Herbal supplements

The larger the benefit, the smaller the number of subjects required to show statistical significance. For example, if a herbal supplement is expected to produce a 5% lowering of the blood cholesterol level vs placebo, this will require many more subjects than a study evaluating the effects of a drug that is expected to produce a 50% reduction vs placebo. 

Scimone A and Scimone A (1998). US sees the green in herbal supplements. Chemical Market Reports, 13 July, fr3-fr4. 

Finally, a particularly interesting ongoing challenge will be to understand the potential for do-it-yourself immune stimulation to have unintended consequences. There are now many herbal supplements, functional foods and other over-the-counter products that promise to boost the immune response and most are considered to be safe for use by the general public. Although there is limited published evidence of adverse immune system effects of these materials, some have been associated with autoimmunity [95,96], See chapter 11 for a detailed discussion of the beneficial and potential adverse effects of nutraceuticals and functional foods. 

Lee, A.N. and Werth, V.P., Activation of autoimmunity following use of immunostimula-tory herbal supplements, Arch. Dermatol., 140, 723, 2004. 

Elizabeth was a healthy child and has lived most of her life in Michigan. Except for two incidents when her joints swelled—once at age seven or eight and again in her teenage years—she had no signs of allergies until the birth of her first child. When I met her she was reactive to many foods and to most vitamins, herbal supplements and medications in addition to chemicals. 

Valerian root, an over-the-counter herbal supplement, has also been used for insomnia. Thought to act, like the benzodiazepines, by increasing the activity of the neurotransmitter GABA, preliminary studies indicate that 400 mg of valerian root decreases sleep latency and enhances sleep quality. 

Kroll DJ. (2001) Concerns and needs for research in herbal supplement pharmacotherapy and safety. J Herbal Pharmacother 1 3-23. 

Prescribers are advised to consult the package insert of any medication administered concomitantly with hormonal contraceptives, because some medications may decrease the effectiveness of these birth control products. Patients should be prospectively cautioned not to self-medicate with the herbal supplement St. John s wort because a possible interaction has been suggested with hormonal contraceptives based on reports of breakthrough bleeding while on oral contraceptives shortly after starting St. John s wort. Pregnancies have been reported by users of combined hormonal contraceptives who also used some form of St. John s wort. 

SR020 Hsieh, T. C., and J. M. Wu. Mechanism of action of herbal supplement... 

Barone GW, Gurley BJ, Ketel BL, Abul-Ezz SR. Herbal supplements a potential for drug interactions in transplant recipients. Transplantation 2001 71(2) 239-241. 

Blumenthal M. The rise and fall of PC-SPES new generation of herbal supplement, adulterated product, or new drug Integrative Cancer Therapies 2002 1 266-270. 

Drugs That Interfere with Hormonal Contraceptives Concomitant use of HIV-protease inhibitors, griseofulvin, modafinil, penicillins, rifampin, rifabutin, phenytoin, carbamazepine, or certain herbal supplements such as St. John s wort with hormonal contraceptive agents may reduce the effectiveness of the contraception and up to one month after discontinuation of these concomitant therapies. Therefore, women requiring treatment with one or more of these drugs must use two other effective or highly effective methods of contraception or abstain from heterosexual sexual contact while taking thalidomide... 

Hoffman FA. Botanicals as drugs a US perspective. In Lam YW, Huang S-M, Hall SD, eds. Herbal Supplements - Drug Interactions. Taylor Francis, 2006. 

Herbal Supplements-Drug Interactions Scientific and Regulatory Perspectives, edited byY.W. Francis Lam, Shiew-Mei Huang, and Stephen D. Hall... 

Today foxglove is still the source of digitoxin, a widely used drug that increases the force of the heart s contraction. To produce it chemists separate and purify one compound from the plant s roughly thirty cardiac glycosides, each of which has different activity. Manufacturers of herbal supplements do not note such distinctions they merely try to justify their products by pointing out that many of our prescription pharmaceuticals derive from plant sources. 

Volate SR, Davenport DM, Muga SJ, Wargovich MJ. 2005. Modulation of aberrant crypt foci and apoptosis by dietary herbal supplements (quercetin, curcumin, silymarin, ginseng and rutin). Carcinogenesis 26 1450-1456. 

Why is an herbal supplement in a book intended to report upon the things hardcore athletes have done It should be recalled that most AAS synthesis begins with a plant extract as does ephedrine, methamphetamine, and heroin. The point being that powerful things come from many places... sometimes. 

St. John s wort is derived from the flowers of the Hypericum perforatum plant that grows throughout England, Europe, Asia, and parts of the United States. This herbal supplement has been used extensively to treat symptoms of depression and anxiety. Although the details are unclear, St. John s wort probably contains several chemicals that alter the balance of central nervous system (CNS) neurotransmitters affecting mood and behavior.46,84 As discussed in Chapter 7, depression seems to be associated with a fundamental defect in amine neurotransmitters such as serotonin, norepinephrine, and dopamine. St. John s wort may promote changes in these neurotransmitters in a manner similar to conventional prescription antidepressants.56,84 Many people have therefore used St. John s wort as an alternative medication to help improve mood and resolve the symptoms of depression.46,72... 

McKenna, D. J., Jones, K., Hughes, K., and Humphrey, S., Botanical Medicines, The Desk Reference for Major Herbal Supplements, 2nd ed., Haworth Press, New York, 2002. 

The therapeutic treatment of obesity with caffeine is another controversial area of interest. Many over-the-counter diet aids contain caffeine, but it has not yet been determined whether there is a medically safe way to use caffeine as a fat fighter. A 2000 study showed that a combination of herbal ephedra and caffeine lowered participants body weight by both decreasing fat and decreasing the body mass index (BMI). Losses were 15 and 7 pounds for those taking the herbal supplement and a placebo, respectively. 

In other independent tests, ConsumerLab.com, a privately held U.S. company that specializes in laboratory analysis of nutritional and herbal supplements for purity, strength, and truth in labeling, found that 15% of creatine supplements tested did not meet industry standards for creatine content, purity, and label claims. 

Like most herbal supplements, the federal regulation that applies to ephedra is the Dietary Supplement Health and Education Act (DSHEA). This law was first passed in 1994 and allows supplement manufacturers to market and sell products without federal regulation. The FDA can only step in to regulate ephedra or other herbal supplements when they are proven to be unsafe or pose a risk to users. 

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