Re: Liquorice with steroids and in anaemia.

[Guest guest]

Oh dear, I've become a sad person who responds to their own emails!

Really, I just want to put this request for information forward again.

Please give your thoughts, no matter how tenuous they seem to you. I would

appreciate any ideas anyone might have on the matter.

Once again, thanks in anticipation.

Kate

Liquorice with steroids and in anaemia.

> Dear All,

> What is your general feeling about/experience of using liquorice long-term

whilst the Px is taking steroids long-term? If potassium loss is the issue,

could this be rectified by diet or herbs such as dandelion leaf?

>

> I would like to use liquorice for its liver protective effects with a

little girl who has autoimmune hepatitis and a form of haemolytic anaemia

(hereditary spherocytosis). She will be on steroids for at least 2 years if

not for the rest of her life, but it is at low dose (5mg prednisolone

daily). She is stable and seems to be responding well to all her other

treatments, including herbs (milk thistle and Chinese angelica amonst

others).

>

> Another query: why is liquorice contra-indicated in anaemia and would this

C/I apply to haemolytic anaemia?

>

> Thanks in anticipation

>

>

> Kate MNIMH

> kb.herbs@...

>

>

>

[Guest guest]

Dear Kate and all

Ref to liquorice reducing haemoglobin and that being the cause of increased

bile flow in pharmacology notes from school of phyto-apparently the ACTH

(aldosterone) action is responsible but can't help on why/how? chris

Caton MNIMH

chris@...

Re: Liquorice with steroids and in anaemia.

> " Morag Chacksfield " wrote to

> ukherbal-listegroups:

>

> >Dear Kate, Dear Stuart,

> >I found information about Glycyrrhiza on a site called Camilla's

page(www.

> >primenet.com/~camilla/herbs.htm). Camilla is a nurse who burrows through

> >Medline etc. for her information and has fierce things to say about using

> >licorice. When I first read it, it scared me stiff! I would be interested

in

> >your comments...

>

> Camilla's guru is Varro Tyler. Take it from there...

>

> Henriette

>

> --

> hetta@... Helsinki, Finland http://ibiblio.org/herbmed

> Medicinal and Culinary herbFAQs, jpegs, database, neat stuff, archives...

>

>

> List Owner

>

>

>

> Graham White, MNIMH

>

>

[Guest guest]

Kate

Sorry for lack of response, I should certainly answer your question, I think

I hold a world record for using liquorice, and only ever the 1:1.

I have used liquorice long term in too many cases to count. Probably my most

common application of this herb is to ulcerative colitis and asthma. Most of

these patients were/are taking oral steroids or inhalers. I even supply it

for other health care practitioners from doctors to homoeopaths (usually as

an 'adrenal tonic'). I have only once come across a patient who experienced

a rise in blood pressure consequent on the commencement of liquorice. Most

certainly this herb can be used to reduce steroid dosages, and I always

start giving the liquorice for these purposes alongside the drug.

Some of these patients have taken liquorice for a year or more. Obviously

regular blood pressure checks and follow up consultations should be carried

out. The major contra-indication is if the patient is using diuretics.

Certainly if the potassium problem was encountered then supplemental

potassium would be useful, either pills or tarax. Again though I have never

seen this problem in these patients. Has anyone else?

One interesting side effect though that I have encountered is in women with

fibroids. Liquorice and other triterpenoid saponin containing herbs can

definitely increase the heavy bleeding.

Why liquorice is contra-indicated in anaemia is a new one on me. Where did

this reference come from? In fact when I was a child, being brought up in a

herb using family, I remember old herbalists giving liquorice to anaemic

girls (teenagers with heavy periods more specifically). It was seen as a

basic tonic, nutritive agent. Much like it is a Qi tonic in Chinese medicine

I suppose.

Another set of conditions I use liquorice for is rheumatoid arthritis and

other auto-immune conditions so I would be inclined to try it in your

patient. A blindingly good combination I have found in auto-immune diseases

is liquorice and Rehmmania glutinosa (sheng di huang, not to be confused

with other forms of this herb, available from East-West). This herb

lengthens the effect of your own cortisone and thus is anti-inflammatory,

but in the case of the patient you describe it may well also be useful as it

is hepato-protective and used to treat hepatitis (all be it anicteric

forms).

I too would be interested in further commentary on this question.

Stuart Fitz

[Guest guest]

Dear Stuart,

There was an article I read in a Chinese journal about 15 years ago on RA.

The Chinese doctor there used exactly this combination (Sheng Di and Gan Cao

_ Raw Rehmannia and Liquorice) to treat Re Bi (inflammatory arthritis) with

excellent results. I also use this in these circumstances. How did you come

by this combination, I would be interested to know?

Mci

Re: Liquorice with steroids and in anaemia.

Kate

Sorry for lack of response, I should certainly answer your question, I think

I hold a world record for using liquorice, and only ever the 1:1.

I have used liquorice long term in too many cases to count. Probably my most

common application of this herb is to ulcerative colitis and asthma. Most of

these patients were/are taking oral steroids or inhalers. I even supply it

for other health care practitioners from doctors to homoeopaths (usually as

an 'adrenal tonic'). I have only once come across a patient who experienced

a rise in blood pressure consequent on the commencement of liquorice. Most

certainly this herb can be used to reduce steroid dosages, and I always

start giving the liquorice for these purposes alongside the drug.

Some of these patients have taken liquorice for a year or more. Obviously

regular blood pressure checks and follow up consultations should be carried

out. The major contra-indication is if the patient is using diuretics.

Certainly if the potassium problem was encountered then supplemental

potassium would be useful, either pills or tarax. Again though I have never

seen this problem in these patients. Has anyone else?

One interesting side effect though that I have encountered is in women with

fibroids. Liquorice and other triterpenoid saponin containing herbs can

definitely increase the heavy bleeding.

Why liquorice is contra-indicated in anaemia is a new one on me. Where did

this reference come from? In fact when I was a child, being brought up in a

herb using family, I remember old herbalists giving liquorice to anaemic

girls (teenagers with heavy periods more specifically). It was seen as a

basic tonic, nutritive agent. Much like it is a Qi tonic in Chinese medicine

I suppose.

Another set of conditions I use liquorice for is rheumatoid arthritis and

other auto-immune conditions so I would be inclined to try it in your

patient. A blindingly good combination I have found in auto-immune diseases

is liquorice and Rehmmania glutinosa (sheng di huang, not to be confused

with other forms of this herb, available from East-West). This herb

lengthens the effect of your own cortisone and thus is anti-inflammatory,

but in the case of the patient you describe it may well also be useful as it

is hepato-protective and used to treat hepatitis (all be it anicteric

forms).

I too would be interested in further commentary on this question.

Stuart Fitz

List Owner

Graham White, MNIMH

[Guest guest]

I came by this combo as a trial and error type project. I was looking for

herbs that depress immune function for treatment of auto-immunity (in

general) and scanned through loads of info on appropriate phyto-chemicals.

The Indian herb Hemidesmus indica looked promising at the time but I could

not get hold of it then. Rehmannia was the next on the list, and after

trying it out on patients found it worked really well. I have also found it

effective (Rehmannia alone, that is) in treating menopausal/menstrual

problems and eczema/psoriasis. it's an under-rated herb.

I must apologise, by the way, for the likes of myself. I never use the

Chinese phiosophy, terminology etc in the way I work. Basically, I trawl

through it, dismantle it and translate it into western scientific terms.

Stuart Fitz

[Guest guest]

" Morag Chacksfield " wrote to

ukherbal-listegroups:

>Dear Kate, Dear Stuart,

>I found information about Glycyrrhiza on a site called Camilla's page(www.

>primenet.com/~camilla/herbs.htm). Camilla is a nurse who burrows through

>Medline etc. for her information and has fierce things to say about using

>licorice. When I first read it, it scared me stiff! I would be interested in

>your comments...

Camilla's guru is Varro Tyler. Take it from there...

Henriette

--

hetta@... Helsinki, Finland http://ibiblio.org/herbmed

Medicinal and Culinary herbFAQs, jpegs, database, neat stuff, archives...

[Guest guest]

Dear Henrietta, Dear Stuart,

Thank you for reassuring input.

Re: Camilla's comments about grapefruit, grapefruit extracts and gr.seed

extracts like " citricidal " all of which contain naringin which can increase

Na retention/K loss because it inactivates 11-beta-HSD pathway.

In view of the fact that grapefruit is implicated in a number of medical

drug side effects( including Viagra), has anyone come across symptoms of

grapefruit/licorice interaction? Or of grapefruit/licorice/medical drug

interaction?

>Morag

>moragchacksfield@...

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[Guest guest]

>Dear Henrietta, Dear Stuart,

>

>Thank you for reassuring input.

>Re: Camilla's comments about grapefruit, grapefruit extracts and gr.seed

>extracts like " citricidal " all of which contain naringin which can increase

>Na retention/K loss because it inactivates 11-beta-HSD pathway.

>In view of the fact that grapefruit is implicated in a number of medical

>drug side effects( including Viagra), has anyone come across symptoms of

>grapefruit/licorice interaction? Or of grapefruit/licorice/medical drug

>interaction?

>

>>Morag

> >moragchacksfield@...

>

Dear Morag,

as a long time cyber-herbonaut person i would endorse henriette'

kress's comments about camilla - i crossed virtual swords with her

many years ago....(as did hetty) she is undoubtedly well

intentioned, but an extreme " quackbuster " in orientation.

interestingly her views on herbs have moderated since she became a

PWC (person with CFIDS in the jargon) but one should never

underestimate the effect of the adverse propaganda that is out

there... McIntyre notes in his account of the Irish

justification of the SJW restriction that the Irish government quoted

from camilla's web site - which of course does not say a lot for the

Irish government either...

as to your specific interaction points you know it is likely that

other citrus compounds rather than naringen cause the CYP3A4

inhibition, it is also the case that the apparent mineralocoticoid

effects of liquorice are not fully understood if you delve deeply

into them, and the effects of the whole extract on various steroidal

enzymes ( 5-alpha and 5 beta reductase as well as 11 and 17-OHSD are

not fully elucidated, especially in humans....

in my research on licorice interactions, i could not find any reports of AME

(apparent mineralocorticoid excess) that were attributed to

therapeutic doses of whole liquoriceroot or extracts of same - all

the literature is concerned with " abusive " consumption of

flavouring/concentrated extract products of a non medicinal nature.

as with a lot of this interactions talk, the vast majority of it

remains hypothetical and frankly rather unimportant in the general

scheme of herbal therapeutics - people like Camilla have no

experience with <herbal medicine. as oppposed to the data about

<herbal medicines> and should be either ignored or better refuted.....

jonathan