Herbal Supplements

HERBAL SUPPLEMENTS NOTICE:

The source of the following information is the National Institutes of Health website: nlm.nih.gov/medlineplus/druginfo/herb. Since there are no standard doses for herbs, please read the instructions on the products you purchase or consult the NIH website for more details regarding safe dosing. Herbs have natural ingredients that are pharmacologically active. Therefore, the same cautions and concerns must be considered as one would for using prescription medications. Safety in pregnancy, herb-drug interactions, effects of long-term use, and side effects are often not well studied. Caution with their use is appropriate. It is generally a safe policy to avoid all herbs during pregnancy unless advised by a physician knowledgeable in the use of herbal medicines. Some of the herbs presented below lack adequate studies to determine their effectiveness and safety. Some of these herbs may, in fact, be shown to be effective in future studies, but are lacking sufficient evidence at the present time. Again, please consult the NIH website for more details before using these herbs.

HERBS

Bromelain: This is an enzyme extracted from pineapples that has anti-inflammatory properties. It is possibly effective for degenerative arthritis, also called osteoarthritis. It is often found in combination with other anti-inflammatory agents and herbs such as Turmeric. It should be used with caution with medications or herbs that slow clotting of the blood. Avoid if allergic to pineapples.

Devil’s Claw: This herb from Africa has many medicinal uses. It is a natural anti-inflammatory herb that is possibly effective for decreasing low back pain, and pain due to osteoarthritis. Its use in conjunction with a non-steroidal anti-inflammatory drug (NSAID) may allow lowering of the dose of the latter, thus reducing NSAID side effects, such as GI upset, bleeding, kidney damage. It should be used with caution if you have ulcers, take Coumadin, or take other medications.

Feverfew: This herb is possibly effective to prevent migraine headaches. The usual dose is 50-100 mg/day. It may take up to three months of use daily before its migraine preventive effects are noticed. Use caution when using it with anti-clotting drugs and herbs. It may affect the metabolism of medications.

Ginger: This tasty herb has several uses such as treatment for nausea and motion sickness. It has been used for reducing the pain of rheumatoid and osteoarthritis as demonstrated in some studies, however NIH finds there is insufficient evidence to rate its effectiveness for this use. More studies are needed.

Ginkgo: The herb from the leaves of this ancient tree is possibly effective for increasing blood flow and decreasing clotting that may help with leg pain while walking due to poor circulation (claudication). It is possibly effective for improving thinking problems related to ageing, and for cold hands and feet (Raynaud’s syndrome). It should not be used before surgery, with NSAIDs, Coumadin, or with other blood thinning medications and herbs. Avoid if you have ever had a seizure.

Passionflower: This plant has calming properties that make it suitable as a sedative, anti-anxiety agent. It is possibly effective for Generalized Anxiety Disorder, Adjustment Disorder with Anxiety, insomnia, and for opiate withdrawal when used in combination with clonidine, a prescription medication. It is generally safe. It is sold as an extract or as a capsule. One product recommends 90 mg at bedtime for sleep.

Senna: This is a natural laxative that is beneficial when taken for opiate-induced constipation. It can be combined with a stool softener, but should be used cautiously with other stimulant laxatives. A typical dose is 17.2 to 34.4 mg/day.

Shark Cartilage: Although this product has been promoted for cancer prevention and for osteoarthritis pain, there is insufficient evidence to demonstrate efficacy for the latter condition, and is likely to be ineffective for cancer prevention. I can’t recommend it.

Turmeric: This spice is found in curry and provides its mustard yellow color. It is considered possibly effective for an upset stomach. It is often used as an anti-inflammatory herb for the treatment of osteoarthritis, rheumatoid arthritis, and low back pain. There is insufficient evidence to rate its effectiveness for arthritic pain. It should be used with caution with herbs and medications that are blood thinners. Otherwise, it is fairly safe with few side effects. As a capsule, the daily dose is 500 mg 4X/day.