Botanical Medicine April 23, 2009
Herbal Medicines
Might consist of any part of a plant or plant product used for therapeutic purposes.
Algae and medicinal mushrooms are also used.
Have been traditionally used all over the world, and are included in some of the earliest writings-- Long history of use.
Are considered a Biologically based CAM modality by NCCAM.
Herbal Medicine Today
Also known as phytotherapy or botanical medicine.
Is used by a significant and growing percentage of U.S. Adults, and over 75% of the world’s population.
May be used with or without the assistance of a provider.
Regulation of botanical medicines
Regulated by FDA as dietary supplements-- no pre-market clinical trials required.
Manufacturers now required to follow strict GMP’s-- good manufacturing practices
Reports of Adulteration and contamination still do occur.
Ginkgo
Ginkgo biloba
Used to support healthy brain function and circulation
Primary mechanism of action appears to be vasodilation/anticoagulant properties
May increase bleeding, especially when taken with other anticoagulants
St. Johnswort
Hypericum perforatum
Used to support a healthy mood-- often as a remedy for depression or anxiety.
Contains MAOI and SSRI consituents; side effects generally well tolerated.
Strong inducer of CYP450 (3a4) pathway; numerous drug interactions.
Photosensitizes some individuals
Ginseng
Panax spp.
Used to improve stamina and general wellness
Contains steroidal saponosides, micronutrients, polysaccharides
Often has stimulant-like effects, occasionally causes increase in blood pressure
Echinacea
Echinacea spp.
Taken to support the immune system; Tends to increase immune responses
Traditionally used to maintain, rather than restore, good health; Modern users may apply differently
Should not be taken by individuals with autoimmune conditions, or those undergoing immunosuppressive therapy
Soy
Glycine max
Taken to supplement levels of estrogen; often consumed as food, sometimes a major component of dietary intake
Contains Isoflavones (phytoestrogens) which may increase or decrease total estrogenic activity
Cascara Sagrada
Frangula purshiana
Stimulant laxative; use may lead to dependence
Fluid extract is regulated as a drug by FDA; May also be sold as dietary supplement
Occasionally misbranded as a “fiber-based laxative”; users may be unaware of risks
Licorice
Glycyrhiza glabra
Used effectively for short-term relief of gastric pain
Long-term use may cause hypokalemia
Various other indications and uses
Red Clover
Trifolium repens
Used for phytoestrogen content (comparable to soy); also used as a “blood purifier”
Mass-processed herbal products may contain dicoumarol, a potent anticoagulant
Valerian
Valeriana officinalis
Effectively used as an anxiolytic, also widely used to promote sleep
Contains Valeric acid and its derivatives, substances similar to valproic acid (propyl valeric acid)
Side effects are usually limited to drowsiness, vivid dreams
Chamomile
Matricaria et Anthemis spp.
Used to promote sleep, reduce anxiety, and for several other indications; also widely consumed as a beverage
May antagonize benzodiazepines
Rumors of cross-sensitivity with ragweed are unsubstantiated; serious allergic reactions are rare |
