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

Dosage Range GENERAL GUIDE • Dried herb: 3 g/day of either Echinacea angustifolia or Echinacea purpurea. • Liquid extract (1:2): 3-6 mL/day of either Echinacea angustifolia or Echinacea purpurea. This dose may be increased to 10-20 mL/day in acute conditions. Treatment is usually started at the first sign of URTI and continued for 7-14 days. SPECIFIC GUIDE • Echinacea angustifolia dried root: 1-3 g/day. • Echinacea purpurea dried root: 1.5-4.5 g/day. • Echinacea purpurea dried aerial parts: 2.5-6.0 g/day. • Echinacea purpurea expressed juice of fresh plant: 6-9 mL/day. • Echinacea pallida ethanolic extract of root: 2-4 mL/day. Although controversy still exists over which part of the plant and which particular plant has the strongest pharmacological activity, it appears that the cold-pressed juice of Echinacea purpurea is the most studied preparation for URTIs. Adverse Reactions Oral dose forms and topical preparations tend to be well tolerated, although allergic reactions are possible in rare cases (mainly to the aerial parts, in contact dermatitis). One study using Echinacea purpurea in children found that rash occurred in 7.1% of children using echinacea compared with 2.7% with Read more […]

Echinacea: Uses

Clinical Use Clinical trials using echinacea have used various preparations, such as topical applications, homeopathic preparations, injectable forms and oral dose forms, characteristics that should be noted when reviewing the data available. Overall, the majority of clinical studies performed in Europe have involved a commercial product known as Echinacin (Madaus, Germany), which contains the fresh-pressed leaf juice of Echinacea purpurea stabilised in ethanol. UPPER RESPIRATORY TRACT INFECTIONS Overall, clinical studies support the use of echinacea in URTIs, such as bacterial sinusitis, common cold, influenza-like viral infections and streptococcal throat. Evidence is strongest for use of echinacea in adults as an acute treatment; however, results in children have been disappointing. A 1999 review of 13 clinical trials consisting of 9 treatment studies and 4 prevention studies concluded that 8 of 9 treatment trials produced positive results whereas 3 of 4 prevention trials suggested modest effects. In other words, current evidence is stronger for supporting the use of echinacea as acute treatment in URTIs than as prophylactic treatment. In 2000, a Cochrane review was published that had assessed the evidence Read more […]

Echinacea: Background. Actions

Historical Note Echinacea was first used by Native American Sioux Indians centuries ago as a treatment for snakebite, colic, infection and external wounds, among other things. It was introduced into standard medical practice in the USA during the 1 800s as a popular anti-infective medication, which was prescribed by eclectic and traditional doctors until the 20th century. Remaining on the national list of official plant drugs in the USA until the 1940s, it was produced by pharmaceutical companies during this period. With the arrival of antibiotics, echinacea fell out of favour and was no longer considered a ‘real’ medicine for infection. Its use has re-emerged, probably because we are now in a better position to understand the limitations of antibiotic therapy and because there is growing public interest in self-care. The dozens of clinical trials conducted overseas have also played a role in its renaissance. Common Name Echinacea Other Names Echinacea angustifolia — American coneflower, black sampson, black susans, coneflower, echinaceawurzel, Indian head, kansas snakeroot, purple coneflower, purpursonnenhutkraut, racine d’echinacea, Rudbeckia angustifolia L, scurvy root, snakeroot Echinacea purpurea — Read more […]

Grapeseed extract: Interactions. Precautions. Practice Points

Toxicity Tests in animal models have found grapeseed extract to be extremely. Adverse Reactions Studies using doses of 150 mg/day have found it to be well tolerated. Significant Interactions Controlled studies are not available, therefore interactions are theoretical and based on evidence of pharmacological activity. ANTIPLATELET DRUGS Additive effect theoretically possible — observe patient. ANTICOAGULANT DRUGS Increased risk of bleeding theoretically possible — caution. IRON AND IRON-CONTAINING PREPARATIONS Decreased iron absorption. Tannins can bind to iron, forming insoluble complexes — separate doses by 2 hours. Contraindications and Precautions None known. Pregnancy Use Safety has not been scientifically established. Practice Points / Patient Counselling • Grapeseed extract has considerable antioxidant activity and appears to regenerate alpha-tocopherol radicals to their antioxidant form. • Grapeseed extract also has anti-inflammatory actions, reduces capillary permeability, enhances dermal wound healing and reduces photo-damage, inhibits platelet aggregation and may enhance rhodopsin regeneration or content in the retina. • It is popular in Europe as a treatment forvenous insufficiency Read more […]

Grapeseed extract: Uses. Dosage

Clinical Use Free radical damage has been strongly associated with virtually every chronic degenerative disease, including cardiovascular disease, arthritis and cancer. Clearly, due to the potent antioxidant activity of grapeseed, its therapeutic potential is quite broad. Most clinical studies have been conducted in Europe using a commercial product known as Endotelon®. Due to the poor bioavailability of high-molecular-weight proanthocyanidins, it is advised that products containing chiefly low-molecular-weight PCs be used in practice. FLUID RETENTION, PERIPHERAL VENOUS INSUFFICIENCY AND CAPILLARY RESISTANCE Several clinical studies have investigated the use of grapeseed extract in fluid retention, capillary resistance or venous insufficiency, producing positive results. Hormone replacement therapy and fluctuations in hormone levels can produce symptoms of venous insufficiency in some women. One large study involving 4729 subjects with peripheral venous insufficiency due to HRT showed that grapeseed extract decreased the sensation of heaviness in the legs in just over half the subjects by day 45 whereas 89.4% of subjects experienced an improvement by day 90. According to an open multicentre study of women aged Read more […]

Grapeseed extract: Actions

Main Actions Most evidence of activity derives from in vitro and animal studies for oligomeric proanthocyanidin complexes (OPCs) or grapeseed extract; however, some clinical studies are also available. The stilbene resveratrol (3, 4′, 5 trihydroxystilbene) has also been the focus of much investigation and exhibits anti-inflammatory, antithrombotic, anticarcinogenic and antibacterial activities, but it is uncertain whether significant amounts are present in the seeds and GSE. ANTIOXIDANT Grapeseed PC extract has demonstrated excellent free radical scavenging abilities, in both test tube and animal models, and provided significantly greater effects than vitamins C, E and beta-carotene. In vitro tests have further identified a vitamin E sparing effect, in which proanthocyanidins prevent vitamin E loss and cause alpha-tocopherol radicals to revert to their antioxidant form. INHIBITS PLATELET AGGREGATION Grapeseed extract has been shown to inhibit platelet aggregation, and combining extracts of grapeseed and grape skin produces a far greater antiplatelet effect in test tubeand ex vivo tests. Inhibition of platelet function was confirmed more recently by Vitseva et al (2005). STABILISES CAPILLARY WALLS AND ENHANCES Read more […]

Grapeseed extract: Background

Historical Note In the 1 500s a French expedition in North America found itself trapped in ice and forced to survive on salted meat and stale biscuits. After a time, the crew began to show signs of what we now recognise as scurvy. It is believed that the men survived because a Native American Indian showed them how to make a tea from the bark and needles of pine trees. The French explorer wrote of this encounter in a bookthat was subsequently read by researcher Jacques Masquelier, also a Frenchman, in the 20th century. Intrigued by the story, he began to investigate the chemistry and properties of pine bark and identified oligomeric proanthocyanidin complexes (OPCs). Several years later, he extracted OPCs from grapeseed extract (GSE), which is now considered the superior source of oligomeric proanthocyanidin complexes. Common Name grapeseed extract Botanical Name / Family Vitis vinifera/Vitaceae Plant Parts Used Seeds, grape skins Chemical Components The skin of the grapeseed is a rich source of proanthocyanidins (also referred to as procyanidins). Mixtures of procyanidins are referred to as oligomeric proanthocyanidin complexes. Grapeseed extract contains OPCs made up of dimers or trimers of (+)-catechin and Read more […]

Honey: Uses

Clinical Use BURNS Honey-dressed wounds had a more rapid reduction in local inflammation, better infection control and more rapid healing than for standard treatment with silver sulfadiazine (SSD) in a randomised clinical trial. Of the 25 patients with wounds, 84% treated with honey achieved satisfactory epithelialisation by day 7 and 100% by day 21 compared with 72% and 84% respectively with SSD. Histological evidence confirmed honey‘s superiority, with 80% of wounds showing significant reparative activity and decreased inflammation by day 7 compared with 52% with SSD. WOUND HEALING Honey applications have been used to treat various types of wounds, such as leg ulcers and bed sores. Honey has also been used to enhance postoperative wound healing and partial-thickness wounds such as split-thickness skin graft donor sites. One study involving 59 patients with wounds or ulcers not responding to conventional treatment were treated with topical unprocessed honey. Of these, 58 cases were reported as showing remarkable recovery, with all sterile wounds remaining sterile until healed and infected wounds becoming sterile within 1 week. The one case that did not respond involved a malignant ulcer. Clinically, honey promoted Read more […]

Honey: Chemical Components. Actions

Historical Note Honey has been used since ancient times as a healing agent for wounds and a treatment for gastric complaints. In ancient Greece, Hippocrates recommended honey and vinegar for pain and honey combinations for fever. It is also recommended by the Bible and Koran as a medicinal agent. Over the past few decades, scientific research has confirmed its role as a successful wound treatment. It is also known as honig and miel blanc. Chemical Components Caffeic acids, benzoic acid and its esters, phenolic acid and its esters, flavanoids, beeswax, inhibin, glucose oxidase and catalase, although other as yet unidentified constituents also exist. The composition of a particular honey greatly depends on the composition of the nectar it originated from, and therefore the plant species involved in its production. Main Actions ANTIBACTERIAL The type of plant species involved in honey production is significant, as some confer greater antibacterial properties than others. Currently, evidence suggests honey produced from the tea trees Leptospermum scoparium (New Zealand manuka) and Lipolygalifolium (Australian jelly bush) are the most effective, but batch testing is still required to verify the antibacterial activity Read more […]

Zinc: Practice Points – Patient Counselling. FAQ

Zinc is involved in many chemical reactions that are important for normal body functioning and it is essential for health and wellbeing. • Although zinc supplements are traditionally used to treat deficiency, they are also used to prevent deficiency in conditions associated with low zinc status or deficiency, such as acrodermatitis enteropathica, anorexia nervosa, malabsorption syndromes, conditions associated with chronic diarrhea, alcoholism, diabetes, HIV and AIDS, recurrent infections, severe burns, Wilson’s disease and sickle cell anaemia. • Zinc supplements are also popular among athletes in order to counteract zinc loss that occurs through perspiration. • Zinc lozenges have been used to prevent and treat the symptoms of the common cold and oral supplements have been used to treat acnevulgaris, improve wound healing and chronic leg ulcers, resolve intestinal permeability problems and reduce recurrences in Crohn’s disease, treat recalcitrant warts, reduce symptoms of tinnitus and improve ADHD. • Topical applications of zinc have been used to treat acnevulgaris (in combination with erythromycin), herpes simplexand to promotewound healing. • Numerous interactions exist between other minerals, Read more […]