Josef A. Brinckmann and Michael P. Lindenmaier
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 In addition, since 1994, Germany's maximum allowable residue limits regulation ("Ruckstands-H6chstmengen-Ver-ordnung"= RHmVO) for food products (including changes applicable to "tea and tea-like products"), have also applied to plant-based drugs; this led to extreme requirements for herbal products, and thus, in the meantime, these limits have been relaxed to more realistic limits by subsequent revisions in the RHmVO regulations. |
Ray Strand, M.D.
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 The FDA has received reports of more than forty deaths and hundreds of serious injuries in patients using herbal products containing ephedra. It is a popular product found in many natural herbal weight-loss and energy-boosting products. Adding caffeine to the ephedra accentuates the adverse side effects of increased heart rate and blood pressure and has led to strokes, heart attacks, and seizures in numerous individuals.5
The FDA has issued warnings about the amount of ephedra that consumers should use. |
Gary Null
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| Kapadia and his group at Howard University, School of Pharmacy, studied a number of herbal products in the lab and their activity against Epstein-Barr virus antigen, which serves as a model to test antitumor agents. In this experiment thirty-six extracts of thirty-two herbs belonging to twenty-seven families in use as herbal remedies were studied. They included ginkgo, black cohosh, echinacea, kava-kava, saw palmetto, turmeric, angelica, wild yam, cat's claw, passionflower, muira puama, feverfew, blueberry, chasteberry, licorice, nettle, goldenseal, pygeum, ginger, valerian, and hops. |
Bradley J. Willcox, D. Craig Willcox, and Makoto Suzuki
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 The Germans have a government agency called Commission E that assesses herbal products and licenses them for use for specific ailments.4 In the United States, more than 60 million people use some form of alternative medicinal product, many of them herbs.5 Indeed, most of the world's people use herbs in one form or another in their medical systems.
The National Center for the Study of Complementary and Alternative Medicine (NCCAM), at the National Institutes of Health, was set up to study herbal products, a clear demonstration that there is significant interest in the United States. |
volker schulz and Rudolf Hansel
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 As Table A3 indicates, these 100 herbal products rank among the 2267 most commonly prescribed medications in Germany. Their sales in 2002 totaled 420 million €, compared with total sales of 19,507 billion € for the 2267 most commonly prescribed drugs. Thus, the 100 herbal remedies accounted for 2.15 % of the total drug expenditures that were covered by health insurance programs. Fifty-nine of the 100 most-prescribed phytomedicines are 68 single-herb products (297 million € = 70 % of the herbal drug market), and 32 are combination products (124 million € = 30 %). |
The Life Extension Editorial Staff
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 If one desires to use any of these herbal products, it is advisable to do so under the care of a physician and with careful monitoring of liver enzymes and hepatitis C viral counts (Harvey et al. 1981;Gossrau et al. 1990).
@ SUMMARY
Conventional physicians administer a two-drug combination consisting of interferon and ribavirin in an attempt to eradicate HCV. While this dmg therapy is very effective in some patients, it fails in many others. |
volker schulz and Rudolf Hansel
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| Besides pharmaceutical quality, dosage is a critical concern in the prescription of herbal products. In most cases, it is reasonable to estimate that approximately 200-500 mg of extract (depending on the strength of the extract) is equivalent to the traditional single dose that is delivered in one cup of medicinal tea. Relatively large capsules, pills, tablets, etc. are often the only dosage forms that can accommodate these amounts of extract. |
| Since the change was enacted, proprietary herbal products can be approved either by citing original studies on efficacy and safety ("rational phytomedicines," see examples in Table 1.2) or by citing long-term experience with their therapeutic use ("traditional phytomedicines"). In the latter case, manufacturers are exempt from having to furnish their own proof of efficacy and safety for a list of designated herbal preparations. This exemption does not affect the manufacturers' obligation to guarantee the pharmaceutical quality of their products. |
| QU Drug Products
The Rote Liste 2003 lists well over 100 herbal products under the heading of Antitussives and Expectorants, consisting mostly of fixed combinations of active ingredients along with numerous products containing a single active ingredient (Tables 4.1-4.4). The 100 most commonly prescribed phytomedicines in Germany include 25 herbal antitussive-expectorants, consisting of 10 single-herb products and 15 combination products. |
| The synthetic drugs are comparable to the herbal products in efficacy, but the herbals are associated with fewer and milder adverse side effects, particularly with regard to sexual function (Bach et al., 1996; Carraro et al., 1996).
Besides the pharmacodynamic effects of the active constituents, the therapeutic context has a significant impact on treatment response in BPH as it is in other conditions. Placebo-controlled studies show that this effect accounts for approximately 30-60 % of the attainable therapeutic response, depending on the outcome measures that are used. |
The Life Extension Editorial Staff
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| Arkopharma is the largest phytopharma-ceutical company in Europe and is dedicated to natural herbal products. Research scientists have identified 20 active alkaloids in SPV-30 of a total of nearly 100, using HPLC (high performance liquid chromatography) and gas chromatography. The five most active alkaloids are buxtaurine, cyclobuxine D, boxamine, cyclovirobuxine D, and cyclovirobuxine C.
The potential of SPV-30 as a natural antiretro-viral was first identified by Jacques Durant, M.D., head of the Infectious Diseases Department of the Hospital de l'Archet in Nice. |
Schuyler W. Lininger, Jr. DC
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 The huge root, which can grow to the size of a human body, is the source of medicinal preparations used in traditional Chinese medicine and modern herbal products. Kudzu grows in most shaded areas in mountains, fields, along roadsides, thickets, and thin forests throughout most of China and the southeastern United States. The root of another Asian species of kudzu, Pueraria thomsonii, is also used for herbal products.
In What Conditions Might
Kudzu Be Supportive?
Ranking
Health Concerns
Other
Alcohol withdrawal support (p. 6) Angina (p. |
The Life Extension Editorial Staff
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| Always speak with your physician or renal dietitian befote using or adding any supplements or herbal products.
Multivitamins. In addition to eating a diet that contains appropriate nutrients and levels of protein, a comptehensive multivitamin is often required to replace vitamins that are lost during dialysis treatments (National Kidney Foundation 2001e).
Vitamin B. Vitamins Bg, B12, and folate (folic acid) are members of the B vitamin group. |
volker schulz and Rudolf Hansel
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| Of the approximately 300 medicinal herbs and herbal products that have been officially evaluated by the German Commission E, 47 herbs have been approved for dermatologic indications. The Commission has given a positive rating to 25 of these herbs, but only about half of the 25 play a significant role in therapeutic practice. Ten important herbs and herbal preparations that are used topically for dermatologic indications are reviewed in Table 8.1. A Commission E monograph was not issued for evening primrose oil, which was approved on a pro duct-specific basis for the treatment of atopic eczema. |
Alan Keith Tillotson, Ph.D., A.H.G., D.Ay.
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 Quality control is the process of ensuring that herbal products actually have the characteristics the manufacturers claim. All herbal manufacturers must have some form of quality control. This will vary depending on the size of the company and the type of product it is manufacturing. While there is no simple formula for quality, there are some basics you should be aware of:
First, you have to distinguish "suppliers" from "distributors" and "manufacturers." Suppliers of raw materials are the farmers or collectors in the wild who sell their products to manufacturers. |
| In fact, many critics talk about poisonous plants that are not even found in herbal products. For example, they warn against using uzara root, which contains cardiac glycosides. This product is rarely used in herbal medicine today.
• Use examples of overdose or misuse of an herb instead of appropriate properly prescribed dosage. Ephedra has been used for centuries in China to safely treat asthma. But companies here in the United States began to add the extracted alkaloids in high doses to weight-loss products, causing serious problems. |
| The laboratories in which herbal products are manufactured are quite large and sophisticated. They usually range from 1,000 to 2,000 square feet in size, have two or more well-trained employees on site, and house several major pieces of equipment with names like HPLC (high-performance liquid chromatography), GC (gas chromatography), UV/VIS (ultraviolet/visible spectrophotometer), and AA (atomic absorption spectroscopy). They also need hardness testers, analytical balances, rotoevaporators, disintegration/dissolution apparatus, chemicals and solvents, and so on. |
| Critics of herbal products claim that they have not been proven efficacious or safe using the objective, scientific methods of placebo-controlled double-blind studies and rigorous testing. Yet such critics conveniently ignore the fact that some 85% of everyday medical treatments have never been scientifically validated! For example, each year 700,000 children have tubes inserted into their ears to treat inner ear infections. However, several research groups have raised doubts as to the usefulness of this procedure. |
American Medical Publishing
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| This study demonstrates how dangerous that interaction can be and how important it is for patients to keep their physician and pharmacist informed about any use of herbal products."
Adverse interactions also have been reported between St John's wort and cyclosporine, a drug used to reduce the risk of organ transplant rejection. Potentially dangerous changes in drug effects can occur when medications such as cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin, Lanoxicaps) and warfarin (Coumadin) are taken with St. John's Wort extracts.
So, as you can clearly see, St. |
Michael T. Murray, N.D., Joseph E. Pizzorno, N.D.
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 Treatment with Naturopathic Medicines
In addition to promoting good health, herbal products and nutritional supplements are often used as direct substitutes for conventional drugs. However, an important distinction must be made: in most cases, these natural medicines promote the healing process, rather than suppressing symptoms. To illustrate this point, let's compare the natural approach with the drug approach to osteoarthritis—the most common form of arthritis.
Osteoarthritis is characterized by a breakdown of cartilage. Cartilage plays an important role in joint function. |
Earl Mindell, R.Ph., Ph.D.
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 The weaker yohimbe herbal products can be purchased over the counter. There are no scientific studies to back up the claim that these products can improve sexual function; however, there are anecdotal reports from men who claim that they can work wonders. Many combination products designed to improve sexual performance for men include yohimbe, along with ginkgo biloba, zinc, and L-arginine. Since yohimbine hydrochloride can cause serious side effects in some men, I err on the side of caution with yohimbe. Before you use it, I recommend that you check with your physician or natural healer. |
| Look for horny goat weed in male potency herbal products as well as products for cardiovascular health.
Immature Bitter Orange
A member of the citrus family, this herb has been used to treat digestive problems, coughs, allergies, and inflammatory conditions. Today, you will find immature bitter orange included in herbal combinations to treat allergies and cold symptoms. It contains a potent antioxidant called nobelitin.
Kudzu
This Hot 100 herb is being marketed in the West as a treatment for alcohol abuse and hangovers. |
| In fact, there are several brands of Chinese herbal products available at natural food stores. Herbs may be sold individually, or in combination with other herbs designed to treat specific symptoms. There have been a few distressing reports of herbs imported from China that were of poor quality or even contaminated. To ensure quality, look for standardized products that assure purity and potency, preferably from well-established companies.
Here is a list of some popular Chinese herbs that can be found at your natural food store. |
Linda B. White, M.D.
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 The majority of serious reactions to herbs or herbal products stem from misinformation.
One final note: the rapid pace of research involving both drugs and herbs isn't likely to slow down at any time soon. If a drug that you're taking isn't mentioned in this book, that may be because it was developed after the book was produced. Likewise, new herbal remedies are being discovered every year. So if you can't find an answer in this book, your best bet is to ask your doctor or other qualified health practitioner.
Chapter l
What Is Herbal Medicine? |
American Medical Publishing
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| It's vital that we understand how drugs and herbal products interact," said Dr. John I. Gallin, Clinical Center director. "This research is important because it demonstrates that a common agent such as St. John's wort may have unsuspected adverse effects on the function of a drug essential to the health of a very vulnerable population."
Indinavir belongs to a class of drugs known as protease inhibitors. These drugs are among the most potent agents available for treating HIV infection and have been shown to prolong survival and slow the progression of the disease. Substances in both St. |
Phyllis A. Balch, CNC
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 CONSIDERATIONS
_J Of all the herbal products available for HIV infection, curcumin may be the most versatile for stopping the virus at every stage of infection. It deactivates the gene in HIV that takes the virus out of its dormant state. It contains chemicals that stop the action of integrase, an enzyme the virus needs to take over the DNA of an infected cell. And it prevents the production of tumor necrosis factor (TNF), a hormone that signals HIV if there are weakened or injured cells ready to be infected. |
American Medical Publishing
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| Ma huang
Ma huang is one of several names for herbal products containing members of the genus Ephedra. There are many common names for these evergreen plants, including squaw tea and Mormon tea. Serious adverse effects, including hypertension (elevated blood pressure), palpitation (rapid heart rate), neurophathy (nerve damage), myopathy (muscle injury), psychosis, stroke, and memory loss, have been reported to FDA with products containing Ma huang as ingredients and are currently under investigation. |
Linda B. White, M.D.
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| The fact is, despite the abundance of herbal products, there just aren't very many places that you can find accurate, impartial information about these herbs—places that will tell you the risks as well as the benefits. That's what Herbs jor Health magazine has been doing for the past five years. It's the first magazine dedicated to reporting the most accurate research and recommendations from the field of herbal medicine.
Several of the magazine's top herbal experts have contributed to the creation of this book. In many cases, they've written books of their own about herbal medicines. |
American Medical Publishing
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| Get as educated as possible before you start growing, harvesting and using your own herbal products. Many herbalist spend years studying the long-range effects of herbs and all possible interactions and drawbacks. If you are not ready to make the commitment and do all the hard work, seek the advice and help of a trusted expert instead.
• A particularly potent way to take herbs is to buy preparations based on what is known as "essential oils." These are concentrations of specific volatile compounds found in plants. |
Isadore Rosenfeld, M.D.
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 My wife insists, however, that I continue to use aluminum-containing roll-on deodorants because she doesn't think the aluminum-free herbal products are as effective—at least not for me!
The evidence implicating aluminum in Alzheimer's disease is not overwhelming, but neither is the possibility far-fetched. Although I am much more excited by the promise of some of the new drugs now being developed to prevent or reverse this disease, until these are available, avoiding large amounts of aluminum, where practical, certainly can't hurt. |
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