herbal supplements: safety & research support
TRANSCRIPT
Herbal Supplements: Safety & Research Support
Rosanne Pruitt, PhD, APRN, FNP-BC, ProfessorSenior Honors Students: Adam Carroll & Ashley Lemanski
Clemson University School of NursingSigma Theta Tau International Gamma Mu Chapter
Herbal Supplements
Extensive use worldwideConsidered a safe alternative by consumers due to natural ingredients 1
Many herbs can be traced to ancient timesLack of awareness of research on efficacy, safety, interactions
Herb use is often not part of communication with health care providers.
Nurses & other health care professionals typically receive very little formal education about herbs.
Few pharmaceutical companies are involved in research due to inability to patent naturally occurring substances-often market combination products
Some herbs are effective & can be used to maintain & enhance health alone or in conjunction with other therapies
Others interact with prescription medication enhancing or inhibiting action which may be unintended & harmful2
Current research findings demonstrate that costly supplements may be no better than a placebo3
Purpose: fill a gap & provide evidence to inform practice
Evaluating research supporting commonly used herbs
Translating the information into an easily accessible format.
Focus: 55 commonly used herbs and essential oils
Reviewing of over 150 research studies, many meta-analyses
Quality of Research Evidence
Rated for each herb:
1 = Clinical trials or Meta-analysis
2 = Correlation, surveys
3 = Insufficient, animal studies
Variations for individual herbs:
Gamma linolenic acid for rheumatoid arthritis (1)
Type II Diabetes (2)
Side effects or precautions and drug interactions are also addressed.
Avocado5-6
Generally safe
Recommended uses(1) Abdominal fat deposits
1-1.5 avocados q day x 2-4 weeks
(3) Decrease LDL, triglycerides & hypertension
No known precautions
Lavender EO7-10
Generally safe
Recommended uses
(1) Antibacterial, antifungal, sleep quality, stress and anxiety, postpartum depression
Precautions
Inhaled oil bottle necklaces lack efficacy
Peppermint, leaf or EO11-16
Generally safe
Recommended uses
(1) Antioxidant, IBS, dyspepsia
Enteric coated caps TID 15 min a meals x 28 days
(1) Congestion 3-4 drops inhaled
(2) Antimicrobial, virucidal, nausea, tension headaches
Precautions
Contraindicated with GERD (due to GI relax), gallbladder disease, or liver disease
Milk Thistle17-21
Generally safe
Recommended uses(3) Chronic Liver Disease, Decrease Cholesterol, Renal Protective, Decrease Atherosclerosis Plaques, Decrease Blood Glucose
PrecautionsLong-term effects not studied
Research limited to animal studies
Ginseng22-23
Generally safe
Recommended uses(1) Peripheral Vasodilation
(3) Regulate Glucose, Decrease Weight, Increase LBM
PrecautionsNo Anticoagulation drugs
St. Johns Wart24-26
Use with Caution
Recommended uses(1) Mild to Moderate Depression
PrecautionsShort term use only: less than 3 months
Drug Interactions
Ginkgo27-28
Use with Caution
Recommended uses(1) Periodontitis
(2) Adjunct for Attention Deficit Disorder
PrecautionsNo Anticoagulants
No Thiazide Diuretics
Long-term use unknown
Goldenseal29-31
Not Recommended
Commonly Used ForSore throat, gastrointestinal disease, wound healing
PrecautionsIncrease risk of liver tumors
DNA damage
Ephedra32-35
Not Recommended
Commonly Used ForWeight Loss
Energy
PrecautionsHypertension
Stoke
Heart attack
Death
Our focus was adults age 18-65.
Usage recommendations are consistent with health authorities and specialty organizations.
Chart developed for use by nurses and other healthcare providers was piloted with health care providers for utility. It received favorable ratings with one recommendation to increase the font size which we did.
Providers have asked about my use of herbs
13%
23%
17%13%
34%
Strongly agree
Somewhat agree
Neutral
Somewhat disagree
Strongly disagree
47% Disagree17% Neutral36% Agree
Regular Use of Herbs without Telling Provider
Strongly Agree Somewhat Agree Neutral Somewhat Disagree Strongly Disagree
60% Disagree13% Neutral27% Agree
Most commonly used herbs by participants
Green TeaGinger Garlic
Cinnamon Avocado
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