Herbal Medicines

Introduction

This fact sheet provides basic information about soy-uses, potential side effects, and resources for more information. Soy, a plant in the pea family, has been common in Asian diets for thousands of years. It is found in modern American diets as a food or food additive. Soybeans, the high-protein seeds of the soy plant, contain isoflavones-compounds similar to the female hormone estrogen. This fact sheet highlights what is known about soy when used by adults for health purposes.

Common Names—soy

Latin Names—Glycine max

What It Is Used For

People use soy products to prevent or treat a variety of health conditions, including high cholesterol levels, menopausal symptoms such as hot flashes, osteoporosis (a condition in which bones become thin and brittle), memory problems, high blood pressure, breast cancer, and prostate cancer.

How It Is Used

• Soy is available in dietary supplements, in forms such as tablets and capsules. Soy supplements may contain isoflavones or soy protein or both.
• Soybeans can be cooked and eaten or used to make tofu, soy milk, and other foods. Also, soy is sometimes used as an additive in various processed foods, including baked goods, cheese, and pasta.

What the Science Says

• Research suggests that daily intake of soy protein may slightly lower levels of LDL (”bad”) cholesterol.
• Some studies suggest that soy isoflavone supplements may reduce hot flashes in women after menopause. However, the results have been inconsistent.
• There is not enough scientific evidence to determine whether soy supplements are effective for any other health uses.
• NCCAM is supporting ongoing studies of soy, including its effects on women’s arteries and bones after menopause.

Side Effects and Cautions

• Soy is considered safe for most people when used as a food or when taken for short periods as a dietary supplement.
• Minor stomach and bowel problems such as nausea, bloating, and constipation are possible.
• Allergic reactions such as breathing problems and rash can occur in rare cases.
• The safety of long-term use of soy isoflavones has not been established. Evidence is mixed on whether using isoflavone supplements, over time, can increase the risk of endometrial hyperplasia (a thickening of the lining of the uterus that can lead to cancer). Studies show no effect of dietary soy on risk for endometrial hyperplasia.
• Soy’s possible role in breast cancer risk is uncertain. Until more is known about soy’s effect on estrogen levels, women who have or who are at increased risk of developing breast cancer or other hormone-sensitive conditions (such as ovarian or uterine cancer) should be particularly careful about using soy and should discuss it with their health care providers.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources

Balk E, Chung M, Chew P, et al. Effects of Soy on Health Outcomes. Evidence Report/Technology Assessment no. 126. Rockville, MD: Agency for Healthcare Research and Quality; 2005. AHRQ publication no. 05-E024-1.

Low Dog T. Menopause: a review of botanical dietary supplements. American Journal of Medicine. 2005;118(suppl 12B):98S-108S.

Sacks FM, Lichtenstein A, Van Horn L, et al. Soy protein, isoflavones, and cardiovascular health: an American Heart Association Science Advisory for professionals from the Nutrition Committee. Circulation. 2006;113(7):1034-1044.

Soy. Natural Medicines Comprehensive Database Web site. Accessed on January 2, 2007.

Soy (Glycine max [L.] Merr.). Natural Standard Database Web site. Accessed on January 2, 2007.

		© Steven Foster

Introduction

This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. saw palmetto–common names, uses, potential side effects, and resources for more information. Saw palmetto grows in the southern United States.

Common Names–saw palmetto, American dwarf palm tree, cabbage palm

Latin Names–Serenoa repens, Sabal serrulata

What It Is Used For

• Saw palmetto is used mainly for urinary symptoms associated with an enlarged prostate gland (also called benign prostatic hyperplasia, or BPH).
• Saw palmetto is also used for other conditions, including chronic pelvic pain, bladder disorders, decreased sex drive, hair loss, and hormone imbalances.

How It Is Used

The ripe fruit of saw palmetto is used in several forms, including ground and dried fruit or whole berries. It is available as a liquid extract, tablets, capsules, and as an infusion or a tea.

What the Science Says

• Several small studies suggest that saw palmetto may be effective for treating BPH symptoms.
• In 2006, a large study of 225 men with moderate-to-severe BPH found no improvement with 320 mg saw palmetto daily for 1 year versus placebo. NCCAM cofunded the study with the National Institute of Diabetes and Digestive and Kidney Diseases.
• There is not enough scientific evidence to support the use of saw palmetto for reducing the size of an enlarged prostate or for any other conditions.
• Saw palmetto does not appear to affect readings of prostate-specific antigen (PSA) levels. PSA is protein produced by cells in the prostate. The PSA test is used to screen for prostate cancer and to monitor patients who have had prostate cancer.

Side Effects and Cautions

• Saw palmetto may cause mild side effects, including stomach discomfort.
• Some men using saw palmetto have reported side effects such as tender breasts and a decline in sexual desire.
• Tell your health care providers about any herb or dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. you are using, including saw palmetto. This helps to ensure safe and coordinated care.

Sources

Saw palmetto. Natural Medicines Comprehensive Database Web site. Accessed March 30, 2006.

Saw palmetto (Serenoa repens [Bartran] Small). Natural Standard Database Web site. Accessed March 30, 2006.

Saw palmetto (Serenoa repens) In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005;635-644.

De Smet PA. Herbal remedies. New England Journal of Medicine. 2002;347(25):2046-2056.

National Cancer Institute. The Prostate-Specific Antigen (PSA) Test: Questions and Answers. National Cancer Institute Web site. Accessed at http://www.cancer.gov/cancertopics/factsheet/Detection/PSA on March 30, 2006.

Saw palmetto berry. In: Blumenthal, M, Goldberg, A, Brinckman, J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:335-340.

Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. New England Journal of Medicine. 2006;354(6):557-566.

		© Steven Foster

Introduction

This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. red clover–common names, uses, potential side effects, and resources for more information. Like peas and beans, red clover belongs to the family of plants called legumes. Red clover contains phytoestrogens–compounds similar to the female hormone estrogen.

Common Names–red clover, cow clover, meadow clover, wild clover

Latin Name–Trifolium pratense

What It Is Used For

• Historically, red clover has been used for cancer and respiratory problems, such as whooping cough, asthma, and bronchitis.
• Current uses of red clover are for menopausal symptoms, breast pain associated with menstrual cycles, high cholesterol, osteoporosis, and symptoms of prostate enlargement.

How It Is Used

The flowering tops of the red clover plant are used to prepare extracts available in tablets and capsules, as well as in teas and liquid forms.

What the Science Says

• Although several small studies of red clover for menopausal symptoms had mixed results, a large study found that red clover had no beneficial effects on menopausal symptoms.
• There is not enough scientific evidence to determine whether red clover is effective for any other health conditions.
• NCCAM is studying red clover to learn more about its active components and how they might work in the body, including a clinical trial investigating the safety and effectiveness of red clover for menopausal symptoms.

Side Effects and Cautions

• Red clover seems to be safe for most adults when used for short periods of time. No serious adverse effects have been reported.
• Because red clover contains estrogen-like compounds, there is a possibility that its long-term use would increase the risk of women developing cancer of the lining of the uterus. However, studies to date have been too brief (less than 6 months) to evaluate whether red clover has estrogen-like effects on the uterus.
• It is unclear whether red clover is safe for women who are pregnant or breastfeeding, or who have breast cancer or other hormone-sensitive cancers.
• Tell your health care providers about any herb or dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. you are using, including red clover. This helps to ensure safe and coordinated care.

Sources

Red clover. Natural Medicines Comprehensive Database Web site. Accessed on May 30, 2006.

Natural Standard Research Collaboration. Red clover (Trifolium pratense). MedlinePlus Web site. Accessed at medlineplus.gov on May 30, 2006.

Fugh-Berman A, Kronenberg F. Red clover (Trifolium pratense) for menopausal women: current state of knowledge. Menopause. 2001;8(5):333-337.

Tice JA, Ettinger B, Ensrud K, et al. Phytoestrogen supplements for the treatment of hot flashes: the Isoflavone Clover Extract (ICE) study. Journal of the American Medical Association. 2003;290(2):207-214.

Red Clover (Trifolium pratense). In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005:587-602.

		© Steven Foster

Introduction

This fact sheet provides basic information about peppermint oil–uses, potential side effects, and resources for more information. The herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. peppermint, a cross between two types of mint (water mint and spearmint), grows throughout Europe and North America. Peppermint is often used to flavor foods, and the leaves can be used fresh or dried in teas.

Common Names–peppermint oil

Latin Names–Mentha x piperita

What It Is Used For

• Peppermint oil has been used for a variety of health conditions, including nausea, indigestion, and cold symptoms.
• Peppermint oil is also used for headaches, muscle and nerve pain, and stomach and bowel conditions such as irritable bowel syndrome.

How It Is Used

Essential oil of peppermint can be taken in very small doses in capsule or liquid forms. The essential oil can also be diluted with another oil and applied to the skin.

What the Science Says

• Results from several studies suggest that peppermint oil may improve symptoms of irritable bowel syndrome.
• A few studies have found that peppermint oil, in combination with caraway oil, may help relieve indigestion, but this evidence is preliminary.
• Although there are some promising results, there is no clear-cut evidence to support the use of peppermint oil for other health conditions.

Side Effects and Cautions

• Peppermint oil appears to be safe for most adults when used in small doses. Possible side effects include allergic reactions and heartburn.
• Capsules containing peppermint oil are often coated to reduce the likelihood of heartburn. If they are taken at the same time as medicines such as antacids, this coating can break down more quickly and increase the risk of heartburn and nausea.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources

Peppermint. Natural Medicines Comprehensive Database Web site. Accessed on December 28, 2006.

Peppermint oil (Mentha x piperita L.). Natural Standard Database Web site. Accessed on December 28, 2006.

Peppermint. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:297-303.

Introduction

This fact sheet provides basic information about noni-common names, uses, potential side effects, and resources for more information. Noni is an evergreen shrub or small tree that grows throughout the tropical regions of the Pacific Ocean, from Southeast Asia to Australia and especially in Polynesia.

Common Names—noni, morinda, Indian mulberry, hog apple, canary wood

Latin Names—Morinda citrifolia

What It Is Used For

• Noni has been traditionally used in Polynesia as a dye, but it also has a history of use as a topical preparation for joint pain and skin conditions.
• Today, people drink noni fruit juice as a general health tonic, as well as for cancer and chronic conditions such as cardiovascular disease and diabetes.

How It Is Used

• Traditionally, the leaves and fruit of noni have been used for health purposes.
• Today, the fruit is most commonly combined with other fruits (such as grape) to make juice. Preparations of the fruit and leaves are also available in capsules, tablets, and teas.

What the Science Says

• In laboratory research, noni has shown antioxidant, immune-stimulating, and tumor-fighting properties. These results suggest that noni may warrant further study for conditions such as cancer and cardiovascular disease. However, noni has not been well studied in people for any health condition.
• Recent NCCAM-funded research includes a study on noni for cancer to determine its safety and potential effects on tumors and symptoms. The National Cancer Institute is funding preliminary research on noni for breast cancer prevention and treatment.

Side Effects and Cautions

• Noni is high in potassium. People who are on potassium-restricted diets because of kidney problems should avoid using noni.
• Several noni juice manufacturers have received warnings from the U.S. Food and Drug Administration about making unsubstantiated health claims.
• Although there have been few reported side effects from using noni, its safety has not been adequately studied.
• There have been reports of liver damage from using noni. It should be avoided if you have liver disease because it contains compounds that may make your disease worse.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources

Morinda. Natural Medicines Comprehensive Database Web site. Accessed on February 7, 2007.

Noni (Morinda citrifolia). Natural Standard Database Web site. Accessed on February 7, 2007.

Pawlus A, Bao-Ning S, Kinghorn A. Noni (Morinda citrifolia). In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005:1-8.

Mueller BA, Scott MK, Sowinski KM, et al. Noni juice (Morinda citrifolia): hidden potential for hyperkalemia? American Journal of Kidney Disease. 2000;35(2):310-312.

		® 2004 Horticopia, Inc. Photography by Robert E. Lyons

Introduction

This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. milk thistle–common names, uses, potential side effects, and resources for more information. Milk thistle is a plant that is native to the Mediterranean region. It has been used for thousands of years as a remedy for a variety of ailments, especially liver problems.

Common Names–milk thistle, Mary thistle, holy thistle. Milk thistle is sometimes called silymarin, which is actually a mixture of the herb’s active components, including silybinin (also called silibinin or silybin).

Latin Name–Silybum marianum

What It Is Used For

Milk thistle is believed to have protective effects on the liver and improve its function. It is typically used to treat liver cirrhosis, chronic hepatitis (liver inflammation), and gallbladder disorders. Treatment claims also include:

• Lowering cholesterol levels
• Reducing insulin resistance in people with type 2 diabetes who also have cirrhosis
• Reducing the growth of cancer cells in breast, cervical, and prostate cancers

How It Is Used

Milk thistle is a flowering herb. Silymarin, which can be extracted from the seeds (fruit), is believed to be the biologically active part of the herb. The seeds are used to prepare capsules containing powdered herb or seed; extracts; and infusions (strong teas).

What the Science Says

• There have been some studies of milk thistle on liver disease in humans, but these have been small. Some promising data have been reported, but study results at this time are mixed.
• Although some studies conducted outside the United States support claims of oral milk thistle to improve liver function, there have been flaws in study design and reporting. To date, there is no conclusive evidence to prove its claimed uses.
• NCCAM is supporting a phase II research study to better understand the use of milk thistle for chronic hepatitis C. With the National Institute of Diabetes and Digestive and Kidney Diseases, NCCAM is planning further studies of milk thistle for chronic hepatitis C and nonalcoholic steatohepatitis (liver disease that occurs in people who drink little or no alcohol).
• The National Cancer Institute and the National Institute of Nursing Research are also studying milk thistle, for cancer prevention and to treat complications in HIV patients.

Side Effects and Cautions

• In clinical trials, milk thistle generally has few side effects. Occasionally, people report a laxative effect, upset stomach, diarrhea, and bloating.
• Milk thistle can produce allergic reactions, which tend to be more common among people who are allergic to plants in the same family (for example, ragweed, chrysanthemum, marigold, and daisy).
• It is important to inform your health care providers about any herb or dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. you are using, including milk thistle. This helps to ensure safe and coordinated care.

Sources

Agency for Healthcare Research and Quality. Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects. Evidence Report/Technology Assessment no. 21. Rockville, MD: Agency for Healthcare Research and Quality; 2000. 01-E024.

Milk thistle (Silybum marianum). In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005:467-482. Accessed at Dekker Encyclopedias Web site on August 22, 2005.

Milk thistle. Natural Medicines Comprehensive Database. Accessed on August 22, 2005.

Milk thistle (Silybum marianum), silymarin. Natural Standard Database Web site. Accessed on August 22, 2005.

Milk thistle fruit. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:257-263.

National Center for Complementary and Alternative Medicine. Hepatitis C and Complementary and Alternative Medicine: 2003 Update. National Center for Complementary and Alternative Medicine Web site. Accessed on August 22, 2005.

		© Steven Foster

Introduction

This fact sheet provides basic information about licorice root–common names, uses, potential side effects, and resources for more information. Most licorice is grown in Greece, Turkey, and Asia. Licorice contains a compound called glycyrrhizin (or glycyrrhizic acid).

Common Names–licorice root, licorice, liquorice, sweet root, gan zao (Chinese licorice)

Latin Name–Glycyrrhiza glabra, Glycyrrhiza uralensis (Chinese licorice)

What It Is Used For

Licorice root has been used as a dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. for stomach ulcers, bronchitis, and sore throat, as well as infections caused by viruses, such as hepatitis.

How It Is Used

• Peeled licorice root is available in dried and powdered forms.
• Licorice root is available as capsules, tablets, and liquid extracts.
• Licorice can be found with glycyrrhizin removed; the product is called DGL (for “deglycyrrhizinated licorice”).

What the Science Says

• A review of several clinical trials found that glycyrrhizin might reduce complications from hepatitis C in some patients. However, there is not enough evidence to confirm that glycyrrhizin has this effect.
• There are not enough reliable data to determine whether licorice is effective for stomach ulcers.

Side Effects and Cautions

• In large amounts, licorice containing glycyrrhizin can cause high blood pressure, salt and water retention, and low potassium levels, which could lead to heart problems. DGL products are thought to cause fewer side effects.
• The safety of using licorice as a supplement for more than 4 to 6 weeks has not been thoroughly studied.
• Taking licorice together with diuretics (water pills) or other medicines that reduce the body’s potassium levels could cause dangerously low potassium levels.
• People with heart disease or high blood pressure should be cautious about using licorice.
• When taken in large amounts, licorice can affect the body’s levels of a hormone called cortisol and related steroid drugs, such as prednisone.
• Pregnant women should avoid using licorice as a supplement or consuming large amounts of licorice as food, as some research suggests it could increase the risk of preterm labor.
• Tell your health care providers about any herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. or dietary supplement you are using, including licorice root. This helps to ensure safe and coordinated care.

Sources

National Center for Complementary and Alternative Medicine. Hepatitis C and Complementary and Alternative Medicine: 2003 Update. National Center for Complementary and Alternative Medicine Web site. Accessed at nccam.nih.gov/health/hepatitisc on May 30, 2006.

Licorice (Glycyrrhiza glabra). In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005:391-399.

Licorice. Natural Medicines Comprehensive Database Web site. Accessed on May 30, 2006.

Natural Standard Research Collaboration. Licorice (Glycyrrhiza glabra L.) and DGL (deglycyrrhizinated licorice). MedlinePlus Web site. Accessed at medlineplus.gov on May 30, 2006.

Licorice root. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:233-239.

		© Karen Bergeron

Introduction

This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. lavender–common names, uses, potential side effects, and resources for more information. Lavender is native to the Mediterranean region. It was used in ancient Egypt as part of the process for mummifying bodies. Lavender’s use as a bath additive originated in Persia, Greece, and Rome. The herb’s name comes from the Latin lavare, which means “to wash.”

Common Names–lavender, English lavender, garden lavender

Latin Names–Lavandula angustifolia

What It Is Used For

• Historically, lavender was used as an antiseptic and for mental health purposes.
• Today, the herb is used for conditions such as anxiety, restlessness, insomnia, and depression.
• Lavender is also used for headache, upset stomach, and hair loss.

How It Is Used

• Lavender is most commonly used in aromatherapyA therapy in which the scent of essential oils from flowers, herbs, and trees is inhaled to promote health and well-being., in which the scent of the essential oil from the flowers is inhaled.
• The essential oil can also be diluted with another oil and applied to the skin.
• Dried lavender flowers can be used to make teas or liquid extracts that can be taken by mouth.

What the Science Says

• There is little scientific evidence of lavender’s effectiveness for most health uses.
• Small studies on lavender for anxiety show mixed results.
• Some preliminary results indicate that lavender oil, combined with oils from other herbs, may help with hair loss from a condition called alopecia areata.

Side Effects and Cautions

• Topical use of diluted lavender oil or use of lavender as aromatherapy is generally considered safe for most adults. However, applying lavender oil to the skin can cause irritation.
• Lavender oil is poisonous if taken by mouth.
• When lavender teas and extracts are taken by mouth, they may cause headache, changes in appetite, and constipation.
• Using lavender with sedative medications may increase drowsiness.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources

Lavender. Natural Medicines Comprehensive Database Web site. Accessed on December 28, 2006.

Lavender (Lavandula angustifolia Miller). Natural Standard Database Web site. Accessed on December 28, 2006.

Lavender flower. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:226-229.

		© Steven Foster

Introduction

This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. kava–common names, uses, potential side effects, and resources for more information. Kava is native to the islands of the South Pacific and is a member of the pepper family.

Common Names–kava kava, awa, kava pepper

Latin Names–Piper methysticum

What It Is Used For

• Kava has been used as a ceremonial beverage in the South Pacific for centuries.
• Kava has also been used to help people fall asleep and fight fatigue, as well as to treat asthma and urinary tract infections.
• Topically (on the skin), kava has been used as a numbing agent.
• Today, kava is used primarily for anxiety, insomnia, and menopausal symptoms.

How It Is Used

The root and rhizome (underground stem) of kava are used to prepare beverages, extracts, capsules, tablets, and topical solutions.

What the Science Says

• Although scientific studies provide some evidence that kava may be beneficial for the management of anxiety, the U.S. Food and Drug Administration (FDA) has issued a warning that using kava supplements has been linked to a risk of severe liver damage.
• Kava is not a proven therapy for other uses.
• NCCAM-funded studies on kava were suspended after the FDA issued its warning.

Side Effects and Cautions

• Kava has been reported to cause liver damage, including hepatitis and liver failure (which can cause death).
• Kava has been associated with several cases of dystonia (abnormal muscle spasm or involuntary muscle movements).
• Kava may interact with several drugs, including drugs used for Parkinson’s disease.
• Long-term and/or heavy use of kava may result in scaly, yellowed skin.
• Avoid driving and operating heavy machinery while taking kava because the herb has been reported to cause drowsiness.
• Tell your health care providers about any herb or dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. you are using, including kava. This helps to ensure safe and coordinated care.

Sources

National Center for Complementary and Alternative Medicine. Kava Linked to Liver Damage. National Center for Complementary and Alternative Medicine Web site. Accessed at http://nccam.nih.gov/health/alerts/kava/ on March 30, 2006.

Kava. Natural Medicines Comprehensive Database Web site. Accessed March 30, 2006.

Kava (Piper methysticum G. Forst). Natural Standard Database Web site. Accessed March 30, 2006.

Kava kava rhizome (root). In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:221-225.

Kava (Piper methysticum). In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005:373-380.

Food and Drug Administration. Kava-Containing Dietary Supplements May Be Associated With Severe Liver Injury. Food and Drug Administration Web site. Accessed at http://www.cfsan.fda.gov/~dms/addskava.html on March 30, 2006.

Pittler MH, Ernst E. Kava extract versus placebo for treating anxiety. Cochrane Database of Systematic Reviews. 2003;(1):CD003383. Accessed at http://www.cochrane.org on April 25, 2006.

		© Steven Foster

Introduction

This fact sheet provides basic information about horse chestnut–common names, uses, potential side effects, and resources for more information. Horse chestnut trees are native to the Balkan Peninsula (for example, Greece and Bulgaria), but grow throughout the northern hemisphere. Although horse chestnut is sometimes called buckeye, it should not be confused with the Ohio or California buckeye trees, which are related but not the same species.

Common Names–horse chestnut, buckeye, Spanish chestnut

Latin Names–Aesculus hippocastanum

What It Is Used For

• For centuries, horse chestnut seeds, leaves, bark, and flowers have been used for a variety of conditions and diseases.
• Horse chestnut seed extract has been used to treat chronic venous insufficiency (a condition in which the veins in the legs do not efficiently return blood to the heart). This condition is associated with varicose veins, pain, ankle swelling, feelings of heaviness, itching, and nighttime leg cramping.
• The seed extract has also been used for hemorrhoids.

How It Is Used

Horse chestnut seed extract standardized to contain 16 to 20 percent aescin (escin), the active ingredient, is the most commonly used form. Topical preparations have also been used.

What the Science Says

• Small studies have found that horse chestnut seed extract is beneficial in treating chronic venous insufficiency and is as effective as wearing compression stockings.
• There is not enough scientific evidence to support the use of horse chestnut seed, leaf, or bark for any other conditions.

Side Effects and Cautions

• Homemade preparations of horse chestnut should not be used. Raw horse chestnut seeds, leaves, bark, and flowers contain esculin, which is poisonous.
• When properly processed, horse chestnut seed extract contains little or no esculin and is considered generally safe. However, the extract can cause some side effects, including itching, nausea, or gastrointestinal upset.
• Tell your health care providers about any herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. or dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. you are using, including horse chestnut. This helps to ensure safe and coordinated care.

Sources

Horse chestnut. Natural Medicines Comprehensive Database Web site. Accessed May 3, 2006.Horse chestnut. Natural Standard Database Web site. Accessed May 3, 2006.

Horse chestnut seed extract. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:201-204.