HERBAL SUPPLEMENTS

1. BLACK COHOSH: it has been promoted for the treatment of post-menopausal symptoms. it causes hypotension, adverse estrogenic effects, and hepatotoxicity.

2. LICORICE: it contains glycyrrhenetic acid, which inhibits the conversion of cortisol to cortisone. it is used for viral infections/ bronchitis, and stomach ulcer.

3. Ginkgo biloba: it has been marketed as an anti-oxidant, used for memory enhancement. it is also used in dementia, macular degeneration, and peripheral vascular disease. Adverse effects include increased bleeding, especially in people taking aspirin.

4. Ginseng: it is also used for memory enhancement. Side effects include increased bleeding.

5. saw palmetto: it is used for the treatment of Benign prostate hyperplasia. Its adverse effects include mild stomach discomfort and increased bleeding risk

6. St John wort: It has been marketed for use in mild to moderate depression and insomnia. it is also used as an anti-inflammatory and wound healing. Its adverse effects include hypertensive crisis. It also causes significant drug interactions with anti-depressants (serotonin syndrome), and anticoagulants (increased bleeding). It also interacts with digoxin. it causes enzyme induction of OCP, antiretrovirals, immunosuppressants, narcotics, and antifungals.

7. KAVA: it is used for anxiety and insomnia.

               adverse effect: hepatotoxicity

8. Echinacea: It is used for the prevention and treatment of cold and flu. It has a tendency to cause anaphylaxis, especially in asthmatics.

9. Ephedra: Its use includes: a) treatment and prevention of cold and flu

                                            b) improving athletic performance

                                           c) for weight loss

Side effects of ephedra: hypertension, arrhythmia, MI, sudden death, stroke, seizure

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