Herbs in the News

Two popular herbs, Echinacea and St. John's wort have gotten more than their share of recent publicity. Echinacea has been defrocked as a common cold preventative, and St. John's wort has come up short in the safety sector. A third perennial favorite, ginseng — sold as Ginkgo biloba — has also been demoted. Ephedra has also received bad marks, in this case, an F.

Echinacea (Echinacea ssp.)

Echinacea is also known as purple coneflower and is grown in many perennial and herb gardens. The Native Americans used it for a variety of ailments. Echinacea is sold in extracts, tinctures, tablets, capsules, and ointments and in combination with other herb products. However, a study published in 2005 in the New England Journal of Medicine busted the myth that echinacea could ward off the common cold. Researchers found that echinacea just didn't make any difference.

Warning! Echinacea is not the benign herb that you may have been led to believe, and its use is contraindicated in people with tuberculosis, leukemia, diabetes, connective tissue disorders, multiple sclerosis, HIV/AIDS, autoimmune disease, or liver disorders. People taking autoimmune suppressants should not use echinacea. If you have asthma or certain allergies, you may experience an allergic reaction to echinacea, ranging from mild to life-threatening.

Ephedra (Ephedra ssp.)

Ephedra looks like a stubby pine tree or a horsetail plant. It's been used extensively in Chinese medicine, where it's known as mahuang. A tea made from the dried branches has been used to treat stress and depression.

Warning! The FDA published a final rule on April 12, 2004, banning the sale of dietary supplements containing ephedrine alkaloids. The principal active ingredient ephedrine is an amphetamine-like compound. The FDA found that these supplements present an unreasonable risk of heart problems and stroke.

The National Center for Complementary and Alternative Medicine (NCCAM ) has reported that calls to poison control centers revealed a disproportionate rate of reactions to ephedra relative to other herbal products. There is strong evidence that ephedra is associated with an increased risk of side effects, possibly even fatal ones.

Ginseng (Panax quinquefolius)

Ginseng, also known as ginkgo biloba, has been used to treat stress and depression and is widely used both in the United States and Europe. It's a staple in the Chinese pharmacopeia, and like soy, it's been touted as a cure for just about everything. It comes in pill form. Ginkgo biloba extract (GBE) is manufactured from the plant's leaves.

Warning! Children under age 12, as well as pregnant and nursing women should not consume ginkgo biloba. If you are scheduled for surgery, discontinue use of ginkgo biloba at least 36 hours prior to surgery to avoid the risk of bleeding complications, according to the University of Michigan Medical Center.

Warning #2! The University of Michigan Medical Center advises that ginkgo may negatively interact with some prescription and over-the-counter drugs, including selective serotonin reuptake inhibitors (SSRIs) fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and escitalopram (Lexapro). Ginkgo may cause serotonin syndrome, which is characterized by rigidity, tachycardia (fast heart rate), restlessness, and diaphoresis (sweating).

Ginkgo may enhance the effects (both good and bad) of antidepressant medications known as MAOIs, such as phenelzine (Nardil). There has been a report of an adverse interaction between ginkgo and trazodone (Desyrel), an antidepressant medication that resulted in an elderly patient going into a coma.

Before you consider using ginkgo biloba, consult with your physician. If you are taking any medications — prescribed or otherwise — be sure ginkgo biloba will not cause adverse reactions with them.

St. John's Wort (Hypericum perforatum)

St. John's wort is an attractive plant with pretty yellow flowers. It's been used for centuries to induce a sense of well-being, and for that reason it's commonly used to help alleviate the symptoms of depression. It can be toxic in large doses. It's used more in Europe than in the United States.

Warning! The Food and Drug Administration (FDA) issued a Public Health Advisory in February 2000 noting that St. John's wort appeared to affect an important metabolic pathway used by specific medications, including antidepressant medications. Before using St. John's wort, you should consult with your prescribing physician.

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