Herbs, supplements and HIV

Akebia trifoliata caulis (Mu Tong)

Kidney toxicity, kidney failure. This herb contains aristolochic acid. In 2001 the FDA classified it as a Class 1 toxic substance and product recalls were started.

Aloe Vera (Carrisyn)

Severe diarrhea without proper preparation, must be processed properly. Refrain from ingesting aloe vera plant directly, or use proper preparations. 1,2

Apple seeds

May cause cyanide poisoning and death if consumed in large quantities. 3

Apricot Seeds

May cause cyanide poisoning (possibly death) if consumed in large quantities. 3

Asarum sieboldii herba cum Radix (Xi Xin)

Kidney toxicity, kidney failure. This herb contains aristolochic acid. In 2001 the FDA classified it as a Class 1 toxic substance and product recalls were started.

Astragalus (Huang-chi)

Low blood pressure, low blood sugar and increased urine production. May result in dizziness and fatigue. 1,2

Atractylodes (Bai-zhu, Pai-chu)

Liver toxicity, sedation, dehydration (diuretic), low blood sugar. 1,2

Bitter almond seeds

May cause cyanide poisoning (possibly death) if consumed in very large quantities. 3

Black Tree Fungus

Can inhibit blood clotting and trigger hemorrhagic syndrome. 1

Borage (Borago officinalis)

Liver toxicity.

Buckthorn Bark (Rhamnus)

Increased bowel movements, diarrhea 3

Burdock (Arctium lappa)

Neurologic effects, blurred vision, dry mouth, constipation, bizarre behavior and speech (including hallucinations), increased urine (diuretic), low blood sugar and may impact estrogen activity. 2,3

Calamus

Kidney toxicity

Cassava beans

May cause cyanide poisoning and death if consumed in large quantities. 3

Chamomile

Belongs to ragweed family. People with allergies to ragweeds may experience allergic symptoms to chamomile. 1

Chaparrel (Larrea divericata, Larrea tidentata, Creosote bush)

Nausea, vomiting, diarrhea, cramps, skin irritation, mouth sores and may promote tumor growth. The FDA issued a health warning in 1992 and many companies’ voluntary removed chaparrel from their products or recalled products containing chaparrel. Some may still exist on the market, however. 2

Cherry pits

May cause cyanide poisoning and death if consumed in large quantities. 3

Choke cherry pits

May cause cyanide poisoning and death if consumed in large quantities. 3

Coconoosis (Codonopsis pilosula, Tang-shen)

Low blood pressure 2

Coltsfoot

Liver toxicity, light sensitivity

Comfrey [Symphytum officionale (common comfrey), S. asperum (prickley comfrey), and S. x uplandicum (Russian comfrey)]

Liver toxicity: Vaso-occlusive disease, fatal liver intoxification. In 2001 the FDA’s Center for Food Safety and Applied Nutrition sent letters to dietary supplement manufacturers advising that comfrey be removed from all nutritional health products due to potentially serious and life-threatening consequences of comfrey ingestion. 2,5

Compound Q (Trichosanthes, Guaiougen, GLQ223, Chinese cucumber root)

Severe neurologic side effects (ranging from dizziness to coma) at very high doses, low blood sugar, induces abortion. 2

Dandelion (Taraxacum)

Excessive gas, nausea and vomiting; skin rashes, allergic reaction; increased urination (diuretic). Diuretic effect is likely no more than what is seen with coffee. 2,3

Devil’s Claw Root (Hapagophytum procumbens)

Induces abortion 3

Dock Roots

Increased bowel movements, diarrhea 3

Echinacea

Skin rash and insomnia. Allergic reaction. May aggravate auto-immune disorders (like lupus). 1,2

Ephedra

Heart failure, stroke, increased blood pressure

Ganoderma (Ling-zhi, reishi)

Can inhibit blood clotting and trigger hemorrhagic syndrome. 1,2

Garlic (Allium sativum, Dasuan)

Can inhibit blood clotting and interfere with thyroid function. Diarrhea, vomiting, nausea, weight loss, loss of appetite and skin rashes have been reported. 1,2

Germander

Inflammation of the liver (hepatitis), liver injury and death. Early symptoms appear to resolve after stopping the herb. Re-starting herb appears to result in immediate return of the problem. The risk or degree of liver injury is not apparently associated with dose or duration of use. 5

Ginseng (Wuchaseng, Siberian, wjuia, ren-shen)

Ginseng is touted the “most abused” or “mis-used” herb. Ginseng Abuse Syndrome (GAS) is associated with its long-term use. Various forms exist. Panax and Eleutherococcus ginsengs produce morning diarrhea, insomnia, nervousness, depression, confusion, skin rashes and high blood pressure. Ginsengs are known to increase effects of some anti-depressants called Monoamine Oxidase Inhibitors (MOIs). Women may experience breast swelling or tenderness and changes in menstrual cycle (amenorrhea) due to impact on estrogen. 1,2,3,4

Horsetail (Equisetum arvense)

Excitement, loss of appetite and muscle control, diarrhea, labored breath, convulsion, coma and death. 3

Hypericin (St. John’s Wort)

May induce sensitivity to light (photosensitivity), resulting in severe rash following sun exposure. May also have interactions with some anti-depressants called Monoamine Oxidase Inhibitors (MOIs). In 2000, the FDA issued a warning about this herb and its interactions with anti-HIV drugs. 1,2,3

Isatis (Pan-lan-ken, dyers’ wood root)

Can inhibit blood clotting. 2

Iscador (Mistletoe)

Liver toxicity, seizures, shock, heart failure 2,3

Juniper Berry

Stomach upset 3

Kava (Piper methysticum)

Liver-related injuries including hepatitis, cirrhosis and liver failure. In at least eight cases liver failure resulting in liver transplantation was required and death has been reported in three. In 2002 the FDA issued a warning noting that while liver-related injury associated with kava use is low, consumers should be warned of risks. Further, those with liver disease or taking other drugs that affect the liver should be especially careful.

Kelp (Laminara japonica, Kombu)

Interferes with thyroid function. Goiters 2

Licorice

High blood pressure, water retention and even serious heart problems 1,2,3

Life root (Senecio aureo)

Veno-occlusive disease

Lobelia (Lobelia inflata)

Depending on the dose, lobeline can cause either autonomic nervous system stimulation or depression. At low doses, it produces bronchial dilation and increased respiratory rate. Higher doses result in respiratory depression, as well as sweating, rapid heart rate, hypotension, and even coma and death. As little as 50mg of dried herb or a single milliliter of lobelia tincture has caused these reactions. 5

Lycium Fruit (Kuo-chi-tzu, gouqizi, wolfberry, false jessamine)

Low blood sugar, mouth sores 2

Magnolia

Adverse effects were published in February 1993, of 48 women identified with serious kidney disease associated with the use of a Chinese diet herbal product containing this herb. Eighteen had terminal kidney failure that will require either kidney transplantation or life-long renal dialysis. 5

Nutmeg

Very high doses can cause altered mental status, liver damage and death. Fairly small amounts can cause headaches, cramps and nausea. 3

Pau d’Arco

Nausea, vomiting, weight loss and has been shown to inhibit blood clotting. 1,2

Peach pits

May cause cyanide poisoning (possibly death) if consumed in large quantities. 3

Pear seeds

May cause cyanide poisoning (possibly death) if consumed in large quantities. 3

Pennyroyal Oil (Hedeoma pulegiodes, Mentha pulegium)

Has been used to induce menstruation and induces abortion. Has caused death due to kidney and liver toxicity. 3

Peony (Paeonia, Moutan bark, chi-shao, bai-shoa, mudan-pi)

Stomach upset, nausea, diarrhea, depression, low blood pressure, increased urination (diuretic) 2

Plum pits

May cause cyanide poisoning (possibly death) if consumed in very large quantities. 3

Poke Plant (pokeweed, inkberry)

The root is particularly toxic. Can cause severe stomach upset, shortness of breath and death. Children have died from eating the berries. 3

Privet (Ligustrum, Nuzhenzi)

Kidney failure, low blood pressure 2

Propolis

Allergic reaction, skin rashes 2

Prunella (Xia-ku-cao, woundwort, allheal)

Low blood pressure, increased urination (diuretic), contractions of uterus, increased bowel movements. 2

Red Clover

Interferes with blood clotting 2

Rehmennia (Sheng-ti-huang)

Low blood sugar 2

Salvia (Tan-shen)

Interferes with blood clotting, platelets, tiredness/fatigue, low blood pressure, low blood sugar, increased urination (diuretic). 3

Sassafras Root Bark

Causes cancer and liver toxicity in animal studies. 3

Schizandra (Gomishi)

Depression, low blood pressure, contractions of the uterus 2

Senna leaves (Cassia angustafolia)

Increased bowel movements, diarrhea 3

Shave Grass

Excitement, loss of appetite and muscle control, diarrhea, labored breath, convulsion, coma and death. Shave grass may lead to thiamine deficiency with symptoms. 3

Shiitake Mushroom (Lentinus edodes, Xiangling)

Can inhibit blood clotting and trigger hemorrhagic syndrome. Skin rashes, low blood pressure 1,2

Stephania

Adverse effects were published in February 1993, of 48 women identified with serious kidney disease associated with the use of a Chinese diet herbal product containing this herb. Eighteen had terminal kidney failure that will require either kidney transplantation or life-long renal dialysis. 5

Sweet wormwood (Artemisa, Quindhaosu, mugwort)

Allergic reactions, skin rashes, altered mental status 2

Tang-kuei (Angelica, Du-huo, bai-zhi)

Interferes with blood clotting and platelets, depression, sensitivity to light. 2

Tremella (Auriculariaceae, Bai-mur, white tree ear)

Inhibits platelets 2

Yarrow (Achillea millefoleum, Milfoil)

Interferes with blood clotting, allergic reactions, skin rashes, sensitivity to light. 2,3

Yohimbe (Pausinystalia yohimbe)

Kidney failure, seizures and death. Should also be avoided by individuals with low blood pressure, diabetes, and heart, liver or kidney disease. Symptoms of over dosage include weakness and nervous stimulation followed by paralysis, fatigue, stomach disorders and ultimately death. Certain foods (cheese, red wine, liver) can increase likelihood of side effects, as can concurrent use of over-the-counter therapies (diet aids, decongestants). 5

Conclusion

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NIH Study of St. John’s Wort