Thursday, December 31, 2009

Medicinal Herbs: Wild Yam

Wild yam

Overview

In the 18th and 19th centuries, herbalists used wild yam (Dioscorea villosa ) to treat menstrual cramps and problems related to childbirth, as well as for stomach upset and coughs. In the 1950s, scientists discovered that the roots of wild yam (not to be confused with the sweet potato yam) contain diosgenin, a phytoestrogen (derived from plants) that can be chemically converted into a hormone called progesterone. Diosgenin was used to make the first birth control pills in the 1960s.

Although herbalists continue to use wild yam to treat menstrual cramps, nausea, and morning sickness associated with pregnancy, inflammation, osteoporosis, menopausal symptoms, and other health conditions, there is no evidence that it works. Indeed, several studies have found that it has no effect at all. That is because the body cannot change diosgenin into progesterone; it has to be done in a lab. Wild yam, by itself, does not contain progesterone.

General

Early Americans used wild yam to treat colic; another name for the plant is colic root. Traditionally, it has been used to treat inflammation, muscle spasms, and a range of disorders, including asthma. However, there is no scientific evidence that it works.

Menopause and Osteoporosis

Although wild yam is often touted as a natural source of estrogen, there is essentially no scientific evidence of wild yam's effectiveness in treating menopausal symptoms or osteoporosis. In fact, several studies have found that wild yam does not reduce the symptoms of menopause (such as hot flashes) or increase levels of estrogen or progesterone in the body. Some preparations of wild yam may contain progesterone, but only because a synthetic version of progesterone (medroxyprogesterone acetate or MPA) has been added to the herb.

High Cholesterol

Researchers have theorized that taking wild yam may help reduce levels of cholesterol in the blood, although studies have shown mixed results. Diosgenin seems to block the body from absorbing cholesterol, at least in animal studies. But in studies of people, cholesterol levels have not gone down (although fats -- triglycerides -- in the blood have decreased). More research is needed to say whether wild yam is beneficial for people with high cholesterol.

Plant Description

Also known as colic root, wild yam is a twining, tuberous vine. One species is native to North America; another is native to China. Both contain diosgenin and have similar medicinal properties. There are an estimated 600 species of yam in the genus Dioscorea, many of them wild species that flourish in damp woodlands and thickets, and not all contain diosgenin. Wild yam is a perennial vine with pale brown, knotty, woody cylindrical rootstocks, or tubers. Unlike sweet potato yams, the roots are not fleshy. Instead they are dry, narrow, and crooked, and bear horizontal branches of long creeping runners. The thin reddish-brown stems grow to a length of over 30 feet. The roots initially taste starchy, but soon after taste bitter and acrid.

The wild yam plant has clusters of small, greenish-white and greenish-yellow flowers. The heart-shaped leaves are long and broad and long-stemmed. The upper surface of the leaves is smooth while the underside is downy.

What's it Made of?

The dried root, or rhizome, is used in commercial preparations. It contains diosgenin, a phytoestrogen that can be chemically converted to the hormone progesterone; however, diosgenin on its own does not seem to act like estrogen in the body.

Available Forms

Wild yam is available as liquid extract and as a powder. The powdered form may be purchased in capsules or compressed tablets. The fluid extract can be made into tea. Creams containing wild yam are also available.

How to Take It

Pediatric

It is not known whether wild yam is safe for pediatric use, so do not give it to children.

Adult

The following are recommended adult doses for wild yam:

  • Dried herb to make tea: 1 - 2 tsp dried root to 1 cup water. Pour boiling water over dried root, steep 3 - 5 minutes. Drink 3 times a day
  • Tincture: 40 - 120 drops, 3 times a day
  • Fluid extract: 10 - 40 drops, 3 - 4 times per day
  • Creams: Contain 12% of wild yam extract; use as directed

Note: Wild yam is often combined with other herbs said to have estrogen-like effects, such as black cohosh. Creams containing wild yam, as well as tablets and powders, may contain synthetic hormones. Check the ingredients carefully.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

Although it does not appear to have hormone-like effects in the body, there is a slight risk that wild yam could produce effects similar to estrogen. Because of that risk, anyone with a personal or family history of hormone-related cancer should check with their doctor before using any form of "natural" hormone replacement, including wild yam.

Pregnant women and nursing mothers should avoid wild yam.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use wild yam without first talking to your health care provider.

Hormone Replacement Therapy or Birth Control Pills -- An animal study indicated that the active component of wild yam, diosgenin, may interact with estradiol, a hormone that occurs naturally in the body and also is used in some birth control medications and certain hormone replacement therapies.

Wednesday, December 30, 2009

Medicinal Herbs: Valerian

Valerian

Overview

Valerian has been used to ease insomnia, anxiety, and nervous restlessness since the second century A.D., and grew especially popular in Europe in the 17th century. It is also used to treat stomach cramps and as a diuretic. Now research has begun to confirm the scientific validity of these historic uses. Germany's Commission E approved valerian as an effective mild sedative and the United States Food and Drug Administration listed valerian as "Generally Recognized As Safe" (GRAS). Scientists aren't sure how valerian works, but they believe it increases the amount of a chemical called gamma aminobutyric acid (GABA) in the brain. GABA helps regulate nerve cells and has a calming effect on anxiety. A class of drugs called benzodiazepines, which includes alprazolam (Xanax) and diazepam (Valium), also work by increasing the amount of GABA in the brain. Researchers think valerian may have a similar, but weaker effect.

Insomnia

Valerian is a popular alternative to commonly prescribed medications for sleep problems because it is considered to be both safe and gentle. Some studies bear this out, although not all have found valerian to be effective. One of the best designed studies found that valerian was no more effective than placebo for the first 28 days, but after that valerian greatly improved sleep for those who were taking it. That has led researchers to speculate that you may need to take valerian for a few weeks before it begins to work. Other studies show that valerian reduces the time it takes to fall asleep and improves the quality of sleep itself. Plus, unlike many prescription sleep aids, valerian may have fewer side effects such as morning drowsiness.


Plant Description

Valerian is a perennial plant that is native to Europe and grows up to 2 feet tall. It is cultivated to decorate gardens but also grows wild in damp grasslands. Straight, hollow stems are topped by umbrella-like heads. Its dark green leaves are pointed at the tip and hairy underneath. Small, sweet-smelling white, light purple or pink flowers bloom in June. The root is light grayish brown and has little odor when fresh.


What's It Made Of?

The root of the plant is used medicinally and is pressed into fresh juice or freeze-dried to form powder.


Available Forms

Valerian fluid extracts and tinctures are sold in alcohol or alcohol-free (glycerite) bases. Powdered valerian is available in capsule or tablet form, and also as a tea.

Valerian root has a sharp odor. It iis often combined with other calming herbs, including passionflower (Passiflora incarnata), hops (Humulus lupulus), lemon balm (Melissa officinalis), skullcap (Scutellaria lateriflora), and kava (Piper methysticum) to mask the scent. Kava, however, has been associated with liver damage, so it is best to avoid it.


How to Take It

Valerian is often standardized to contain 0.3 - 0.8% valerenic or valeric acid, although researchers aren't sure that those are the active ingredients.

Pediatric

Although one pilot study found no side effects using valerian in children, you should talk to your doctor before giving valerian to a child.

Adult

For insomnia, valerian may be taken 1 - 2 hours before bedtime, or up to 3 times in the course of the day, with the last dose near bedtime. It may take a few weeks before the effects are felt.

  • Tea: Pour 1 cup boiling water over 1 teaspoonful (2 - 3 g) of dried root, steep 5 - 10 minutes.
  • Tincture (1:5): 1 - 1 1/2 tsp (4 - 6 mL)
  • Fluid extract (1:1): 1/2 - 1 tsp (1 - 2 mL)
  • Dry powdered extract (4:1): 250 - 600 mg
  • For anxiety, 200 mg 3 - 4 times per day

Once sleep improves, valerian should be continued for 2 - 6 weeks.


Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

Valerian is generally regarded as safe.

Even though most studies show no adverse effects on fertility or fetal development, more research is needed in humans. Experts advise pregnant and nursing women to avoid taking valerian.

Some people may have a "paradoxical reaction" to valerian, feeling anxious and restless after taking the herb instead of calm and sleepy.

Valerian does not appear to cause dependency or result in withdrawal symptoms for most people when they stop taking it. But there are a few reports of withdrawal symptoms when valerian has been used over very long periods of time. If you want to stop taking valerian, taper your dose gradually rather than stopping all at once.

Valerian should not be used while driving, operating heavy machinery, or during other activities that require you to be alert. It is best not to use valerian for longer than 1 month without your health care provider's approval.

Tuesday, December 29, 2009

Medicinal Herbs: Uva Ursi

Uva ursi

Overview

Uva ursi (Arctostaphylos uva ursi), also known as bearberry because bears like eating the fruit, has been used medicinally since the 2nd century. Native Americans used it as a remedy for urinary tract infections. In fact, until the discovery of sulfa drugs and antibiotics, uva ursi was a common treatment for such bladder and related infections. Through modern-day scientific research in test tubes and animals, researchers have discovered that uva ursi's antibacterial properties, which can fight infection, are due to several chemicals, including arbutin and hydroquinone. The herb also contains tannins that have astringent effects, helping to shrink and tighten mucous membranes in the body. That, in turn, helps reduce inflammation and fight infection.

Today, uva ursi is sometimes used to treat urinary tract infections and cystitis (bladder inflammation). Researchers believe the herb is most effective when a person's urine is alkaline since acid destroys its antibacterial effect. However, more research is needed to determine if uva ursi is effective in humans.

In addition, uva ursi can be toxic: Hydroquinone can cause serious liver damage. Conventional medications that have fewer risks are available to treat urinary tract infections.


Plant Description

Uva ursi is a trailing evergreen shrub that produces red berries and flourishes in alpine forests in many regions, including North America, Europe, the Iberian Peninsula, Siberia, and the Himalayas. It grows slowly but succeeds in places where other plants cannot, such as the walls of canyons. It has short, creeping, red-brown branches and pink or white bell-shaped flowers that bloom in the summer, followed by clusters of berries. Bears are said to be fond of the shiny, bright red or pink fruit, which is edible but sour tasting.


Parts Used

Only the leaves -- not the berries -- are used in medicinal preparations.


Available Forms

Uva ursi is commercially available as crushed leaf or powder preparations.


How to Take It

Pediatric

Do not give uva ursi to children.

Adult

Because uva ursi can be toxic, talk to your doctor before taking it. Recommended adult doses are:

  • Dried herb (available in capsules): 2 - 4 g per day, standardized to 400 - 800 mg of arbutin
  • Tea: Soak 3 g of dried leaves in 5 oz. of water for 12 hours. Strain and drink hot or cold 3 - 4 times per day.

Uva ursi should not be taken for more than 5 days at a time. (See "Precautions" section.) Do not take with vitamin C or orange juice.


Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

Because uva ursi requires an alkaline urine to work as an antibiotic, you should avoid eating foods that contribute to forming acidic urine.

One of the chemicals in uva ursi, hydroquinone, can be very toxic to the liver. Uva ursi should be taken only for short periods (no longer than 5 days) under a doctor's supervision, and should not be repeated more than 5 times in 1 year. Do not exceed recommended doses.

Reported side effects are generally mild and include nausea and vomiting, irritability, and insomnia.

Women who are pregnant or breastfeeding, or people with high blood pressure, should not take uva ursi.


Possible Interactions

If you are currently being treated with any of the following medications, you should not use uva ursi without first talking to your health care provider.

Drugs and supplements that make urine more acidic -- These include vitamin C, cranberry juice, orange juice, and other citrus fruits and juices.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids -- Animal studies conducted in Japan suggest uva ursi may increase the anti-inflammatory effects of these drugs, although it isn't known whether the herb would have that effect in people.

Monday, December 28, 2009

Medicinal Herbs: Turmeric

Turmeric

Overview

Turmeric (Curcuma longa) has been used for 4,000 years to treat a variety of ailments. Studies show that turmeric may help treat a number of illnesses, however, it is important to remember several facts when you hear news reports about turmeric's medicinal properties. First, many studies have taken place in test tubes and animals, and the herb may not work as well in humans. Second, some studies have used an injectable form of curcumin (the active substance in turmeric). Finally, some of the studies show conflicting evidence. Nevertheless, turmeric may have promise for fighting infections and some cancers, reducing inflammation, and treating digestive problems.

Turmeric is widely used as a food coloring and gives Indian curry its distinctive flavor and yellow color. It is also used in mustard and to color butter and cheese. Turmeric has been used in both Ayurvedic and Chinese medicine as an anti-inflammatory, to treat digestive and liver problems, skin diseases, and wounds. The curcumin in turmeric has been shown to stimulate the production of bile by the gallbladder. Curcumin is also a powerful antioxidant; antioxidants scavenge particles in the body known as free radicals, which damage cell membranes, tamper with DNA, and even cause cell death. Antioxidants can neutralize free radicals and may reduce or even help prevent some of the damage they cause. In addition, curcumin reduces inflammation by lowering levels of two inflammatory enzymes (called COX-2 and LOX) in the body and stops platelets from clumping together to form blood clots.

Research suggests that turmeric may be helpful for the following conditions:

Indigestion or Dyspepsia

Curcumin stimulates the gallbladder to produce bile, which some people think may help improve digestion. In Germany, the German Commission E, an authoritative body that determines which herbs can be safely prescribed in that country, has approved turmeric for a variety of digestive disorders. And at least one double-blind, placebo-controlled study showed that turmeric reduced symptoms of bloating and gas in people suffering from indigestion.

Ulcerative colitis

Turmeric may help maintain remission in people with ulcerative colitis. In one double-blind, placebo-controlled study, people whose ulcerative colitis was in remission received either curcumin or placebo, along with conventional medical treatment, for 6 months. Those who took curcumin had a relapse rate that was much lower than those who took placebo.

Stomach Ulcers

Turmeric does not appear to be helpful in treating stomach ulcers, and there is some evidence that it may increase the amount of acid in the stomach, making existing ulcers worse. (See "Precautions" section.)

Osteoarthritis

Because of its ability to reduce inflammation, turmeric may help relieve the symptoms of osteoarthritis. A study of people using an Ayurvedic formula of herbs and minerals containing turmeric, as well as Withinia somnifera (winter cherry), Boswellia serrata (Boswellia), and zinc, significantly reduced pain and disability. While encouraging for the value of this Ayurvedic combination therapy to help with osteoarthritis, it is difficult to know how much of this success is from turmeric alone, one of the other individual herbs, or the combination of herbs working in tandem.

Atherosclerosis

Early studies suggest that turmeric may help prevent atherosclerosis (the buildup of plaque that can block arteries and lead to heart attack or stroke) in one of two ways. First, in animal studies an extract of turmeric lowered cholesterol levels and kept LDL or "bad" cholesterol from building up in blood vessels, a process that helps form plaque. Because it stops platelets from clumping together, turmeric may also prevent blood clots from building up along the walls of arteries. However, it isn't yet known whether turmeric would have this effect in humans, or how much you would have to take to see any benefit.

Cancer

There has been a great deal of research on turmeric's anti-cancer potential, but results are still very early. Evidence from test tube and animal studies suggests that curcumin may help prevent, control, or kill several types of cancers, including prostate, breast, skin, and colon. Curcumin's effects may be due to its ability to stop the blood vessels that supply cancerous tumors from growing, and its preventive effects may come from its strength as an antioxidant, protecting cells from damage. More research is needed. Cancer should be treated with conventional medications; never rely on alternative therapies alone to treat cancer.

Diabetes

When researchers gave laboratory animals with diabetes turmeric, their blood sugar levels dropped, as did their blood cholesterol levels. But researchers don't yet know whether turmeric would be helpful in treating diabetes in people. (See "Precautions" section.)

Bacterial and Viral Infections

Test tube and animal studies suggest turmeric may have antibacterial and antiviral properties, but whether it would be effective in humans is unclear.

Uveitis

A preliminary study suggests curcumin may help treat uveitis, an inflammation of the eye. In one study of 32 people with uveitis, curcumin appeared to be as effective as corticosteroids, the type of medication generally prescribed for this eye disorder. More research is needed.


Plant Description

A relative of ginger, turmeric is a perennial plant that grows 5 - 6 feet high in the tropical regions of Southern Asia, with trumpet-shaped, dull yellow flowers. Its roots are bulbs that also produce rhizomes, which then produce stems and roots for new plants. Turmeric is fragrant and has a bitter, somewhat sharp taste. Although it grows in many tropical locations, the majority of turmeric is grown in India, where it is used as a main ingredient in curry.


Parts Used

The roots, or rhizomes and bulbs, are used in medicinal and food preparations. They are generally boiled and then dried, turning into the familiar yellow powder. Curcumin, the active ingredient, has antioxidant properties, which some claim may be as strong as vitamins C and E. Other substances in this herb have antioxidant properties as well.


Available Forms

Turmeric is available in the following forms:

  • Capsules containing powder
  • Fluid extract
  • Tincture

Because bromelain increases the absorption and anti-inflammatory effects of curcumin, it is often combined with turmeric products.


How to Take It

Pediatric

There is no recommended dosage for children. Consider adjusting the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. Therefore, if the child weighs 50 lb (20 - 25 kg), the appropriate dose of turmeric for this child would be 1/3 of the adult dosage.

Adult

The following are doses recommended for adults:

  • Cut root: 1.5 - 3 g per day
  • Dried, powdered root: 1 - 3 g per day
  • Standardized powder (curcumin): 400 - 600 mg, 3 times per day
  • Fluid extract (1:1) 30 - 90 drops a day
  • Tincture (1:2): 15 - 30 drops, 4 times per day

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and may interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

The amounts of turmeric found in foods are considered safe.

Turmeric and curcumin are considered safe when taken at the recommended doses. However, taking large amounts of turmeric for long periods of time may produce stomach upset and, in extreme cases, ulcers. People who have gallstones or obstruction of the bile passages should talk to their doctor before taking turmeric.

If you have diabetes, talk to your doctor before taking turmeric supplements. Turmeric may lower blood sugar levels, and when combined with medications for diabetes could cause hypoglycemia (low blood sugar).

Although it is safe to eat foods containing turmeric, pregnant and breastfeeding women should not take turmeric supplements.


Possible Interactions

If you are currently being treated with any of the following medications, you should not use turmeric or curcumin in medicinal forms without first talking to your health care provider.

Antiplatelet and anticoagulant drugs (blood-thinners) -- Stinging nettle may affect the blood's ability to clot, and could interfere with any blood-thinning drugs you are taking, including:

  • Warfarin (Coumadin)
  • Clopidogrel (Plavix)
  • Aspirin

Drugs that reduce stomach acid -- Turmeric may interfere with the action of these drugs, increasing the production of stomach acid:

  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Ranitidine (Zantac)
  • Esomeprazole (Nexium)
  • Omeprazole
  • Lansoprazole (Prevacid)

Drugs for diabetes (that lower blood sugar) -- Turmeric may increase the effects of these drugs, increasing the risk of hypoglycemia (low blood sugar).

Sunday, December 27, 2009

Medicinal Herbs: St. John's Wort

St. John's wort

Overview

St. John's wort (Hypericum perforatum) has a history of medicinal use dating back to ancient Greece, where it was used to treat a range of illnesses, including various "nervous disorders." St. John's wort also has antibacterial and antiviral properties and, because of its anti-inflammatory properties, has been used topically to help heal wounds and burns. St. John's wort is one of the most commonly purchased herbal products in the United States.

In recent years, there has been renewed interest in St. John's wort as a treatment for depression and there has been a great deal of scientific research on this topic. Most studies show that St. John's wort may be an effective treatment for mild-to-moderate depression, and has fewer side effects than most other prescription antidepressants. But the herb interacts with a wide variety of medications, so it is important to take it only under the guidance of a health care provider.

It is also important to note that severe depression (characterized by an inability to function with daily activities, thoughts of suicide or of harming yourself or others) should not be treated with herbs. Always see a doctor if your depression is serious (See "Precautions" section).

Depression

Several studies have shown that St. John's wort is effective in reducing symptoms in people with mild-to-moderate but not severe (or major) depression. In certain studies it appears to work as well as selective serotonin reuptake inhibitors (SSRIs), a popular type of antidepressant that includes fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) without one of the most common side effects, loss of libido.

St. John's wort contains several chemicals, including hypericin, hyperforin and flavonoids. Researchers aren't exactly sure how St. John's wort works, although it has been suggested that the herb acts like an SSRI, making more serotonin, dopamine and norepinephrine available to the brain. These neurotransmitters help improve one's mood. Scientists thought that hypericin was responsible for these effects, but now they believe that other chemicals in St. John's wort have a beneficial effect.

Not all studies agree, however. In one study, St. John's wort was found to be no more effective than placebo for treating depression; however, in the same study, Zoloft also failed to show any benefit in treating depression. A number of other studies have compared St. John's wort to Prozac, Celexa, paroxetine (Paxil), and Zoloft, and found that the herb is just as effective as the drug. Other studies are ongoing.

Other Uses

St. John's wort has also shown promise in treating the following conditions, a few of which are related to depression.

  • Bacterial and viral infections: In laboratory studies, St. John's wort has demonstrated the ability to fight certain infections, including some bacteria that are resistant to antibiotics. But it isn't known whether St. John's wort would have the same effect in people.
  • HIV infection and AIDS: While laboratory research suggests that St. John's wort may kill or slow the growth of human immunodeficiency virus (HIV), St. John's wort interferes with medications used to treat people with the virus. In addition, it appears that the doses of St. John's wort that would be needed are so high that side effects become intolerable. For now, people with HIV or AIDS should not take St. John's wort.
  • Premenstrual syndrome (PMS): An early study suggests that St. John's wort may help relieve physical and emotional symptoms of PMS, including cramps, irritability, food cravings, and breast tenderness.
  • Menopause: Studies suggest that St. John's wort, especially in combination with black cohosh, is useful in alleviating mood and anxiety changes during menopause.
  • Seasonal affective disorder (SAD): Used alone, St. John's wort has improved mood in those suffering from SAD (a type of depression that occurs during the winter months because of lack of sunlight). This condition is usually treated with photo (light) therapy. There is some evidence that using St. John's wort together with phototherapy produces even better results.
  • Eczema, wounds, minor burns, hemorrhoids: St. John's wort has antibacterial properties and may also help fight inflammation. Applied topically (to the skin), it may relieve symptoms associated with minor wounds and skin irritation.
  • Obsessive compulsive disorder, social phobia: St. John's wort has been proposed as a treatment for these conditions, but two preliminary studies in 2005 showed that the herb was not effective in relieving symptoms.

Plant Description

St. John's wort is a shrubby plant with clusters of yellow flowers that have oval, elongated petals. Scientists believe it is native to Europe, parts of Asia and Africa, and the western United States. The plant gets its name because it is often in full bloom around June 24, the day traditionally celebrated as the birthday of John the Baptist. Both the flowers and leaves are used for medicinal purposes.


What's It Made Of?

The best-studied active components are hypericin and pseudohypericin, found in both the leaves and flowers. Now research suggests, however, that these best-studied components may not be responsible for the plant's medicinal effects. Scientists are now studying St. John's wort's essential oils and flavonoids to see if they have benefits.


Available Forms

St. John's wort can be obtained in many forms: capsules, tablets, tinctures, teas, and oil-based skin lotions. Chopped or powdered forms of the dried herb are also available. Most products are standardized to contain 0.3% hypericin.


How to Take It

Pediatric

Most studies on St. John's wort have been conducted in adults. However, one study (more than 100 children under age 12) indicated that St. John's wort may be a safe and effective way of treating mild-to-moderate symptoms of depression in children. Talk to your doctor before giving St. John's wort to a child -- do not give your child a dose without medical supervision. Children being treated with St. John's wort should be carefully monitored for side effects, such as allergic reactions or upset stomach.

Adult

  • Dry herb (in capsules or tablets): The usual dose for mild depression and mood disorders is 300 mg (standardized to 0.3% hypericin extract), 3 times per day, with meals. St. John's wort is available in time-release capsules.
  • Liquid extract (1:1): 40 - 60 drops, 2 times per day.
  • Tea: Pour one cup of boiling water over 2 - 4 tsp of dried St. John's wort and steep for 10 minutes. Drink up to 3 cups per day for 4 - 6 weeks.
  • Oil or cream: To treat inflammation, as in wounds, burns or hemorrhoids, an oil-based preparation of St. John's wort can be applied topically.

It may take 3 - 4 weeks to feel any effects from St. John's wort.


Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

St. John's wort is often used to treat depression. If your depression is severe -- causing problems with your daily life or accompanied by thoughts of suicide or of harming yourself or others -- you need to see a doctor immediately. St. John's wort should not be used to treat severe depression.

You should see a doctor to make sure you have the right diagnosis before taking St. John's wort. Your doctor can help you determine the right dose and make sure you are not taking any other medications that might interact with St. John's wort.

Side effects from St. John's wort are generally mild and include stomach upset, hives or other skin rash, fatigue, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion. St. John's wort can also make the skin overly sensitive to sunlight (called photodermatitis). If you have light skin and are taking St. John's wort on a regular basis, be careful about sun exposure. Wear long sleeves and a hat, and use a sunscreen with at least SPF 15 or higher. Avoid sunlamps, tanning booths, and tanning beds.

Since St. John's wort can interact with medications used during surgery, you should stop taking it at least 5 days before surgery. Make sure your doctor and surgeon know you are taking St. John's wort.

Do not take St. John's wort if you have bipolar disorder.

St. John's wort should not be taken by women who are pregnant, trying to become pregnant, or breastfeeding.

Saturday, December 26, 2009

Medicinal Herbs: Saw Palmetto

Saw palmetto

Overview

Saw palmetto (Serenoa repens/Sabal serrulata) is a palm-like plant with berries that were a staple food and medicine for the Native Americans of the southeastern United States. In the early 1900s, men used the berries to treat urinary tract problems, and even to increase sperm production and boost libido. Today, the primary use of saw palmetto is to treat benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland. Researchers aren't sure exactly how saw palmetto works, but it contains plant-based chemicals that may be effective for BPH. Researchers think that saw palmetto may affect the level of testosterone in the body, and perhaps reduce the amount of an enzyme that promotes the growth of prostate cells. Saw palmetto is often combined with nettle extract to treat BPH.

Benign Prostatic Hyperplasia (BPH)

Evidence is mixed about whether saw palmetto works to treat BPH. A number of studies suggest that the herb is effective for treating symptoms, including too-frequent urination, having trouble starting or maintaining urination, and needing to urinate during the night. The urethra, the tube that empties urine from the body, runs through the prostate gland in men; when the prostate gland is enlarged, men may have trouble urinating.

Some studies show that saw palmetto is as effective in treating symptoms as finasteride (Proscar) without side effects such as loss of libido. Other studies suggest that saw palmetto may actually shrink the size of the prostate gland. Due to the short duration (usually less than 3 months) of these studies, it's not possible to say for sure that saw palmetto is truly effective for preventing complications of BPH. In fact, a well-conducted study published in the February 9, 2006, edition of the New England Journal of Medicine found that saw palmetto was no better than placebo in relieving the signs and symptoms of BPH.

It is important to receive a proper diagnosis of BPH from your doctor to rule out prostate cancer.

Other Uses

Animal studies have shown that saw palmetto inhibits the growth of tumor cells indicating that it may be a helpful in the treatment of prostate cancer. Other studies have shown that saw palmetto improves urinary tract symptoms related to BPH. While these studies are promising, more research is needed to determine whether saw palmetto is effective for these conditions.


Plant Description

Saw palmetto is a fan palm that grows as a tree or shrub that can reach heights of 10 feet in warm climates with leaf clusters that can reach 2 feet or more. It has a creeping, horizontal growth pattern. In the United States, it grows in the warm climates of the southeast coast, from South Carolina to throughout Florida. Lush, green, "saw-toothed" leaves fan out from thorny stems. The plant has white flowers, which produce yellow berries. The berries turn bluish-black when ripe, and are dried for medicinal use.


What's It Made Of?

Saw palmetto's active ingredients include fatty acids, plant sterols, and flavonoids. The berries also contain high molecular weight polysaccharides (sugars), which may reduce inflammation or strengthen the immune system.


Available Forms

Saw palmetto can be purchased as dried berries, powdered capsules, tablets, liquid tinctures, and liposterolic extracts. The product label should indicate that contents are standardized and contain 85 - 95% fatty acids and sterols. Read labels carefully and buy only from reputable companies.


How to Take It

Children

Saw palmetto is not recommended for children.

Adult

  • Liposterolic extract in capsules: The recommended dosages for early stages of BPH is 160 mg, twice a day. The supplement should be a fat-soluble saw palmetto extract that contains 85 - 95% fatty acids and sterols.
  • Liquid extract: 5 - 6 mL per day. This preparation has not been tested in any studies, so its effectiveness is not known.
  • Tea: Saw palmetto can be taken as a tea, but its active ingredients (fatty acids) are not soluble in water, so tea may not be effective. It has not been tested in any studies. Capsules are recommended instead of tea.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

Saw palmetto is generally thought to be safe a when used as directed. Side effects are very rare, although mild stomach complaints and minor headaches may occur. In at least one case, significant bleeding during surgery was attributed to saw palmetto.

Do not self-treat for BPH with saw palmetto; see your doctor for a proper diagnosis to rule out prostate cancer.

Saw palmetto may have effects similar to some hormones, and should not be used in pregnant or nursing women, or women who have had or are at risk for hormone-related cancers.

Saw palmetto may interfere with the absorption of iron.


Possible Interactions

Finasteride(Proscar) -- Because saw palmetto may work similarly to finasteride (Proscar), you should not use this herb in combination with finasteride or other medications used to treat BPH.

Antiplatelet and anticoagulant drugs (blood-thinners) -- Saw palmetto may affect the blood's ability to clot, and could interfere with blood-thinning drugs, including:

  • Warfarin (Coumadin)
  • Clopidogrel (Plavix)
  • Aspirin

Oral contraceptives -- Because saw palmetto may have hormone-like effects, it may make oral contraceptives less effective, raising the risk of unplanned pregnancy.

Friday, December 25, 2009

Medicinal Herbs: Siberian Ginseng

Siberian ginseng

Overview

Siberian ginseng (Eleutherococcus senticosus), also known as eleuthero, has been used for centuries in Eastern countries, including China and Russia. Despite its name, it is only a distant relative of American (Panax quinquefolius) and Asian ginseng (Panax ginseng), and it has different active chemical components. The active ingredients in Siberian ginseng, called eleutherosides, are thought to stimulate the immune system.

Traditionally used to prevent colds and flu and to increase energy, longevity, and vitality, it is widely used in Russia as an "adaptogen." An adaptogen is a substance that is supposed to help the body better cope with stress, either mental or physical. For example, an adaptogen might lower blood pressure in someone who has high blood pressure, but it might raise blood pressure in someone who has low blood pressure. However, any scientific evidence of adaptogens is lacking.

Until recently, most scientific research on Siberian ginseng was conducted in Russia. Research on Siberian ginseng has included studies on the following:

Colds and flu

Some double-blind studies have found that a specific product containing Siberian ginseng and andrographis reduced the severity and length of colds, when taken with 72 hours of symptoms starting. It's not possible to say whether Siberian ginseng was responsible, or whether it was andrographis or the combination of the two herbs.

One study found that people with flu who took the same product reduced symptoms quicker than those who took the antiviral drug amantadine.

A 4-week study in healthy subjects found that those who took Siberian ginseng extract had improvements in a number of measures that indicate how well the immune system is functioning.

Herpes viral infection

One 6-month study of 93 people with herpes simplex virus type 2 (which can cause genital herpes) found that Siberian ginseng reduced frequency, severity, and length of outbreaks. Talk to your doctor about whether use Siberian ginseng as a supplement to prevent herpes outbreaks is right for you.

Mental performance

Another popular but unproven use of Siberian ginseng is to maintain or restore mental alertness. One preliminary 3-month human study found that middle-aged volunteers who took Siberian ginseng had an improvement in memory compared to those who took placebo.

Physical performance

Although Siberian ginseng is frequently suggested to improve physical stamina and increase muscle strength, studies have shown only mixed results.

Quality of life

One study found that elderly people who took Siberian ginseng improved mental health and social functioning after 4 weeks of therapy, compared to those who took placebo. But after 8 weeks, the benefits decreased.


Plant Description

Siberian ginseng is a shrub native to the Far East that grows 3 - 10 feet high. Its leaves are attached to a main stem by long branches. Both the branches and the stem are covered with thorns. Flowers, yellow or violet, grow in umbrella-shaped clusters, and turn into round, black berries in late summer. The root itself is woody and is brownish, wrinkled, and twisted.


What's It Made Of?

Siberian ginseng supplements are made from the root. The root contains a mixture of components called eleutherosides, that are thought to be responsible for some of the medicinal effects. Among the other ingredients are chemicals called polysaccharides, which in animal tests have been found to boost the immune system and lower blood sugar levels.


Available Forms

Siberian ginseng is available as liquid extracts, solid extracts, powders, capsules, and tablets, and as dried or cut root for tea.

There can be wide variation in the quality of many herbal supplements, including Siberian ginseng. Tests of commercial products claiming to have Siberian ginseng found that as many as 25% had no measurable amount of the herb at all. Plus, many were contaminated with contents not marked on the label. Be sure you purchase Siberian ginseng and all herbal products from reputable manufacturers. Ask your pharmacist.


How to Take It

Pediatric

Siberian ginseng is not recommended for use in children.

Adult

  • Dried root: The recommended dose is 500 - 3,000 mg, daily (tea, or in capsules).
  • Tincture: (herb and alcohol; or herb, alcohol, and water), 1/2 - 1 tsp, 2 - 3 times daily
  • Standardized extract: 100 - 200 mg, 2 times daily, standardized to contain 0.8 - 1% eleutherosides Band E

For chronic conditions, such as fatigue or stress, Siberian ginseng can be taken for 3 months, followed by 2 - 3 weeks off. These cycles can be repeated, but this should be done under the supervision of a health care provider.


Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.

Siberian ginseng is generally considered safe when used as directed. However, people with high blood pressure, obstructive sleep apnea, narcolepsy, or women who are pregnant or breastfeeding should not take Siberian ginseng.

Some side effects may include:

  • High blood pressure
  • Insomnia
  • Drowsiness
  • Vomiting
  • Headache
  • Confusion
  • Irregular heart rhythm
  • Nosebleed

Possible Interactions

If you are being treated with any of the following medications, you should not use Siberian ginseng without first talking to your health care provider:

Digoxin -- Siberian ginseng may raise blood levels of digoxin, a medication used to treat heart conditions. This can increase the risk of side effects.

Anticoagulants (blood thinners) -- Siberian ginseng may interact with blood-thinners, such as warfarin (Coumadin), increasing the risk of bleeding.

Sedatives for insomnia -- Siberian ginseng may increase the effects of sedatives, primarily barbiturates (medications, including pentobarbital, used to treat insomnia or seizures).

Thursday, December 24, 2009

Medicinal Herbs: Roman Chamomile

Roman chamomile

Overview

There are two plants known as chamomile. One is the more popular German chamomile (Matricaria recutita), while the other is called the Roman, or English, chamomile ( Chamaemelum nobile). Although they belong to different species, they are used to treat similar conditions. Both are used to calm frayed nerves, to treat various digestive disorders, to relieve muscle spasms, and to treat a range of skin conditions and mild infections. Chamomile can also be found in a variety of face creams, drinks, hair dyes, shampoos, and perfumes.
Most research on chamomile has been done with German chamomile, which has similar, but not identical, active ingredients.
Traditionally, Roman chamomile has been used to treat nausea, vomiting, heartburn, and excess intestinal gas. It is widely valued for its anxiety-relieving properties. Used topically, this herb may also reduce inflammation associated with cuts or hemorrhoids. It may ease the discomfort associated with conditions such as eczema and gingivitis (swollen gums).
Test tube studies have also shown that chamomile has antibacterial, antifungal, and antiviral properties. It also has antispasmodic properties, meaning it helps relax muscle contractions, particularly in the smooth muscles that make up the intestines.

Plant Description

Roman chamomile originates in northwestern Europe and Northern Ireland, where it creeps close to the ground and can reach up to one foot in height. Gray-green leaves grow from the stems, and the flowers have yellow centers surrounded by white petals, like miniature daisies. Its leaves are thicker than German chamomile, and it grows closer to the ground. The flowers smell like apples.

What's It Made Of?

Chamomile teas, ointments, and extracts all start with the white and yellow flower head. The flower heads may be dried and used in teas or capsules or crushed and steamed to produce a blue oil, which has medicinal benefits. The oil contains ingredients that reduce swelling and may limit the growth of bacteria, viruses, and fungi.

Available Forms

Roman chamomile is available as dried flowers in bulk, tea, tinctures, and in creams and ointments.

How to Take It

Pediatric
There are no known scientific reports regarding the appropriate pediatric dose of Roman chamomile. Herbal practitioners may recommend dosing similar to German chamomile, 1 - 2 oz. of tea per day. Talk to your doctor to determine a proper dose before giving Roman chamomile to a child.
Adult
  • Tea: Pour 1 cup of boiling water over 2 - 3 heaping tbls. (2 - 4 g) of dried herb, steep 10 - 15 minutes. Drink 3 to 4 times per day between meals.
  • Liquid extract (1:1, 70% alcohol) 20 - 120 drops, 3 times per day.
  • Bath: Use 1/4 lb of dried flowers per bath, or add 5 - 10 drops of essential oil to a full tub of water to soothe hemorrhoids, cuts, eczema, perineal pain, or insect bites.
  • Cream/Ointment: Apply cream or ointment containing 3 - 10% chamomile content.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.
Roman chamomile is considered generally safe.
Chamomile may make asthma worse, so people with asthma should not take it.
Pregnant women should avoid chamomile because of the risk of miscarriage, but sitz baths with Roman chamomile may help heal the perineum after birth.
If you are sensitive to asters, daisies, chrysanthemums, or ragweed, you may also be allergic to chamomile.
Drinking large amounts of highly concentrated chamomile tea may cause vomiting.

Possible Interactions

If you currently take any of the following drugs, you should not use German chamomile without first talking to your health care provider.
Anticoagulants (blood-thinning medication) -- Chamomile may increase the risk of bleeding when taken with anticoagulant drugs such as warfarin.
Sedatives -- Chamomile can increase the effect of drugs that have a sedating effect, including:
  • Anticonvulsants, such as phenytoin (Dilantin) and valproic acid (Depakote)
  • Barbituates
  • Benzodiazepines, such as alprazolam (Xanax) and diazepam (Valium)
  • Drugs to treat insomnia, such as zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem)
  • Tricyclic antidepressants, such as amitriptyline (Elavil)
  • Alcohol
The same is true of herbs with a sedating effect, such as valerian, kava, and catnip.
Other drugs -- Because chamomile is broken down by certain liver enzymes, it may interact with other drugs that are broken down by the same enzymes, including:
  • Fexofenadine (Seldane)
  • Statins (drugs taken to lower cholesterol)
  • Birth control pills
  • Some antifungal drugs

Wednesday, December 23, 2009

Medicinal Herbs: Rosemary

Rosemary

Overview

Rosemary (Rosmarinus officinalis) is widely used as a spice when cooking, especially in Mediterranean dishes. It is also used for its fragrance in soaps and other cosmetics. Traditionally, rosemary has been used medicinally to improve memory, relieve muscle pain and spasm, stimulate hair growth, and support the circulatory and nervous systems. It is also believed to increase menstrual flow, act as an abortifacient (causing miscarriage), increase urine flow, and treat indigestion. Almost none of these uses have been studied scientifically in humans, however.

In the lab, rosemary has been shown to have antioxidant properties. Antioxidants can neutralize harmful particles in the body known as free radicals, which damage cell membranes, tamper with DNA, and even cause cell death. Also in the lab, rosemary oil appears to have antimicrobial properties (killing some bacteria and fungi in test tubes). It isn't known whether rosemary would have the same effect in humans.

Indigestion

Rosemary leaf is used in Europe for indigestion (dyspepsia) and is approved by the German Commission E, which examines the safety and efficacy of herbs.

Muscle and Joint Pain

Applied topically (to the skin), rosemary oil is sometimes used to treat muscle pain and arthritis, and to improve circulation. It is approved by the German Commission E for this purpose. However, there is no scientific evidence that it works.

Alopecia

Historically, rosemary has been used to stimulate hair growth. Rosemary was used in one study of 84 people with alopecia areata (a disease in which hair falls out, generally in patches). Those who massaged their scalps with rosemary and other essential oils (including lavender, thyme, and cedarwood) every day for 7 months experienced significant hair re-growth compared to those who massaged their scalps without the essential oils. But the study was not well designed, and it is impossible to say whether rosemary caused the hair growth.

Improve Memory or Concentration

Rosemary is often used in aromatherapy to increase concentration and memory, and to relieve stress. One study suggests that rosemary, combined with other pleasant-smelling oils, may help reduce anxiety. However, in another study, people who inhaled rosemary said they felt more anxious than those who inhaled lavender and those who did not inhale a scent.


Plant Description

Native to the Mediterranean area, rosemary now grows widely in other parts of the world. It thrives in a warm and sunny climate. The plant takes its name from rosmarinus, a Latin term meaning "sea dew." It is an upright evergreen shrub that can grow to a height of 6-and-a-half feet. The woody rootstock bears rigid branches with fissured bark. The long, needle-like leaves are dark green on top and pale beneath. Both the fresh and dried leaves are aromatic. The small flowers are pale blue. The leaves and parts of the flowers contain volatile oil.


What's It Made Of?

The leaves and twigs of the rosemary plant are used for culinary and medicinal purposes.


Available Forms

  • Dried whole herb
  • Dried, powdered extract (in capsules)
  • Preparations made from fresh or dried leaves, such as alcohol tinctures, teas, and liquid extract
  • Volatile oil (to be used externally, not orally)

How to Take It

Pediatric

Because rosemary has not been studied in children, it is not recommended for medicinal use in those under age 18. It is safe to eat as a spice in food, however.

Adult

Listed below are the recommended adult doses for rosemary. Total daily intake should not exceed 4 - 6 grams of the dried herb. Do not take rosemary oil orally.

  • Tea: Steep 6 g of dried herb in 2 cups boiling water; strain and cool. Divide into 3 cups and drink during the course of one day.
  • Tincture (1:5): 2 - 4 mL three times per day
  • Fluid extract (1:1 in 45% alcohol): 1 - 2 mL three times per day

Topically, rosemary may be used as follows:

  • Essential oil (6 - 10%): 2 drops semisolid or liquid in 1 tablespoon base oil. Avoid contact with eyes and do not apply to an open wound.
  • Decoction (for bath): Place 50 g herb in 1 liter water, boil, then let stand for 30 minutes. Add to bath water.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care practitioner.

Rosemary is generally considered safe when taken in recommended doses. However, there have been occasional reports of allergic reactions. Large quantities of rosemary leaves, because of their volatile oil content, can cause serious side effects, including vomiting, spasms, coma and, in some cases, pulmonary edema (fluid in the lungs).

Because higher doses of rosemary may cause miscarriage, pregnant and nursing women should not take rosemary as a supplement. It is safe to eat as a spice in food, however.

People with high blood pressure, ulcers, Crohn's disease, or ulcerative colitis should not take rosemary.

Rosemary oil can be toxic if ingested and should never be taken orally.


Possible Interactions

Antiplatelet and anticoagulant drugs (blood-thinners) -- Rosemary may affect the blood's ability to clot. It could interfere with any blood-thinning drugs you are taking, including:

  • Warfarin (Coumadin)
  • Clopidogrel (Plavix)
  • Aspirin

ACE inhibitors -- Rosemary may interfere with the action of ACE inhibitors taken for high blood pressure.

  • Captpril (Capoten)
  • Elaropril (Vasotec)
  • Lisinopril (Zestril)
  • Fosinopril (Monopril)

Diuretics (water pills) -- Because rosemary can act as a diuretic, it can increase the effects of these drugs. That can raise your risk of dehydration.

  • Furosemide (Lasix)
  • Hydrocholorothiazide

Lithium -- Because of its diuretic effects, rosemary might cause the body to lose too much water and the amount of lithium in the body to build up to toxic levels.

Diabetes -- Rosemary may alter blood sugar levels and could interfere with any drugs taken to control diabetes.

Tuesday, December 22, 2009

Medicinal Herbs: Peppermint

Peppermint

Overview

Peppermint (Mentha piperita), a popular flavoring for gum, toothpaste, and tea, is also used to soothe an upset stomach or to aid in digestion. Because it has a calming and numbing effect, it has been used to treat headaches, skin irritations, anxiety associated with depression, nausea, diarrhea, menstrual cramps, and flatulence. It is also an ingredient in chest rubs, used to treat symptoms of the common cold. In test tubes, peppermint kills some types of bacteria and viruses, suggesting it may have antibacterial and antiviral properties. A number of studies support the use of peppermint for indigestion and irritable bowel syndrome.

Indigestion

Peppermint calms the muscles of the stomach and improves the flow of bile, which the body uses to digest fats. As a result, food passes through the stomach more quickly. However, if your symptoms of indigestion are related to a condition called gastroesophageal reflux disease or GERD, peppermint should not be used (see "Precautions" section).

Flatulence/Bloating

Peppermint relaxes the muscles that allow painful digestive gas to pass.

Irritable Bowel Syndrome (IBS)

A number of studies have shown that enteric-coated peppermint capsules can help treat symptoms of IBS, such as pain, bloating, gas, and diarrhea. (Enteric-coated capsules keep peppermint oil from being released in the stomach, which can cause heartburn and indigestion.) However, a few studies have shown no effect. One study examined 57 people with irritable bowel syndrome who received either enteric-coated peppermint capsules or placebo twice a day for 4 weeks. Of the people who took peppermint, 75% had a significant reduction of IBS symptoms. Another study comparing enteric-coated peppermint oil capsules to placebo in children with IBS found that after 2 weeks, 75% of those treated had reduced symptoms.

Itching and Skin Irritations

Peppermint, when applied topically, has a soothing and cooling effect on skin irritations caused by hives, poison ivy, or poison oak.

Tension Headache

One small study suggested that peppermint applied to the forehead and temples helped reduce headache symptoms.

Colds and Flu

Peppermint and its main active agent, menthol, are effective decongestants. Because menthol thins mucus, it is also a good expectorant, meaning that it helps loosen and breaks up coughs with phlegm. It is soothing and calming for sore throats (pharyngitis) and dry coughs as well.

Plant Description

Peppermint plants grow to about 2 - 3 feet tall. They bloom from July through August, sprouting tiny purple flowers in whorls and terminal spikes. Dark green, fragrant leaves grow opposite white flowers. Peppermint is native to Europe and Asia, is naturalized to North America, and grows wild in moist, temperate areas. Some varieties are indigenous to South Africa, South America, and Australia.

What's It Made Of?

The leaves and stems, which contain menthol, a volatile oil, are used medicinally, as a flavoring in food, and in cosmetics (for fragrance).

Available Forms

Peppermint tea is prepared from dried leaves of the plant and is widely available commercially.

Peppermint spirit (tincture) contains 10% peppermint oil and 1% peppermint leaf extract in an alcohol solution. A tincture can be prepared by adding 1 part peppermint oil to 9 parts pure grain alcohol.

Enteric-coated capsules are specially coated to allow the capsule to pass through the stomach and into the intestine (0.2 mL of peppermint oil per capsule).

Creams or ointments (should contain 1 - 16% menthol)

How to Take It

Pediatric

Do not give peppermint to an infant or small child. Peppermint oil applied to the face of infants can cause life-threatening breathing problems. In addition, peppermint tea may cause a burning sensation in the mouth. For digestion and upset stomach in older children: 1 - 2 mL peppermint glycerite per day

Adult

  • Tea: Steep 1 tsp. dried peppermint leaves in 1 cup boiling water for 10 minutes; strain and cool. Drink four to five times per day between meals. Peppermint tea appears to be safe even in large quantities.
  • Enteric-coated capsules: 1 - 2 capsules (0.2 ml of peppermint oil) two or three times per day for IBS.
  • Tension headaches: Using a tincture of 10% peppermint oil to 90% ethanol, lightly coat the forehead and allow the tincture to evaporate.
  • Itching and skin irritations: Apply menthol, the active ingredient in peppermint, in a cream or ointment form no more than three to four times per day.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider.

Do not take peppermint or drink peppermint tea if you have gastroesophageal reflux disease (GERD -- a condition where stomach acids back up into the esophagus) or hiatal hernia. Peppermint can relax the sphincter between the stomach and esophagus, allowing stomach acids to flow back into the esophagus. (The sphincter is the muscle that separates the esophagus from the stomach.) By relaxing the sphincter, peppermint may actually make the symptoms of heartburn and indigestion worse.

Pregnant or nursing mothers should avoid peppermint and peppermint tea.

Never apply peppermint oil to the face of an infant or small child, as it may cause spasms that inhibit breathing.

Peppermint may make gallstones worse.

Large doses of peppermint oil can be toxic. Pure menthol is poisonous and should never be taken internally. It is important not to confuse oil and tincture preparations.

Menthol or peppermint oil applied to the skin can cause a rash.

Possible Interactions

Cyclosporine -- This drug, which is usually taken to prevent rejection of a transplanted organ, suppresses the immune system. Peppermint oil may slow down the rate at which the body breaks down cyclosporine, meaning more if it stays in your bloodstream. Do not take peppermint oil if you take cyclosporine.

Drugs that reduce stomach acid -- If peppermint capsules are taken at the same time as drugs that lower the amount of stomach acid, then the enteric-coated peppermint capsules may dissolve in the stomach instead of the intestines. This could mean the effects of peppermint are lessened. Take peppermint at least 2 hours before or after an acid-reducing drug. Antacids include:

  • Famotidine (Pepcid)
  • Cimetidine (Tagamet)
  • Ranitidine (Zantac)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec)

Drugs that treat diabetes -- Test tube studies suggest peppermint may lower blood sugar, raising the risk of hypoglycemia (low blood sugar).

Anti-hypertensive drugs (blood pressure medications) -- Some animal studies suggest that peppermint may lower blood pressure. If you take medications to lower blood pressure, taking peppermint also might make their effect stronger.

Monday, December 21, 2009

Medicinal Herbs: Milk Thistle

Milk thistle

Overview

Milk thistle (Silybum marianum) has been used for 2,000 years as an herbal remedy for a variety of ailments, particularly liver and gall bladder problems. Several scientific studies suggest that substances in milk thistle (especially a flavonoid called silymarin) protect the liver from toxins, including certain drugs such as acetaminophen (Tylenol), which can cause liver damage in high doses. Silymarin has antioxidant and anti-inflammatory properties, and it may help the liver repair itself by growing new cells.

Although a number of animal studies demonstrate that milk thistle can be helpful in protecting the liver, results in human studies are mixed.

Liver disease from alcohol

Milk thistle is often suggested as a treatment for alcoholic hepatitis and alcoholic cirrhosis. But scientific studies show mixed results. Most studies show milk thistle improves liver function and increases survival in people with cirrhosis or chronic hepatitis. But problems in the design of the studies (such as small numbers of participants and differences in dosing and duration of milk thistle therapy) make it hard to draw any real conclusions.

Viral hepatitis

Milk thistle is widely used in the treatment of viral hepatitis (particularly hepatitis C). But studies show mixed results. Some found improvements in liver function, while others did not. None of the studies compared milk thistle with interferon or other medications for viral hepatitis.

Mushroom poisoning

Based on traditional use, milk thistle has been used as an emergency antidote to poisoning by deathcap mushroom (Amanita phalloides). Animal studies have found that milk thistle extract completely counteracts the toxic effects of the mushroom when given within 10 minutes of ingestion. If given within 24 hours, it significantly reduces the risk of liver damage and death.

Cancer

Early laboratory studies also suggest that silymarin and other active substances in milk thistle may have anti-cancer effects. These substances appear to stop cancer cells from dividing and reproducing, shorten their life span, and reduce blood supple to tumors. More studies are needed, however, to show whether milk thistle has any effects in the body (not just test tubes).

Plant Description

Milk thistle is native to the Mediterranean region, and is now found throughout the world. This stout thistle usually grows in dry, sunny areas. The spiny stems branch at the top, and reach a height of 4 to 10 feet. The leaves are wide, with white blotches or veins. Milk thistle gets its name from the milky white fluid that comes from the leaves when they are crushed. The flowers are red-purple. The small, hard-skinned fruit is brown, spotted, and shiny. Milk thistle spreads quickly (it is considered a weed in some parts of the world), and it matures quickly, in less than a year.

What's It Made Of?

The active ingredient -- the one that protects the liver -- in milk thistle is known as silymarin. Silymarin is actually a group of flavonoids (silibinin, silidianin, and silicristin), which are thought to help repair liver cells damaged by alcohol and other toxic substances. Silymarin also keeps new liver cells from being destroyed by these same toxins. It reduces inflammation (which is why it is often suggested for people with liver inflammation or hepatitis), and is a strong antioxidant.

Most milk thistle products are standardized preparations made from the seeds of the plant. Most preparations are standardized to contain 70 - 80% of silymarin.

Available Forms

  • Capsules of standardized dried herb (each capsule contains about 120 - 140 mg silymarin)
  • Liquid extract
  • Tincture
  • Silymarin phosphatidylcholine complex

A few studies show that a silymarin-phosphatidylcholine complex may be absorbed more easily than regular standardized milk thistle. Phosphatidylcholine is a key element in cell membranes. It helps silymarin attach easily to cell membranes, which may keep toxins from getting inside liver cells. Alcohol extracts should be avoided by anyone with alcohol-related liver disease.

How to Take It

Pediatric

There are no studies showing whether it is safe to give milk thistle to a child. Liver problems can be serious and should be diagnosed by a physician. Talk to your doctor before giving milk thistle to a child.

Adult

If you think you have a liver problem, you should see a doctor. Liver disease can be life threatening.

  • Recommended dose: 280 - 450 mg per day in divided doses or silymarin-phosphatidylcholine complex 100 - 200 mg two times per day.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care practitioner.

Milk thistle is generally regarded as safe. Side effects are usually mild and may involve stomach upset and diarrhea. Some people may get a rash from touching milk thistle plants.

Milk thistle should not be used by pregnant or breastfeeding women.

People with a history of hormone-related cancers, including breast and uterine cancer and prostate cancer, should not take milk thistle.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use milk thistle without first talking to your healthcare provider.

  • Antipsychotics -- includes butyrophenones (such as haloperidol) and phenothiazines (such as chlorpromazine, fluphenazine, and promethazine)
  • Phenytoin (Dilantin) -- a medication used for seizures
  • Halothane -- a medication used during general anesthesia

Milk thistle may interfere with the following medications, because both milk thistle and these medications are broken down by the same liver enzymes:

  • Allergy drugs -- such as fexofenadine (Allegra)
  • Drugs for high cholesterol -- including statins such as lovastatin (Mevacor, Altocor)
  • Anti-anxiety drugs -- including alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan)
  • Antiplatelet and anticoagulant drugs (blood thinners) -- including clopidogrel (Plavix) and warfarin (Coumadin)
  • Some cancer drugs

Sunday, December 20, 2009

Medicinal Food: Passionflower

Passionflower

Overview

Passionflower (Passiflora incarnata) was used traditionally in the Americas and later in Europe as a "calming" herb for anxiety, insomnia, seizures, and hysteria. It is still used today to treat anxiety and insomnia. Although scientists aren't sure, it is believed that passionflower works by increasing levels of a chemical called gamma-aminobutyric acid (GABA) in the brain. GABA lowers the activity of some brain cells, making you more relaxed.

Passionflower tends to have effects that aren't as strong as valerian (Valeriana officinalis) or kava (Piper methysticum), two other herbs used to treat anxiety. Passionflower is often combined with valerian, lemon balm (Melissa officinalis), or other calming herbs. Few scientific studies have tested passionflower as a treatment for anxiety or insomnia, however. And because it is often combined with other calming herbs, it is difficult to tell what the effects of passionflower alone might be.

One study of 36 people with generalized anxiety disorder found that passionflower was as effective as the drug oxazepam (Serax) for treating symptoms. However, the study lacked a placebo group, so it is not considered to be definitive. In another study of 91 people with anxiety symptoms, researchers found that an herbal European product containing passionflower and other herbal sedatives significantly reduced symptoms compared to placebo. A more recent study found that patients who were given passionflower before surgery had less anxiety, but recovered from anesthesia just as quickly, than those given placebo.

Plant Description

Native to southeastern parts of the Americas, passionflower is now grown throughout Europe. It is a perennial climbing vine with herbaceous shoots and a sturdy woody stem that grows to a length of nearly 10 meters (about 32 feet). Each flower has 5 white petals and 5 sepals that vary in color from magenta to blue. According to folklore, passionflower got its name because its corona resembles the crown of thorns worn by Jesus during the crucifixion. The passionflower's ripe fruit is an egg-shaped berry that may be yellow or purple. Some kinds of passionfruit are edible.

Parts Used

The above-ground parts (flowers, leaves, and stems) of the passionflower are used for medicinal purposes.

Available Forms

Available forms include the following:

  • Infusions
  • Teas
  • Liquid extracts
  • Tinctures

How to Take It

Pediatric

No studies have examined the effects of passionflower in children, so do not give passionflower to a child without a doctor's supervision. Adjust the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. So if a child weighs 50 lb (20 - 25 kg), the appropriate dose of passionflower for this child would be 1/3 of the adult dosage.

Adult

The following are recommended adult doses for passionflower:

  • Tea: Steep 0.5 - 2 g (about 1 tsp.) of dried herb in 1 cup boiling water for 10 minutes; strain and cool. For anxiety, drink 3 to 4 cups per day. For insomnia, drink one cup an hour before going to bed.
  • Fluid extract (1:1 in 25% alcohol): 10 - 30 drops, three times a day
  • Tincture (1:5 in 45% alcohol): 10 - 60 drops, three times a day

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider.

Do not take passionflower if you are pregnant or breastfeeding.

For others, passionflower is generally considered to be safe and nontoxic in recommended doses.

Possible Interactions

Passionflower may interact with the following medications:

Sedatives (drugs that cause sleepiness) -- Because of its calming effect, passionflower may make the effects of sedative medications stronger. These can include:

  • Anticonvulsants such as phenytoin (Dilantin)
  • Barbiturates
  • Benzodiazepines such as alprazolam (Xanax) and diazepam (Valium)
  • Drugs for insomnia, such as zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), ramelteon (Rozerem)
  • Tricyclic antidepressants, such as amitriptyline (Elavil), amoxapine, doxepin (Sinequan), and nortriptyline (Pamelor)

Antiplatelets and anticoagulants (blood thinners) -- Passionflower may increase the amount of time blood needs to clot, so it could make the effects of blood-thinning medications stronger and increase your risk of bleeding. Blood-thinning drugs include:

  • Clopidogrel (Plavix)
  • Warfarin (Coumadin)
  • Aspirin

Monoamine oxidase inhibitors (MAO inhibitors or MAOIs) -- MAO inhibitors are an older class of antidepressants that are not often prescribed now. Theoretically, passionflower might increase the effects of MAO inhibitors, as well as their side effects, which can be dangerous. These drugs include:

  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)

Saturday, December 19, 2009

Medicinal Herbs: Lavender

Lavender

Overview

Many people appreciate lavender (Lavandula angustifolia, or Lavandula officinalis) for its fragrance, used in soaps, shampoos, and sachets for scenting clothes. The name lavender comes from the Latin root lavare, which means "to wash." Lavender may have earned this name because it was frequently used in baths to help purify the body and spirit. However, this herb has also been used as a remedy for a range of ailments from insomnia and anxiety to depression and fatigue. Research has confirmed that lavender produces slight calming, soothing, and sedative effects when its scent is inhaled.

Plant Description

Lavender is native to the mountainous zones of the Mediterranean where it grows in sunny, stony habitats. Today, it flourishes throughout southern Europe, Australia, and the United States. Lavender is a heavily branched short shrub that grows to a height of roughly 60 centimeters (about 24 inches). Its broad rootstock bears woody branches with upright, rod-like, leafy, green shoots. A silvery down covers the gray-green narrow leaves, which are oblong and tapered, attached directly at the base, and curled spirally.

The oil in lavender's small, blue-violet flowers gives the herb its fragrant scent. The flowers are arranged in spirals of 6 - 10 blossoms, forming interrupted spikes above the foliage.

Parts Used

Essential oil is extracted from the fresh flowers of the lavender plant and used for medicinal purposes.

Medicinal Uses and Indications

A number of studies have reported that lavender essential oil may be beneficial in a variety of conditions, including insomnia, alopecia (hair loss), anxiety, stress, and postoperative pain. However, most of these studies have been small. Lavender is also being studied for antibacterial and antiviral properties. Lavender oil is often used in other forms of integrative medicine, such as massage, acupuncture, and chiropractic manipulation.

Insomnia or Agitation

In folklore, pillows were filled with lavender flowers to help restless people fall sleep. Scientific evidence suggests that aromatherapy with lavender may slow the activity of the nervous system, improve sleep quality, promote relaxation, and lift mood in people suffering from sleep disorders. Studies also suggest that massage with essential oils, particularly lavender, may result in improved sleep quality, more stable mood, better concentration, and reduced anxiety. In one recent study, people who received massage with lavender felt less anxious and more positive than those who received massage alone. Several small studies suggest that lavender aromatherapy may help reduce agitation in patients with dementia. Lavender flowers have also been approved in Germany as a tea for insomnia, restlessness, and nervous stomach irritations.

Alopecia areata

In one study of 86 people with alopecia areata (an autoimmune disease that causes hair to fall out, often in patches), those who massaged their scalps with lavender and other essential oils daily for 7 months experienced significant hair re-growth compared to those who massaged their scalps without the essential oils. However, there is no way to tell whether it was one or the combination of oils that was effective.

Other uses

Aromatherapists also use lavender in inhalation therapy to treat headaches, nervous disorders, and exhaustion. Herbalists treat skin ailments, such as fungal infections (like candidiasis), wounds, eczema, and acne, with lavender oil. It is also used in a healing bath for joint and muscle pain. One study evaluating treatments for children with eczema founded it was therapeutic touch from the mother that improved symptoms; in other words, massage with and without essential oils (including lavender) both reduced the dry, scaly skin lesions. Another study found that lavender oil may improve pain control after surgery. Fifty patients undergoing breast biopsy surgery received either oxygen supplemented with lavender oil or oxygen alone. Patients in the lavender group reported better pain control than patients in the control group.

Available Forms

Commercial preparations are made from dried flowers and essential oils of the lavender plant. These preparations are available in the following forms:

  • Aromatherapy oil
  • Bath gels
  • Extracts
  • Infusions
  • Lotions
  • Soaps
  • Teas
  • Tinctures
  • Whole, dried flowers

How to Take It

Pediatric

  • Oral use in children is not recommended.
  • May be used topically in diluted concentrations to treat skin infections and injuries, such as minor cuts and scrapes. Never use lavender on an open wound; seek immediate medical attention.
  • A small study published in the New England Journal of Medicine in 2007 concluded that lavender and tea oils in some shampoos, soaps, and lotions may cause gynecomastia, breast development in a male, in boys. If you have any concerns, ask your doctor about using lavender for a child.
  • May be used as aromatherapy for children. Use 2 - 4 drops in 2 - 3 cups of boiling water. Inhale vapors for headache, depression, or insomnia.

Adult

The following are recommended adult doses for lavender:

  • Internal use: Tea: 1 - 2 tsp whole herb per cup of hot water. Steep for 10 - 15 minutes and drink, 1 - 3 times a day.
  • Tincture (1:4): 20 - 40 drops, 3 times a day
  • Inhalation: 2 - 4 drops in 2 - 3 cups of boiling water. Inhale vapors for headache, depression, or insomnia.
  • Topical external application: lavender oil is one of the few oils that can be safely applied undiluted. For ease of application, add 1 - 4 drops per tablespoon of base oil (such as almond or olive oil). Lavender oil is toxic if taken orally. Only use the oil externally or by inhalation. Also, avoid contact with eyes or mucous membranes such as the lips and nostril.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active components that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.

Some people may develop an allergic reaction to lavender. Nausea, vomiting, headache, and chills have also been reported in some people after inhaling or absorbing lavender through the skin.

Pregnant and breastfeeding women should avoid using lavender.

Possible Interactions

  • CNS Depressants -- There are no known scientific reports of interactions between lavender and conventional medications. However, because lavender promotes relaxation, it may make the effects of central nervous depressants stronger. These drugs include narcotics such as morphine or oxycodone (OxyContin) for pain, and sedative and anti-anxiety agents such as lorazepam (Ativan), diazepam (Valium), and alprazolam (Xanax). Ask your doctor before using lavender with these and other sedatives.

Friday, December 18, 2009

Medicinal Herbs: Kava Kava

Kava kava

Overview

Kava kava (Piper methysticum) has been used as a ceremonial drink in the Pacific Islands for hundreds of years. It has been reported to have an effect similar to an alcoholic drink.

The roots are chewed or ground into a pulp and added to cold water. The resulting thick brew, which has been compared to the social equivalent of wine in France, is offered to guests and dignitaries visiting the Pacific Islands.

In addition to its ceremonial uses, kava is best known for its relaxing qualities. Kava is said to elevate mood, well-being, and contentment, and produce a feeling of relaxation. Several studies have found that kava may be useful in the treatment of anxiety, insomnia, and related nervous disorders.

However, there is serious concern that kava may cause liver damage. More than 30 cases of liver damage have been reported in Europe. It's not clear whether the kava itself was the cause of the liver damage or whether it was taking kava in combination with other drugs or herbs. It's also not clear whether kava is dangerous at previously recommended doses, or only at higher doses. Some countries have taken kava off the market. It remains available in the United States, but the Food and Drug Administration (FDA) issued a consumer advisory in March of 2002 regarding the "rare" but potential risk of liver failure associated with kava-containing products. (See "Precautions" section.)

Because it is impossible to say what -- if any -- dose of kava might be safe, you should not take kava unless you are under a doctor's close supervision.

Plant Description

Kava is a tall shrub that grows in the islands of the Pacific Ocean. This shrub produces large, green, heart-shaped leaves that grow thickly on the branches. Long, slender flowers grow where the branches meet the stems. The roots look like bundles of woody, hairy branches. The root is the part of the plant used medicinally.

Medicinal Uses and Indications

Because kava may cause liver damage, you should not use it unless you are under a doctor's supervision. Evidence suggests kava may be helpful for the following health problems:

Anxiety

A number of clinical studies -- though not all -- have found kava kava to be effective in treating symptoms associated with anxiety. In a review of seven scientific studies, researchers concluded that a standardized kava extract was significantly more effective than placebo in treating anxiety. Another study found that kava substantially improved symptoms after only 1 week of treatment. Another study found that kava may be as effective as some prescription anti-anxiety medications. In fact, according to one study, kava and diazepam (Valium) cause similar changes in brain wave activity, suggesting that they may work in the same ways to calm the mind.

Research on using kava for anxiety has decreased because of reports of liver toxicity.

A 2004 study found that 300 mg of kava may improve mood and cognitive performance. That is significant because some prescription drugs used to treat anxiety, such as benzodiazepines (like Valium and alprazolam or Xanax), tend to decrease cognitive function.

Insomnia

There is some preliminary evidence that kava may help improve sleep quality and decrease the amount of time needed to fall asleep. However, more studies would be needed to say for sure. Because of the concerns about kava's safety and the fact that other herbs can treat sleeplessness, kava is not the best choice for treating insomnia.

What's It Made Of?

The main active ingredients in kava root are called kavalactones (kavapyrones). These chemicals (including kawain, dihydrokawain, and methysticum) have been extensively studied in laboratory and animal studies. They have been found to reduce convulsions, promote sleep, and relax muscles in animals. They also have pain-relieving properties, which may explain why chewing kava root tends to cause a temporary numbness and tingling sensation on the tongue.

Available Forms

In some parts of the world, whole kava roots are chewed for their medicinal value. Kava is also available in liquid form, as tinctures or standardized extracts, and powdered in capsules or tablets.

How to Take It

Because some people have developed severe liver damage, even liver failure, after taking kava you should only take it under a doctor's close supervision (See "Precautions" section). If you have liver disease (such as cirrhosis or hepatitis), you should not take kava at all.

Pediatric

Kava should not be given to children.

Adult

The doses listed below are the ones used in most studies. However, given reports of liver damage, it is now impossible to say what dose of kava may be considered safe. That is why it is important to have your doctor determine any dose of kava you may take.

Standardized dosage: 150 - 300 mg, 1 - 3 times daily as needed for anxiety or nervousness, standardized to contain 30 - 70 % kavalactones. Most clinical trials have used the German kava extract WS 1490.

Kava dried root: 2.0 - 4.0 grams as a decoction (a preparation made by boiling down the herb in water), up to 3 times daily.

It may take 4 weeks before you notice improvement. Kava should not be taken for more than 3 months without a 2-week rest period.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine. This is particularly true for kava, because there is evidence it may cause liver damage.

Reports in the United States and Europe have linked kava with severe liver problems. Kava-containing products have been associated with at least 25 reports of liver-related injuries (including hepatitis, cirrhosis, liver failure, and death). In one case report, a 50-year-old man developed hepatitis after taking three to four kava extracts daily for 2 months. His condition quickly deteriorated, and he needed a liver transplant.

There is much we don't know about kava's effect on the liver. It may be that the kava supplements some people took were contaminated with other substances that caused liver damage. Or it is possible that some people already had liver problems before taking kava, or that they took a combination of kava and other prescription medications or herbs that damaged their livers. It is also possible that the doses generally recommended for kava affect people differently, so that a dose that would cause liver damage in one person might have no effect on the liver in another person.

Because of the uncertainty around kava, you should only take it with your doctor's supervision. If you have taken kava and are experiencing symptoms of liver damage [such as yellow skin (jaundice), fatigue, abdominal pain, loss of appetite, nausea, vomiting, and joint pain], seek immediate medical attention.

People with liver damage should not take kava.

Pregnant or breastfeeding women should not take kava.

Do not take kava if you are going to have surgery (and tell your surgeon if you have taken it in the past). Kava can prolong the effect of anesthesia.

Do not drink alcohol and take kava.

Other side effects associated with kava include allergic skin reactions (such as contact dermatitis), dizziness, drowsiness, restlessness, stomach upset, and tremors. Long-term use at high doses may cause flaky, dry, and yellowish discoloration of the skin, hair loss (alopecia), partial loss of hearing, and loss of appetite. Like alcohol, kava may have intoxicating effects and should not be taken before operating a car or other machinery.

Possible Interactions

Do not take kava unless you are under the supervision of a doctor, especially if you are being treated for any disease. Do not take kava with any prescription and non-prescription medications.

Kava kava may interact with the following:

Anticonvulsants -- Kava may increase the effects of medications, such as phenytoin (Dilantin), that are used to treat seizures.

Alcohol -- Do not use kava and alcohol together. The risk of impairment and the risk of liver damage are greatly increased.

Anti-anxiety agents -- Kava may increase the effects of CNS depressants such as benzodiazepines, used for sleep disturbances or anxiety (particularly alprazolam or Xanax), and barbiturates (such as pentobarbital) which are used for sleep disorders and seizures. Benzodiazepines include:

  • Alprazolam (Xanax)
  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Triazolam (Halcion)
  • Chlordiazepoxide (Librium)

Diuretics (water pills) -- These drugs help rid the body of excess fluid. Kava can make the effects of these drugs stronger, raising the risk of dehydration.

Phenothiazine medications -- Kava may increase the risk of side effects associated with phenothiazine medications (often used for the treatment of schizophrenia), including chlorpromazine (Thorazine); and promethazine (Phenergan), which is used as an antihistamine.

Levodopa -- There has been at least one report that kava may reduce the effectiveness of levodopa, a medication used to treat Parkinson's disease. You should not take kava if you are taking any medications containing levodopa or if you have Parkinson's disease.