Historical Note Damiana is a wild deciduous shrub found in the arid and semi-arid regions of South America, Mexico, United States and West Indies. It is believed that Mayan Indians used damiana to prevent giddiness, falling and loss of balance, and as an aphrodisiac. It has also been used during childbirth, and to treat colic, stop bed wetting and bring on suppressed menses. Today its leaves are used for flavouring in food and beverages, and infusions and other preparations are used for a variety of medicinal purposes. Common Name Damiana Other Names Herba de la pastora, Mexican damiana, miziboc, old woman’s broom, shepherd’s herb, stag’s herb Botanical Name / Family Turnera diffusa, Damiana aphrodisiaca, Turnera aphrodisiaca (family Turneraceae) Plant Parts Used Dried leaves and stems Chemical Components Sesquiterpenes, alkaloids, essential oils containing caryophyllene, delta-cadinene, beta-elemeneand 1-8 cineol and other lesser constituents, tetraphylin B (a cyanogenic glycoside, 0.26%), resin, tannins, gum, mucilage, starch, a bitter element and possibly caffeine. Damiana also contains a flavone and at least five flavonoids including arbutin. Main Actions The pharmacological actions of damiana have Read more […]

Hops: Interactions. Practice Points. FAQ

Adverse Reactions Drowsiness is theoretically possible at excessive doses. Contact with the herb or oil has resulted in reports of systemic urticaria, allergic dermatitis, respiratory allergy and anaphylaxis. Significant Interactions Interactions reported here are theoretical and have yet to be tested clinically for significance. PHARMACEUTICAL SEDATIVES Additive effects are theoretically possible — observe the patient (this interaction may be beneficial). DRUGS METABOLISED CHIEFLY WITH CYP2B OR CYP3A Altered drug effect — CYP induction and inhibition has been demonstrated. However, it is unknown if these effects are clinically significant — observe the patient for signs of altered drug effectiveness. ANTI-OESTROGENIC DRUGS Hops may alter the efficacy of these medicines; use with caution in patients taking anti-oestrogenic drugs. Contraindications and Precautions According to one source, hops should be used with caution in depression. Due to the herb’s oestrogenic activity, disruption to the menstrual cycle is considered possible. Use is contraindicated in patients with oestrogen-dependent tumours. Pregnancy Use Caution in pregnancy because of possible hormonal effects. Practice Points / Patient Read more […]

Hops: Uses. Dosage.

Clinical Use In practice, the herb is prescribed in combination with other herbal medicines, such as valerian and passionflower. As is representative of clinical practice, most studies have investigated the effects of hops in combination with other herbs. RESTLESSNESS AND ANXIETY Based on the herb’s sedative activity, it is likely to have some effect in the treatment of restlessness and anxiety, but careful dosing would be required to avoid sedation. This indication has been approved by Commission E and ESCOP. SLEEP DISTURBANCES Although there have been no clinical studies to support hops as a stand-alone sedative agent, several studies have demonstrated formulas combining hops with other sedative herbs are effective for insomnia. Two randomised double-blind studies have investigated the effects of an oral preparation of hops and valerian in sleep disorders. One study observed equivalent efficacy and tolerability of a hops-valerian preparation comparable to benzodiazepine treatment, with withdrawal symptoms only reported for benzodiazepine use. Improvement in subjective perceptions of sleep quality was confirmed in another study, which also reported that a hops-valerian combination was well tolerated compared Read more […]

Hops: Background. Actions

Historical Note Although hops are most famous for producing the bitter flavour in beer, this plant has been used since ancient times to treat digestive complaints and for its slight narcotic and sedative actions. The climbing nature of the herb influenced its common name, as this is derived from the Anglo-Saxon hoppan, which means ‘to climb’. Common Name Hops Other Names Common hops, European hops, hop strobile, hopfen, houblon, humulus, lupulus, lupulin Botanical Name / Family Humulus lupulus (family Cannabinaceae) Plant Part Used Dried strobiles Chemical Components Resinous bitter principles (mostly alpha-bitter and beta-bitter acids) and their oxidative degradation products, polyphenolic condensed tannins, volatile oil, polysaccharides, mainly monoterpenes and sesquiterpenes, flavonoids (xanthohumol, isoxantholumol, kaempferol, quercetin and rutin), phenolic acids, and amino acids. Main Actions Traditionally, hops are viewed as a bitter tonic with antispasmodic, relaxant and sedative actions. SEDATIVE A long history of use within well-established systems of traditional medicine, together with scientific testing, have suggested that hops have significant sedative activity. A recent in vivo study found Read more […]

Red clover: Practice Points – Patient Counselling. FAQ

• Red clover flower heads are traditionally considered a dermatological agent, mild antispasmodic and expectorant and specifically used for eczema and psoriasis. In practice, it is often combined with yellow dock for treatment of chronic skin disease. • In recent years, red clover isoflavones have been studied and shown to have an affinity for oestrogen alpha- and beta-receptors and may act as both agonists and antagonists, depending on the level of endogenous oestrogens. • Evidence that red clover-derived isoflavones reduce hot flush frequency in menopause is unconvincing. • Preliminary evidence suggests a possible preventative role in osteoporosis; however, further research is required. • Concentrated isoflavone extracts from red clover are used in cardiovascular disease as there is weak evidence that it may reduce arterial stiffness. • Evidence from animal studies and case series suggests a potential role in BPH. • Cancer (there is weak evidence that red clover isoflavone extracts may reduce risk of hormone-sensitive cancers and that they may be beneficial in the treatment of prostate cancer). Answers to Patients’ Frequently Asked Questions What will this herb do for me? Red Read more […]

Red clover: Significant Interactions. Pregnancy Use

Adverse Reactions The oestrogenic potency of the isoflavones has been well documented. Overgrazing cattle or sheep on red clover can be detrimental to their fertility. In ‘clover disease’, ewes are made permanently infertile by clover consumption. In animals with clover disease, the uterine response to oestrogen is reduced, as is the surge in LH. Clover disease has not been observed with normal therapeutic doses in humans. None of the trials has reported adverse effects. An isoflavone preparation from soya bean, and red clover extracts containing genistein, daidzein, biochanin A and formononetin, did not modify the endometrial architecture in 25 postmenopausal women taking the preparation for 1 year. Significant Interactions Controlled studies are not available; therefore, interactions are based on evidence of activity and are largely theoretical and speculative. ANTICOAGULANT AGENTS Red clover contains coumarin, which could theoretically exert anticoagulant activity and therefore increase the clinical effects of warfarin. However, it is only the byproduct, dicoumarol (produced by microorganism in poorly dried sweet clover) that has established anticoagulant effects. Interaction with anticoagulant medication is Read more […]

Red clover: Clinical Use. Dosage

Considerable research has been carried out on the constituents of red clover. However, most of the investigations have been undertaken for agricultural rather than medicinal purposes. Very few investigations have concentrated specifically on the flower heads and the traditional uses. RELIEF OF MENOPAUSAL SYMPTOMS Although extracts standardised for soy isoflavone levels may help relieve symptoms, such as hot flushes and other symptoms frequently associated with menopause, the evidence from red clover isoflavones is less convincing. A 2004 systematic review that included data from five trials published between 1966 until March 2004 concluded that phyto-oestrogens from red clover have not been shown to reduce hot flushes. The trials were placebo-controlled, involved a total of 400 women and tested a standardised red clover isoflavone extract available commercially as Promensil (Novogen Ltd, Sydney, NSW, Australia), which contains 40 mg isoflavones. Two of the smallest trials (n = 30 each) reported a significant decrease in hot flush frequency; however, three, double-blind placebo-controlled trials found little effect in reducing the incidence or severity of hot flushes. The largest and highest quality study involved Read more […]

Red clover: Background. Actions

Common Name Red clover Other Names Cow clover, meadow clover, purple clover, trifoil Botanical Name / Family Trifolium pratense L. (family Fabaceae) Plant Parts Used Flower head or leaf Historical Note Red clover has been used for a long time as an animal fodder as well as a human medicine. Traditionally, it is considered an alternative remedy with good cleansing properties useful in the treatment of skin diseases such as psoriasis, eczema and rashes. A strong infusion was used to ease whooping cough and other spasmodic coughs due to measles, bronchitis and laryngitis. It was recommended for ‘ulcers of every kind, and deep, ragged-edged, and otherwise badly-conditioned burns. It possesses a peculiar soothing property, proves an efficient detergent, and promotes a healthful granulation’. Combined with other herbs, red clover was recommended for syphilis, scrofula, chronic rheumatism, glandular and various skin affections. Interestingly, red clover was not traditionally used for the treatment of menopausal symptoms. Chemical Components FLOWER HEAD Flavonoids, including formononetin; flavonols, including isorhamnetin and quercetin glucosides; phenolic acids, including salicylic and p-coumaric acids; volatile Read more […]

Rosemary: Practice Points – Patient Counselling

Rosemary is widely used as a food seasoning and preservative. • Rosemary extract exhibits antioxidant, antibacterial, anti-inflammatory, hepatoprotective and chemoprotective activity in various in vitro and experimental models. • Rosemary oil is widely used to assist in concentration and memory and to stimulate blood flow. • Traditionally, it has been used to relieve stomach, gall bladder and menstrual cramps, but its internal use has not yet been significantly investigated in controlled studies. • Rosemary is generally safe when the leaves are consumed in dietary amounts, although excessive intake may cause stomach irritation and seizures in susceptible people.

Rosemary: Significant Interactions. Pregnancy Use

Adverse Reactions Rosemary is generally recognised as safe for human consumption in quantities used as food. Consuming large amounts of rosemary may cause stomach and intestinal irritation, as well as seizures, owing to the high content of highly reactive monoterpene ketones, such as camphor. Topically, rosemary is not considered to be highly allergenic; however allergic contact dermatitis from rosemary has been reported, as has asthma from repeated occupational exposure. Rosemary essential oil should be diluted before topical application to minimise irritation. Significant Interactions Controlled studies are not available; therefore, interactions are based on evidence of activity and are largely theoretical and speculative. IRON Rosemary extracts are widely used as an antioxidant to preserve foods; however, the phenolic-rich extracts may reduce the uptake of dietary iron. Separate doses by 2 hours. ANTICOAGULANTS Increased bruising and bleeding theoretically possible— use caution. DRUGS DEPENDENT ON P-GLYCOPROTEIN TRANSPORT Theoretically, increased drug uptake can occur with those drugs dependent on P-glycoprotein transport. The clinical significance of this finding remains to be tested, although it has Read more […]