Dr Clare Materia Medica

Lady’s Mantle. Alchemilla vulgaris

Also Known As:

Lion's Foot, Manto de la Virgen, Nine Hooks, Nueve Ganchos, Pie de León, Silerkraut.

CAUTION: See separate listing for Alpine Lady's Mantle.

Scientific Name:

Alchemilla xanthochlora; Alchemilla vulgaris.

Family: Rosaceae.

People Use This For:

Alchemilla is used for mild diarrhoea, heavy menstrual flow, diabetes, menopausal

complaints, painful menses, gastrointestinal disorders, as a relaxant for muscle spasms, an anti-inflammatory, a diuretic, and as a garglefor mouth and throat inflammation.

Topically, alchemilla is used as an astringent for bleeding, to improve wound healing, for ulcers, eczema, skin rashes, and as a bath additive for treating lower-abdominal ailments.

Safety:

Alchemilla has been used for many years without reports of significant toxicity (2, 3, 4).

No scientific studies have been carried out for topical use of alchemilla.

Pregnancy: There are no scientific studies available. A 2012 pharmaceutical review assessment describes it as safe in pregnancy 

Breastfeeding: There are no scientific studies available.The above review has no comment for avoiding or for indications for use.

Effectiveness:

There is insufficient reliable information available about the effectiveness of alchemilla.

Mechanism of Action:

The above ground parts are used. Alchemilla contains 6-8% tannins (3), which are likely to account for its perceived astringent activity (2). A water extract of Alchemilla xanthochlora demonstrates lipid peroxidation and superoxide anion scavenging activity (2). Flavonoid extracts inhibit proteolytic enzymes, including elastase, trypsin, and alpha-chymotrypsin. This property suggests alchemilla might have a role in protecting conjunctive and elastic tissues (2).

Adverse Reactions:

Although one reference refers to an association with liver damage no cases have

been reported and the association is likely to be spurious (3).

Interactions with Herbs & Supplements:

None known.

Interactions with Drugs:

None known.

Interactions with Foods:

None known.

Interactions with Lab Tests:

None known

Interactions with Diseases or Conditions:

None known

Dosage/Administration:

Oral: For diarrhoea, a typical dose is one cup tea, prepared by steeping 1-4 grams above ground parts in boiling water for 10 minutes and then straining (3), used up to three times per day between meals. The average amount used per day is 5-10 grams. Equivalent preparations can also be used (1). Diarrhoea persisting for more than 3-4 days should be medically evaluated (3).

Topical: No typical dosage.

Specific References: LADY’S MANTLE

1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.

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

3. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.

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

Also Known As:

Common Lavender, English Lavender, French Lavender, Garden Lavender.

Scientific Name:

Lavandula angustifolia, synonyms Lavandula officinalis, Lavandula vera, Lavandula spica; Lavandula dentata; Lavandula latifolia; Lavandula pubescens; Lavandula stoechas.

Family: Lamiaceae/Labiatae.

People Use This For:

Orally, lavender is used for restlessness, insomnia, nervousness, depression, meteorism (abdominal swelling from gas in the intestinal or peritoneal cavity), and loss of appetite. Lavender is also used orally for flatulence, upset stomach, giddiness, migraine headaches, toothaches, sprains, neuralgia, rheumatism, acne, sores, nausea, vomiting, to promote menstruation, and to treat cancer.

Topically, lavender is used for alopecia areata, pain, and in baths for circulation disorders, and improving psychological well-being. It is also used topically as a mosquito repellent and insect repellent.

By inhalation, lavender is used as aromatherapy for insomnia, pain, and agitation related to dementia.

In foods and beverages, lavender is used as a flavour component.

In manufacturing, lavender is utilized in pharmaceutical products and as a fragrance ingredient in soaps and cosmetics. Lavender is also used as an insect repellent.

Safety:

No concerns regarding safety when used orally in amounts commonly found in foods. Lavender has Generally Recognized as Safe (GRAS) status for food use in the US.(31). No concerns regarding safety when used orally and appropriately, (32) when used topically and appropriately. Lavender oil has been used safely for up to 7 months in adults.(33) when the essential oil is inhaled as a part of aromatherapy. (34,35,36,37)

Children: Possibly Unsafe when applied topically. Anecdotal reports suggest that applying topical products containing lavender oil to prepubertal boys can result in gynecomastia in some cases.(38)

Products with a higher concentration of lavender oil and more frequent applications might be more likely to result in gynecomastia.

Pregnancy and Lactation: Insufficient reliable information available; avoid using.

Effectiveness:

POSSIBLY EFFECTIVE

Alopecia areata. There is some evidence that applying lavender oil in combination with the essential oils from thyme, rosemary,and cedarwood might improve hair growth by as much as 44% after 7 months of treatment.(33)

INSUFFICIENT RELIABLE EVIDENCE to RATE

Agitation. Evidence regarding the efficacy of lavender aromatherapy for agitation is conflicting. In one preliminary clinical study, nightly use of lavender oil in a bedside diffuser for 3 weeks reduced agitation scores in patients with various types of dementia.(36)

However, continuous use of lavender oil on a pad attached to a patient's shirt had no effect in a small group of patients with advanced dementia. (35)

Depression. In mild to moderate depression, tincture of lavender appears to be slightly less effective than imipramine (Tofranil). Lavender might have some additive antidepressant effect with imipramine.

(32)

Insomnia. Preliminary clinical research suggests using lavender oil in a vaporizer overnight might help some people with mild insomnia.(37)

Psychological well-being. Preliminary clinical research suggests that adding 3 mL of a 20% lavender oil and 80% grapeseed oil mixture to daily baths produces modest improvements in mood, compared with baths containing grapeseed oil alone. (39) More evidence is needed to rate lavender for these uses.

Mechanism of Action:

The applicable parts of lavender are the flowers, leaves, and oil. Lavender contains several potential active constituents including cineole from the essential oil and borneol and camphor from the leaves. (40)

The oil also contains linalool, linalyl acetate, and carophyllene epoxide.(36)

Lavender preparations and the isolated constituents have several pharmacological effects in vitro and in animals. However, the effects in humans are less well known. Lavender seems to induce relaxation and sedation. Lavender decreases EEG potentials and decreases alertness in humans.(41)

There is some evidence that lavender has spasmolytic effects on smooth muscle (42)

and might have analgesic effects.(34)

There is also some evidence from animal models that lavender might have anticonvulsant effects and possibly potentiate chloral hydrate and pentobarbital effects.(41)

In animal models, lavender leaf extract and essential oils seem to have analgesic and anti-inflammatory properties. (40)

Lavender oil has modest estrogenic effects and antiandrogenic effects in vitro.(38)

Lavender might also have stimulant effects on hair growth; (33) however, the mechanism of this effect is not known.

Adverse Reactions:

Tincture of lavender may cause headache.(32)

Interactions with Herbs & Supplements:

None known.

Interactions with Drugs:

May enhance the effects of sedative herbs. Advise patients th at lower than usual dose may be necessary. Refer to a Medical Adviser.

Interactions with Foods:

None known.

Interactions with Lab Tests:

None reported.

Interactions with Diseases or Conditions:

None reported.

Dosage/Administration:

Dr Clare’s Blends: Dose 455mgs per day. 1.5mls 1:3 Tincture.

Oral: For depression, tincture of lavender (1:5 in 50% alcohol) 60 drops per day has been used for 4 weeks.(32)

Topical: For alopecia areata, one study used a combination of essential oils including lavender 3 drops (108mg), rosemary 3 drops (114 mg), thyme 2 drops (88mg), and cedarwood 2 drops (94 mg), all mixed with 3 mL jojoba oil and 20 mL grapeseed oil. Each night, the mixture is massaged in

to the scalp for 2 minutes with a warm towel placed around the head to increase absorption.(33)

For agitation associated with dementia, lavender aromatherapy has been used by applying lavender oil to a pad attached to clothingor placed in a bedside diffuser.

(35,36)

For insomnia, lavender aromatherapy has been used by placing lavender oil in a vaporizer. (37)

For general psychological well-bei9ng, adding 3 mL of a mixture of lavender oil 20% and grapeseed oil

80% in bath water has been used.(39)

Specific References: LAVENDER

31. FDA. Center for Food Safety and Applied Nutrition, Office of Premarket Approval, EAFUS: A food additive database. Available at: vm.cfsan.fda.gov/~dms/eafus.html.

32. Akhondzadeh S, Kashani L, Fotouhi A, et al. Comparison of Lavandula angustifolia Mill. tincture and imipramine in the treatment of mild tomoderate depression: a double-blind, randomized trial. Prog Neuropsychopharmacol Biol Psychiatry 2003;27:123-7

33. Hay IC, Jamieson M, Ormerod AD. Randomized trial

Also Known As:

Melissa

Scientific Name:

Melissa officinalis.

Family: Lamiaceae/Labiatae.

People Use This For:

Orally, lemon balm is used for anxiety, insomnia, dyssomnia, restlessness, dyspepsia, bloating, flatulence, colic, and for attention deficit-hyperactivity disorder (ADHD). Lemon balm is also used for Graves' disease (overactive thyroid), painful periods, cramps and headache. It is also used orally for Alzheimer's disease, melancholia, nervous palpitations, vomiting, and high blood pressure.

Topically, lemon balm is used for cold sores (herpes labialis).

Safety:

No concerns regarding safety when used orally in amounts commonly found in foods.

Possibly Safe when used orally or topically and appropriately, short-term. Lemon balm has been used with apparent safety for up to 4 months.^{76,77,78,79,80}

There is insufficient scientific information to comment about the safety of lemon balm when used long-term.

Children: Possibly Safe when used orally and appropriate, short-term. A specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 1-2 tablets once or twice daily has been safely used in children under age 12 years for about a month.⁸¹ Preliminary clinical research also suggests that a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (Colimil) is safe in infants when used for up to a week.⁸²

Pregnancy and Lactation: Refer to a Medical Herbalist

Effectiveness:

POSSIBLY EFFECTIVE

Alzheimer's disease. Taking a standardized extract of lemon balm orally, daily for 4 months, seems to reduce agitation and improve symptoms of mild to moderate Alzheimer's disease on standard Alzheimer's disease rating scales.⁷⁷

Colic. A clinical trial shows that breast-fed infants with colic who are given a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (Colimil) twice daily for a week have reduced crying times compared to placebo.⁸²

Dyspepsia. A specific combination product containing lemon balm (Iberogast, Medical Futures, Inc) seems to improve symptoms of dyspepsia. The combination includes lemon balm plus peppermint leaf, German chamomile, caraway, licorice, clown's mustard plant, celandine, angelica, and milk thistle.^{83, 80} A meta-analysis of studies using this combination product suggests that taking 1 mL orally three times daily over a period of 4 weeks significantly reduces severity of acid reflux, epigastric pain, cramping, nausea, and vomiting compared to placebo.⁸⁴

Herpes labialis (cold sores). Applying a lip balm containing 1% lemon balm extract seems to shorten healing time, prevent infection spread, and reduce symptoms of recurring cold sores.^76,79

Sleep. Taking a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) three times daily appears to improve the quality and quantity of sleep in healthy people.⁸⁵

INSUFFICIENT RELIABLE EVIDENCE to RATE

Restless Sleep. Preliminary evidence suggests that a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg 

(Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 1-2 tablets once or twice daily might decrease symptoms in children under age 12 years who have pathological restlessness.⁸¹ More evidence is needed to rate lemon balm for this use.

Mechanism of Action:

The applicable part of lemon balm is the leaf. Lemon balm seems to have sedative, antioxidant, and antiviral effects.^76,77,78,79 Lemon balm contains citronellal, neral, and geranial aldehydes; flavonoids and polyphenolic compounds; and monoterpene glycosides. These substances may contribute to the behavioral effects of lemon balm leaf and essential oil.⁷⁸ Clinical research suggests that lemon balm induces a calming effect and reduces alertness.⁷⁸

Adverse Reactions:

Orally, lemon balm is well tolerated. Rarely it may cause nausea, vomiting, abdominal pain, dizziness, and wheezing.⁷⁷

Topically, there is one report of irritation and one report of exacerbation of herpes symptoms when lemon balm was applied.⁷⁶

Interactions with Herbs & Supplements:

Additive effect with other nervine (relaxing) herbs.

Interactions with Drugs:

CNS Depressants: Theoretically, concomitant use of lemon balm with drugs with sedative properties may cause additive effects and side effects.⁷⁸

Interactions with Foods:

None reported

Interactions with Lab Tests:

None known.

Interactions with Diseases or Conditions:

Thyroid Disorders: In laboratory studies thyroid hormone release is affected by Lemonbalm. No reported clinical cases.

Glaucoma: Animal studies incicate there may be a problem. No reported clinical cases.

Surgery: Tell patients to discontinue lemon balm at least 2 weeks before elective surgical procedures.

Dosage/Administration:

Dr Clare’s Blends: 1 gm per day

Oral: For mild to moderate Alzheimer's disease, 60 drops per day of a standardized lemon balm extract, prepared 1:1 in 45% alcohol, has been used.⁷⁷

For improving sleep in healthy adults, a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 3 times daily has been used for up to 30 days.⁸⁵

For colic in infants, a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (Colimil) twice daily for a week has been used,⁸²

For dyspepsia, a specific combination product containing lemon balm (Iberogast, Medical Futures, Inc) and several other herbs has been used in a dose of 1 mL three times daily.^83,80,84

For dyssomnia in children, a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 1-2 tablets once or twice daily has been used.8¹

Topical: For herpes labialis (cold sores), the cream or ointment containing 1% of a 70:1 lyophilized aqueous extract is usually applied two to four times daily from first symptom to a few days after the lesions have healed.^76,79

Specific References: LEMON BALM

76.  Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine 1994;1:25-31.

77.  Akhondzadeh S, Noroozian M, Mohammadi M, et al. Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomised, placebo controlled trial. J Neurol Neurosurg Psychiatry 2003;74:863-6.

78.  Kennedy DO, Scholey AB, Tildesley NT, et al. Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). Pharmacol Biochem Behav 2002;72:953-64.

79.  Koytchev R, Alken RG, Dundarov S. Balm mint extract (Lo-701) for topical treatment of recurring herpes labialis. Phytomedicine 1999;6:225-30.

80.  Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69:45-52.

81.  Muller SF, Klement S. A combination of valerian and lemon balm is effective in the treatment of restlessness and dyssomnia in children. Phytomedicine 2006;13:383-7.

82.  Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res 2005;19:335-40.

83.  Holtmann G, Madisch A, Juergen H, et al. A double-blind, randomized, placebo-controlled trial on the effects of an herbal preparation in patients with functional dyspepsia [Abstract]. Ann Mtg Digestive Disease Week 1999 May.

84.  Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87.

85.  Cerny A, Shmid K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers (a double blind, placebo-controlled, multicentre study). Fitoterapia 1999;70:221-8.

Also Known As:

European Linden, Lime Flower, Lime Tree, Linden Charcoal, Tila,  

Scientific Name:

Tilia europaea, Tilia cordata.

Family: Malvaceae or Tiliaceae.

People Use This For:

Linden flower and flower bract is used for colds, nasal congestion, throat irritation, palpitations, hypertension, headaches, insomnia, sinus headache, migraine headache, incontinence, hemorrhage, arteriosclerotic hypertension, fever, and nervous tension. It is also used to induce sweating, diuretic, antispasmodic, and as an expectorant for coughs. 

Safety:

No concerns regarding safety when used orally and appropriately.⁴³

Pregnancy and Lactation: Refer to a Medical Herbalist.

Effectiveness:

There is insufficient scientific information available to comment. 

Mechanism of Action:

The applicable parts of linden are the dried flower and flower bract.

Linden has antispasmodic, diaphoretic, diuretic, sedative, mild astringent, and antifungal activity.^44,45

In vitro, its antispasmodic activity is attributed to p-coumaric acid and the flavonoid constituents.⁴⁴ Diaphoretic effects are thought to be due to kaempferol, p-coumaric acid, and quercetin constituents.⁴⁵

The volatile oils, including citral, citronellal, citronellol, eugenol, and limonene, exert sedative and antispasmodic effects.^44,45

Adverse Reactions:

None known.

Interactions with Herbs & Supplements:

None known.

Interactions with Drugs:

Lithium

Interactions with Foods:

None known.

Interactions with Lab Tests:

None known.

Dosage/Administration:

Dr Clare’s Blends: Dose 455mgs per day. 1.5mls 1:3 Tincture.

Oral: Traditionally 1-2 cups of the tea has been used. Additionally, 2-4 mL of the tincture (1:5 in 45% alcohol), and 1-2 mL of the liquid extract (1:1 in 25% alcohol) is 1-2 mL has also been used.⁴⁴

Specific References: LINDEN

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

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

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

Also Known As:

Chinese Licorice. 

Scientific Name:

Glycyrrhiza glabra; 

Family: Fabaceae/Leguminosae.

People Use This For:

Licorice is used for stomach and duodenal ulcers, sore throat, bronchitis, gastritis, indigestion, colic, insufficiency of the adrenal cortex and cough. In combination with Panax ginseng and Bupleurum falcatum, licorice is used orally to help stimulate adrenal gland function, particularly in patients with a history of long-term corticosteroid use. As a component of the herbal formula, Shakuyaku-Kanzo-To, licorice is used to increase fertility in women with polycystic ovary syndrome. In combination with other herbs, licorice is used to treat prostate cancer and eczema.

Safety:

No concerns regarding safety when used orally in amounts commonly found in foods. 

Possibly Safe when used orally and appropriately for medicinal purposes in the short-term.^{23,24,25,26,29,32}

Long-term use increases the risk of side effects such as hypertension and low potassium³³ in susceptible people. 

Pregnancy and Lactation: Refer to a Medical Herbalist.

Effectiveness:

POSSIBLY EFFECTIVE

Dyspepsia. A specific combination product containing licorice (Iberogast, Medical Futures, Inc) seems to improve symptoms of dyspepsia. The combination includes licorice plus peppermint leaf, German chamomile, caraway, lemon balm, clown's mustard plant, celandine, angelica, and milk thistle.^30,27 A meta-analysis of studies using this combination product suggests that taking 140 mL orally three times daily over a period of 4-weeks significantly reduces severity of acid reflux, stomach pain, cramping, nausea, and vomiting compared to placebo.³¹

INSUFFICIENT SCIENTIFIC EVIDENCE to VERIFY:

Muscle cramps. Preliminary clinical research suggests taking a specific combination of licorice and peony may reduce muscle cramps in patients with hepatic cirrhosis or in patients undergoing hemodialysis.^34,35,36

Peptic ulcers. There is some evidence that deglycyrrhizinated licorice might accelerate the healing of peptic ulcers.^29,32

Weight loss. There is conflicting information about the use of licorice for weight loss. Licorice has been shown to reduce body fat, however accompanying fluid retention offsets any change in body weight.²⁶

More evidence is needed to rate licorice for these uses. 

Mechanism of Action:

The applicable part of licorice is the root. Licorice has antispasmodic, anti-inflammatory, laxative, and soothing properties.

Licorice appears to block metabolism of prostaglandins linked to inflammation, which suggests the possible beneficial effect on peptic ulcer. 

Cortisol promotes sodium and water retention and potassium excretion.^28,37,38,41Excessive licorice ingestion can therefore produce a syndrome of apparent excess of adrenal cortical hormones leading to increased urinary potassium loss and hypertension.^{42,43,44,45,46,39,40,41}

There is considerable variation in the amount of licorice needed to cause these effects, due in part to variation in the glycyrrhizic acid content of licorice preparations. There is also variation in people's response to licorice. Those with hypertension, heart disease, kidney disease, or a high salt intake are more sensitive to its effects.^47,37,40,41 Finally, case reports of adverse reactions to licorice do not always make it clear whether licorice intake is in grams of pure licorice, or grams of sweet licorice candy or salty licorice or another preparation.

The increases in blood pressure, and cortisol to cortisone ratio are proportional to the amount of glycyrrhizic acid ingested.³³

Licorice appears to have anti-estrogenic and estrogenic action. Preliminary research indicates that licorice does not stimulate the growth of estrogen dependent breast cancer cells.⁴⁸ However, the estrogenic effects of licorice might be concentration dependent. Glabridin, an isoflavone constituent of licorice, seems to have an estrogen receptor-dependent growth-promoting effect at low concentrations. At higher concentrations, it seems to have an estrogen receptor-independent antiproliferative effect.⁵¹  

Adverse Reactions:

Orally. excessive licorice ingestion can cause a problem with overproduction of adrenal cortex hormones.^{42,28,43,44,37,38,45,46,39,40,41,52,53} These effects are most likely to occur when 30 grams or more of licorice is consumed daily for several weeks.^{42,49,4438,46,39,50,41,53}  

Interactions with Herbs & Supplements:

Cardiac Glycoside-Containing Herbs: None commonly found in products in Ireland.

Stimulant Lasative Herbs: Excessive amounts can be an issue. 

Interactions with Drugs:

Antihypertensive Drugs: Refer to Medical Herbalist

Corticosteroids: Refer to Medical Herbalist

Digoxin: Refer to Medical Herbalist

Diuretic Drugs: Refer to Medical Herbalist.

Estrogens: Avoid high dosages and prolonged treatment.^{R1 pp.474}

Warfarin: (Coumadin)

Interactions with Foods:

Grapefruit Juice: Theoretically, grapefruit juice and its component naringenin might enhance the mineralocorticoid activities of licorice, by blocking the conversion of cortisol to cortisone.^54,55

Salt: A high salt diet can exacerbate adverse effects of licorice such as sodium and water retention and hypertension.⁴¹

Interactions with Lab Tests:

1407-Hydroxyprogesterone: Licorice can increase serum 1407-hydroxyprogesterone concentrations and test results in healthy volunteers who consume 7 grams of licorice per day.^56,57

Potassium: Excessive use of licorice can affect Potassium levels

Interactions with Diseases or Conditions:

Heart Disease: Refer to a Medical Herbalist.

Hormone Sensitive Cancers/Conditions: As above.

Hypertension: Advise patients with hypertension to avoid excessive amounts of licorice.^58,59

Kidney Insufficiency: Advise patients with severe renal insufficiency to avoid excessive amounts of licorice.⁶⁰

Surgery: discontinue licorice 2 weeks before elective surgical procedures.

Dosage/Administration:

Dr Clare’s Blends: has a recommended dose of 5mls per week i.e 140.4mls per day of 140:3 extract = ½ gram daily.

Oral: For dyspepsia, a specific combination product containing licorice (Iberogast, Medical Futures, Inc) and several other herbs has been used in a dose of 140 mL three times daily.^30,27,31 

2-6ml/day of 140:140 extract

6-1402ml/day of 140:3 extract

Dried Root 140-4gms per day. 

Dr Clare’s Comment:

The effect of liquorice on the Adrenal Glands is beneficial for most patients, however a small group of patients are sensitive to the effects on blood pressure. Under normal circumstances this would not be significant for short term low dose use. It can be monitored by taking blood pressure and many chemists have a blood pressure machine patients can check during treatment if you do not have resources to check the blood pressure.

Specific References: LICORICE

23. Abe Y, Ueda T, Kato T, Kohli Y. [Effectiveness of interferon, glycyrrhizin combination therapy in patients with chronic hepatitis C]. [Article in Japanese]. Nippon Rinsho 140994;52:14081407-22.

24. Acharya SK, Dasarathy S, Tandon A, et al. A preliminary open trial on interferon stimulator (SNMC) derived from Glycyrrhiza glabra in the treatment of subacute hepatic failure. Indian J Med Res 140993;98:69-74.

25. Zhang XH, Lowe D, Giles P, et al. Gender may affect the action of garlic oil on plasma cholesterol and glucose levels of normal subjects. J Nutr 200140;1403140:14047140-8.

26. Armanini D, De Palo CB, Mattarello MJ, et al. Effect of licorice on reduction of body fat mass in healthy subjects. J Endocrinol Invest 2003;26:646-50.

27. Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69:45-52.

28. Hussain RM. The sweet cake that reaches parts other cakes can't! Postgrad Med J 2003;79:1401405-6.

29. Turpie AG, Runcie J, Thomson TJ. Clinical trial of deglydyrrhizinized liquorice in gastric ulcer. Gut 140969;1400:299-302.

30. Holtmann G, Madisch A, Juergen H, et al. A double-blind, randomized, placebo-controlled trial on the effects of an herbal preparation in patients with functional dyspepsia [Abstract]. Ann Mtg Digestive Disease Week 140999 May.

31. Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:140279-87.

32. Tewari SN, Wilson AK. Deglycyrrhizinated liquorice in duodenal ulcer. Practitioner 140973;21400:820-3.

33. Sigurjonsdottir HA, Franzson L, Manhem K, et al. Liquorice-induced rise in blood pressure: a linear dose-response relationship. J Hum Hypertens 200140;1405:549-52.

34. Kumada T, et al. Effect of Shakuyaku-kanzo-to (Tsumura TJ-68) on muscle cramps accompanying cirrhosis in a placebo-controlled double-blind parallel study. J Clin Ther Med 140999;1405:499-523.

35. Hyodo T, Taira T, Kumakura M, et al. The immediate effect of Shakuyaku-kanzo-to, traditional Japanese herbal medicine, for muscular cramps during maintenance hemodialysis. Nephron 2002;90:240

36. Hinoshita F, Ogura Y, Suzuki Y, et al. Effect of orally administered shao-yao-gan-cao-tang (Shakuyaku-kanzo-to) on muscle cramps in maintenance hemodialysis patients: a preliminary study. Am J Chin Med 2003;3140:445-53.

37. Elinav E, Chajek-Shaul T. Licorice consumption causing severe hypokalemic paralysis. Mayo Clin Proc 2003;78:767-8.

38. Eriksson JW, Carlberg B, Hillom V. Life-threatening ventricular tachycardia due to liquorice-induced hypokalemia. J Intern Med 140999;245:307-1400.

39. van den Bosch AE, van der Klooster JM, Zuidgeest DM, et al. Severe hypokalemic paralysis and rhabdomyolysis due to ingestion of liquorice. Neth J Med 2005;63:14046-8.

40. van Uum SH. Liquorice and hypertension. Neth J Med 2005;63:1401409-20.

41. Stormer FC, Reistad R, Alexander J. Glycyrrhizic acid in liquorice - evaluation of health hazard. Food Chem Toxicol 140993;3140:303-1402.

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