjuncts to these treatments. Overall, studies have yielded conflicting results,...

Preventing Bone Loss

Quercetin is claimed to play an important role in preventing bone loss by affecting osteoclastogenesis and regulating many systemic and local factors, including hormones and cytokines (Son et al 2006), providing a theoretical basis for its use in the prevention of postmenopausal bone loss. In vitro studies demonstrate that bone resorption is mediated by oestrogen-receptor proteins through the inhibition of FiANK protein or the activation of caspases (Rassi et al 2005, Wattel et al 2003)....

Prevention Of Colorectal Cancer

High dietary intake of calcium has demonstrated a reasonably consistent risk reduction of between 15 and 40 for colorectal cancer. Clear parameters for dosing are not yet available, with some studies showing no further benefit above Calcium 155 700-800 mg day of total calcium, while other studies suggest an ongoing inverse dose-dependent relationship without cut-off (Schatzkin & Peters 2004). A 2005 Cochrane review examining the effect of supplementary calcium on the incidence of colorectal...

Acne Vulgaris

An open study of 117 subjects with different forms of acne found that after 6 weeks' treatment with a 0.2 dried extract of Vitex agnus-castus and a topical disinfectant, 70 of cases experienced total resolution with the highest success rates reported for acne vulgaris, foilicularis and excoriated acne (Amann 1975). A group that was not treated with the herb took 30-50 longer to achieve similar results. Although encouraging, it is difficult to determine the contribution of vitex treatment to...

Preventing Diabetic Complications

In diabetic patients with neuropathy, retinopathy or nephropathy, sorbitokglucose ratios are significantly higher than in those without these complications and ratios increase as complications become more severe (Aida et al 1990b). As licorice and its component isoliquiritigenin have been shown to inhibit aldolase reductase and suppress sorbitol accumulation in red blood cells in vitro (Aida et al 1990b, Zhou & Zhang 1990), a theoretical basis exists for its use in the prevention of diabetic...

Stress

Siberian ginseng is widely used to treat individuals with nervous exhaustion or anxiety due to chronic exposure to stress, or what is now termed 'allostatic load situations'. The biochemical effects on stress responses observed in experimental and human Ginseng Siberian 581 studies provide a theoretical basis for this indication (Abramova et al 1972, Gaffney et al 2001a). One placebo-controlled study conducted over 6 weeks investigated the effects of an ethanolic extract of Siberian ginseng (8...

Deficiency

100 mg taken 3-5 times daily until 4000 mg has been administered, followed by a maintenance dose of 100 mg day and encouragement to eat a diet with fresh fruit and vegetables. In cases of acute infection, CAM practitioners frequently recommend vitamin C in doses of 1000 g (or more) to be taken in divided doses every few hours until loose bowels are experienced, otherwise known as 'bowel tolerance'. The rationale behind this dosage regimen is that body requirements during infection are...

Reducing Chemotherapy Sideeffects

Results from a small, open, prospective study of subjects with advanced gastric cancer suggests that intravenous administration of a polysaccharide fraction isolated from E. purpurea may be effective in reducing chemotherapy-induced leucopenia (Melchart et al 2002). Test subjects had advanced gastric cancer and were undergoing palliative chemotherapy with etoposide, leucovorin and 5-fluorouracil. The median number of leukocytes 14-16 days after chemotherapy was 3630 microL (range 1470-5770) in...

Hypoglycaemic Agents

If used in combination with oral glucose-lowering conventional or complementary medicines it may contribute to hypoglycaemia (oral doses) blood glucose levels should be monitored (Springhouse 2001). Essential oils are not recommended in the first 3 months of life because the barrier Eucalyptus 3o7 function of the skin is not fully developed. Eucalyptus globulus may cause skin allergy 2007 Elsevier Australia in susceptible individuals (those prone to asthma, allergies, and previous reaction to...

Cystic Fibrosis

Cystic fibrosis (CF) is characterised by exocrine pancreatic insufficiency and reduced absorption of fat-soluble vitamins, as well as chronic lung inflammation and an associated increased oxygen free radical generation. Patients with CF have been found to have lower levels of beta-carotene and it has been suggested that they would benefit from beta-carotene supplementation (Cobanoglu et al 2002, Walkowiak et al 2004). This suggestion is supported by a study of 52 patients with CF that found a...

Arrhythmias

A small open study of 27 volunteers showed that CoQ10 exerts antiarrhythmic effects in some individuals (Fujioka et al 1983). Because CoQ10 is essential for energy metabolism, researchers have speculated that it may improve athletic performance. Eight clinical studies investigating the effects of CoQ10 supplementation on physical capacity were located, generally showing negative results (Bonetti et al 2000, Braun et al 1991, Laaksonen et al 1995, Malm et al 1997, Nielsen et al 1999, Porter et...

Info

Monitor for signs and symptoms of B2 deficiency Tricyclic antidepressants may reduce the absorption of riboflavin. Increased B2 Intake may be required with long-term therapy A combination of imipramine with L-tryptophan 6 g day and niacinamide 1500 mg day has been shown to be more effective for people with bipolar disorder than imipramine alone Increased drug effects and reduced side-effects Observe beneficial interaction possible under professional supervision Three clinical trials demonstrate...

Vision

Vitamin A is involved in ocular health and function in two distinct ways. First, in the form retinaldehyde, it is an essential component of rhodopsin and is necessary for maintaining vision (Wahlqvist et al 1997). Deficiency states initially cause a reversible night-blindness that can progress to complete blindness due to photoreceptor degeneration (McCaffery & Drager 1993). Second, as retinoic acid it maintains normal differentiation of cells in the conjunctiva, cornea and other ocular...