Table Of ContentCD to accompany
Herbs & Natural
Supplements
An Evidence-based Guide
Second Edition
CD to accompany
Herbs & Natural
Supplements
An Evidence-based Guide
Second Edition
Lesley Braun
Pharmacist, Naturopath, Herbalist and
Industry Consultant and Lecturer at RMIT and
Monash Universities
Marc Cohen
Professor and Head of Department of
Complementary Medicine,
RMIT University, Melbourne
Sydney Edinburgh London New York
Philadelphia St Louis Toronto
indicates a herb or supplement action with particular significance for pregnant women
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CONTENTS
Click on the name of the item that you are interested in, or use the PDF
bookmarks to navigate through this document.
An index to the herbal medicines, conditions and main actions (clinical
uses) discussed in the book is located at the end of the PDF.
Adhatoda Chondroitin
Albizia Chromium
Aloe vera Cinnamon
Andrographis Citrus aurantium
Astragalus Cloves
Baical skullcap Cocoa
Beta-carotene Coenzyme Q10
Bilberry Colostrum
Bitter melon Cranberry
Black cohosh Creatine
Brahmi Damiana
Calcium Dandelion
Calendula Devil’s claw
Carnitine Dong quai
Celery Echinacea
Chamomile Eucalyptus
Chaste tree Evening primrose oil
Chickweed Fenugreek Contents 4
Chitosan Feverfew
© 2007 Elsevier Australia
Fish oils Magnesium
Flaxseed oil Meadowsweet
Folate Mullein
Garlic Myrrh
Gentian New Zealand green-lipped mussel
Ginger Noni
Ginkgo biloba Oats
Ginseng—Korean Olive
Ginseng—Siberian Passionflower
Globe artichoke Peppermint
Glucosamine Perilla
L-Glutamine Policosanol
Goldenrod Probiotics
Goldenseal Psyllium
Grapeseed extract Pygeum
Green tea Quercetin
Guarana Raspberry leaf
Gymnema sylvestre Red clover
Hawthorn Rosemary
Honey Sage
Hops St John’s wort
Horse chestnut St Mary’s thistle
Horseradish S-Adenosyl-L-Methionine (SAMe)
Iodine Saw palmetto
Iron Schisandra
Kava kava Selenium
Lavender Shark cartilage
Lemon balm Slippery elm
Licorice Soy
Lutein and Zeaxanthin Stinging nettle
Lycopene Tea tree oil Contents 5
L-Lysine Thyme
© 2007 Elsevier Australia
Tribulus Vitamin E
Turmeric Wild yam
Tyrosine Willowbark
Valerian Withania
Vitamin A Zinc
Vitamin B1 Appendix 1
Vitamin B2 — Riboflavin Appendix 2
Vitamin B3 — Niacin Appendix 3
Vitamin B5 — Pantothenic acid Appendix 4
Vitamin B6 Appendix 5
Vitamin B12 Appendix 6
Vitamin C Appendix 7
Vitamin D Index
Contents 6
© 2007 Elsevier Australia
MONOGRAPHS
Adhatoda
Historical note Used for hundreds of years as an important herb in Ayurvedic
medicine, adhatoda is used traditionally for cough, asthma, bronchitis and
tuberculosis.
COMMON NAMES
Adhatoda, Malabar nut tree
OTHER NAMES
Adhatoda zeylanica, arusha, bakash justicia adhatoda, vasaka, vasa
BOTANICAL NAME/FAMILY
Adhatoda vasica (family Acanthaceae)
PLANT PARTS USED
Leaves and roots
CHEMICAL COMPONENTS
The leaves contain several different alkaloids, including vasicine, vasicinone, vasicinol,
adhatodine, adhatonine, adhavasinone, anisotine, peganine (Claeson et al 2000),
betaine, steroids and alkanes. The root also contains alkaloids (vasicinol, vasicinolone,
vasicinone, adhatonine), a steroid (daucosterol), carbohydrates and alkanes (Claeson
et al 2000).
Clinical note
One of the alkaloids found in the herb (vasicine) has been chemically modified and
is referred to as RLX (6,7,8,9,10,12-hexahydro-azepino-[2,1-b]-quinazoline-12-one)
in the medical literature (Johri & Zutshi 2000). It has been shown in animal studies
© 2007 Elsevier Australia
to inhibit antigen-induced mast-cell degranulation and histamine release and exert
bronchodilator activity.
MAIN ACTIONS
Adhatoda has not been significantly investigated in clinical studies, so information is
generally derived from in vitro and animal studies and is largely speculative. As with
many Ayurvedic herbs, most investigation has been undertaken in India and locating
original research from these sources is difficult.
ANTITUSSIVE EFFECTS
Results from animal studies show that Adhatoda vasica extract exerts considerable
antitussive activity when administered orally and is comparable to codeine when
cough is due to irritant stimuli (Dhuley 1999). The antitussive activity may be due to
the action of vasicinone and vasicinol, which have activity in the cerebral medulla.
ANTI-INFLAMMATORY
Potent anti-inflammatory activity has also been demonstrated for the alkaloid fraction
and shown to be equivalent to that of hydrocortisone in one study (Chakraborty &
Brantner 2001).
BRONCHODILATOR AND ANTI-ASTHMATIC ACTIVITY
According to a 2002 review, both vasicine and vasicinone possess in vitro and in vivo
bronchodilatory activity and inhibit allergen-induced bronchial obstruction in a
manner comparable to that of sodium cromoglycate (Dorsch & Wagner 1991, Jindal
et al 2002).
OTHER ACTIONS
HEPATOPROTECTIVE
Adhatoda vasica leaf (50–100 mg/kg) was shown to protect against induced liver
damage in rats (Bhattacharyya et al 2005); 100 mg/kg of Adhatoda vasica was
comparable to the hepatoprotective ability of silymarin at 25 mg/kg. An earlier study
showed that Adhatoda vasica (100–200 mg/kg) protected against carbon tetra-
chloride-induced liver damage in rats (Pandit et al 2004). The leaf extract
significantly enhanced the protective enzymes superoxide dismutase and catalase in
the liver: 200 mg/kg of Adhatoda vasica was shown to be comparable to 25 mg/kg
of silymarin.
PROTECTS AGAINST RADIATION DAMAGE
Adhatoda vasica (800 mg/kg) protects hematopoietic stem cells against radiation Adhatoda 8
damage by inhibiting glutathione deletion, reducing lipid peroxidation and increas-
© 2007 Elsevier Australia
ing phosphatase activity in mice (Kumar et al 2005). Animals pretreated with oral
doses of adhatoda showed an 81.25% survival rate at 30 days as compared to
control animals who could not survive past 25 days.
ENZYME INDUCTION
In vitro tests show that Adhatoda vasica acts as bifunctional inducer, since it induces
both phase I and phase II enzyme systems (Singh et al 2000).
ABORTIFACIENT
One of the traditional uses of the herb is as an abortifacient; however, inconsistent
results from in vivo studies have made it difficult to determine whether adhatoda has
significant abortifacient activity. One study investigating oral administration of leaf
extracts showed 100% abortive rates at doses equivalent to 175 mg/kg of starting dry
material (Nath et al 1992). Another study found that an Adhatoda vasica extract had
anti-implantation activity in 60–70% of test animals (Prakash et al 1985).
ANTISPASMODIC
The essential oil from the leaves has been shown to exert antispasmodic action on
guinea pig tracheal chain (Claeson et al 2000).
ANTIOXIDANT ACTIVITY
In vitro tests also show the extract is effective in inducing glutathione S-transferase
and DT-diaphorase in lungs and forestomach, and superoxide dismutase and catalase
in kidneys (Singh et al 2000).
CLINICAL USE
Adhatoda has not been significantly investigated in clinical studies, so information is
generally derived from in vitro and animal studies and is largely speculative.
COUGH
The antitussive activity of adhatoda extract has been compared to that of codeine in
two different models of coughing and in two different animal species (Dhuley 1999).
When administered orally, Adhatoda vasica extract produced antitussive effects
comparable to those of codeine against coughing induced by peripheral irritant
stimuli. When coughing was induced by electrical stimulation of the tracheal mucosa,
adhatoda extract was only one-quarter as active as codeine. Intravenous adminis-
tration was far less effective in both cough models. A double-blind, randomised,
controlled trial of Adhatoda vasica in combination with Echinacea purpurea and
Eleutherococcus senticosus was compared with an Echinacea and Eleutherococcus
Adhatoda 9
mixture and bromhexine (Narimanian et al 2005). Bromhexine is a semi-synthetic
derivative of the alkaloid vasicine found in Adhatoda vasica (Grange & Snell 1996)
© 2007 Elsevier Australia
and is found in some pharmaceutical cough mixtures. The Adhatoda vasica
combination reduced the severity of cough, increased mucus discharge and reduced
nasal congestion compared to the other two formulas. Both the herbal mixtures
reduced the frequency of cough compared to bromhexine.
ASTHMA
Although used for asthma in combination with other herbs, clinical evidence is
unavailable to determine effectiveness. Evidence of bronchodilator activity from in
vitro and animal studies provides a theoretical basis for use in this indication.
OTHER USES
Adhatoda is traditionally used to treat cough, asthma, bronchitis and colds, but has
also been used to treat fever, dysentery, diarrhoea, jaundice, to stimulate the birthing
process and aid healing afterwards, tuberculosis, headache, and as an antispasmodic
(Claeson et al 2000). It has also been used as an abortifacient in some Indian villages.
Topical application of leaves that have been warmed on the fire is used in the
treatment of joint pain, lumber pain and sprains.
The powder is reported to be used as a poultice on rheumatic joints, as a
counterirritant for inflammatory swelling, on fresh wounds, and in urticaria and
neuralgia (Dhuley 1999).
DOSAGE RANGE
As clinical research is lacking, the following dosages come from Australian manufac-
turer recommendations.
• Liquid extract tincture (1:2): 1–3 mL/day.
• Dried herb: 0.5–1.5 g/day.
ADVERSE REACTIONS
Insufficient reliable information is available.
SIGNIFICANT INTERACTIONS
Controlled studies are not available, so interactions are based on evidence of activity
and are largely theoretical and speculative.
CODEINE AND OTHER ANTITUSSIVE DRUGS
Theoretically, adhatoda may increase antitussive effects of these drugs — beneficial
interaction possible under professional supervision.
CONTRAINDICATIONS AND PRECAUTIONS
Insufficient reliable information is available.
Adhatoda 10
© 2007 Elsevier Australia
