Fenugreek: Interactions. Contraindications. Pregnancy Use. Practice Points. FAQ

Toxicity Safety studies indicate that fenugreek is extremely safe. When consumed as 20% of the diet, it did not produce toxic effects in animal tests. Adverse Reactions One clinical study found that a dose of 50 g taken twice daily produced mild gastrointestinal symptoms, such as diarrhea and flatulence, which subsided after 3-4 days. Allergic reactions have been reported, but are rare. Significant Interactions Where controlled studies are not available, interactions are speculative and based on evidence of pharmacological activity and case reports. HYPOGLYCAEMIC AGENTS Additive effects are theoretically possible in diabetes — monitor concomitant use and monitor serum glucose levels closely — potentially beneficial interaction. IRON Frequent use of fenugreek can inhibit iron absorption — separate doses by 2 hours. WARFARIN Although there is a theoretical concern that concomitant use could increase bleeding risk due to the herb’s coumarin content, this is unlikely. A placebo-controlled study found that fenugreek does not affect platelet aggregation, fibrinolytic activity or fibrinogen. Contraindications and Precautions Fenugreek is contraindicated in people with allergy to the herb, which has been Read more […]

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 […]

Lemon balm: Questions – Answers

Answers to Patients’ Frequently Asked Questions What will this herb do for me? Lemon balm has several different actions and is used for a number of different conditions. Taking the herb internally may help reduce anxiety and improve mood and mental concentration. When taken together with valerian, it can relieve insomnia. It may also relieve stomach spasms associated with nervousness, or in chronic, non-specific colitis when taken as part of a specific herbal combination. Melissa cream applied four times daily to herpes simplex infections can reduce symptoms, accelerate healing and reduce the chance of the infection spreading. When will it start to work? Approximately 1 month’s treatment with the essential oil is required for calming effects on agitation in dementia to be seen. Taken internally with valerian, effects on sleep may be seen after 9 days’ use. Improved memory occurred within 2.5 hours according to one study; however, it is not known if and when effects are seen in dementia. Melissa cream has been shown to significantly reduce symptoms of herpes simplex within 2 days, when applied fourtimes daily. Are there any safety issues? One study using lemon balm in tablet form found that it was well Read more […]

Lemon balm: Adverse Reactions. Interactions. Pregnancy Use. Practice Points

Toxicity Not known Adverse Reactions Lemon balm is well tolerated according to one double-blind, randomised crossover study. Significant Interactions Controlled clinical studies are not available, so interactions are speculative and based on evidence of activity. BARBITURATES Increased sedative effects: one animal study found that concomitant administration of lemon balm extract with pentobarbital produced an increased sedative effect — observe patients taking this combination. CHOLINERGIC DRUGS Additive effects are theoretically possible and may be beneficial — observe patients taking this combination. Contraindications and Precautions Hypothyroidism — one in vitro study found that an extract of Melissa officinalis inhibited both the extrathyroidal enzymic T4-5′-deiodination to T3 and the T4-5′-deiodination. Whether this has any clinical significance has yet to be determined. Pregnancy Use Safety has not been scientifically established and is unknown. Practice Points / Patient Counselling • Lemon balm has been used traditionally to treat insomnia, irritability, restlessness, anxiety and dementia. It is also used to relieve gastrointestinal symptoms associated with spasms and nervousness. • Read more […]

Lemon balm: Clinical Use. Dosage

In clinical practice, lemon balm is often prescribed in combination with other herbal medicines. As a reflection of this, many clinical studies have investigated the effects of lemon balm as an ingredient of a herbal combination, making it difficult to determine the efficacy of this herb individually. ANXIETY Although used traditionally as a treatment for anxiety, most modern-day evidence comes from in vivo studies, as the herb has not been clinically tested to a significant degree. However, the essential oil of lemon balm has been investigated under double-blind placebo-controlled conditions and found to be a safe and effective treatment for clinically significant agitation in people with severe dementia. The trial, which involved 71 subjects, found that after 1 month’s treatment, patients were less agitated, less socially withdrawn and spent more time in constructive activities than those in the placebo group. Commission E approves the use of lemon balm in the treatment of anxiety and restlessness. COGNITIVE FUNCTION Lemon balm has been used for centuries to improve cognitive function and encouraging results from a 2002 clinical study confirm that it can influence memory. The randomised, double-blind crossover Read more […]

Lemon balm: Background. Actions

Common Name Lemon balm Other Names Balm mint, bee balm, blue balm, common balm, cure-all, dropsy plant, garden balm, sweet balm Botanical Name / Family Melissa officinalis (family Labiatae) Plant Part Used Aerial parts Historical Note Lemon balm was used in ancient Greece and Rome as a topical treatment for wounds. In the Middle Ages it was used internally as a sedative and by the 17th century, English herbalist Culpeper claimed it could improve mood and stimulate clear thinking. Nowadays, it is still used to induce a sense of calm and help with anxiety, but is also added to cosmetics, insect repellants, furniture polish and food. Chemical Components Flavonoids, phenolic acids, tannins, triterpenes, essential oil and sesquiterpenes. Of note, the herb contains citronellal, caffeic acid, eugenol, rosmarinic acid and choline. Growing and harvesting methods have a major influence on the amount of volatile oil present in the leaves. It has been found that the oil content in the herb is highest in the top third and lowest in the bottom two-thirds. Lemon balm: Main Actions ANXIOLYTIC AND SEDATIVE Over the years, a number of studies involving rodents have suggested specific anxiolytic or sedative effects. More Read more […]

Selenium: Practice Points – Patient Counselling. FAQ

Selenium is a trace element that is essential for health. • Low selenium states have been associated with a variety of conditions, such as cardiovascular disease, cancer, asthma, atopy, male subfertility, rheumatoid arthritis, depression and anxiety and compromised immune function. • Studies have identified selenium deficiency in a significant number of people with the HIV infection and suggested a link between selenium levels and mortality rate. • It is also involved in the detoxification of some heavy metals and xenobiotics. • Selenium-enriched yeast is the safest way to supplement the diet, but other forms are also used. Answers to Patients’ Frequently Asked Questions What will this supplement do for me? Selenium supplementation may reduce the risk of developing certain cancers and heart disease and help to improve a range of conditions such as rheumatoid arthritis, asthma, autoimmune thyroiditis, male subfertility, depression and anxiety. When will it start to work? If a protective effect is to occur with selenium against cancer or cardiovascular disease, the effect appears to develop slowly over several years’ consistent intake. Are there any safety issues? High intakes Read more […]

Selenium: Adverse Reactions. Interactions. Pregnancy Use.

Toxicity Long-term ingestion of excessive levels of selenium (> 1000 µg/day) may produce fatigue, depression, arthritis, hair or fingernail loss, garlicky breath or body odour and gastrointestinal disorders or irritability. Adverse Reactions Nausea, vomiting, nail changes, irritability and fatigue have been reported. The organic form of selenium found in high-selenium yeast is often preferred because it is less toxic. The National Health and Medical Research Council of Australia states that selenium intake should not exceed 600 µg/day. Significant Interactions CISPLATIN Selenium may reduce associated nephrotoxicity, myeloid suppression and weight loss, according to in vitro and in vivo tests — beneficial interaction. HEAVY METALS (E.G. MERCURY, LEAD, ARSENIC, SILVER AND CADMIUM) Selenium reduces toxicity of heavy metals such as mercury, lead, arsenic, silver and cadmium by forming inert complexes — beneficial interaction. Contraindications and Precautions Sensitivity to selenium. Pregnancy Use Considered safe in usual dietary doses; safety at higher levels is unknown.

Selenium: Clinical Use. Dosage

DEFICIENCY STATES: PREVENTION AND TREATMENT Traditionally, selenium supplementation has been used to treat deficiency or prevent deficiency in conditions such as malabsorption syndromes. CANCER: PREVENTION AND POSSIBLE ADJUNCT TO TREATMENT Selenium supplementation is used to reduce total cancer incidence and mortality. Chemoprevention Collectively, geographical studies, epidemiological data, laboratory bioassays, studies in over 12 different animal models and human intervention trials generally support a protective role for selenium against the development of cancer. Populations who live in low selenium environments and have low selenium intakes tend to have higher cancer mortality rates. However, the results from epidemiological studies have been less consistent and show the effect is strongest in males. Total cancer incidence and mortality The Nutritional Prevention of Cancer Trial was a large multicentre, double-blind, randomised, placebo-controlled trial conducted with 1312 patients with a history of basal cell or squamous cell carcinomas of the skin, which investigated the effects of 200 µg selenium daily (as 500 mg brewer’s yeast) as a cancer protective agent. Selenium supplementation in this population Read more […]