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HERBAL MEDICATIONS

Herbal medications are a part of standard eastern medicine. Toda! more patients and an increasin"
n#mber of p$sicians are #sin" sin"le $erbs and combinations in %estern medicine. Alt$o#"$ t$ese
preparations are belie&ed to $a&e some medicinal &al#e! t$ere is also a ris' of to(icit.
T$e follo%in" $erbs $a&e been described to ca#se a &ariet of li&er problems ran"in" from $epatitis
to li&er fail#re and s$o#ld not be cons#med if o# $a&e li&er disease
)!*
. If o# are bein" treated %it$
interferon! $erbs s$o#ld not be ta'en #nless #nder strict s#per&ision. Ma'e s#re o# disc#ss t$e
potential reactions and interactions %it$ bot$ +estern and C$inese medicine practitioners before
ta'in" an medication or $erbal remed. Additionall! o# s$o#ld discontin#e ta'in" an $erb if o#
e(perience a s'in ras$! s#bstantial na#sea! bloatin"! fati"#e and,or ac$in" in t$e area of t$e li&er
ello%in" of t$e s'in -.a#ndice/ or pale feces.
Latin Names +estern Names
Atractlis 0#nnifera Asfetida
A1adirac$1a indica Mar"osa Oil
Berberis &#l"aris Comfr
Calliepsis la#reola 0entian
Cassia an"#stifolia Senna
C$elidoni#m ma.#s 0ordolobo erba tea
Cordalis 0reater celandine
Crotalaria 0ro#ndsel
Ep$edra Ma H#an"
E#patori#m Hops
0insen" radi( 2a&a
0lcrr$i1ae radi( 2a&a 'a&a
Hedeoma p#le"oides Mar"osa oil
Heliotropi#m Mat3 tea
Larrea tridentate c$apparal
Lcopodi#m serrat#m
Mari.#ana
4ennroal -s5#a%mint/ oil,6in B# 6#an
Ment$a p#le"i#m 4eppermint
Morinda citrifolia Noni
4inelliae t#ber Sassafras
4iper met$stic#m Senna
Sassafras albid#m S'#llcap
Sassafras albid#m Sassafras
Sc#telleria Sop$ora
Sc#terarie 7alerian
Senecio lon"ilob#s -senecio species/ 7isc#m alba
)
Larre! D8 9Seminars in Li&er Disease.: );;<. )<8 ))=>?))==.
*
Am J Gastro );;@8 @A>.
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Serrenoa serrulata
9prostate:
Step$ania Amanita
Step$aniae Sinica Lepiota $el&eola
Smp$t#m officinale Comfre
Te#cri#m c$amaedrs ,poli#m 0ermander
T#ssila"o farfara
7aleriana officinalis
7isc#m Alb#m Mistletoe
Bin"eberis r$i1oma
Bipip$ fr#ct#s
Blac' Co$os$
CIt appears t$at St. 6o$nDs +ort and mil' t$istle -silmarin/ do not $a&e si"nificant li&er to(icit
potential b#t $a&e dr#" dr#" interactions %it$ &ario#s medications especiall %it$ intestinal p?
"lcoprotein.
A comment on8 Asian Herbal 4reparations
Herbal patent medicines! tonics! eli(irs and prepac'a"ed sol#tions are partic#larl ris' for anone!
%$et$er t$e $a&e li&er disease or not. Ear too often in"redient labels are incomplete or
mistranslated. Herbs t$at are dan"ero#s or inappropriate in combination %it$ ot$er $erbs are
sometimes mista'enl #sed in concoctions.
T$e best ad&ice is to a&oid all premi(ed preparations. Rel on t$e best?trained and most
e(perienced $erbalist a&ailable to indi&id#ali1e o#r $erbal t$erap and monitor o#r reactions.
Eollo%in" is a list of contaminated form#las containin" $ea& metals! poisons and ot$er potentiall
li&er?to(ic s#bstances identified b t$e Oriental Herbal Association8
Asian Names
An 0on" Ni# H#an" +an
Aristoloc$ia
A# S$# Lin"
Bi Ton" 4ian
Bi Fan 4ian -C$#n" Lian Brand/
C$aso - +ei"$t Loss 4ro"ram /
Dai?sai'o?to
Da H#o L#o +an
Dendrob#m Moniliforme
Earf#noemin'am +an
0an Mao Lin" -Fan" C$en/
Hi"$?Stren"$ Fin C$en"
Ho S$o# +#
H#an" Lien S$an" C$in" 4ian
6in B# H#an
Ma Hsin" B$e 2e 4ian
Ma H#an"
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Mar"#erite Acne pills
Ni"$t Si"$t pills
Ni# H#an" C$ian" Fa +an
OnS$ido - +ei"$t Loss /
4e Min 2an +an -C$# 2ian"! Fan 6ian"/
S$osai'oto
S$en Lin" Bai B$# 4ian
Ta H#o Lo Tan
Tsai Tsao +an
Giaoic$ai?$#?tan"
Fin C$iao C$ie$ T# 4ian -Fan" C$en"! 4l#m Elo%er/
Fe Bai He
B$i S#o Din" C$#am +an
B$on" 0an Lin"
Common To(ic In"redients in Asian Herbal 4reparations
T$e follo%in" list! pro&ided b t$e Oriental Herbal Association! identifies $armf#l in"redients for
%$ic$ patients %it$ li&er disease s$o#ld be on "#ard8
Aconite or Aconit#m Ca#ses paralsis and deat$ if not $i"$l processed before #se
Acor#s Ca#ses Con&#lsions and deat$
Bora( Tri""ers sse&ere 'idne dama"e
Borneal Tri""ers internal bleedin" and deat$
B#fonis Can paral1e $eart m#scle and l#n"s
B#t$#s Ca#ses paralsis of t$e $eart and deat$
Calomel A merc#r compo#nd
Cinnabar A merc#r compo#nd
Lit$ar"e Contains lead o(ide
Mini#m Contains lead o(ide
Miabris Can tri""er con&#lsions! &omitin" and deat$
Orpiment Contains arsenic
Real"ar Contains arsenic
Scorpion Ca#ses paralsis of t$e $eart and deat$
Semen strc$ni Strc$nine?containin" seeds ca#se respirator fail#re and deat$
Strc$nos n#( &omica Strc$nine?containin" seeds ca#se respirator fail#re and deat$
Toad secretion Can paral1e $eart m#scle and l#n"s
Special Cases
LicoriceHa mainsta of C$inese form#las! licorice is #sed in &er small 5#antities to balance
$erbal action and often appears as "lcrr$i1in -licorice root/. Ho%e&er! licorice prod#ces %ell?
doc#mented side effects s#c$ as $peraldosteronism -an increase in le&els of t$e adrenal
$ormone aldosteron! tri""erin" imbalance of electroltes/ %$en ta'en in doses of more t$an <A
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"rams a da or for si( %ee's or lon"er. Ho%e&er! no side effects $a&e been seen in smaller
doses o&er >A das or in $i"$er doses for a &er s$ort period of time.
S'#llcapHalso called sc#telleria! t$is $erb is #sed in man form#las to "ood effect. Ho%e&er! it
appears t$at t$e to(ic s#bstance! "ermander! often is s#bstit#ted for s'#llcap in form#las %it$o#t
bein" properl identified. As a res#lt! s'#llcap loo's li'e t$e offendin" s#bstance. +$ene&er
s'#llcap appears in a form#la ma'e s#re t$at it! not "ermander! is in fact bein" #sed. If o#
cannot be s#re! do not ta'e t$e form#la or $erb.
Mil' T$istleH+$ile mil' t$istle $as been s$o%n to $a&e an anti?inflammator effect! it $as no
direct anti&iral effect alt$o#"$ t$e e(tract! silmarin! %$en "i&en I7! can decrease HC7 RNA
le&els in t$e blood et %ill not c#re &iral $epatitis C at an si"nificant le&el. -a#t$ors comments/
T$e follo%in" is an e(cerpt from 9Mil' T$istle I Li&er E#nction: b Eli1abet$ B#rc$! ND! t$at
details t$e impact of t$is $erb on li&er disease. -As modified b Dr 0is$./
9J. Is mil' t$istle reall $elpf#l in $elpin" t$e li&er f#nction betterK As an e(?drin'er! %o#ld
it be to m ad&anta"e to #se mil' t$istleK:
9A. T$e seed of t$e mil' t$istle plant contains $i"$ le&els of silmarin! a fla&onoid comple(
%it$ &er potent li&er protecti&e action. Silmarin can pre&ent li&er dama"e from a &ariet
of to(ins. It %or's b in$ibitin" factors t$at ca#se li&er dama"e and stim#lates t$e "ro%t$ of
ne% li&er cells. Silmarin is a potent antio(idant! protectin" t$e li&er from dama"e b free
radical molec#les. It also increases "l#tat$ione le&els in t$e li&erH"l#tat$ione acts to
deto(if $ormones! dr#"s and c$emicals. And silmarin in$ibits t$e formation of li&er?
dama"in" le#'otrienes! pre&entin" inflammation and dama"e of t$e li&er cells. Most
remar'able is silmarinDs abilit to stim#late t$e prod#ction of ne% li&er cells to replace
dama"ed ones. In e(perimental st#dies! silmarin $as been s$o%n to protect t$e li&er from
dama"e b s#c$ to(ic c$emicals as carbon tetrac$loride! alco$ol and t$e Amanita m#s$room
to(in.
Clinical st#dies %it$ silmarin $a&e s$o%n it is ineffecti&e in treatin" a n#mber of li&er
conditions! incl#din" cirr$osis! c$ronic $epatitis and fatt li&er from alco$ol inta'e
accordin" to a Coc$rane analsis. T$ere is no concl#si&e e&idence t$at dama"ed li&ers %ere
restored to normal cell str#ct#re %it$ lon"?term #se of silmarin.
Mil' t$istle ma be a s#pplement for an e(?drin'er to $elp 9restore: t$e normal str#ct#re
and f#nction of t$e li&er t$ro#"$ its anti?inflammator effect. T$e dose of mil' t$istle is
based on silmarin contentL @A?*)A m" of silmarin s$o#ld be ta'en t$ree times a da. Loo'
for a prod#ct t$at $as a standardi1ed amo#nt of silmarin per caps#le.
St#dies $a&e s$o%n t$at mil' t$istle e(tracts are essentiall non?to(ic. Beca#se silmarin
ca#ses an increase in bile secretion! lar"e doses ma ca#se loose stools. T$is can be
pre&ented b t$e #se of fiber! s#c$ as pslli#m or pectin.:
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Ot$er comments8
Liv.52: Liv.52 contains Capparis spinosa (capers), Cichorium intibus (ild chicor!), "erminalia ar#una
(ar#una), Solanum ni$rum (blac% ni$htshade), &chillea millefolium (!arro), and others. Liv.52 as reported
to protect a$ainst e'perimental to'ic liver dama$e ()*+, and su$$ested to be useful for human alcohol,related
liver cirrhosis b! loerin$ acetaldeh!de, the hi$hl! to'ic first metabolite of alcohol de$radation ())+. "his
initiated a 2,!ear -uropean randomi.ed controlled clinical trial in /)) patients ith alcoholic liver cirrhosis
()0+. 1hile no effect of Liv.52 on survival as noticed in cirrhotics ith Child class & and 2, increased liver,
related mortalit! amon$ those ith child class C as found leadin$ to premature termination of the stud!.
"his emphasi.es the potential ha.ards of poorl! defined and incompletel! tested herbal medications.
Cinnamon $as a ris' of li&er to(icit &ia Co#madin li'e effects on t$e li&er