Dr Clare Materia Medica

Also Known As:

Medicago, Purple Medick,

Scientific Name:

Medicago sativa

Botanic Family: Fabaceae/Leguminosae.

People Use This For:

Alfalfa is used as a diuretic, for kidney conditions, bladder and prostate conditions, asthma, arthritis, rheumatoid arthritis, diabetes, indigestion, and thrombocytopenic purpura. It is also used orally as a source of vitamins A, C, E, and K4; and minerals calcium, potassium, phosphorous, and iron.

Constituents: Alfalfa contains Protein Vitamin D, Calcium plus other minerals, B Vitamins, Vitamin C, Vitamin E and Vitamin K.

Safety:

Likely Safe: When the leaves are used orally and appropriately (1,2,3). Avoid excessive amounts of seeds long-term. Consult a medical herbalist if used in more than usual dietary amounts (1,4).

Pregnancy and Breastfeeding: Consult a medical herbalist if used in more than usual dietary amounts (1,4).

Scientific knowledge of effectiveness: There is insufficient scientific information available about the effectiveness of alfalfa.

Mechanism of Action: The leaves and sprouts contain saponins. The saponins appear to decrease serum cholesterol, but not triglycerides, by binding cholesterol and decreasing its absorption(6,7).

Alfalfa leaves also contain triterpene glycosides including medicagol, which appear to have antifungal and antibacterial activity (15,16). The isoflavonoids coumetrol, genistein, biochanin A, and daidzein have also been isolated and may be responsible for alfalfas reported estrogenic effects (17).

Adverse Reactions: Alfalfa herb is well tolerated at usual dietary doses (1,2,3). Associations of Alfalfa with autoimmune disease relate to the seeds, mostly in animal studies.

Interactions with Herbs & Supplements: VITAMIN E: Alfalfa contains saponins which may interfere with the absorption or activity of vitamin E (17).

Interactions with Drugs: 

CONTRACEPTIVE DRUGS Excessive doses of alfalfa may interfere with contraceptive drugs. Alfalfa contains isoflavonoids with estrogenic effects (1). Herb teas would not constitute excessive doses in usual amounts on a daily basis.

ESTROGENS Excessive doses of alfalfa may interfere with hormone therapy due to estrogenic effects of isoflavonoids alfalfa (1). Herb teas would not constitute excessive doses in usual amounts on a daily basis.

IMMUNOSUPPRESSANTS Alfalfa seeds may influence the immune system (8, 9,13). This is not relevant to leaves used in herbal teas.

PHOTOSENSITIZING DRUGS Excessive doses of alfalfa may potentiate photosensitivity induced by antipsychotic drugs (18). Herb teas of the leaves would not constitute excessive doses in usual amounts on a daily basis.

WARFARIN (Coumadin) Alfalfa contains large amount of vitamin K (1,2) which may reduce the activity of warfarin.

Interactions with Foods: None known.

Interactions with Lab Tests: 

CHOLESTEROL: Alfalfa seed might lower serum cholesterol concentrations and test results in individuals with type II hyperlipoproteinemia (1). Alfalfa leaves may reduce total Cholesterol(6,7).

Interactions with Diseases or Conditions:

AUTOIMMUNE DISEASES: alfalfa seed (not herb as found in Dr Clare’s Herb Tea Blends) might have immunostimulant effects in animal studies (8, 9,13).

DIABETES: Alfalfa might reduce blood sugar levels; monitor closely (1). Patients may have reduced requirement for blood sugar reducing medications, introduce slowly and increase the amount gradually. Advise patients to check blood blood sugar a little more frequently and discuss any changes with their medical adviser.

HORMONE SENSITIVE CANCERS/CONDITIONS: Because alfalfa may have estrogenic effects (17), women with hormone sensitive conditions should avoid alfalfa in doses in excess of usual dietary amounts.

Consult a medical Herbalist

KIDNEY TRANSPLANT: Avoid with immune suppressant drugs. Alfalfa is thought to have immune stimulating effects that might counteract the immunosuppressant effects of cyclosporine (8).

SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): Long-term use of alfalfa seed products may reactivate latent SLE. There are two case reports of patients experiencing disease flare after taking alfalfa seed products long-term (19). Tell patients with a history of SLE or drug-induced lupus reactions to avoid alfalfa seed products until more information is known.

Dosage/Administration:

ORAL: A typical dosage is 5-10 grams, or as steeped strained tea, three times a day (1). Liquid extract (1:1 in 25% alcohol) 5-10 mL three times a day has also been used (1).

Comment Dr Clare

Alfalfa leaves within usual dietary amounts only are used in Dr Clare’s Tea Blends. The problem with research is that animal studies are extrapolated to humans, in fact the herb to be tested may not ever be eaten by the test species of animal as part of their normal diet. Therefore they may not have the appropriate enzyme systems to digest the herb rendering it toxic to that animal where it would be properly metabolosed by humans. Seeds are especially nutrient packed with added potential for inappropriate reactions in animal studies under these conditions. There is virtually no research on the Alfalfa herb, it has been used as part of a normal diet and as a medicine for over 1.500 years with an excellent safety record.

Specific reference: Alfalfa

1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.

2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.

3. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

4. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.

5. Molgaard J, von Schenck H, Olsson AG. Alfalfa seeds lower low density lipoprotein cholesterol and apolipoprotein B concentrations in patients with type II hyperlipoproteinemia. Atherosclerosis 1987;65:173-9.

6. Story JA, LePage SL, Petro MS, et al. Interactions of alfalfa plant and sprout saponins with cholesterol in vitro and in cholesterol-fed rats. Am J Clin Nutr 1984;39:917-29.

7. Malinow MR, McLaughlin P, et al. Comparative effects of alfalfa saponins and alfalfa fiber on cholesterol absorption in rats. Am J Clin Nutr 1979;32:1810-2.

8. Light TD, Light JA. Acute renal transplant rejection possibly related to herbal medications. Am J Transplant 2003;3:1608-9.

9. Alcocer-Varela J, Iglesias A, Llorente L, Alarcon-Segovia D. Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa. Arthritis Rheum 1985;28:52-7. Montanaro A, Bardana EJ Jr. Dietary amino acid-induced systemic lupus erythematosus.

10.  Rheum Dis Clin North Am 1991;17:323-32.

11. Bardana EJ Jr, Malinow MR, Houghton DC, et al. Diet-induced systemic lupus erythematosus (SLE) in primates. Am J Kidney Dis 1982;1:345-52

12.Malinow MR, Bardana EJ Jr, Goodnight SH Jr. Pancytopenia during ingestion of alfalfa seeds.

13.Prete PE. The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum 1985;28:1198-200.

14. Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4.

15.Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.

16.Zehavi U, Polacheck I. Saponins as antimycotic agents: glycosides of medicagenic acid. Adv Exp Med Biol 1996;404:535-46.

17.Timbekova AE, Isaev MI, Abubakirov NK. Chemistry and biological activity of triterpenoid glycosides from Medicago sativa. Adv Exp Med Biol 1996;405:171-82.

18. Brown R. Potential interactions of herbal medicines with antipsychotics, antidepressants and hypnotics. Eur J Herbal Med 1997;3:25-8.

19. ƒarber JM, Carter AO, Varughese PV, et al. Listeriosis traced to the consumption of alfalfa tablets and soft cheese [Letter to the Editor]. N Engl J Med 1990;322:338.

20. Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med 1983;308:1361.

Also Known As: Withania.

Scientific Name: Withania somnifera.

Family: Solanaceae.

People Use This For:

Ashwagandha is traditionally used for arthritis, anxiety, insomnia, tumors, tuberculosis, and chronic liver disease. Ashwagandha is also used as an "adaptogen" to increase resistance to environmental stress, and as a general tonic. It is also used for immunomodulatory effects, improving cognitive function, decreasing inflammation, preventing the effects of aging, for emaciation, infertility in men and women, menstrual disorders, fibromyalgia, and hiccups. It is also used orally as an aphrodisiac.

Safety: Possibly safe when used orally and appropriately, short-term.17,18

Pregnancy and Breastfeeding: Insufficient scientific information available, consult a medical herbalist.

Effectiveness: There is insufficient scientific information available to comment.

Mechanism of Action: The applicable parts of ashwagandha are the root and berry. Ashwagandha contains several active constituents including alkaloids, steroidal lactones, and saponins.19,18. Animal model research suggests that ashwagandha has a variety of pharmacological effects including pain relief, lowering temperature, reducing anxiety, inflammatory, and antioxidant effects.17,20,21,19,18 , sedative, blood pressure lowering, anti-immunomodulatory. Some researchers think ashwagandha has a so-called "anti-stressor" effect. Preliminary increases of dopamine receptors in the corpus striatum of the brain.  17 It also appears to reduce stress-induced increases of plasma corticosterone, blood urea nitrogen, and blood lactic acid.18 Ashwagandha seems to have anxiolytic effects, possibly by acting as a gamma-aminobutyric acid (GABA) mimetic agent. Research suggests ashwagandha suppresses stress-induced anxiety. Ashwagandha and its constituents also seem to have modulating effects on the immune system. The withanolides and sitoindosides seem to cause a mobilization of phagocytosis, and lysosomal enzymes.18 

Adverse Reactions: Ashwagandha is well tolerated.

Interactions with Herbs & Supplements

Herbs and Supplements with Sedative Properties: Theoretically, used with herbs that have sedative properties they may have an additive effect. This needs to be taken into account with the dosage.

Interactions with Drugs: Benzodiazepines e.g.Valium, Xanax

CNS Depressants: Theoretically, Ashwagandha's sedative effect may add to the effects of barbiturates (rarely prescribed now except for epilepsy), other sedatives, and drugs for anxiety,17 needed.

Immunosuppressants; refer to medical herbalist

Thyroid Hormone: Theoretically, ashwagandha might have additive effects when used with thyroid supplements. There is preliminary evidence that ashwagandha might boost thyroid hormone synthesis and/or secretion.17

Refer patients on medication to a well qualified Medical Herbalist. 

Interactions with Foods: None known.

Interactions with Lab Tests: Digoxin blood levels (heart medication).

Interactions with Diseases or Conditions: Autoimmune effects.17,20,22,18 The modulating effects on the immune system can be helpful but should be prescribed by a Medical Herbalist.

Diseases: Ashwagandha may have immunostimulant properties.

Dosage/Administration: 

Dr Clare’s Blends: 1gm per day

Oral: People typically use 1 to 6 grams daily of the whole herb in capsule or tea form.17 The tea is prepared by boiling ashwagandha roots in water for 15 minutes and cooled. The usual dose is 3 cups daily. Tincture or fluid extracts are dosed 2 to 4 mL 3 times per day.

Topical: No typical dosage.

Specific References: ASHWAGANDHA Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and 

17. therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.

18. Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania

somnifera (ashwagandha): a review. Altern Med Rev 2000;5:334-46.

19. Bhattacharya SK, Satyan KS, Ghosal S. Antioxidant activity of glycowithanolides from Withania somnifera. Indian J Exp Biol 1997;35:236-9.

20. Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17.

21. Archana R, Namasivayam A. Antistressor effect of Withania somnifera. J Ethnopharmacol 1999;64:91-3.

22. Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol

Also Known As: Astragali Membranaceus.

Scientific Name:Astragalus membranaceus.

Family: Fabaceae/Leguminosae or Papilionaceae.

People Use This For: Astragalus is used for common cold, upper respiratory infections, allergic rhinitis, swine ‘flu, to strengthen and regulate the immune system, fibromyalgia, anemia, and HIV/AIDS, chronic fatigue syndrome, as an antibacterial, antiviral, tonic, liver protectant, anti-inflammatory, antioxidant, as a diuretic, vasodilator, and as a hypotensive agent. Topically, astragalus is used as a vasodilator and to speed healing.

Safety: No concerns regarding safety.

Pregnancy and Breast Feeding: Refer to a Medical Herbalist.

Effectiveness: Not enough scientific information available to comment.

Allergic rhinitis: Preliminary clinical research shows that a specific astragalus root extract standardized to contain 34% polysaccharides twice daily for 3 to 6 weeks significantly improves symptoms such as runny nose, sneezing, and itching compared to placebo.1

Breast cancer: There is preliminary evidence that adjunctive use of astragalus in combination with glossy privet (Ligustrum lucidum) might increase survival rates in patients being treated conventionally for breast cancer.2

Common cold: There is preliminary evidence that long-term ingestion of astragalus might reduce the risk of catching the common cold.2

Hepatitis: There is preliminary evidence that intravenous use of astragalus might be beneficial for patients with chronic hepatitis.2

Mechanism of Action: The part used is the root. Astragalus contains a variety of active constituents including more than 34 saponins such as astragaloside, several flavonoids including isoflavones, pterocarpans, and isoflavans, polysaccharides, multiple trace minerals, amino acids, and coumarins.2,3 Astragalus has antioxidant effects. It inhibits free radical production, increases superoxide dismutase, and decreases lipid peroxidation.2,4 Astragalus is often promoted for its effects on the immune system, liver, and cardiovascular system. Astragalus seems to improve the immune response. In vitro, the polysaccharide constituents appear to bind and activate B cells and macrophages, but not T cells.5 Astragalus potentiates the effects of interferon, increases antibody levels of immunoglobulins in nasal secretions, and increases interleukin-2 levels.2,6,7 It also seems to improve the response of mononuclear cells and stimulate lymphocyte production.8 Additionally, there is preliminary evidence that astragalus extracts can restore or improve immune function in cases of immune deficiency.9,10 Astragalus seems to restore in vitro T-cell function which is suppressed in cancer patients.9,11 Astragalus also seems to have broad-spectrum in vitro antibiotic activity.2 There is interest in astragalus for increasing fertility. In vitro, astragalus appears to increase sperm motility.12 In individuals with chronic hepatitis, astragalus seems to improve liver function as demonstrated by improvement in serum glutamate pyruvate transaminase levels.2 Astragalus is also thought to cause vasodilation and increase cardiac output which might be beneficial in angina, congestive heart failure, and post-myocardial infarction.2 In animal models of heart failure, astragalus appears to increase myocardial and renal function, possibly due to diuretic and natriuretic effects.13 In animal models of coxsackie viral myocarditis, astragalus appears to reduce myocardial lesion size and viral titers.14 A pharmacokinetic evaluation in vitro and in a healthy human volunteer, suggests that astragalus flavonoids can be absorbed in the gastrointestinal tract. The major metabolites of the flavonoid constituents are glucuronides.15 These help with excretion of toxic substances.

Adverse Reactions: Astragalus root is well-tolerated.

Interactions with Herbs & Supplements: None known.

Interactions with Drugs: Cyclophosphamide, Immunosuppressants, Lithium

Interactions with Foods: None known.

Interactions with Lab Tests: None known.

Interactions with Diseases or Conditions: Autoimmune Diseases: Refer to Medical Herbalist

Dosage/Administration: Dr Clare’s Blends: 3ml of 1:3 tincture/day = 1gm per day.

Oral: For allergic rhinitis, a specific astragalus root extract standardized to contain 34% polysaccharides (Lectranal) 160 mg twice daily has been used.1 For prevention of the common cold, 4-7 grams per day is commonly used.2 Traditionally, astragalus powder 1-30 grams per day is used.16,2 In some cases, people have used astragalus powder 30-54 grams per day.2 However, this should be avoided because some research suggests that doses greater than 28 grams per day offers no additional benefit and might even cause immune suppression.3 Astragalus decoction 0.5-1 L per day (maximum of 120 grams of whole root per liter of water) has been used.2 As a soup, mix 30 grams in 3.5 L of soup and simmer with other food ingredients.2

Topical: No typical dosage.

Specific References: ASTRAGALUS

Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in

1. the treatment of patients with seasonal allergic rhinitis. Phytother Res 2010;18:175-81.

2. Upton R, ed. Astragalus Root: Analytical, quality control, and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia. 1999:1-19.

3. McCulloch M, See C, Shu XJ, et al. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: meta-analysis of randomized trials. J Clin Oncol 2006;18:419-30. Hong CY, Lo YC, Tan FC, et al. Astragalus membranaceus and Polygonum multiflorum

4. protect rat heart mitochondria against lipid peroxidation. Am J Chin Med 1994;22:57-70.

5. Shao BM, Xu W, Dai H, et al. A study on the immune receptors for polysaccharides from the roots of Astragalus membranaceus, a Chinese medicinal herb. Biochem Biophys Res Commun 2004;320:1103-11.

6. Qun L, Luo Q, Zhang ZY, et al. Effects of astragalus on IL-2/IL-2R system in patients with maintained hemodialysis. Clin Nephrol 1999;46:333-4.

7. Hou YD, Ma GL, Wu SH, et al. Effect of Radix Astragali seu Hedysari on the interferon system. Chin Med J (Engl) 1981;94:29-34. Sun Y, Hersh EM, Lee SL, et al. Preliminary observations on the effects of the Chinese

8. medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J Biol Response Mod 1983;2:227-31. Sun Y, Hersh EM, Talpaz M, et al. Immune restoration and/or augmentation of local graft

9. versus host reaction by traditional Chinese medicinal herbs. Cancer 1983;46:70-3.

10. Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J Clin Lab Immunol 1988;19:125-9.

11. Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. I. Immune restoration of local xenogeneic graft-versus-host reaction in cancer patients by fractionated Astragalus membranaceus in vitro. J Clin Lab Immunol 1988;19:119-17.

12. Hong CY, Ku J, Wu P. Astragalus membranaceus stimulates human sperm motility in vitro. Am J Chin Med 1992;20:289-94.

13. Ma J, Peng A, Lin S. Mechanisms of the therapeutic effect of astragalus membranaceus on sodium and water retention in experimental heart failure. Chin Med J (Engl) 1998;111:17-17.

14. Yang YZ, Jin PY, Guo Q, et al. Treatment of experimental Coxsackie B-3 viral myocarditis with Astragalus membranaceus in mice. Chin Med J (Engl) 1990;103:14-8.

15. Xu F, Zhang Y, Xiao S, et al. Absorption and metabolism of Astragali radix decoction: in silico, in vitro, and a case study in vivo. Drug Metab Dispos 2006;28:913-18.

16. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.