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AbstractThe growing co-consumption of botanical natural products with conventional medications has intensified the need to understand potential effects on drug safety and efficacy. This review delves into the intricacies of intestinal pharmacokinetic interactions between botanical natural products and drugs, such as alterations in drug solubility, permeability, transporter activity, and enzyme-mediated metabolism. It emphasizes the importance of understanding how drug solubility, dissolution, and osmolality interplay with botanical constituents in the gastrointestinal tract, potentially altering drug absorption and systemic exposure. Unlike reviews that focus primarily on enzyme and transporter mechanisms, this article highlights the lesser known but equally important mechanisms of interaction. Applying the Biopharmaceutics Drug Disposition Classification System (BDDCS) can serve as a framework for predicting and understanding these interactions. Through a comprehensive examination of specific botanical natural products such as byakkokaninjinto, green tea catechins, goldenseal, spinach extract, and quercetin, we illustrate the diversity of these interactions and their dependence on the physicochemical properties of the drug and the botanical constituents involved. This understanding is vital for healthcare professionals to effectively anticipate and manage potential natural product-drug interactions, ensuring optimal patient therapeutic outcomes. By exploring these emerging mechanisms, we aim to broaden the scope of natural product-drug interaction research and encourage comprehensive studies to better elucidate complex mechanisms. [ABSTRACT FROM AUTHOR]

We aimed to evaluate herbal medicine and supplement use patterns among adolescent and young adult women at a clinic focused on family planning. We conducted a cross-sectional survey of patients (age 14-25) at an adolescent Title X clinic. Participants completed an electronic survey that assessed herbal medicine and supplement use, baseline demographic characteristics, and current contraceptive method. We evaluated supplement-drug interactions using the Natural Medicines database Interaction Checker. Quantitative analyses were performed using χ2 and independent medians tests. We enrolled 99 participants with a median age of 20 (15-24) years. Overall, 42.4% of patients reported ever having used supplements or herbal medicines, with 29.9% of patients reporting current supplement or herbal medicine use. Patients with higher education and private insurance were more likely to report a history of and current supplement use (P <.05). The most common herbal supplements reported were green tea (n = 26), cannabidiol (n = 17), and cranberry (n = 16), with 29.6% of participants reporting use to their general health care provider. The most common reasons for use were general health and wellness (29.1%), immune support (23.2%), stress (16.8%), and menstrual irregularities (6.0%). We found 62 moderate risk supplement-drug interactions, with 50 interactions attributed to hormonal contraceptive therapies. The most common interactions were via cytochrome P450 enzyme (CYP3A4 or CYP1A2) inhibition, decreased caffeine clearance, and potential hepatotoxicity. Adolescent and young adult women frequently reported past and current herbal medicine and supplement use, with high rates of moderate-risk supplement-drug interactions. Further research is needed to better elucidate these clinically relevant supplement-contraception interactions. [ABSTRACT FROM AUTHOR]

Serotonin toxicity is a well-described phenomenon that is commonly attributed to a variety of drug–drug combinations. Some unregulated herbal supplements have been implicated in the onset of serotonin toxicity, however, there is currently minimal literature available on the potential for black cohosh to contribute to rhabdomyolysis and serotonin toxicity, in spite of its known serotonergic properties. A middle-aged woman presented to the emergency department with serotonin toxicity and rhabdomyolysis shortly after taking black cohosh supplements in the setting of long-term dual antidepressant use. The serotonin toxicity and rhabdomyolysis resolved with IV fluids, benzodiazepines, and discontinuation of the offending drugs. Patients are sometimes not aware of how over-the-counter supplements might interact with their prescription medications. Female patients taking black cohosh to manage hot flashes and menopausal symptoms could be at risk for developing rhabdomyolysis and serotonin toxicity if they are also taking other serotonergic agents. [ABSTRACT FROM AUTHOR]

An herbal supplement made with thyme, mint, cilantro, and rowan and viburnum fruit has been used to fortify wheat bread with antioxidants. The antioxidant activity of raw materials and bread was determined by the spectrophotometric method. To determine substances with antioxidant properties, the HPLC method was used. The chromatogram of the alcoholic extract of the herbal supplement showed that the supplement contains organic acids, flavonoids and anthocyanins. The HPLC method was used to determine the amount of flavonoids in the supplement and bread. Micrographs of the surface of slices of bread with a phytonutrient were obtained by scanning electron microscopy. The presence of chemical elements with antioxidant properties was determined using an X-ray EMF detector in the scanning electron microscope system. The use of phytonutrients in bread technology has been found to lead to an increase in the quality of the product and its antioxidant activity. [ABSTRACT FROM AUTHOR]

Objective: Understanding the changes in consumer use of herbal products and what has influenced these changes is key in the promotion of evidence informed use. The last analysis of evidence informed herbal supplement use involved the 2002 National Health Interview Survey (NHIS) analysis. This study reproduces and expands upon that earlier analysis, with the most recent NHIS dataset to report herb use patterns. It also explores the guiding resources consulted by consumers in their decision to use. Methods: Secondary analysis of cross-sectional data from the NHIS identified the 10 herbal supplements with the most reported use in 2012. The reasons reported by the NHIS for taking herbal supplements were compared with the 2019 Natural Medicines Comprehensive Database (NMCD) to determine whether reasons cited in consumption were supported by evidence. Logistic regression models were fit according to NHIS sampling weights to examine the relationship between evidence-based use and user characteristics, guiding resources, and health care professional engagement surrounding use. Results: Of the 181 reported uses of herb supplements for a specific health condition, 62.5% were for reasons supported by evidence-based indications (EBIs). The odds of herb use consistent with evidence significantly increased for those reporting higher education status (odds ratio [OR] = 3.01, 95% confidence interval [CI] [1.70–5.34]). Herbal supplement use consistent with EBIs was more likely among those who disclosed their herb use to a health care professional (OR = 1.77, 95% CI [1.26–2.49]). Evidence-based herb use was also less frequently informed by Media sources (OR = 0.43, 95% CI [0.28–0.66]) compared with non-EBI use. Conclusion: Approximately 62% of the reasons cited for taking the most consumed herbs in 2012 were in alignment with 2019 EBIs. This increase may be due to improved awareness of health care professionals and/or an increase of evidence for traditional uses of herbal products. Future research should explore the role of each of these stakeholders in improving evidence-based herb use in the general population. [ABSTRACT FROM AUTHOR]

Pyrrolizidine alkaloids (PAs) are noted for their hepatotoxic, genotoxic, and carcinogenic effects in animals and humans following metabolic activation in the liver. In this study, herbal supplements sold in Ghana for sexual improvement were analysed for the presence of 64 PAs using LC-MS/MS analysis. Up to 17 different PAs were identified in 19 out of the 37 samples analysed. The sum of PAs in samples ranged from 5 to 3204 μg kg−1. Since the PA content in the herbal medicinal preparations was generally lower than in honey samples, their presence was mainly attributed to cross-contamination. The observed levels would result in estimated daily intakes from 0.01 to 12 μg per day or 0.0002 to 0.2 μg kg−1 bw day−1 for a person weighing 70 kg. The margins of exposure ranged from 1200 to 1,400,000 with eight samples showing values below 10,000, thus indicating a health concern. [ABSTRACT FROM AUTHOR]

The research was carried out on the possibility of using potherbs in bakery industry. Powder of plants were used to replace 0.5%, 2%, 5%, 10% and 15% of wheat flour: Chenopōdium quīnoa L.; Cyperus esculentus L.; Physalis tomentous L.; Cosmos sulphureus Cav.; Pycnanthemum virginianum L.; Pycnanthemum trifolium L.; Agastache rugosa (Fisch. & C.A. Mey.) Kuntze; Agastache urticifolia (Benth.) Kuntze, cv. Weide Kerze; Mentha spicаta L. 'Moroccan'; Achillea setacea Waldst. Et Kit.; Isodon japonicus var. Glaucocalyx (Maxim.) H. W. Li; Satureja montana L.; Teucrium scorodonia L.; Ruta montana L.; Népeta argolica Bory et Chaub.; Népeta grandiflora L.; Népeta mussinii Spreng. Ex Henckel., cv. Posviata Meisu; Népeta nepetelia L. In order to develop an effective technology for its use, creating new types of products with properties that meet current needs of consumers in Ukraine and the world, it is necessary to clarify the relation of potherbs with other components. Baking properties determine the behavior of flour in technological process, namely, they form the quality of bread and depend on the state of carbohydrate-amylase, protein-proteinase, lipidlipolytic complexes, as well as the content of compounds that cause darkening of flour during the process of bread making. Use of herbs in bakery is promising. The data obtained allows manufacturers to recommend the use of herbs during the production of bread. [ABSTRACT FROM AUTHOR]

Reactive oxygen and nitrogen species (ROS/RNS) are known to cause oxidative damage to cells and macromolecules. Intake of antioxidant-rich fruits and vegetables has been touted as a strategy to mitigate oxidative stress, but this is not always accommodated in modern diets. Augmentation with antioxidant-rich herbal supplements may be a preventive measure against the negative effects of ROS/RNS. In this study, we verify and compare the antioxidant claims of herbal supplements by measuring their phytochemical content and antioxidant capacities through the oxygen radical absorption capacity-multi-radical (ORAC MR5) assays. ORAC MR5 measures antioxidant activity against five biologically relevant ROS/RNS (peroxyl and hydroxyl radical, superoxide anion, singlet oxygen, and peroxynitrite). Four products were tested: two multi-herbal capsules (INT and Oxxy), a mangosteen fruit pulp powder capsule (MPC), and a mixed herbal drink (MHD). Phytochemical content was quantified through total phenolic and flavonoid content assays. Oxxy had the highest flavonoid content per serving (106.4 mg catechin eq/450 mg capsule) and ORAC MR5 value (37,503 μmol Trolox eq/450 mg capsule), followed by INT (53.5 mg catechin eq and 17,298 μmol Trolox eq/200 mg capsule), MPC (48.1 mg catechin eq and 7,675 μmol Trolox eq/500 mg capsule), and then MHD (7.4 mg catechin eq and 146.7 μmol Trolox eq/30 mL drink). Significant antioxidant activities against peroxyl radicals and singlet oxygen were observed for INT and Oxxy, whereas the antioxidant activity of MPC and MHD were mostly towards peroxyl radicals. A strong correlation was found between phenolic and flavonoid contents and ORAC MR5 values, and we confirmed supplier claims on standardized phenolic content or antioxidant activity of INT and Oxxy. This study demonstrated the utility of ORAC MR5 as a measure of in vitro antioxidant activity of herbal supplements against biologically relevant ROS/RNS and may be used for the development and quality control of herbal supplements. [ABSTRACT FROM AUTHOR]

In most cases, herbal supplements found in illegal centers and herbal medicine stores have harmful content that causes irreparable damage to people. As a representative of the green chemistry method, a rapid and efficient dispersive micro solid-phase extraction (D-mSPE) method was applied to extract dexamethasone adulterant from handmade supplements sold as power natural enhancing materials. The quantification of the analyte was performed by high performance liquid chromatography with an ultraviolet detector. Effective parameters on the extraction recovery, including the type and amount of adsorbent, the kind of elution solvent, and the time of extraction and elution, were systematically investigated. The limit of detection of the method was 0.05 μg mL–1. Furthermore, inter-day precisions calculated as relative standard deviations were better than 10%. Ten dietary supplements, including liquid, capsule, tablet forms, and powder, were analyzed using the developed method, and four of them were detected as adulterated with dexamethasone. The developed method purifies the complex plant-based samples and results in a clean analysis with separation instruments. [ABSTRACT FROM AUTHOR]

The overstoring of surplus calories in mature adipocytes causes obesity and abnormal metabolic activity. The anti-obesity effect of a Celosia cristata (CC) total flower extract was assessed in vitro , using 3T3-L1 pre-adipocytes and mouse adipose-derived stem cells (ADSCs), and in vivo , using high-fat diet (HFD)-treated C57BL/6 male mice. CC extract was co-incubated during adipogenesis in both 3T3-L1 cells and ADSCs. After differentiation, lipid droplets were assessed by oil red O staining, adipogenesis and lipolytic factors were evaluated, and intracellular triglyceride and glycerol concentrations were analyzed. For in vivo experiments, histomorphological analysis, mRNA expression levels of adipogenic and lipolytic factors in adipose tissue, blood plasma analysis, metabolic profiles were investigated. CC treatment significantly prevented adipocyte differentiation and lipid droplet accumulation, reducing adipogenesis-related factors and increasing lipolysis-related factors. Consequently, the intracellular triacylglycerol content was diminished, whereas the glycerol concentration in the cell supernatant increased. Mice fed an HFD supplemented with the CC extract exhibited decreased HFD-induced weight gain with metabolic abnormalities such as intrahepatic lipid accumulation and adipocyte hypertrophy. Improved glucose utilization and insulin sensitivity were observed, accompanied by the amelioration of metabolic disturbances, including alterations in liver enzymes and lipid profiles, in CC-treated mice. Moreover, the CC extract helped restore the disrupted energy metabolism induced by the HFD, based on a metabolic animal monitoring system. This study suggests that CC total flower extract is a potential natural herbal supplement for the prevention and management of obesity. [Display omitted] • CC inhibits lipid droplet accumulation and adipocyte differentiation. • The treatment with CC exhibits a protective effect on hepatic steatosis, adipocyte hypertrophy, and elevated liver enzymes. • CC extract improves glucose tolerance, insulin activity, and lipid profiles. • This study provides potential benefits of CC in obesity management. [ABSTRACT FROM AUTHOR]

Phytogenic additives have been implicated in aquafeed owing to their proven growth-stimulating, antimicrobial, antioxidant, and immune-enhancing efficacies. Herein, a short-term feeding experiment (21 days) was designed to explore the effects of a phytogenic additive, PASSIF MOOD® (PM, a mixture of Valeriana officinalis and Passiflora incarnata extracts), on growth, haemato-biochemical variables, immunity, and mRNA expression responses of rainbow trout fingerlings. After feeding, fish were experimentally infected with Lactococcus garvieae and monitored for an additional 20 days. Six groups were fed a commercial diet supplied with different PM levels as 0, 470, 940, 1410, 1880, and 2350 mg/kg and labeled as PM0 (control), PM1, PM2, PM3, PM4, and PM5 groups, respectively. Results revealed significant improvements in the growth of PM-supplied groups compared to the control. Dietary PM significantly increased RBC count, hemoglobin, and hematocrit values compared to those fed on a control diet. Stress indicators such as blood glucose and cortisol levels were significantly decreased in all PM groups than in controls. Moreover, there were significant increases in myeloperoxidase, respiratory burst, and lysozyme activities in PM groups than the control. The highest expression levels of the lysozyme II gene were found in the PM3, PM4, and PM5 groups. Moreover, the mRNA transcripts of il-10 and IgM heavy chain genes were significantly increased in all PM groups compared to the controls. Alternatively, the expression of tnf-α and hsp70 genes were significantly decreased in all PM groups compared to the controls. After challenge, the survival rates in PM0, PM1, PM2, PM3, PM4, and PM5 groups were 37.34%, 84.0%, 85.34%, 68.0%, 64.0%, and 36.0%, respectively, suggesting enhancement of the fish resistance in PM1, PM2, PM3, and PM4 groups compared to control. The results suggest the growth-promoting, antistress, and immunomodulatory roles of the tested phytogenic additive. • PASSIF MOOD® (PM, a mixture of Valeriana officinalis and Passiflora incarnata extracts) was used as a herbal supplement in rainbow trout diets. • Immunological indices such as respiratory burst, lysozyme, and myeloperoxidase activities were increased in PM-supplied groups after the feeding trial. • The expression of tnf-α and hsp70 genes were significantly decreased in all PM-supplemented groups compared to the controls. • The mRNA transcripts of the il-10 and IgM heavy chain genes were significantly increased in PM groups compared to the controls. • A dietary supplementation dose of up to 1880 mg/kg was suitable as an effective strategy to reduce fish losses resulting from Lactococcus garvieae in rainbow trout. [ABSTRACT FROM AUTHOR]

Quercetin (QUE) is a powerful antioxidant and one of the common phenolic compounds found in plants, vegetables, and fruits, which has shown many pharmacological activities. The complex nature of the matrix in which QUE is found and its importance and potential uses in diverse applications force the researchers to develop selective and sensitive sensors. In the present work, a novel molecularly imprinted polymer (MIP)-based electrochemical sensor was fabricated for the selective and sensitive determination of the QUE in plant extracts and food supplements. Tryptophan methacrylate (TrpMA) was chosen as the functional monomer, whereas the photopolymerization (PP) method was applied using a glassy carbon electrode (GCE). Electrochemical and morphological characterizations of the developed sensor (TrpMA@QUE/MIP-GCE) were performed using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and scanning electron microscopy (SEM). The linear range of the developed sensor was determined to be in the range of 1.0–25 pM, while the limit of detection (LOD) was calculated to be 0.235 pM. In conclusion, The TrpMA@QUE/MIP-GCE sensor might be classified as a promising platform for selective and sensitive determination of QUE not only in plant extracts but also in commercial food supplements because of its reliability, reproducibility, repeatability, stability, and fast response time. [Display omitted] • MIP-based electrochemical determination of antioxidant phenolic compound QUE. • Highly selective application in plant extracts (fruit, stem, leaf, and flower). • Accurate determination of QUE content in commercial herbal supplements. • Superior selectivity, rapid, and easy analysis compared to other studies. [ABSTRACT FROM AUTHOR]

The use of medicinal plants is significant in the long tradition of folklore and traditional medicine in Malaysia, which continues to the present day. To support the growth of the local herbal industry, the Malaysian Herbal Monograph (MHM) was introduced, with monographs of 76 commonly used local medicinal plants published to date. Despite their health benefits and important pharmacological activities, 11 plant species that could potentially contain genotoxic and carcinogenic phytochemicals such as alkenylbenzenes (methyleugenol, safrole and estragole) and pyrrolizidine alkaloids (monocrotaline, lasiocarpine, riddelliine and senecionine) were investigated. A further search on QUEST3+, a database maintained by the National Pharmaceutical Regulatory Agency, Ministry of Health Malaysia, revealed that hundreds of registered natural products, including traditional medicines and herbal supplements (TMHS), contain these plant species as ingredients. In conclusion, consumers could be exposed to genotoxic and carcinogenic phytochemicals through consumption of these registered TMHS thus increasing the risk of developing cancer. [ABSTRACT FROM AUTHOR]

Worldwide, the consumption of dietary supplements for the enhancement of sexual performance is common. Consumers are generally fond of these products because they often want to avoid drugs, preferring "natural" than "chemical" solutions. This is challenging, as many of these supplements labelled "herbal" or "natural" are actually adulterated with drugs, mainly phosphodiesterase‐5 inhibitors. This phenomenon is facilitated by fewer demanding regulations for marketing supplements. Thus, consumers may be widely exposed to serious adverse events, such as acute liver injury, kidney failure, pulmonary embolism, stroke or even death. We aim to warn physicians about this issue. This multidisciplinary review simultaneously deals with clinical consequences of this phenomenon, analytical toxicology and regulation. Indeed, after outlining this worldwide issue and highlighting that a drug‐adulterated dietary supplement is actually a falsified drug, we discuss its main contributing factors. Then, we describe some examples of adverse events of which a case of sildenafil–tadalafil‐induced ischaemic stroke that benefited medical care in our hospital. Furthermore, we present some means to avoid adulteration and discuss their limitations that may be explained by the heterogeneity of the regulation of dietary supplements between countries. Doing so, we point out the requirement of a global harmonization of this regulation for an efficient eradication of this public health threat. Meanwhile, dietary supplements should be considered adulterated until proven otherwise. Thus, we encourage physicians to investigate these products in the drug histories of their patients, especially when clinical conditions cannot be explained by classical aetiologies. [ABSTRACT FROM AUTHOR]

Today, orthodox medicine has almost exceeded its limits in resolving subfertility problems in animals, thus making phytomedicine a primary tool in the treatment of infertility. In this work, three herbal supplements obtained from freshly air-dried Moringa oleifera, Phyllanthus amarus and Viscum album leaves were evaluated to ascertain their comparative effect on the reproductive potentials of bucks. Sixty bucks were allotted four diets made up of standard grower rabbit ration without supplement and with 5% Moringa, Mistletoe and Phyllanthus supplementation for 84 days. Semen samples were collected from all bucks using artificial vagina, for semen quality and seminal oxidative stress markers. The organ weights, testicular and epididymal spermatozoa reserves were assessed to determine sperm production potentials using standard procedures. The result obtained revealed that spermatozoa concentration, progressive motility, curvilinear velocity, average path velocity and the amplitude of lateral head was significantly (p < 0.05) higher in the group fed with mistletoe supplemented diet compared to that recorded in the control groups. The inclusion of herbal supplements linearly (p < 0.05) increased the seminal total antioxidant activity with a corresponding decrease in the seminal lipid peroxidation across the herbal supplemented treatments compared to the control. The gonadal and extra-gonadal sperm reserves of bucks fed on the herbal supplements were depleted compared to bucks on control. Bucks on mistletoe supplementation rivalled the superior daily sperm production and testicular sperm reserve in bucks without herbal supplements. In conclusion, Viscum album supplements in bucks' diets encouraged daily sperm production, testicular sperm reserves, testosterone, as well as spermatozoa kinetics. The three herbal supplements did enhance semen oxidative stability. • Moringa oleifera, Viscum album and Phyllanthus amarus supplements in rabbit diet stimulate better spermatozoa kinetics. • Moringa oleifera supplements in bucks' diets enhanced serum LH and reproductive organ weights. • Viscum album supplements encouraged daily sperm production, testicular sperm reserves and testosterone over other herbs supplements. • Phyllanthus amarus supplements enhanced weight gain, serum FSH, epididymal sperm reserves, over other herbal supplements. • Strategic herbal supplementation would be required to meet different reproductive desires in rabbit bucks. [ABSTRACT FROM AUTHOR]

Introduction: Medication nonadherence contributes to poor blood pressure control and increases cardiovascular disease risk in patients with hypertension. Identifying modifiable risk factors for low or nonadherence to antihypertensive medication is needed. Studies that have examined the relationship between herbal or dietary supplement (HDS) use and antihypertensive medication nonadherence provide inconsistent findings. Data from the National Health and Nutrition Examination Survey were used to examine the association between HDS use, current use of prescribed antihypertensive medication, and blood pressure status. Methods: The study sample included hypertensive adults (n = 5,478) who have been told by a health professional to take prescribed medication for their health condition. Respondents were classified as either HDS users or HDS nonusers. Depending on the kind of supplement used, HDS users were further divided into three mutually exclusive groups: hypertension HDS users, nonhypertension HDS users, and those who used both kinds of supplements. Supplements groupings were based on reports in the literature. Blood pressure status definition was based on Eighth Joint National Committee (JNC 8) recommendations. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were obtained from logistic models. Results: Overall HDS use prevalence was 62%. Current medication use did not significantly differ between patients reporting no HDS use and those reporting HDS use (aOR: 1.45; 95% CI: 0.78–2.69). No observable differences were found in current medication use between patients reporting no HDS use and those taking nonhypertension HDS or both kinds of supplements. Use of hypertension HDS was associated with improved blood pressure (aOR: 1.90; 95% CI: 1.07–3.36) compared with no HDS use. Conclusion: In a nationally representative U.S. sample, HDS use did not compromise current use of prescribed medication and was associated with improved blood pressure control. More research is needed to better understand why HDS use is associated with better blood pressure control. [ABSTRACT FROM AUTHOR]

Background: Herbal supplements (HS) are one of the most commonly used complementary and alternative medicines in cancer. Reduced therapeutic efficacy of prescription anticancer agents through unwarranted herb-drug interactions is a major efficacy/safety concern. In view of the rising cancer prevalence in India along with a high degree of reliance and cultural acceptability in favor of traditional medicine drugs, prevalence data exclusively of HS usage during cancer treatment are of considerable epidemiological significance.Methodology: This questionnaire-based prospective observational study aimed at estimating the prevalence of HS among cancer patients during treatment at our tertiary care medical center. Taken on a population of 220 patients within a period of 9 months, data were generated by a customized validated questionnaire and the same processed by IBM SPSS Statistics for Windows, version XXIV, Armonk, NY: IBM Corp. Differences between HS use and nonuse with respect to demographic, disease, and treatment characteristics were assessed by Chi-square test. For examining the latter variables as possible predictors of HS usage, they were entered into bivariate logistic regression with odds ratio and confidence intervals calculated for each.Results: Out of 220 patients, 57 (26%) were HS users and 163 (74%) were nonusers. Majority of the users (42.1%) were on self-prepared folklore herbal medicine postdiagnosis of cancer (57.9%), the most common reason cited being symptom palliation (35.1%) on the advice of friends and family (64.9%). Fear of disapproval was the most common reason cited (68.4%) for not disclosing HS usage to the physician.Conclusion: Chemotherapy and unemployment are predictors of HS usage, and there is a significant association between occupation status and HS usage. This first study on HS prevalence among South Indian population proposes the need for a more robust evidence base for understanding all aspects of HS use in cancer. [ABSTRACT FROM AUTHOR]

The article deals with the improvement of the technology of fish pudding for infant nutrition. The current state and innovative developments of domestic and foreign scientists have been analyzed, perspective directions of enrichment of the fish puddings range and development of the market of products for infant nutrition have been defined. It is established that the main leaders in the production of this type of product are: Italy, England, Germany, Norway, Bulgaria, which specialize in vegetable and fish products. The effectiveness of combining fish, vegetable and animal raw materials in order to perform the nutritional value of fish puddings, in accordance with the requirements of baby food products, is theoretically substantiated and experimentally confirmed. Through the experimental research, the ingredient composition has been optimized and recipes for new fish puddings for infant nutrition based on fish (hake, pike-perch), vegetable (pumpkin) and animal raw materials (butier, milk, eggs) have been developed in the following ratio: sample 1 (hake - 50, pumpkin - 16, butier - 4, milk - 13,4, eggs - 16,2); sample 2 (pikeperch - 50, potato -16, butier - 4, milk - 13,4, eggs - 16,2). The results of researches of structural and mechanical indicators, namely - boundary shear stress, are given in the study. Studies have shown that adding pumpkin to the pudding reduces this indicator. This can be explained by the increase in moisture retention capacity, which makes the finished product susceptible to mechanical impact, ie more so􀅌 and juicy. To ensure the warranty period of storage, the patierns and dynamics of changes in quality indicators during the storage have been studied. The results of studies of acid and peroxide values of fat showed that with increasing duration of storage, these indicators increase within acceptable limits, which confirms the possibility of the selected raw materials usage in the recipes of new fish puddings. Based on the obtained results, the prospects of further research are determined - to develop a technological scheme for the production of fish puddings based on representatives of freshwater fish, namely grass carp and silver carp. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the patterns of vitamin and herbal supplement use among patients with advanced gastrointestinal (GI) cancers and the association of such behavior with the efficacy and toxicity of systemic anticancer treatment. Methods: Project data sphere (PDS) was used to access de-identified datasets of eight clinical trials of advanced GI cancers. Multivariable logistic regression analysis was used to identify factors predicting the use of supplements. Kaplan–Meier survival estimates were used to evaluate the association of supplement use with overall and progression-free survival. Results were stratified according to the site of the primary tumor [pancreatic, gastric, colorectal or hepatocellular carcinoma (HCC)] The association between supplement use and selected chemotherapy side effects was evaluated through Chi-squared testing and subsequent logistic regression. Results: A total of 3441 patients were included in the analysis. Of these, 775 patients reported use of supplements and 2666 patients reported no use of supplements. Higher ECOG performance score (Odds ratio: OR for ECOG 1 versus 0: 1.629; 95% CI 1.363–1.947; P < 0.001) and pancreatic primary site (OR for gastric cancer versus pancreatic cancer: 0.538; 95% CI 0.408–0.709; P < 0.001) was associated with greater use of these supplements. Supplement use was associated with a better overall survival among patients with pancreatic cancer (P = 0.002) but not other GI malignancies. Supplement use was associated with a higher probability of anemia and diarrhea among patients with pancreatic cancer (P < 0.001 for both), gastric cancer (P = 0.016; P = 0.036, respectively) and colorectal cancer (P < 0.001 for both). Conclusions: There is an association between the use of vitamin and herbal supplements and a higher probability of hematologic and gastrointestinal toxicities. There is a need for more studies to confirm the association between such behavior and better overall survival among patients with pancreatic cancer. [ABSTRACT FROM AUTHOR]

Botanical dietary supplements are complex mixtures with numerous potential sources of variation along the supply chain from raw plant material to the market. Approaches for determining sufficient similarity (ie, complex mixture read-across) may be required to extrapolate efficacy or safety data from a tested sample to other products containing the botanical ingredient(s) of interest. In this work, screening-level approaches for generating both chemical and biological-response profiles were used to evaluate the similarity of black cohosh (Actaea racemosa) and Echinacea purpurea samples to well-characterized National Toxicology Program (NTP) test articles. Data from nontargeted chemical analyses and gene expression of toxicologically important hepatic receptor pathways (aryl hydrocarbon receptor [AhR], constitutive androstane receptor [CAR], pregnane X receptor [PXR], farnesoid X receptor [FXR], and peroxisome proliferator-activated receptor alpha [PPARα]) in primary human hepatocyte cultures were used to determine similarity through hierarchical clustering. Although there were differences in chemical profiles across black cohosh samples, these differences were not reflected in the biological-response profiles. These findings highlight the complexity of biological-response dynamics that may not be reflected in chemical composition profiles. Thus, biological-response data could be used as the primary basis for determining similarity among black cohosh samples. Samples of E. purpurea displayed better correlation in similarity across chemical and biological-response measures. The general approaches described herein can be applied to complex mixtures with unidentified active constituents to determine when data from a tested mixture (eg, NTP test article) can be used for hazard identification of sufficiently similar mixtures, with the knowledge of toxicological targets informing assay selection when possible. [ABSTRACT FROM AUTHOR]

Purpose: Overweight and obesity represent worldwide a rising health problem. In this context, dietary supplements and herbal preparations are often used as self-medication for weight loss. The aim of this study was to describe the safety profile of dietary supplements for weight control by analyzing spontaneous reports of suspected adverse reactions (ARs) received by the Italian Phytovigilance System, from July 2010 to October 2017. Methods: The suspected ARs were collected using an ad hoc reporting form, registered in a database at the National Institute of Health and evaluated by a multidisciplinary group of experts. The causality assessment was performed using the WHO-UMC system or the CIOMS/RUCAM score. In case of serious adverse reactions, a feedback is provided to the reporter by e-mail. Results: Sixty-six spontaneous reports were collected. ARs involved cardiovascular system (26%), liver (14%), central nervous system (12%), skin (9%), gastrointestinal system (17%), thyroid (8%), kidney (4%), and other organs/systems (10%). In 64% of cases, the reaction was serious. Dechallenge was positive in 46 cases; three cases of positive rechallenge were reported. After the causality assessment, the association between the product intake and the adverse reaction was judged as possible in the majority of the cases (n = 43; 65%). Conclusions: The data collected confirmed the existence of safety concerns on herbal dietary supplements used for body weight control, mainly related to quality of products and their use as self-medication. In this scenario, spontaneous reports represent the only tools available to monitor safety of these products. [ABSTRACT FROM AUTHOR]

The use of complementary and alternative medicine (CAM) is widespread among adults in the United States to self-treat a range of disorders, including gastrointestinal (GI) disorders. This study determined the self-reported use of CAM, including dietary supplements, in managing GI symptoms among Internet users and investigated perceived effects of supplement use on GI symptoms. We used a cross-sectional, descriptive, correlational design. A Qualtrics online survey was utilized to collect data through various websites. Focused areas include demographics, health evaluation, health issue(s), supplement and CAM use, and GI symptoms. Of the participants included in the study, a majority (88%) were women and half (50.1%) were between the ages of 26 and 45. Most participants (84.5%) reported use of herbal supplements, and 84.8% of the participants used herbal supplements for a specific health problem. The most common reported health condition was gastroesophageal reflux (44.4%). The attrition rate was low at 22%. The novelty of using an anonymous online survey to collect data on supplement use in GI disorders indicated a high prevalence of dietary and herbal supplement use among persons with GI disorders comparable to previous reports. Health-care providers should ask patients about supplement use in addition to prescribed medications and communicate effectively if conventional pharmacotherapy is not sufficient to manage symptoms or patients are inclined to use supplements. [ABSTRACT FROM AUTHOR]

Aim: To assess the effect of oral complementary and alternative medicine (CAM) on the oocyte, embryo and pregnancy rate in first‐cycle in vitro fertilisation (IVF). Method: A prospective cohort study using the International CAM Questionnaire, reviewing patient IVF outcomes. Local ethics approval was obtained. Results: Over 18 months (October 2015 to April 2017) 25 patients were prospectively recruited, with 52% (n = 13) using herbal or dietary supplements, including Chinese medicine, fish oil, liver 'detox', co‐enzyme Q10, spirulina, probiotics and maca root. Comparing users to non‐users, there was no statistical difference in age, body mass index, primary infertility, gravidity or parity. Total follicle‐stimulating hormone dose was equivalent (2760 vs 2451 IU, P = 0.60), but there was a significant difference in maximum oestradiol response (4134 vs 8335, P = 0.045), on univariate analysis alone. While no difference was found in the number of follicles >11 mm (7.5 vs 11.5, P = 0.80), or eggs collected (8.0 vs 12.5, P = 0.91), there was a lower number of eggs fertilised in users (3.0 vs 4.0, P = 0.046). There was no difference in the chemical or clinical pregnancy rate. Conclusion: This small study demonstrates a high use of oral CAM in first‐cycle IVF patients, with a wide range of types. There appears to be a lower fertilisation rate in the women who used oral CAMs. It is unclear whether this is a negative effect of the CAM or selection bias. This concern about confounders supports the need for further research into unregulated herbal medicine on IVF outcomes, given that so many women are using these substances. [ABSTRACT FROM AUTHOR]

Purpose: To develop a system to estimate the risk of herb-drug interactions that includes the available evidence from clinical and laboratory studies, transparently delineates the algorithm for the risk estimation, could be used in practice settings and allows for adaptation and update. Methods: We systematically searched Drugbank, Transformer, Drug Information Handbook, European and German Pharmacopoeia and MEDLINE for studies on herb-drug interactions of five common medicinal plants (coneflower, ginseng, milk thistle, mistletoe and St. John's wort). A diverse set of data were independently extracted by two researchers and subsequently analysed by a newly developed algorithm. Results are displayed in the form of interaction risk categories. The development of the algorithm was guided by an expert panel consensus process. Results: From 882 publications retrieved by the search, 154 studies were eligible and provided 529 data sets on herbal interactions. The developed algorithm prioritises results from clinical trials over case reports over in vitro investigations and considers type of study, consistency of study results and study outcome for clinical trials as well as identification, permeability, bioavailability, and interaction potency of an identified herbal perpetrator for in vitro investigations. Risk categories were assigned to and dynamically visualised in a colour-coded matrix format. Conclusions: The novel algorithm allows to transparently generate and dynamically display herb-drug interaction risks based on the available evidence from clinical and laboratory pharmacologic studies. It provides health professionals with readily available and easy updatable information about the risk of pharmacokinetic interactions between herbs and oncologic drugs. [ABSTRACT FROM AUTHOR]

Botanicals and botanical preparations including plant food supplements as well as medicinal herbal supplements can contain possible beneficial health compounds, but also ingredients of concern. Compounds that are both genotoxic and carcinogenic have been found in herbal supplements and may raise a safety concern. Genotoxic carcinogens that can be present in botanicals and botanical preprations include especially pyrrolizidine alkaloids (PAs), aristolochic acids (AAs) and alkenylbenzenes (ABs). The present manuscript provides an overview of the levels of these compounds reported to date to be present in herbal supplements with an associated risk assessment. Exposure was estimated based on levels of PAs, AAs and ABs in individual supplements and their proposed uses. In addition a probabilistic exposure assessment was performed based on the distribution of the level of the compounds of concern in the food supplements and of the recommended uses, resulting in 5th to 95th percentile consumer exposure values. To evaluate the risk of these exposures, the margin of exposure (MOE) approach for lifetime exposure was used. To correct exposure estimates for shorter than lifetime exposure, Haber's rule as a first tier approach was applied. It is concluded that the proposed uses and use levels as well as the presence of AAs, ABs and PAs in food supplements should be carefully monitored to manage potential consumer risks. More information on estimated daily intake resulting from supplement use, as well as consequences of concomitant exposure will further improve the risk evaluation of products containing these compounds of concern. [ABSTRACT FROM AUTHOR]

Objective: In this paper, we describe prescription medication, over-the counter (OTC) medication, vitamin, and herbal remedy use during pregnancy by Hispanic women in Utah County. Methods: Self-identified Hispanic women (N = 138) in Utah County, Utah completed a questionnaire in a non-profit community health center. Questions addressed use of prescription and non-traditional medications as well as demographic factors and characteristics. Associations between variables were analyzed with Pearson chi-square tests of independence with Monte Carlo simulations. Results: Our results showed that 53% of patients surveyed used prescription medications, 27% used OTC medications, 79% used prenatal vitamins, and 60% used herbal remedies. Maternal age was associated with doctors discussing OTC medications at prenatal visits (p = .002). Women reporting one birth were most likely to use the Internet (p = .019); women with "elementary education" were unlikely to identify "doctor" as their primary information source (p = .022). Physicians did not always discuss OTC or alternative remedies with their patients. Conclusions: There remains a need for patient and provider education on the topic of traditional and alternative remedies. This education can foster trust and cooperativity between patient and physician and ensure high quality perinatal care among Hispanic women. [ABSTRACT FROM AUTHOR]

Garcinia cambogia supplements are widely used for weight loss. Knowing that epilepsy patients are at greater risk of developing overweight/obesity, the investigation of herb-drug interactions involving antiepileptic drugs of narrow therapeutic index is fully justified. This work was planned to assess potential pharmacokinetic-based interactions between G. cambogia extract and lamotrigine (LTG) through two independent pharmacokinetic studies. In the first study (co-administration study), rats were orally co-administered with a single-dose of G. cambogia extract (821 mg/kg) and LTG (10 mg/kg). In the second study (pre-treatment study), rats were orally pre-treated for 14 days with G. cambogia extract (821 mg/kg/day), being LTG administered (10 mg/kg) on the 15th day. Rats of the control groups received water instead of the extract. Following LTG administration, blood samples were collected until 96 h post-dose, and plasma LTG concentrations were determined and submitted to a non-compartmental analysis. Globally, no statistically significant effects were identified in the co-administration study of G. cambogia extract and LTG. In the 14-day pre-treatment study, a statistically significant decrease in the rate of systemic exposure to LTG and an increase of apparent volume of distribution were found. Even so, a minor or no clinical impact is expected from the administration of G. cambogia dietary supplements and LTG. Image 1 • Garcinia cambogia supplements are an attractive alternative to counteract obesity. • Epilepsy and obesity are comorbid conditions. • G. cambogia and lamotrigine co-administration did not change the drug kinetics. • A 14-day pre-treatment period with G. cambogia reduced the C max of lamotrigine. [ABSTRACT FROM AUTHOR]

Objectives: Nutraceuticals are advertised and sold with the label claim of being natural and safe herbal products. Due to the absence of clear regulations and guidelines for safety assessments of these products, nutraceuticals are commonly adulterated in order to increase sales. The objective of the current study was to design a comprehensive evaluation system to assess the safety, efficacy, authenticity according to label claim, and pharmaceutical quality of herbal slimming products in between 2015 and 2017.Methods: We designed a comprehensive assessment system to evaluate the safety, authenticity according to label claim, and pharmaceutical quality of slimming nutraceuticals. Six different popular products were evaluated (Zotreem Plus®, Zotreem Extra®, Malaysian Super Slim®, AB Slim®, Chinese Super Slim®, and Metabolites®). The pharmaceutical evaluation included analyzing the samples via high-performance liquid chromatography to determine any possible adulterants. Additionally, the products' physical properties were assessed via pharmacopeial tests. Finally, a microbial evaluation and a cross-sectional observational retrospective prevalence study were conducted to assess the products' safety and efficacy. -Results: The tested products were found to be adulterated with unreported active pharmaceutical ingredients such as sibutramine, sildenafil, phenolphthalein, and orlistat. Furthermore, they contained heterogeneous amounts of adulterants and exhibited an unsatisfactory pharmaceutical and microbial quality. Finally, the observational survey conducted on users showed that high percentages of participants suffered from common side effects such as depression, diarrhea, and hypertension.Conclusions: These products threaten the health of consumers. There is a need to raise awareness of the lethal consequences of illegal nutraceuticals. [ABSTRACT FROM AUTHOR]

Herbalife® is a global nutrition and weight management company selling and marketing nutritional and weight loss supplements. The United States Federal Trade Commission described Herbalife® in 2016 as a scam disguised as healthy living. Herbalife®-associated liver injury was reported from multiple countries in the West. India is fast becoming the largest growing market for Herbalife® products, expected to surpass the United States in sales revenue. We report the first case of a fatal acute liver failure from the Asia-Pacific region, in a young woman who consumed Herbalife® products over 2 months. We also present unsettling data that showcase heavy metal contamination, toxic compounds, psychotropic substances, and pathogenic bacterial contamination in similar Herbalife® products in India. The growth of Herbalife® in India and expansion of its nutrition clubs in major cities that promise fake health benefits portend a serious public health concern. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Combined 1D and 2D qNMR approach was developed for quantification of the alkaloids beberine, canadine and hydrastine, in goldenseal extracts. • Berberine with non-overlapped signals was quantified by 1D 1H NMR. • Overlapped and low-intensity signals of hydrastine and canadine were quantified by 2D Q QUIPU HSQC NMR. • Berberine, an unstable alkaloid, was not quantified by 2D Q QUIPU due to long durations. • NMR quantitative results are in good agreement with UV and MS. Abstract Authentication of natural products is of major relevance in the context of manufactured drugs or herbal supplements since such active products generate a lucrative market. The analytical method to identify and quantify valuable natural products is critical for quality control and product assignment of herbal supplements. In this framework, we propose to apply a recently developed quantitative 2D NMR approach called Q QUIPU (Quick QUantItative Perfected and pUre shifted) in combination with 1D 1H NMR capable to access the concentration of three major alkaloids, berberine, β-hydrastine and canadine, in the root extract of goldenseal (Hydrastis canadensis), one of the 20 most popular herbal supplements used worldwide. We highlight the complementarity of 1D and 2D quantitative NMR to accurately assess the amount of alkaloids with different range of concentrations and stability within extracts. In particular, unstable natural products having non-overlapped signals like berberine could only be quantified by sensitive and fast 1D 1H, while overlapped signals of β-hydrastine and low intense ones of canadine could only be quantified with the recent 2D Q QUIPU HSQC. Results obtained from this combined approach have led to a good accuracy (<10%) as compared with coupled UHPLC-MS/UV techniques. This quantitative NMR approach paves the way to numerous applications where the accurate quantification of targeted compounds in complex mixtures is required, for instance in agricultural, food and pharmaceuticals products. [ABSTRACT FROM AUTHOR]

Tinospora cordifolia herbal supplements have recently gained prominence due to their promising immunomodulatory and anti-viral effects against SARS-CoV-2. Mislabelling or diluting Tinospora supplements for profit may harm public health. Thus, validating the label claim of these supplements in markets is critical. This study investigated how high resolution mass spectrometry-based metabolomics and chemometrics can be used to distinguish Tinospora cordifolia from two other closely related species (T. crispa and T. sinensis). The Orthogonal Partial Least Square Discriminant Analysis (OPLS-DA) and PLS-DA based chemometric models predicted the species identity of Tinospora with 94.44% accuracy. These classification models were trained using 54 T. cordifolia , 21 T. crispa , and 21 T. sinensis samples. We identified 7 biomarkers, including corydine, malabarolide, ecdysterone, and reticuline, which discriminated Tinospora cordifolia from the two other species. The label claim of 25 commercial Tinospora samples collected from different parts of India was verified based on the relative abundance of the biomarker compounds, of which 20 were found authentic. The relative abundance of biomarkers significantly varied in the 5 suspicious market samples. This pilot study demonstrates a robust metabolomic approach for authenticating Tinospora species, which can further be used in other herbal matrices for product authentication and securing quality. [Display omitted] • HRMS-based metabolomic fingerprinting for species authentication in herbal supplements of Tinospora cordifolia. • Metabolites were identified using comprehensive custom curated accurate mass library. • Chemometric models were developed as proof of concept for authenticating Tinospora cordifolia herbal supplements. • Biomarkers were identified and their relative abundance were compared in authentic and adulterated samples. • This study could help in developing a rugged method for regulatory control of quality and authenticity of herbal supplements. [ABSTRACT FROM AUTHOR]

This letter aims to inform the medical community about herbal supplements that have steroidal and non-steroidal drugs hidden in their formulation, entailing risks to the health of consumers, in addition to the fact that they are not regulated at the local level and the producers of these supplements try to sell them internationally, which would bring serious consequences, since it would become a serious global health problem; these supplements have provoked Cushing's syndrome, diabetes mellitus, sepsis, pneumonitis and invasive helminthiasis. [ABSTRACT FROM AUTHOR]

Recently, sugar maize has become more and more widely used for the production of new types of food. Its use in the production of cereal products for babies makes it possible to use no sugar in their composition, switch to the production of dietary and prophylactic products, which acquires high importance against the background of “rejuvenation” of diabetes and the manifestation of other nutritional diseases. To enhance the consumer properties of the finished product, to give it the appropriate taste, colour and aroma, as well as to enrich with vitamins, mineral components, flavonoids, phytoncides and glucosides, the following raw materials were selected as the main components for their preparation: maize grains, hullless barley grains in the ratio 1:1, liquorice root (2-4%), carrot roots (2-4%). The article presents the results of microbiota studies of extruded grain products with plant additives during storage. The obtained samples were stored in the laboratory in polypropylene, plastic packaging and cardboard boxes at room temperature of the air +(15-20)°C and air humidity 60-75%. The obtained results allow us to establish that with prolonged storage of commercial samples of extruded grain products with the inclusion of vegetable additives in different temperature and humidity conditions, as the shelf life increases, the number of bacteria decreases. The absolute number of spore-forming bacteria in the samples under study, which were stored in synthetic packaging, remained at the same level, and their relative content in the total bacterial flora increased. On the basis of the research, it has been established that the enrichment of products extruded from sugar maize grain with vegetable additives does not impair their microbiological and physico-chemical characteristics during long-term storage in unregulated conditions. It also allows expanding the range of this type of products. [ABSTRACT FROM AUTHOR]

Herbal medicine use in the United States has increased substantially. Despite this upward trend, patients often fail to disclose use of these medicines to their healthcare provider. Currently, the US Food and Drug Administration (FDA) does not require preclinical animal studies, controlled clinical trials, or postmarket surveillance of herbal supplements. Lack of FDA oversight leads to product variation in quality, purity, efficacy, harvesting, and storage. Intentional or unintentional addition of contaminants to these products remains substantial. Because herbal medicines have the potential to adversely react with medications used in the perioperative period, anesthesia providers should be aware of the purported uses of common herbal supplements, potential drug interactions with these medicines or possible contaminants, and the anesthetic implications for patients who use these medicines. [ABSTRACT FROM AUTHOR]

Herbal supplements are used extensively worldwide without much awareness regarding their safety and efficacy. Extensive research to determine the safety, utility, and level of research support for commonly used herbs has culminated in an easily accessible summary chart for NP providers. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To identify which herbal supplements are used, to identify the motivations for their use and to determine the potential for interactions when herbal supplements are used concurrently with prescribed medications. Method: A descriptive study was conducted using patient interviews and surveys to a sample of 150 patients, residents of the northeastern area of Puerto Rico. Results: Over half of the patients (n = 80) mostly were women 51–60 years old had used herbals supplements during the 6 months prior to the study. Patients reported that they used herbals to help improve their health, because they liked using such supplements, and because they are cheaper than prescription medications. The potential for at least one drug–herbal interaction was found in 71% (n = 57) of the herbal supplement users in our sample group. The most frequently identified interactions involved various prescription drugs and green tea, cinnamon and aloe vera. Variable comparison did not show any statistical relationship due to sample size. Conclusion: Concurrent use of herbal supplements and prescription drugs is a common practice which can expose patients to risk, unsafe drug–herbal use and interfere with drug‐use optimization. Although this study was not intended to identify actual adverse events caused by herbal–drug interactions, the risk that such potential interactions might cause significant clinical consequences cannot be ignored. To minimize these potentially harmful interactions, healthcare providers must be aware that herbal supplement use is common among patients and perform routine evaluations of patient herbal supplement use. [ABSTRACT FROM AUTHOR]

Pyrrolizidine alkaloids (PAs) are secondary metabolites of plant families such as Asteraceae or Boraginaceae and are suspected to be genotoxic carcinogens. Recent investigations revealed their frequent occurrence in honey and particularly in tea. To obtain a comprehensive overview of the PA content in animal- and plant-derived food from the European market, and to provide a basis for future risk analysis, a total of 1105 samples were collected in 2014 and 2015. These comprised milk and milk products, eggs, meat and meat products, (herbal) teas, and (herbal) food supplements collected in supermarkets, retail shops, and via the internet. PAs were detected in a large proportion of plant-derived foods: 91% of the (herbal) teas and 60% of the food supplements contained at least one individual PA. All types of (herbal) teas investigated were found to contain PAs, with a mean concentration of 460 µg kg-1 dry tea (corresponding to 6.13 µg L-1 in [herbal] tea infusion). The highest mean concentrations were found in rooibos tea (599 µg kg-1 dry tea, 7.99 µg L-1 tea infusion) and the lowest in camomile tea (274 µg kg-1 dry tea, 3.65 µg L-1 tea infusion). Occurrence of PAs in food supplements was found to be highly variable, but in comparable ranges as for (herbal) tea. The highest concentrations were present in supplements containing plant material from known PA-producing plants. In contrast, only 2% of the animalderived products, in particular 6% of milk samples and 1% of egg samples, contained PAs. Determined levels in milk were relatively low, ranged between 0.05 and 0.17 µg L-1 and only trace amounts of 0.10-0.12 µg kg-1 were found in eggs. No PAs were detected in the other animal-derived products. [ABSTRACT FROM AUTHOR]

The gut microbiome is the community of healthy, and infectious organisms in the gut and its interaction in the host gut intestine (GI) environment. The balance of microbial richness with beneficial microbes is very important to perform healthy body functions like digesting food, controlling metabolism, and precise immune function. Alternately, this microbial dysbiosis occurs due to changes in the physiochemical condition, substrate avidity, and drugs. Moreover, various categories of diet such as "plant-based", "animal-based", "western", "mediterranean", and various drugs (antibiotic and common drugs) also contribute to maintaining microbial flora inside the gut. The imbalance (dysbiosis) in the microbiota of the GI tract can cause several disorders (such as diabetes, obesity, cancer, inflammation, and so on). Recently, the major interest is to use prebiotic, probiotic, postbiotic, and herbal supplements to balance such microbial community in the GI tract. But, there has still a large gap in understanding the microbiome function, and its relation to the host diet, drugs, and herbal supplements to maintain the healthy life of the host. So, the present review is about the updates on the microbiome concerns related to diet, drug, and herbal supplements, and also gives research evidence to improve our daily habits regarding diet, drugs, and herbal supplements. Because our regular dietary plan and traditional herbal supplements can improve our health by balancing the bacteria in our gut. • The microbiome has been strongly linked to several factors of health and development. • Diet and drugs are key contributors to gut microbial dysbiosis. • Various diseases are triggered by microbial dysbiosis (such as diabetes, obesity, cancer, inflammation, and so on). • Herbal supplements, probiotics, prebiotics, and postbiotics can be maintained the GI tract's microbial balance. [ABSTRACT FROM AUTHOR]

In this work, for the first time, a high-performance ion mobility spectrometry with electrospray ionization (ESI-HPIMS) method has been employed as a rapid screening tool for the detection of acetaminophen, ibuprofen, naproxen, diclofenac sodium and indomethacin illegally added in anti-rheumatic herbal supplements and herbal remedies. Samples were dissolved and filtered through a 0.45 μm microporous membrane, then the filtrate was directly injected into the high-performance ion mobility spectrometry for analysis. Using this approach, the screening of illegal additions can be accomplished in as rapid as two to three minutes with no pretreatment required. The proposed method provided a LOD of 0.06–0.33 μg mL −1 , as well as a good seperation of the five NSAIDs. The precision of the method was 0.1–0.4% (repeatability, n = 6) and 0.9–3.3% (reproducibility, n = 3). The proposed method appeared to be simple, rapid and highly specific, thus could be effective for the in-situ screening of NSAIDs in anti-rheumatic herbal supplements and herbal remedies. [ABSTRACT FROM AUTHOR]

This review aims to highlight recent approaches concerning usage of (traditional) herbal medicinal products in pregnancy and to discuss appropriate strategies to handle limited information. Therefore, published monographs of the Committee on Herbal Medicinal products (HMPC) and selected publicly funded webpages, medicinal handbooks, publications and industry and health care organisations webpages were evaluated. While within the monographs of the HMPC a rather conservative approach could be found (mainly because of lacking nonclinical and/or clinical studies), all other sources display a wide variety of information or assessments, thereby often giving contradictory recommendations. However, some experience with the usage of herbal substances/preparations exists in daily clinical practise without clinical trials or observational studies and some herbal substances/preparations are also used as food/food supplements/cosmetics/medical devices. Discussions should be started how to use that knowledge and experience to adjust regulatory decisions on a case-by-case basis, if possible. [ABSTRACT FROM AUTHOR]

An ion mobility spectrometry (IMS) method was developed for the rapid detection of mitragynine, the most abundant alkaloid in Mitragyna speciosa also known as kratom. The peak corresponding to the mitragynine protonated ion exhibited a reduced ion mobility of 0.95 ± 0.00014 cm 2 /(V s), and the mitragynine limit of detection using IMS was 0.5 ng. The IMS method was applied to the analysis of 15 commercial samples suspected of containing kratom. IMS results were compared to those obtained from liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis of the same samples. Mitragynine was conclusively detected in 14 of 15 samples using LC–MS/MS and 13 of 15 samples using IMS. The discrepancy between methods reflected the fact that one sample contained mitragynine at a concentration below the IMS detection limit. This study demonstrates the utility of IMS for the rapid screening of products containing kratom as well as the scientific reliability of the IMS screening method, which was demonstrated by comparing the IMS results to the confirmatory results obtained using LC–MS/MS. [ABSTRACT FROM AUTHOR]

This article examines key issues concerning the regulation of dietary supplements in Canada. The article looks at problems related to both the composition of supplements and of marketing practices. It looks back to the situation around 1999, the year of the introduction of the new system for the regulation of supplements, and then assesses the situation now. The new system has failed to bring about the intended improvement in either the formulation of supplements or the level of honesty in their marketing. [ABSTRACT FROM AUTHOR]

Herbal supplements are generally considered safe; however, drug disposition is influenced by the interactions of herbal supplements and food constituents with transport and metabolic processes. Although the interference of herbal supplements with drug metabolism has been studied extensively, knowledge of how they interact with the drug transport processes is less advanced. Therefore, we describe here specific examples of experimental and human interaction studies of herbal supplement components with drug transporters addressing, for example, organic anion transporting polypeptides or P-glycoprotein, as such interactions may lead to severe side effects and altered drug efficacy. Hence, it is clearly necessary to increase the awareness of the clinical relevance of the interference of herbal supplements with the drug transport processes. [ABSTRACT FROM AUTHOR]

This study investigated the role of phytogenic supplements on the reproductive physiology and metabolic hormones of rabbits exposed to heat stress conditions. Fresh Moringa oleifera, Phyllanthus amarus and Viscum album leaves were obtained and processed into a leaf meal using standard procedure and served as a phytogenic supplements. Eighty rabbit bucks of 6 weeks old (514.84 ± 14.10 g) were randomly assigned to the four dietary groups consisting of Diet 1 without the leaf meal (control diet) and Diets 2 (D2); 3 (D3) and 4 (D4) contained 10% Moringa, 10% Phyllanthus and 10% Mistletoe, respectively, in an 84-day feed trial at the peak of thermal discomfort. Semen kinetics and seminal oxidative status, reproductive and metabolic hormones were assessed using standard procedure. Results reveal that sperm concentration and motility traits of bucks on D2, D3 and D4 were significantly (p < 0.05) higher than bucks on D1. Spermatozoa speed traits of bucks on D4 were significantly (p < 0.05) higher than bucks on other treatments. Seminal lipid peroxidation of bucks in D2-D4 was significantly (p < 0.05) lower than bucks on D1. Corticosterone of bucks on D1 was significantly higher than bucks on other treatments (D2-D4). Lutenizing hormone of bucks on D2 and testosterone of bucks on D3 was higher (p < 0.05) than in other groups, while follicle stimulating hormone of bucks on D2 and D3 were higher (p < 0.05) than bucks on D1 and D4. In conclusion, the three phytogenic supplements improved sex hormones, enhanced spermatozoa kinetics, viability and seminal oxidative stability of bucks during heat stress condition. • Bucks under heat stress had lower libido, semen output, T3, LH, testosterone, seminal antioxidant activity. • Moringa oleifera supplements in bucks' diets enhanced libido, LH, FSH, sperm count, seminal GPx. • Phyllanthus amarus enhanced spermatozoa trajectory traits and count, T3, insulin, FSH, testosterone over other supplements. • Viscum album supplementation improved libido, spermatozoa speed and tranjectory traits of bucks during heat stress. • The three phytogenic supplements enhanced sperm motility traits and sperm viability in bucks during heat stress conditions. • They enhanced seminal total antioxidant activity, lower seminal lipid peroxidation in bucks during heat stress conditions. [ABSTRACT FROM AUTHOR]

In the last of a three-part series on herbal supplements, laws and guidelines impacting the use of herbal supplements are discussed. Distinct differences exist between regulations for herbal supplements and those products defined as drugs. Consideration of herbal therapy should be approached within a context of holistic treatment. [ABSTRACT FROM AUTHOR]

This is part 2 of a three-part series designed to provide clinicians with a working knowledge of the use of herbal supplements for health and disease states. Part 2 of the series focuses on the efficacy of herbal supplements used in the treatment of common chronic conditions. [ABSTRACT FROM AUTHOR]

In the United States, nearly 44,000 people are diagnosed with oral or pharyngeal cancer annually. The life expectancy for those who are diagnosed have a survival rate of 57% after five years. Among them, oral cancer can be classified as benign or malignant tumors and is diagnosed at several stages in the development: premalignant conditions, premalignant lesions, and malignant cancer. The early signs of oral cancer often go unnoticed by the individual and are often discovered during routine dental examinations. Early detection and treatment may help to increase patient survival rates. The most widely used treatments for oral cancer include surgery, radiation, and chemotherapy—alone or in combination. Preclinical and clinical evidence for the use of green tea, raspberry, asparagus, and cannabis extracts is discussed in this review. Diet changes, supplementation with antioxidants, high-dose vitamin C therapy, and cannabinoid use have been suggested to decrease cancer cell replication and increase chance of remission. Early detection and lifestyle changes, including the use of dietary supplements in at-risk populations, are critical steps in preventing and successfully treating oral cancer. The main evidence for supplement use is currently in cancer prevention rather than treatment. Further research, determination, and mechanism of action for bioactive compounds such as epigallocatechin, epicatechin-3-gallate, and Bowman-Birk inhibitor concentrate, through in vitro, in vivo, and clinical trials need to be completed to support the use of natural products and their effectiveness in preventative care and supporting therapeutic approaches. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to measure the prevalence of using herbal supplements for weight loss in patients with metabolic syndrome and their level of knowledge about the supplements according to education, gender, and age. Method: The study was conducted with patients who agreeing to participate. Patients were diagnosed with metabolic syndrome according to the Diabetes Foundation-2005 Metabolic Syndrome Diagnostic Critery; they were 18-65 year old males (n=50) and females (n=50). Their level of knowledge about the supplements were measured according to their gender, age, educational status, and income level. A face-to-face questionnaire with 15 questions was applied. Results: The majority of the patients were between the ages of 30-49 with 54 people. When the educational status of the patients was questioned, 77% were primary and secondary school graduates. The income level of the patients was mainly at the level of 6,000 ₺/month (64%). There was no significant difference between men and women in the definition of herbal supplements. Seventeen of male patients (34%) and 33 in females (66%) (p=0.001) were using herbal supplements. Seventeen of male patients (34%) knew that herbal supplements could have side effects and 32 in females (64%) (p=0.01). When the level of knowledge about side effects was compared between the age groups, there was no significant difference (p=0.45). The level of knowledge about the herbal supplements increases with education level (p=0.002). Conclusion: In conclusion, the number of women using herbal supplements for losing weight and the knowledge level of women about these supplements are higher than men. The level of knowledge about the herbal supplements also increases with education level. [ABSTRACT FROM AUTHOR]

The article presents the first of a three-part series on herbal supplements for health promotion and disease prevention in the U.S. Topics discussed include the definition of dietary supplements, herbals, and botanicals, and the identification of the herbal supplements used for health promotion and disease prevention. The history of the use of herbal products in the country and implications for nursing practitioners are mentioned.