Additional Information
Book Details
Abstract
Essential Herbs and Natural Supplements is an evidence-based quick reference guide.
This go-to resource is essential for safe and effective clinical recommendations of herbal medicines and natural supplements. It provides current, evidence-based monographs on the 50 most commonly used herbs, nutrients and food supplements.
It emphasises safe practice with strategies to prevent adverse drug reactions, guidelines in assessing benefit, risk and harm and the evaluation of research.
- 50 evidence-based monographs on the most used herbs and natural supplements
- Up-to-date evidence on the latest research impacting on herbal and natural medicine by top leaders within the fields of Pharmacy, Herbal Medicine and Natural Medicine
- Considerations of herbs and natural supplements in pregnancy
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Essential Herbs and Natural Supplements | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| About the Authors | vi | ||
| Contributors | viii | ||
| Reviewers | x | ||
| Preface | xi | ||
| Herbal and natural supplements | 1 | ||
| 1 Introduction to Herbal Medicine | 1 | ||
| Herbs, Drugs and Phytochemicals | 2 | ||
| Pharmacognosy | 3 | ||
| Chemical Complexity | 3 | ||
| Synergistic Interactions | 5 | ||
| Key Constituent Groups | 6 | ||
| Flavonoids | 6 | ||
| Tannins | 6 | ||
| Coumarins | 6 | ||
| Alkaloids | 6 | ||
| Terpenes | 8 | ||
| Glycosides | 8 | ||
| Chemotherapeutics Versus Herbalism | 9 | ||
| Product Variation and Standardisation | 10 | ||
| Standardisation | 11 | ||
| Limitations | 11 | ||
| Herbal Safety | 13 | ||
| Interactions with Pharmaceutical Drugs | 14 | ||
| References | 14 | ||
| 2 Introduction to Clinical Nutrition | 15 | ||
| Consequences of Poor Nutrition | 15 | ||
| Mortality risk: cardiovascular disease and cancer | 15 | ||
| Food Under the Microscope | 16 | ||
| Macronutrients | 17 | ||
| Carbohydrates | 18 | ||
| Lipids | 18 | ||
| Protein | 18 | ||
| Minerals | 18 | ||
| Micronutrients | 19 | ||
| Vitamins | 19 | ||
| Essential trace minerals | 19 | ||
| Phytochemicals | 19 | ||
| Food labels | 19 | ||
| Nutritional Deficiencies | 20 | ||
| Primary deficiency | 20 | ||
| Inadequate dietary intake | 20 | ||
| Evidence of deficiency in Australia and New Zealand | 22 | ||
| Barriers to good nutrition | 23 | ||
| Secondary deficiency | 23 | ||
| RDA and RDI reference values for Australia and New Zealand | 24 | ||
| RDI and nutritional deficiencies | 25 | ||
| Serious deficiencies of reference values | 26 | ||
| Optimal nutrition: a state beyond RDI | 27 | ||
| Redefining an essential nutrient | 28 | ||
| Nutritional Genomics | 29 | ||
| Nutritional deficiency, genome damage and clinical practice | 31 | ||
| Nutritional supplementation | 31 | ||
| Safety issues | 32 | ||
| Adverse reactions and interactions | 32 | ||
| Toxicity | 32 | ||
| Natural versus synthetic | 32 | ||
| Rational use of supplements | 33 | ||
| References | 34 | ||
| Clinical Practice | 36 | ||
| 3 Safety of Complementary Medicines | 36 | ||
| A Brief History of Medication Safety | 37 | ||
| What is Safety? | 39 | ||
| Benefits, risk and harm | 39 | ||
| Adverse drug reactions (ADRs) | 41 | ||
| Type A reactions | 42 | ||
| Type B reactions | 42 | ||
| Extrinsic factors | 44 | ||
| Regulation and Product Information | 45 | ||
| Reliable information sources | 46 | ||
| Medical databases and texts: inconsistency | 48 | ||
| ADR Incidence | 48 | ||
| Case reports and post-marketing surveillance systems | 50 | ||
| Black cohosh | 52 | ||
| Kava kava | 53 | ||
| Factors that make an ADR more likely | 54 | ||
| Patient-related factors | 54 | ||
| Therapeutic factors | 55 | ||
| Strategies for preventing and limiting ADRs | 56 | ||
| Strategies for clinicians | 56 | ||
| Strategies for patients | 56 | ||
| The Rational Use of Herbal and Natural Medicines | 57 | ||
| References | 59 | ||
| 4 Interactions with Herbal and Natural Medicines | 61 | ||
| Interaction Mechanisms | 62 | ||
| Pharmacokinetic interactions | 62 | ||
| Factors affecting absorption | 62 | ||
| Changes in relative rate of absorption | 63 | ||
| Changes in extent of absorption | 63 | ||
| Mucilaginous herbs | 63 | ||
| Nutrients | 64 | ||
| Intrinsic drug transporters | 64 | ||
| Herbal and natural medicines affecting P-gp | 64 | ||
| Factors affecting metabolism | 66 | ||
| Cytochromes | 68 | ||
| Enzyme inhibition | 70 | ||
| Enzyme induction | 71 | ||
| Lack of in vitro–in vivo correlation | 72 | ||
| Factors affecting excretion | 72 | ||
| Pharmacodynamic interactions | 73 | ||
| Physicochemical interactions | 73 | ||
| Reduced absorption | 74 | ||
| Tannins | 74 | ||
| Chelation | 74 | ||
| Increased absorption | 75 | ||
| Synergy herbal research | 76 | ||
| Interaction screening tools | 76 | ||
| In vitro tests | 76 | ||
| Animal studies | 76 | ||
| Clinical studies | 78 | ||
| Putting Theory Into Practice | 78 | ||
| Interaction mechanisms | 78 | ||
| Medicine factors | 78 | ||
| Individual patient factors | 79 | ||
| Problems and pitfalls interpreting the evidence | 80 | ||
| A predictive algorithm | 80 | ||
| Medication and mechanisms | 80 | ||
| Evidence available? | 80 | ||
| Timing and dose — introducing which, when and for how long? | 80 | ||
| Outcomes possible | 80 | ||
| Practitioner considerations | 81 | ||
| Individual considerations | 81 | ||
| Action required | 81 | ||
| Assessing the likelihood of an adverse drug–herb interaction | 81 | ||
| Patient evaluation | 81 | ||
| Causality and probability | 82 | ||
| Next steps if interaction is likely | 83 | ||
| Analysis of the medicine | 83 | ||
| Case reporting | 83 | ||
| Two Medicines Requiring Special Attention | 83 | ||
| Digoxin | 83 | ||
| Potassium changes | 83 | ||
| P-gp and changes to metabolism | 85 | ||
| Pharmacodynamic interactions | 85 | ||
| Interference with therapeutic drug monitoring for digoxin | 86 | ||
| Warfarin | 86 | ||
| Pharmacodynamic interactions | 86 | ||
| Pharmacokinetic interactions | 87 | ||
| The Rational Use of Herbal and Natural Medicines | 87 | ||
| References | 88 | ||
| 5 Herbs and Natural Supplements in Pregnancy | 92 | ||
| Introduction | 92 | ||
| Part 1 — Herbs and Natural Supplements Used in Pregnancy | 93 | ||
| Nutritional medicine | 94 | ||
| Long-term impact of maternal nutrition | 94 | ||
| Herbal medicine | 95 | ||
| A traditional approach | 95 | ||
| Abortifacients | 95 | ||
| Emmenagogues | 95 | ||
| Historical perspectives | 96 | ||
| Contemporary use by Western herbalists | 98 | ||
| Part Two — Safety in Pregnancy | 99 | ||
| Critical periods in human development | 100 | ||
| Teratogenesis | 100 | ||
| Neonatal withdrawal | 101 | ||
| How is safety evaluated in pregnancy? | 101 | ||
| Epidemiological studies | 101 | ||
| Animal studies | 102 | ||
| Post-marketing surveillance systems | 102 | ||
| Adverse event case reports | 102 | ||
| Examples of case reports: | 103 | ||
| Clinical studies | 104 | ||
| Example: echinacea | 104 | ||
| Long-term use | 104 | ||
| Weighing up the evidence | 104 | ||
| Proposing a different system for complementary medicines | 105 | ||
| Using the safety matrix | 105 | ||
| Echinacea spp. (Echinacea) | 105 | ||
| Zingiber officinalis (Ginger) | 108 | ||
| Rubus idaeus (raspberry leaf) | 110 | ||
| Cimicifuga racemosa (Black cohosh) | 111 | ||
| Vitex agnus castus (Chaste tree) | 111 | ||
| Part Three — Advising Patients in Clinical Practice | 112 | ||
| Factors to consider in practice | 112 | ||
| Individual prescribing | 112 | ||
| Timing of the intervention | 113 | ||
| Informed consent | 113 | ||
| Appendix 5.1: Nutrients during pregnancy | 116 | ||
| Appendix 5.2: NHMRC dosage recommendations for pregnancy | 130 | ||
| References | 130 | ||
| Monographs | 139 | ||
| Alpha lipoic acid | 139 | ||
| Historical Note | 139 | ||
| Other Names | 139 | ||
| Background and Relevant Pharmacokinetics | 139 | ||
| Chemical structure | 139 | ||
| Pharmocokinetics and bioavailability of LA | 139 | ||
| Food Sources | 140 | ||
| Deficiency Signs and Symptoms | 140 | ||
| Main Actions | 141 | ||
| Mitochondrial energy metabolism | 141 | ||
| Antioxidant | 141 | ||
| Glucose uptake and metabolism | 141 | ||
| Endothelial function | 142 | ||
| Hypotensive | 142 | ||
| Anti-inflammatory | 142 | ||
| Neuroprotective | 143 | ||
| Hepatoprotective | 143 | ||
| Antiatherosclerotic | 143 | ||
| Cardioprotective | 144 | ||
| Other Actions | 144 | ||
| Metal chelation | 144 | ||
| Signal transduction | 144 | ||
| Cataract protection | 144 | ||
| Cancer | 144 | ||
| Prevention | 144 | ||
| Treatment | 144 | ||
| Neuromodulation | 145 | ||
| Radioprotection | 145 | ||
| Clinical Use | 145 | ||
| Diabetes | 145 | ||
| Insulin resistance | 145 | ||
| Diabetic polyneuropathy | 146 | ||
| Diabetic nephropathy | 148 | ||
| Diabetic retinopathy | 148 | ||
| Age-related macular degeneration (AMD) | 148 | ||
| Peripheral neuropathic pain (sciatic nerve pain) | 148 | ||
| Cardiac autonomic neuropathy and platelet reactivity | 149 | ||
| HIV/AIDS | 149 | ||
| Multiple sclerosis | 149 | ||
| Weight loss | 150 | ||
| Weight loss in schizophrenia | 151 | ||
| Migraine prophylaxis | 151 | ||
| Other Uses | 151 | ||
| Alzheimer’s disease (AD) | 151 | ||
| Polycystic ovary syndrome (PCOS) | 152 | ||
| Hepatoprotection | 152 | ||
| Hypertension | 152 | ||
| Kwashiorkor | 153 | ||
| Burning-mouth syndrome | 153 | ||
| Carpal tunnel syndrome — in combination | 153 | ||
| Erectile dysfunction | 153 | ||
| Wound healing | 153 | ||
| Glaucoma | 154 | ||
| Photoageing of skin | 154 | ||
| Amanita spp. mushroom poisoning | 154 | ||
| Dosage Range | 154 | ||
| Toxicity | 155 | ||
| Adverse Reactions | 155 | ||
| Significant Interactions | 155 | ||
| Copper | 155 | ||
| Manganese | 156 | ||
| Zinc | 156 | ||
| Hypoglycaemic agents | 156 | ||
| Vitamin E, vitamin C, coenzyme Q10 and glutathione | 156 | ||
| Warfarin | 156 | ||
| Levothyroxine | 156 | ||
| References | 157 | ||
| Andrographis | 162 | ||
| Historical Note | 162 | ||
| Common Names | 162 | ||
| Botanical Name/Family | 162 | ||
| Plant Parts Used | 162 | ||
| Chemical Components | 162 | ||
| Main Actions | 163 | ||
| Immunomodulation | 163 | ||
| Anticancer activity | 163 | ||
| Antimicrobial | 164 | ||
| Cardiovascular effects | 164 | ||
| Hypoglycaemic | 165 | ||
| Hepatoprotective | 165 | ||
| Antipyretic and anti-inflammatory | 165 | ||
| Antiplatelet activity | 166 | ||
| Other Actions | 166 | ||
| Anti-HIV activity | 166 | ||
| Snake antivenom activity | 166 | ||
| Clinical Use | 166 | ||
| Upper respiratory tract infections and the common cold | 166 | ||
| Comparisons between andrographis and echinacea in the treatment of the common cold in children | 167 | ||
| Pharyngotonsillitis | 168 | ||
| Ulcerative colitis | 168 | ||
| Rheumatoid arthritis | 168 | ||
| Other Uses | 168 | ||
| Familial Mediterranean fever — in combination | 168 | ||
| HIV infection | 169 | ||
| Cancer (in combination) | 169 | ||
| Spermatogenesis | 169 | ||
| Traditional uses | 169 | ||
| Dosage Range | 169 | ||
| Upper respiratory tract infection | 170 | ||
| Toxicity | 170 | ||
| Adverse Reactions | 170 | ||
| Significant Interactions | 170 | ||
| Anticoagulants | 170 | ||
| Antiplatelet drugs | 170 | ||
| Barbiturates | 170 | ||
| Hypoglycaemic agents | 170 | ||
| Cytochrome p450 enzyme metabolism | 170 | ||
| Immunosuppressants | 171 | ||
| References | 172 | ||
| Astragalus | 174 | ||
| Historical Note | 174 | ||
| Common Name | 175 | ||
| Other Names | 175 | ||
| Botanical Name/Family | 175 | ||
| Plant Part Used | 175 | ||
| Chemical Components | 175 | ||
| Main Actions | 175 | ||
| Immune modulation | 175 | ||
| Hypotensive and positive inotrope | 176 | ||
| Antioxidant | 176 | ||
| Anticarcinogenic effects | 176 | ||
| Hypoglycaemic | 177 | ||
| Hepatoprotective actions | 177 | ||
| Renal protective | 177 | ||
| Neuroprotective | 177 | ||
| Other Actions | 177 | ||
| Traditional action | 177 | ||
| Hypocholesterolaemic | 178 | ||
| Digestive effects | 178 | ||
| Improved sperm motility | 178 | ||
| Cytochrome 1A2 inhibition | 178 | ||
| Clinical Use | 178 | ||
| Viral infection | 178 | ||
| Viral myocarditis | 178 | ||
| Cardiovascular disease | 179 | ||
| Congestive heart failure | 179 | ||
| Angina pectoris | 179 | ||
| Stroke | 179 | ||
| Cancer | 180 | ||
| Colorectal cancer | 180 | ||
| Prostate cancer (in combination) | 180 | ||
| Chronic kidney disease | 181 | ||
| Glucose regulation | 181 | ||
| Adaptogenic tonic – traditional use | 181 | ||
| Cholesterol reduction (in combination with other herbs) | 182 | ||
| Asthma (in combination with other herbs and minerals) | 182 | ||
| Memory deficits (in combination with other herbs) | 182 | ||
| Dosage Range | 182 | ||
| Toxicity | 182 | ||
| Adverse Reactions | 182 | ||
| Significant Interactions | 183 | ||
| Aciclovir | 183 | ||
| Immunosuppressant medication | 183 | ||
| Positive inotropic drugs | 183 | ||
| Cyclophosphamide | 183 | ||
| References | 184 | ||
| Black cohosh | 186 | ||
| Historical Note | 186 | ||
| Common Name | 186 | ||
| Other Names | 186 | ||
| Botanical Name/Family | 186 | ||
| Plant Parts Used | 186 | ||
| Chemical Components | 187 | ||
| Main Actions | 187 | ||
| Hormone modulation | 187 | ||
| Anti-inflammatory | 188 | ||
| Serotonergic | 188 | ||
| Dopaminergic | 188 | ||
| Cytochromes and P-glycoprotein | 188 | ||
| Other Actions | 188 | ||
| Clinical Use | 189 | ||
| Menopausal symptoms | 189 | ||
| Systematic reviews and meta-analyses | 189 | ||
| Comparison studies | 191 | ||
| Weight gain | 192 | ||
| Osteoporosis prevention | 192 | ||
| Breast cancer protection | 192 | ||
| Premenstrual syndrome and dysmenorrhoea | 193 | ||
| Menstrual migraine | 193 | ||
| Primary and secondary infertility | 193 | ||
| Prostate cancer | 194 | ||
| Other Uses | 194 | ||
| Safety | 194 | ||
| Dosage Range | 195 | ||
| Toxicity | 195 | ||
| Idiosyncratic hepatic reactions | 195 | ||
| Adverse Reactions | 196 | ||
| Significant Interactions | 197 | ||
| Cisplatin | 197 | ||
| Clomiphene citrate | 197 | ||
| Doxorubicin | 197 | ||
| Docetaxel | 197 | ||
| References | 198 | ||
| Brahmi | 201 | ||
| Historical Note | 201 | ||
| Common Name | 201 | ||
| Other Names | 201 | ||
| Botanical Name/Family | 202 | ||
| Plant Parts Used | 202 | ||
| Chemical Components | 202 | ||
| Main Actions | 202 | ||
| Antioxidant | 202 | ||
| Neuroprotective | 202 | ||
| Cognitive or nootropic effects — multiple mechanisms | 203 | ||
| Antidepressant activity | 204 | ||
| Antiulcer effects | 204 | ||
| Anti-inflammatory effects | 204 | ||
| Other Actions | 205 | ||
| Adaptogen | 205 | ||
| Antinociceptive activity | 205 | ||
| Mast cell stabilisation | 205 | ||
| Increased thyroid hormone levels | 205 | ||
| Antispasmodic effect on smooth muscle | 205 | ||
| Anticlastogenic effect | 205 | ||
| Hepatoprotective | 205 | ||
| Cholesterol-lowering activity | 206 | ||
| Anticonvulsant activity | 206 | ||
| Clinical Use | 206 | ||
| Improving cognitive function — learning, memory, intelligence | 206 | ||
| Healthy adults | 206 | ||
| Older adults | 207 | ||
| Acute effects in healthy people | 207 | ||
| Children | 208 | ||
| Anxiety | 208 | ||
| Other Uses | 208 | ||
| Traditional uses | 208 | ||
| Irritable bowel syndrome | 209 | ||
| Dosage Range | 209 | ||
| According to clinical studies | 209 | ||
| Toxicity | 209 | ||
| Adverse Reactions | 209 | ||
| Significant Interactions | 209 | ||
| Cholinergic drugs | 209 | ||
| Serotonergic drugs | 209 | ||
| References | 211 | ||
| Calcium | 213 | ||
| Background and Relevant Pharmacokinetics | 213 | ||
| Food Sources | 214 | ||
| Deficiency Signs and Symptoms | 214 | ||
| Primary deficiency | 215 | ||
| Secondary deficiency | 215 | ||
| Main Actions | 215 | ||
| Bone and teeth mineralisation | 215 | ||
| Muscle contraction | 215 | ||
| Blood clotting | 216 | ||
| Nerve conduction | 216 | ||
| Altered membrane functions | 216 | ||
| Other Actions | 216 | ||
| Clinical Use | 216 | ||
| Calcium deficiency | 216 | ||
| Rickets and osteomalacia | 216 | ||
| Infants | 216 | ||
| Bone mineral density (BMD), osteoporosis prophylaxis and reducing fracture risk | 216 | ||
| Children and adolescents | 217 | ||
| Postmenopausal women | 218 | ||
| Men | 219 | ||
| The elderly | 219 | ||
| Glucocorticoid (GC)-induced osteoporosis | 219 | ||
| Supplementation during pregnancy and lactation | 220 | ||
| Prevention of hypertension and preeclampsia | 220 | ||
| Leg cramps | 221 | ||
| Lead toxicity | 221 | ||
| Neonatal benefits | 222 | ||
| Dyspepsia | 222 | ||
| Prevention of cancer | 222 | ||
| Prevention of colorectal cancer and recurrence of adenomatous polyps | 222 | ||
| Other cancers | 224 | ||
| Hypertension | 224 | ||
| Premenstrual syndrome | 225 | ||
| Weight loss | 226 | ||
| Nephrolithiasis | 227 | ||
| Other Uses | 228 | ||
| Hyperlipidaemia | 228 | ||
| Dry eye | 230 | ||
| Fluorosis | 230 | ||
| Dosage Range | 230 | ||
| Australian RDIs | 230 | ||
| According to clinical studies | 231 | ||
| Adverse Reactions | 231 | ||
| Hypercalcaemia | 231 | ||
| Significant Interactions | 231 | ||
| Antacids, including H2 antagonists and proton pump inhibitors | 231 | ||
| Bisphosphonates | 231 | ||
| Caffeine | 232 | ||
| Calcium channel blockers | 232 | ||
| Cardiac glycosides (e.g. digoxin) | 232 | ||
| Corticosteroids | 232 | ||
| Excess dietary fat | 232 | ||
| Excess fibre, including guar gum | 232 | ||
| Iron | 232 | ||
| Levothyroxine | 232 | ||
| Lysine | 232 | ||
| Magnesium | 232 | ||
| Oestrogen and progesterone | 232 | ||
| Phosphorus | 233 | ||
| Quinolone antibiotics | 233 | ||
| Tetracyclines | 233 | ||
| Thiazide diuretics | 233 | ||
| Zinc | 233 | ||
| References | 234 | ||
| Chaste tree | 239 | ||
| Historical Note | 239 | ||
| Other Names | 239 | ||
| Botanical Name/Family | 239 | ||
| Plant Part Used | 239 | ||
| Chemical Components | 239 | ||
| Main Actions | 240 | ||
| Decreases prolactin release | 240 | ||
| Oestrogen receptor binding | 240 | ||
| Increases progesterone levels | 240 | ||
| Opioid receptors | 240 | ||
| Cytotoxic activity | 241 | ||
| Other Actions | 241 | ||
| Clinical Use | 241 | ||
| Premenstrual syndrome | 241 | ||
| Comparison to SSRI drugs | 244 | ||
| Comparison to vitamin B6 | 244 | ||
| Mastalgia | 244 | ||
| Irregularities of the menstrual cycle | 244 | ||
| Menopause | 245 | ||
| Poor lactation | 245 | ||
| Fertility disorders | 246 | ||
| Acne vulgaris | 246 | ||
| Other Uses | 246 | ||
| Dosage Range | 246 | ||
| General guide | 246 | ||
| According to clinical studies | 246 | ||
| PMS | 246 | ||
| Cyclic mastalgia | 246 | ||
| Menstrual irregularities | 246 | ||
| Infertility | 246 | ||
| Adverse Reactions | 247 | ||
| Significant Interactions | 247 | ||
| Dopamine antagonists | 247 | ||
| Oral contraceptives | 247 | ||
| References | 248 | ||
| Chondroitin | 250 | ||
| Other Names | 250 | ||
| Background and Relevant Pharmacokinetics | 250 | ||
| Chemical Components | 250 | ||
| Food Sources | 251 | ||
| Main Actions | 251 | ||
| Chondroprotective effect | 251 | ||
| Anti-inflammatory | 252 | ||
| Viscoelastic agent | 252 | ||
| Other Actions | 252 | ||
| Clinical Use | 252 | ||
| Osteoarthritis: symptom control and retarding disease progression | 252 | ||
| Comparisons with NSAIDs | 253 | ||
| Combined use of chondroitin sulfate and glucosamine sulfate | 254 | ||
| Topical preparations | 254 | ||
| Other Uses | 254 | ||
| Heart disease | 254 | ||
| Snoring | 254 | ||
| Ophthalmic surgery and dry eyes | 255 | ||
| Psoriasis | 255 | ||
| Interstitial cystitis | 255 | ||
| Dosage Range | 255 | ||
| Adverse Reactions | 255 | ||
| Significant Interactions | 255 | ||
| Anticoagulants | 255 | ||
| Non-steroidal anti-inflammatory drugs | 256 | ||
| References | 257 | ||
| Chromium | 260 | ||
| Historical Note | 260 | ||
| Background and Relevant Pharmacokinetics | 260 | ||
| Chemical Components | 260 | ||
| Food Sources | 261 | ||
| Deficiency Signs and Symptoms | 261 | ||
| Primary deficiency | 261 | ||
| Secondary deficiency | 261 | ||
| Main Actions | 262 | ||
| Important cofactor | 262 | ||
| Improves blood sugar control | 262 | ||
| Lipid-lowering activity | 262 | ||
| Antihypertensive, cardioprotective | 262 | ||
| Antidepressant/neurotransmitter effects | 262 | ||
| Other Actions | 263 | ||
| Immunomodulation | 263 | ||
| Bone density protection | 263 | ||
| Antioxidant | 263 | ||
| Anti-inflammatory | 263 | ||
| Increases dehydroepiandrosterone (DHEA) | 263 | ||
| Hepatoprotection | 264 | ||
| Clinical Use | 264 | ||
| Deficiency states: prevention and treatment | 264 | ||
| Diabetes | 264 | ||
| Type 2 diabetes mellitus (T2DM) | 264 | ||
| Type 1 diabetes mellitus (T1DM) | 266 | ||
| Gestational diabetes mellitus (GDM) | 266 | ||
| Corticosteroid-induced diabetes mellitus | 266 | ||
| Antiretroviral medication-induced dysglycaemia | 266 | ||
| Prevention of long-term diabetic complications | 266 | ||
| Hypoglycaemia | 267 | ||
| Hyperlipidaemia | 267 | ||
| Obesity | 267 | ||
| Atypical depression | 268 | ||
| Other Uses | 268 | ||
| Exercise aid — not effective | 268 | ||
| Polycystic ovarian syndrome (PCOS) | 269 | ||
| Critical care | 269 | ||
| Osteoporosis | 270 | ||
| Dosage Range | 270 | ||
| Australian adequate intake | 270 | ||
| Adverse Reactions | 270 | ||
| No adverse effects on iron status | 271 | ||
| Significant Interactions | 271 | ||
| Corticosteroids | 271 | ||
| Hypoglycaemic medicines | 271 | ||
| Hormone replacement therapy | 271 | ||
| Lipid-lowering medicines | 271 | ||
| References | 272 | ||
| Coenzyme Q10 | 276 | ||
| Other Names | 276 | ||
| Background and Relevant Pharmacokinetics | 276 | ||
| Chemical Components | 276 | ||
| Food Sources | 276 | ||
| Deficiency Signs and Symptoms | 277 | ||
| Main Actions | 277 | ||
| Antioxidant | 277 | ||
| Cardioprotective | 278 | ||
| Doxorubicin — induced cardiotoxicity | 279 | ||
| Antihypertensive | 279 | ||
| Immunostimulant activity | 279 | ||
| Endothelial function | 280 | ||
| Neuroprotective | 280 | ||
| Regulates genomic expression | 280 | ||
| Other Actions | 280 | ||
| Tissue protection | 280 | ||
| Clinical Use | 281 | ||
| Cardiovascular diseases | 281 | ||
| Congestive heart failure (CHF) | 281 | ||
| Clinical studies | 282 | ||
| Mortality and CHF | 284 | ||
| Paediatric myopathy | 284 | ||
| Haemodialysis | 284 | ||
| Hypertension | 285 | ||
| In conjunction | 285 | ||
| Cardiac surgery | 285 | ||
| Angina pectoris | 287 | ||
| Statin drug use | 287 | ||
| Statin-induced myalgia | 288 | ||
| Statin-induced cognitive impairment | 289 | ||
| Statin use and CoQ10 supplementation | 289 | ||
| Arrhythmias | 289 | ||
| Hypercholesterolemia | 289 | ||
| Sports supplement/ergogenic aid | 289 | ||
| Postpolio syndrome | 290 | ||
| Chronic obstructive pulmonary disease (COPD) | 291 | ||
| Cystic fibrosis | 291 | ||
| Periodontal disease | 291 | ||
| Parkinson’s disease | 292 | ||
| Alzheimer’s dementia | 293 | ||
| Haemodialysis | 293 | ||
| Migraine | 294 | ||
| Fibromyalgia | 294 | ||
| Male infertility | 295 | ||
| Other Uses | 296 | ||
| Cancer | 296 | ||
| Reducing cardiotoxic effects of anthracyclines | 296 | ||
| Reducing side effects of tamoxifen | 297 | ||
| Mitochondrial myopathy | 297 | ||
| Age-related macular degeneration (in combination) | 297 | ||
| Friedreich’s ataxia | 298 | ||
| Tinnitus and hearing loss | 298 | ||
| Myelodysplastic syndromes | 299 | ||
| Huntington’s chorea | 299 | ||
| Preeclampsia | 300 | ||
| Diabetes | 300 | ||
| Peyronie’s disease | 300 | ||
| Dosage Range | 300 | ||
| According to clinical studies | 300 | ||
| Adverse Reactions | 301 | ||
| Significant Interactions | 301 | ||
| Beta-adrenergic antagonists | 301 | ||
| Doxorubicin | 301 | ||
| Phenothiazines | 301 | ||
| Statin drugs | 301 | ||
| Sulfonylureas | 302 | ||
| Tamoxifen | 302 | ||
| Theophylline | 302 | ||
| Timolol | 302 | ||
| Tricyclic antidepressants | 302 | ||
| Warfarin | 302 | ||
| Vitamin E | 302 | ||
| References | 304 | ||
| Cranberry | 310 | ||
| Historical Note | 310 | ||
| Other Names | 310 | ||
| Botanical Name/Family | 310 | ||
| Plant Part Used | 310 | ||
| Chemical Components | 310 | ||
| Main Actions | 311 | ||
| Bacteriostatic and antiadhesive activity | 311 | ||
| Antioxidant | 311 | ||
| Increases excretion of oxalic acid and uric acid | 312 | ||
| Alterations to urinary pH | 312 | ||
| Chemoprotective | 312 | ||
| Cytochromes | 312 | ||
| Other Actions | 312 | ||
| Antiviral activity | 312 | ||
| Antifungal activity | 312 | ||
| ACE inhibitor | 313 | ||
| Lipid lowering and anti-inflammatory | 313 | ||
| Clinical Use | 313 | ||
| Prevention of UTI | 313 | ||
| Why the conflicting conclusions? | 313 | ||
| Renal transplant patients | 315 | ||
| Spinal cord injuries | 315 | ||
| Radiotherapy and UTI prevention | 315 | ||
| Gynaecological surgery and UTI prevention | 315 | ||
| Children | 315 | ||
| Catheterisation and renal disease | 315 | ||
| Recurrent UTIs in children | 316 | ||
| Treatment of UTI | 316 | ||
| Nephroprotection | 317 | ||
| Other Uses | 317 | ||
| Gout | 317 | ||
| Oral hygiene | 317 | ||
| Prevention and treatment of Helicobacter infection | 317 | ||
| Cardioprotection | 317 | ||
| Type 2 diabetes | 318 | ||
| Prostate health | 318 | ||
| Urinary deodorising activity | 318 | ||
| Dosage Range | 318 | ||
| Preventing UTI | 318 | ||
| According to clinical studies | 318 | ||
| Adverse Reactions | 319 | ||
| Significant Interactions | 319 | ||
| CYP3 A substrates | 319 | ||
| Proton pump inhibitors | 319 | ||
| Warfarin | 319 | ||
| References | 321 | ||
| Devil’s claw | 324 | ||
| Historical Note | 324 | ||
| Common Names | 324 | ||
| Botanical Name/Family | 324 | ||
| Plant Part Used | 324 | ||
| Chemical Components | 324 | ||
| Main Actions | 325 | ||
| Anti-inflammatory/analgesic | 325 | ||
| Chondroprotective | 326 | ||
| Hypoglycaemic | 326 | ||
| Other Actions | 326 | ||
| Clinical Use | 327 | ||
| Arthritis | 327 | ||
| Comparison studies | 327 | ||
| Back pain | 328 | ||
| Dyspepsia | 329 | ||
| Other Uses | 329 | ||
| Use in oncology | 329 | ||
| Traditional use | 329 | ||
| Dosage Range | 329 | ||
| Musculoskeletal conditions | 329 | ||
| Digestive conditions (e.g. dyspepsia) | 329 | ||
| Toxicity | 329 | ||
| Adverse Reactions | 330 | ||
| Significant Interactions | 330 | ||
| Warfarin | 330 | ||
| Anti-arrhythmic drugs | 330 | ||
| Contraindications and Precautions | 330 | ||
| Pregnancy Use | 330 | ||
| References | 331 | ||
| Echinacea | 333 | ||
| Historical Note | 333 | ||
| Common Name | 334 | ||
| Other Names | 334 | ||
| Botanical Name/Family | 334 | ||
| Plant Parts Used | 334 | ||
| Chemical Components | 334 | ||
| Pharmacokinetics | 334 | ||
| Main Actions | 335 | ||
| Immunomodulator | 335 | ||
| Anti-inflammatory | 336 | ||
| COX-1/COX-2 | 336 | ||
| Cannabinoid and TRPV1 receptor interaction | 337 | ||
| Antiviral activity | 337 | ||
| Herpes simplex virus | 337 | ||
| Antibacterial activity | 337 | ||
| Cytochromes and P-glycoprotein | 338 | ||
| Other Actions | 339 | ||
| Antioxidant | 339 | ||
| Anaesthetic | 339 | ||
| Apoptosis | 339 | ||
| Chemoprevention | 339 | ||
| Immunological adjuvants | 340 | ||
| Antifungal activity | 340 | ||
| Antiparasitic | 340 | ||
| Anxiolytic | 340 | ||
| Hypoglycaemic | 340 | ||
| Clinical Use | 340 | ||
| Upper respiratory tract infections | 341 | ||
| Prevention | 341 | ||
| Athletes | 342 | ||
| Paediatric studies | 342 | ||
| Acute sore throat | 343 | ||
| Wound healing | 343 | ||
| Genital herpes (Condyloma acuminata) | 343 | ||
| Reducing chemotherapy side effects | 344 | ||
| Radiation-associated leucopenia | 344 | ||
| Halitosis | 344 | ||
| Recurrent candidiasis | 344 | ||
| Other Uses | 345 | ||
| Dosage Range | 345 | ||
| General guide | 345 | ||
| Specific guide | 345 | ||
| Doses according to clinical trials | 345 | ||
| URTI: Treatment | 345 | ||
| Prevention | 345 | ||
| Protection from radiation | 346 | ||
| Genital herpes | 346 | ||
| Adverse Reactions | 346 | ||
| Significant Interactions | 347 | ||
| Cyclophosphamide | 347 | ||
| Immunosuppression agents (e.g. cyclosporine) | 347 | ||
| Myelosuppressive chemotherapeutic agents | 347 | ||
| Etoposide | 347 | ||
| Duration of use | 348 | ||
| References | 349 | ||
| Feverfew | 354 | ||
| Historical Note | 354 | ||
| Other Names | 354 | ||
| Botanical Name/Family | 354 | ||
| Plant Part Used | 354 | ||
| Chemical Components | 354 | ||
| Main Actions | 355 | ||
| Anti-inflammatory and analgesic | 355 | ||
| Antispasmodic | 356 | ||
| Inhibits serotonin release and binding | 356 | ||
| Anticancer activity | 356 | ||
| Other Actions | 358 | ||
| Platelet aggregation inhibition | 358 | ||
| Mast cell stabilisation | 358 | ||
| Hepatoprotective effects | 358 | ||
| Bone regulation effects | 358 | ||
| Clinical Use | 359 | ||
| Migraine headache | 359 | ||
| Arthritic conditions | 361 | ||
| Other Uses | 362 | ||
| Dermatology | 362 | ||
| Oncology | 362 | ||
| Dosage Range | 362 | ||
| Toxicity | 362 | ||
| Adverse Reactions | 363 | ||
| Significant Interactions | 363 | ||
| Anticoagulants | 363 | ||
| References | 364 | ||
| Fish oils | 366 | ||
| Background and Relevant Pharmacokinetics | 366 | ||
| Chemical Components | 367 | ||
| Food Sources | 367 | ||
| Deficiency Signs and Symptoms | 367 | ||
| Primary deficiency | 368 | ||
| Secondary deficiency | 368 | ||
| Main Actions | 368 | ||
| Cardiovascular effects | 368 | ||
| Prevent malignant cardiac arrhythmias | 368 | ||
| Triglyceride (TG)-lowering activity | 369 | ||
| Lipoprotein effects | 369 | ||
| Improved endothelial function | 369 | ||
| Reducing resting heart rate | 369 | ||
| Reduce blood pressure | 369 | ||
| Reduce and possibly reverse atherogenesis | 371 | ||
| Antithrombotic and antiplatelet | 371 | ||
| Anti-inflammatory | 372 | ||
| Neurological effects | 372 | ||
| Prenatal and postnatal neurological development | 373 | ||
| Chemopreventive effects | 373 | ||
| Clinical Use | 373 | ||
| Prevention of morbidity and mortality of cardiovascular disease | 374 | ||
| Meta-analyses | 376 | ||
| Congestive heart failure | 377 | ||
| Patients with implantable cardioverter defibrillators (ICDs) | 377 | ||
| Elevated triglyceride levels | 378 | ||
| Hypertension | 378 | ||
| Prior to cardiac surgery | 379 | ||
| Intermittent claudication | 379 | ||
| Neurological effects | 381 | ||
| Cognitive function | 381 | ||
| Alzheimer’s dementia | 381 | ||
| Brain trauma injury | 382 | ||
| Autism spectrum disorder (ASD) | 382 | ||
| Pregnancy, breastfeeding and infants | 383 | ||
| Prevention of atopy in at-risk infants | 383 | ||
| Cognitive development | 384 | ||
| Prevention and treatment of postpartum depression (PPD) | 385 | ||
| Preventing depression | 386 | ||
| Treating depression | 387 | ||
| Bipolar disorder | 388 | ||
| Addiction/abstinence | 388 | ||
| Aggressive and impulsive behaviour | 389 | ||
| Anxiety | 389 | ||
| Attention-deficit hyperactivity disorder | 390 | ||
| Schizophrenia | 390 | ||
| Cancer | 391 | ||
| Breast and prostate cancers | 391 | ||
| Colorectal cancer | 392 | ||
| Diabetes | 393 | ||
| Weight reduction | 394 | ||
| Polycystic ovarian syndrome (PCOS) | 394 | ||
| Inflammatory diseases | 395 | ||
| Rheumatoid arthritis | 395 | ||
| Reducing incidence of RA | 396 | ||
| Asthma | 396 | ||
| Atopic dermatitis and eczema | 399 | ||
| Other Uses | 399 | ||
| Dosage Range | 399 | ||
| Cardiovascular disease | 399 | ||
| Other conditions | 400 | ||
| Adverse Reactions | 400 | ||
| Significant Interactions | 400 | ||
| Antiplatelet agents | 400 | ||
| Anticoagulants | 401 | ||
| Non-steroidal anti-inflammatory drugs | 401 | ||
| Pravastatin | 401 | ||
| References | 402 | ||
| Folate | 409 | ||
| Historical Note | 409 | ||
| Other Names | 409 | ||
| Background and Relevant Pharmacokinetics and Chemical Components | 409 | ||
| Food Sources | 411 | ||
| Deficiency | 411 | ||
| Signs and symptoms of deficiency | 411 | ||
| Primary deficiency | 411 | ||
| Folate enzyme polymorphisms | 412 | ||
| Secondary deficiency | 412 | ||
| Excess folic acid | 412 | ||
| Main Actions | 413 | ||
| Coenzyme | 413 | ||
| DNA and RNA synthesis | 413 | ||
| Production of the active form of B12 | 413 | ||
| Reduction of homocysteine levels | 413 | ||
| Synthesis of S-adenosyl-l-methionine (SAMe) | 413 | ||
| Amino acid metabolism | 413 | ||
| Clinical Use | 413 | ||
| Prevention and treatment of deficiency | 413 | ||
| Preconception and during pregnancy | 414 | ||
| Neural tube defects | 414 | ||
| Other neonatal outcomes | 414 | ||
| Childhood diseases | 416 | ||
| OCP-induced folate deficiency | 416 | ||
| Hyperhomocysteinaemia | 416 | ||
| Bone health and fracture risk | 416 | ||
| Cardiovascular protection and treatment | 417 | ||
| Alzheimer’s dementia and impaired cognitive function in the elderly | 417 | ||
| Diabetes mellitus | 418 | ||
| Renal transplant recipients | 418 | ||
| Restenosis after percutaneous coronary intervention | 418 | ||
| Idiopathic recurrent miscarriage (IRM) | 418 | ||
| Cardiovascular disease protection and treatment independent of homocysteine status | 419 | ||
| Stroke | 419 | ||
| Carotid intima-media thickness | 419 | ||
| Hypertension and glucose control | 420 | ||
| Cognitive decline, dementia and Alzheimer’s disease prevention or treatment independent of homocysteine status | 420 | ||
| Anticonvulsant-induced folate deficiency | 421 | ||
| Psychiatric illness | 421 | ||
| Depression | 421 | ||
| Aetiological role | 421 | ||
| Therapeutic role | 422 | ||
| Improves response to standard antidepressants | 422 | ||
| Schizophrenia | 422 | ||
| Other neurological and psychiatric presentations | 423 | ||
| Chemopreventative role | 423 | ||
| Colon cancer | 424 | ||
| Breast cancer | 424 | ||
| Cervical cancer | 424 | ||
| Other cancers | 425 | ||
| Periodontal disease | 425 | ||
| Methotrexate toxicity | 425 | ||
| Sickle cell anaemia | 425 | ||
| Vitiligo | 426 | ||
| Erectile dysfunction | 426 | ||
| Dosage Range | 426 | ||
| Australian RDI (NHMRC 2006) | 426 | ||
| According to clinical studies | 426 | ||
| Adverse Reactions | 427 | ||
| Significant Interactions | 427 | ||
| Antacids | 427 | ||
| Anticonvulsants (phenytoin) | 427 | ||
| Cholestyramine (e.g. Questran) | 427 | ||
| Gastric acid inhibitors (proton-pump inhibitors) | 427 | ||
| Methotrexate | 427 | ||
| Oral contraceptives | 427 | ||
| Pancreatin | 428 | ||
| Pyrimethamine (e.g. maloprim) | 428 | ||
| Sulfasalazine | 428 | ||
| Trimethoprim | 428 | ||
| Zinc | 428 | ||
| References | 429 | ||
| Garlic | 435 | ||
| Historical Note | 435 | ||
| Common Name | 436 | ||
| Other Names | 436 | ||
| Botanical Name/Family | 436 | ||
| Plant Part Used | 436 | ||
| Chemical Components | 436 | ||
| Main Actions | 436 | ||
| Antioxidant | 436 | ||
| Protection against ischaemic and reperfusion injury | 437 | ||
| Anti-inflammatory activity | 437 | ||
| Inhibits platelet aggregation and antithrombotic effects | 438 | ||
| Stimulates fibrinolysis | 438 | ||
| Antiatherosclerotic activity | 438 | ||
| Reduces serum cholesterol levels | 439 | ||
| Hypoglycaemic activity | 440 | ||
| Antihypertensive activity | 440 | ||
| Enhances microcirculation | 441 | ||
| Antimicrobial and immune-enhancing activities | 441 | ||
| Helicobacter pylori infection | 442 | ||
| Antineoplastic and chemopreventive effects | 442 | ||
| Other Actions | 444 | ||
| Hepatoprotective effects | 444 | ||
| Homocysteine-lowering action | 444 | ||
| Inhibits CYP 2E1 and induces P-glycoprotein | 444 | ||
| Quality of life | 445 | ||
| Clinical Use | 445 | ||
| Cardiovascular disease | 445 | ||
| Hypertension | 446 | ||
| Hyperlipidaemia | 447 | ||
| Comparative studies | 448 | ||
| Diabetes mellitus (plus hyperlipidaemia) | 449 | ||
| Adjunctive therapy to metformin | 450 | ||
| Antiplatelet effects | 450 | ||
| Peripheral arterial occlusive disease | 450 | ||
| Infection | 450 | ||
| Tinea pedis, tinea corporis, tinea cruris | 450 | ||
| Vaginitis | 451 | ||
| Common cold prevention | 451 | ||
| Helicobacter pylori infection | 451 | ||
| Protective effects against cancer | 451 | ||
| Intervention study in colorectal cancer | 452 | ||
| Endometrial cancer | 452 | ||
| Other Uses | 452 | ||
| Dosage Range | 453 | ||
| General guide | 453 | ||
| According to clinical studies | 453 | ||
| Adverse Reactions | 453 | ||
| Internal use | 453 | ||
| Topical use | 453 | ||
| Significant Interactions | 454 | ||
| Saquinavir, darunavir and ritonavir | 454 | ||
| Anticoagulants | 454 | ||
| Antiplatelet drugs | 454 | ||
| Antihypertensive agents | 454 | ||
| Antihyperlipidaemic agents | 454 | ||
| Helicobacter pylori triple therapy | 454 | ||
| Hepatotoxic drugs | 454 | ||
| Paracetamol | 454 | ||
| Hydrochlorothiazide | 455 | ||
| References | 456 | ||
| Ginger | 463 | ||
| Historical Note | 463 | ||
| Other Names | 463 | ||
| Botanical Name/Family | 463 | ||
| Plant Part Used | 463 | ||
| Chemical Components | 463 | ||
| Pharmacokinetics | 463 | ||
| Main Actions | 464 | ||
| Anti-emetic | 464 | ||
| Gastrointestinal activity | 464 | ||
| Anti-ulcer activity | 464 | ||
| Hypolipidaemic | 465 | ||
| Glycaemic response | 466 | ||
| Anti-inflammatory and analgesic | 466 | ||
| Antiplatelet | 467 | ||
| Antimicrobial and antiparasitic | 467 | ||
| Ginger constituents | 468 | ||
| Antifungal and antiviral | 468 | ||
| Antioxidant | 468 | ||
| Immunomodulation | 469 | ||
| Hepatoprotective | 469 | ||
| Nephroprotection | 469 | ||
| Chemoprotective | 469 | ||
| Other Actions | 471 | ||
| Antihistamine | 471 | ||
| Anxiolytic | 471 | ||
| Antifibrotic | 471 | ||
| Positive inotrope | 471 | ||
| Thermogenic | 471 | ||
| Hypotensive | 471 | ||
| Clinical Use | 472 | ||
| Prevention of nausea and vomiting | 472 | ||
| Nausea and vomiting in pregnancy | 472 | ||
| Nausea of pregnancy | 472 | ||
| Comparative studies | 473 | ||
| Postoperative nausea | 473 | ||
| Motion sickness | 474 | ||
| Chemotherapy-induced nausea and vomiting (CINV) | 475 | ||
| Comparative studies | 475 | ||
| Use with other anti-nausea medication | 475 | ||
| Nausea and vomiting with antiretroviral treatment | 475 | ||
| Musculoskeletal disorders | 475 | ||
| Topical ginger preparation | 476 | ||
| Post-exercise muscle pain | 476 | ||
| Dysmenorrhoea | 476 | ||
| Dyspepsia | 477 | ||
| Hyperlipidaemia | 477 | ||
| Migraine | 477 | ||
| Pain | 477 | ||
| Other Uses | 477 | ||
| Cognitive function | 477 | ||
| Diabetes | 478 | ||
| Weight loss | 478 | ||
| Asthma | 478 | ||
| Ulcerative colitis | 478 | ||
| Dosage Range | 478 | ||
| According to clinical studies | 478 | ||
| Adverse Reactions | 479 | ||
| Significant Interactions | 479 | ||
| Antibiotics | 479 | ||
| Warfarin | 479 | ||
| Antiplatelet drugs | 479 | ||
| Cisplatin | 479 | ||
| References | 481 | ||
| Ginkgo biloba | 487 | ||
| Historical Note | 487 | ||
| Common Name | 487 | ||
| Other Names | 487 | ||
| Botanical Name/Family | 487 | ||
| Plant Parts Used | 487 | ||
| Chemical Components | 487 | ||
| Main Actions | 488 | ||
| Antioxidant | 488 | ||
| Cardioprotective | 489 | ||
| Anti-inflammatory | 489 | ||
| Ginkgo extract | 489 | ||
| Ginkgetin | 489 | ||
| Vascular effects | 490 | ||
| Vasodilation | 490 | ||
| Reduces oedema | 490 | ||
| Antiplatelet and anticoagulant — no significant effect | 490 | ||
| Alters neurotransmitters | 491 | ||
| Monoamine oxidase (MAO) inhibition — not in vivo | 491 | ||
| Serotonin | 491 | ||
| Cholinergic effects | 491 | ||
| Gamma-aminobutyric acid (GABA) receptors | 491 | ||
| Corticosterone | 491 | ||
| Dopamine | 491 | ||
| Neuroprotection | 492 | ||
| Beta-amyloid | 492 | ||
| Cerebral ischaemia | 492 | ||
| Stabilisation and protection of mitochondrial function | 492 | ||
| Immunostimulant | 493 | ||
| Anticancer | 493 | ||
| Other Actions | 493 | ||
| Antiatherosclerotic | 493 | ||
| Antiviral | 493 | ||
| Glycaemia | 494 | ||
| Antiosteoporotic | 494 | ||
| Activity on cytochromes and P-glycoprotein | 494 | ||
| Antiasthmatic | 494 | ||
| Clinical Use | 494 | ||
| Dementia, memory impairment | 495 | ||
| Alzheimer’s disease or vascular dementia with neuropsychiatric features | 497 | ||
| Use in healthy subjects | 497 | ||
| Vascular cognitive impairment | 498 | ||
| Ginkgo complexed with phospholipids | 499 | ||
| Cognitive effects in postmenopausal women | 499 | ||
| Comparisons with anticholinesterase drugs | 499 | ||
| Dementia prevention | 500 | ||
| Acute ischaemic stroke | 500 | ||
| Depression | 501 | ||
| Generalised anxiety disorder (GAD) | 501 | ||
| Peripheral vascular diseases | 501 | ||
| Intermittent claudication | 502 | ||
| Raynaud’s syndrome | 502 | ||
| Vertigo, tinnitus, labyrinthitis and sudden deafness | 503 | ||
| Tinnitus | 503 | ||
| Salicylate-induced tinnitus | 503 | ||
| Vertigo | 503 | ||
| Labyrinthitis | 504 | ||
| Sudden deafness | 504 | ||
| Macular degeneration, glaucoma and retinopathy | 504 | ||
| Macular degeneration | 504 | ||
| Glaucoma | 504 | ||
| Chloroquine retinopathy | 505 | ||
| Prevention of altitude sickness/acute mountain sickness | 505 | ||
| Premenstrual syndrome (PMS) | 506 | ||
| Vitiligo | 507 | ||
| Sexual dysfunction/sexual function | 507 | ||
| Other Uses | 507 | ||
| Attention-deficit hyperactivity disorder and autism — no effect | 508 | ||
| Addiction — no effect | 508 | ||
| Allergic conjunctivitis | 508 | ||
| Adjunct in cancer treatment | 508 | ||
| Asthma | 509 | ||
| Cancer prevention | 509 | ||
| Cardiac surgery support | 509 | ||
| Diabetic nephropathy | 509 | ||
| Migraine headache | 509 | ||
| Multiple sclerosis | 510 | ||
| Parkinson’s disease | 510 | ||
| Schizophrenia — adjunctive treatment | 510 | ||
| Tardive syndromes — including tardive dyskinesias | 511 | ||
| Dosage Range | 511 | ||
| General guide | 511 | ||
| According to clinical studies | 511 | ||
| Adverse Reactions | 512 | ||
| Significant Interactions | 513 | ||
| Adriamycin | 513 | ||
| Antidepressant drugs | 513 | ||
| Bleomycin | 514 | ||
| Cholinergic drugs | 514 | ||
| Cilostazol | 514 | ||
| Cisplatin | 514 | ||
| Clozapine | 514 | ||
| Doxorubicin | 514 | ||
| Haloperidol | 514 | ||
| Platelet inhibitor drugs | 514 | ||
| Valproate, Dilantin, Depakote | 514 | ||
| Warfarin | 515 | ||
| Cerebral haemorrhage and epilepsy | 515 | ||
| References | 516 | ||
| Glucosamine | 524 | ||
| Other Names | 524 | ||
| Background and Relevant Pharmacokinetics | 524 | ||
| Chemical Components | 525 | ||
| Food Sources | 525 | ||
| Main Actions | 525 | ||
| Chondroprotective effect | 525 | ||
| Anti-inflammatory | 526 | ||
| Glucose metabolism | 526 | ||
| Gastrointestinal protection | 527 | ||
| Other Actions | 527 | ||
| Clinical Use | 527 | ||
| Osteoarthritis | 527 | ||
| Compared to standard treatments | 528 | ||
| Long-term use | 529 | ||
| Combination therapy | 531 | ||
| With chondroitin sulfate (see Chondroitin monograph for more information) | 531 | ||
| With omega-3 EFAs | 532 | ||
| With MSM | 532 | ||
| Topical, with camphor | 532 | ||
| With NSAIDs | 532 | ||
| Comparisons with NSAIDs | 532 | ||
| Inflammatory bowel disease | 532 | ||
| Chronic lower back pain | 533 | ||
| Other Uses | 533 | ||
| Veterinary use | 533 | ||
| Skincare use | 533 | ||
| Dosage Range | 533 | ||
| Adverse Reactions | 534 | ||
| Significant Interactions | 535 | ||
| Non-steroidal anti-inflammatory drugs | 535 | ||
| Warfarin | 535 | ||
| References | 536 | ||
| Green tea | 540 | ||
| Historical Note | 540 | ||
| Common Name | 540 | ||
| Other Names | 540 | ||
| Botanical Name/Family | 540 | ||
| Plant Part Used | 540 | ||
| Chemical Components | 540 | ||
| Main Actions | 541 | ||
| Antioxidant | 541 | ||
| Antibacterial activity | 541 | ||
| Oral pathogens | 541 | ||
| Antiviral activity | 542 | ||
| Antimalarial | 542 | ||
| Anticarcinogenic | 542 | ||
| Adjunct in cancer treatment | 543 | ||
| Antihypertensive | 543 | ||
| Cardioprotective | 543 | ||
| Neuroprotective/neurorescue | 543 | ||
| Iron chelation | 544 | ||
| Thermogenic activity | 544 | ||
| Other Actions | 545 | ||
| Hepatoprotective | 545 | ||
| Antithyroid | 545 | ||
| Clinical Use | 545 | ||
| Cancer prevention | 545 | ||
| All cancers | 546 | ||
| Breast cancer | 546 | ||
| Ovarian cancer | 546 | ||
| Endometrial cancer | 547 | ||
| Prostate cancer | 547 | ||
| Colorectal cancer | 548 | ||
| Pancreatic cancer | 548 | ||
| Leukaemia | 548 | ||
| Lung cancer | 548 | ||
| Liver cancer | 549 | ||
| Bladder/kidney cancer | 549 | ||
| Oesophageal cancer | 549 | ||
| Gastric cancer | 550 | ||
| Cancer treatment | 550 | ||
| Epithelial ovarian cancer | 550 | ||
| Cervical cancer | 551 | ||
| Colorectal cancer | 551 | ||
| Oral premalignant lesions | 551 | ||
| Prostate cancer | 551 | ||
| Leukaemia | 552 | ||
| Adjunct in breast cancer treatment | 552 | ||
| Reducing cancer drug side effects | 552 | ||
| Cardiovascular protection | 552 | ||
| Lipid lowering | 554 | ||
| Hypertension | 555 | ||
| Weight loss | 555 | ||
| Combination of green tea with exercise for weight loss | 557 | ||
| Diabetes | 557 | ||
| Dental caries and gingivitis | 558 | ||
| Genital warts | 559 | ||
| Infections | 559 | ||
| Influenza | 559 | ||
| Pneumonia | 560 | ||
| Tuberculosis | 560 | ||
| Sunburn protection and skin ageing | 560 | ||
| Liver disease | 560 | ||
| Other Uses | 561 | ||
| Allergic rhinitis | 561 | ||
| Ulcerative colitis | 561 | ||
| Dementia/cognitive impairment | 561 | ||
| Depression | 562 | ||
| Beta-thalassaemia | 562 | ||
| Amyloid light-chain amyloidosis | 562 | ||
| Renal failure | 562 | ||
| Urinary stones | 562 | ||
| Osteoporosis | 562 | ||
| Dosage Range | 562 | ||
| Adverse Reactions | 563 | ||
| Significant Interactions | 564 | ||
| Anticoagulants | 564 | ||
| Hypoglycaemic agents | 564 | ||
| Iron | 564 | ||
| CNS stimulants | 564 | ||
| CNS depressants | 564 | ||
| Antidepressants | 564 | ||
| Bortezomib (BZM) and other boronic acid-based proteasome inhibitors | 564 | ||
| Diuretics | 565 | ||
| Drugs metabolised by cytochrome P450 system | 565 | ||
| References | 566 | ||
| Iodine | 574 | ||
| Background and Relevant Pharmacokinetics | 574 | ||
| Food Sources | 574 | ||
| Best sources | 575 | ||
| Deficiency Signs and Symptoms | 575 | ||
| Primary deficiency | 575 | ||
| Fetal deficiency | 576 | ||
| Premature infant deficiency | 577 | ||
| Secondary deficiency | 577 | ||
| Low selenium intake | 577 | ||
| Signs and Symptoms | 577 | ||
| Mild hypothyroidism | 577 | ||
| Congenital hypothyroidism | 577 | ||
| Adult hypothyroidism | 578 | ||
| Main Actions | 578 | ||
| Thyroid hormone production | 578 | ||
| Other Actions | 578 | ||
| Clinical Use | 578 | ||
| Treatment and prevention of deficiency | 579 | ||
| Pregnancy | 579 | ||
| Infants | 579 | ||
| Children and adolescents | 579 | ||
| Adults | 581 | ||
| Non-toxic goitre thyroidectomy | 581 | ||
| Antiseptic | 582 | ||
| Water purification | 582 | ||
| Other Uses | 582 | ||
| Fibrocystic breast disease and cyclic mastalgia | 582 | ||
| Breast cancer | 583 | ||
| Prevention of attention-deficit hyperactivity disorder | 583 | ||
| Dosage Range | 584 | ||
| Australia and New Zealand recommended daily intake (RDI) | 584 | ||
| According to clinical studies | 584 | ||
| Toxicity | 584 | ||
| Significant Interactions | 585 | ||
| Goitrogens | 585 | ||
| Soy | 585 | ||
| Selenium | 585 | ||
| References | 587 | ||
| Iron | 588 | ||
| Background and Relevant Pharmacokinetics | 588 | ||
| Solubility enhancers of non-haem iron | 588 | ||
| Solubility inhibitors of non-haem iron | 589 | ||
| Chemical Components | 590 | ||
| Food Sources | 590 | ||
| Haem iron | 590 | ||
| Non-haem iron | 590 | ||
| Deficiency Signs and Symptoms | 590 | ||
| Risk groups for iron deficiency | 591 | ||
| Primary deficiency | 591 | ||
| Secondary deficiency | 592 | ||
| Main Actions | 592 | ||
| Oxygen transport and storage | 592 | ||
| Immunity | 592 | ||
| Protein and enzyme systems | 593 | ||
| Clinical Use | 593 | ||
| Iron deficiency and iron-deficiency anaemia | 593 | ||
| Children | 594 | ||
| Elderly | 594 | ||
| Pregnancy | 595 | ||
| Postpartum anaemia | 596 | ||
| Restless-leg syndrome | 596 | ||
| Unexplained fatigue without anaemia | 596 | ||
| Improving athletic performance | 596 | ||
| Anaemia of inflammation/chronic disease | 597 | ||
| Cognitive function | 597 | ||
| Attention-deficit hyperactivity disorder (ADHD) in children | 598 | ||
| Perioperative care | 598 | ||
| Gastric bypass patients | 599 | ||
| Blood donors | 599 | ||
| Other Uses | 599 | ||
| Breath-holding spells | 599 | ||
| Haemodialysis | 599 | ||
| Hypothyroidism | 599 | ||
| Adjunct therapy in thyroid disorders | 599 | ||
| Dosage Range | 599 | ||
| Toxicity | 600 | ||
| Adverse Reactions | 601 | ||
| Significant Interactions | 601 | ||
| References | 606 | ||
| l-Glutamine | 610 | ||
| Historical Note | 610 | ||
| Background and Relevant Pharmacokinetics | 610 | ||
| Common forms available | 611 | ||
| Food Sources | 611 | ||
| Deficiency Signs and Symptoms | 611 | ||
| Main Actions | 611 | ||
| Gastrointestinal protection/repair | 612 | ||
| Immunomodulation | 612 | ||
| Antioxidant | 612 | ||
| Anabolic/anticatabolic | 613 | ||
| Cardioprotective | 613 | ||
| Neurotransmission | 614 | ||
| Clinical Use | 614 | ||
| Deficiency: prevention and treatment | 614 | ||
| Critical care settings | 614 | ||
| Abdominal surgery and trauma | 615 | ||
| Trauma | 615 | ||
| Burns | 616 | ||
| Infants | 616 | ||
| Strenuous exercise | 617 | ||
| Gut repair | 618 | ||
| Crohn’s disease | 618 | ||
| HIV | 618 | ||
| Cancer prevention | 619 | ||
| Gastrointestinal effects | 620 | ||
| Chemotherapy-induced diarrhoea | 621 | ||
| Chemotherapy-induced peripheral neuropathy | 621 | ||
| Other benefits | 622 | ||
| Other Uses | 622 | ||
| Growth and development | 622 | ||
| Radiation injury | 622 | ||
| Alcoholism | 622 | ||
| Acute pancreatitis | 623 | ||
| Sickle cell disease | 623 | ||
| Other conditions | 623 | ||
| Dosage Range | 623 | ||
| Adverse Reactions | 623 | ||
| Significant Interactions | 624 | ||
| Radiation and chemotherapy | 624 | ||
| Indomethacin/NSAIDs | 624 | ||
| Human growth hormone | 624 | ||
| References | 625 | ||
| l-Lysine | 628 | ||
| Background | 628 | ||
| Chemical Components | 628 | ||
| Main Actions | 628 | ||
| Essential amino acid | 628 | ||
| Antiviral | 629 | ||
| Calcium regulation | 629 | ||
| Inhibition of protein glycation and advanced glycation end products | 629 | ||
| Other Actions | 629 | ||
| Clinical Use | 629 | ||
| Herpes simplex — prevention and treatment | 629 | ||
| Preventing an outbreak | 629 | ||
| Reducing severity and/or healing time | 630 | ||
| Other Uses | 631 | ||
| Diabetes/hyperlipidaemia | 631 | ||
| Body composition | 631 | ||
| Osteoporosis prevention | 632 | ||
| Anxiety and mood disturbances | 632 | ||
| Cancer treatment (in combination) | 632 | ||
| Lysinuric protein intolerance | 632 | ||
| Dosage Range | 633 | ||
| Herpes simplex infections | 633 | ||
| Osteoporosis prevention | 633 | ||
| Toxicity | 633 | ||
| Adverse Reactions | 633 | ||
| Significant Interactions | 633 | ||
| Calcium | 633 | ||
| References | 634 | ||
| Lutein and zeaxanthin | 635 | ||
| Background and Relevant Pharmacokinetics | 635 | ||
| Chemical Components | 637 | ||
| Food Sources | 637 | ||
| Deficiency Signs and Symptoms | 637 | ||
| Main Actions | 637 | ||
| Antioxidant | 637 | ||
| Blue light filter | 638 | ||
| Macular pigment development | 638 | ||
| Immunomodulation | 638 | ||
| Anti-inflammatory | 639 | ||
| Photoprotection | 639 | ||
| Clinical Use | 639 | ||
| Age-related macular degeneration | 639 | ||
| Cataracts | 641 | ||
| Retinitis pigmentosa | 642 | ||
| Retinopathy of prematurity | 642 | ||
| Cancer prevention | 642 | ||
| Lung cancer | 642 | ||
| Cervical cancer | 643 | ||
| Endometrial cancer | 643 | ||
| Ovarian cancer | 643 | ||
| Breast cancer | 643 | ||
| Gastric cancer | 643 | ||
| Bowel cancer | 643 | ||
| Prostate cancer | 644 | ||
| Laryngeal cancer | 644 | ||
| Other Uses | 644 | ||
| Sleep duration | 644 | ||
| Cognitive impairment | 644 | ||
| Atherosclerosis | 644 | ||
| Dosage Range | 645 | ||
| According to clinical studies | 645 | ||
| Toxicity | 645 | ||
| Adverse Reactions | 645 | ||
| Significant Interactions | 645 | ||
| Vitamin C | 645 | ||
| Vitamin E | 645 | ||
| Phytosterols | 645 | ||
| Orlistat | 646 | ||
| Olestra | 646 | ||
| References | 647 | ||
| Magnesium | 651 | ||
| Historical Note | 651 | ||
| Background and Relevant Pharmacokinetics | 651 | ||
| Magnesium assessment | 652 | ||
| Food Sources | 653 | ||
| Deficiency Signs and Symptoms | 653 | ||
| Primary deficiency | 654 | ||
| Secondary deficiency | 654 | ||
| Medicines increasing risk of deficiency | 656 | ||
| Main Actions | 656 | ||
| Interaction with other nutrients | 656 | ||
| Other Actions | 656 | ||
| Clinical Use | 656 | ||
| Deficiency: treatment and prevention | 657 | ||
| Constipation | 657 | ||
| Dyspepsia | 657 | ||
| Cardiovascular disease (CVD) | 658 | ||
| Mitral valve prolapse | 658 | ||
| Symptoms of coronary artery disease (CAD) | 659 | ||
| Hypertension | 659 | ||
| Stroke protection | 659 | ||
| Dyslipidaemia | 660 | ||
| Arrhythmia prevention | 660 | ||
| In congestive heart failure | 660 | ||
| Postoperative recovery from cardiac surgery | 660 | ||
| Postsurgical pain | 661 | ||
| Migraine headaches: prevention | 661 | ||
| Menstrual migraine headache | 662 | ||
| Migraine prophylaxis in children | 662 | ||
| Attention-deficit hyperactivity disorder (ADHD) | 662 | ||
| Autism spectrum disorders (ASD) | 662 | ||
| Kidney stone prevention | 663 | ||
| Premenstrual syndrome (PMS) | 663 | ||
| Dysmenorrhoea | 663 | ||
| Osteoporosis prevention | 664 | ||
| Fibromyalgia | 664 | ||
| Asthma | 664 | ||
| Pregnancy | 665 | ||
| Pregnancy-induced hypertension | 665 | ||
| Pregnancy-induced leg cramps | 665 | ||
| Preterm birth and low birth weight | 665 | ||
| Pre-eclampsia and eclampsia | 665 | ||
| Diabetes mellitus | 666 | ||
| Type 1 diabetes mellitus (T1DM) | 666 | ||
| Type 2 diabetes mellitus (T2DM) | 666 | ||
| Chronic leg cramps | 667 | ||
| Cancer | 667 | ||
| Colorectal cancer (CRC) | 667 | ||
| Lung cancer | 667 | ||
| Prostate cancer | 667 | ||
| Other Possible Uses | 668 | ||
| Dosage Range | 668 | ||
| Australian RDI for adults | 668 | ||
| Men | 668 | ||
| Women | 668 | ||
| Pregnancy | 668 | ||
| Lactation | 668 | ||
| According to clinical studies | 668 | ||
| Adverse Reactions | 669 | ||
| Toxicity | 669 | ||
| Significant Interactions | 669 | ||
| Alcohol | 669 | ||
| Aminoglycosides (e.g. gentamicin) | 669 | ||
| Calcium | 669 | ||
| Calcium-channel blockers | 670 | ||
| Fluoroquinolones | 670 | ||
| Loop diuretics and thiazide diuretics | 670 | ||
| Potassium | 670 | ||
| Potassium-sparing diuretics | 670 | ||
| Tetracycline antibiotics | 670 | ||
| Dasatinib | 670 | ||
| Neuromuscular blockers | 670 | ||
| l-thyroxine | 670 | ||
| References | 671 | ||
| New Zealand green-lipped mussel | 676 | ||
| Historical note | 676 | ||
| Background and relevant pharmacokinetics | 676 | ||
| Chemical components | 676 | ||
| Main actions | 676 | ||
| Anti-Inflammatory | 676 | ||
| Other actions | 677 | ||
| Clinical use | 677 | ||
| Osteoarthritis | 677 | ||
| Rheumatoid arthritis (RA) | 678 | ||
| Asthma | 678 | ||
| Other uses | 679 | ||
| Veterinary use for osteoarthritis | 679 | ||
| Inflammatory bowel disease | 679 | ||
| Muscle damage and soreness in athletes — no effect | 680 | ||
| Cancer — no effect | 680 | ||
| Dosage range | 680 | ||
| Toxicity | 680 | ||
| Adverse reactions | 680 | ||
| Significant interactions | 681 | ||
| Anti-inflammatory agents | 681 | ||
| References | 682 | ||
| Passionflower | 683 | ||
| Historical Note | 683 | ||
| Common Name | 683 | ||
| Other Names | 683 | ||
| Botanical Name/Family | 683 | ||
| Plant Parts Used | 683 | ||
| Chemical Components | 683 | ||
| Harmine | 683 | ||
| Harman | 684 | ||
| Main Actions | 684 | ||
| Anxiolytic and sedative activity | 684 | ||
| Anticonvulsant | 684 | ||
| Other Actions | 684 | ||
| Antiepileptic | 684 | ||
| Aphrodisiac | 685 | ||
| Antitussive and antiasthmatic activity | 685 | ||
| Antidiabetic | 685 | ||
| Nicotine withdrawal | 685 | ||
| Clinical Use | 685 | ||
| Anxiety and nervous restlessness | 685 | ||
| Presurgery use | 686 | ||
| Opiate withdrawal | 686 | ||
| Insomnia | 686 | ||
| Other Uses | 687 | ||
| Traditional uses | 687 | ||
| Dosage Range | 687 | ||
| Toxicity | 687 | ||
| Adverse Reactions | 687 | ||
| Significant Interactions | 687 | ||
| Benzodiazepines | 687 | ||
| Barbiturates | 687 | ||
| References | 688 | ||
| Pelargonium | 690 | ||
| Historical Note | 690 | ||
| Common Name | 690 | ||
| Other Names | 690 | ||
| Botanical Name/Family | 690 | ||
| Plant Parts Used | 690 | ||
| Chemical Components | 690 | ||
| Main Actions | 691 | ||
| Antibacterial activity | 691 | ||
| Antiadhesion properties | 691 | ||
| Immune enhancement | 691 | ||
| Antiviral activity | 691 | ||
| Other Actions | 691 | ||
| Clinical Use | 691 | ||
| Respiratory tract infections — bronchitis, common cold, sinusitis | 692 | ||
| Common cold | 694 | ||
| Immune modulation in athletes | 694 | ||
| Other Uses | 694 | ||
| Dosage Range | 695 | ||
| According to clinical studies | 695 | ||
| Treatment of acute bronchitis | 695 | ||
| Treatment for the common cold | 695 | ||
| Acute sinusitis treatment | 695 | ||
| Reducing the frequency of an asthma attack during respiratory tract infection in children with mild asthma | 695 | ||
| Toxicity | 695 | ||
| Adverse Reactions | 695 | ||
| Significant Interactions | 696 | ||
| Immunosuppressant drugs | 696 | ||
| References | 696 | ||
| Prebiotics | 697 | ||
| Historical Note | 697 | ||
| Background and Relevant Pharmacokinetics | 697 | ||
| Chemical Components | 698 | ||
| Food Sources | 699 | ||
| Deficiency Signs and Symptoms | 700 | ||
| Main Actions | 700 | ||
| Stimulation of beneficial bacteria and prevention of GIT infections | 700 | ||
| Immunomodulation and enhanced mucin production | 700 | ||
| Cancer prevention | 701 | ||
| Other Actions | 701 | ||
| Mineral metabolism | 701 | ||
| Improved bioavailability of phyto-oestrogens | 701 | ||
| Clinical Use | 702 | ||
| Irritable bowel syndrome | 702 | ||
| Inflammatory bowel disease | 702 | ||
| Crohn’s disease | 702 | ||
| Ulcerative colitis | 703 | ||
| Pouchitis | 704 | ||
| Constipation | 704 | ||
| Diarrhoea | 704 | ||
| Traveller’s diarrhoea | 704 | ||
| Clostridium difficile-associated diarrhoea (CDAD) | 705 | ||
| Allergic disease and food hypersensitivity | 705 | ||
| Improved immune response | 705 | ||
| Use in children | 705 | ||
| Use in adults | 706 | ||
| Cancer of the colon | 707 | ||
| Prevention of urinary tract infections | 707 | ||
| Bone health | 708 | ||
| Promotion of satiety | 708 | ||
| Metabolic syndrome | 708 | ||
| Other Uses | 708 | ||
| Liver disease — hepatic encephalopathy | 708 | ||
| Pancreatitis | 709 | ||
| Dosage Range | 709 | ||
| Toxicity | 709 | ||
| Adverse Reactions | 709 | ||
| Significant Interactions | 710 | ||
| References | 711 | ||
| Probiotics | 715 | ||
| Historical Note | 715 | ||
| Background and Relevant Pharmacokinetics | 715 | ||
| Chemical Components | 717 | ||
| Common probiotic microorganisms | 717 | ||
| Food Sources | 718 | ||
| Deficiency Signs and Symptoms | 718 | ||
| Main Actions | 718 | ||
| Immune modulation | 719 | ||
| Anti-inflammatory activity | 719 | ||
| GIT transit time modification | 719 | ||
| Induction of oral tolerance | 719 | ||
| Decrease visceral hypersensitivity | 719 | ||
| Competition for gastrointestinal adhesion sites | 719 | ||
| Antagonism against potentially pathogenic microorganisms and viruses | 720 | ||
| Selective gastrointestinal antimicrobial activity | 720 | ||
| Production of beneficial compounds | 720 | ||
| Strengthen the intestinal barrier | 720 | ||
| Chemopreventive effects | 721 | ||
| Other Actions | 721 | ||
| Clinical Use | 721 | ||
| Restoring GIT microflora after antibiotic use | 721 | ||
| Abdominal pain (functional) | 723 | ||
| Atopic eczema | 724 | ||
| Prevention of atopic eczema | 724 | ||
| Treatment of atopic eczema | 726 | ||
| Gastrointestinal infections | 726 | ||
| Diarrhoea | 727 | ||
| Viral gastroenteritis — prevention | 727 | ||
| Treatment | 727 | ||
| Bacterial gastroenteritis — traveller’s diarrhoea | 727 | ||
| Clostridium difficile-associated diarrhoea | 729 | ||
| Vancomycin-resistant enterococci | 729 | ||
| Pancreatitis | 729 | ||
| Chemotherapy-induced diarrhoea | 730 | ||
| AIDS-related diarrhoea | 730 | ||
| Constipation | 730 | ||
| Immune enhancement/infection prevention | 731 | ||
| Infantile colic | 731 | ||
| Irritable bowel syndrome | 731 | ||
| Inflammatory bowel disease | 734 | ||
| Crohn’s disease | 734 | ||
| Ulcerative colitis | 736 | ||
| Pouchitis | 737 | ||
| Probiotics and diverticular disease | 737 | ||
| Alcohol-induced liver disease | 739 | ||
| Non-alcoholic fatty liver disease (NAFLD) | 740 | ||
| Hepatic encephalopathy | 740 | ||
| Colon cancer | 740 | ||
| High cholesterol | 741 | ||
| Mastitis | 742 | ||
| Postpartum obesity | 743 | ||
| Urogenital infections | 743 | ||
| Bacterial vaginosis | 743 | ||
| Urinary tract infections | 744 | ||
| Vaginal candidiasis | 745 | ||
| Other Uses | 746 | ||
| Dosage Range | 747 | ||
| Adverse Reactions | 747 | ||
| Significant Interactions | 748 | ||
| Antibiotics | 748 | ||
| References | 749 | ||
| S-Adenosyl-l-methionine (SAMe) | 756 | ||
| Historical Note | 756 | ||
| Background and Relevant Pharmacokinetics | 756 | ||
| Main Actions | 756 | ||
| Antidepressant activity | 757 | ||
| Anti-inflammatory | 757 | ||
| Hepatoprotective and restorative effects | 757 | ||
| Anticancer activity | 758 | ||
| Other Actions | 758 | ||
| Prolactin and thyroid-stimulating hormone (TSH) effects | 758 | ||
| Antioxidant | 758 | ||
| Clinical Use | 759 | ||
| Depression | 759 | ||
| Treatment-resistant depression | 759 | ||
| Osteoarthritis | 760 | ||
| Comparative studies | 760 | ||
| Fibromyalgia | 760 | ||
| Schizophrenia | 761 | ||
| Parkinson’s disease | 761 | ||
| Liver cirrhosis | 761 | ||
| Alcoholic liver disease | 761 | ||
| Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) | 762 | ||
| Prevention of drug-induced liver toxicity | 763 | ||
| Other Uses | 763 | ||
| Alzheimer’s dementia (AD) | 763 | ||
| Cholestasis of pregnancy | 763 | ||
| Hepatitis C management | 764 | ||
| Cancer | 764 | ||
| Hepatic cancer | 764 | ||
| Colorectal cancer | 764 | ||
| Breast and cervical cancer | 764 | ||
| Dosage Range | 765 | ||
| Based on clinical studies | 765 | ||
| Adverse Reactions | 765 | ||
| Significant Interactions | 765 | ||
| Tricyclic antidepressants and other serotonergic agents | 765 | ||
| Hepatotoxic drugs | 765 | ||
| l-Dopa | 765 | ||
| Thyroxine | 765 | ||
| Betaine | 765 | ||
| References | 767 | ||
| Schisandra | 770 | ||
| Historical Note | 770 | ||
| Other Names | 770 | ||
| Botanical Name/Family | 770 | ||
| Plant Part Used | 770 | ||
| Chemical Components | 770 | ||
| Main Actions | 770 | ||
| Antioxidant | 771 | ||
| Hepatoprotective activity | 771 | ||
| Decreases hepatotoxic damage | 771 | ||
| Liver regeneration | 772 | ||
| Anti-inflammatory | 772 | ||
| Immunomodulatory | 773 | ||
| Antidiabetic | 773 | ||
| Antiobesity | 773 | ||
| Antiallergic | 774 | ||
| Nephroprotective | 774 | ||
| Cardiovascular effects | 774 | ||
| Antitumour | 775 | ||
| Neuroprotective | 776 | ||
| Gastrointestinal actions | 777 | ||
| Antibacterial | 777 | ||
| Other Actions | 777 | ||
| Lipid lowering | 777 | ||
| Improved erectile function | 777 | ||
| Anxiolytic and sedative | 777 | ||
| Inhibits leukotriene formation | 778 | ||
| Platelet-activating factor antagonist | 778 | ||
| Enhanced exercise endurance | 778 | ||
| Bone mineralisation | 778 | ||
| Cytochromes and P-glycoprotein | 778 | ||
| Cytochrome 3A4 | 778 | ||
| P-glycoprotein | 779 | ||
| Clinical Use | 779 | ||
| Liver damage, hepatoprotection | 779 | ||
| Adaptogen | 779 | ||
| Infection | 780 | ||
| Other Uses | 780 | ||
| Dosage Range | 780 | ||
| Toxicity | 780 | ||
| Adverse Reactions | 781 | ||
| Significant Interactions | 781 | ||
| CYP3A4 substrates | 781 | ||
| P-glycoprotein substrates | 781 | ||
| Drugs metabolised by UGT1A3 | 781 | ||
| References | 782 | ||
| Selenium | 788 | ||
| Historical Note | 788 | ||
| Background and Relevant Pharmacokinetics | 788 | ||
| Chemical Components | 789 | ||
| Food Sources | 789 | ||
| Deficiency Signs and Symptoms | 789 | ||
| Main Actions | 790 | ||
| Antioxidant | 790 | ||
| Chemopreventative | 790 | ||
| Immunomodulation | 790 | ||
| Thyroid hormone modulation | 791 | ||
| Other Actions | 791 | ||
| Male fertility | 791 | ||
| Anti-inflammatory | 791 | ||
| Reduces heavy metal toxicity | 791 | ||
| Antiatherogenic activity | 792 | ||
| Bone health | 792 | ||
| Clinical Use | 792 | ||
| Deficiency states: prevention and treatment | 792 | ||
| Cancer: prevention and possible adjunct to treatment | 792 | ||
| Chemoprevention | 792 | ||
| Total cancer incidence and mortality | 793 | ||
| Liver cancer | 793 | ||
| Prostate cancer | 793 | ||
| Stomach and oesophageal cancers | 795 | ||
| Colorectal cancer | 795 | ||
| Premalignant skin lesions | 795 | ||
| Female reproductive | 795 | ||
| Oral cancer | 796 | ||
| Lymphoma | 796 | ||
| Lung cancer | 796 | ||
| Reducing radiotherapy-related adverse effects | 796 | ||
| Reducing mortality from HIV infection | 796 | ||
| Cardiovascular disease prevention | 797 | ||
| Dyslipidaemia | 798 | ||
| Diabetes | 798 | ||
| Adiposity | 799 | ||
| Respiratory diseases | 799 | ||
| Asthma | 799 | ||
| Autoimmune thyroiditis | 800 | ||
| Rheumatoid arthritis (RA) | 801 | ||
| Lowered male fertility | 801 | ||
| General immune enhancement | 801 | ||
| Critically ill patients | 801 | ||
| Mood elevation and reduced anxiety | 802 | ||
| Reducing morbidity in preterm babies | 802 | ||
| Other Uses | 803 | ||
| Dosage Range | 803 | ||
| Australian RDI | 804 | ||
| Children | 804 | ||
| 14–18 years | 804 | ||
| Adults | 804 | ||
| According to clinical studies | 804 | ||
| Toxicity | 804 | ||
| Adverse Reactions | 804 | ||
| Significant Interactions | 804 | ||
| Cisplatin | 804 | ||
| Heavy metals (e.g. mercury, lead, arsenic, silver and cadmium) | 804 | ||
| References | 805 | ||
| Ginseng — Siberian | 811 | ||
| Historical Note | 811 | ||
| Other Names | 812 | ||
| Botanical Name/Family | 812 | ||
| Plant Part Used | 812 | ||
| Chemical Components | 812 | ||
| Main Actions | 812 | ||
| Adaptogenic (modulates stress response) | 812 | ||
| Immunomodulation | 813 | ||
| Antiviral | 814 | ||
| Anabolic activity | 814 | ||
| Anti-inflammatory | 814 | ||
| Glycaemic control and insulin-sensitising effect | 814 | ||
| Hepatoprotective | 815 | ||
| Neuroprotective | 815 | ||
| Other Actions | 816 | ||
| Anticoagulant and antiplatelet effects | 816 | ||
| Antiallergic | 816 | ||
| Antioxidant | 816 | ||
| Cardioprotective | 816 | ||
| Radioprotective | 816 | ||
| Vascular relaxant | 816 | ||
| Clinical Use | 816 | ||
| Stress | 817 | ||
| Fatigue | 817 | ||
| Cardioprotective | 818 | ||
| Ergogenic aid | 818 | ||
| Prevention of infection | 818 | ||
| Herpes simplex virus type 2 infection | 819 | ||
| Cancer therapy | 819 | ||
| Other Uses | 819 | ||
| Dosage Range | 820 | ||
| Adverse Reactions | 820 | ||
| Significant Interactions | 820 | ||
| Anticoagulants | 820 | ||
| Chemotherapy | 820 | ||
| Diabetic medications | 821 | ||
| Influenza virus vaccine | 821 | ||
| References | 822 | ||
| Slippery elm | 825 | ||
| Historical Note | 825 | ||
| Common Name | 825 | ||
| Other Names | 825 | ||
| Botanical Name/Family | 825 | ||
| Plant Part Used | 825 | ||
| Chemical Components | 825 | ||
| Main Actions | 826 | ||
| Soothes irritated and inflamed tissue | 826 | ||
| Nutritive demulcent | 826 | ||
| Antioxidant | 826 | ||
| Clinical Use | 826 | ||
| Gastrointestinal conditions | 826 | ||
| Dermatitis and wounds | 827 | ||
| Laryngeal ‘soothing’ effect | 827 | ||
| Other Uses | 827 | ||
| Dosage Range | 827 | ||
| Gastrointestinal symptoms | 828 | ||
| External use | 828 | ||
| Toxicity | 828 | ||
| Adverse Reactions | 828 | ||
| Significant Interactions | 828 | ||
| References | 829 | ||
| St John’s wort | 830 | ||
| Historical Note | 830 | ||
| Other Names | 830 | ||
| Botanical Name/Family | 830 | ||
| Plant Parts Used | 830 | ||
| Chemical Components | 830 | ||
| Main Actions | 831 | ||
| Antidepressant | 831 | ||
| Inhibits synaptic reuptake of several neurotransmitters | 831 | ||
| GABA receptor binding | 832 | ||
| Upregulation of serotonin receptors | 832 | ||
| Dopamine beta-hydroxylase inhibition | 832 | ||
| Inhibition of catechol-O-methyltransferase | 832 | ||
| Suppresses interleukin-6 (IL-6) synthesis | 832 | ||
| Monoamine oxidase (MAO) inhibition | 832 | ||
| Anxiolytic | 832 | ||
| Cognitive effects | 832 | ||
| Neuroprotective | 833 | ||
| Anticonvulsant effects | 833 | ||
| Effects on alcohol and food intake | 833 | ||
| Effects on morphine withdrawal syndrome | 833 | ||
| Anti-inflammatory and analgesic | 833 | ||
| Anticancer effects | 834 | ||
| Antiretroviral, antifungal and antibacterial | 834 | ||
| Cardiovascular effects | 835 | ||
| Gastrointestinal effects | 835 | ||
| Other Actions | 835 | ||
| Induction of CYP3A4 activity in the intestinal wall | 835 | ||
| Increases levels of intestinal P-glycoprotein | 836 | ||
| Decreases levels of P-glycoprotein at blood–brain barrier | 836 | ||
| Clinical Use | 836 | ||
| Depression | 836 | ||
| Mild to moderate depression | 837 | ||
| Major depression | 838 | ||
| Comparative studies | 838 | ||
| SJW vs SSRIs | 838 | ||
| Citalopram | 839 | ||
| Sertraline | 839 | ||
| SJW vs TCAs | 839 | ||
| SJW vs SSRI and SNRI and others (mirtazapine) | 839 | ||
| Paediatric use | 840 | ||
| Preventing relapse of depression | 840 | ||
| Postnatal depression | 841 | ||
| Obsessive-compulsive disorder (OCD) | 842 | ||
| Autism | 842 | ||
| Seasonal affective disorder (SAD) | 842 | ||
| Polyneuropathy | 842 | ||
| Menopause: psychological and psychosomatic symptoms | 842 | ||
| SJW and chaste tree | 843 | ||
| Perimenopause | 843 | ||
| Premenstrual syndrome | 843 | ||
| Attention-deficit hyperactive disorder (ADHD) | 844 | ||
| Nervous agitation in children | 844 | ||
| Smoking cessation | 844 | ||
| Herpes infection | 844 | ||
| Topical use | 844 | ||
| Atopic dermatitis | 844 | ||
| Treatment of acute and contused injuries | 845 | ||
| Herpes simplex 1 and 2 | 845 | ||
| Myalgia | 845 | ||
| First-degree burns | 845 | ||
| Plaque-type psoriasis | 845 | ||
| Ultraviolet (UV)-protective effects | 845 | ||
| Caesarean section | 845 | ||
| Diabetic foot | 845 | ||
| Venous ulcers | 846 | ||
| Scalp wounds | 846 | ||
| Photodynamic therapy | 846 | ||
| Other Uses | 846 | ||
| Dosage Range | 846 | ||
| External use | 847 | ||
| According to clinical studies | 847 | ||
| Adverse Reactions | 848 | ||
| Photosensitivity (unlikely at therapeutic doses) | 848 | ||
| Significant Interactions | 848 | ||
| Alprazolam | 848 | ||
| Amitriptyline | 848 | ||
| Antidepressants (SSRIs and SNRIs) | 849 | ||
| Anticonvulsants | 849 | ||
| Antineoplastic drugs | 849 | ||
| Atorvastatin | 849 | ||
| Bupropion | 849 | ||
| Cisplatin | 849 | ||
| Clopidogrel | 849 | ||
| Cyclosporin | 849 | ||
| Digoxin | 849 | ||
| Fexofenadine | 850 | ||
| Finasteride | 850 | ||
| Gliclazide | 850 | ||
| HIV non-nucleoside transcriptase inhibitors | 850 | ||
| HIV protease inhibitors | 850 | ||
| Indinavir | 850 | ||
| Ketamine | 850 | ||
| Methadone | 850 | ||
| Methotrexate | 850 | ||
| Midazolam | 850 | ||
| Nifedipine | 850 | ||
| Non-steroidal anti-inflammatory drugs (etoricoxib) | 851 | ||
| Omeprazole | 851 | ||
| Oral contraceptives | 851 | ||
| Oxycodone | 851 | ||
| Pegylated interferon-alpha (peginterferon-α) | 851 | ||
| Psoralen plus UVA therapy | 851 | ||
| Simvastatin | 851 | ||
| Tacrolimus | 851 | ||
| Verapamil | 851 | ||
| Warfarin | 851 | ||
| Zolpidem | 852 | ||
| People with cancer and undergoing treatment | 852 | ||
| References | 853 | ||
| St Mary’s thistle | 859 | ||
| Historical Note | 859 | ||
| Other Names | 859 | ||
| Botanical Name/Family | 859 | ||
| Plant Part Used | 859 | ||
| Chemical Components | 860 | ||
| Main Actions | 860 | ||
| Hepatoprotective | 860 | ||
| Toxin blockade | 861 | ||
| Chelates iron and decreases iron excess | 861 | ||
| Antioxidant | 861 | ||
| Anti-inflammatory | 861 | ||
| Antifibrotic | 862 | ||
| Antitumour effects | 862 | ||
| Brain, neuroprotective activity | 863 | ||
| Nephroprotective effect | 863 | ||
| Gastroprotective effect | 863 | ||
| Antidiabetic effect | 864 | ||
| Antiviral effect | 864 | ||
| Mast-cell stabilisation | 864 | ||
| Asthma | 864 | ||
| Cytochromes | 865 | ||
| Effects on Phase I CYP450 | 865 | ||
| Effects on phase II conjugation pathways | 865 | ||
| P-glycoprotein | 865 | ||
| Other Actions | 865 | ||
| Cholesterol lowering | 865 | ||
| Clinical Use | 866 | ||
| Dyspepsia | 866 | ||
| Toxic liver damage | 866 | ||
| Mushroom poisoning (Amanita phalloides) | 866 | ||
| Environmental toxins and drugs | 867 | ||
| Supportive treatment in chronic liver diseases | 867 | ||
| Alcoholic liver disease | 867 | ||
| Acute viral hepatitis | 868 | ||
| Hepatitis C infection | 868 | ||
| Non-alcoholic fatty liver disease (NAFLD) | 869 | ||
| Diabetes | 870 | ||
| Other Uses | 871 | ||
| Haemochromatosis | 871 | ||
| Hypercholesterolaemia | 871 | ||
| Cancer prevention and treatment | 871 | ||
| Chemotherapy support | 871 | ||
| Obsessive compulsive disorder | 872 | ||
| Pharmacokinetics of silymarin | 872 | ||
| Dosage Range | 873 | ||
| Toxicity | 873 | ||
| Extremely low | 873 | ||
| Adverse Reactions | 874 | ||
| Significant Interactions | 874 | ||
| Cisplatin | 874 | ||
| Doxorubicin | 874 | ||
| Hepatotoxic substances | 874 | ||
| References | 875 | ||
| Turmeric | 881 | ||
| Historical Note | 881 | ||
| Common Name | 881 | ||
| Other Names | 881 | ||
| Botanical Name/Family | 882 | ||
| Plant Part Used | 882 | ||
| Chemical Components | 882 | ||
| Main Actions | 882 | ||
| Antioxidant | 882 | ||
| Anti-inflammatory | 883 | ||
| NF-kappa-B inhibition | 883 | ||
| Gastrointestinal effects | 883 | ||
| Hepatoprotective | 883 | ||
| Cholagogue and hypolipidaemic | 884 | ||
| Antispasmodic | 884 | ||
| Cancer | 884 | ||
| Chemoprevention | 884 | ||
| Apoptosis | 885 | ||
| Antiproliferative | 885 | ||
| Antimetastatic | 886 | ||
| Chemotherapy | 886 | ||
| Immunomodulation | 886 | ||
| Cardiovascular effects | 887 | ||
| Antiplatelet | 887 | ||
| Anti-atherogenic | 887 | ||
| Wound healing | 887 | ||
| Antibacterial/Antimicrobial | 888 | ||
| Other Actions | 888 | ||
| Clinical Use | 888 | ||
| Arthritis | 888 | ||
| Rheumatoid arthritis | 889 | ||
| Osteoarthritis | 889 | ||
| Cancer | 889 | ||
| Cardiovascular disease | 890 | ||
| Hyperlipidaemia | 890 | ||
| Diabetes | 891 | ||
| Dyspepsia/peptic ulcers | 891 | ||
| Irritable bowel syndrome (IBS) | 892 | ||
| Inflammatory bowel disease | 892 | ||
| Ophthalmology | 892 | ||
| Psoriasis | 893 | ||
| Other Uses | 893 | ||
| Chronic anterior uveitis | 893 | ||
| Oral submucous fibrosis | 893 | ||
| Reducing alcohol intoxication | 893 | ||
| Dosage Range | 893 | ||
| Internal use | 893 | ||
| External use | 894 | ||
| Adverse Reactions | 894 | ||
| Significant Interactions | 894 | ||
| Antiplatelet drugs | 895 | ||
| Anticoagulants | 895 | ||
| Cyclophosphamide | 895 | ||
| References | 896 | ||
| Valerian | 901 | ||
| Historical Note | 901 | ||
| Common Name | 902 | ||
| Other Names | 902 | ||
| Botanical Name/Family | 902 | ||
| Plant Part Used | 902 | ||
| Chemical Components | 902 | ||
| Main Actions | 902 | ||
| Anxiolytic and hypnotic | 902 | ||
| Antispasmodic, vasorelaxant and anti-convulsant | 903 | ||
| Other Actions | 903 | ||
| Clinical Use | 903 | ||
| Insomnia | 903 | ||
| Valerian herbal combinations | 905 | ||
| Valerian monotherapy | 906 | ||
| Restless legs syndrome and insomnia | 906 | ||
| Post-menopausal women with insomnia | 906 | ||
| Comparisons with benzodiazepines | 907 | ||
| Children | 907 | ||
| Anxiety and psychological stress states | 907 | ||
| Obsessive-Compulsive Disorder (OCD) | 908 | ||
| Muscle spasm, cramping and dysmenorrhoea | 908 | ||
| Other Uses | 909 | ||
| Fibromyalgia | 909 | ||
| Benzodiazepine withdrawal | 909 | ||
| Dosage Range | 909 | ||
| According to clinical studies | 909 | ||
| Toxicity | 909 | ||
| Hepatotoxicity | 909 | ||
| Adverse Reactions | 910 | ||
| Significant Interactions | 910 | ||
| Pharmaceutical sedatives / benzodiazepines | 910 | ||
| Alcohol | 911 | ||
| Haloperidol | 911 | ||
| References | 911 | ||
| Vitamin B1 | 913 | ||
| Historical Note | 913 | ||
| Background and Relevant Pharmacokinetics | 913 | ||
| Chemical Components | 914 | ||
| Food Sources | 914 | ||
| Deficiency Signs and Symptoms | 914 | ||
| Primary deficiency | 916 | ||
| Secondary deficiency | 916 | ||
| Main Actions | 916 | ||
| Coenzyme | 916 | ||
| Neurotransmitter biosynthesis | 917 | ||
| DNA | 917 | ||
| Neuropsychological actions and neurodegenerative diseases | 917 | ||
| Energy production | 917 | ||
| Antioxidant | 918 | ||
| Mood | 918 | ||
| Clinical Use | 918 | ||
| Deficiency: treatment and prevention | 918 | ||
| Hyperemesis | 918 | ||
| Alcoholism | 918 | ||
| Total parenteral nutrition | 919 | ||
| Hyperthyroidism | 919 | ||
| Surgical patients | 919 | ||
| Acute alcohol withdrawal | 919 | ||
| Alzheimer’s disease (AD) | 919 | ||
| Diabetes | 920 | ||
| Congestive heart failure (CHF) | 921 | ||
| Dysmenorrhoea | 922 | ||
| Epilepsy | 922 | ||
| Other Uses | 922 | ||
| Cataracts | 922 | ||
| Coma | 922 | ||
| Mortality in the elderly | 922 | ||
| Polycystic ovarian syndrome | 923 | ||
| Tumour proliferation | 923 | ||
| Fibromyalgia | 923 | ||
| HIV | 923 | ||
| Neurogenic impotence | 924 | ||
| Maple syrup urine disease | 924 | ||
| Optic neuropathy | 924 | ||
| Fertility, preconception and health of the offspring | 924 | ||
| Dosage Range | 925 | ||
| Australian RDI | 925 | ||
| Toxicity | 925 | ||
| Adverse Reactions | 925 | ||
| Supplemental Forms | 925 | ||
| Significant Interactions | 926 | ||
| Antibiotics | 926 | ||
| Coffee, tea, blueberries, red cabbage and Brussels sprouts | 926 | ||
| Vitamin C and citric acid | 926 | ||
| Iron | 926 | ||
| Loop diuretics | 926 | ||
| Other B vitamins | 926 | ||
| Sulfites | 926 | ||
| Tannins | 926 | ||
| Horsetail (Equisetum arvense) | 926 | ||
| Contraindications and Precautions | 926 | ||
| Cancer | 926 | ||
| Pregnancy Use | 927 | ||
| References | 927 | ||
| Vitamin B12 | 930 | ||
| Background and Relevant Pharmacokinetics | 930 | ||
| Chemical Components | 931 | ||
| Food Sources | 931 | ||
| Deficiency Signs and Symptoms | 931 | ||
| Primary deficiency | 932 | ||
| Secondary deficiency | 932 | ||
| Elevated B12 levels | 933 | ||
| Liver failure mortality | 933 | ||
| Main Actions | 934 | ||
| Important cofactor | 934 | ||
| Homocysteine reduction | 934 | ||
| Nervous system | 934 | ||
| Immune system | 934 | ||
| Liver | 934 | ||
| Antioxidant capacity | 934 | ||
| Clinical Use | 934 | ||
| Deficiency: treatment and prevention | 934 | ||
| Pernicious anaemia | 935 | ||
| Atrophic gastritis | 935 | ||
| Infants | 935 | ||
| Elderly | 935 | ||
| Pemetrexed treatment | 935 | ||
| Hyperhomocysteinaemia | 936 | ||
| Cardiovascular protection | 936 | ||
| Cardiovascular disease | 936 | ||
| Renal transplant recipients | 937 | ||
| Restenosis after percutaneous coronary intervention | 937 | ||
| Neural tube defects | 937 | ||
| Noise-induced hearing loss | 937 | ||
| Recurrent abortion | 937 | ||
| Osteoporosis — inconclusive | 938 | ||
| Depression | 938 | ||
| AIDS and HIV | 938 | ||
| Adjuvant treatment in hepatitis C infection | 938 | ||
| Cognitive impairment and dementia | 938 | ||
| Diabetic neuropathy | 939 | ||
| Sleep disorders | 939 | ||
| Tinnitus | 939 | ||
| Other Uses | 940 | ||
| Prostate cancer risk — no association | 940 | ||
| Erythema nodosum | 940 | ||
| Atopic dermatitis | 940 | ||
| Multiple sclerosis | 940 | ||
| Amyotrophic lateral sclerosis (ALS) | 940 | ||
| Schizophrenia | 940 | ||
| Dosage Range | 940 | ||
| Australian recommended daily intake | 940 | ||
| Adverse Reactions | 941 | ||
| Significant Interactions | 941 | ||
| Carbamazepine | 941 | ||
| Colchicine | 941 | ||
| Gastric acid inhibitors: PPI and H2 receptor antagonists | 941 | ||
| Hydrochlorothiazide | 941 | ||
| Lithium | 941 | ||
| Metformin | 942 | ||
| Oral contraceptive pill | 942 | ||
| Phenobarbitone and phenytoin | 942 | ||
| Prednisolone | 942 | ||
| Sodium valproate | 942 | ||
| Tetracycline antibiotics | 942 | ||
| References | 944 | ||
| Vitamin B2 — riboflavin | 947 | ||
| Background and Relevant Pharmacokinetics | 947 | ||
| Food Sources | 948 | ||
| Deficiency Signs and Symptoms | 948 | ||
| Primary deficiency | 949 | ||
| Secondary deficiency | 949 | ||
| Signs and symptoms of deficiency | 949 | ||
| Main Actions | 949 | ||
| Coenzyme functions | 950 | ||
| Clinical Use | 950 | ||
| Wound healing | 950 | ||
| Migraine headaches: prophylaxis | 950 | ||
| Migraine prophylaxis in children | 951 | ||
| Comparative trial | 952 | ||
| Age-related cataract prevention | 952 | ||
| Congestive heart failure | 953 | ||
| Anticarcinogenesis | 953 | ||
| Breast cancer | 953 | ||
| Breast cancer — adjunctive treatment to tamoxifen | 954 | ||
| Role in folate and pyridoxine metabolism and the methylation pathologies | 955 | ||
| Fertility and pregnancy | 955 | ||
| Postpartum depression (PPD) | 956 | ||
| Pre-eclampsia | 956 | ||
| Sickle cell anaemia | 956 | ||
| Rheumatoid arthritis | 956 | ||
| Osteoarthritis | 956 | ||
| Other Uses | 957 | ||
| HIV/AIDS | 957 | ||
| Dosage Range | 957 | ||
| Australian recommended dietary intake | 957 | ||
| <70 years | 957 | ||
| >70 years | 957 | ||
| Toxicity | 957 | ||
| Adverse Reactions | 957 | ||
| Significant Interactions | 957 | ||
| Antibiotics | 957 | ||
| Oral contraceptive pill | 957 | ||
| Tricyclic antidepressants | 957 | ||
| Amitryptyline | 958 | ||
| Contraindications and Precautions | 958 | ||
| Pregnancy Use | 958 | ||
| References | 958 | ||
| Vitamin B5 — pantothenic acid | 960 | ||
| Background and Relevant Pharmacokinetics | 960 | ||
| Chemical Components | 961 | ||
| Food Sources | 961 | ||
| Deficiency Signs and Symptoms | 961 | ||
| Main Actions | 962 | ||
| Coenzyme function | 962 | ||
| CoA and the Krebs cycle | 962 | ||
| Acyl carrier protein | 962 | ||
| Indirect antioxidant effects | 962 | ||
| Adrenal Cortex Function and Neurotransmitter Synthesis | 963 | ||
| Other functions | 963 | ||
| Lipid lowering | 963 | ||
| Wound healing | 963 | ||
| Clinical Use | 963 | ||
| Deficiency states: prevention and treatment | 964 | ||
| Enhances wound healing | 964 | ||
| Topical use | 964 | ||
| Acne vulgaris | 965 | ||
| Nasal spray | 965 | ||
| Elevated cholesterol and triglyceride levels | 965 | ||
| Obesity and weight loss | 966 | ||
| Other Uses | 967 | ||
| Stress | 967 | ||
| Ulcerative colitis (UC) | 967 | ||
| Coeliac disease | 968 | ||
| Lupus erythematosus | 968 | ||
| Ergogenic aid and athletic performance | 968 | ||
| Reducing drug toxicity | 969 | ||
| Female alopecia — ineffective | 969 | ||
| Testicular endocrinology, sperm motility and male fertility | 969 | ||
| Female fertility | 969 | ||
| Dosage Range | 969 | ||
| Australian adequate intake | 969 | ||
| According to clinical studies | 969 | ||
| Toxicity | 969 | ||
| Adverse Reactions | 969 | ||
| Significant Interactions | 970 | ||
| Antibiotics | 970 | ||
| Oral contraceptive pill | 970 | ||
| Isotretinoin | 970 | ||
| Acetylcholinesterase inhibitor drugs | 970 | ||
| References | 971 | ||
| Vitamin B6 | 973 | ||
| Background and Relevant Pharmacokinetics | 973 | ||
| Chemical Components | 973 | ||
| Food Sources | 973 | ||
| Deficiency Signs and Symptoms | 974 | ||
| Primary deficiency | 974 | ||
| Secondary deficiency | 974 | ||
| Main Actions | 975 | ||
| Coenzyme | 975 | ||
| Homocysteine | 975 | ||
| Serotonin, adrenaline and noradrenaline | 975 | ||
| Niacin synthesis | 975 | ||
| Antioxidant | 975 | ||
| Antitumour | 975 | ||
| Reducing diabetic complications | 975 | ||
| Other Actions | 976 | ||
| Myelin formation | 976 | ||
| Gene expression | 976 | ||
| Clinical Use | 976 | ||
| Deficiency | 976 | ||
| Premenstrual syndrome (PMS) | 976 | ||
| Comparative study | 976 | ||
| Dysmenorrhoea | 977 | ||
| Pregnancy | 977 | ||
| Homocysteine and recurrent miscarriages | 977 | ||
| Morning sickness | 977 | ||
| Heart disease | 978 | ||
| Elevated homocysteine levels | 978 | ||
| Venous thrombosis (VT) | 979 | ||
| Reducing thromboembolism | 979 | ||
| Improving outcomes after heart transplantation | 980 | ||
| Cancer | 980 | ||
| Ovarian cancer | 980 | ||
| Breast cancer | 980 | ||
| Bladder cancer | 981 | ||
| Colorectal cancer | 981 | ||
| Lung cancer prognosis and vitamin B6 | 982 | ||
| Carpal tunnel syndrome (CTS) | 982 | ||
| Autism | 983 | ||
| Seizures | 984 | ||
| Convulsions during a febrile episode | 984 | ||
| Symptomatic treatment for stress | 984 | ||
| Cognitive performance/Alzheimer’s disease | 985 | ||
| Homocysteine and Alzheimer’s disease | 985 | ||
| Brain matter | 985 | ||
| Schizophrenia | 986 | ||
| Tardive dyskinesia (TD) | 986 | ||
| Parkinson’s disease (PD) | 986 | ||
| Other Uses | 986 | ||
| Dream states | 987 | ||
| Leg cramps during pregnancy | 987 | ||
| Irritable bowel syndrome (IBS) | 987 | ||
| Mortality in the elderly | 987 | ||
| Dosage Range | 987 | ||
| Toxicity | 988 | ||
| Adverse Reactions | 988 | ||
| Significant Interactions | 988 | ||
| Amiodarone | 988 | ||
| Antibiotics | 988 | ||
| Hydralazine | 988 | ||
| Isoniazid | 988 | ||
| l-dopa (without carbidopa) | 988 | ||
| Oral contraceptives | 989 | ||
| Penicillamine | 989 | ||
| Phenobarbitone, phenytoin | 989 | ||
| Theophylline | 989 | ||
| Contraindications and Precautions | 989 | ||
| Pregnancy Use | 989 | ||
| References | 990 | ||
| Vitamin C | 994 | ||
| Historical Note | 994 | ||
| Background and Relevant Pharmacokinetics | 994 | ||
| Chemical Components | 995 | ||
| Food Sources | 995 | ||
| Deficiency Signs and Symptoms | 996 | ||
| Primary deficiency | 996 | ||
| Secondary deficiency | 996 | ||
| Main Actions | 997 | ||
| Antioxidant and pro-oxidant | 997 | ||
| Maintenance of connective tissue | 997 | ||
| Collagen stability | 998 | ||
| Brain and nerve function | 998 | ||
| Immunostimulant | 998 | ||
| Antihistamine | 999 | ||
| Anticancer | 999 | ||
| Modulation of gene expression | 1000 | ||
| Other Actions | 1000 | ||
| Clinical Use | 1000 | ||
| Deficiency: prevention and treatment | 1000 | ||
| Iron-deficiency anaemia | 1000 | ||
| Dermatological uses | 1000 | ||
| Wound healing | 1000 | ||
| Photo-damaged skin | 1002 | ||
| Prevention of sunburn | 1002 | ||
| Hyperpigmentation | 1002 | ||
| Antiageing | 1003 | ||
| Upper respiratory tract infections | 1003 | ||
| Reduction in all-cause mortality | 1004 | ||
| Prevention of cardiovascular disease | 1005 | ||
| Possible mechanisms | 1005 | ||
| Nitrate tolerance | 1006 | ||
| Myocardial infarction (MI) | 1006 | ||
| Clinical studies involving vitamin C supplementation | 1007 | ||
| Effects on blood pressure | 1007 | ||
| Postmenopausal cardiovascular health | 1008 | ||
| Cancer: prevention and treatment | 1008 | ||
| Prevention | 1009 | ||
| Clinical studies | 1009 | ||
| Intravenous vitamin C | 1010 | ||
| Adjunct to oncology treatments | 1011 | ||
| Breast cancer | 1011 | ||
| Oral cancer | 1011 | ||
| Prevention of cataracts | 1012 | ||
| Diabetes | 1012 | ||
| Blood glucose | 1013 | ||
| Endothelial function | 1013 | ||
| Eye health | 1013 | ||
| Pneumonia | 1014 | ||
| Asthma | 1014 | ||
| Asthma and atopy in children | 1015 | ||
| Bone mineral density (BMD) | 1015 | ||
| Vitamin C supplementation | 1015 | ||
| Sports | 1016 | ||
| Prevention of postendurance exercise infections | 1016 | ||
| Alterations to neurotransmitters and adrenal hormones | 1016 | ||
| Male infertility | 1016 | ||
| Pregnancy | 1017 | ||
| Alzheimer’s disease (AD) | 1018 | ||
| Periodontal disease | 1018 | ||
| Complex regional pain syndrome (CRPS) | 1018 | ||
| Adjunct therapy for haemodialysis patients | 1018 | ||
| Other Uses | 1019 | ||
| Dosage Range | 1019 | ||
| Australian and New Zealand RDI | 1019 | ||
| Infants | 1019 | ||
| Children | 1019 | ||
| Adults | 1019 | ||
| Pregnancy | 1019 | ||
| Lactation | 1019 | ||
| Deficiency | 1019 | ||
| According to clinical studies | 1020 | ||
| Adverse Reactions | 1020 | ||
| Significant Interactions | 1021 | ||
| Aluminium-based antacids | 1021 | ||
| Aspirin | 1021 | ||
| Chitosan | 1021 | ||
| Cisplatin | 1021 | ||
| Corticosteroids | 1021 | ||
| Cyanocobalamin | 1022 | ||
| Cyclophosphamide | 1022 | ||
| Doxorubicin | 1022 | ||
| Etoposide | 1022 | ||
| Fluorouracil | 1022 | ||
| Iron | 1022 | ||
| l-Dopa | 1022 | ||
| Tamoxifen | 1022 | ||
| Vincristine | 1022 | ||
| PS-341 (bortezomib, Velcade) | 1022 | ||
| Intravenous vitamin C | 1023 | ||
| Laboratory tests | 1023 | ||
| References | 1024 | ||
| Vitamin D | 1032 | ||
| Historical Note | 1032 | ||
| Background and Relevant Pharmacokinetics | 1032 | ||
| Chemical Components | 1033 | ||
| Are all vitamin D forms alike? | 1034 | ||
| Food Sources | 1035 | ||
| Deficiency Signs and Symptoms | 1035 | ||
| Primary deficiency | 1036 | ||
| Deficiency more prevalent than once thought | 1036 | ||
| Secondary deficiency | 1038 | ||
| Signs and symptoms of deficiency | 1038 | ||
| Main Actions | 1039 | ||
| Regulation of calcium and phosphorus levels | 1040 | ||
| Modelling and remodelling of bone | 1040 | ||
| Cell differentiation, proliferation and growth | 1040 | ||
| Reduction of PTH and regulation of growth of the parathyroid gland | 1040 | ||
| Immunomodulation | 1041 | ||
| Other Actions | 1041 | ||
| Haematopoietic tissues | 1042 | ||
| Muscle function | 1042 | ||
| Vascular function | 1043 | ||
| Pancreatic function | 1043 | ||
| Brain function | 1044 | ||
| Clinical Use | 1044 | ||
| Deficiency states | 1045 | ||
| Pregnancy and lactation supplementation | 1045 | ||
| Children | 1046 | ||
| Treatment of deficiencies secondary to malabsorptive syndromes | 1046 | ||
| Reducing all-cause mortality | 1046 | ||
| Cancer prevention | 1047 | ||
| Improving cancer prognosis | 1048 | ||
| Colorectal cancer and prevention of adenomatous polyps | 1048 | ||
| Prostate | 1049 | ||
| Breast | 1049 | ||
| Autoimmune diseases | 1050 | ||
| Type 1 diabetes mellitus | 1050 | ||
| Type 2 diabetes mellitus (T2DM) | 1052 | ||
| Hypoparathyroidism | 1053 | ||
| Secondary hyperparathyroidism | 1053 | ||
| Hypophosphataemia | 1053 | ||
| Osteoporosis and fracture prevention | 1053 | ||
| Reducing falls in the elderly | 1054 | ||
| Anticonvulsant-induced osteomalacia | 1056 | ||
| Hepatic and renal osteodystrophy | 1056 | ||
| Localised and systemic scleroderma | 1056 | ||
| Prevention and treatment of infections and tuberculosis | 1057 | ||
| Depression | 1058 | ||
| Other Uses | 1059 | ||
| Multiple sclerosis | 1059 | ||
| Crohn’s disease and other inflammatory bowel disease | 1060 | ||
| Lupus (SLE) | 1060 | ||
| Psoriasis | 1061 | ||
| Vaginal atrophy | 1061 | ||
| Dosage Range | 1061 | ||
| Acceptable daily intake (ADI) | 1061 | ||
| According to clinical studies | 1062 | ||
| Toxicity | 1062 | ||
| Adverse Reactions | 1062 | ||
| Significant Interactions | 1062 | ||
| Antituberculosis drugs | 1063 | ||
| Calcium channel blockers | 1063 | ||
| Glucocorticoids | 1063 | ||
| Ketoconazole | 1063 | ||
| Lipid-lowering drugs | 1063 | ||
| Magnesium | 1064 | ||
| Mineral oil | 1064 | ||
| Oestrogens | 1064 | ||
| Orlistat | 1064 | ||
| Phenytoin and valproate | 1064 | ||
| References | 1065 | ||
| Vitamin E | 1071 | ||
| Historical Note | 1071 | ||
| Background and Relevant Pharmacokinetics | 1071 | ||
| Chemical Components | 1072 | ||
| Relative strengths of the various forms of vitamin E | 1072 | ||
| Food Sources | 1072 | ||
| Fortified foods | 1073 | ||
| Deficiency Signs and Symptoms | 1074 | ||
| Retinal degeneration | 1074 | ||
| Main Actions | 1074 | ||
| Antioxidant | 1075 | ||
| Regulates immunocompetence | 1075 | ||
| Other Actions | 1075 | ||
| Cell signalling | 1076 | ||
| Telomere length | 1076 | ||
| Clinical Use | 1076 | ||
| Deficiency: prevention and treatment | 1076 | ||
| Cardiovascular disease | 1077 | ||
| Epidemiological and clinical studies | 1077 | ||
| Restenosis | 1087 | ||
| Angina pectoris | 1088 | ||
| Nitrate tolerance | 1088 | ||
| Hypertension | 1088 | ||
| All-cause mortality (ACM) | 1089 | ||
| Parkinson’s disease | 1091 | ||
| Alzheimer’s dementia and cognitive decline | 1092 | ||
| Prevention | 1093 | ||
| Immunity in the elderly | 1093 | ||
| Common cold and respiratory disease | 1093 | ||
| Haemodialysis (HD) | 1094 | ||
| Premenstrual syndrome (PMS) | 1094 | ||
| Dysmenorrhoea | 1094 | ||
| Intermittent claudication | 1095 | ||
| Cancer | 1095 | ||
| All cancers | 1095 | ||
| Urinary tract cancer | 1096 | ||
| Respiratory tract cancers | 1097 | ||
| Breast cancer | 1097 | ||
| Ovarian cancer | 1097 | ||
| Colorectal cancer | 1097 | ||
| Prostate cancer | 1098 | ||
| Pancreatic cancer | 1098 | ||
| Adjunct with cisplatin | 1099 | ||
| Arthritis | 1099 | ||
| Osteoarthritis | 1099 | ||
| Rheumatoid arthritis | 1100 | ||
| Comparisons with pharmaceutical medication | 1101 | ||
| Menopausal symptoms | 1101 | ||
| Male infertility | 1101 | ||
| Dermatological conditions | 1102 | ||
| Sunburn protection | 1102 | ||
| Scar tissue | 1103 | ||
| Type 1 diabetes | 1103 | ||
| Type 2 diabetes | 1103 | ||
| Chronic hepatitis C | 1103 | ||
| Asthma and atopy | 1103 | ||
| Age-related macular degeneration (AMD) | 1104 | ||
| Neurogenerative disease | 1104 | ||
| Other Uses | 1104 | ||
| Dosage Range | 1105 | ||
| Recommendations for adults (Australian adequate intake) | 1105 | ||
| According to clinical studies | 1105 | ||
| Toxicity | 1106 | ||
| Adverse Reactions | 1106 | ||
| Significant Interactions | 1106 | ||
| Oral contraceptive pill | 1106 | ||
| HMG-CoA reductase inhibitors (statins) | 1106 | ||
| Chloroquine | 1106 | ||
| Chlorpromazine | 1106 | ||
| Cisplatin | 1106 | ||
| Warfarin | 1106 | ||
| Doxorubicin | 1107 | ||
| Nitrates | 1107 | ||
| NSAIDs and simple analgesics | 1107 | ||
| Propranolol | 1107 | ||
| References | 1109 | ||
| Zinc | 1115 | ||
| Background and Relevant Pharmacokinetics | 1115 | ||
| Chemical Components | 1117 | ||
| Food Sources | 1117 | ||
| Deficiency Signs and Symptoms | 1117 | ||
| Signs and symptoms of deficiency | 1118 | ||
| Most consistently reported | 1118 | ||
| Less consistently reported | 1118 | ||
| Primary Deficiency (Table 1) | 1118 | ||
| Secondary Deficiency | 1119 | ||
| Main Actions | 1121 | ||
| Cofactor in many biochemical reactions | 1121 | ||
| Growth and development | 1122 | ||
| Normal immune responses | 1122 | ||
| Gastrointestinal structure and function | 1122 | ||
| Neurological function | 1122 | ||
| Prostate health | 1123 | ||
| Fertility | 1123 | ||
| Pregnancy and lactation | 1124 | ||
| Antioxidant | 1124 | ||
| Supporting glycaemic control | 1124 | ||
| Clinical Use | 1125 | ||
| Deficiency | 1125 | ||
| Common cold | 1125 | ||
| Acute treatment | 1126 | ||
| Nasal preparations | 1126 | ||
| Oral supplements | 1126 | ||
| Prevention of colds | 1127 | ||
| In children | 1128 | ||
| In the elderly | 1128 | ||
| Pneumonia | 1128 | ||
| Prevention | 1128 | ||
| Active treatment | 1129 | ||
| Age-related macular degeneration (ARMD) | 1130 | ||
| Herpes simplex virus (HSV) infection | 1131 | ||
| Diabetes mellitus (type 1 and 2) | 1132 | ||
| Wound healing | 1134 | ||
| Oral application | 1134 | ||
| Topical application | 1134 | ||
| Arterial and venous leg ulcers | 1134 | ||
| Acne and other skin conditions | 1135 | ||
| Oral supplementation | 1135 | ||
| Topical application | 1136 | ||
| Reduced male fertility | 1136 | ||
| Impotence | 1137 | ||
| Attention-deficit hyperactivity disorder (ADHD) | 1137 | ||
| Depression | 1139 | ||
| Diarrhoea | 1140 | ||
| Coeliac disease | 1140 | ||
| Crohn’s disease | 1141 | ||
| Anorexia nervosa | 1141 | ||
| Improves taste perception | 1142 | ||
| Tinnitus | 1143 | ||
| Warts | 1144 | ||
| Wilson’s disease | 1144 | ||
| Other Uses | 1144 | ||
| Reducing the risk of cancer | 1144 | ||
| HIV and AIDS | 1144 | ||
| Malaria | 1145 | ||
| Alzheimer’s dementia | 1146 | ||
| Dosage Range | 1146 | ||
| Australian RDI | 1146 | ||
| Children | 1146 | ||
| Adults | 1147 | ||
| Pregnancy | 1147 | ||
| Deficiency | 1147 | ||
| According to clinical studies | 1147 | ||
| Toxicity | 1148 | ||
| Adverse Reactions | 1148 | ||
| Significant Interactions | 1148 | ||
| Calcium | 1148 | ||
| Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and thiazide diuretics | 1148 | ||
| Coffee | 1148 | ||
| Copper | 1148 | ||
| Folate | 1148 | ||
| Iron | 1148 | ||
| Non-steroidal anti-inflammatory drugs | 1149 | ||
| Tetracyclines and quinolones | 1149 | ||
| Thiazide and loop diuretics | 1149 | ||
| Methylphenidate | 1149 | ||
| Vaccinations | 1149 | ||
| Radiotherapy | 1149 | ||
| Interferon-alpha/ribavirin | 1149 | ||
| Orlistat | 1149 | ||
| Tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) | 1149 | ||
| References | 1150 | ||
| Index | 1158 | ||
| A | 1158 | ||
| B | 1162 | ||
| C | 1163 | ||
| D | 1167 | ||
| E | 1169 | ||
| F | 1170 | ||
| G | 1170 | ||
| H | 1171 | ||
| I | 1173 | ||
| J | 1175 | ||
| K | 1175 | ||
| L | 1175 | ||
| M | 1176 | ||
| N | 1177 | ||
| O | 1179 | ||
| P | 1180 | ||
| Q | 1183 | ||
| R | 1183 | ||
| S | 1183 | ||
| T | 1185 | ||
| U | 1186 | ||
| V | 1187 | ||
| W | 1188 | ||
| X | 1188 | ||
| Z | 1188 |