Fenugreek: Uses. Dosage

Clinical Use DYSPEPSIA AND LOSS OF APPETITE Although controlled studies are unavailable, the increased activity of pancreatic and intestinal lipase seen in animal studies provides a theoretical basis for its use in dyspepsia. Commission E approved the internal use of fenugreek seed for loss of appetite. 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. 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 volunteers demonstrated significant reductions in total cholesterol and LDL-choles-terol levels. A placebo-controlled study found no effect after 3 months with a lower dose of 5 g seed daily, suggesting that higher intakes may be required for lipid-lowering activity to become significant. DIABETES Fenugreek is a popular natural treatment used to aid blood sugar regulation in diabetes. Overall, results from clinical studies have produced positive results however trials have used diverse Read more […]

Fenugreek: Background. Actions

Historical Note Fenugreek’s seeds and leaves are used not only as food but also as an ingredient in traditional medicine. It is indigenous to Western Asia and Southern Europe, but is now mainly cultivated in India, Pakistan, France, Argentina and North African countries. In ancient times it was used as an aphrodisiac by the Egyptians and, together with honey, for the treatment of rickets, diabetes, dyspepsia, rheumatism, anaemia and constipation. It has also been described in early Greek and Latin pharmacopoeias for hyperglycaemia and was used by Yemenite Jews for type 2 diabetes. In India and China it is still widely used as a therapeutic agent. In the United States, it has been used since the 19th century for postmenopausal vaginal dryness and dysmenorrhea. Common Name Fenugreek Other Names Trigonella seeds, bird’s foot, Greek hay, hu lu ba, methi, trigonella Botanical Name / Family Trigonella foenum graecum (family Leguminosae) Plant Parts Used Dried mature seed, although leaves are used less commonly. Chemical Components The main chemical constituents are fibre, tannicacid, fixed and volatile oils and a bitter extractive, steroidal saponins, flavonoids, polysaccharides, alkaloids, trigonelline, trigocoumarin, Read more […]

Feverfew: Adverse Reactions. Interactions. Pregnancy Use. Practice Points

Toxicity Unknown, although no major safety issues have been identified. Adverse Reactions According to a Cochrane systematic review of five studies, feverfew is well tolerated and adverse events are generally mild and reversible. Symptoms were most frequently reported by long-term users and were predominantly mouth ulceration and gastrointestinal symptoms. Contact dermatitis, mouth soreness and lip swelling has also been reported when leaves are chewed. Significant Interactions Controlled studies are not available; therefore, interactions are based on evidence of activity and are largely theoretical and speculative. ANTICOAGULANTS Theoretically, feverfew may increase bruising and bleeding; however, although feverfew inhibits platelet aggregation in vitro and in vivo, no effects were seen in a clinical study — observe patients taking this combination. ANTIPLATELET DRUGS Theoretically, feverfew may increase bruising and bleeding; however, contradictory evidence exists — observe patients taking this combination. Contraindications and Precautions Hypersensitivity to plants in theAsteraceae (Compositae) (daisy) family (e.g. chamomile, ragweed). Pregnancy Use Contraindicated in pregnancy. Practice Points Read more […]

Feverfew: Uses. Dosage

Clinical Use PROPHYLAXIS OF MIGRAINE HEADACHE The first double-blind study investigating feverfew in migraine prophylaxis was published in 1985 and involved 17 patients who had been chewing fresh feverfew leaves on a daily basis. Therapeutic effect was maintained when capsules containing freeze-dried feverfew powder were continued, whereas those allocated placebo capsules experienced a significant increase in the frequency and severity of headache, nausea, and vomiting during the early months of withdrawal. Since then, numerous clinical studies have been conducted to determine the role of feverfew in the prevention of migraine headache. In 2000, Ernst and Pittler published a systematic review of six randomised, placebo-controlled double-blind trials of feverfew as a prophylactic treatment and concluded that the current evidence favours feverfew as an effective preventative treatment against migraine headache, and is generally well tolerated. Clinical note — Migraine Migraine is a common episodic familial headache disorder characterised by a combination of headache and neurologic, gastrointestinal, and autonomic symptoms. It has a 1 -year prevalence of approximately 18 % in women, 6% in men, and 4% in children Read more […]

Feverfew: Background. Actions

Historical Note Feverfew has been used for centuries in Europe to treat headaches, arthritis and fever and used as an emmenagogue and anthelmintic agent. In the 1970s it was ‘rediscovered’ by the medical establishment and subjected to clinical studies, which produced encouraging results that suggested feverfew was an effective prophylactic medicine for migraine headache. Other Names Altamisa, bachelor’s button, camomile grande, featherfew, featherfoil, chrysanthemum parthenium, mutterkraut, matrem, tanaceti parthenii herba/folium Botanical Name / Family Tanacetum parthenium (family [Asteraceae] Compositae) Plant Part Used Leaf Chemical Components The leaves and flowering tops contain many monoterpenes and sesquiterpenes as well as sesquiterpenes lactones (chrysanthemolide, chrysanthemonin, 10-epi-canin, magnoliolide and parthenolide), reynosin, santamarin, tanaparthins and other compounds. Until recently, the sesquiterpene lactone parthenolidewas thought to be the major biologically active constituent. However, in vitro and in vivo research suggests others are also present. Clinical note – Natural variations in parthenolide content The amount of parthenolide present in commercial preparations of feverfew Read more […]

Garlic: Contraindications. Practice Points. FAQ

Contraindications and Precautions Patients with bleeding abnormalities should avoid therapeutic doses of garlic. Although usual dietary intakes are likely to be safe prior to major surgery, suspend the use of high-dose garlic supplements 1 week before, as garlic may increase bleeding risk. If being used as part of a topical application, a test patch is advised before more widespread application. Pregnancy Use Garlic is not recommended at doses greater than usual dietary intakes. Practice Points / Patient Counselling • Garlic is both a food and a therapeutic medicine capable of significant and varied pharmacological activity. • It has antioxidant, antimicrobial, antiplatelet, antithrombotic, antihypertensive, lipid-lowering, anti-atherosclerotic and vasoprotective activity. • It also enhances microcirculation and may have hypoglycaemic, anti-inflammatory and immunostimulant activity. • Garlic is used as a treatment for many common infections, to reduce the incidence of colds, improve peripheral circulation and manage hyperlipidaemia and hypertension. • Increased consumption of garlic has been associated with a decreased risk of stomach and colorectal cancer, according to a review of the Read more […]

Garlic: Dosage. Adverse Reactions. Interactions.

Dosage Range GENERAL GUIDE • Fresh garlic: 2-5 g/day (ensure it is bruised, crushed or chewed). • Dried powder: 0.4-1.2 g/day. • Aged-garlic extracts have been studied in amounts ranging from 2.4 to 7.2 g/day. • Oil: 2-5 mg/day. • Garlic preparations that will provide 4-12 mg alliin daily. • Fluid extract (1:1): 0.5-2 mL three times daily. ACCORDING TO CLINICAL STUDIES • Hypertension: 600-900 mg/day in divided doses (delivering approximately 5000-6000 µg allicin potential). • Hyperlipidaemia: 600-9000 mg/day. • Fungal infection: topical 0.4-0.6% ajoene cream applied twice daily. • Occlusive arterial disease: 600-800 mg/day. It is important to be aware of the thiosulfinate content, in particular allicin-releasing ability, of any commercial product to ensure efficacy. Adverse Reactions INTERNAL USE Breath and body odour, allergic reactions, nausea, heartburn, flatulence, abdominal discomfort and diarrhea have been reported. Headache, myalgia and fatigue were reported in one study using a dose of 900 mg garlic powder (standardised to 1.3% alliin). TOPICAL USE An ajoene 0.6% gel produces a transient burning sensation after application, according to one study. Contact Read more […]

Garlic: Uses

Clinical Use Most studies have used a non-enteric coated dehydrated garlic powder preparation standardised to 1.3% alliin content (Kwai, Lichtwer Pharma) or an aged garlic extract (Kyolic, Wakunaga of America). CARDIOVASCULAR DISEASE Epidemiologic studies show an inverse correlation between garlic consumption and progression of CVD in general. This review will consider the evidence for garlic in the management of specific risk factors such as hypertension and hyperlipidaemia. Additionally, investigation into the effects of garlic directly on the atherosclerotic and arteriosclerotic processes is presented. Hypertension A meta-analysis of seven clinical trials using a garlic preparation, produced commercially as Kwai, found that three showed a significant reduction in SBP and four in DBP. Kwai was used in these studies in the dosage of 600-900 mg daily. Garlic treatment resulted in a mean reduction in SBP of 7.7 mmHg and 5.0 mmHg in DBP compared with placebo. In 2000, the Agency for Health Care Research and Quality analysed results from 27 randomised, placebo-controlled trials and reported that results were mixed. When significant reductions in blood pressure were observed, these were small. Several newer Read more […]

Garlic: Background. Actions

Historical Note Garlic has been used as both a food and a medicine since antiquity. Legend has it that garlic was used in ancient Egypt to increase workers’ resistance to infection and later used externallyto prevent wound infection. Other ancient civilizations have also used it medicinally. Sanskrit records document the use of garlic approximately 5000 years ago and the Chinese have been using it for over 3000 years. One of the uses of garlic was as a treatment for tumours, a use which extends back to the Egyptian Codex Ebers of 1550 BC. Louis Pasteur was one of the first scientists to confirm that garlic had antimicrobial properties. Garlic was used to prevent gangrene and treat infection in both world wars. Traditionally, garlic has been used as a warming and blood cleansing herb to prevent and treat colds and flu, coughs, menstrual pain and expel worms and other parasites. Common Name Garlic Other Names Ail, ajo, allium, camphor of the poor, da-suan, knoblauch, la-juan, poor man’s treacle, rustic treacle, stinking rose Botanical Name / Family Allium sativum (family Liliaceae) Plant Part Used Bulb, and oil from the bulb Chemical Components Garlic bulbs contain organosulfur compounds, protein (mainly alliinase), Read more […]

Ginger: Practice Points – Patient Counselling. FAQ

Pregnancy Use Although Commission E suggests that ginger is contraindicated in pregnancy, more recent research suggests that ginger is not contraindicated in pregnancy — doses up to 2 g/day of dried ginger root have been used safely. No adverse effects on pregnancy were observed in multiple studies of ginger or nausea and vomiting. Practice Points / Patient Counselling • Ginger is most often used for its anti-emetic, anti-inflammatory and gastrointestinal effects. • There is clinical support for the use of ginger in the treatment of nausea and vomiting associated with motion sickness, the postoperative period, pregnancy and chemotherapy. • Ginger is traditionally used for gastrointestinal disorders including dyspepsia, poor appetite, flatulence, colic, vomiting, diarrhea and spasms, as well as a diaphoretic in the treatment of the common cold and influenza. • Ginger is also used as an anti-inflammatory agent for arthritis, although large controlled studies have yet to produce strong support for this use. • Although antiplatelet effects have been reported, this requires very large doses and is not likely to be significant in normal therapeutic doses or dietary intake levels. Answers to Read more […]