High Cholesterol : Supplements

A number of clinical studies have indicated that garlic can offer modest reductions in cholesterol. A 1997 study by nutrition researchers at Pennsylvania State University found men who took garlic capsules for five months reduced their total chole...

Water-soluble, B complex vitamin. Prescription-only preparations are FDA-labeled for use as antilipemic agents. Do not use dietary supplement preparations and prescription-only preparations interchangeably. (See Substitution of Different Niacin Preparations under Cautions.)

Niacin is a type of B vitamin. It is water-soluble, which means it is not stored in the body. Water-soluble vitamins dissolve in water. Leftover amounts of the vitamin leave the body through the urine. That means you need a continuous supply of such vitamins in your diet.

Niacin, also known as Vitamin B 3 , is important for the normal function of many bodily processes. Like other B vitamins , it is water-soluble and plays a role in turning food into energy, as well as in the metabolism of fats and carbohydrates . Niacin can also act as an antioxidant within cells, which means it can destroy cell-damaging free radicals. In conjunction with riboflavin and pyridoxine, it helps to keep the skin, intestinal tract and nervous system functioning smoothly.

Niacin, also known as Vitamin B 3 , is important for the normal function of many bodily processes. Like other B vitamins, it is water-soluble and plays a role in turning food into energy, as well as in the metabolism of fats and carbohydrates. Niacin can also act as an antioxidant within cells, which means it can destroy cell-dam-aging free radicals. In conjunction with riboflavin and pyridoxine , it helps to keep the skin, intestinal tract and nervous system functioning smoothly.

Red yeast rice is the product of yeast ( Monascus purpureus ) grown on rice, and is served as a dietary staple in some Asian countries. It contains several compounds collectively known as Monacolins, substances known to inhibit cholesterol synthesis. One of these, "Monacolin K" is a potent inhibitor of HMG-CoA reductase, and is also known as Mevinolin or Lovastatin (Mevacor®, a drug produced by Merck & Co., Inc). Red yeast rice extract has been sold as a natural cholesterol-lowering agent in over the counter supplements, such as Cholestin TM (Pharmanex, Inc). However, there has been legal and industrial dispute as to whether red yeast rice is a drug or dietary supplement, involving this manufacturer, the U.S. Food and Drug Administration (FDA) and the pharmaceutical industry (particularly producers of HMG-CoA reductase inhibitor prescription drugs or "statins"). The use of red yeast rice in China was first documented in the Tang Dynasty in 800 A.D. A detailed description of its manufacture is found in the ancient Chinese pharmacopoeia, Ben Cao Gang Mu-Dan Shi Bu Yi, published during the Ming Dynasty (1368-1644). In this text, red yeast rice is proposed to be a mild aid for gastric problems (indigestion, diarrhea), blood circulation and spleen and stomach health. Red yeast rice in a dried, powdered form is called Zhi Tai. When extracted with alcohol it is called Xue Zhi Kang.

Native to China, red yeast rice extract is the byproduct of Monascus purpureus Went (red yeast) fermenting on rice. Part of the Monascaceae family, Monascus purpureus is identified by its ascospores. The color of the mycelium is initially white, but soon changes to pink and then yellow-orange due to an increase in acidity and the development of hyphae. They explain that as the culture ages, it is characterized by a dark crimson color at the substratum.

Psyllium, also referred to as ispaghula, is derived from the husks of the seeds of Plantago ovata . Psyllium contains a high level of soluble dietary fiber, and is the chief ingredient in many commonly used bulk laxatives, including products such as Metamucil® and Serutan®. Psyllium has been studied as a "non-systemic" cholesterol-lowering agent, with generally modest effects seen on total cholesterol and low-density lipoprotein levels. Several psyllium-containing cereals such as Heartwise® and Bran Buds® have appeared in the United States marketplace during the last 15 years, and have been touted for their potential lipid lowering and "heart health promoting" effects. Allergic reactions, including anaphylaxis have been reported, particularly in healthcare workers with previous experience preparing psyllium-containing bulk laxatives. Obstruction of the gastrointestinal tract by such laxatives has also been reported, particularly in patients with prior bowel surgeries or anatomic abnormalities, or when mixed with inadequate amounts of water.

Cellulose derivatives (methylcellulose), calcium polycarbophil, malt soup extract, and psyllium preparations are bulk-forming laxatives.

Psyllium is a seed used for medicinal purposes taken from the common fleawort, Plantago psyllium . There are about 250 species of the genus Plantago found worldwide; they belong to the Plantaginaceae family. The most common species producing seed for medicinal use, in addition to P. psyllium, are P. afra, P. isphagula, P. ovata , and P. indica . Psyllium is extensively cultivated in many parts of the world. Shrubby perennial plants with narrow green leaves put up spikes of small flowers that mature into seedpods. The seeds and husks are harvested and used in healing. The seeds are small (1.5–2 cm) and brown or reddish-brown. Psyllium has been used in Ayurvedic medicine in India and in traditional Chinese medicine for thousands of years. It has also been used in Europe for many years, but it has become common in North American healing only near the end of the twentieth century.

Soy is a subtropical plant, native to southeastern Asia. This member of the pea family (Fabaceae) grows from one to five feet tall and forms clusters of three to five pods, each containing two to four beans per pod. Soy has been a dietary staple in Asian countries for at least 5,000 years, and during the Chou dynasty in China (1134-246 B.C.), fermentation techniques were discovered that allowed soy to be prepared in more easily digestible forms such as tempeh, miso, and tamari soy sauce. Tofu was invented in 2nd Century China. Soy was introduced to Europe in the 1700s, and to the United States in the 1800s. Large-scale soybean cultivation began in the United States during World War II. Currently, Midwestern U.S. growers produce approximately half of the world's supply of soybeans. Soy and components of soy called "isoflavones" have been studied scientifically for numerous health conditions. Isoflavones (such as genistein) are believed to have estrogen-like effects in the body, and as a result are sometimes called "phytoestrogens." In laboratory studies, it is not clear if isoflavones stimulate or block the effects of estrogen, or both (acting as "mixed receptor agonists/antagonists").

The soybean has been a part of the human diet for almost 5,000 years. Unlike most plant foods, the soybean is high in protein and is considered equivalent to animal foods in terms of the quality of the protein it contains.

A meat analog is a manufactured food product that looks and tastes like meat. Vegetarians and other health-conscious individuals eat meat analogs because they are relatively high in protein . They are also very versatile and can be broiled, baked, or roasted. Soy, wheat gluten , beans, and/or nuts are used as the main protein source, with other ingredients used to provide texture and a meat-like taste. Meat analogs can be purchased to replace hamburger, steak, chicken, hot dogs, sausage, and many other meat products. SEE ALSO P ROTEIN ; S OY ; V EGETARIANISM . Lenore S. Hodges Cheryl Flynt

Policosanol is a cholesterol-lowering natural mixture of primary alcohols, isolated and purified from sugar cane wax. Policosanol is safe and well tolerated, even in populations with high use of concomitant medications. Lipid profile improvements with the use of policosanol are seen in healthy volunteers, patients with type II hypercholesterolemia (high cholesterol), type 2 diabetics with hypercholesterolemia, postmenopausal women with hypercholesterolemia, and patients with combined hypercholesterolemia and abnormal liver function tests. Policosanol has performed equal to or better than simvastatin, pravastatin, lovastatin, probucol, or acipimox with fewer side effects in patients with type II hypercholesterolemia. Policosanol was approved for use in Cuba in 1991. Currently it is used in more than 25 countries throughout the world, mainly in South America and in the Caribbean region.

Vitamin B3 is made up of niacin (nicotinic acid) and its amide, niacinamide, and can be found in many foods, including yeast, meat, fish, milk, eggs, green vegetables, and cereal grains. Dietary tryptophan is also converted to niacin in the body. Vitamin B3 is often found in combination with other B vitamins including thiamine, riboflavin, pantothenic acid, pyridoxine, cyanocobalamin, and folic acid.

Zinc is an important trace mineral. This element is second only to iron in its concentration in the body.

Zinc is a mineral that is essential for a healthy immune system, production of certain hormones, wound healing, bone formation, and clear skin. It is required in very small amounts, and is thus known as a trace mineral. Despite the low requirement, zinc is found in nearly every cell of the body and is a key to the proper function of more than 300 enzymes, including superoxide dismutase. Normal growth and development cannot occur without it.

Zinc is a mineral that is essential for a healthy immune system , production of certain hormones, wound healing, bone formation, and clear skin. It is required in very small amounts, and is thus known as a trace mineral. Despite the low requirement, zinc is found in nearly every cell of the body and is a key to the proper function of over 300 enzymes, including superoxide dismutase. Normal growth and development cannot occur without it.

Avocados are fruits that contain 60% more potassium than bananas; they are also sodium and cholesterol-free. An avocado has a higher fat content (5 grams per serving) than other fruit, but the fat is monounsaturated fat, which is considered healthy when consumed in moderation. Diets rich in monounsaturated fatty acids can reduce total cholesterol levels in the blood and increase the ratio of high-density lipoprotein (HDL, "good" cholesterol) to low-density lipoprotein (LDL, "bad" cholesterol). In addition to high cholesterol, avocado has been taken by mouth to treat osteoarthritis. Its oils have been used topically to treat wounds, infections, arthritis, and to stimulate hair growth. The seeds, leaves, and bark have been used for dysentery and diarrhea. It is also used in topical creams for regular skincare. Historically the Amazonian natives used avocado to treat gout, and the Mayan people believed it could keep joints and muscles in good condition, avoiding arthritis and rheumatism. The most promising use for avocado is in a combination product, avocado/soybean unsaponifiables (ASU), which is a combination of avocado oil and soybean oil. Caution is advised when taking Mexican avocado due to the constituents, estragole and anethole, which may be liver damaging and cancer causing.

The almond is closely related to the peach, apricot, and cherry (all classified as drupes). Unlike the others, however, the outer layer of the almond is not edible. The edible portion of the almond is the seed. Sweet almonds are a popular nutritious food. Researchers are especially interested in their level of monounsaturated fats, as these appear to have a beneficial effect on blood lipids. Almond oil is widely used in lotions and cosmetics.

Zinc formulations have been used since Ancient Egyptian times to enhance wound healing, although the usefulness of this approach is only partially confirmed by clinical data of today. Zinc is necessary for the functioning of over 300 different enzymes and plays a vital role in an enormous number of biological processes. Zinc is a cofactor for the antioxidant enzyme superoxide dismutase (SOD) and is in a number of enzymatic reactions involved in carbohydrate and protein metabolism. Its immunologic activities include regulation of T lymphocytes, CD4, natural killer cells, and interleukin II. In addition, zinc has been claimed to possess antiviral activity. It has been shown to play a role in wound healing, especially following burns or surgical incisions. Zinc is necessary for the maturation of sperm and normal fetal development. It is involved in sensory perception (taste, smell, and vision) and controls the release of stored vitamin A from the liver. Within the endocrine system, zinc has been shown to regulate insulin activity and promote the conversion thyroid hormones thyroxine to triiodothyronine. Based on available scientific evidence, zinc may be efficacious in the treatment of (childhood) malnutrition, acne vulgaris, peptic ulcers, leg ulcers, infertility, Wilson's disease, herpes, and taste or smell disorders. Zinc has also gained popularity for its use in prevention of the common cold. The role for zinc is controversial in some cases, as the results of published studies provide either contradictory information, and/or the methodological quality of the studies do not allow for a confident conclusion regarding the role of zinc in those diseases.

Carob ( Ceratonia siliqua ) is a leguminous evergreen tree of the family Leguminosae (pulse family). Although it was originally native to Mediterranean regions, it is now cultivated in many warm climates, including Florida and California. The pods may be ground into a flour, which is often used as a cocoa substitute because it has a somewhat similar taste to chocolate and one-third the calories. Carob has been used to treat infantile diarrhea and carob bean gum has been used to control hyperlipidemia (high cholesterol) and as a dietary adjunct to elevated plasma cholesterol management. There is conflicting data on the effect of carob bean gum as a formula thickener and its effect on regurgitation frequency. The use of soluble dietary fibers, such as carob bean gum, has been shown to alter food structure, texture and viscosity, the rate of starch degradation during digestion, and the regulation of postprandial blood sugar and insulin levels. As a food, the U.S. Food and Drug Administration (FDA) has given carob generally recognized as safe (GRAS) status.

Vitamin E is a fat-soluble vitamin with antioxidant properties. Vitamin E exists in eight different forms ("isomers"): alpha, beta, gamma and delta tocopherol; and alpha, beta, gamma and delta tocotrienol. Alpha-tocopherol is the most active form in humans. Dosing and daily allowance recommendations for vitamin E are often provided in Alpha-Tocopherol Equivalents (ATE) to account for the different biological activities of the various forms of vitamin E, or in International Units (IU) which food and supplement labels may use. Vitamin E supplements are available in natural or synthetic forms. The natural forms are usually labeled with the letter "d" (for example, d-gamma-tocopherol), whereas synthetic forms are labeled "dl" (for example, dl-alpha-tocopherol). Vitamin E has been proposed for the prevention or treatment of numerous health conditions, often based on its antioxidant properties. However, aside from the treatment of vitamin E deficiency (which is rare), there are no clearly proven medicinal uses of vitamin E supplementation beyond the recommended daily allowance. There is ongoing research in numerous diseases, particularly in cancer and heart disease. Recent concerns have been raised about the safety of vitamin E supplementation, particularly in high doses. An increased risk of bleeding has been proposed, particularly in patients taking blood-thinning agents such as warfarin, heparin, or aspirin; or in patients with vitamin K deficiency. Recent evidence suggests that regular use of high-dose vitamin E supplements may increase the risk of death (from "all causes") by a small amount, although a different study found no effects on mortality in women who took vitamin E daily. Caution is warranted.

Fat-soluble vitamin; an antioxidant.

Vitamin E is a fat-soluble vitamin that acts as an antioxidant.

Vitamin E is an antioxidant responsible for proper functioning of the immune system and for maintaining healthy eyes and skin. It is actually a group of fat soluble compounds known as tocopherols (i.e., alpha tocopherol and gamma tocopherol). Gamma tocopherol accounts for approximately 75% of dietary vitamin E. Vitamin E rich foods include nuts, cereals, beans, eggs, cold-pressed oils, and assorted fruits and vegetables. Because vitamin E is a fat soluble vitamin, it requires the presence of fat for proper absorption. Daily dietary intake of the recommended daily allowance (RDA) of vitamin E is recommended for optimum health. Vitamin E is absorbed by the gastrointestinal system and stored in tissues and organs throughout the body. Certain health conditions may cause vitamin E depletion, including liver disease, celiac disease , and cystic fibrosis. Patients with end-stage renal disease (kidney failure) who are undergoing chronic dialysis treatment may be at risk for vitamin E deficiency. These patients frequently receive intravenous infusions of iron supplements, which can act against vitamin E. Vitamin E deficiency can cause fatigue , concentration problems, weakened immune system, anemia , and low thyroid levels. It may also cause vision problems and irritability. Low serum (or blood) levels of vitamin E have also been linked to major depression .

Green tea is made from the dried leaves of Camellia sinensis , a perennial evergreen shrub. Green tea has a long history of use, dating back to China approximately 5,000 years ago. Green tea, black tea, and oolong tea are all derived from the same plant. Tea varieties reflect the growing region (for example, Ceylon or Assam), the district (for example, Darjeeling), the form (for example, pekoe is cut, gunpowder is rolled), and the processing method (for example, black, green, or oolong). India and Sri Lanka are the major producers of green tea. Historically, tea has been served as a part of various ceremonies, and has been used to stay alert during long meditations. A legend in India describes the story of Prince Siddhartha Gautama, the founder of Buddhism, who tore off his eyelids in frustration at his inability to stay awake during meditation while journeying through China. A tea plant is said to have sprouted from the spot where his eyelids fell, providing him with the ability to stay awake, meditate, and reach enlightenment. Turkish traders reportedly introduced tea to Western cultures in the 6th Century.

Green tea is produced from the leaves of the Camellia sinensis , or tea plant. Oolong and black tea are also produced from the plant, but are processed and oxidized in different manners. Of the three, green tea contains the highest levels of polyphenols, the antioxidant substance that is believed to be beneficial in protecting against both cancer and atherosclerosis . The tea plant is actually a variation of evergreen bush, with glossy green leaves and small white to pink flowers. The plants can reach a height of 30–40 ft (9–12 m) or taller in the wild, but are generally kept to a height of 6 ft (1.2 m) or less on the tea plantations and gardens where they are grown in China, Argentina, Japan, India, Indonesia, Kenya, Malawi, Sri Lanka, Turkey, Pakistan, Bangladesh, and Tanzania. Tea plants are cultivated in countries where warm, rainy growing conditions are abundant, and are also frequently grown in high altitude areas. When tea plants reach maturity at three or four years of age, the young leaves and leaf buds—the parts of the plant highest in polyphenols—are harvested. Green tea is produced by steaming or roasting the leaves as soon as they are picked, and then rolling and drying the tea leaves to remove any moisture.

Honey is a sweet, viscid fluid produced by honeybees ( Apis melliflera ) from the nectar of flowers. It is generally recognized as safe (GRAS), but there have been numerous reports of certain types of honey produced from the nectar of flowering plants from the genus Rhododendron and others that have toxic effects in humans and in animals. Honey is easily absorbed and utilized by the body. It contains about 70-80% sugar; the rest is water, minerals, and traces of protein, acids, and other substances. Honey has been used by ancient Egyptians, Assyrians, Chinese, Romans, and Greeks as a medicinal remedy for the management of wounds, skin ailments, and various gastrointestinal diseases. Honey's therapeutic importance as a known antibacterial agent has been recognized since 1892. Modern research has been conducted on the role of honey in chronic wound management and other indications. However, high quality studies are lacking, and further research is warranted to establish the therapeutic effect of honey in any indication.

The term spirulina refers to a large number of cyanobacteria, or blue-green algae. Both Spirulina spp . and non- Spirulina spp. fall into the classification of cyanobacteria, and include: Aphanizomenon spp., Microcystis spp., Nostoc spp., and Spirulina spp. Most commercial products contain Aphanizomenon flos-aquae, Sprirulina maxima, and/or Spirulina platensis. These algae are found in the warm, alkaline waters of the world, especially of Mexico and Central Africa. Spirulina spp. are most often grown under controlled conditions and are subject to less contamination than the non-spirulina species that are harvested naturally. Spirulina is a rich source of nutrients, containing up to 70% protein, B-complex vitamins, phycocyanin, chlorophyll, beta-carotene, vitamin E, and numerous minerals. In fact, spirulina contains more beta-carotene than carrots. Spirulina has been used since ancient times as a source of nutrients and has been said to possess a variety of medical uses, including as an antioxidant, antiviral, antineoplastic, weight loss aid, and lipid-lowering agent. Preliminary data from animal studies demonstrate effectiveness for some conditions as well as safety, although human evidence is lacking. Based on available research, no recommendation can be made either for or against the use of spirulina for any indication.

Spirulina is a genus of blue-green algae used as a nutritional supplement. Blue-green algae, which are microscopic fresh-water organisms, are also known as cyanobacteria. Their color is derived from the green pigment of chlorophyll, and the blue from a protein called phycocyanin. The species most commonly recommended for use as a nutritional supplement are Spirulina maxima and Spirulina platensis . These occur naturally in warm, alkaline, salty, brackish lakes, but are also commonly grown by aquaculture and harvested for commercial use. Spirulina contains many nutrients, including B vitamins, beta-carotene, gamma-linolenic acid, iron, calcium, magnesium, manganese, potassium, selenium, zinc, bioflavonoids , and protein. Spirulina is about 65% protein by composition. These proteins are complete, in that they contain all essential amino acids , plus some nonessential ones. In that regard, it is similar to animal protein, but does not contain saturated fats, or residues of hormones or antibiotics that are in some meats. Since spirulina is normally taken in small amounts, the quantity of dietary protein supplied for the average reasonably well-nourished person would not be significant. However, it is a good source of trace minerals, some vitamins, bioflavonoids, and other phytochemicals. It also has high digestibility and bioavailability of nutrients.

Creatine is naturally synthesized in the human body from amino acids primarily in the kidney and liver, and transported in the blood for use by muscles. Approximately 95% of the body's total creatine content is located in skeletal muscle. Creatine was discovered in the 1800s as an organic constituent of meat. In the 1970s, Soviet scientists reported that oral creatine supplements may improve athletic performance during brief, intense activities such as sprints. Creatine gained popularity in the 1990s as a "natural" way to enhance athletic performance and build lean body mass. It was reported that skeletal muscle total creatine content increases with oral creatine supplementation, although response is variable. Factors that may account for this variation are carbohydrate intake, physical activity, training status, and muscle fiber type. The finding that carbohydrate enhances muscle creatine uptake increased the market for creatine multi-ingredient sports drinks. Use of creatine is particularly popular among adolescent athletes, who are reported to take doses that are not consistent with scientific evidence, and to frequently exceed recommended loading and maintenance doses. Published reports suggest that approximately 25% of professional baseball players and up to 50% of professional football players consume creatine supplements. According to a survey of high school athletes, creatine use is common among football players, wrestlers, hockey players, gymnasts, and lacrosse players. In 1998, the creatine market in the U.S. was estimated at $200 million. Most athletic associations have not banned this supplement, including the International Olympic Committee, the International Amateur Athletic Federation, and the National Collegiate Athletic Association. Creatinine excreted in urine is derived from creatine stored in muscle.

With its promises of bigger muscles and improved athletic performance, creatine has generated more interest and controversy than almost any other dietary supplement. It is widely used by body builders and athletes of all levels, from famous baseball sluggers to high school jocks. Even without taking supplements, all people have a small amount of this protein in their bodies. Some of it comes from food, especially meat and fish, while the rest is made by the body from amino acids . No one disputes the fact that creatine plays an important role in converting food into energy. The real question is whether taking extra amounts of creatine can make muscles bigger, boost athletic performance, or improve the health of people with muscle or nerve disease. Creatine is considered important because it can increase the amount of energy available to working muscles. The protein is used by the body to make a chemical compound called adenosine triphosphate (ATP), the immediate fuel source used by muscles during short but intense bursts of activity. Through its conversion into phosphocreatine, a related substance, creatine appears to delay muscle fatigue by re-supplying muscles with ATP. Because creatine can be stored for later use by cells, consuming extra amounts of the protein may create a deeper energy reserve for muscles and other tissues. Excess creatine is eliminated by the kidneys. This means that creatine supplements may be of little value in people who have sufficient levels of the protein, since the kidneys automatically remove extra amounts. A significant amount of research is still required to determine the long-term effects of taking creatine, proper dosage, and whether age, gender, or the presence of existing diseases can affect use of the supplements. However, as of 2002, studies found a lower risk of training-related injuries in athletes who used the supplement and new therapeutic uses of the supplement were being tested.

Lycopene is a carotenoid, and is present in human serum, liver, adrenal glands, lungs, prostate, colon, and skin at higher levels than other carotenoids. Lycopene has been found to possess antioxidant and antiproliferative properties in animal and in vitro studies, although activity in humans remains controversial. Numerous epidemiological investigations have correlated high intake of lycopene-containing foods or high lycopene serum levels with reduced incidence of cancer, cardiovascular disease, and macular degeneration. However, estimates of lycopene consumption have been based on reported tomato intake, not on the use of lycopene supplements. Since tomatoes are sources of other nutrients including vitamin C, folate, and potassium, it is not clear that lycopene itself is beneficial. There is no established definition of "lycopene deficiency," and no direct evidence that repletion of low lycopene levels has any benefit.

Lycopene is a red, fat-soluble pigment found in vegetables, and most commonly found in tomatoes. It is one of a family of pigments called carotenoids . Carotenoids are naturally occurring pigments responsible for the brightly colored fall leaves and the vivid colors of flowers, fruits, and vegetables. In fruits and vegetables, these pigments range in hue from bright yellow in squash, to orange in carrots, to bright red in tomatoes and peppers. Although the human body does not produce lycopene, it is readily available through the diet. Minor sources include guava, rosehip, watermelon, and pink grapefruit. However, about 85% of lycopene in the U.S. diet comes from tomatoes and tomato products such as juice, soup, sauce, paste, and ketchup. A diet rich in carotenoid-containing foods is associated with a variety of health benefits. Once lycopene is absorbed in the body, it is deposited widely in the liver, lungs, prostate gland, colon, and skin. Its concentration in body tissues tends to be higher than most other carotenoids. Working as a powerful antioxidant, lycopene fights free radicals—highly reactive molecules that damage cell membranes, attack DNA, and cause disease. Studies have found that patients with HIV infection, inflammatory diseases, and high cholesterol levels (with and without lipid-lowering treatment) may have depleted lycopene serum (blood) levels. In contrast to other carotenoids, serum levels of lycopene are not usually reduced by smoking or alcohol consumption but rather by increasing age.

The rhizome (root) of turmeric ( Curcuma longa Linn.) has long been used in traditional Asian medicine to treat gastrointestinal upset, arthritic pain, and "low energy." Laboratory and animal research has demonstrated anti-inflammatory, antioxidant, and anti-cancer properties of turmeric and its constituent curcumin. Preliminary human evidence, albeit poor quality, suggests possible efficacy in the management of dyspepsia (heartburn), hyperlipidemia (high cholesterol), and scabies (when used on the skin).

Turmeric is a member of the Curcuma botanical group, which is part of the ginger family of herbs, the Zingiberaceae. Its botanical name is Curcuma longa . Turmeric is widely grown both as a kitchen spice and for its medicinal uses. Two closely related plants, Curcuma petolata and Curcuma roscoeana , are natives of Cambodia and are grown for their decorative foliage and blossoms. All curcumas are perennial plants native to southern Asia. They grow in warm, humid climates and thrive only in temperatures above 60°F (29.8°C). India, Sri Lanka, the East Indies, Fiji, and Queensland (Australia) all have climates that are conducive to growing turmeric. The turmeric plant is identifiable by both its characteristic tuberous root and the leaves that extend upward from erect, thick stems arising from the root. Turmeric root is actually a fleshy oblong tuber 2–3 in (5–10 cm) in length, and close to 1 in (2.54 cm) wide. It is tapered at each end, and its exterior can be yellow, tan, or olive-green in color. The interior of the root is hard, firm, and either orange-brown or deeply rust-colored, with transverse resinous parallel rings. M. Grieve, in A Modern Herbal , states that the root is dense and breaks into a powder that is lemon yellow in color. Turmeric root has a fragrant aroma and a somewhat bitter, peppery, biting taste reminiscent of ginger. When eaten, it colors the saliva yellow and leaves a warm sensation in the mouth. The root contains a bitter volatile oil, brown coloring matter, gum, starch, calcium chloride, woody fiber and a yellowish coloring material that is known as cucurmin. In addition to the root, the turmeric plant produces rhizomes, which are underground stems growing parallel to the ground that produce roots below and new shoots from their upper surface. Turmeric rhizomes have also been used for medicinal purposes. The plant's leaves are divided, lance-shaped and narrower at each end. They are close to 2 ft (61 cm), lustrous and deep green. The flowers arise from those leaves, and are a pale yellow color, growing in groupings of three to five.

Milk thistle has been used medicinally for over 2,000 years, most commonly for the treatment of liver and gallbladder disorders. A flavonoid complex called silymarin can be extracted from the seeds of milk thistle, and is believed to be the biologically active component. The terms "milk thistle" and "silymarin" are often used interchangeably. Milk thistle products are popular in Europe and the United States for various types of liver disease. Although numerous human trials have been published, most studies have not been well designed or reported.

Milk thistle ( Silybum marianum or Cardus marianum ) is a plant used for treating liver disorders, breast-feeding problems , and other illnesses. The active ingredient of the herb, silymarin, is found in the ripe seeds of the plant. The milk thistle plant has a long stem, green leaves with white spots, and pink to purple spiky flowered head (which true to its name, resembles a thistle). The plant is native to Europe and grows in the wild in the United States and South America. Other common names for the plant include Mary thistle, St. Mary thistle, Marian thistle, and lady's thistle. The medicinal benefits of milk thistle have been valued for more than 2,000 years. Written records show that as early as the first century, Romans were using the plant as a liver-protecting agent. The plant was also frequently used throughout the Middle Ages, and it is in the herbal literature of this period that the medicinal properties of milk thistle seeds are first noted. Nicholas Culpepper, a British herbalist, wrote about the value of the herb in treating diseases of the liver and spleen in the late eighteenth century, and by the end of the next century, records show that American physicians were also prescribing the substance. Silymarin was first isolated from the milk thistle plant by German scientists in the 1960s. The leaves and stem of the milk thistle plant are edible, and can be used in salads or eaten raw. The plant was cultivated as a vegetable in Europe through the end of the nineteenth century.

Safflower is an annual herb whose botanical name is Carthamus tinctorius . It is a member of the Asteraceae family. It has long, spiny leaves and yellow or reddish flowers on a stiff, upright stem. The seeds produce an edible oil. Safflower grows to a height of about 3 ft (1 m) in poor, dry soils in full sun. The origins of this plant are not clear, although some herbalists suggest the basin of the Euphrates River. Today safflower grows wild in Iran, northwest India, and North Africa. It has also spread to the Far East and North America. Safflower is cultivated extensively both as a herb and as a food crop. Other names for safflower include false saffron , dyer's saffron, American saffron, bastard saffron, Mexican saffron, and zaffer. Despite these names, safflower is in no way related to true saffron, although it is sometimes used to adulterate that spice because true saffron is very expensive and safflower is relatively cheap. In Chinese medicine, safflower flower is called hong hua ; in India it is known as koosumbha .

Pantothenic acid (vitamin B5) is essential to all life, and is a component of coenzyme A (CoA), a molecule that is necessary for numerous vital chemical reactions to occur in cells. Pantothenic acid is essential to the metabolism of carbohydrates, proteins, and fats, as well as for the synthesis of hormones and cholesterol. The name pantothenic acid comes from the Greek word pantos, meaning "everywhere," referring to its wide distribution in most plants and animals. Rich food sources include meats, liver, kidney, fish/shellfish, chicken, vegetables, legumes, yeast, eggs, and milk. However, freezing and canning may lead to a loss of much of the pantothenic acid content. Whole grains are also a good source, although refining may degrade much of the pantothenic acid content. In commercial supplement products, vitamin B5 is available as D-pantothenic acid and as the synthetic products dexpanthenol (converted in the body to pantothenic acid) or calcium pantothenate. Pantothenic acid is frequently used in combination with other B vitamins in vitamin B complex formulations. Only the dextrorotatory (D) isomer of pantothenic acid possesses biologic activity. Pantothenic acid deficiency is exceedingly rare, and likely only occurs only in cases of the most severe life-threatening malnutrition. Most individuals likely obtain sufficient amounts from dietary sources. Pantothenic acid has been used or studied for numerous health conditions, but has not been clearly demonstrated as beneficial for any. Oral, topical (on the skin), or injected forms have been used.

Pantothenic acid and biotin are types of B vitamins. They are water-soluble, which means that the body can't store them. If the body can't use all of the vitamin, the extra leaves the body through the urine. Therefore, these vitamins must be replaced every day.

Pantothenic acid, also known as vitamin B 5 , is a member of the water-soluble B vitamin family. It is an essential ingredient of two substances, coenzyme A and acyl carrier protein, which are needed to metabolize carbohydrates and fats. The same coenzymes play a part in production of certain hormones, vitamin D , red blood cells, and the neurotransmitter acetylcholine. Pantothenic acid is necessary for proper growth and development. Studies of Mexican infants whose diets are deficient in micronutrients have shown that those who receive dietary supplements containing pantothenic acid do not show the growth retardation that appears in control groups.

Guggul (gum guggul) is a resin produced by the mukul mirth tree. Guggulipid is extracted from guggul, and contains plant sterols (guggulsterones E and Z), which are believed to be its bioactive compounds. Prior to 2003, the majority of scientific evidence suggested that guggulipid elicits significant reductions in serum total cholesterol, low-density lipoprotein (LDL), and triglycerides, as well as elevations in high-density lipoprotein (HDL). Although recent evidence provides preliminary evidence against the efficacy of guggul for hypercholesterolemia, and thus, further study is necessary before a definitive conclusion can be reached. Initial research reports that guggulsterones are antagonists of the farsenoid X receptor (FXR) and the bile acid receptor (BAR), nuclear hormones that are involved with cholesterol metabolism and bile acid regulation.

The mukul myrrh tree, or Commiphora mukul , is small, thorny, and usually devoid of foliage. It grows naturally throughout India and Arabia. Guggul is the gum resin that comes from this tree, which belongs to the same genus as myrrh and has some similar components and actions. Guggul resin contains steroids, diterpenoids, alipathic esters, and carbohydrates. These factors appear to work together to exert the beneficial effects of this botanical. Guggul has been traditionally used in Ayurvedic medicine to treat arthritis, inflammation, bone fractures , overweight, and disorders of lipid metabolism. One ancient Ayurvedic reference describes the power of guggul to treat "coating and obstruction of channels." This description stimulated further research into the properties of this botanical medicine for preventing and treating atherosclerosis , as well as other conditions resulting from high levels of lipids in the body.

Taurine, or 2-aminoethanesulfonic acid, was originally discovered in ox ( Bos taurus ) bile and was named after taurus, or bull. A nonessential amino acid-like compound, taurine is found in high abundance in the tissues of many animals, especially sea animals, and in much lower concentrations in plants, fungi, and some bacteria. As an amine, taurine is important in several metabolic processes of the body, including stabilizing cell membranes in electrically active tissues, such as the brain and heart. It also has functions in the gallbladder, eyes, and blood vessels, and may have some antioxidant and detoxifying properties. Taurine is a constituent of some energy drinks, including Red Bull®. Numerous clinical trials suggest Red Bull® and similar energy drinks may be effective in reducing fatigue, and improving mood and endurance. However, these drinks contain other ingredients, which may also offer benefit in these areas, including caffeine and glucuronolactone. The effect of taurine alone in energy drinks has not been studied. Thus, the effectiveness of taurine in energy drinks is unclear and further research is still required. Several taurine derivatives are being investigated for medical use, such as taltrimide as an antiepileptic drug. Other taurine derivatives in various stages of development include acamprosate (antialcoholic), tauromustine (anticancer), and tauroursodeoxycholic acid (liver disorders). The efficacy of taurine has been investigated for diabetes, hypertension (high blood pressure), cystic fibrosis, liver disorders, cardiovascular disorders, and nutritional support. Although promising in many fields, additional study is needed before a firm recommendation can be made for these indications. Taurine is added to many infant formulas based on the decreased ability to form taurine from cysteine in this population.

Red clover is a legume, which like soy contains "phytoestrogens" (plant-based chemicals that are similar to estrogen, and may act in the body like estrogen or may actually block the effects of estrogen). Red clover was traditionally used to treat asthma, pertussis, cancer, and gout. In modern times, isoflavone extracts of red clover are most often used to treat menopausal symptoms, as an alternative hormone replacement therapy, for high cholesterol, or to prevent osteoporosis. However, at this time, there are no high-quality human studies supporting the use of red clover for any medical condition.

Red clover ( Trifolium pratense ) is a familiar meadow herb, one of 250 species in the Leguminosae, or pea family. The Irish shamrock is another species in this family of plants. Red clover is a European native naturalized throughout North America and Canada. This familiar short-lived perennial grows wild along roadsides, in meadows, and in fields, and is extensively cultivated as a forage crop for cattle. It grows best in soils that are rich in calcium, potassium , and phosphorus . The common names for this sweet herb include wild clover, meadow trefoil, bee bread, trefoil, cow grass, purple clover, and three-leafed grass. Red clover grows to about 2 ft (61 cm) high from a short, woody rootstock. The leaves are palmate and arranged alternately along the round, grooved, and hairy stem. They are divided into three oblong or oval leaflets, a characteristic that has given the genus its name. The dark green leaves often have a splash of a pale green or white on each leaflet. The leaf margins are toothed. The red-purple or magenta-hued blossoms comprise numerous florets that form a globe-shaped flower on the end of the stalk. Red clover blooms throughout the summer. The edible blossoms are sweet-tasting with a honey-like fragrance. Bees are attracted to clover blossoms, but seem to prefer the white blossoms of another common variety of clover, often growing nearby.

Alfalfa is a legume that has a long history of dietary and medicinal uses. A small number of animal and preliminary human studies report that alfalfa supplements may lower blood levels of cholesterol and glucose. However, most research has not been well designed. Therefore, there is not enough reliable evidence available to form clear conclusions in these areas. Alfalfa supplements taken by mouth appear to be generally well tolerated. However, ingestion of alfalfa tablets has been associated with reports of a lupus-like syndrome or lupus flares. These reactions may be due to the amino acid L-canavanine which appears to be present in alfalfa seeds and sprouts, but not in the leaves. There are also rare cases of pancytopenia (low blood counts), dermatitis (skin inflammation), and gastrointestinal upset.

Alfalfa is the plant Medicago sativa . There are many subspecies. It is a perennial plant growing up to 30 in (0.75 m) in height in a wide range of soil condition. Its small flowers range from yellow to purple. Alfalfa is probably native to the area around the Mediterranean Sea, but it is extensively cultivated as fodder for livestock in all temperate climates. Alfalfa is a member of the legume family. It has the ability to make nutrients available to other plants both through its very long, deep (6–16 ft [2–5 m]) root system, and because it has a hosts beneficial nitrogen-fixing bacteria. For these reasons it is often grown as a soil improver or "green manure." The medicinal parts of alfalfa are the whole plant and the seeds. It is used both in Western and traditional Chinese medicine . In Chinese it is called zi mu . Other names for alfalfa include buffalo grass, buffalo herb, Chilean clover, purple medick, purple medicle, and lucerne.

Goldenseal is one of the five top-selling herbal products in the United States. However, there is little scientific evidence about its safety or effectiveness. Goldenseal can be found in dietary supplements, eardrops, feminine cleansing products, cold/flu remedies, allergy remedies, laxatives, and digestive aids. Goldenseal is often found in combination with echinacea in treatments for upper respiratory infections, and is suggested to enhance the effects of echinacea. However, the effects when these agents are combined are not scientifically proven. Goldenseal has been used by some people due to the popular notion that detection of illegal drugs in urine may be hidden by use of the herb, although scientific information is limited in this area. The popularity of goldenseal has led to a higher demand for the herb than growers can supply. This high demand has led to the substitution of other herbs such as Chinese goldthread ( Coptis chinensis Fransch.) and Oregon grape ( Mahonia aquifolium [Pursh] Nutt.), that do not contain exactly the same isoquinoline alkaloids, and may not affect the body in the same way as goldenseal. Studies of the effectiveness of goldenseal are limited to one of its main chemical ingredients, berberine salts (there are few published human studies of goldenseal itself). Due to the small amount of berberine actually present in most goldenseal preparations (0.5-6%), it is difficult to extend the research of berberine salts to the use of goldenseal. Therefore, there is not enough scientific evidence to support the use of goldenseal in humans for any medical condition.

Goldenseal ( Hydrastis canadensis ) is a perennial North American native plant found wild in eastern deciduous woodlands and damp meadows as far north as Vermont and Minnesota, and south to Georgia and Arkansas. This versatile herb is sought for its valuable rootstock and inner twig bark. Goldenseal is a member of the Ranunculaceae, or buttercup family. It is a mainstay of Native American medicine , and a popular folk remedy. Goldenseal has multiple uses, both internally and externally. It is sometimes called poor man's ginseng. This traditional medicinal herb has been known by many names, including yellow paint root, orange root, eye root, Indian plant, tumeric root, eye balm, jaundice root, yellow puccoon, and ground raspberry . Native American tribes valued this natural antiseptic herb for many medicinal uses and as a clothing dye. Early colonists soon came to appreciate its infection-fighting action. The Native American use of goldenseal as a cancer treatment was first mentioned in the herbal, Essays Toward a Materia Medica of the United States first published by Benjamin Smith Barton in 1798. The yellow rootstock is the main, known medicinal part of the herb. In cultivation, goldenseal requires up to four years growth before the rootstock is ready for harvest. The thick and knotty rhizome produces a hairy stem Cluster of goldenseal plants. ( Photo Researchers, Inc. Reproduced by permission. ) that grows to 2 ft (61 cm) high. Goldenseal has only two large leaves, each five-lobed with double-toothed edges growing atop a forked stem. Leaves are serrated at the top edges. A single flower with greenish-white sepals crowns the hairy stem. The fruit looks like a raspberry, hence one of the plant's common names. Pharmaceutical companies harvest goldenseal root in large quantities for use. The herb is fully endangered on extinction risk lists in the wild due to over-collection of the rhizome. An estimated 250,000 pounds of rootstock of this popular herbal remedy are sold each year, and most of this has been collected in the wild.

Pycnogenol® is the patented trade name for a water extract of the bark of the French maritime pine ( Pinus pinaster ssp. atlantica ), which is grown in coastal south-west France. Pycnogenol® contains oligomeric proanthocyanidins (OPCs) as well as several other bioflavonoids: catechin, epicatechin, phenolic fruit acids (such as ferulic acid and caffeic acid), and taxifolin. Procyanidins are oligometric catechins found at high concentrations in red wine, grapes, cocoa, cranberries, apples, and some supplements such as Pycnogenol®. There has been some confusion in the U.S. market regarding OPC products containing Pycnogenol® or grape seed extract (GSE), because one of the generic terms for chemical constituents ("pycnogenols") is the same as the patented trade name (Pycnogenol®). Some GSE products were formerly erroneously labeled and marketed in the U.S. as containing "pycnogenols." Although GSE and Pycnogenol® do contain similar chemical constituents (primarily in the OPC fraction), the chemical, pharmacological, and clinical literature on the two products is distinct. The term Pycnogenol® should therefore only be used to refer to this specific proprietary pine bark extract. Scientific literature regarding this product should not be referenced as a basis for the safety or effectiveness of GSE.

Pine bark extract is made from the bark of a European coastal pine tree called the Landes or maritime pine, whose scientific name is Pinus maritima . The maritime pine is a member of the Pineaceae family. Pine bark extract is a new nutritional supplement used for its antioxidant properties, which are believed to be effective for a wide range of healing and preventative purposes. Pine bark extract has been patented by a French researcher under the name Pycnogenol (pronounced pick-nah-jen-all). Pine bark extract has a 450-year-old legend surrounding it. There is a written account of an event that happened in 1534, when a French ship led by explorer Jacques Cartier became stranded in ice near Quebec, Canada. Cartier's crew became severely sick from scurvy, which used to be a fatal disease caused by a lack of vitamin C in the diet. Cartier's crew was saved when a Quebec Indian instructed them to drink a brew made from pine bark and needles. Four centuries later, a French researcher named Jacques Masquelier discovered the reason for the effectiveness of this remedy. A substance found in pine bark acts as an antioxidant in the body, and greatly increases the effectiveness of the vitamin C found in the pine needles. During the 1950s, Masquelier had heard the story of Cartier when he was in Canada performing research. He was investigating a group of substances called flavonols, which he originally found in peanut skins. Flavonols and bioflavonoids are substances in fruits and vegetables that give them their color. Masquelier found that these substances have beneficial effects in the body, particularly in improving circulation and repairing tissue. He later found that an abundant source of these substances was the bark of pine trees that grew on the coasts of southern France. Pine bark was also the most efficient source of the substance, because it took only warm water and pressure to extract the substance from trees that were considered a waste product. Masquelier called his pine bark extract Pycnogenol, and continued his research on pine bark extract and bioflavonoids for decades. In 1987, the United States awarded him a patent. Only Masquelier's pine bark extract can legally claim to have antioxidant properties. Antioxidants play a key role of repairing and protecting cells in the body. They help protect against free radicals, which are damaging byproducts of metabolism and exposure to environmental pollutants. Free radical damage is believed to contribute to aging , as well as too severe conditions including heart disease and cancer . Common antioxidants are vitamins A, C, E, and the mineral selenium . Researchers have termed the group of antioxidants found in pine bark extract oligomeric proanthocyanidins, or OPCs for short. OPCs (also referred to as PCOs) are some of the most powerful antioxidants available. OPCs are found in many common foods. In fact, OPCs are at the center of what has been called the French paradox. The French paradox has to do with the fact that the French eat as much cholesterol as Americans, yet have a significantly reduced incidence of heart disease. Researchers have theorized that one reason for this paradox is the French consumption of red wine with meals. Red wine is rich in bioflavonoids, including OPCs, which have been shown to protect blood vessels from cholesterol. Another OPC supplement on the market besides pine bark extract is grape seed extract , which is the cheapest and most widely used source of OPCs. Much research has been conducted on OPCs and on pine bark extract. In France, pine bark extract and OPCs have been rigorously tested for safety and effectiveness, and pine bark extract is a registered drug. Pine bark extract has been shown to contain a powerful antioxidant that helps protect cells from free radical damage and increases the effectiveness of vitamin C. Pine bark extract has been shown to help lower cholesterol, and to decrease the risk and severity of atherosclerosis , or damage t

Preliminary human evidence suggests that gymnema may be effective in the management of blood sugar levels in type 1 and type 2 diabetes, as an adjunct to conventional drug therapy, for up to 20 months. Gymnema appears to lower serum glucose and glycosylated hemoglobin (HbA1c) levels following chronic use, but may not have significant acute effects. High-quality human trials are lacking in this area. Some of the available research has been conducted by authors affiliated with manufacturers of gymnema products.

Gymnema ( Gymnema sylvestre ) is a climbing plant that grows in the tropical forests of central and southern India. The woody gymnema plant also grows in parts of Africa. Leaves of this long, slender plant have been used for more than 2,000 years in India to treat diabetes. Gymnema is also known as gurmar, gurmabooti, periploca of the woods, and meshasringi (ram's horn).

Yucca is the common name for the more than 40 species of perennials in the Yucca genus. The plants are well known for their tough, sword-like leaves and a large spike of whitish flowers. They are native to the hot and dry parts of North America, Central America, and the West Indies, although they are popular landscaping plants and can be found worldwide. There is insufficient evidence in humans to support the use of yucca for any indication. One human study indicates that a blend of Yucca schidigera and Quillaja saponaria extracts may reduce cholesterol levels in hypercholesterolemic patients. Preliminary studies also indicate that yucca may have antioxidant, antifungal, and anti-inflammatory properties.

The yucca plant is native to the high deserts of the southwestern United States and Mexico. It is also found less commonly in parts of the eastern United States and West Indies. Extracts from the plant's root are used in alternative medicine as a soap and as an herbal dietary supplement. The yucca has at least 40 species, including Yucca filamentosa , the most common type, Yucca brevifolia (Joshua tree), Yucca aloifolia (Spanish bayonet), and Yucca gloriosa (Spanish dagger). Two other species, Yucca baccata and Yucca glauca , are called soap plant because their roots are especially good for making soap. Yucca plants are tree-like succulents of the lily family (Liliaceae) with stemless stiff, pointed leaves that end in a sharp needle. The Joshua tree, the namesake of Joshua Tree National Park near Palm Springs, California, is believed to have been named by Mormon settlers because the plant's angular branches resembled the outstretched arms of Joshua leading them out of the desert. The yucca flower is a series of white or purple blossoms on a long stalk.

Probiotics are beneficial bacteria (sometimes referred to as "friendly germs") that help to maintain the health of the intestinal tract and aid in digestion. They also help keep potentially harmful organisms in the gut (harmful bacteria and yeasts) under control. Most probiotics come from food sources, especially cultured milk products. Probiotics can be consumed as capsules, tablets, beverages, powders, yogurts and other foods. Pro biotics should not be confused with pre biotics. Prebiotics are complex sugars (such as lactulose, lactitol, a variety of fructo-oligosaccharides and inulin) that are used as fuel by the healthful bacteria to stimulate their growth and activity while suppressing the growth and activity of harmful organisms. Other foods that support probiotic activity include Japanese miso, tempeh, kefir, raw milk, kombucha, bananas, garlic and onions. When prebiotics and probiotics are combined in one product, it is called a syn biotic. Probiotics work by colonizing the small intestine and crowding out disease-causing organisms, thereby restoring proper balance to the intestinal flora. They compete with harmful organisms for nutrients and may also produce substances that inhibit growth of harmful organisms in the gut. Probiotic bacteria have been found to stimulate the body's immune system. They may also aid in several gastrointestinal illnesses such as inflammatory bowel diseases, antibiotic-related diarrhea, Clostridium difficile toxin-induced colitis, infectious diarrhea, hepatic encephalopathy, irritable bowel syndrome and allergy. Probiotics have been found to enhance the digestion and absorption of proteins, fats, calcium and phosphorus. They may help overcome lactose intolerance. Finally they may help restore healthful bacteria after a course of antibiotic therapy has altered the normal gastrointestinal flora.

It has been hypothesized that wild yam ( Dioscorea villosa and other Dioscorea species) possesses dehydroepiandrosterone (DHEA)-like properties, and acts as a precursor to human sex hormones such as estrogen and progesterone. Based on this proposed mechanism, extracts of the plant have been used to treat dysmenorrheal (painful menstruation), hot flashes, and headaches associated with menopause. However, these uses are based on a misconception that wild yam contains hormones or hormonal precursors - largely due to the historical fact that progesterone, androgens, and cortisone were chemically manufactured from Mexican wild yam in the 1960s. It is unlikely that this chemical conversion to progesterone occurs in the human body. The hormonal activity of some topical wild yam preparations has been attributed to adulteration with synthetic progesterone by manufacturers, although there is limited evidence in this area. The effects of the wild yam saponin constituent "diosgenin" on lipid metabolism are well documented in animal models, and are possibly due to impaired intestinal cholesterol absorption. However, its purported hypocholesterolemic effect in humans and the feasibility of long-term use warrant further investigation. There are few reported contraindications to the use of wild yam in adults. However, there are no reliable safety or toxicity studies during pregnancy, lactation, or childhood.

Chinese yam ( Dioscorea opposita ) is a root that is used in traditional Chinese medicine . The Chinese pharmaceutical name for this herbal is Rhizoma dioscoreae . Other names for Chinese yam include dioscorea and shan yao. Chinese yam is native to China, Japan, Korea, and Taiwan, where it can be found growing wild on hill slopes and in valleys. It is also propagated for medicinal and dietary uses. The genus name Dioscorea is dedicated to the Greek physician and naturalist, Diosorides. There are between 600 and 800 different species of Dioscorea , making it one of the largest genera of the plant kingdom. Many species in this genus are grown and collected for their medicinal properties. Sweet potatoes are often called yams, although they are different plants. The Chinese yam plant is a climbing vine that supports itself by coiling around the branches of other vegetation. The plant can be 9.75 ft (3 m) high and 5 ft (1.5 m) wide. Chinese yam has heart-shaped leaves and it produces small white flowers which have a cinnamon-like aroma. Small tubers (called tubercles) form in the axials (the angles between the leaves and the stem). These pea-sized tubercles are harvested in the late summer or early fall and are used to propagate the plant. Chinese yam plants take three or four years to reach maturity, although fairly large roots may be harvested from well developed plants after the first year. Chinese yam is a spindle-shaped, thick, hard root or tuber that is white on the inside. However, cultivated forms from China or Japan may have different root shapes. The yam may be up to 1 yd (about 1 m) in length. Chinese yam is dug up in the winter. After the rough bark is removed, the root is washed and allowed to dry in either the shade or the sun. The dried root is rehydrated in water and then cut into slices. Chinese yam contains large amounts of mucilage. Mucilage is a thick, slimy substance produced by plants. It has a soothing effect on mucous membranes, such as the tissues that line the respiratory passages. This may explain why Chinese yam is effective at relieving cough .

A cobalt-containing, B complex vitamin. Cyanocobalamin and hydroxocobalamin are synthetic forms of vitamin B 12 . Hydroxocobalamin: Antidote for cyanide poisoning.

Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses these vitamins, leftover amounts leave the body through the urine. Typically, water-soluble vitamins can not be stored by the body. Vitamin B12 is special, because the body can store it for years in the liver.

Cobalamin, also known as B 12 , is a member of the water-soluble family of B vitamins. It is a key factor in the body's proper use of iron and formation of red blood cells. The nervous system also relies on an adequate supply of cobalamin to function appropriately, as it is an essential component in the creation and maintenance of the myelin sheath that lines nerve cells. Other roles of cobalamin include working with pyridoxine (vitamin B 6 and folic acid to reduce harmful homocysteine levels, participating in the metabolization of food, and keeping the immune system operating smoothly.

Cobalamin, also known as B 12 , is a member of the water-soluble family of B vitamins . It is a key factor in the body's proper use of iron and formation of red blood cells. The nervous system also relies on an adequate supply of cobalamin to function appropriately, as it is an essential component in the creation and maintenance of the myelin sheath that lines nerve cells. Other roles of cobalamin include working with pyridoxine (vitamin B 6 and folic acid to reduce harmful homocysteine levels, participating in the metabolization of food, and keeping the immune system operating smoothly.

Two parts of the safflower are primarily used: the flower itself and safflower seeds. There are two types of safflower oil with corresponding types of safflower varieties: those high in monounsaturated fatty acid (oleic) and those high in polyunsaturated fatty acid (linoleic). Currently, the seed varieties that produce oil high in oleic acid and very low in saturated fatty acids predominate in the United States market. High oleic safflower oil is lower in saturates and higher in monounsaturates than olive oil. In the U.S. diet, safflower oil has been frequently substituted for oils with higher saturated fat content, as monounsaturated fat may have a beneficial effect on the risk of coronary heart disease. Some clinical studies have shown that safflower oil supplementation may be helpful in patients with cystic fibrosis, Friedreich's ataxia, and neurotoxicity from lithium. However, more study is needed in these areas before a firm conclusion can be drawn. In traditional Chinese medicine, safflower is used to invigorate the blood, dissipate stasis, amenorrhea (absence of menstruation), pain, and traumatic injuries. It is also used to "calm" a live fetus and abort a dead fetus, and is therefore used cautiously during pregnancy.

A bacterium that creates an environment unfavorable to the overgrowth of potentially pathogenic fungi and bacteria; used as an antidiarrheal agent.

Berberine is a bitter-tasting, yellow, plant alkaloid with a long history of medicinal use in Chinese and Ayurvedic medicine. Berberine is present in the roots, rhizomes and stem bark of various plants including Hydrastis canadensis (goldenseal), Coptis chinensis (coptis or goldenthread), Berberis aquifolium (Oregon grape), Berberis vulgaris (barberry), and Berberis aristata (tree turmeric). Berberine has also been used historically as a dye, due to its yellow color. Clinical trials have been conducted using berberine. There is some evidence to support its use in the treatment of trachomas (eye infections), bacterial diarrhea, and leishmaniasis (parasitic disease). Berberine has also shown antimicrobial activity against bacteria, viruses, fungi, protozoans, helminths (worms), and chlamydia (STD). Future clinical research is warranted in these areas, as well as cardiovascular disease, skin disorders, and liver disorders. Berberine has been shown to be safe in the majority of clinical trials. However, there is a potential for interaction between berberine and many prescription medications, and berberine should not be used by pregnant or breastfeeding women, due to potential for adverse effects in the newborn.

Lemongrass ( Cymbopogon citrates ) is used in Cuban folk medicine to lower high blood pressure and as an anti-inflammatory. In India, lemongrass is used as a medicinal herb and in perfumes. It is also used in Brazilian folk medicine in a tea called "abafado" as a sedative, for gastrointestinal problems, and for fever. Lemongrass oil is a yellow/brown oil with a tinge of red. It has a fresh, strong, lemon-like and pungent odor with herbal and leaf aspects. Lemongrass oil is an essential oil used in deodorants, herbal teas, skin care products, fragrances, insect repellents, and for aromatherapy. Currently, there is very little scientific evidence investigating the use of lemongrass in humans and more evidence is needed to make strong recommendations for its use as a sedative or for lowering high cholesterol. Lemongrass is not approved by the German Commission E, but does have generally recognized as safe (GRAS) status in the United States.

Resembling a gigantic weed, lemongrass is an aromatic tropical plant with long, slender blades that can grow to a height of 5 ft (1.5 m). Believed to have a wide range of therapeutic effects, the herb has been used for Large lemongrass plant. (© PlantaPhile , Germany. Reproduced by permission. ) centuries in South America and India and has also become popular in the United States. Aside from folk medicine, lemongrass is a favorite ingredient in Thai cuisine and dishes that boast a tangy, Asian flavor. While there are several species of lemongrass, Cymbopogon citratus is the variety most often recommended for medicinal purposes. Native to Southeast Asia, lemongrass can also be found growing in India, South America, Africa, Australia, and the United States. Only the fresh or dried leaves of lemongrass, and the essential oil derived from them, are used as a drug. Cymbopogon citratus , which belongs to the Poaceae family of plants, is also referred to as West Indian lemongrass. Not to be confused with lemon balm , which is an entirely different herb, lemongrass is considered by herbalists to have several useful properties, including antibacterial, antifungal, and fever-reducing effects. Some of these claims have been supported by animal and laboratory studies. In one test-tube investigation, published in the medical journal Microbios in 1996, researchers demonstrated that lemongrass was effective against 22 strains of bacteria and 12 types of fungi. Scientific research has also bolstered the herb's reputation as an analgesic and sedative. A study conducted in rodents suggests that myrcene, a chemical found in the essential oil of Cymbopogon citratus , may act as a site-specific pain reliever. Unlike aspirin and similar analgesics, which tend to alleviate pain throughout the body, myrcene seems to work only on particular areas. A study involving people indicates that lemongrass may also affect the way the body processes cholesterol. More recently, lemongrass has been shown to have antimutagenic properties; that is, researchers have found that it is able to reverse chemically induced mutations in certain strains of bacteria. While they may not be aware of it, most Americans have already tried lemongrass in one form or another. Citral, a key chemical found in Cymbopogon citratus , is an ingredient in a variety of foods and beverages (including alcohol). It can be found in candies, puddings, baked goods, meat products, and even in certain fats and oils. Citral is a pale yellow liquid that evaporates rapidly at room temperature. Like other essential oils , lemongrass is also used as a fragrance enhancer in many perfumes, soaps, and detergents.

Ashwaganda, also spelled ashwagandha, is a member of the pepper family known as Withania somnifera . The small evergreen grows in the frost-free drier parts of western India, northern Africa, the Mediterranean, and the Middle East. Ashwaganda grows to a height of 2–3 ft (about 1 m) and has oval leaves, showy yellow flowers, and red, raisin-sized fruits. All parts of the plant, including the root, are used medicinally. Ashwaganda is also called winter cherry, withania, asgandh, and Indian ginseng.

Since ancient Egypt, white horehound ( Marrubium vulgare L.) has been used as an expectorant (to facilitate removal of mucus from the lungs or throat). Ayurvedic, Native American and Australian Aboriginal medicines have traditionally used white horehound to treat respiratory (lung) conditions. The United States Food and Drug Administration (FDA) banned horehound from cough drops in 1989 due to insufficient evidence supporting its efficacy. However, horehound is currently widely used in Europe, and can be found in European-made herbal cough remedies sold in the United States (for example, Ricola®). There is no well-defined clinical evidence to support any therapeutic use of white horehound. The expert German panel, the Commission E, has approved white horehound for lack of appetite, dyspepsia (heartburn), and as a choleretic. There is promising early evidence favoring the use of white horehound as a hypoglycemic agent for diabetes mellitus, and as a non-opioid pain reliever. There is limited evidence on safety or toxicity in humans. White horehound has been reported to cause hypotension (low blood pressure), hypoglycemia (low blood sugar), and arrhythmias (abnormal heart rhythms) in animal studies

Vitamin B12 is an essential water soluble vitamin that is commonly found in a variety of foods such as fish, shellfish, meats, and dairy products. Vitamin B12 is frequently used in combination with other B vitamins in a vitamin B complex formulation. It helps maintain healthy nerve cells and red blood cells, and is also needed to make DNA, the genetic material in all cells. Vitamin B12 is bound to the protein in food. Hydrochloric acid in the stomach releases B12 from protein during digestion. Once released, B12 combines with a substance called intrinsic factor (IF) before it is absorbed into the bloodstream. The human body stores several years' worth of vitamin B12, so nutritional deficiency of this vitamin is extremely rare. Elderly are the most at risk. However, deficiency can result from being unable to use vitamin B12. Inability to absorb vitamin B12 from the intestinal tract can be caused by a disease known as pernicious anemia. Additionally, strict vegetarians or vegans who are not taking in proper amounts of B12 are also prone to a deficiency state. A day's supply of vitamin B12 can be obtained by eating 1 chicken breast plus 1 hard-boiled egg plus 1 cup plain low-fat yogurt, or 1 cup milk plus 1 cup raisin bran.

Lactobacilli are bacteria that normally live in the human small intestine and vagina. Lactobacillus acidophilus is generally considered to be beneficial because it produces vitamin K, lactase, and anti-microbial substances such as acidolin, acidolphilin, lactocidin, and bacteriocin. Multiple human trials report benefits of L. acidophilus for bacterial vaginosis. Other medicinal uses of L. acidophilus are not sufficiently studied to form clear conclusions. The term "probiotic" is used to describe organisms that are used medicinally, including bacteria such as L. acidophilus and yeast such as Saccharomyces boulardii . Although generally believed to be safe with few side effects, oral L. acidophilus should be avoided in people with intestinal damage, a weakened immune system, or with overgrowth of intestinal bacteria.

Chinese herbalists have relied on rhubarb rhizomes and roots for thousands of years. The rhizomes and roots contain powerful anthraquinones and tannins that act as stimulant laxatives and astringents, respectively. In traditional Chinese medicine, rhubarb is also used to treat gastric ulcers, chronic renal (kidney) failure, and pregnancy-induced hypertension (high blood pressure), pre-eclampsia and eclampsia. European herbalists have recommended rhubarb as a laxative, diuretic, and to treat kidney stones, gout (foot inflammation), and liver diseases. Externally, it is recommended to heal skin sores and scabs. The current practice of using rhubarb to treat cancer (as an ingredient in the herbal Essiac® formula) lacks the support of controlled clinical trials. However, rhubarb is being tested for multiple other conditions, including hyperlipidemia (high cholesterol) and obesity. Use for gingivitis, chronic renal failure and upper gastrointestinal bleeding seem to be the most promising, although more research should be done in these areas, specifically with rhubarb as a monotherapy.

Rhubarb, also called sweet round-leaved dock or pieplant, is usually thought of as a fruit, but it is actually one of the few perennial vegetables in existence. Ordinary garden rhubarb carries the botanical name of Rheum rhaponticum , though there are other members of this botanical group that are also used for medicinal purposes. Chinese rhubarb, which is called da huang in traditional Chinese medicine , has the botanical name Rheum palmatum . Chinese rhubarb has a much stronger taste and properties than the common American variety. Rhubarb is a member of the same family as buckwheat, the Polygonaceae family. It originally came from Mongolia in northern Asia, but was long ago introduced to both India and Turkey. It was formerly called India or Turkey rhubarb. In the 1760s, in England, an Oxfordshire pharmacist named Hayward began developing and growing the type of rhubarb most commonly grown today. Records indicate that rhubarb was first grown as a market crop in England in 1810. But because it was unknown, few people purchased it. In the next one hundred years, its popularity grew tremendously. The average life expectancy of rhubarb plants is five to eight years. Although rhubarb produces seeds, they can give birth to plants remarkably different from the parent plant. For this reason, rhubarb cultivation is usually done by cutting and replanting pieces of its large storage root. Rhubarb is an early plant that is extremely hardy. It is relatively immune to attack by insects or disease. It puts out smaller feeder roots in early spring; even in colder regions, reddish bud-like projections appear in early April. These develop rapidly into long thick succulent stalks that can grow from 1–3 ft (approximately 30–90 cm) in length. Rhubarb stalks are generally ready for harvesting by late May. One very large spade-shaped leaf with curled edges grows at the tip of each stalk. There is considerable evidence that these leaves should be considered poisonous due to their high content of salts of oxalic acid. Oxalic acid is a powerful but toxic cleaning agent. Although M. Grieve reports that people have eaten both the leaves and the newly formed rhubarb buds without any problem, she also mentions several sources that listed several cases of death by rhubarb leaf poisoning around 1910. Rhubarb stalks have a tangy, sweet-sour taste much prized for the making of desserts, especially pies. Rhubarb stalks are a good source of ascorbic acid ( vitamin C ). Chinese rhubarb produces a yellowish root with a distinctive network of white lines running along the outer surface. Chinese rhubarb root is much larger and more firmly textured than its Western relatives, and has much stronger laxative qualities, but it is also less astringent. The root of Western garden rhubarb is smaller, spongier, and is usually pinkish in color. It has sporadic star-shaped spots evident along its transverse sections.

Astaxanthin is classified as a xanthophyll, which is a carotenoid pigment, and can be found in microalgae, yeast, salmon, trout, krill, shrimp, crayfish, crustaceans, and the feathers of some birds. Haematococcus pluvialis , a green microalga and one of the richest sources of natural astaxanthin, was reviewed and cleared for marketing by the United States Food and Drug Administration (FDA) in August 1999 as a new dietary ingredient by means of the Dietary Supplement Health and Education Act (DSHEA) (21 CRF part 190.6). Astaxanthin is most commonly used as an antioxidant and may be beneficial in decreasing the risks of certain chronic diseases, such as cancer and cardiovascular diseases. Astaxanthin may also be effective in carpal tunnel syndrome, rheumatoid arthritis, muscle strength and endurance, high cholesterol (LDL oxidation), musculoskeletal injuries, and male infertility. Astaxanthin has been used as a feed supplement and food coloring additive for salmon, crabs, shrimp, chickens, and egg production. According to the Code of Federal Regulations, astaxanthin is generally recognized as safe (GRAS) when used as a color additive in salmon foods to obtain the desired pink to orange-red color.

The name "acacia" is derived from the Greek word "akis" meaning "sharp point," and relates to the sharp thorny shrubs and trees of tropical Africa and Western Asia that were the only known acacias at the time that the name was published. The Australian acacias are commonly called "wattles" because of their pliable branches that were woven into the structure of early wattle houses and fences. Acacia is commonly present in chewing sticks, mainly as an antimicrobial with activity against Streptococcus fecalis . Acacia has also shown some cholesterol-lowering and antidiabetic properties, although there is insufficient evidence in support of these uses. Acacia is generally considered to be safe. Adverse reactions appear to be mild, with occasional gastrointestinal symptoms. Acacia has been used to treat high cholesterol, diabetes, cancer, gingivitis, stomatitis (mouth sores), pharyngitis, and indigestion in children. Acacia gum is used as a food additive. Acacia concinna is often used in cosmetics.

Omega-6 fatty acids are one of two groups of essential fatty acids (EFAs) that are required in human nutrition . (The other is the omega-3 fatty acid group.) Omega-6 fatty acids include linoleic acid and its derivatives. Essential means that these fatty acids must be consumed in the diet because humans cannot manufacture them from other dietary fats or nutrients, nor can they be stored in the body. They must be consumed daily to meet the body's requirements. They are macronutrients, required in amounts of grams per day (compared to micronutrients such as vitamins, which are required in milligrams per day). EFAs provide energy and are also components of nerve cells, cellular membranes, and are converted to hormone-like substances known as prostaglandins. In the body, prostaglandins and EFAs are necessary for normal physiology, including: producing steroids and synthesizing hormones regulating pressure in the eye, joints, and blood vessels mediating immune response regulating bodily secretions and their viscosity dilating or constricting blood vessels regulating collateral circulation directing endocrine hormones to their target cells regulating smooth muscles and autonomic reflexes being primary constituents of cell membranes regulating the rate of cell division maintaining the fluidity and rigidity of cellular membranes regulating the inflow and out-flux of substances into and out of cells transporting oxygen from red blood cells to the tissues maintaining proper kidney function and fluid balance keeping saturated fats mobile in the blood stream preventing blood cells from clumping together (conglomeration, which is the cause of atherosclerotic plaque, and blood clots , can be a cause of stroke ) mediating the release of inflammatory substances from cells that may trigger allergic conditions regulating nerve transmission and communication being the primary energy source for the heart muscle EFAs are therapeutic, and clinical trials have shown that EFAs protect against such conditions as heart disease ; cancer ; autoimmune diseases, including rheumatoid arthritis and multiple sclerosis ; skin diseases, including acne, atopic eczema , and psoriasis ; and may protect against stroke. The prevalence of heart disease in populations has been shown to be inversely proportional to the relative concentration of linoleic acid in the diet. Both linoleic acid and its derivatives are obtained from plant and animal sources. Plant sources include unprocessed, unheated vegetable oils such as corn, sunflower seed, safflower, soy, sesame, and cottonseed oils. They are also found in plant materials such as evening primrose, black currant seeds, and gooseberry oils as well as in raw nuts and seeds, legumes, and leafy greens. Animal sources of omega-6 fatty acids (although in smaller amounts than in plants) are lean meats, organ meats, and breast milk. Linoleic acid is an 18-carbon long polyunsaturated fatty acid containing two double bonds. Its first double bond occurs at the sixth carbon from the omega end, classifying it as an omega-6 oil. As linoleic acid is absorbed and metabolized in the human body, it is converted into a derivative fatty acid, gamma linoleic acid (GLA), which is converted into di-homo-gamma linoleic acid (DGLA) and arachidonic acid (AA). The DGLA and AA are then converted into two types of prostaglandins by adding two carbon molecules and removing hydrogen molecules. There are three families of prostaglandins, PGE1, PGE2, and PGE3. DGLA is converted to PGE1, while AA is converted into PGE2. PGE3 is made by the conversion of omega-3 fatty acids . Both PGE1 and PGE3, anti-inflammatory agents, protect against coronary disease by keeping blood platelets slippery and flowing, thus preventing blood clotting. PGE2 is inflammatory and increases platelet stickiness and blood clotting. All three forms must be present to ensure a functioning clotting system. There must be enough PGE2 to ensure healthy clotting, but enough PGE1 and PGE3

Fatty acids are organic compounds composed of carbon chains of varying lengths, with an acid group on one end and hydrogen bound to all the carbons of the chain. Essential fatty acids (EFAs) are those that are necessary for health, but cannot be synthesized by the body. Therefore, it is important to supply the body with EFAs through one's daily dietary intake. EFAs are also called vitamin F or polyunsaturates. They are important ingredients for the growth and maintenance of cells. The body utilizes essential fatty acids for hormone production, specifically for the production of prostaglandins , which aid in reducing hypertension , migraine headaches, and arthritis . Essential fatty acids offer many positive effects for the body, including the nourishment of skin and hair; reduction of blood pressure , cholesterol , and triglyceride levels; prevention of arthritis and inflammation; and the reduction of the risk of blood clotting . Furthermore, essential fatty acids help protect the body from cardiovascular disease, candidiasis , eczema , and psoriasis , and they play a critical role in brain development and in the transmission of nerve impulses.

Dietary sources of omega-3 fatty acids include fish oil and certain plant/nut oils. Fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), while some nuts (English walnuts) and vegetable oils (canola, soybean, flaxseed/linseed, olive) contain alpha-linolenic acid (ALA). There is evidence from multiple studies supporting intake of recommended amounts of DHA and EPA in the form of dietary fish or fish oil supplements lowers triglycerides, reduces the risk of death, heart attack, dangerous abnormal heart rhythms, and strokes in people with known cardiovascular disease, slows the buildup of atherosclerotic plaques ("hardening of the arteries"), and lowers blood pressure slightly. However, high doses may have harmful effects, such as an increased risk of bleeding. Although similar benefits are proposed for alpha-linolenic acid, scientific evidence is less compelling, and beneficial effects may be less pronounced. Some species of fish carry a higher risk of environmental contamination, such as with methylmercury.

Antilipemic agent; combination consisting predominantly of ethyl esters of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Omega-3 fatty acids are one of two groups of fatty acids—the omega-3s and the omega-6s—that are vital to human life. They are called essential fatty acids (EFAs), which the body cannot make but absolutely needs for normal growth and development. These fats must be supplied by diet. People living in industrialized western countries eat up to 30 times more omega-6 than omega-3 fatty acids, resulting in a relative deficiency of omega-3 fats. Omega-6 metabolic products (inflammatory prostaglandins, thromboxanes, and leukotrienes) are formed in excessive amounts causing allergic and inflammatory disorders and making the body more prone to heart attacks, strokes, and cancer . Eating diets rich in omega-3 acids or taking fish oil supplements can restore the balance between the two fatty acids and can possibly reverse these disease processes.