Herbal Supplements: Safety & Research Support

Rosanne Pruitt, PhD, APRN, FNP-BC, ProfessorSenior Honors Students: Adam Carroll & Ashley Lemanski

Clemson University School of NursingSigma Theta Tau International Gamma Mu Chapter

Herbal Supplements

Extensive use worldwideConsidered a safe alternative by consumers due to natural ingredients 1

Many herbs can be traced to ancient timesLack of awareness of research on efficacy, safety, interactions

Herb use is often not part of communication with health care providers.

Nurses & other health care professionals typically receive very little formal education about herbs.

Few pharmaceutical companies are involved in research due to inability to patent naturally occurring substances-often market combination products

Some herbs are effective & can be used to maintain & enhance health alone or in conjunction with other therapies

Others interact with prescription medication enhancing or inhibiting action which may be unintended & harmful2

Current research findings demonstrate that costly supplements may be no better than a placebo3

Purpose: fill a gap & provide evidence to inform practice

Evaluating research supporting commonly used herbs

Translating the information into an easily accessible format.

Focus: 55 commonly used herbs and essential oils

Reviewing of over 150 research studies, many meta-analyses

Quality of Research Evidence

Rated for each herb:

1 = Clinical trials or Meta-analysis

2 = Correlation, surveys

3 = Insufficient, animal studies

Variations for individual herbs:

Gamma linolenic acid for rheumatoid arthritis (1)

Type II Diabetes (2)

Side effects or precautions and drug interactions are also addressed.

Avocado5-6

Generally safe

Recommended uses(1) Abdominal fat deposits

1-1.5 avocados q day x 2-4 weeks

(3) Decrease LDL, triglycerides & hypertension

No known precautions

Lavender EO7-10

Generally safe

Recommended uses

(1) Antibacterial, antifungal, sleep quality, stress and anxiety, postpartum depression

Precautions

Inhaled oil bottle necklaces lack efficacy

Peppermint, leaf or EO11-16

Generally safe

Recommended uses

(1) Antioxidant, IBS, dyspepsia

Enteric coated caps TID 15 min a meals x 28 days

(1) Congestion 3-4 drops inhaled

(2) Antimicrobial, virucidal, nausea, tension headaches

Precautions

Contraindicated with GERD (due to GI relax), gallbladder disease, or liver disease

Milk Thistle17-21

Generally safe

Recommended uses(3) Chronic Liver Disease, Decrease Cholesterol, Renal Protective, Decrease Atherosclerosis Plaques, Decrease Blood Glucose

PrecautionsLong-term effects not studied

Research limited to animal studies

Ginseng22-23

Generally safe

Recommended uses(1) Peripheral Vasodilation

(3) Regulate Glucose, Decrease Weight, Increase LBM

PrecautionsNo Anticoagulation drugs

St. Johns Wart24-26

Use with Caution

Recommended uses(1) Mild to Moderate Depression

PrecautionsShort term use only: less than 3 months

Drug Interactions

Ginkgo27-28

Use with Caution

Recommended uses(1) Periodontitis

(2) Adjunct for Attention Deficit Disorder

PrecautionsNo Anticoagulants

No Thiazide Diuretics

Long-term use unknown

Goldenseal29-31

Not Recommended

Commonly Used ForSore throat, gastrointestinal disease, wound healing

PrecautionsIncrease risk of liver tumors

DNA damage

Ephedra32-35

Not Recommended

Commonly Used ForWeight Loss

Energy

PrecautionsHypertension

Stoke

Heart attack

Death

Our focus was adults age 18-65.

Usage recommendations are consistent with health authorities and specialty organizations.

Chart developed for use by nurses and other healthcare providers was piloted with health care providers for utility. It received favorable ratings with one recommendation to increase the font size which we did.

Providers have asked about my use of herbs

13%

23%

17%13%

34%

Strongly agree

Somewhat agree

Neutral

Somewhat disagree

Strongly disagree

47% Disagree17% Neutral36% Agree

Regular Use of Herbs without Telling Provider

Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree

60% Disagree13% Neutral27% Agree

Most commonly used herbs by participants

Green TeaGinger Garlic

Cinnamon Avocado

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