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PubMed2002

The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines.

BACKGROUND: Some herbal remedies are sold as food additives and are believed to have immune-enhancing properties. OBJECTIVES: To study the effect of five herbal remedies--Sambucol Black Elderberry Extract, Sambucol Active Defense Formula and Sambucol for Kids (with known antiviral properties), Protec and Chizukit N (containing propolis and Echinacea, claimed to be immune enhancers)--on the production of cytokines, one of the main components of the immune system. METHODS: The production of four inflammatory cytokines (interleukin-1 beta, tumor necrosis factor alpha, and IL-6 and IL-8) and one anti-inflammatory cytokine (IL-10) was tested using blood-derived monocytes from 12 healthy donors. RESULTS: The Sambucol preparations increased the production of five cytokines (1.3-6.2 fold) compared to the control. Protec induced only a moderate production of IL-8 (1.6 fold) and IL-10 (2.3 fold) while Chizukit N caused only a moderate increase in IL-10 production (1.4 fold). Both Protec and Chizukit N caused moderate decreases in IL-1 beta, TNF alpha and IL-6 production. Lipopolysaccharide, a known activator of monocytes, induced the highest levels of cytokine production (3.6-10.7 fold). CONCLUSIONS: The three Sambucol formulations activate the healthy immune system by increasing inflammatory and anti-inflammatory cytokines production, while the effect of Protec and Chizukit N is much less. Sambucol could therefore have immunostimulatory properties when administered to patients suffering from influenza (as shown before), or immunodepressed cancer or AIDS patients who are receiving chemotherapy or other treatments.

Anti-Infective Agents↗
PubMed2002

Herbs commonly used by women: an evidence-based review.

OBJECTIVE: To review the evidence of herbs commonly used by women. DATA SOURCES: Articles were located by searching Medline, Cochrane Database of Systemic Reviews, and the Combined Health Information Database and by hand searching the reference lists of recent systematic reviews. The databases were searched in January 2000 and October 2000 by using the Latin and common name of each herb. METHODS OF STUDY SELECTION: Preference was given to randomized, placebo-controlled trials. When available, English language studies were reviewed. If not, data are presented from review articles that summarize the foreign study. RESULTS: Many women use herbal therapies. In the United States, herbs are considered dietary supplements. The Food and Drug Administration (FDA) cannot remove them from the market unless they are proven unsafe. The herb industry plans to improve monitoring. Many prospective randomized controlled trials are being funded. Gingko biloba seems to slow the progression of dementia but increases the risk of bleeding. St John's Wort is efficacious for treating mild to moderate depression but has many drug interactions. Ginseng seems to improve well being in perimenopausal women, but it is often impure and has side effects and drug interactions. Garlic slightly lowers blood pressure and lipids. Echinacea slightly decreases the duration of colds but does not prevent them. Valerian is beneficial for insomnia, but there is no long-term safety data. Black cohosh may help the symptoms of perimenopause, and chasteberry may improve premenstrual syndrome. More study is needed on both herbs. CONCLUSION: Some herbs are medically useful, but the American public would benefit from increased regulation. Manufacturers should be able to ensure that herbs contain pure ingredients. Side effects and drug interactions should be listed. Well-designed studies are being conducted. The results will be helpful to physicians and patients when the clinical evidence becomes available.

Cimicifuga↗
PubMed2002

[Herbal preparations have both effects and side effects. Widespread usage dictates knowledge among physicians].

The article gives a clinically oriented overview of the efficacy and safety of Ginkgo biloba, St. John's wort, ginseng, Echinacea, saw palmetto and kava based on American experiences. Clinical data support the efficacy for some of these drugs. None of them is free of adverse effects. Generally speaking, trials of herbal medicinal products have been too few, too small and too short. The lack of long-term studies is especially unfortunate since many of the drugs are used for a long time. The difference between American and Swedish legislation on herbal medicine products is described.

Echinacea↗
PubMed2003

The effect of herbal remedy on the development of Trichinella spiralis infection in mice.

The effect of Alchinal (a complex preparation consisting of three substances: Echinacea purpurea extract, Allium sativum extract, cocoa) on the development of Trichinella spiralis infection in mice was studied. The preparation was administered to the animals orally, twice a day in 30 microl doses for 10 days after infecting mice with Trichinella larvae (500 larvae per mouse). It was demonstrated that after Alchinal administration, the number of adult forms (10 dpi--days post infection) and muscular larvae (36 dpi) significantly decreased. It is suggested that the remedy studied causes antiparasitic immunity enhancement in mice. Modulation of immunity by individual component(s) and/or joint action of the substances contained in Alchinal increases the antiparasitic defence of the organism.

Adjuvants, Immunologic↗
PubMed2004

Herbal supplement use among US women, 2000.

OBJECTIVE: To examine the prevalence of herbal supplement use and its association with sociodemographic, health status, and health behavior characteristics in a nationally representative sample of US women. METHODS: We analyzed the cancer supplement file of the 2000 National Health Interview Survey, which included 11,888 non-Hispanic white, 2866 non-Hispanic black, 3035 Hispanic, and 599 non-Hispanic other women. Bivariate and multivariate analyses were conducted to examine the relationship between sociodemographic, health status, and health behavior characteristics and the use of: 1) any herbal supplement; 2) Echinacea, Ginkgo biloba, ginseng, or St. John's wort; and 3) at least 3 herbal supplements concurrently. RESULTS: Nearly one-sixth of US women took at least 1 herbal supplement in 2000. Logistic regression showed that women who were non-Hispanic white, aged 35 to 64 years, more educated, not poor, current alcohol users, residents of the South and West, and who had functional limitations and chronic conditions were significantly more likely to take the most commonly reported herbal supplements. CONCLUSION: Our study suggests high levels of herbal supplement use among US women. Supplement use is generally associated with higher education, higher income, residence in the South and West, and health needs. The growing practice of herbal supplement use suggests a need for public health guidance on the safe and efficacious use of these products.

Adolescent↗
PubMed2004

[Potential risks, adverse effects and drug interactions associated with herbal medicine in dental patients].

Herbal medicine is an increasingly common form of alternative therapy in the United States. Most herbal products are considered dietary supplements and thus are not regulated as medicines. They are marketed without prior approval of their efficacy and safety by the Food and Drug Administration (FDA). Some herbal medications have potentially harmful side effects as well as adverse interactions with conventional drugs. The adverse reactions involve all systems, age groups and severity. It is important for dentists and other health care providers to obtain adequate information as to what herbal medications their patients are taking. It is also necessary for professionals to acquire knowledge regarding herbal medications as to their use and to educate their patients about the risk-benefit and potential interactions these medications may have with over-the-counter and prescription drugs. The purpose of this article was to review the literature on the potential risks of commonly used herbal medications: Ginkgo Biloba, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, Garlic, Kava and Ephedra.

Echinacea↗
PubMed2005

[Technology of extract improving the immune system].

The article deals with the production of the extract of Echinacea purpurea herbs when selecting an extractant concentration, the size of particles in a raw material and the method of extraction. Using 60% (v/v) ethanol for production of the immune system enhancing extract, the extract becomes green due to pigmental substances; therefore, 60% (v/v), 70% (v/v), and 96% (v/v) ethanol was not used for extraction. It is recommended to use 50% (v/v) ethanol for extraction. Using 40% (v/v) ethanol not all active substances are extracted and resistance of the extract to microbial contamination is weaker. It was determined that the method of repercolation should be used to yield the largest amount of active substances. The largest amount of active substances in the immune system enhancing extract was obtained when the flow speed of extract was 0.2 ml/min. The quality of extract was tested within the period of 26 months by the monitoring of following parameters: appearance of the extract, refraction index, relative density, ethanol concentration, the amounts of dry residue and chicoric acid. The analysis was carried out every three months. The samples of the extract remained stable during storage: no alterations of color, smell or taste were observed. Some of the samples had deposits, which is quite natural in the production of drugs from herbal material, as they have no influence on the quality of the drug (the amounts of active substances were found to be within acceptable limits). On the basis of the obtained results, the period of expiry of the immune system enhancing tincture was confirmed to be 2 years.

Caffeic Acids↗
PubMed2006

Influence of garlic, synthetic 1,2,4-triasole derivative and herbal preparation echinovit C on selected indices of turkey-hens non-specific immunity.

Successful results of earlier studies on testing the immune-modulating and anti-microbial properties of 1,2,4-triasole derivative as well as benefitial application of natural bio-stimulators in animal's prophylaxis and treatment inspired us to undertake further investigations. The aim of the present study was to evaluate and compare the prophylaxis effects of two natural immune-modulating agents, garlic (Allium sativum) extract and Echinovit C preparation and synthetic derivative of 1,2,4-triasole on non-specific immunity indices in slaughter turkey-hens. The results obtained suggest that the strongest stimulatory effect is exerted by garlic followed by 1,2,4-triasole derivative and Echinacea juice. Immune-modulating action of the substances applied was manifested by an increase in cellular immune parameters: the percentage of phagocyting cells, NBT-positive granulocytes and lysozyme level.

Animals↗
PubMedDate not supplied

[Effect of supposed radioprotectors on oxidation-reduction of vitamin E in the tissues of irradiated rats].

In experiments with mature Wistar male rats under irradiation by dose of 5 Gy the effect of emoxypine, citomedine and echinacea purpurea on the content of liposoluble vitamin A, carotene, vitamin E and its metabolites (quinone and oxidized tocopherol) in blood plasma, spleen, liver and testes was studied. It was shown the drugs under study mobilized the internal reserves of these vitamins and promoted effective functioning of vitamin E redox system. Mechanisms of their action are different. The drugs might be used as radioprotectors, but they exhaust the reserves of the liposoluble vitamins. Therefore they should be used in a combination with vitamin preparations.

Animals↗
PubMed2003

Variations in product choices of frequently purchased herbs: caveat emptor.

BACKGROUND: Patients who report use of herbs to their physicians may not be able to accurately describe the ingredients or recommended dosage because the products for the same herb may differ. The purpose of this study was to describe variations in label information of products for each of the 10 most commonly purchased herbs. METHODS: Products for each of 10 herbs were surveyed in a convenience sample of 20 retail stores in a large metropolitan area. Herbs were those with the greatest sales dollars in 1998: echinacea, St John's wort, Ginkgo biloba, garlic, saw palmetto, ginseng, goldenseal, aloe, Siberian ginseng, and valerian. RESULTS: Each herb had a large range in label ingredients and recommended daily dose (RDD) across available products. Strengths were not directly comparable because of ingredient variability. Among 880 products, 43% were consistent with a benchmark in ingredients and RDD, 20% in ingredients only, and 37% were either not consistent or label information was insufficient. Price per RDD was a significant predictor of consistency with the benchmark, but store type was not. CONCLUSIONS: Persons self-medicating with an herb may be ingesting ingredients substantially different from that recommended by a benchmark, both in quantity and content. Higher price per label RDD was the best predictor of consistency with a benchmark. This study demonstrates that health providers and consumers need to closely examine label ingredients of presumably the same or similar herbal products.

Cross-Sectional Studies↗
PubMed2006

Factors associated with dietary supplement use among prescription medication users.

BACKGROUND: We examined the patterns of nonvitamin dietary supplement (NVDS) use among adult prescription medication users in the United States. METHODS: Using the 2002 National Health Interview Survey, we analyzed factors associated with NVDS use and prescription medication use in the prior 12 months with descriptive, chi(2), and logistic regression analysis. RESULTS: In the United States, 21% of adult prescription medication users reported using NVDSs in the prior 12 months. Of the respondents who used both prescription medications and NVDSs in the prior 12 months, 69% did not discuss this use with a conventional medical practitioner. Among adults who used prescription medications in the prior 12 months, the most commonly used supplements included echinacea, ginseng, ginkgo, garlic, and glucosamine chondroitin. Prescription medication users with menopause and chronic gastrointestinal disorders had the highest rates of NVDS use (33% and 28%, respectively), and prescription medication users with coronary heart disease and history of myocardial infarction had the lowest rates of use (12% each). In the adjusted analysis, factors associated with increased use of NVDSs by prescription medication users included being female, being Hispanic, having more years of education, living in the West, lacking medical insurance, and having chronic conditions. Elderly respondents were less likely to use NVDSs. CONCLUSION: One in 4 prescription medication users took an NVDS in the prior 12 months, yet the majority did not share this with a conventional medical professional.

Adult↗
PubMed2003

Internet marketing of herbal products.

CONTEXT: Passage of the Dietary Supplement Health and Education Act in 1994 restricted the Food and Drug Administration's control over dietary supplements, leading to enormous growth in their promotion. The Internet is often used by consumers as a source of information on such therapies. OBJECTIVE: To assess the information presented and indications claimed on the Internet for the 8 best-selling herbal products. DATA SOURCES: We searched the Internet using the 5 most commonly used search engines. For each, we entered the names of the 8 most widely used herbal supplements (ginkgo biloba, St John's wort, echinacea, ginseng, garlic, saw palmetto, kava kava, and valerian root). We analyzed the health content of all Web sites listed on the first page of the search results. STUDY SELECTION: We analyzed all accessible, English-language Web sites that pertained to oral herbal supplements. A total of 522 Web sites were identified; of these, 443 sites met inclusion criteria for the analysis. DATA EXTRACTION: The nature of the Web site (retail or nonretail), whether it was a sponsored link, and all references, indications, claims, and disclaimers were recorded. Two reviewers independently categorized medical claims as disease or nondisease according to Food and Drug Administration criteria. DATA SYNTHESIS: Among 443 Web sites, 338 (76%) were retail sites either selling product or directly linked to a vendor. A total of 273 (81%) of the 338 retail Web sites made 1 or more health claims; of these, 149 (55%) claimed to treat, prevent, diagnose, or cure specific diseases. More than half (153/292; 52%) of sites with a health claim omitted the standard federal disclaimer. Nonretail sites were more likely than retail sites to include literature references, although only 52 (12%) of the 443 Web sites provided referenced information without a link to a distributor or vendor. CONCLUSIONS: Consumers may be misled by vendors' claims that herbal products can treat, prevent, diagnose, or cure specific diseases, despite regulations prohibiting such statements. Physicians should be aware of this widespread and easily accessible information. More effective regulation is required to put this class of therapeutics on the same evidence-based footing as other medicinal products.

Advertising↗
PubMed2001

High-performance liquid chromatography determination of hydrastine and berberine in dietary supplements containing goldenseal.

Goldenseal (Hydrastis canadensis L., Ranunculaceae) is an ingredient of various dietary supplements intended for enhancing general body immunity. Many goldenseal products are currently available in the United States, either alone or in combination with echinacea. In most products, the content of the main active alkaloids of goldenseal, hydrastine and berberine, is not indicated on the label. A high-performance liquid chromatography (HPLC) method has been developed for the detection and quantification of hydrastine and berberine in a number of products obtained from the United States market. The method uses a Phenomenex Luna C(18) column, a mobile phase consisting of solvent A (100 mM sodium acetate/acetic acid, pH 4.0) and solvent B (acetonitrile/methanol; 90/10, v/v). Elution was run at a flow rate of 1.0 mL/min, with a linear gradient of 80- 40% A in B over 20 min and ultraviolet detection at 290 nm. A wide range of content variation was observed for both alkaloids in the tested samples.

Alkaloids↗
PubMed2004

Consumption of dietary supplements in a liver transplant population.

The extensive use of alternative medicine products, herbal remedies, and vitamins in large doses has reached an all time high in the general public. Some agents are reported and advertised as immune stimulants and may interfere with patients suffering from immune modification, autoimmune diseases, or transplant recipients. In this report, we will present an investigation into the use of herbal remedies and vitamins in our liver transplant population. We performed an investigation using a questionnaire to determine the use of herbal products and vitamins in our liver transplant population. Medical records were reviewed for each liver transplant recipient that admitted to consuming herbal products or vitamins. Information collected included patient demographics, transplant related information, laboratory tests, outcomes, and herbs or vitamin products used. A total of 290 patients completed and returned the questionnaire. We found 156 admitting to taking more than a standard multivitamin and/or an herbal remedy. All patients were treated with steroids for allograft rejection and experienced a recurrence of amino transaminases following the removal of steroids. Further investigation into dietary supplements using a patient questionnaire form revealed that nearly 50% of patients admitted to using vitamins following transplantation, while 19% used herbal remedies combined with vitamins, most admitting to silymarin. One recipient was ingesting colostrum and required admission for the management of allograft rejection, while 5 patients had consumed large amounts of echinacea or CoEnzyme Q-10 and experienced elevations in their transaminases that resolved with discontinuation of the herb. The review also identified 4 patients with primary biliary cirrhosis and with transaminase elevation (mean values of aspartate aminotransferase and alanine aminotransferase levels of 88 and 95, respectively). All recipients were consuming vitamins, in particular high doses of vitamin E (tocopherol), more than 1 gram per day. All of the transplant recipients were instructed to discontinue all vitamin E products and the amino transaminases resolved over the following 30 to 60 days. In conclusion, this information reveals that a significant proportion of our liver transplant recipients consume herbal remedies. The results of this report suggest that transplant teams need to question each recipient about the use of herbal and vitamin remedies and educate them regarding the potential hazards.

Adult↗
PubMed2006

Herbal products: behaviors and beliefs among Italian women.

PURPOSE: The use of phytotherapy is growing worldwide, but the popular perception is that this kind of approach is natural and therefore safer than traditional medicine; for this reason the use is frequently not communicated to the doctor. Instead, even if many herbal remedies are benign in nature, some of these therapies have potentially harmful side effects or adverse interactions with other medications. So, the purpose of our study was to analyze the behavior patterns and decision-making modalities about herbal remedy use among a sample of Italian women. METHODS: During a 5-month period, interviews to women attending the outpatient ambulatory of an urban university general hospital were made on the basis of a pre-structured 25-item questionnaire. RESULTS: Among a random study population of 1,044 subsequent patients, 491 women (47.03%) reported to have been taking one or more herbal products in the last year, sometimes used during pregnancy or given to their children (35.23%). The 10 most frequently used herbal products reported were propolis, aloe, valerian root, blueberry, fennel, dandelion, mallow, arnica, thyme, and Echinacea. The major purposes for using these products were to stimulate the immune system and to cure respiratory problems. 47/491 (9.57%) women reported side effects, but only 36% referred to the doctor. In most of the cases, herbal products were taken in combination with drugs (44.61%) or homeopathic treatments (11.81%). The majority of our women did not obtain information about this kind of therapy from a health care provider (72.71%). CONCLUSIONS: The present survey highlights the general use of phytomedicines by a sample of Italian women, the potential risk of their confidence with the 'natural world,' and the lack of discussion on this argument with doctors and pharmacists. This suggests the importance of training for health care providers and the need of informational programs for consumers.

Adult↗
PubMed2004

Use of herbal drugs in pregnancy: a survey among 400 Norwegian women.

PURPOSE: To investigate the use of herbal drugs by pregnant women. METHODS: We interviewed 400 postpartum women at Ullevål University Hospital in Oslo, Norway about the use of herbal drugs, within 3 days after giving birth by using a structured questionnaire in the period from February to June 2001. RESULTS: We found that 36% of the pregnant women had used herbal drugs during pregnancy with an average of 1.7 products per woman. The proportion of women using herbal drugs increased throughout the first, second and third pregnancy trimester. The most commonly used herbs were echinacea, iron-rich herbs, ginger, chamomile and cranberry. Among the women having used herbal drugs in pregnancy, 39% had used herbal drugs that were considered possibly harmful or herbs where information about safety in pregnancy was missing. Herbal galactagogues had been used by 43% of the women who had breastfed a prior child during their breast-feeding period. Use of herbal drugs in pregnancy had most commonly been recommended by family or friends. CONCLUSION: The widespread use of herbal drugs during pregnancy indicates an increased need for documentation about the safety of herbal drugs in pregnancy. To meet the needs of pregnant women, it is necessary for health care personnel to have knowledge about herbal drugs during pregnancy.

Adult↗
PubMed2002

Inhibitory effect of herbal remedies on 12-O-tetradecanoylphorbol-13-acetate-promoted Epstein-Barr virus early antigen activation.

For the past several years we have been evaluating natural products as potential cancer chemopreventive agents in a short term in vitro assay involving Epstein--Barr virus early antigen (EBV-EA) activation in Raji cells promoted by phorbol ester, 12-O-tetradecanoylphorbol-13-acetate (TPA). Because of the current interest in the use of herbal remedies, we considered examining them for their cancer chemopreventive activities, using their extracts with a view to uncovering such benefits (if any) these remedies might possess. Thirty-six extracts of 32 herbs belonging to 27 families in use as herbal remedies including those of gingko, black cohosh, echinacea, kava-kava, saw palmetto, turmeric, angelica, wild yam, cat's claw, passion flower, muira puama, feverfew, blueberry, chasteberry, licorice, nettle, golden seal, pygeum, ginger, valerian and hops were prepared and evaluated. Turmeric at a concentration of 10 microg x ml (-1)exhibited the most potent anti-EBV-EA activity, which is ten times more than passionflower, that is next in the order of activity. At the concentration level of 100 microg ml (-1), several of the herbal remedies tested inhibited the EBV-EA in Raji cells exposed to the tumor promoter TPA (32 pM) by more than 90%. We also report for the first time the activities of 16 new medicinal plants as potential cancer chemopreventive agents. Since inhibitors of EBV-EA promoted by TPA in vitro have been shown to be effective anti-tumor promoting agents in laboratory animal models, our results indicate new and potential applications of these herbal remedies as cancer chemopreventive agents since they are already in clinical use in the human population.

Antigens, Viral↗
PubMed1996

The efficacy of Prrrikweg gel in the treatment of insect bites: a double-blind, placebo-controlled clinical trial.

OBJECTIVE: This study was conducted to examine the efficacy of Prrikweg gel, a homeopathic after-bite gel, in relieving the effects of mosquito bites, in particular itching and erythema. DESIGN: A double-blind, randomized, placebo-controlled clinical trial. SETTING: London School of Hygiene and Tropical Medicine. SUBJECTS: 100 healthy volunteers. METHODS: All subjects were bitten under laboratory conditions by Aedes aegypti mosquitoes at one spot on the ventral aspect of the left forearm and another on a corresponding position on the right forearm. One spot was treated with the homeopathic after-bite gel and the other with a placebo gel. MAIN OUTCOME MEASURES: Itching was assessed on a 5-point discrete rating scale at 0, 0.5, 1, 26.5, and 48 h post-bite to compare the itch-relieving efficacy of the two treatments. Erythema development was assessed by photographing the bite sites, measuring length and width of the erythema with a calliper, and comparing the ratio of the erythema surface at baseline T(0) to the mean erythema surface at 0.5, 1, 26.5, and 48 h post-bite (T mean) for the two treatments. RESULTS: Testing erythema development by comparing the ratio T(0)/T (mean, after-bite gel) and the ratio T(0)/T (mean, placebo gel) gave a two-tailed p = 0.098(95% Cl, -0.031-0.361) in favour of the after-bite gel. There was not a statistically significant difference between the itch relief provided by the two treatments (two-tailed p = 0.424; 95 percent Cl, -0.541-0.191). The correlation between itching and erythema was significant (r = 0.46; p < 0.001). CONCLUSIONS. There are strong indications that the homeopathic after-bite gel reduces erythema development following mosquito bites. The homeopathic mother tinctures of Echinacea angustifolia DC., Ledum palustre L., Urtica urens L. as well as the Hamamelis extract in this gel, whether alone or in combination, are the biologically active ingredients. The homeopathic after-bite gel was not demonstrated to relieve itching; however, based on the correlation between erythema and itching, an effect on itching is not inconceivable.

Adult↗