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Medicinal plant products have been used in health care since time immemorial. During the past three decades, the use of herbal supplements has been on the rise in the USA. A number of these products have been shown to possess the potential to interfere with blood clotting. This paper is a review of blood-thinning herbal supplements commonly used in the USA, accompanied by discussion of the dental implications of their use along with suggestions for prediction and prevention of the risk of bleeding. Twenty herbal supplements belonging to four pharmacological groups are identified and reviewed. While the majority (45%) of the supplements reviewed possesses antiplatelet properties, the remaining are dispersed among anticoagulant (15%), a combination of antiplatelet and anticoagulant (15%), and other diverse groups (25%). The literature reveals that most of the available information on blood-thinning herbs is based on in vitro experiments, animal studies, and individual clinical case reports. Some herbal effects are also speculated based on theoretical grounds. These observations, together with the deficiency of the law regulating herbal supplements, indicate limitations of the literature and the regulatory mechanisms related to these products, further implying the need for additional research and improved regulation. While emphasizing the dental implications of the findings reported in the literature, suggestions were made for prediction and prevention of the risk of bleeding caused by herbal medications, based on the concepts of predictive, preventive, and personalized medicine. [ABSTRACT FROM AUTHOR]

Herbal supplements or "botanicals," are a type of complementary and alternative medicine (CAM) made from one or more plants, and are thought to be useful in treating diseases or maintaining health. These supplements are usually found in pharmacies, and continue to gain popularity among consumers today. The aim of this study was to assess the perceptions and knowledge of community pharmacists practicing in Zaria & Kaduna metropolis on herbal supplements. A cross-sectional survey was carried out from July to October 2016 on pharmacists working in 82 randomly selected community pharmacies. A structured questionnaire containing four sections and 45 questions was used to collect data from respondents on their demographic characteristics, personal experiences with herbal supplements, knowledge of selected herbal supplements and general perceptions of herbal supplements. Data collected was coded and analyzed using SPSS version 20, and descriptive statistics used to report results. While 120 questionnaires were distributed, only 99 were eventually retrieved. Majority of the respondents were male (80%), and had BPharm as their highest educational qualification (97%). Most of the respondents reported having used herbal supplements before (92%) and up to 71% had used these supplements within the last 12 months. Many of the respondents (70%) had poor knowledge regarding the indications, safety and interactions associated with the use of selected herbal supplements. Over 90% of them agreed that herbal supplements are beneficial, and should be integrated into conventional clinical care, however less than half of them believed that these supplements were safe and had fewer side effects than conventional medicines. Community pharmacists in Kaduna have poor knowledge but largely positive perceptions of herbal supplements. [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]

Background: Stroke is one of the leading causes of global disability. Post stroke rehabilitation program becomes the key to gain functional recovery. Thus it minimizes disabilities. Multiple studies have been carried out to gain greater functional outcomes for post stroke patients, including medical therapy such as supplements. However, supplement effectiveness in providing stroke recovery or prevention is still debatable. There is no data of supplement consumption among post stroke patients; therefore, the aim of this study was to determine the supplement consumption among post stroke patients. Methods: This study was a cross sectional descriptive study using primary data with a consecutive sampling method. Minimum samples for this study were 42 post stroke respondents who followed rehabilitation program. This study was conducted at Physical Medicine and Rehabilitation Clinic of Dr. Hasan Sadikin General Hospital Bandung from June until November 2013. The interviews were done after written informed consent was obtained. Descriptive statistics such as frequency distributin and proportion were used to analyze the data. Results: From 42 respondents, 23 (55%) respondents consumed the supplement. From 34 supplements recorded, 56% were herbs supplements; followed by multivitamin (29%), mineral (6%), multivitamin and mineral (6%), and other supplement (3%). The most frequent ingredients composed in the supplements were B1, B6 and B12 vitamin (7%). Conclusions: More than a half of post stroke patients at Physical Medicine and Rehabilitation Clinic Dr. Hasan Sadikin General Hospital are supplement users, with herbal supplements as the majority. The most frequent ingredients used are B1, B6 and B12 vitamin.

Millions of Americans regularly use herbal supplements, but many are unaware of the potential hidden dangers. Numerous supplements have been associated with hepatotoxicity and, indeed dietary/herbal supplements represent an increasingly common source of acute liver injury. We report a case of acute liver failure requiring liver transplantation associated with the use of Garcinia cambogia, a supplement widely promoted for weight loss. When patients present with acute hepatitis or liver failure from an unknown etiology, a careful history of supplement use should be performed.

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]

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acquired ichthyosis is an uncommon finding in the outpatient dermatology clinic. This case portrays a presentation of ichthyosis induced by the medicinal drink, kava, which is becoming a more mainstream beverage in American culture. This case provides an overview of the clinical presentation of ichthyosis and a historical background on kava as well as recent studies on kava-induced ichthyosis or kava dermopathy. It also highlights the need to consider the use of herbal and alternative therapies when considering the underlying causes of skin disorders. [ABSTRACT FROM AUTHOR]

Silymarin, extracted from milk thistle ( Silybum marianum ), is esteemed for its antioxidative, anti-inflammatory, and antifibrotic properties, notably within liver-related contexts. Nevertheless, a comprehensive grasp of its effects on liver enzymes remains elusive. This systematic review aims to scrutinize the influence of silymarin supplements on liver enzyme levels, elucidating its potential for hepatoprotection. Following PRISMA 2020 guidelines, we systematically reviewed pertinent studies in PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online). Our inclusion criteria comprised randomized clinical trials (RCTs) published between 1992 and 2023, accessible in English, with a primary focus on liver enzyme levels. Non-original research, ambiguously defined studies, and those lacking essential data were excluded. Of the 1,707 initially identified articles, 29 RCTs met the inclusion criteria, encompassing 3,846 participants with diverse underlying conditions. Silymarin dosages ranged from 140 mg to 420 mg, administered for various durations. Results revealed that 65.5% of the studies reported reduced liver enzyme levels, 20.7% exhibited no significant change, and 13.8% observed elevated liver enzymes. The systematic review implies a potential advantageous influence of silymarin on liver enzyme levels, indicating its hepatoprotective potential. Nevertheless, outcome disparities may stem from comorbidities, suboptimal doses, and underlying diseases. Notably, silymarin's impact on liver enzymes could be context-dependent, with varying responses among different conditions, with the decrease of liver enzyme levels in patients with non-alcoholic fatty liver disease. Silymarin supplements exhibit potential for hepatoprotection by ameliorating liver enzyme levels across diverse conditions. Further research should ascertain optimal dosages and contexts, accounting for individual patient characteristics and underlying diseases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Calderon Martinez et al.)

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]

The objective of this study was to evaluate the electrocardiographic effects of hawthorn in healthy adult volunteers. It was double-blind cross-over trial randomized 20 healthy adult volunteers to receive either a single oral 160-mg dose of hawthorn or matching placebo. Triplicate 12-lead electrocardiograms were taken before treatment and at 1-, 2-, 4-, and 6-hr post-dose. Following at least a 7-day washout period, participants were crossed over to the opposing treatment arm and had the measurements repeated. The primary endpoint was the change in corrected (Fridericia) QT intervals (QTc I) at 4 and 6 hr. Maximum post-dose QTc I and changes in PR and QRS intervals were measured. No significant differences in 4- or 6-hr QTc I were seen between hawthorn and placebo. Maximum post-dose QTc I in the hawthorn and placebo groups were similar (346 ± 35 vs 346 ± 40 ms; p = .979). No significant adverse events were seen. In conclusion, a single dose of oral hawthorn had no effect on electrocardiographic parameters in healthy volunteers. [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]

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

During the past few years, there have been growing interests in business development of herbal supplements in many developing countries especially in Iran. Herbal supplements are used to cure many deceases such as medicating anxiety, acne, weight loss, depression, etc. In this paper, we present an empirical investigation to detect important factors influencing exporting herbal supplements. The proposed study designs a questionnaire consists of 31 questions, distributes it among 210 experts who are professional in the area of production and distribution of herbal supplements and using factor analysis, the study detects eight factors including supportive laws and regulations, organizational atmosphere, marketing structure, knowledge oriented, feasibility study, research and development, competitive strategy and partnership strategies.

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]

Several drugs, including aminoglycosides and platinum-based chemotherapy agents, are well known for their ototoxic properties. However, FDA-approved drugs are not routinely tested for ototoxicity, so their potential to affect hearing often goes unrecognized. This issue is further compounded for natural products, where there is a lack of FDA oversight and the manufacturer is solely responsible for ensuring the safety of their products. Natural products such as herbal supplements are easily accessible and commonly used in the practice of traditional eastern and alternative medicine. Using the zebrafish lateral line, we screened a natural products library to identify potential ototoxins. We found that the flavonoids quercetin and kaempferol, both from the Gingko biloba plant, demonstrated significant ototoxicity, killing up to 30 % of lateral line hair cells. We then examined a third Ginkgo flavonoid, isorhamnetin, and found similar levels of ototoxicity. After flavonoid treatment, surviving hair cells demonstrated reduced uptake of the vital dye FM 1-43FX, suggesting that the health of the remaining hair cells was compromised. We then asked if these flavonoids enter hair cells through the mechanotransduction channel, which is the site of entry for many known ototoxins. High extracellular calcium or the quinoline derivative E6 berbamine significantly protected hair cells from flavonoid damage, implicating the transduction channel as a site of flavonoid uptake. Since known ototoxins activate cellular stress responses, we asked if reactive oxygen species were necessary for flavonoid ototoxicity. Co-treatment with the antioxidant D-methionine significantly protected hair cells from each flavonoid, suggesting that antioxidant therapy could prevent hair cell loss. How these products affect mammalian hair cells is still an open question and will be the target of future experiments. However, this research demonstrates the potential for ototoxic damage caused by unregulated herbal supplements and suggests that further supplement characterization is warranted. [ABSTRACT FROM AUTHOR]

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is a clinico-radiologic syndrome characterized by thunderclap headache and reversible multifocal arterial constrictions that resolves within 3 months. RCVS can be either spontaneous or related to a trigger; vasoactive drugs including over-the-counter medicine are common culprits. Nevertheless, there are sparse data on the association of herbal supplements in the genesis of unexplained RCVS.Methods: We describe a case of RCVS with a temporal association with the consumption of a diet pill composed of green tea, L-carnitine, and conjugated linoleic acid. We reviewed the literature describing RCVS cases associated with consumption of herbal supplements or plants.Results: A 50-year-old black woman presented at the emergency room with a thunderclap headache less than 1 week after beginning a new herbal supplement with weight loss purpose. Angiographic study revealed multiple arterial constriction of virtually all intracranial territories that were reversed 28 days later. The patient was discharged with minimal symptoms. From our review, we identified 5 previous reports of herbal product-related triggers.Conclusions: Different factors can trigger RCVS. Besides our case, at least 5 other nutraceutical products were described to be associated with the disorders, 3 of them in patients without any other clear cause. Clinicians should be aware of the possible role of herbal supplements in RCVS, and their use should be systematically assessed in large RCVS cohorts to clarify this association. [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]

Complementary and alternative medicines have become increasingly popular among cancer patients over the past 45 to 55 years. Among the various types of complementary and alternative therapies, vitamins, minerals, and supplements appear to be most commonly used. This literature review aims to identify evidence related to the efficacy and safety of vitamins, minerals, herbal supplements, and any other dietary supplements (VMHD) as complementary and alternative therapies in the treatment of cancer. Methods: A literature search was conducted using Ovid MEDLINE, Embase, and Cochrane Central databases to identify any trials assessing the efficacy and safety of VMHD over the past 5 years. Results: Twenty studies were included in this review. Included studies investigated the use of VMHD as treatments for traditional medicine side effects, or as potential treatments for cancer. Goshajinkigan was reported to significantly reduce peripheral neurotoxicity in two independent studies. However, outcomes for other VHMD therapies were not reported across multiple studies, making comparison of findings challenging. Conclusions: Limited evidence supporting VHMD therapies for disease management and remedying the side-effects of traditional treatments is available from the past five years. Comparisons using recent trial evidence are challenging due to limited cases where multiple studies evaluate the same VHMD therapies for the same outcomes, and quality of evidence is limited by small sample sizes and drawbacks in study design. Future syntheses may benefit from inclusion of other study designs and peer-reviewed literature published prior to the year 2011. [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]

The advent of Corona virus Disease 2019 (COVID-19) distorted health systems of many countries. Efforts have been made to either develop new treatment solutions such as vaccines or repurpose previously adopted drugs. Challenges in accessing available treatment, inadequate, non-existent, or overstretched healthcare facilities, long COVID disease, cultural practices and beliefs about vaccination, vaccine hesitancy, availability, accessibility and perceived safety of herbal supplements seem to be major factors propelling individuals to use herbal supplements. Published reports advocating for clinical development of herbal supplements for COVID-19 and other emerging and re-emerging viral diseases are sparse. This paper aims to review the pathogenesis of COVID-19, use of herbal products during the pandemic and make case for clinical development of herbal supplements through the adoption of modern and acceptable technologies and research processes. This was a scoping review. Database searches of Google Scholar, PubMed and ResearchGate among others were performed using related keywords to identify relevant journals and lists of primary articles. Clinical trial databases:-Clinicaltrial.gov, Pan African Clinical Trial Registry (PACTR) and WHO international clinical trial registry (ICTRP) were reviewed to extract data. The use of herbal supplements during COVID-19 was not only peculiar to individuals living in Sub-Saharan Africa, but a global practice. Herbal supplements recommended to manage COVID-19 have not been validated using clinical trials. Available data showed that the number of herbal supplements undergoing clinical trial for COVID-19 indication in Africa was low. The availability of medicinal plants in Sub-Saharan Africa if well explored has great potentials to address various emerging and re-emerging viral diseases confronting the region. The economic potential of clinically validated herbal supplements are huge, and tapping into this opportunity created by preference of population to herbal supplement could increase export of herbal supplement and gross domestic product (GDP) of respective countries in Africa., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background and Aim: The outbreak of coronavirus (COVID-19) has made a global public health disaster. Little information is known about how to combat this infection. Therefore, preventive health measures that can reduce the severity and progression of this disease are needed. Some dietary supplements and herbal products have antiviral and anti-inflammatory effects. Thus, it may be used to enhance immunity and reduce the risk of COVID-19 infection. In this study, we reviewed selected supplements that may play a key role in the prevention and management of COVID-19 (e.g. vitamin D, vitamin C, and zinc), and that was to determine the level of knowledge and attitudes toward them by the adult population in Jordan., Methodology: This is a cross-sectional study design, in which an online questionnaire was conducted and distributed on different social media websites. People who are above 18 years old were included in this study. Demographic, Attitudes, and knowledge data were collected and then analyzed using the Statistical Package for Social Sciences (SPSS 23)., Results: In this study, (62.8%) of participants became more concerned with their health during the COVID-19 pandemic, and (49.2%) of them used dietary and herbal supplements to protect themselves from the coronavirus. In addition, (18.5%) of participants reported that they had used these supplements for a while and then stopped., Conclusion: The findings of our study provided evidence that the general population in Jordan has a reasonable level of knowledge and acceptance of dietary and herbal supplements used during the COVID-19 pandemic., Competing Interests: There is no conflict of interest., (© 2023 The Author(s).)

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]

Analgesics, such as acetaminophen (APAP) and codeine (COD), are used to adulterate medicinal herbs and/or herbal supplements. This study evaluated the APAP and COD levels in 60 herbal supplement and/or herb-based medicine samples collected from apothecaries in Hamadan, Iran. The samples were analysed using a high-performance liquid chromatography (HPLC) system. The results showed that 15% of the samples contained 38900-165200 ng/g and 31.1-603.3 ng/g of APAP and COD, respectively. Due to the side-effects of analgesic drugs in human, control of these drugs is recommended in herbal supplements. [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]

Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) Hypericum perforatum (St. John's Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by Crocus sativus L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John's Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression.