Adverse Reactions Associated with Echinacea and Other Asteraceae

Fifty percent of Australians report using some form of complementary alternative medicines (CAM) apart from vitamins in any 12-month period, with similar patterns of use in British and North American subjects. Despite the common perception that “natural therapy” is safe, toxic and hypersensitivity reactions to complementary and alternative medicine have been described. Given that these products are rarely packaged in childproof containers, accidental exposure also occurs. Allergic reactions are most common in atopic subjects. This is not surprising when one considers that up to 20% of atopic subjects use CAM. Furthermore, these patients are more likely than others to become sensitized to cross-reactive allergens and some use (or are advised to use) products such as Echinacea for treatment of allergic disease. When interpreting reports of immediate hypersensitivity to Asteraceae-derived CAM, it is helpful to bear in mind a number of important concepts: (1) exposure to Asteraceae is common; (2) sensitization is more common in subjects with preexistent allergic disease; (3) there is allergenic cross-reactivity between different Asteraceae, and between Asteraceae and some foods; and (4) patients sensitized by inhalation Read more […]

Anxiety Disorders: Supplements With Possible Efficacy

In addition to supplements discussed above, a few other compounds may also have some efficacy in treating symptoms of anxiety. However, since the data that supports the use of the following supplements is extremely limited, clinicians should proceed with caution, and consider the use of the compounds discussed in this section as experimental. St. John’s Wort As described in site, St. John’s Wort (Hypericum perforatum) is an herb that exists in many species throughout the world, and it is widely used as an antidepressant. It is available in a variety of preparations, including capsules, liquid, oils, and raw herb to be brewed as tea. St. John’s Wort contains a plethora of active ingredients, including flavonoids, naphthodianthrones, phloroglucinols, phenolic acids, terpenes, and xanthones. These exert a variety of psychoactive effects, and several of these are described below. Of all herbal supplements, St. John’s Wort is the one that has been researched most extensively and there is strong support for its efficacy in reducing depressive symptoms. The use of St. John’s Wort as an anxiolytic is more recent, but a few studies suggest that is may be effective. Davidson and Connor (2001) reported case studies of patients Read more […]

Ginger (Zingiber Officinale)

Medical Uses Ginger is used for nausea and vomiting, motion sickness, and inflammation. It may help to prevent cancer. Historical Uses Greek bakers imported ginger from the Orient to make gingerbread. Spanish mariners brought ginger to the New World. Growth Ginger is cultivated in tropical climates. Ginger: Part Used • The knotted and branched rhizome (an underground stem) called the root. Major Chemical Compounds • Volatile oils, particularly zingiberene, bisabolene, gingerols, and shogaols • Niacin • Vitamin A Ginger: Clinical Uses Ginger is used for nausea and vomiting, motion sickness, and inflammation. It also has anticancer effects. Ginger has been shown to relieve nausea and vomiting during pregnancy without adverse effects. It is approved by the German Commission E and the World Health Organization (WHO) for “prevention of motion sickness.” WHO also has approved ginger for postoperative nausea, pernicious vomiting in pregnancy, and seasickness, whereas the German Commission E approved ginger only for dyspepsia and does not recommend its use during pregnancy. Mechanism of Action Ginger does not influence the inner ear or the oculomotor system; apparently it exerts its antiemetic effect Read more […]

Herbal Medicine

Herbal medicine is the use of plants as medicines. Herbal medicine is also known as phytotherapy (especially in Europe; from Greek phyton meaning plant), botanical medicine, medical herbalism and herbology (USA). More specifically, the term herbal medicine refers to the therapeutic use of relatively crude and therefore chemically complex plant extracts, or simply the herb in its dried form. In this way herbal medicines are distinct from plant-derived pharmaceutical drugs, which contain single chemical compounds extracted from plants in their pure form. All human societies of which we have any knowledge have availed themselves of plants for use as medicines. Herbal medicine in the widest sense is therefore a global form of medicine, which exists in a vast (albeit declining) diversity, forming a dynamic part of the rich cultural tapestry of our planet. Some of the most successful and sophisticated systems of herbal medicine prevailing today are Chinese Herbal Medicine (an integral part of Traditional Chinese Medicine) and the herbal medicine that forms part of the Ayurveda, the traditional system of medicine/health from India. These systems are treated elsewhere in this book. This chapter is concerned with the type Read more […]

Ginger (Zingiber officinale)

Ginger is the underground rhizome of the tropical flowering plant Zingiber officinale. The term officinale in the Latin name of a plant indicates that it was sold by apothecaries in past times and thus has a long history of medicinal use. Zingiber means horn-shaped in Sanskrit and refers to the shape of the ginger rhizome. Ginger has a sharp, sweet flavour and is used to flavour foods and drinks. The oil of ginger root contains the sesquiterpenes zingiberene and ƛ-bisabolene whilst the oleoresin contains a group of pungent phenolic compounds called gingerols and their degradation products. The gingerols are widely regarded as the components of ginger and ginger extracts that are responsible for any pharmacological actions. The gingerols are structurally related to capsaicin in chilli peppers and they bind to the same pain receptors (vanilloid receptor 1, VR1) that are abundant in the mouth and skin. Activation of VR1 receptors is responsible for the searing sensation of eating chilli peppers and also presumably for the pungency of ginger. The chemical structures of capsaicin and several gingerols may be found in Dedov et al. (2002). These same VR1 receptors may also be largely responsible for the chest pain experienced Read more […]

Nausea And Vomiting Of Pregnancy

Nausea And Vomiting Of Pregnancy And Hyperemesis Gravidarum Nausea and vomiting of pregnancy (NVP), generally referred to as “morning sickness,” is a common pregnancy discomfort. Its association with pregnancy was documented on papyrus dating as far back as 2000 bce. The earliest reference is in Soranus’ Gynecology from the 2nd century ce.s9 Some degree of nausea, with or without vomiting, occurs in 50% to 90% of all pregnancies. It generally begins at about five to six weeks of gestation and usually abates by 16 to 18 weeks gestation. As many as 15% to 20% of pregnant women will continue to experience some degree of nausea and vomiting of pregnancy into the third trimester, and approximately 5% will continue to experience it until birth. The socioeconomic impact of nausea and vomiting of pregnancy on time lost from either paid employment or household work is substantial, with one study reporting as many as 8.6 million hours of paid employment and 5.8 million hours of household work lost each year because of nausea and vomiting of pregnancy. Additionally, women experiencing more extreme versions of nausea and vomiting of pregnancy or hyperemesis gravidarum are vulnerable to social isolation, and possibly depression, Read more […]

Botanical Treatment Of Nausea And Vomiting Of Pregnancy And Hyperemesis Gravidarum

According to Borrelli et al., the potential teratogenic effects of drugs administered during the critical embryogenie period of pregnancy drastically limit their use. Because of this, many pregnant women turn to complementary and alternative therapies including vitamins, herbal products, homeopathic preparation, acupressure, and acupuncture. A recent literature survey reports that the most commonly used botanicals for the treatment of morning sickness are ginger, chamomile, peppermint, and raspberry leaf. Only ginger has been subjected to investigation of its safety and efficacy for nausea and vomiting of pregnancy. Botanical Treatment Strategies for nausea and vomiting of pregnancy and Hyperemesis Gravidarum Therapeutic Goal Therapeutic Activity Botanical Name Common Name Reduce nausea and vomiting Antinauseant  Antiemetic Cannabis spp. Marijuana Mentha piperita Peppermint Zingiber officinalis Ginger Relieve stomach cramps Antispasmodic Dioscorea villosa Wild yam Matricaria recutita Chamomile Support digestion / appetite Digestive bitters Ballota nigra Black horehound Taraxacum officinale Dandelion root   The botanical approach to Read more […]

Herb-Drug Interactions: Ginger

Zingiber offidnale Roscoe (Zingiberaceae) Synonym(s) and related species Gan Jiang, Zingiber. Not to be confused with the wild gingers, which are Asarum canadense L. and Asarum europaeum L. Pharmacopoeias Ginger (British Ph 2009, European Ph 2008, US Ph 32); Ginger Capsules (US Ph 32); Ginger Tincture (US Ph 32); Powdered Ginger (The United States Ph 32). Constituents The constituents of ginger vary depending on whether fresh or dried forms are used. Generally, ginger rhizomes contain volatile oils of which zingiberene and bisabolene are major components: zingerone, zingiberol, zingiberenol, curcumene, camphene and linalool are minor components. The rhizomes also contain gingerols and their derivatives, gingerdiols, gingerdiones and dihydrogingerdiones. Sho-gaols are formed from gingerols during drying, and together these make up the pungent principles of ginger. Ginger extracts have been standardised to contain a minimum of 15mL/kg of essential oil with reference to the dried drug. Use and indications Ginger is thought to possess carminative, anti-emetic, anti-inflammatory, antispasmodic and antiplatelet properties. Both fresh and dried ginger are mainly used to settle the stomach, to alleviate Read more […]

Ginger: Uses

Clinical Use Although ginger is used in many forms, including fresh ginger used in cooking or chai (Indian spicy tea), pickled or glazed ginger, ethanol extracts and concentrated powdered extracts, preparations made with the root are used medicinally. Depending on the specific solvent used, the resultant preparation will contain different concentrations of the active constituents and may differ markedly from crude ginger. Although the great majority of research refers specifically to the species Zingiber officinale, there is the potential for confusion with other species or even with other genera. Furthermore, there are reported to be wide variations in the quality of commercial ginger supplements with concentrations of gingerols ranging from 0.0 to 9.43 mg/g. As such, the results of specific research can not necessarily be extrapolated to different preparations. PREVENTION OF NAUSEA AND VOMITING Many clinical studies have investigated the effects of ginger in the prevention and treatment of nausea and vomiting associated with different circumstances, including pregnancy, the postoperative period, motion sickness and chemotherapy. A recent systematic review of 24 RCTs covering 1073 patients suggest that results Read more […]

Raspberry leaf: Clinical Use. Dosage

The therapeutic effects of raspberry have not been significantly investigated under clinical trial conditions, so most evidence is derived from traditional, in vitro and animal studies. UTERINE TONIC Raspberry leaf is commonly used as a ‘partus preparator’ to prepare the uterus for delivery and to facilitate labour, as well as for morning sickness, dysmenorrhoea, leukorrhoea and menorrhagia. In vitro studies using pregnant rat and human uteri preparations suggest that raspberry may increase the regularity and decrease the frequency of uterine contractions. In a double-blind trial of 192 low-risk nulliparous women, raspberry leaf (2 x 1.2 g/day), consumed from 32 weeks’ gestation until labour, was associated with a lower rate of interventions with no adverse effects for mother or baby. Raspberry leaf did not shorten the first stage of labour; however, it did significantly reduce the second stage. A retrospective, observational study of 108 mothers also found that treatment with raspberry leaf was associated with a lower rate of medical intervention. This study further suggested that treatment may shorten labour, and reduce the incidence of pre- and post-term labour. Some pregnant women commenced use of raspberry Read more […]