How many Adults in the US report taking an herbal product?
1 in 5
1 in 7
1 in 3
1 in 10
What is the GRAS list, and how many products are on it?
An FDA developed list - Generally Recognized as Safe; 250 herbals
An FDA developed list - Generously Regulated and Sold; 400 herbals
A DEA developed list - Get Regional as Supplied; 300 herbals
A DEA developed list - Get Rich: A Scam; 500 herbals
The Dietary Supplement health Education Act shifted the burden of proof for safety and efficacy to the DEA
33-50% of modern drugs have botanical origins. Match the medication to the source. digoxin: ❌ morphine: ❌ aspirin: ❌ tamoxifen: ❌
An herb can be any part of a plant.
Its easy to reproduce an herbal product.
Herbs can be sold...
raw
as extracts
as a standardized product
What of the following is true about Echinacea
Used for common cold treatment
Safe with minimal side effects
Long term use may suppress immunity
All strains are equal
Why use ginseng?
energy and physical or cognitive performance
sleep
focus
heart health
Ginseng is on the GRAS list
What of the following is TRUE about Ginseng?
Not recommended for pregnant or lactating females
Approved for use in children
Avoid use with other stimulants or CV disease
Siberian Ginseng contains no Ginseng
Ginkgo is typically used for ❌ and ❌
Ginkgo is effective for improving cognitive function in elderly without dementia
Ginkgo can improve pain-free walking distance in patients with claudication
Ginkgo has a reported association with
spontaneous bleeding
shortness of breath
slowed bowel function
It's perfectly ok to use Ginkgo seeds medicinally.
Garlic can be effective in any form
Which of the following is true about Garlic?
Can lower cholesterol 4-6%
Can cause increased bleeding with use
Considered safe by the FDA
Side effects include GI problems, garlic breath, rare allergies and contact dermatitis
St John's Wort is effective in moderate-severe depression
What is true about St John's Wort?
Photosensitivity common
Few drug interactions
Contraindicated in pregnancy
Peppermint can be used as a treatment for IBS
What is true about ginger
Used for treatment of nausea
Numerous side effects
Included on the GRAS list
Soy is used for
hot flashes
lowering cholesterol
nausea
depression
Its perfectly safe to use chamomile with any allergy
Chamomile
Used as a sedative, anxiolytic, and intestinal spasms
has the active ingredient Apigenin, which binds to the same receptors as benzos
Uses verified by numerous studeis
Both kava and valerian are used as sedative/relaxants
Kava has been associated with
severe hepatotoxicity
renal failure
contact dermatitis
respiratory distress
Some people get paradoxical effect with stimulation from valerian
Avoid using kava and valerian ...
in pregnancy
with other sedatives
before any activity where alertness is necessary
Sam E is
contraindicated in pregnancy
used as a sedative
an alternative to insulin
extremely stable
When do you used feverfew?
for headaches
in clotting disorders
Saw Palmetto is best used for
BPH
ADHD
CAD
HIV
Passionflower can be used for
Anxiety
Insomnia
menopause
muscle relaxation
Biotin is vitamin B7
Most biotin supplements contain far more than the daily recommended value
Biotin can alter thyroid tests
What is true about L-methylfolate
helps regulate 5HT, NE & DA production
Uncommon side effects
No contraindications
Up to 70% of patients with depression may have genetic factor that limits the ability to convert folic acid/folate from mood to l-methylfolate
N-acetylcycsteine...
trial showed improved depression in bipolar depression
great for hair and nails
improves insomnia
enhances memory and concentration
Melatonin...
used for sleep maintenance insomnia
used for jetlag
Vit D, L-lysine & L-arginie, Magnesium have unsubstantiated restuls
Other avenues of treatment include
Psychotherapy
Bright light therapy
Exercise
Omega 3
Netflix & margaritas
Psychotherapy has well documented used for anxiety and depression
Bright light therapy...
Useful for SAD and "hibernation effects"
has no established guidelines
Can be from any light source
has shown modest efficacy in MDD and BPD
has shown reduction in risk for MS
can cause toxicity in large doses
When prescribing Omega 3, use caution in patients with High LDL, risk for bleeding, ventricular arrhythmia/tachycardia, and fish allergies
❌: depression and anxiety ❌: depression, anxiety and stress reduction; fibromyalgia ❌: elderly depression and fibromyalgia ❌: relaxation and stress control
Lavender activates which pathway, leading to decreased anxiety?
5HT1A
5HT2A
DA
