What everyone should know before trying herbs

[Guest guest]

What everyone should know before trying herbs :

1] Some herbal remedies may afford some benefit to the liver in

specific instances

- however, these specific circumstances have not as yet been clearly

established or defined by

generally accepted and approved medical standards

2] Herbs are not regulated by the FDA

- they are exempt from FDA investigation and restrictions

- proof of safety and possible side effect data is not required prior

to being made available to the

consumer

3] Labeling of bottles is totally unregulated

- The exact ingredients, amount and potency of ingredients, and the

presence of other herbs or

substances are not required to appear on labels

- adulteration by other substances, such as steroids, atropine, lead,

and caffeine, has been reported

4] Some herbs actually may cause liver disease

The following is a list of herbs that you should absolutely avoid if

you have liver disease. Ingestion of

these herbs have been reported to cause liver related complications

ranging from acute hepatitis and

jaundice to cirrhosis and death from liver failure :

1. COMFREY [bush tea]

2. GERMANDER

3. CHAPARRAL

4. JIN BU HUAN

5. NUTMEG

6. PENNYROYAL OIL

7. MISTLETOE

8. TANSY RAGWORT

9. SENNA

10. SASSAFRAS

11. VALERIAN

5] One should carefully evaluate all claims made about an herbal

remedy prior to ingesting it

- are claims based on human or animal studies ?

- are you reading a confirmed,respected research study, or simply an

advertisement ?

6] Find a liver specialist who is clearly knowledgeable about the

pros and cons of herbal

supplements

- Inform him/her as to the herbal preparation you are taking or

planning to take so that potential

side effects, drug interactions and results can be more safely and

appropriately evaluated and

monitored

Herbal medicines - Are they safe?

EXETER, ENGLAND. Dr. Edzard Ernst, MD, Professor of Complementary

Medicine at the University of Exeter has just released a major report

on the safety of herbal medicines. Dr. Ernst surveyed the medical

literature between 1992 and 1996 for reports concerning adverse

effects of herbal remedies. Among his findings are:

Royal jelly has been linked to several cases of severe bronchospasm;

Twenty-two cases of severe toxic effects involving pennyroyal have

been reported;

Germander has been linked to 30 cases of acute liver failure;

Chaparral, comfrey and skullcap have all been linked to liver

problems and the shiitake mushroom has been associated with

dermatitis;

Chinese herbal medicines have been linked to a host of adverse

effects and are often contaminated, especially with heavy metals;

Siberian ginseng can interact with digoxin, licorice with prednisone,

and some Chinese herbal preparations with warfarin;

Four per cent (108) of 2695 patients admitted to a Taiwanese hospital

had drug-related problems. Herbal medicines ranked third among the

categories of medicines responsible for causing adverse effects;

Out of 1701 patients admitted to a Hong Kong hospital three were

admitted because of adverse reactions to Chinese herbal drugs;

The London-based National Poisons Unit received a total of 1070

enquiries relating to herbal and other traditional medicines between

January 1983 and March 1989.

Table 2. Interference of Herbal Products in Therapeutic Drug

Monitoring of Digoxin*

Herbal Product Level of Interference Comments

Chan Su High Chan Su has active components such as bufalin, which

cross-react with digoxin assays; only Bayer assay has

no interference; monitoring free digoxin also eliminates interference

Dan Shen Moderate Falsely elevated (FPIA) or falsely low (MEIA)

digoxin level; no interference with EMIT, Bayer, Randox, Roche, or

Beckman assays; monitoring free digoxin eliminates interference

Uzara root (diuretic) Additive effect with digoxin; also interferes

with digoxin assay

Siberian ginseng Moderate Falsely elevated (FPIA) or falsely low

(MEIA) digoxin level; no interference with EMIT, Bayer, Randox,

Roche, or

Beckman assays; monitoring free digoxin does not eliminate

interference

Asian ginseng Moderate Falsely elevated (FPIA) or falsely low (MEIA)

digoxin level; no interference with EMIT, Bayer, Randox, Roche, or

Beckman assays; monitoring free digoxin does not eliminate

interference

FPIA, fluorescence polarization immunoassay; MEIA, microparticle

enzyme immunoassay.

* Bayer Diagnostics, Tarrytown, NY; Roche Diagnostics, Indianapolis,

IN; Beckman Coulter, Fullerton, CA.

Table 3. Common Drug-Herb Interactions

Herbal Product Interacting Drug Comments

Ginseng Warfarin Ginseng may decrease effectiveness of warfarin

Phenelzine Toxic symptoms, eg, headache, insomnia, and irritability

St 's wort Paroxetine hydrochloride Lethargy, incoherence, nausea

Digoxin Decreased AUC; peak and trough concentration of digoxin; may

reduce effectiveness of digoxin

Cyclosporine Lower cyclosporine concentration due to increased

clearance may cause transplant rejection

Theophylline Lower concentration, thus decreases the efficacy of

theophylline

Indinavir Lower concentration may cause treatment failure in patients

with HIV

Ginkgo biloba Aspirin Bleeding; ginkgo can inhibit PAF

Warfarin Hemorrhage

Thiazide Hypertension

Kava Alprazolam Additive effects with CNS depressants, alcohol

Garlic Warfarin Increased effectiveness of warfarin; bleeding

Ginger Warfarin Increased effectiveness of warfarin; bleeding

Feverfew Warfarin Increased effectiveness of warfarin; bleeding

Dong quai Warfarin Dong quai contains coumarin; dong quai increases

INR for warfarin, causes bleeding

Dan Shen Warfarin Increased effectiveness of warfarin owing to

reduced elimination of warfarin

Soy milk Warfarin Causes decline in INR

Comfrey Phenobarbital Increased metabolism of comfrey producing a

lethal metabolite from pyrrolizidine; severe hepatotoxic

effects

Borage oil Phenobarbital May lower seizure threshold, requiring

dosage increase

Evening primrose oil Phenobarbital May lower seizure threshold,

requiring dosage increase

Licorice Spironolactone May offset the effect of spironolactone

Shankhapushpi Phenytoin Lower phenytoin level and loss of seizure

control

AUC, area under the curve; CNS, central nervous system; INR,

international normalized ratio; PAF,

platelet-activating factor.

Table 4. Potentially Toxic Herbs

Herb Toxic Effect or System Affected Intended Use (Should Anyone

Use?)

Comfrey Hepatotoxic Repairing of bone and muscle; prevention of

kidney stones

Ephedra Cardiovascular Herbal weight loss

Chan Su Cardiovascular Tonic for heart

Borage oil Hepatotoxic; hepatocarcinogenic Source of essential fatty

acids; rheumatoid arthritis; hypertension

Calamus Carcinogenic Psychoactive, not promoted in the United States

Chaparral Hepatotoxic; nephrotoxic; carcinogenic General cleansing

tonic; blood thinner; arthritis remedy; weight loss product

Licorice Pseudoaldosteronism (sodium and water Treatment of peptic

ulcer; flavoring agent retention, hypertension, heart failure)

Herbal Products to Avoid

Chan Su: Topical aphrodisiac sold as Stone, LoveStone, RockHard. It

has caused death when swallowed.

Chaparral tea: From leaves and twigs of the desert creosote bush,

this is promoted as an antioxidant, a pain reliever, etc. It has

caused liver failure requiring liver transplantation.

Coltsfoot (for respiratory problems), comfrey (for arthritis,

infections), and sassafras (a general tonic) have caused liver

problems and cancer in laboratory animals.

Jin Bu Huan: An ancient Chinese sedative and analgesic containing

morphine-like substances. It causes hepatitis.

Kombucha tea: Made from mushroom culture (used as a cure all), this

has caused death from acidosis.

Lobelia: Used for respiratory congestion, this has caused respiratory

system paralysis and death.

Ma huang or ephedra: An herbal form of the central nervous system

stimulant commonly known as speed. It is sold with names like Herbal

Ecstasy, Cloud 9, and Ultimate Xphoria. It causes heart attacks,

seizures, psychotic episodes and death.

Pennyroyal: This is a tea made from leaves that treats coughs and

upset stomach. Its oil is highly toxic to the liver and interferes

with blood clotting.

Yohimbe bark: Used as aphrodisiac this raises blood pressure and is

associated with psychotic episodes.

Twelve supplements you should avoid

The 12 supplement ingredients in this table have been linked to

serious adverse events or, in the case of glandular supplements, to

strong theoretical risks. They're all readily available on the Web,

where our shoppers bought them both individually and in multi-

ingredient " combination products. " We think it's wise to avoid all of

them. But the strength of that warning varies with the strength of

the evidence and the size of the risk. So we've divided the dirty

dozen into three categories: definitely hazardous, very likely

hazardous, and likely hazardous.

Name

(Also known as)

Dangers

Regulatory actions

DEFINITELY HAZARDOUS

Documented organ failure and known carcinogenic properties

Aristolochic acid(Aristolochia, birthwort, snakeroot, snakeweed,

sangree root, sangrel, serpentary, serpentaria; asarum canadense,

wild ginger). Can be an ingredient in Chinese herbal products labeled

fang ji, mu tong, ma dou ling, and mu xiang. Can be an unlabeled

substitute for other herbs, including akebia, asarum, clematis,

cocculus, stephania, and vladimiria species.

Potenthuman carcinogen; kidney failure, sometimes requiring

transplant; deaths reported.

FDAwarning to consumers and industry and import alert, in April

2001. Banned in 7 European countries and Egypt, Japan, and Venezuela.

VERY LIKELY HAZARDOUS

Banned in other countries, FDA warning, or adverse effects in studies

Comfrey (Symphytum officinale, ass ear, black root, blackwort,

bruisewort, consolidae radix, consound, gum plant, healing herb,

knitback, knitbone, salsify, slippery root, symphytum radix, wallwort)

Abnormalliver function or damage, often irreversible; deaths

reported.

FDAadvised industry to remove from market in July 2001.

Androstenedione

(4-androstene-3, 17-dione, andro, androstene)

Increased cancer risk, decrease in HDL cholesterol.

FDAwarned 23 companies to stop manufacturing, marketing, and

distributing in March 2004. Banned by athletic associations.

Chaparral(Larrea divaricata, creosote bush, greasewood, hediondilla,

jarilla, larreastat)

Abnormalliver function or damage, often irreversible; deaths

reported.

FDAwarning to consumers in December 1992.

Germander (Teucrium chamaedrys, wall germander, wild germander)

Abnormalliver function or damage, often irreversible; deaths

reported.

Bannedin France and Germany.

Kava (Piper methysticum, ava, awa, gea, gi, intoxicating pepper, kao,

kavain, kawa-pfeffer, kew, long pepper, malohu, maluk, meruk, milik,

rauschpfeffer, sakau, tonga, wurzelstock, yagona, yangona)

Abnormalliver function or damage, occasionally irreversible; deaths

reported.

FDAwarning to consumers in March 2002. Banned in Canada, Germany,

Singapore, South Africa, and Switzerland.

LIKELY HAZARDOUS Adverse-event reports or theoretical risks

Bitter orange(Citrus aurantium, green orange, kijitsu, neroli oil,

Seville orange, shangzhou zhiqiao, sour orange, zhi oiao, zhi xhi)

Highblood pressure; increased risk of heart arrythmias, heart

attack, stroke.

None

Organ/glandular extracts (brain/adrenal/pituitary/

placenta/other gland " substance " or " concentrate " )

Theoretical risk of mad cow disease, particularly from brain

extracts.

FDAbanned high-risk bovine materials from older cows in foods and

supplements in January 2004. (High-risk parts from cows under 30

months still permitted.) Banned in France and Switzerland.

Lobelia(Lobelia inflata, asthma weed, bladderpod, emetic herb,

gagroot, lobelie, indian tobacco, pukeweed, vomit wort, wild tobacco)

Breathing difficulty, rapid heartbeat, low blood pressure, diarrhea,

dizziness, tremors; possible deaths reported.

Bannedin Bangladesh and Italy.

Pennyroyaloil (Hedeoma pulegioides, lurk-in-the-ditch, mosquito

plant, piliolerial, pudding grass, pulegium, run-by-the-ground, squaw

balm, squawmint, stinking balm, tickweed)

Liverand kidney failure, nerve damage, convulsions, abdominal

tenderness, burning of the throat; deaths reported.

None

Scullcap(Scutellaria lateriflora, blue pimpernel, helmet flower,

hoodwort, mad weed, mad-dog herb, mad-dog weed, quaker bonnet,

scutelluria, skullcap)

Abnormalliver function or damage.

None

Yohimbe (Pausinystalia yohimbe, johimbi, yohimbehe, yohimbine)

Changein blood pressure, heart arrythmias, respiratory depression,

heart attack; deaths reported.

None

[Guest guest]

Good one Liz,, yep, everyone should talk with someone who really knows herbs before taking them.. but we all must remember too that even allopathic meds can cause severe life threatening problems as well.. The one thing I wondered about and asked my own gastro about is the senna,because I MUST take it in order to manage my pain with Morphine, he said the the studies show that one must take in MASSIVE, MASSIVE doses for years to get into trouble with that.. The other thing that I wonder about is homeopathy,, especially in regards to things like valarian.. because when you use a homeopathic preparation,, it only has the "imprint" of the herb but when you break it down in the lab, they cannot find even a molecule of it in the prep.. but they do work.. I guess,, being openminded that I would just suggest that anyone thinking about taking any herbs etc should talk with someone who really knows them before taking them,, kind of like

heart medicine, or diabetes,, one wouldnt take any medicine for either one of those conditions WITHOUT talking with a doc who specializes in the care of those conditions,, so I really think it should be the same way with herbs and supplements..Does that make sense you guys? The one thing I want to say in defense of supplements NOT being regulated by the FDA,, first off, I dont trust the FDA to begin with,, but there are many good supplement companies that have been around for many many years that have a good record of manufacturering quality products,, one has to look for the word "Standardized" on the bottle,, that indicates that what you see written on the label IS what you get inside the bottle.. there are many good companies like "Source Naturals", Rexall ( now known as "Unicity") out there that have been around for years and have a good tract record . Those are the ones you should use IF You use supplements at

all,, and not just go and buy anything you see on the shelves at the grocery store.. Good luck to everyone on this subject.. There certainly does need to be more studies done on them,, to verify what DOES work and what DOESN'T work.. safety, dose, etc, the problem is that very few companies have the monies needed to do the kind of studies that the FDA does,, but then again,,,, who pays for all those studies,, oh dont get me started,, lol,, love to all jaxelizabethnv1 <elizabethnv1@...> wrote: What everyone should know before trying herbs : 1] Some herbal remedies may afford some benefit to the liver in specific instances - however, these specific circumstances have not as yet been clearly established or defined by generally accepted and approved medical

standards 2] Herbs are not regulated by the FDA - they are exempt from FDA investigation and restrictions - proof of safety and possible side effect data is not required prior to being made available to the consumer 3] Labeling of bottles is totally unregulated - The exact ingredients, amount and potency of ingredients, and the presence of other herbs or substances are not required to appear on labels - adulteration by other substances, such as steroids, atropine, lead, and caffeine, has been reported 4] Some herbs actually may cause liver disease The following is a list of herbs that you should absolutely avoid if you have liver disease. Ingestion of these herbs have been reported to cause liver related complications ranging from acute hepatitis and jaundice to cirrhosis and death from liver failure : 1. COMFREY [bush tea] 2. GERMANDER 3. CHAPARRAL 4.

JIN BU HUAN 5. NUTMEG 6. PENNYROYAL OIL 7. MISTLETOE 8. TANSY RAGWORT 9. SENNA 10. SASSAFRAS 11. VALERIAN 5] One should carefully evaluate all claims made about an herbal remedy prior to ingesting it - are claims based on human or animal studies ? - are you reading a confirmed,respected research study, or simply an advertisement ? 6] Find a liver specialist who is clearly knowledgeable about the pros and cons of herbal supplements - Inform him/her as to the herbal preparation you are taking or planning to take so that potential side effects, drug interactions and results can be more safely and appropriately evaluated and monitoredHerbal medicines - Are they safe? EXETER, ENGLAND. Dr. Edzard Ernst, MD, Professor of Complementary Medicine at the University of Exeter has just released a major report on the safety of herbal medicines. Dr.

Ernst surveyed the medical literature between 1992 and 1996 for reports concerning adverse effects of herbal remedies. Among his findings are: Royal jelly has been linked to several cases of severe bronchospasm;Twenty-two cases of severe toxic effects involving pennyroyal have been reported;Germander has been linked to 30 cases of acute liver failure;Chaparral, comfrey and skullcap have all been linked to liver problems and the shiitake mushroom has been associated with dermatitis;Chinese herbal medicines have been linked to a host of adverse effects and are often contaminated, especially with heavy metals;Siberian ginseng can interact with digoxin, licorice with prednisone, and some Chinese herbal preparations with warfarin;Four per cent (108) of 2695 patients admitted to a Taiwanese hospital had drug-related problems. Herbal medicines ranked third among the categories of

medicines responsible for causing adverse effects;Out of 1701 patients admitted to a Hong Kong hospital three were admitted because of adverse reactions to Chinese herbal drugs;The London-based National Poisons Unit received a total of 1070 enquiries relating to herbal and other traditional medicines between January 1983 and March 1989.Table 2. Interference of Herbal Products in Therapeutic Drug Monitoring of Digoxin*Herbal Product Level of Interference Comments Chan Su High Chan Su has active components such as bufalin, which cross-react with digoxin assays; only Bayer assay hasno interference; monitoring free digoxin also eliminates interference Dan Shen Moderate Falsely elevated (FPIA) or falsely low (MEIA) digoxin level; no interference with EMIT, Bayer, Randox, Roche, orBeckman assays; monitoring free digoxin eliminates interference Uzara root (diuretic) Additive effect

with digoxin; also interferes with digoxin assay Siberian ginseng Moderate Falsely elevated (FPIA) or falsely low (MEIA) digoxin level; no interference with EMIT, Bayer, Randox, Roche, orBeckman assays; monitoring free digoxin does not eliminate interference Asian ginseng Moderate Falsely elevated (FPIA) or falsely low (MEIA) digoxin level; no interference with EMIT, Bayer, Randox, Roche, orBeckman assays; monitoring free digoxin does not eliminate interference FPIA, fluorescence polarization immunoassay; MEIA, microparticle enzyme immunoassay. * Bayer Diagnostics, Tarrytown, NY; Roche Diagnostics, Indianapolis, IN; Beckman Coulter, Fullerton, CA. Table 3. Common Drug-Herb InteractionsHerbal Product Interacting Drug Comments Ginseng Warfarin Ginseng may decrease effectiveness of warfarin Phenelzine Toxic symptoms, eg, headache, insomnia, and irritability St 's wort

Paroxetine hydrochloride Lethargy, incoherence, nausea Digoxin Decreased AUC; peak and trough concentration of digoxin; may reduce effectiveness of digoxin Cyclosporine Lower cyclosporine concentration due to increased clearance may cause transplant rejection Theophylline Lower concentration, thus decreases the efficacy of theophylline Indinavir Lower concentration may cause treatment failure in patients with HIV Ginkgo biloba Aspirin Bleeding; ginkgo can inhibit PAF Warfarin Hemorrhage Thiazide Hypertension Kava Alprazolam Additive effects with CNS depressants, alcohol Garlic Warfarin Increased effectiveness of warfarin; bleeding Ginger Warfarin Increased effectiveness of warfarin; bleeding Feverfew Warfarin Increased effectiveness of warfarin; bleeding Dong quai Warfarin Dong quai contains coumarin; dong quai increases INR for warfarin, causes bleeding Dan Shen Warfarin Increased effectiveness of

warfarin owing to reduced elimination of warfarin Soy milk Warfarin Causes decline in INR Comfrey Phenobarbital Increased metabolism of comfrey producing a lethal metabolite from pyrrolizidine; severe hepatotoxiceffects Borage oil Phenobarbital May lower seizure threshold, requiring dosage increase Evening primrose oil Phenobarbital May lower seizure threshold, requiring dosage increase Licorice Spironolactone May offset the effect of spironolactone Shankhapushpi Phenytoin Lower phenytoin level and loss of seizure control AUC, area under the curve; CNS, central nervous system; INR, international normalized ratio; PAF,platelet-activating factor. Table 4. Potentially Toxic HerbsHerb Toxic Effect or System Affected Intended Use (Should Anyone Use?) Comfrey Hepatotoxic Repairing of bone and muscle; prevention of kidney stones Ephedra Cardiovascular Herbal weight loss

Chan Su Cardiovascular Tonic for heart Borage oil Hepatotoxic; hepatocarcinogenic Source of essential fatty acids; rheumatoid arthritis; hypertension Calamus Carcinogenic Psychoactive, not promoted in the United States Chaparral Hepatotoxic; nephrotoxic; carcinogenic General cleansing tonic; blood thinner; arthritis remedy; weight loss product Licorice Pseudoaldosteronism (sodium and water Treatment of peptic ulcer; flavoring agent retention, hypertension, heart failure) Herbal Products to Avoid Chan Su: Topical aphrodisiac sold as Stone, LoveStone, RockHard. It has caused death when swallowed. Chaparral tea: From leaves and twigs of the desert creosote bush, this is promoted as an antioxidant, a pain reliever, etc. It has caused liver failure requiring liver transplantation. Coltsfoot (for respiratory problems), comfrey (for arthritis, infections), and sassafras (a general tonic) have caused liver

problems and cancer in laboratory animals. Jin Bu Huan: An ancient Chinese sedative and analgesic containing morphine-like substances. It causes hepatitis. Kombucha tea: Made from mushroom culture (used as a cure all), this has caused death from acidosis. Lobelia: Used for respiratory congestion, this has caused respiratory system paralysis and death. Ma huang or ephedra: An herbal form of the central nervous system stimulant commonly known as speed. It is sold with names like Herbal Ecstasy, Cloud 9, and Ultimate Xphoria. It causes heart attacks, seizures, psychotic episodes and death. Pennyroyal: This is a tea made from leaves that treats coughs and upset stomach. Its oil is highly toxic to the liver and interferes with blood clotting. Yohimbe bark: Used as aphrodisiac this raises blood pressure and is associated with psychotic episodes. Twelve supplements you should avoid The 12

supplement ingredients in this table have been linked to serious adverse events or, in the case of glandular supplements, to strong theoretical risks. They're all readily available on the Web, where our shoppers bought them both individually and in multi-ingredient "combination products." We think it's wise to avoid all of them. But the strength of that warning varies with the strength of the evidence and the size of the risk. So we've divided the dirty dozen into three categories: definitely hazardous, very likely hazardous, and likely hazardous. Name(Also known as)DangersRegulatory actions DEFINITELY HAZARDOUSDocumented organ failure and known carcinogenic properties Aristolochic acid(Aristolochia, birthwort, snakeroot, snakeweed, sangree root, sangrel, serpentary, serpentaria; asarum canadense, wild ginger). Can be an ingredient in Chinese herbal products labeled fang ji, mu tong,

ma dou ling, and mu xiang. Can be an unlabeled substitute for other herbs, including akebia, asarum, clematis, cocculus, stephania, and vladimiria species. Potenthuman carcinogen; kidney failure, sometimes requiring transplant; deaths reported.FDAwarning to consumers and industry and import alert, in April 2001. Banned in 7 European countries and Egypt, Japan, and Venezuela.VERY LIKELY HAZARDOUSBanned in other countries, FDA warning, or adverse effects in studies Comfrey (Symphytum officinale, ass ear, black root, blackwort, bruisewort, consolidae radix, consound, gum plant, healing herb, knitback, knitbone, salsify, slippery root, symphytum radix, wallwort)Abnormalliver function or damage, often irreversible; deaths reported.FDAadvised industry to remove from market in July 2001.Androstenedione(4-androstene-3, 17-dione, andro, androstene) Increased cancer risk, decrease

in HDL cholesterol.FDAwarned 23 companies to stop manufacturing, marketing, and distributing in March 2004. Banned by athletic associations.Chaparral(Larrea divaricata, creosote bush, greasewood, hediondilla, jarilla, larreastat) Abnormalliver function or damage, often irreversible; deaths reported.FDAwarning to consumers in December 1992.Germander (Teucrium chamaedrys, wall germander, wild germander) Abnormalliver function or damage, often irreversible; deaths reported.Bannedin France and Germany.Kava (Piper methysticum, ava, awa, gea, gi, intoxicating pepper, kao, kavain, kawa-pfeffer, kew, long pepper, malohu, maluk, meruk, milik, rauschpfeffer, sakau, tonga, wurzelstock, yagona, yangona)Abnormalliver function or damage, occasionally irreversible; deaths reported.FDAwarning to consumers in March 2002. Banned in Canada, Germany, Singapore, South Africa, and

Switzerland.LIKELY HAZARDOUS Adverse-event reports or theoretical risks Bitter orange(Citrus aurantium, green orange, kijitsu, neroli oil, Seville orange, shangzhou zhiqiao, sour orange, zhi oiao, zhi xhi)Highblood pressure; increased risk of heart arrythmias, heart attack, stroke.None Organ/glandular extracts (brain/adrenal/pituitary/placenta/other gland "substance" or "concentrate") Theoretical risk of mad cow disease, particularly from brain extracts.FDAbanned high-risk bovine materials from older cows in foods and supplements in January 2004. (High-risk parts from cows under 30 months still permitted.) Banned in France and Switzerland.Lobelia(Lobelia inflata, asthma weed, bladderpod, emetic herb, gagroot, lobelie, indian tobacco, pukeweed, vomit wort, wild tobacco) Breathing difficulty, rapid heartbeat, low blood pressure, diarrhea, dizziness, tremors; possible

deaths reported.Bannedin Bangladesh and Italy.Pennyroyaloil (Hedeoma pulegioides, lurk-in-the-ditch, mosquito plant, piliolerial, pudding grass, pulegium, run-by-the-ground, squaw balm, squawmint, stinking balm, tickweed) Liverand kidney failure, nerve damage, convulsions, abdominal tenderness, burning of the throat; deaths reported.None Scullcap(Scutellaria lateriflora, blue pimpernel, helmet flower, hoodwort, mad weed, mad-dog herb, mad-dog weed, quaker bonnet, scutelluria, skullcap)Abnormalliver function or damage.None Yohimbe (Pausinystalia yohimbe, johimbi, yohimbehe, yohimbine) Changein blood pressure, heart arrythmias, respiratory depression, heart attack; deaths reported.None Jackie