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Flashcards in Herbals Deck (27)
1

quality control

the wrong part of the plant may be picked (belladonna poisoning,
digitalis poisoning)
heavy metals may be found in herbal preparations(lead, arsenic
cadmium, copper, mercury)
JAMA Dec 2004 article: 20% of Ayurveda (an Indian Medical
System) herbal products sold in Boston contained toxic levels of
lead, mercury, and arsenic

2

EFFICACY AND SAFETY STUDIES

controlled studies of herbals are not profitable
there is little motivation for manufacturers to conduct
randomized, placebo-controlled, double-blinded clinical trials to
prove efficacy because 1) they are not required to do so and 2) they cannot patent the product to recoup the estimated $500 million it
costs to prove a new drug effective and safe
with the resultant lack of solid scientific analysis in the U.S.,
claims for benefits are thus mainly supported solely with anecdotal
case reports that fail to consider the natural history of the disease
or the placebo effect. Toxic effects, if any, are seldom reported.

3

black cohosh root

dec menopausal symptoms

4

echinacea

improved immune functions

5

garlic

dec LDL
low triglycerides
low plaque formation

6

ginkgo biloba leaf

improved cognition

7

ginseng root

low fatigue

8

saw palmetto berry

dec symptoms of BPH

9

st. john's wort

antidepressant for mild to moderate depression

10

valerian root

improved sleep quality

11

soy

improved blood lipids
low LDLs, TG, & cholesterol

12

glucosamine, chondroitin

decjoint pain
incjoint mobility
inc quality of life

13

creatine

may improve muscle mass, strength, & performance during short bouts of intense exercise

14

Top 10 selling herbal supplements

1. Garlic
2. Gingko
3. Echinacea
4. Soy (often included as a nutritional supplement)
5. Saw Palmetto
6. Ginseng
7. St. John’s wort
8. Black cohosh
9. Cranberry
10. Valerian

15

Garlic

a. contains allin which is converted to a bioactive
compound allicin (thought to be the active ingredient);
allicin is a sulfur compound and other sulfur compounds
in garlic may also be beneficial; HMG-CoA reductase
inhibition or block of TXA2 synthesis??
b. 900 mg/day of garlic powder or 2-5 g of fresh garlic
(1-2 cloves) for hyperlipidemia and hypertension
c. Garlic has some anticoagulant properties (prolongs bleed time so caution with warfarin)

16

Gingko

a. contains flavonoids, sesquiterpenes, and terpenes
b. 40-80 mg of gingko extract, three times a day for improved cognitive function

17

Echinacea

a. Echinacea purpura seems to have the greatest immune effect
b. may activate NK cells and monocytes
c. 6-9 mL of fresh juice, 0.9 g of cut root or equivalent extract for colds
d. hepatotoxicity risk if used for longer than 8 weeks

18

Soy

a. contains protein, isoflavones, fiber, and omega-6
fatty acids
b. soy protein seems to be most beneficial on blood lipids
c. 47 g/day for hyperlipidemia

19

Saw palmetto

a. is a type of palm tree in North America (southern
U.S. mainly); the berries have the greatest effect and they contain a variety of fatty acids, esters, and sterols
b. mechanism is proposed to involve inhibition of 5-alpha reductase
c. 1-2 g of cut fruit or 320 mg of lipophilic extract for BPH

20

Ginseng

a. active components in the root are the saponins, called ginsenosides
b. 1-2 g of dried root per day, or 100-300 mg of extract up to 3 times/day for fatigue

21

St. John’s wort

a. the active ingredient is thought to be hyperforin though there are many other compounds proposed to
mediate the antidepressant effect ( inc 5-HT?)
b. 2-4 g of dried herb, or 0.2-1 mg of hypericin for
depression
c. seems to induce CYP450 enzymes

22

Black cohosh

a. extracts are standardized to contain 1 mg of
triterpene saponins per 20 mg of extract
b. 40-80 mg per day for menopause

23

Valerian

a. supplements are standardized by the level of
valerenic acid
b. 400-600 mg/day to improve sleep quality

24

Glucosamine and chondroitin

a. glucosamine is an amino sugar while chondroitin is a glycosaminoglycan
b. 1500 mg/day of glucosamine and 800-2000 mg/day
of chondroitin for osteoarthritis

25

Creatine

a. synthesized endogenously from glycine and
arginine (urea cycle); 95% of total body creatine is in
skeletal muscle
b. dietary sources are meat and fish (~1 g/day)
c. doses usually taken are 20 g/day for 5 days then a maintenance dose of 2-5 g/day (which may be obtained
solely from the diet) for improved exercise performance

26

OTHER HERBS AND THEIR USES

1. Aloe: topically for burns
2. Angelica: gynecologic disorders (postmenopause, menstrual
discomfort)
3. Bee Pollen: allergies, asthma, impotence
4. Capsicum: pain (capsaicin)
5. Coenzyme Q10: heart disease and heart failure
6. DHEA: enhance immune system
7. Dong Quai: gynecologic disorders (irregular menstruation, PMS
8. Gotu Kola: immune stimulant, antifertility
9. Horse Chestnut: varicose veins, hemorrhoids
10. Kava-Kava: seizures, anxiety
11. Licorice: peptic ulcer
12. Melatonin: jet lag, sleep induction, cancer
13. Shark Cartilage: cancer
14. Yohimbe: aphrodisiac, male impotence

27

DANGERS OF USING HERBS

we just don’t know enough about herbs
herbs are not controlled to an extent where they can be
consistently reliable
Toxic ingredients, including pesticides, nondeclared drugs, and
added chemicals, are sometimes found in herbal preparations.
Heavy metals as well as the prescription drugs phenylbutazone
(NSAID that is no longer used due to toxicity), aminopyrine
(NSAID withdrawn from use due to potentially fatal bone marrow
toxicity), prednisone, testosterone, and diazepam, have been found
in herbal preparations.