Dr Clare Materia Medica

Also Known As:

Easter Flower. 

Scientific Name:

Anemone pulsatilla.

Family: Ranunculacaeae.

People Use This For:

Pulsatilla is used for painful conditions of the male or female reproductive system, such as painful periods. Pulsatilla is also used for tension headache, hyperactive states, insomnia, migraines, neuralgia, general restlessness, diseases and functional disorders of the gastrointestinal GI and urinary tract.

Safety:

There are no information scientific studies available.

Pregnancy and Lactation: Refer to a Medical Herbalist.

Effectiveness:

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

Mechanism of Action:

The applicable parts of pulsatilla are the above ground parts. Pulsatilla has analgesic, antispasmodic, sedative, and antibacterial properties. It exhibits both uterine stimulant and depressant activities. Pulsatilla contains ranunculin. Ranunculin hydrolyzes to a toxic unstable compound called protoanemonin, which readily dimerizes to nontoxic anemonin.⁸⁴ Protoanemonin causes central nervous system (CNS) stimulation, then paralysis in experimental animals. It also has antimicrobial activity.⁸⁵ Both anemonin and protoanemonin show some evidence of sedative and antipyretic activity.⁸⁴ Irritation of the kidney and urinary tract might be due to the alkylating action of protoanemonin.⁸⁵ Some evidence suggests anemonin might be cytotoxic.⁸⁴ 

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:

Dr Clare’s Blends: 1 gm/day.

Oral: A typical oral dose is 120-300 mg dried above ground parts three times daily. Alternatively one cup tea consumed three times daily. To make tea, steep or simmer 120-300 mg dried above ground parts in 150 mL water 5-10 minutes, strain,⁸⁴ 0.12-0.3 mL of the liquid extract, 1:1 in 25% alcohol, has been used three times daily.⁸⁴ 0.3-1 mL of the tincture, 1:10 in 40% alcohol, has been used three times daily.⁸⁴

Topical: No typical dosage. 

Specific References: PULSATILLA

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

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

Also Known As:

Pasiflora, Passiflorae Herba.

Scientific Name:

Passiflora incarnata.

Family: Passifloraceae. 

People Use This For:

Passionflower is used for insomnia, gastrointestinal upset related to anxiety or nervousness, generalized anxiety disorder. Passionflower is also used orally for neuralgia, generalized seizures, spasmodic asthma, menopausal symptoms, attention deficit-hyperactivity disorder , nervousness and excitability, palpitations, heart rhythm abnormalities, high blood pressure, fibromyalgia, and pain relief.

In foods and beverages, passionflower extract is used as a flavoring.

Safety:

No concerns regarding safety when used orally in amounts commonly found in foods. Passionflower has Generally Recognized As Safe status (GRAS) for use in foods in the US.⁴⁶ 

No concerns regarding safety when used orally and appropriately, short-term for medicinal purposes. There is evidence that passionflower liquid extracts can be safely used for up to one month.^47,48,49 

Pregnancy and Lactation: Refer to a Medical Herbalist. 

Effectiveness:       

POSSIBLY EFFECTIVE

Adjustment disorder with anxious mood. A specific combination product (Euphytose, EUP) that includes passionflower seems to decrease some symptoms of adjustment disorder with anxious mood. However, it's not known which ingredient or ingredients are responsible for the beneficial effects. Other herbs in the product are crataegus, ballota, and valerian, which have mild sedative effects, and cola and paullinia with stimulant properties.⁵⁰

Anxiety. There is some evidence that passionflower can reduce symptoms of anxiety.⁵¹ Some research shows that a liquid extract 45 drops daily is comparable to oxazepam (Serax) 30 mg for treating symptoms of GAD in some patients.⁴⁹ Additional research shows that a different passionflower extract 90 mg/day reduces symptoms of non-specific anxiety comparable to mexazolam.⁵²

Opiate withdrawal. Passionflower liquid extract 60 drops, in combination with clonidine 0.8 mg daily, seems to be significantly better than clonidine alone when used for reducing symptoms such as anxiety, irritability, insomnia, and agitation. However, the combination is no better than clonidine alone for physical symptoms such as tremor and nausea.⁴⁸ 

Mechanism of Action:

The applicable parts of passionflower are the above ground parts. Passionflower contains several active constituents including a range of flavonoids. The harman (harmala) alkaloids identified in passionflower include harmine, harmaline, harmalol, harman, and harmin.^53,54,55 Other constituents include maltol and ethyl maltol.⁵⁵ 

Passionflower has sedative, hypnotic, anxiolytic, analgesic, and antispasmodic effects.^53,54

Some evidence suggests the passionflower constituent apigenin binds to central benzodiazepine receptors,⁵⁶ possibly causing anxiolytic effects without impairing memory or motor skills.⁵⁶ 

Other evidence suggests passionflower extracts might reduce amphetamine-induced hypermotility, aggressiveness, and restlessness; and raise the pain threshold.^57,58,59

Adverse Reactions:

Passionflower is generally well tolerated with few side effects.^R2pp.329Uncommonly Passionflower may cause dizziness, confusion, sedation, and unsteady gait.^49,52,51 There are 2 case reports of possible severe side effects with Passiflora in the literature.

Interactions with Herbs & Supplements:

Herbs and Supplements with Sedative Properties: May enhance the effectiveness.

Interactions with Drugs:

CNS Depressants: May enhance the effectiveness. Refer to a Medical Herbalist or other Medical Adviser. 

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: The average amount of passionflower is 4-8 grams per day. 

References: monograph: PASSIONFLOWER

46.  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.

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

48        Akhondzadeh S, Kashani L, Mobaseri M, et al. Passionflower in the treatment of opiates withdrawal: a double-blind randomized controlled trial. J Clin Pharm Ther 2001;25:369-73.

49.  Akhondzadeh S, Naghavi HR, Shayeganpour A, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther 2001;26:363-7.

50.  Bourin M, Bougerol T, Guitton B, Broutin E. A combination of plant extracts in the treatment of outpatients with adjustment disorder with anxious mood: controlled study vs placebo. Fundam Clin Pharmacol 1997;11:127-32.

51.  Miyasaka LS, Atallah AN, Soares BG. Passiflora for anxiety disorder. Cochrane Database Syst Rev 2007;(1):CD004518.

52.  Mori A, Hasegawa K, Murasaki M, et al. Clinical evaluation of Passiflamin (passiflora extract) on neurosis - multicenter double blind study in comparison with mexazolam. Rinsho Hyoka Clinical Evaluation) 1993;21:383-440.

53.  Dhawan K, Kumar S, Sharma A. Anxiolytic activity of aerial and underground parts of Passiflora incarnata. Fitoterapia 2001;72:922-6.

54.  Dhawan K, Kumar S, Sharma A. Anti-anxiety studies on extracts of Passiflora incarnata Linneaus. J Ethnopharmacol 2001;78:165-70.

55.  Aoyagi N, Kimura R, Murata T. Studies on passiflora incarnata dry extract. I. Isolation of maltol and pharmacological action of maltol and ethyl maltol. Chem Pharm Bull 1974;22:1008-13.

56.  Salgueiro JB, Ardenghi P, Dias M, et al. Anxiolytic natural and synthetic flavonoid ligands of the central benzodiazepine receptor have no effect on memory tasks in rats. Pharmacol Biochem Behav 1997;58:887-91.

57.  Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.

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

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

Also known as: Black Peppermint, Herba Menthae, Lamb Mint, Mentha Piperita.

Scientific name: Mentha piperita.

Botanical family: Lamiaceae/Labiatae.

Part used: Leaves and stems.

Traditional use.

Peppermint is used for the common cold, cough, inflammation of the mouth and throat, sinusitis, runny nose, fever, liver and gallbladder complaints, irritable bowel syndrome, cramps of the upper gastrointestinal tract and bile ducts, dyspepsia, fever, flatulence, and for tension headache. It is also used for nausea, vomiting, morning sickness, respiratory infections, painful periods, diarrhea, small intestinal bacterial overgrowth, and as a stimulant.

Inhaled peppermint oil is used for symptomatic treatment of cough and colds.

Peppermint oil is used directly on the skin as an analgesic for pain.

Peppermint is a common flavoring agent in foods and beverages.

Peppermint oil is used as a fragrance component in soaps and cosmetics, and as a flavoring agent in pharmaceuticals.

Safety.

There are no concerns regarding safety when used in amounts commonly found in foods. Peppermint has Generally Recognized as Safe (GRAS) status in the US.¹

There are no concerns regarding safety when used in medicinal amounts in children 8 years of age and older.

Traditionally catmint is used for children as it is less stimulant than peppermint e.g. Dr Clare’s Childrens Tea Blend.

Pregnancy: No concerns regarding safety when used orally in amounts commonly found in foods. Peppermint has Generally Recognized as Safe (GRAS) status in the US.¹

Breastfeeding: as for pregnancy.

Constituents.

Essential oils, containing menthol, menthone and menthyl acetate. Trace constituents include alpha-pinene, sabinene, terpinolene, ocimene, gamma-terpinene, fenchene, alpha- and beta-thujone, citronellol, and other compounds.^2,3

Flavonoids; rutin, menthoside, luteolinand rutinosides

Phenolic acids and lactones; rosmarinic acid,  and others.

Miscellaneous; azulenes, choline, carotenes etc

Scientific evidence.

No clinical studies have been done.

Mechanism of action.

Activity is primarily, but not exclusively, due to the actions of the essential oils, from which a direct action on smooth muscle organs cause a stronger anti-spasmodic effect than some of its individual components. The antispasmodic effect has been confirmed on the small intestines of guinea pigs.⁸

Peppermint tea brings about a considerable increases in the production of bile. This activity has been confirmed in animal experiments with dogs. ⁹

The antispasmodic effect of peppermint oil is used internally for irritable bowel syndrome⁴ e.g. the medication colpermin which is derived from peppermint oil. This appears to result from direct relaxing effects on the gastrointestinal tract smooth muscle, characteristic of calcium antagonist action. Be careful with the oral use of any essential oils as they have very powerful effects. The oils have very concentrated constituents. Seek professional advice.

For pain in myalgias (muscle pain) and neuralgias (nerve pain), menthol in topical peppermint oil is thought to have a direct inhibitory effect on the sensitized pain receptors. Menthol might also act on the central nervous system to alter pain perception.⁵

Preliminary research suggests that luteolin-7-O-rutinoside from peppermint leaf can inhibit histamine release.² Laboratory models of allergic rhinitis (runny nose) suggest that peppermint leaf extract might relieve nasal symptoms.⁶

A mild sedative action has been confirmed in animal experiments in mice.¹⁰

Adverse Reactions:

Topically; peppermint oil can cause skin irritation and contact dermatitis.⁵  Always patch test on normal skin before use.

Contact sensitivity in the mouth has been reported.⁷

Interactions with herbs and supplements.

None known.

Interactions with Drugs.

avoid internal use of peppermint oil with Cyclosporine (Neoral, Sandimmune), which is an immune suppressant:

None known.

Dosage.

Recommended dose: 2-7mls per day 1:5 tincture 30% alcohol.

Infusion: range from 3-6 tsps. per day.

Powder/capsule: range from 2-4 gms per day.

Liquid extract: 2-4ml/day.

Dr Clare’s Joint Cleansing Tea provides ½ tsp. per day of peppermint.

References.

1.  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.

2.  Inoue T, Sugimoto Y, Masuda H, Kamei C. Antiallergic effect of flavonoid glycosides obtained from Mentha piperita L. Biol Pharm Bull 2002;25:256-9.

3.  Nair B. Final report on the safety assessment of Mentha Piperita (Peppermint) Oil, Mentha Piperita (Peppermint) Leaf Extract, Mentha Piperita (Peppermint) Leaf, and Mentha Piperita (Peppermint) Leaf Water. Int J Toxicol 2001;20:61-73.

4.  Storr M, Sibaev A, Weiser D, et al. Herbal extracts modulate the amplitude and frequency of slow waves in circular smooth muscle of mouse small intestine. Digestion 2004;70:257-63

5.  Davies SJ, Harding LM, Baranowski AP. A novel treatment of postherpetic neuralgia using peppermint oil.

Clin J Pain 2002;18:200-2.

6.  Inoue T, Sugimoto Y, Masuda H, Kamei C. Effects of peppermint (Mentha piperita L.) extracts on experimental allergic rhinitis in rats. Biol Pharm Bull 2001;24:92-5.

7.  Morton CA, Garioch J, Todd P, et al. Contact sensitivity to menthol and peppermint in patients with intra-oral symptoms. Contact Dermatitis 1995;32:281-4.

8. Forster HB, Niklas H, Lutz S. Planta Med 40, 309-319 (1980).

9. Della Loggia R, Tibaro A, Lunder TL. Fitoterapia 61, 215-221 (1990).

10. Miething H, Holz W. Pharm. Ztg. 133. 16-17. (1988)

Also Known As:

Brown Psyllium, Dietary Fiber, Fibre Alimentaire, Fleaseed, Fleawort, French Psyllium, Graine de Psyllium, Herbe aux Puces, Œil-de-Chien, Plantain, Plantain Pucier, Psyllion, Psyllios, Psyllium, Psyllium Brun, Psyllium d'Espagne, Psyllium Noir, Psyllium Seed, Pucière, Pucilaire, Spanish Psyllium, Zaragatona.
CAUTION: See separate listings for Blond Psyllium, Buckhorn Plantain, Great Plantain, and Water Plantain.

Scientific Name:

Plantago psyllium, synonym Psyllium afra; Psyllium indica, synonym Psyllium arenaria.
Family: Plantaginaceae.

People Use This For:

Orally, black psyllium is used for chronic constipation and for softening stools in conditions such as hemorrhoids, anal fissures, anorectal surgery, and pregnancy. It is also used orally for diarrhea, irritable bowel syndrome (IBS), reducing elevated cholesterol, dysentery, and treating cancer.

Safety:

LIKELY SAFE...when used orally with appropriate fluid intake (3,6,8).
LIKELY UNSAFE ...when used orally without adequate fluid intake because it can cause esophageal obstruction (2,3,7). ...when the seeds of non-commercial preparations of black psyllium are chewed, crushed, or ground because they release a pigment that deposits in renal tubules (5) and can be nephrotoxic (6). This pigment has been removed from most commercial products (6).
PREGNANCY AND LACTATION: LIKELY SAFE ...when used orally with appropriate fluid intake (8).

Effectiveness:

Constipation. Taking black psyllium orally works as a bulk laxative and reduces constipation (8).

POSSIBLY EFFECTIVE

Hypercholesterolemia. Taking black psyllium orally seems to reduce total and LDL cholesterol, and the LDL:HDL ratio (4,5).
There is insufficient reliable information available about the effectiveness of black psyllium for its other uses.

Mechanism of Action:

The applicable part of black psyllium is the seed. Its constituents are not absorbed and have no systemic effects (1). Black psyllium seed forms a mucilaginous mass when mixed with water and has a bulk laxative effect (1,3,4). In people with diarrhea, the mucilage absorbs water, provides mass, and prolongs gastrointestinal transit (1,4). In individuals with constipation, the mucilage absorbs water, swells, and stimulates peristalsis, reducing gastrointestinal transit time (1,3,4). Black psyllium can decrease abdominal pain in people with irritable bowel syndrome (IBS) by reducing rectosigmoidal pressure (9). Psyllium reduces peak blood glucose levels by slowing carbohydrate absorption (1,4) and can decrease cholesterol by absorbing dietary fats in the gastrointestinal tract, thereby preventing systemic absorption. It can also increase cholesterol elimination in the fecal bile acids (1,4,5,6). Chewing or crushing the seeds can release a pigment that deposits in renal tubules (5) and can be nephrotoxic (4). This pigment is removed from most commercial products (4).

Adverse Reactions:

Orally, black psyllium can cause transient flatulence and abdominal distention (3). When consumed without water, it can cause esophageal (3) and bowel obstruction (3,12). Chewing or crushing the seeds can release a pigment that deposits in the renal tubules (5) and can be nephrotoxic (4). This pigment is removed from most commercial products (4). Allergic reactions to black psyllium include allergic rhinitis, conjunctivitis, urticaria, and asthma (7).
Occupational exposure to black psyllium can cause sensitization, of which symptoms include sneezing, watery eyes, chest congestion, and anaphylactoid reaction (4).

Interactions with Herbs & Supplements:

None known.

Interactions with Drugs:

ANTIDIABETES DRUGS <<interacts with>> BLACK PSYLLIUM

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = B

Black psyllium can reduce blood glucose levels in patients with type 2 diabetes (22) and might have additive effects on glucose levels when used with antidiabetes drugs. Monitor blood glucose levels closely. Medication dose adjustments may be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (Diabeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.

CARBAMAZEPINE (Tegretol) <<interacts with>> BLACK PSYLLIUM

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Probable • Level of Evidence = D

Black psyllium can reduce carbamazepine absorption (10).

DIGOXIN (Lanoxin) <<interacts with>> BLACK PSYLLIUM

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Probable • Level of Evidence = D

Concomitant use might reduce digoxin absorption (1), requiring dose adjustment (6).

LITHIUM <<interacts with>> BLACK PSYLLIUM

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Probable • Level of Evidence = D

Black psyllium use can reduce serum lithium levels (11). The fiber in lithium might decrease the absorption of lithium. 

Interactions with Foods:

NUTRIENT ABSORPTION: The long-term use of black psyllium with meals can reduce nutrient absorption requiring vitamin or mineral supplementation (6). 

Interactions with Lab Tests:

BLOOD GLUCOSE: Theoretically, black psyllium might lower postprandial blood glucose levels and test results (1,4,13).
SERUM CHOLESTEROL: Black psyllium can lower total cholesterol and LDL cholesterol levels, LDL:HDL ratio, and test results (1,4,13).

Interactions with Diseases or Conditions:

DIABETES: Black psyllium can lower blood glucose levels in people with type 2 diabetes by retarding carbohydrate absorption (13,17). Monitor blood glucose levels closely. Doses of conventional antidiabetes medications may require adjustment. Also, warn patients with diabetes that some commercial blond psyllium products can contain added sugars and other absorbable carbohydrates which might increase blood glucose levels.

GI CONDITIONS: Black psyllium is contraindicated in people with fecal impaction, GI atony (1), GI tract narrowing, and obstruction or conditions that can lead to obstruction, such as spastic bowel (1,2,3,6,7).
HYPERSENSITIVITY: Some patients can have severe hypersensitivity reactions to black psyllium. This is more likely to occur in patients with previous occupation exposure to black psyllium (14,15,16,18,21). Blond psyllium is contraindicated in these patients.
PHENYLKETONURIA: Avoid products containing aspartame (Nutrasweet) (8).
SURGERY: Black psyllium might affect blood glucose levels. Theoretically, black psyllium might interfere with blood glucose control during and after surgical procedures. Tell patients to discontinue black psyllium at least 2 weeks before elective surgical procedures.
SWALLOWING DISORDERS: Patients with swallowing disorders might be at greater risk for esophageal obstruction when using blond psyllium. Blond psyllium is contraindicated in these patients (19,20).

Dosage/Administration:

ORAL: As a laxative, the typical dose of black psyllium seed is 10-30 grams per day (2,7), in divided amounts. Mix 10 grams seed in 100 mL water, to be followed by at least 200 mL water (7). Avoid chewing or crushing the seeds which can release a pigment that deposits in renal tubules (5). Adequate fluid intake is necessary and should be at least 150 mL water for each 5 grams of drug. The FDA labeling recommends at least 8 ounces (a full glass) of water or other fluid with each dose. Taking this product without enough liquid can cause choking (6). Black psyllium should be taken 30-60 minutes after a meal or the administration of other drugs (8). 

Editor's Comments:

Black psyllium is an aggressive-growing, perennial weed found throughout the world. The plant was spread with the colonization of the New World and was nicknamed "Englishman's foot" by the North American Indians.
The FDA requires that psyllium be labeled: "WARNING: Taking this product without adequate fluid may cause it to swell and block your throat or esophagus and may cause choking. Do not take this product if you have difficulty in swallowing. If you experience chest pain, vomiting, or difficulty in swallowing or breathing after taking this product, seek immediate medical attention" (6).

Specific References: Plantain

1          Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.

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

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

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

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

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

7          Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

8          Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.

9          Cook IJ, Irvine EJ, Campbell D, et al. Effect of dietary fiber on rectosigmoid motility in patients with irritable bowel syndrome: A controlled, crossover study. Gastroenterology 1990;98:66-72. 

10       Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.

11        Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416. 

12        Agha FP, Nostrant TT, Fiddian-Green RG. Giant colonic bezoar: a medication bezoar due to psyllium seed husks. Am J Gastroenterol 1984;79:319-21. 

13       Anderson JW, Allgood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999;70:466-73.

14      Suhonen R, Kantola I, Bjorksten F. Anaphylactic shock due to ingestion of psyllium laxative. Allergy 1983;38:363-5.

15 Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8.

16 Freeman GL. Psyllium hypersensitivity. Ann Allergy 1994;73:490-2. 

17 Wolever TM, Vuksan V, Eshuis H, et al. Effect of method of administration of psyllium on glycemic response and carbohydrate digestibility. J Am Coll Nutr 1991;10:364-71.

18 Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6.

19 Schneider RP. Perdiem causes esophageal impaction and bezoars. South Med J 1989;82:1449-50. 

20 Shulman LM, Minagar A, Weiner WJ. Perdiem causing esophageal obstruction in Parkinson's disease. Neurology 1999;52:670-1. 

21 Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3.

22 Frati Munari AC, Benitez Pinto W, Raul Ariza Andraca C, Casarrubias M. Lowering glycemic index of food by acarbose and Plantago psyllium mucilage. Arch Med Res 1998;29:137-41.

Also known as: Angelica Tree, Northern Prickly Ash, Toothache Bark, Xanthoxylum, Yellow Wood, Zanthoxylum.

Scientific name: Zanthoxylum americanum.

Botanical Family: Rutaceae.

Parts used: Bark.

Traditional use.

Northern prickly ash is used for muscle cramps, Raynaud's syndrome, chronic rheumatic conditions, poor peripheral circulation associated with rheumatic symptoms, intermittent claudication, leg ulcers associated with poor circulation, inflammation, as a stimulant tonic, for toothache, and as a sweating promoter in fever. 

Safety.

There are no concerns regarding safety when the bark is used appropriately in medicinal amounts.¹

Pregnancy: Consult a medical herbalist.

Breastfeeding: Consult a medical herbalist.

Constituents.

Isoquinolone alkaloids; alpha fagarine, beta fagarine, magnoflorine, laurifoline, nitidine, chelerythrine, tambatarine and candicine.

Coumarins; including xanthyletin, xanthoxyletin, xanthotoxin, alloxanthyletin, isoorientin, cnidilin, dipetalin, psorelan and imperatorin.

Lignans; sesamin and asarinin.

Resin, acid volatile oil, and tannins, which may be pharmacologically active. 

Clinical evidence.

There are no clinical trials.

Mechanism of action.

There is woefully little research about the possible mechanism of action and active ingredients for this medicinal herb despite widespread use in many countries.

Chelerythrine is antimicrobial.

Zanthoxylum americanum demonstrates antifungal activity.³

Furanocoumarins found in berries of Zanthoxylum americanum (for example psoralen.) have demonstrated cytotoxic activity against human tumor cells.⁴

Adverse reactions.

None reported.

Interactions with drugs.

None reported. 

Interactions with foods.

None known. 

Interactions with laboratory tests.

None known. 

Interactions with diseases or conditions.

Gastrointestinal conditions. May increase stomach acid.

None known.

Dosage.

Recommended dose: 1.5-5 mls per day 1:5 tincture 45% alcohol.

Decoction: I tsp. per day.

Raw bark: 1-3 grams three times daily; 

The recommended dose of Dr Clare’s Joint Support Blend provides 3mls per day of 1:3 Tincture in 15mls daily, at a dose of 5mls three times a day.

This is equivalent to 375-750mgs per day. 

References:

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

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

3. Bafi-Yeboa, N. F. A., Arnason, J. T., Baker, J., Smith, M.L. (2005). Antifungal constituents of Northern prickly ash, Zanthoxylum americanum Mill. Phytomedicine, 28, 370-377.

4. Saquib, Q. N., Hui, Y.-H., Anderson, J. E., Mclaughlin, J. L. (1990). Bioactive Furanocoumarins from the Berries of Zanthoxylum americanum. Phytotherapy Research, 4, 216-219. ISSN: 1099-1573.