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Medication Information:
Herbal Products

This chart is designed to help identify certain herbs or chemicals that may be found in preparations intended for weight loss or for use as dietary supplements. It can serve as a useful guide in counseling patients on expected side effects

Drug	Use or Claim	Precautions/Comments
Aloe (oral)	strong cathartic	Abdominal cramping with diarrhea, electrolyte imbalance
Astralgalus (tragacanth)	Immune system booster, increase metabolism and energy	Usually used as a pharmaceutical emulsifier. No proof of dietary efficacy.
Bearberry (Uva-Ursi)	diuretic	Not effective in weight loss products. May cause nausea and vomiting
Bee-pollen	energy and endurance booster	Claim not proven. High inter-product variability with some agents containing higher counts of allergenic pollens (i.e. ragweed) than others.
Birch Leaf	diuretic	No side effects have been reported to date. Advise patient to drink plenty of water.
Bladderwrack (brown kelp)	weight loss	Supposedly stimulates iodine-containing thyroid hormones. High potassium and sodium content. May intensify hyperthyroidism. Tastes truly awful.
Cascara and Buckthom	stimulant cathartic	Abdominal cramping and diarrhea. Fresh bark my cause vomiting. Long-term use may cause discoloration deposits on intestinal mucosa. Cascara is found in breast milk
Eleuthero	endurance enhancer	Often mislabeled as Siberian Ginseng. Inadequate Russian studies do not prove safety or efficacy. No side effects were reported.
Ginger	digestive aid, anti-nausea, stimulant, diuretic	Can prolong bleeding times in anti-coagulant therapy. May cause some cardiac arrhythmias in large doses.
Ginseng (Korean and American)	anti-stress, lower cholesterol and blood pressure	May cause or exacerbate nervousness and anxiety. Also headache, insomnia and heart palpitations. Will decrease effectiveness of some diuretics. Has some estrogenic effects that cause bleeding.
Ginseng (Siberian)	immune system booster, endurance enhancer	Some animal studies show increased aggression. This product is frequently mislabeled or contaminated with toxins. Studies do not support claim.
Grapeseed	antioxidant	Contain antioxidant bioflavanoids. Experimental use in ADD. Components of grapeseed extract have shown hepatotoxicity.
Guarana	CNS stimulant	Contains between 2.5 and 5 percent caffeine (coffee seed between 1 and 2 percent). May actually cause an increase in appetite. Also headache, nausea, diarrhea, heart palpitations and increased blood pressure. Extracts may prolong bleeding time.
Kava-Kava	anxiety reduction, sleep, CNS depressant	May potentiate other CNS depressants. Can cause muscle weakness, euphoria, indigestion and drowsiness. May cause visual disturbances.
Kolanut	CNS stimulant	Contains up to 3.5 percent caffeine. (See Guarana precautions.)
Ma Huang (ephedra)	CNS stimulant	Headache, nervousness, diarrhea, nausea, insomnia, heart palpitations, increased blood pressure and hyperglycemia have been reported. May synergistically increase side effects of other CNS stimulants, or interfere with other psychoactive drugs.
Nettle	mild diuretic	Mild G.I. upset reported
Papaya	digestive aid	Papin acts to hydrolyse proteins, carbs and fats. Efficacy questionable as papain is unstable with digestive acids.
Phenylalanine	appetite suppressant	See Spirulina.
Pine Bark	antioxidant	See Grapeseed extract.
Primrose (evening)	lower cholesterol	Studies show some effectiveness, with no adverse reaction reported to date.
Psyllium	bulk-forming laxative	Must be taken with plenty of fluid to prevent formation of bezoars. May bind to some drugs resulting in a decrease in bioavailability.
Sarsparilla	endurance enhancer, diuretic	Contains several steroidal agents, none of which are proven to be active after ingestion. Can cause G.I upset, may bind other drugs, preventing their absorption.
St. John's wort (hypericum)	anti-depressant, sedative, anti-inflammatory	Photosensitive dermatitis with long-term and high-dose use. May potentiate some anti-depressants, as well as other psychoactive drugs, especially with SSRI or MAOI activity.
Senna	strong cathartic	May cause discoloration of urine (turns red). Diarrhea with abdominal cramping, nausea, dehydration, reversible finger-clubbing and intestinal pigmentation deposits reported.
Sirulina (blue-green algae)	appetite suppressant, protein/carbohydrate supplement, anemia	Made of various amino acids (phenylalamine being predominant), vitamins and minerals. FDA review of the drug does not support dietary claims of safety and efficacy.
L-tryptophan	insomnia, essential amino acid nutrient	May have additive effects with SSRIs, possibly resulting in serotonin syndrome. FDA studies link L-tryptophan containing impurities with eosinophilia-myalgia syndrome (EMS). Also a possible link to pancreatitis and myofascial thickening. FDA has imposed an import alert on this substance and controls its use in food substances.
Yerba Mate	CNS stimulant	Contains up to 2 percent caffeine (see Guarana for side effects).
Yohimbe	CNS stimulant (dietary use)	Has ox-2 adrenergic blockade activity. May cause changes in blood pressure, heart palpitations, nausea, vomiting, G.I. upset and psychoses. May have some MAOI activity.