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Possible Side Effects, Contraindications, and Drug Interactions

The three charts below are adapted from information taken from the PDR For Herbal Medicines, The Complete German Commission E Monographs, and Herbal Medicine: Expanded Commission E Monographs. In parenthesis is the source of the information given: CE for either of the two Commission E books, and PDR for the PDR For Herbal Medicines. Where no code is given, information is given according the best of the author's knowledge.

In no case is any citation to be taken as an absolute catalog of all possible side effects, contraindications, or possible drug interactions. That said, the purpose of the tables are to provide for the consumer the most complete picture possible of the risks associated with the herbal products sold by Whole Health Products.

Each person is different, and the way someone reacts to a particular product may be significantly different from another. You should always seek the advice of a health care practitioner before taking any dietary, nutritional, herbal or homeopathic supplement, and inform your pharmacy of its use.

Possible Side Effects

Herbal Single Possible Side Effect
Angelica (Dong Quai) Sensitivity to light (CE)
Bilberry None known (CE)
Black Cohosh Occasional gastric discomfort (CE)
Cascara Sagrada single use: cramps
long term/abuse: disturbance of electrolyte balance, esp. potassium deficiency, which, with abuse, can lead to disorders of heart and muscle function (CE)
Cayenne Rare cases: hypersensitivity (urticaria) (CE)
Chamomile None known (CE)
Chaste Tree Occasional itching, urticarial exanthemas (CE)
Cranberry None known (PDR)
Echinacea None known (CE)
Psyllium Rarely, allergic reaction (CE)
Garlic Rarely, gastrointestinal symptoms, pervasive odor (CE)
Ginger (in Supplemax) None known (CE)
Ginkgo Biloba Rarely, stomach or intestinal upset, headache, allergic skin reaction (CE)
Ginseng None known (CE)
Goldenseal With abuse: digestive disorders, constipation, exitatory states, hallucination, deliria (PDR)
Gotu Kola (in Supplemax) None known (PDR)
Grape Seed None known (PDR)
Green Tea None known if used responsibly, because it contains caffeine: restlessness, irritability, sleeplessness, palpitation, vertigo, diarrhea, loss of appetite, headache (PDR)
Guarana None known if used responsibly, because it contains caffeine: restlessness, irritability, sleeplessness, palpitation, vertigo, diarrhea, loss of appetite, headache (PDR)
Horsechestnut In isolated cases: pruritis, nausea, gastric complaints (CE)
Kava None known. With extended, continuous intake, yellowing of skin, hair and nails. Dry itchy skin can also occur. This reverses on discontinuation. Also enlargement of pupils and disturbances of oculomotor equilibrium have been described (CE)
Larrea tridentata The patented extract used in Larrea Safe™ has none of the hepatotoxic compounds present in the unprocessed plant.
Milk Thistle Crude preparation: none known
Formulations: occasional mild laxative (CE)
Passion Flower None known (CE)
Peppermint (in Supplemax) None known
Saint John's Wort Photosensitization in rare cases. Animal and human research indicates that it would take 30-50 times the recommended daily level of 900mg to produce these effects. (CE)
Saw Palmetto Rarely, stomach problems (CE)
Spirulina None known
Tea Tree None with proper use; contact dermatitis is possible (PDR)
Valerian None known (CE)

Contraindications (CE)

Condition Do Not Take
Abdominal Pain of Unknown Origin Cascara Sagrada
AIDS Echinacea (theoretical concern, not verified)
Allergy/Hypersensitivity Black Cohosh
Cayenne
Ginkgo Biloba
Anxiety Ephedra
Appendicitis Cascara Sagrada
Asthma Melatonin
Autoimmune Disease Echinacea (theoretical concern, not verified)
Bile Duct Obstruction Kava
Peppermint Oil (present in trace amounts in peppermint leaf in Supplemax)
Cerebral Circulation, Impaired Ephedra
Children and Infants Cascara Sagrada
Peppermint Oil (present in trace amounts in peppermint leaf in Supplemax)
Colitis, Ulcerative Cascara Sagrada
Collagenosis Echinacea
Depression Kava
Diabetes Mellitus Psyllium husk
Esophageal Stenosis Psyllium husk
Exanthemas, Urticarial Chaste Tree
Gallbladder Inflammation Peppermint Oil (present in trace amounts in peppermint leaf in Supplemax)
Gallstones Ginger
Peppermint Oil (present in trace amounts in peppermint leaf in Supplemax)
Gastrointestinal Stenosis Psyllium husk
Glaucoma Ephedra
HIV Ginseng
Ephedra
Echinacea (theoretical concern, not verified)
Hypokalemia Flaxseed
Ileus Flaxseed
Psyllium husk
Intestinal Inflammation or Obstruction Cascara Sagrada
Leukosis Echinacea (theoretical concern, not verified)
Liver Disease Peppermint Oil (present in trace amounts in peppermint leaf in Supplemax)
Multiple Sclerosis Echinacea (theoretical concern, not verified)
Pheochromocytoma Ephedra
Progressive Systemic Diseases Echinacea (theoretical concern, not verified)
Prostate Adenoma Ephedra
Restlessness Ephedra
Thyrotoxicosis Ephedra
Tuberculosis Echinacea (theoretical concern, not verified)
Ulcers Kola nut

Possible Drug Interactions

Drug Don't Combine
Alcohol (CE) Kava
Antiarrythmics (CE) Cascara Sagrada
Antithrombolytics (PDR) Ginkgo Biloba
Barbiturates (CE) Kava
Caffeine Green Tea
Guarana
Kola Nut (CE)
St. John's Wort
Cardiac glycosides (CE), (PDR) Cascara Sagrada
Ephedra
Corticosteroids (CE) Cascara Sagrada
Dopamine receptor antagonists (CE), (PDR) Chaste Tree (from animal studies)
Guanethidine (CE), (PDR) Ephedra
Halothane (CE), (PDR) Ephedra
Insulin (PDR) Psyllium may reduce absorption
Licorice Root (CE) Cascara Sagrada
MAO Inhibitors (CE), (PDR) Ephedra
Oxytocin (CE), (PDR) Ephedra
Psychoanaleptics (CE) Kola Nut
Secale alkaloid derivatives (CE) Ephedra
Thiazide diuretics (CE) Cascara Sagrada

References
  1. Blumenthal, Mark; Goldberg, Alicia; Brinckmann, Josef, Eds,; Tyler, VarroE, PhD, ScD. Herbal Medicine: Expanded Commission E Monographs. American Botanical Council, 2000.
  2. Blumenthal, Mark; Busse, Werner R; Goldberg, Alicia; Gruenwald, Joerg, PhD; Hall, Tara; Riggins, Chance W.; Rister, Robert S., Eds, Klein, Sigrid, PhD; Rister, Robert S, Trans, Tyler, VarroE, PhD, ScD. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council, 1998.
  3. Gruenwald, Joerg, PhD; Brendler, Thomas, BA; Jaenicke, Christof, MD. PDR for Herbal Medicines. Medical Economics Company, 1998.

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