What is Ginkgo?

Alternate names: Maidenhair tree, Kew tree, Japanese silver apricot Ginkgo is one of the oldest living tree species. The extract of ginkgo leaves is used medicinally in North America, where it's one of the most popular medicinal herbs, and many other countries around the world. In traditional Chinese medicine, the seeds of the ginkgo tree are used. Why Do People Use Ginkgo?

GARLIC Purported uses To fight infections of the skin: Laboratory studies show that raw garlic has antibacterial, antiviral, antiparasitic, and antifungal activity. There is no proof from clinical trials that this effect occurs in the human body. To prevent and treat cancer: A few clinical trials suggest that high garlic consumption may lower the risk of stomach and colorectal cancers. No evidence supports the use of garlic as a cancer treatment. To treat heart disease: Several clinical trials show that use of garlic supplements reduces cholesterol and triglyceride levels in the blood, which may reduce the risk of heart disease, but a handful of clinical trials contradict these findings. Clinical trials studying the effect of garlic on blood pressure and risk of heart disease have shown mixed results. As an antioxidant: No scientific evidence supports this use. To treat atherosclerosis: Several clinical trials show that use of garlic supplements reduces blood pressure as well as cholesterol and triglyceride blood levels, which are risk factors for developing atherosclerosis, but a handful of clinical trials contradict these findings. Clinical and laboratory studies support garlics antiplatelet activity, which may help prevent blood clots in patients with atheroclerosis. To lower high cholesterol: Several clinical trials show that use of garlic supplements reduces cholesterol and triglyceride levels in the blood, but a handful of clinical trials contradict these findings. To lower high blood pressure: Clinical trials studying the effects of garlic on blood pressure have shown mixed results. To treat circulatory disorders: Clinical and laboratory studies support garlics antiplatelet activity, which may help prevent blood clots in patients with circulatory disorders. Otherwise no scientific evidence supports this use. WarningsDiscontinue use of garlic at least 7 days prior to surgery. Adverse reactions Reported (Oral): Headache, fatigue, altered platelet function with potential for bleeding, offensive odor, GI upset, diarrhea, sweating, changes in the intestinal flora, hypoglycemia. Case Report (Oral): Prolonged bleeding time with spinal epidural hematoma and platelet dysfunction has occurred following excessive usage of garlic. Reported (Topical): Contact dermatitis. Drug interactions Insulin: Dose of insulin may require adjustment due to hypoglycemia effects of garlic. Warfarin: Anticoagulant activity may be enhanced due to increased fibrinolytic activity and diminished human platelet aggregation. Cytochrome P450 3A4: Garlic may cause induction of the 3A4 isoenzyme resulting in enhanced metabolism of certain drugs. Cyclosporine: Effectiveness might be decreased by garlics ability to induce metabolism and decrease levels of drugs like cyclosporine which are substrates of cytochrome P450 3A4. It can potentially cause transplant rejection.

To enhance blood circulation Ginkgo leaves are believed to contain compounds that thin blood and help to improve muscle tone in the walls of blood vessels. This may enhance blood flow. What are the Safety Concerns? Constituents in ginkgo leaves may affect blood clotting, so ginkgo leaf extracts shouldn't be used by people with bleeding disorders. People with epilepsy (or anyone with a history of seizures) should avoid ginkgo, because it may increase the frequency of seizures. Ginkgo leaf products may affect blood sugar levels, so people with diabetes should only be used under the supervision of a health care provider. The safety of ginkgo in pregnant or nursing women and children isn't known. What are the Side Effects of Ginkgo? Side effects of ginkgo leaf include excessive bleeding. Rarely, seizures have been reported in people using either the ginkgo leaf or seed. Other side effects include digestive problems, headaches, allergic skin reactions, or muscle weakness. People should not consume fresh ginkgo seeds. Roasted ginkgo seeds may cause diarrhea, nausea, indigestion, vomiting, or allergic skin reactions. Side effects of fresh ginkgo seeds or over 10 roasted ginkgo seeds may include difficulty breathing, seizures, unconsciousness and death. Possible Drug Interactions Ginkgo can increase the effect of blood-thinners (antiplatelet or anti-clotting drugs), such as clopidogrel, ticlopidine (Ticlid), warfarin (Coumadin), heparin, and aspirin, which may result in uncontrolled bleeding or hemorrhage. Certain herbs, such as danshen, devil's claw, eleuthero, garlic, ginger, horse chestnut, papain, red clover, and saw palmetto, can also increase the risk of bleeding if combined with ginkgo. Ginkgo has been found to interfere with the metabolism of drugs processed by an enzyme called cyp3A4. Ask your doctor to check if you are taking medications of this type. Ginkgo may increase the risk of seizures if combined with other drugs or herbs that do the same, such as antidepressants, bupropion (Wellbutrin, Zyban), certain antibiotics such as penicillin and cephalosporins, Corticosteroids, fentanyl (Actiq, Duragesic), theophylline, methylphenidate (e.g. Concerta, Ritalin), drugs that suppress the immune system, such as azathioprine and cyclosporine, borage, evening primrose, and wormwood. Ginkgo shouldn't be used with the drug cyclosporine (used to suppress the immune system), because it has been found to decrease the effect of that drug. Theoretically, ginkgo may have the same effect with other immunosuppressant drugs. Ginkgo may interact with insulin and other drugs for diabetes, such as metformin (Glucophage), glyburide (Glynase), glimepiride (Amaryl), and glipizide (Glucotrol XL). It shouldn't be used with medications to prevent seizures. There have been some cases of high blood pressure in people taking ginkgo and thiazide diuretics, such as chlorothiazide, chlorthalidone, hydrochlorothiazide, metolazone, and polythiazide.

To improve memory Tinnitus Alzheimer's disease Peripheral artery disease Macular degeneration Glaucoma Alzheimer's disease Sexual dysfunction

extracts primarily use the leaves and flowers. Traditional preparations use the fruit. Hawthorn has been used in connection with the following conditions (refer to the individual health concern for complete information): Historical or traditional use (may or may not be supported by scientific studies) Dioscorides, a Greek herbalist, reportedly used hawthorn in the first century A.D. Although numerous passing mentions are made for a variety of conditions, support for the heart is the main benefit of hawthorn. Active constituents The leaves, flowers, and berries of hawthorn contain a variety of bioflavonoids that appear to be primarily responsible for the cardiac actions of the plant. Flavonoids found in hawthorn include oligomeric procyanidins (OPCs), vitexin, vitexin 4-Orhamnoside, quercetin, and hyperoside. These compounds are often standardized in leaf and flower extracts, which are widely used in Europe. Hawthorn is thought to exert many beneficial effects on the heart and blood vessels. These include improved coronary artery blood flow and strengthening of the contractions of the heart muscle.1 Hawthorn may also improve circulation to the extremities by lowering the resistance to blood flow in peripheral blood vessels. 2 The bioflavonoids in hawthorn are potent antioxidants.3 Hawthorn extracts may mildly lower blood pressure in some people with high blood pressure but should not be thought of as a substitute for cardiac medications for this condition. Clinical trials have confirmed that hawthorn leaf and flower extracts are beneficial for people with stage II (early-stage) congestive heart failure.4 5 6 7 8 People with congestive heart failure taking 160900 mg of hawthorn extract per day for eight weeks showed improved quality of life including greater ability to exercise without shortness of breath and exhaustion. Congestive heart failure is a serious medical condition that requires expert management rather than selftreatment. One study has shown that hawthorn leaf and flower extract may also help those with stable angina.9 How much is usually taken? Extracts of the leaves and flowers are most commonly used in modern herbal medicine. Hawthorn extracts standardized for total bioflavonoid content (usually 2.2%) or oligomeric procyanidins (usually 18.75%) are often suggested. Many doctors recommend 80300 mg of the herbal extract in capsules or tablets two to three times per day.10 If traditional berry preparations are used, the recommendation is at least 45 grams per day or a tincture of 45 ml three times daily. However, this form has not been clinically studied. Hawthorn is slow acting and may take one to two months for maximum effects to be seen. However, it appears to be safe and should be considered a long-term therapy. Are there any side effects or interactions? Hawthorn is safe for long-term use. People taking prescription cardiac medications should consult with their doctor before using hawthorn-containing products. Reports of hawthorn interacting with digitalis to augment its effects have not been confirmed in clinical trials. There are no apparent restrictions to use of hawthorn during pregnancy or breast-feeding. Drug Interactions Certain medicines interact with hawthorn: Some interactions may increase the need for hawthorn (), other interactions may be negative () and indicate hawthorn should not be taken without first speaking with your physician or pharmacist, others may require further explanation (). Refer to the individual drug article for specific details about an interaction. Alfalfa Herbal Remedies for High Cholesterol Alfalfa herbal remedies are often used to treat high cholesterol, a leading cause of heart disease and stroke. Alfalfa has long been recommended by herbalists as a nutritional tonic. It is known to be high in minerals (around 10% by dry weight) and B vitamins. Alfalfa can be thought of as a nutritious herbal supplement to the diet that may have balancing effects on blood cholesterol. It may have beneficial effects on blood flow, blood sugar balance, inhibiting plaque formation

Saquinavir (Fortovase, Invirase): Consuming garlic can significantly decrease serum concentration levels. Garlic can decrease peak levels by 54% and mean trough levels by 49%. These reductions in levels can cause therapeutic failure and increase development. It is suspected that garlic induces cytochrome P450 metabolism of saquinavir. Patients taking other protease inhibitors may be affected; however, only saquinavir interaction has been reported. Hawthorn Botanical names: Crataegus laevigata, Crataegus oxyacantha, Crataegus monogyna Parts used and where grown Hawthorn is commonly found in Europe, western Asia, North America, and North Africa. Modern medicinal

in the vessels and supply some trace minerals and vitamins. Alfalfa has been extensively studied for safety and nutritional benefits because it remains a widely-cultivated and important animal feed. How to take Alfalfa to treat High Cholesterol

with synthetic estrogen supplements, and may provide a protective benefit when used regularly. While there have been few controlled human studies, numerous animal studies on safety and demonstrating various biological effects. Artichoke

Typical Dosage of Alfalfa for High Cholesterol For adults, a typical dose of alfalfa is 40mg of seeds or 5 to 10 gm of dried leaves taken three times per day. When taken as a capsule, always follow the manufacturers recommendation; however, typical doses are 1 gm three times per day. Most manufactures produce 500mg capsules. Acquiring raw alfalfa and processing yourself can yield the best herbal remedy. If you are not able to obtain fresh alfalfa, judge the packaged product based on its freshness. The best product should be processed raw to preserve the important enzymes, and ideally (but may be hard to determine) made mostly from leaves that contain the most saponin. Mature plants that are organically grown are also desirable in both the bulk herb and in finished products like dried and powdered herb packed in capsules or pressed into tablets. Side effects The safety of alfalfa is supported by its high popularity as a livestock feed, with very few reported side effects. Contradictions People with lupus, or at risk because of a family history of lupus should avoid the herb, as lupus-like effects have been reported in the literature, though evidence that this can actually happen because of taking alfalfa leaf or seed products is very scant. The symptoms might be due to L-canavanine, a potentially toxic amino acid, or due to an allergic reaction of some kind. Potential Interactions Alfalfa could theoretically change the way pharmaceutical blood thinners or blood sugar regulating drugs work in the body, though this has not been reported in humans in any published reports to date. You may consider avoiding Alfalfa if you are currently taking medications such as aspirin, warfarin, or heparin. Scientific Evidence Supporting Alfalfa for treating High Cholesterol Alfalfa is an herb high in compounds called saponins that may interfere with lipid breakdown and absorption in the gut, lowering cholesterol. Other compounds may have a beneficial effect on cholesterol balance by regulating bile synthesis in the liver. Natural coumarins have been shown to counteract stagnation of blood in the vessels and stabilize blood vessel membranes, reducing leakiness. In one clinical study, the seeds reduced cholesterol levels in humans. Alfalfa contains phytoestrogens called isoflavones, which can have a moderate estrogenic effect in the body. Isoflavones are also found in red clover and in soy products, and are touted today as a safe alternative to estrogen supplements during and after menopause. It is not uncommon for Asian women to consume up to 200 mg of isoflavones a day in the diet, far higher than the average 10 or 20 mg that is common among North Americans and Europeans. Some research suggests that isoflavones may be partially responsible for the lower rates of prostate and reproductive cancers found in Asia, and possible the lower rate of undesireable menopausal symptoms, though this has yet to be proven in high-quality clinical trials. At the recommended dosage of alfalfa, the estrogenic effect is not likely to be cause side effects usually associated Historical or traditional use (may or may not be supported by scientific studies) The artichoke is one of the worlds oldest medicinal plants. The ancient Egyptians placed great value on the plantit is clearly seen in drawings involving fertility and sacrifice. Moreover, this plant was used by the ancient Greeks and Romans as a digestive aid. In 16th century Europe, the artichoke was favored as a food by royalty.2 Active constituents Artichoke leaves contain a wide number of active constituents, including cynarin, 1,3 dicaffeoylquinic acid, 3-caffeoylquinic acid, and scolymoside. 3 The choleretic (bile stimulating) action of the plant has been well documented in a controlled trial involving a small sample of healthy volunteers.4 After the administration of 1.92 grams of standardized artichoke extract directly into the duodenum, liver bile flow increased significantly. This choleretic effect has led to the popular use of artichoke extract in Europe for the treatment of mild indigestionparticularly following a meal high in fat. In an uncontrolled clinical trial with 553 people suffering from non-specific digestive disorders (including indigestion), 320640 mg of a standardized artichoke extract taken three times per day was found to reduce nausea, abdominal pain, constipation, and flatulence in over 70% of the study participants.5 The standardized extract has also been used to treat high cholesterol and triglycerides. In one preliminary trial6 and one controlled trial,7 use of a standardized artichoke extract was found to lower cholesterol and triglycerides significantly when taken in amounts ranging from 900 to 1,920 mg per day. One preliminary trial failed to find any effect.8 While scientists are not certain how artichoke leaves lower cholesterol, test tube studies have suggested that the action may be due to an inhibition of cholesterol synthesis and/or the increased elimination of cholesterol because of the plants choleretic action. 9 In test tube studies, the flavonoids from the artichoke (e.g., luteolin) have been shown to prevent LDLcholesterol oxidationan effect that may reduce risk of atherosclerosis.10 How much is usually taken? suggested adult amount of the standardized leaf extract is 300640 mg three times daily for a minimum of six weeks.11 Alternatively, if a standardized extract is not available, the amount of the crude, dried leaves is 14 grams, three times a day.12 Are there any side effects or interactions? At the recommended amount and according to the German Commission E Monograph,13 there are no known side effects or drug interactions. The use of artichoke is not recommended for those who are allergic to artichokes and other members of the Compositae (e.g., daisy) family. In addition, those who have any obstruction of the bile duct (e.g., as a result of gallstones) should not employ this plant therapeutically. The plants safety during pregnancy and breastfeeding has not been established. Guggul for High Cholesterol

Although guggul is widely used in India to combat high cholesterol, research on the extract's cholesterollowering effects has yielded mixed results. A 2009 study of 43 adults with moderately high cholesterol, for instance, found that those who took 2,160 mg of guggul in capsule form daily had a greater drop in total cholesterol levels than those who took a placebo pill. However, the study members who used guggul showed no significant reduction in their levels of LDL ("bad") cholesterol. Another study (published in 2003) assigned 103 adults with high cholesterol to take 1,000 mg or 2,000 mg of guggul daily for eight weeks, and found that the extract actually raised levels of LDL cholesterol. More Guggul Benefits Preliminary research suggests that guggul extract may help fight tumors. One 2007 study on human cells found that guggulsterone (a compound found in guggul) induced the death of prostate cancer cells, while a 2008 report revealed that guggulsterone thwarted the growth of skin tumors in mice. Other research shows that guggul extract may help reduce symptoms of osteoarthritis of the knee. Guggul Side Effects Although it's generally considered safe, guggul extract may trigger side effects like headache, nausea, and skin irritation (usually in the form of a rash) in some individuals. Since guggul has also been found to stimulate the thyroid, anyone with a thyroid condition should consult a physician before using guggul extract. In a 2004 study, scientists discovered that guggulsterone may inhibit the action of drugs that are metabolized by the body's CYP3A enzymes. These drugs include Lipitor, cyclosporine, and quinidine.

GINGER Ginger is an herb. The rhizome (underground stem) is used as a spice and also as a medicine. It can be used fresh, dried and powdered, or as a juice or oil. Ginger is commonly used to treat various types of stomach problems, including motion sickness, morning sickness, colic, upset stomach, gas, diarrhea, nausea caused by cancer treatment, nausea and vomiting after surgery, as well as loss of appetite. Other uses include treating upper respiratory tract infections, cough, and bronchitis. Fresh ginger is used for treating acute bacterial dysentery, baldness, malaria, poisonous snake bites, rheumatism, migraine headache, and toothaches. Dried ginger is used for chest pain, low back pain, and stomach pain. Some people pour the fresh juice on their skin to treat burns. The oil made from ginger is sometimes applied to the skin to relieve pain. In foods and beverages, ginger is used as a flavoring agent. In manufacturing, ginger is used as for fragrance in soaps and cosmetics. One of the chemicals in ginger is also used as an ingredient in laxative, anti-gas, and antacid medications. How effective is it? Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to

the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate. The effectiveness ratings for GINGER are as follows:

Are there safety concerns? Ginger is LIKELY SAFE for most people. Some people can have mild side effects including heartburn, diarrhea, and general stomach discomfort. When ginger is applied to the skin, it may cause irritation. Special precautions & warnings: Pregnancy: Using ginger during pregnancy is controversial. There is some concern that ginger might affect fetal sex hormones. There is also a report of miscarriage during week 12 of pregnancy in a woman who used ginger for morning sickness. However, studies in pregnant women suggest that ginger can be used safely for morning sickness without harm to the fetus. The risk for major malformations in infants of women taking ginger does not appear to be higher than the usual rate of 1% to 3%. As with any medication given during pregnancy, its important to weigh the benefit against the risk. Before using ginger during pregnancy, talk it over with your healthcare provider. Breast-feeding: Not enough is known about the safety of using ginger during breast-feeding. Stay on the safe side and dont use it. Bleeding disorders: Taking ginger might increase your risk of bleeding. Avoid using it. Diabetes: Ginger might lower your blood sugar. As a result, your diabetes medications might need to be adjusted by your healthcare provider. Heart conditions: High doses of ginger might worsen some heart conditions. Dont use ginger if you have a heart condition. Are there interactions with medications? Return to top Moderate Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) Ginger might slow blood clotting. Taking ginger along with medications that also slow clotting might increase the chances of bruising and bleeding. Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

sugar closely. The dose of your diabetes medication might need to be changed. Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.

Possibly effective for...

Nausea and vomiting following surgery. Most clinical research shows that taking 1 gram of ginger one hour before surgery seems to reduce nausea and vomiting during the first 24 hours after surgery. One study found ginger reduced nausea and vomiting by 38%. However, ginger might not reduce nausea and vomiting in the period 3-6 hours after surgery. Dizziness. Taking ginger seems to reduce the symptoms of dizziness, including nausea. Preventing morning sickness (discuss the possible risks with your healthcare provider). Ginger seems to reduce nausea and vomiting in some pregnant women. But taking any herb or medication during pregnancy is a big decision. Before taking ginger, be sure to discuss the possible risks with your healthcare provider.

Medications for high blood pressure (Calcium channel blockers) Ginger might reduce blood pressure in a way that is similar to some medications for blood pressure and heart disease. Taking ginger along with these medications might cause your blood pressure to drop too low or cause an irregular heartbeat. Some medications for high blood pressure and heart disease include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others.

Are there interactions with herbs and supplements? Herbs and supplements that might slow blood clotting Using ginger along with herbs that might slow blood clotting could increase the risk of bleeding in some people. These herbs include angelica, clove, danshen, garlic, ginkgo, Panax ginseng, red clover, turmeric, and others.

Possibly ineffective for...

Preventing motion sickness and seasickness. Some people say they feel better after taking ginger before travel. But there is no hard evidence that ginger actually prevents motion sickness or seasickness.

Insufficient evidence to rate effectiveness for...

Rheumatoid arthritis (RA). There is some preliminary evidence that ginger might be helpful for decreasing joint pain in people with RA. Osteoarthritis. There is some evidence that ginger might reduce osteoarthritis pain. But different studies have shown different degrees of benefit, possibly because ginger seems to take many months to start working. Some studies may have been stopped too early. Nausea and vomiting due to chemotherapy. There is contradictory evidence about the effectiveness of ginger for nausea and vomiting caused by chemotherapy for cancer. Loss of appetite. Colds. Flu. Migraine headache. Preventing nausea caused by chemotherapy. Other conditions.

Phenprocoumon Phenprocoumon is used in Europe to slow blood clotting. Ginger can also slow blood clotting. Taking ginger along with phenprocoumon might increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your phenprocoumon might need to be changed.

Warfarin (Coumadin) Warfarin (Coumadin) is used to slow blood clotting. Ginger can also slow blood clotting. Taking ginger along with warfarin (Coumadin) might increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed. Medications for diabetes (Antidiabetes drugs) Ginger might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking ginger along with diabetes medications might cause your blood sugar to go too low. Monitor your blood

More evidence is needed to rate ginger for these uses. How does it work? Ginger contains chemicals that may reduce nausea and inflammation. Researchers believe the chemicals work primarily in the stomach and intestines, but they may also work in the brain and nervous system to control nausea.