Ginger: Background. Actions

Historical Note Ginger has been used as both a food and a medicine since ancient times. Confucius wrote about it in his Analects, the Greek physician, Dioscorides, listed ginger as an antidote to poisoning, as a digestive, and as being warming to the stomach in De Materia Medica, and the Koran, the Talmud and the Bible all mention ginger. Records suggest that ginger was highly valued as an article of trade and in 13th and 14th century England, one pound of ginger was worth the same as a sheep. Ginger is still extremely popular in the practice of phytotherapy, particularly in TCM, which distinguishes between the dried and fresh root. It is widely used to stimulate circulation, treat various gastrointestinal disorders and as a stimulant heating agent. Other Names African ginger, Indian ginger, Jamaica ginger, common ginger, rhizoma zingiberis, shokyo (Japanese) Botanical Name / Family Zingiber officinale Roscoe (family Zingiberaceae) Plant Part Used Rhizome Chemical Components The ginger rhizome contains an essential oil and resin known collectively as oleoresin. The composition of the essential oil varies according to the geographical origin, but the chief constituents, sesquiterpene hydrocarbons, which are Read more […]

Goldenrod: Adverse Reactions. Pregnancy Use. Practice Points

Adverse Reactions Handling the plant has been associated with allergic reactions ranging from allergic rhinoconjunctivitis and asthma to urticaria. There is one study of a cohort predominantly comprising florists who had presented with complaints relating to the handling of plants found that extensive cross-sensitisation to pollen of several members of the Compositae family (e.g. Matricaria, Chrysanthemum and Solidago) and to pollen of the Amaryllidaceae family (Alstroemena and Narcissus). Significant Interactions None known Contraindications and Precautions Commission E cautions against use as irrigation therapy when heart or kidney disease is also present. People with known allergy to goldenrod or who are allergic to the Compositae (Asteraceae) family of plants should avoid this herb. Pregnancy Use From limited use in pregnant women, it appears that no increase in frequency of malformation or other harmful effects have been reported although animal studies are lacking. Practice Points / Patient Counselling • Goldenrod has a long history of use but has not been tested in humans to any significant extent. • Traditionally it has been used internally to reduce upper respiratory catarrh, arthritis, menorrhagia, Read more […]

Goldenrod: Uses. Dosage

Clinical Use Goldenrod has not been significantly investigated under controlled study conditions, so most evidence is derived from traditional use, in vitro and animal studies. CYSTITIS The most common use of goldenrod is in the treatment of bladder infections. Both the Commission E and ESCOP (2003) have approved its use for irrigation of the urinary tract, with ESCOP also indicating usefulness as adjunctive treatment for bacterial UTIs. ARTHRITIS The product Phytodolor contains alcoholic extracts of Populus tremula, Fraximus excelsior and Solidago virgaurea and is standardised to 0.14 mg/mL of isofraxidine, 1 mg/mL salicine, and 0.07 mg/mL of total flavonoids. As part of this combination, goldenrod has been investigated in patients with RA, osteoarthritis and back pain. Pain was significantly reduced by treatment with Phytodolor in a placebo-controlled study of 47 patients. Symptom relief was equally effective amongst patients receiving half strength, normal (60 drops three times daily) or double-strength treatment. A shorter placebo-controlled study of 2 weeks duration found that Phytodolor reduced the need for conventional drug doses in subjects with ‘at least one rheumatological diagnosis’. Similarly, Phytodolor Read more […]

Goldenrod: Background. Actions

Historical Note Goldenrod has been used therapeutically for centuries for bladder conditions and wound healing. The name, Solidago, is from the Latin verb ‘to make whole’. In 1934, reports from the US Department of Agriculture suggested that goldenrod was considered as a potential future source of commercially prepared rubber, although it was noted that domestication of the plant would be difficult as it is vulnerable to fungal infection and insect attack. Common Name Goldenrod Other Names Aaron’s rod, blue mountain tea, sweet goldenrod, woundwort Botanical Name / Family Solidago canadensis (Canadian goldenrod), Solidago virgaurea (European goldenrod) (family Asteraceae [Compositae]). There are numerous species of goldenrod. Plant Parts Used Dried aerial parts — flowers and leaves Chemical Components Flavonoids, including rutin, catechol tannins, triterpene saponins, phenol glycosides, phenolic acids, one essential oil, diterpene lactones, and polysaccharides. Main Actions The pharmacology of goldenrod has not been significantly investigated; therefore, evidence of activity derives from traditional, in vitro and animal studies. DIURETIC Goldenrod is considered an aquaretic medicine, as it promotes fluid Read more […]

Goldenseal: Practice Points – Patient Counselling. FAQ

Pregnancy Use Contraindicated in pregnancy and lactation. In addition to the preceding concerns about bilirubin, berberine has caused uterine contractions in pregnant and non-pregnant experimental models. A recent in vivo study using 65-fold the average human oral dose of goldenseal investigated effects on gestation and birth and found no increase in implantation loss or malformation. The authors conclude that the low bioavailability of goldenseal from the gastrointestinal tract was likely to explain the differences between in vitro and in vivo effects in pregnancy. Hydrastine (0.5 g) has also been found to induce labour in pregnant women. Until more pharmacokinetic studies are done, goldenseal is best avoided in pregnancy. Practice Points / Patient Counselling • Goldenseal has been used traditionally as an antidiarrheal agent and digestive stimulant. • It has been used topically as a wash for sore or infected eyes and as a mouth rinse. • Goldenseal is a bitter digestive stimulant that improves bile flow and improves liver function. • Most clinical evidence has been conducted using the chemical constituent berberine. This data has shown effectiveness against diarrhea, congestive heart failure, Read more […]

Goldenseal: Adverse Reactions. Interactions

Clinical note — Berberine absorption Berberine is poorly absorbed, with up to 5% bioavailability. In vitro data has clearly demonstrated that berberine is a potent antibacterial; however, in vivo data has established low bioavailability. Berberine has been shown to upregulate the expression and function of the drug transporter P-glycoprotein (Pgp). Pgp belongs to the super family of ATP-binding cassette transporters that are responsible for the removal of unwanted toxins and metabolites from the cell. It appears that Pgp in normal intestinal epithelia greatly reduces the absorption of berberine in the gut. In vivo and in vitro methods have been used to determine the role of Pgp in berberine absorption by using the known Pgp inhibitor cyclosporin A. Co-administration increased berberine absorption six-fold and clearly demonstrated the role of Pgp in absorption. Increased expression of Pgp can lead to cells displaying multi-drug resistance. As previously reported a certain flavonolignan in many Berberis spp. has the ability to inhibit the expression of multi-drug resistant efflux pumps allowing berberine and certain antibiotics to be more effective. Adverse Reactions Goldenseal is generally regarded as safe Read more […]

Goldenseal: Uses. Dosage

Clinical Use Goldenseal has not been significantly investigated under clinical trial conditions, so evidence is derived from traditional, in vitro and animal studies. Many of these have been conducted on the primary alkaloids. All results are for the isolated compound berberine, and although this compound appears to havevarious demonstrable therapeutic effects, extrapolation of these results to crude extracts of goldenseal is premature. It should also be noted that equivalent doses of the whole extract of goldenseal are exceptionally high. DIARRHOEA A double-blind, placebo-controlled, randomised trial examined the effect of berberine alone (100 mg four times daily) and in combination with tetracycline for acute watery diarrhea in 400 patients. Patients were divided into four groups and given tetracycline, tetracycline plus berberine, berberine or placebo; 185 patients tested positive for cholera and those in the tetracycline and tetracycline plus berberine groups achieved a significant reduction in diarrhea after 16 hours and up to 24 hours. The group given berberine alone showed a significant reduction in diarrhea volume (1 L) and a 77% reduction in cAMP in stools. Noticeably fewer patients in the tetracycline and Read more […]

Goldenseal: Background. Actions

Historical Note Goldenseal is indigenous to North America and was traditionally used by the Cherokees and then by early American pioneers. Preparations of the root and rhizome were used for gastritis, diarrhea, vaginitis, dropsy, menstrual abnormalities, eye and mouth inflammation, and general ulceration. In addition to this, the plant was used for dyeing fabric and weapons. Practitioners of the eclectic school created a high demand for goldenseal around 1847. This ensured the herb’s ongoing popularity in Western herbal medicine, but unfortunately led to it being named a threatened species in 1997. Today, most high-quality goldenseal is from cultivated sources. Common Name Goldenseal Other Names Eye root, jaundice root, orange root, yellow root Botanical Name / Family Hydrastis canadensis (family Ranunculaceae) Plant Parts Used Root and rhizome Chemical Components Isoquinoline alkaloids, including hydrastine (1.5-5%), berberine (0.5-6%) and canadine (tetrahydroberberine, 0.5-1.0%). Other related alkaloids include canadaline, hydrastidine, corypalmineand isohydrastidine. Clinical note — Isoquinoline alkaloids Isoquinoline alkaloids are derived from phenylalanine or tyrosine and are most frequently found Read more […]

Green tea: Interactions. Contraindications. Pregnancy Use. Practice Points

Adverse Reactions Due to the caffeine content of the herb, CNS stimulation and diuresis is possible when consumed in large amounts. One clinical study found an absence of any severe adverse effects when 15 green tea tablets were taken daily (2.25 g green tea extracts, 337.5 mg EGCG and 135 mg caffeine) for 6 months. Significant Interactions Controlled studies are not available for green tea, so interactions are speculative and based on evidence of pharmacological activity. Therefore, clinical significance is unknown. ANTICOAGULANTS Antagonistic interaction — a case of excessive consumption (2.25-4.5 L of green tea/day) was reported to inhibit warfarin activity and decrease the INR. Intake of large quantities of green tea should be done with caution. HYPOGLYCAEMIC AGENTS Caffeine-containing beverages can increase blood sugar levels when used in sufficient quantity (200 mg of caffeine); however, hypoglycaemic activity has been reported for green tea, which could theoretically negate this effect — the outcome of this combination is uncertain, therefore observe patient. IRON Tannins found in herbs such as Camellia sinensis can bind to iron and reduce its absorption — separate doses by at least 2 hours. Read more […]

Green tea: Uses. Dosage

Clinical Use Evidence is largely based on epidemiological studies with few clinical studies available. 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. A phase 2 RCT evaluated the effects of green tea on oxidative DNA damage in 143 heavy smokers over 4 months and found a significant reduction in damage as evaluated from urine and plasma. A small, controlled, pilot study concluded with similar results when cells from the oral mucosa of smokers showed much less oxidative damage when compared with controls. These trials indicate that green tea may be effective in reducing cancer in smokers, but much larger trials are needed. In contrast, a 2001 prospective study in Japan found no association between green tea consumption and cancer incidence. CANCER TREATMENT Overall, the current evidence does not support the use of green tea as a cancer treatment; however, there are some exceptions, Read more […]