ESULIX with Cordyceps
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Data & Report of ESULIX

WHAT WE FOUND IN OUR STUDY

"... experiments showed that ESULIX can improve significantly diabetes rats with diabetic symptoms', lower blood glucose in diabetic rats, reduce glycosylated serum protein, improve glucose tolerance, blood lipid abnormalities."

"light microscopy also showed that ESULIX can significantly improve the pathological changes of pancreatic tissue and increase the number of islet B cells"

"ESULIX have the same hipoglycemic effect of anti-diabetic medicine"

"ESULIX caused inrease in skeletal mucle glucose transporter 4 gene expression suggesting increased number of insulin receptor by ESULIX. The number of bodies to promote skeletal muscle glucose transporter 4 gene expression, thereby improving insulin sensitivity"

"Studies show that ESULIX through the increasing in insulin sensitivity, enhance cells use glucose to plan the effect of lowering blood glucose can significantly reduce fasting blood glucose, insulin and C-Peptide level, after meal blood glucose and insulin also significant"

Note: ESULIX (2017) - formally name as ESULIN (2009-2017). 

Report Summerise: ENGLISH

Esulix: Medical guideline

resentation Material: Seminar on Herbal Symposium: HOSPITAL SARDJITO, Jodgja (10 May 2010)

with analysis HbA1c of 19 patients with ESULIX herbal formulation

Clinical Trail 20 patients

Esulix: Analysis of HbA1c. A combination methode with anti-diabetic drug and insulin

ESULIX: HbA1c analysis

Hasil Kajian: BAHASA

Esulix: Penunjuk perubatan

Toxicity Test report Local University): summerise

Fungsi ESULIX - Bahasa

Toxicity Test 1: 2009

Analisa HbA1c pesakit 60 orang pesakit

Esulix: Flow chat and process

Esulix in Journal of Applied Biology and Pharmaceutical Technology (2015)

BAHAN UTAMA ESULIX (INGREDIENT)


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  • BITTER MELON
  • CORDYCEPS SINESIS
  • CINNAMON CASSIA
  • PRUNUS PERSICA
  • GLYCYRRHIZAE URALENSIS
  • RHEUM PALMATUM
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 EKSTRAK BUAH PERIA KATAK (Bitter Melon/ Memordica Chanrantia)

Peria Katak mengandungi ‘phyto-insulin’ di samping menghasilkan Vacin, Charantin dan Polypeptide-P yang bertindak sebagai anti-diabetik untuk mengurangkan paras gula dalam darah.
​
Peria Katak juga kaya dengan potassium yang bertindak balas dengan sodium (garam) di dalam badan. Fakta fungsi Peria Katak adalah seperti di bawah:

1. Menurunkan berat badan dan bahan aktif Saponin mampu mengaktif dan merangsang produksi Insulin
2. Sangat rendah kalori, hanya 17 kalori dlm 100g.
3. Tinggi Fiber, Mineral & Anti-oksidan
4. Mempunyai Phyto-nutrient, Poplypeptide-P dan Charatin yang membantu mengawal gula dalam darah. (Bagus untuk pesakit Diabetes Type II)
5. Tinggi Vitamin C, Carotene, Leutein dan zea-xanthin
(Anti-oksida yang bagus untuk anti-penuaan, anti-kanser dan mencegah penyakit kronik)
6. mengandungi Niacin (vitamin B3), Pantothenic acid (vitamin B5), Pyridoxine (Viamin B6), Zat Besi, Zinc, Manganese dan Magnesium.
7. Membantu menurunkan kolestrol
8. Membantu mencegah sembelit
9. Mencegah jangkitan
Bitter Melon

Common Names

  • Bitter gourd; Bitter apple; wild cucumber; bitter cucumber
  • balsam apple; balsam pear; margose
  • la-kwa; leprosy gourd; karela; kugua; cerasee
For Patients & Caregivers

How It Works
 
Bitter melon has been shown to lower the levels of blood sugar.

Several active substances in bitter melon have been studied in both animals and humans. These experiments show that these substances act in the same way as insulin, by increasing the entry of glucose into cells and promoting its processing and storage in the liver, muscle, and fat. Bitter melon also prevents the conversion of stored nutrients to glucose and the release of this glucose into the blood. However, researchers have not established the correct dosage of bitter melon for effectively treating the high blood glucose levels in diabetes, and therefore it cannot be recommended as a replacement therapy for insulin or hypoglycemic drugs.

Bitter melon extracts were shown to kill leukemia cells in the laboratory and slow the growth of breast cancer in mice, but it is unknown whether these effects occur in humans. A study in humans showed bitter melon had little effect on the immune system of cervical cancer patients.

Purported Uses

  • To prevent cancer
    Laboratory studies show that bitter melon extracts can kill certain cancer cells, but it has not been studied in cancer patients.
  • To treat type 2 diabetes
    A few small clinical trials show that bitter melon extracts can lower blood glucose levels, but larger and better-designed clinical trials are needed to fully support this use.
  • To reduce fever
    No scientific evidence supports this use.
  • To treat HIV and AIDS
    Preliminary laboratory studies show that bitter melon can slow the ability of HIV to insert its genes into human chromosomes.
  • To treat infections
    Bitter melon extracts can kill certain viruses on contact in the laboratory, but human data are lacking.
  • To relieve menstrual problems
    This claim is not backed by research.

Patient Warnings

  • The covering on bitter melon seeds (called red arils) are toxic in children, causing vomiting, diarrhea, and death.

Do Not Take If

  • You are pregnant (Bitter melon can cause vaginal bleeding, premature contractions, and abortion).
  • You are taking insulin (Bitter melon may have additive effects).
  • You are taking hypoglycemic medication for diabetes (Bitter melon may have additive effects).

Side Effects

  • Low blood sugar
  • Liver damage (this has been shown in animals, but not in humans)
  • Ingestion of the seeds of bitter melon can cause toxicity to red blood cells, which includes headache, fever, abdominal pain, and coma.
  • A 22-year-old man experienced atrial fibrillation (rapid irregular heartbeat) following ingestion of bitter melon two days before his admission for his dyspeptic complaints. He ingested crushed bitter melon and drank two tablespoons of its juice three times a day, and on the morning of admission as well. His symptoms improved after administering antiarrhythmic medication.
  • A 40-year-old man developed acute gastric ulceration following consumption of half a liter of concentrated homemade liquid extract of bitter melon. His symptoms included severe epigastric pain and hematemesis, which were managed with intravenous fluids, blood transfusion and intravenous rabeprazole.
​Common Names
 
  • Bitter gourd; Bitter apple; wild cucumber; bitter cucumber
  • balsam apple; balsam pear; margose
  • la-kwa; leprosy gourd; karela; kugua; cerasee
For Patients & Caregivers

How It Works
 
Bitter melon has been shown to lower the levels of blood sugar.

Several active substances in bitter melon have been studied in both animals and humans. These experiments show that these substances act in the same way as insulin, by increasing the entry of glucose into cells and promoting its processing and storage in the liver, muscle, and fat. Bitter melon also prevents the conversion of stored nutrients to glucose and the release of this glucose into the blood. However, researchers have not established the correct dosage of bitter melon for effectively treating the high blood glucose levels in diabetes, and therefore it cannot be recommended as a replacement therapy for insulin or hypoglycemic drugs.

Bitter melon extracts were shown to kill leukemia cells in the laboratory and slow the growth of breast cancer in mice, but it is unknown whether these effects occur in humans. A study in humans showed bitter melon had little effect on the immune system of cervical cancer patients.

Purported Uses
 
  • To prevent cancer
    Laboratory studies show that bitter melon extracts can kill certain cancer cells, but it has not been studied in cancer patients.
  • To treat type 2 diabetes
    A few small clinical trials show that bitter melon extracts can lower blood glucose levels, but larger and better-designed clinical trials are needed to fully support this use.
  • To reduce fever
    No scientific evidence supports this use.
  • To treat HIV and AIDS
    Preliminary laboratory studies show that bitter melon can slow the ability of HIV to insert its genes into human chromosomes.
  • To treat infections
    Bitter melon extracts can kill certain viruses on contact in the laboratory, but human data are lacking.
  • To relieve menstrual problems
    This claim is not backed by research.

Patient Warnings
 
  • The covering on bitter melon seeds (called red arils) are toxic in children, causing vomiting, diarrhea, and death.

Do Not Take If
 
  • You are pregnant (Bitter melon can cause vaginal bleeding, premature contractions, and abortion).
  • You are taking insulin (Bitter melon may have additive effects).
  • You are taking hypoglycemic medication for diabetes (Bitter melon may have additive effects).

Side Effects
 
  • Low blood sugar
  • Liver damage (this has been shown in animals, but not in humans)
  • Ingestion of the seeds of bitter melon can cause toxicity to red blood cells, which includes headache, fever, abdominal pain, and coma.
  • A 22-year-old man experienced atrial fibrillation (rapid irregular heartbeat) following ingestion of bitter melon two days before his admission for his dyspeptic complaints. He ingested crushed bitter melon and drank two tablespoons of its juice three times a day, and on the morning of admission as well. His symptoms improved after administering antiarrhythmic medication.
  • A 40-year-old man developed acute gastric ulceration following consumption of half a liter of concentrated homemade liquid extract of bitter melon. His symptoms included severe epigastric pain and hematemesis, which were managed with intravenous fluids, blood transfusion and intravenous rabeprazole.

Special Point
 
Researchers have not established the correct dosage or long-term effects of bitter melon for treating the high blood glucose levels in diabetes, and therefore it cannot be recommended as a replacement therapy for insulin or hypoglycemic drugs.
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For Healthcare Professionals

Scientific Name
 
Momordica charantia

Clinical Summary
 
Bitter melon is a perennial plant that grows in the tropical and subtropical regions of Asia, South America, East Africa, and the Caribbean. It is used both as food and in medicine to treat diabetes, cancer, viral infections, and immune disorders. Its bitterness is attributed to the presence of alkaloids, momordicosides, and momordicines.

In vitro and animal studies indicate anticancer (1) (2) (3), antiviral (4) (5) (6) and lipid lowering (7) effects.
Bitter melon was also shown to exert hypoglycemic effects in both healthy and diabetic patients (8), but further studies are required to recommend its use (9). Recent findings suggest that bitter melon extracts have the potential for increasing insulin sensitivity in patients with type-2 diabetes compared to those with type-1 disease (31).
Bitter melon had no effect on natural killer cell activity in a study of cervical cancer patients (10).
Although bitter melon is consumed as food, consumption of the seeds, extracts, and large quantities of juice can cause adverse effects. It can interact with certain drugs including chemotherapy agents such as vinblastine and paclitaxel (11) (12), and can lower blood sugar levels when combined with insulin or oral hypoglycemic agents.

Purported Uses
 
  • Cancer prevention
  • Diabetes
  • Fever
  • HIV and AIDS
  • Infections

Mechanism of Action
 
In an animal model, bitter melon extract showed hypoglycemic activity by suppressing the enzymes glucose-6-phosphatase and fructose-1,6-bisphosphatase in the liver (14). It improved insulin sensitivity, glucose tolerance and insulin signaling (15). It also reduced insulin resistance by influencing peroxisome proliferator-activated receptor (PPAR) alpha and PPAR gamma expression (16) and by modulating the phosphorylation status of insulin receptor and its downstream signaling molecules (17). A recent stugy showed that the preventive effects of bitter melon against insulin resistance are via modulation of nuclear factor (NF-kappa B) and phospho-c-Jun N-terminal kinase (JNK) pathways (36).

Bitter melon may help weight loss by reducing lipogenesis in adipose tissue. Animals that were fed with bitter melon showed lower fatty acid synthase (18). Bitter melon also affects fat and carbohydrate metabolism by stimulating thyroid hormones and adiponectin, and by enhancing the activity of AMP-activated protein kinase (AMPK) (19). In another study, it was shown to prevent inflammation and oxidative stress, modulate mitochondrial activity, suppress apoptosis activation, and inhibit lipid accumulation during the development of fatty liver (32).
Bitter melon displays cytotoxic activity: A ribosome inhibiting protein (RIP) MCP30 has been shown to inhibit histone deacetylase-1 (HDAC-1) activity and induce apoptosis in prostate cancer cells (1). In another study, a triterpene extracted from bitter melon activated peroxisome proliferator-activated receptor (PPAR) gamma and induced apoptosis in breast cancer cells (20). Bitter melon juice also caused apoptosis by inducing caspase-3 activation through adenosine monophosphate-activated protein kinase (AMPK) in pancreatic cell lines (3). Similar effects were observed with methanol extracts which increase Bax and decrease the anti-apoptotic protein Bcl-2 (21) (22). Other studies demonstrated reduction in metastasis via suppression of MMP-2 and MMP-9 enzymatic activities in lung adenocarcinoma CL1 cells (23). Bitter melon juice was found effective in decreasing phosphorylation of the protein kinases Akt and ERK1/2, and viability of gemcitabine-resistant pancreatic cancer cells (37).

MAP30, a ribosome inhibiting protein (RIP) isolated from bitter melon seeds, inhibits HIV-1 integrase and inactive DNA topology (24), leading to poor viral DNA integration (25) .

Warnings
 
Red arils (covering on seed) are reportedly toxic in children, causing vomiting, diarrhea, and death (26).

Contraindications
 
Bitter melon is contraindicated in pregnant women as it can induce bleeding, contractions, and abortion.

Adverse Reactions
 
  • Hypoglycemia and hepatotoxicity were reported in animal studies (27).
  • Toxicity: Ingestion of vicine (seed) may cause favism characterized by headache, fever, abdominal pain, and coma (26).
    Case Reports
  • A 22-year-old man experienced atrial fibrillation with rapid ventricular response following ingestion of bitter melon two days before his admission for his dyspeptic complaints. He ingested crushed bitter melon and drank two tablespoons of its juice three times a day, and on the morning of admission as well. His symptoms improved after administering antiarrhythmic medication (28).
  • A 40-year-old man developed acute gastric ulceration following consumption of half a liter of concentrated homemade liquid extract of bitter melon. His symptoms included severe epigastric pain and hematemesis, which were managed with intravenous fluids, blood transfusion and intravenous rabeprazole (29).
  • Gastrointestinal problems have been reported with use of bitter melon (19).
  • Bitter melon may cause a non-allergic type-I like hypersensitivity reaction (33).

Herb-Drug Interactions
 
  • P-glycoprotein substrates: Bitter melon inhibits P-glycoprotein and can increase the interacellular concentration and toxicity of substrate drugs, including vinblastine and paclitaxel (11) (12).
  • Cytochrome P450 substrates: Bitter melon extract inhibits CYP2C9 and may affect the metabolism of substrate drugs. (30)
  • Insulin: Bitter melon may have an additive effect when used concomitantly (8).
  • Hypoglycemics: Bitter melon may have additive effects when used concomitantly (8) (34).
  • Chemotherapy: Bitter melon extracts may increase bioavailability and efficacy of certain chemo agents (35).

References
 

  1. Xiong SD, Yu K, Liu XH, et al. Ribosome-inactivating proteins isolated from dietary bitter melon induce apoptosis and inhibit histone deacetylase-1 selectively in premalignant and malignant prostate cancer cells. International journal of cancer Journal international du cancer. Aug 15 2009;125(4):774-782.
  2. Ray RB, Raychoudhuri A, Steele R, et al. Bitter melon (Momordica charantia) extract inhibits breast cancer cell proliferation by modulating cell cycle regulatory genes and promotes apoptosis. Cancer research. Mar 1 2010;70(5):1925-1931.
  3. Kaur M, Deep G, Jain AK, et al. Bitter melon juice activates cellular energy sensor AMP-activated protein kinase causing apoptotic death of human pancreatic carcinoma cells. Carcinogenesis. Jul 2013;34(7):1585-1592.
  4. Lee-Huang S, Huang PL, Chen HC, et al. Anti-HIV and anti-tumor activities of recombinant MAP30 from bitter melon. Gene. Aug 19 1995;161(2):151-156.
  5. Fan JM, Zhang Q, Xu J, et al. Inhibition on Hepatitis B virus in vitro of recombinant MAP30 from bitter melon. Molecular biology reports. Feb 2009;36(2):381-388.
  6. Waiyaput W, Payungporn S, Issara-Amphorn J, et al. Inhibitory effects of crude extracts from some edible Thai plants against replication of hepatitis B virus and human liver cancer cells. BMC complementary and alternative medicine. 2012;12:246.
  7. Nerurkar PV, Lee YK, Linden EH, et al. Lipid lowering effects of Momordica charantia (Bitter Melon) in HIV-1-protease inhibitor-treated human hepatoma cells, HepG2. Br J Pharmacol. Aug 2006;148(8):1156-1164.
  8. Fuangchan A, Sonthisombat P, Seubnukarn T, et al. Hypoglycemic effect of bitter melon compared with metformin in newly diagnosed type 2 diabetes patients. Journal of ethnopharmacology. Mar 24 2011;134(2):422-428.
  9. Ooi CP, Yassin Z, Hamid TA. Momordica charantia for type 2 diabetes mellitus. The Cochrane database of systematic reviews. 2012;8:CD007845.
  10. Pongnikorn S, Fongmoon D, Kasinrerk W, et al. Effect of bitter melon (Momordica charantia Linn) on level and function of natural killer cells in cervical cancer patients with radiotherapy. Journal of the Medical Association of Thailand = Chotmaihet thangphaet. Jan 2003;86(1):61-68.
  11. Konishi T, Satsu H, Hatsugai Y, et al. Inhibitory effect of a bitter melon extract on the P-glycoprotein activity in intestinal Caco-2 cells. Br J Pharmacol. Oct 2004;143(3):379-387.
  12. Pitchakarn P, Ohnuma S, Pintha K, et al. Kuguacin J isolated from Momordica charantia leaves inhibits P-glycoprotein (ABCB1)-mediated multidrug resistance. The Journal of nutritional biochemistry. Jan 2012;23(1):76-84.
  13. Liu JQ, Chen JC, Wang CF, et al. New cucurbitane triterpenoids and steroidal glycoside from Momordica charantia. Molecules. 2009;14(12):4804-4813.
  14. Shibib BA, Khan LA, Rahman R. Hypoglycaemic activity of Coccinia indica and Momordica charantia in diabetic rats: depression of the hepatic gluconeogenic enzymes glucose-6-phosphatase and fructose-1,6-bisphosphatase and elevation of both liver and red-cell shunt enzyme glucose-6-phosphate dehydrogenase. The Biochemical journal. May 15 1993;292 ( Pt 1):267-270.
  15. Sridhar MG, Vinayagamoorthi R, Arul Suyambunathan V, et al. Bitter gourd (Momordica charantia) improves insulin sensitivity by increasing skeletal muscle insulin-stimulated IRS-1 tyrosine phosphorylation in high-fat-fed rats. Br J Nutr. Apr 2008;99(4):806-812.
  16. Shih CC, Lin CH, Lin WL. Effects of Momordica charantia on insulin resistance and visceral obesity in mice on high-fat diet. Diabetes Res Clin Pract. Jun 10 2008.
  17. Nerurkar PV, Lee YK, Motosue M, et al. Momordica charantia (bitter melon) reduces plasma apolipoprotein B-100 and increases hepatic insulin receptor substrate and phosphoinositide-3 kinase interactions. Br J Nutr. Mar 5 2008:1-9.
  18. Huang HL, Hong YW, Wong YH, et al. Bitter melon (Momordica charantia L.) inhibits adipocyte hypertrophy and down regulates lipogenic gene expression in adipose tissue of diet-induced obese rats. Br J Nutr. Feb 2008;99(2):230-239.
  19. Saokaew S, Suwankesawong W, Permsuwan U, et al. Safety of herbal products in Thailand: an analysis of reports in the thai health product vigilance center database from 2000 to 2008. Drug safety : an international journal of medical toxicology and drug experience. Apr 1 2011;34(4):339-350.
  20. Weng JR, Bai LY, Chiu CF, et al. Cucurbitane Triterpenoid from Momordica charantia Induces Apoptosis and Autophagy in Breast Cancer Cells, in Part, through Peroxisome Proliferator-Activated Receptor gamma Activation. Evidence-based complementary and alternative medicine : eCAM.2013;2013:935675.
  21. Li CJ, Tsang SF, Tsai CH, et al. Momordica charantia Extract Induces Apoptosis in Human Cancer Cells through Caspase- and Mitochondria-Dependent Pathways. Evidence-based complementary and alternative medicine : eCAM. 2012;2012:261971.
  22. Fang EF, Zhang CZ, Zhang L, et al. In vitro and in vivo anticarcinogenic effects of RNase MC2, a ribonuclease isolated from dietary bitter gourd, toward human liver cancer cells. The international journal of biochemistry & cell biology. Aug 2012;44(8):1351-1360.
  23. Hsu HY, Lin JH, Li CJ, et al. Antimigratory Effects of the Methanol Extract from Momordica charantia on Human Lung Adenocarcinoma CL1 Cells. Evidence-based complementary and alternative medicine : eCAM. 2012;2012:819632.
  24. Lee-Huang S, Huang PL, Huang PL, et al. Inhibition of the integrase of human immunodeficiency virus (HIV) type 1 by anti-HIV plant proteins MAP30 and GAP31. Proceedings of the National Academy of Sciences of the United States of America. Sep 12 1995;92(19):8818-8822.
  25. Lee-Huang S, Huang PL, Sun Y, et al. Inhibition of MDA-MB-231 human breast tumor xenografts and HER2 expression by anti-tumor agents GAP31 and MAP30. Anticancer research. Mar-Apr 2000;20(2A):653-659.
  26. Cunnick J, Takemoto D. Bitter melon (Momordica charantia).  J Naturopath Med.1993;4:16-21
  27. Effect of Momordica charantia on key hepatic enzymes. Journal of ethnopharmacology. Oct 1994;44(2):93-97.
  28. Erden I, Ordu S, Erden EC, et al. A case of atrial fibrillation due to Momordica charantia (bitter melon). Annals of Saudi medicine. Jan-Feb 2010;30(1):86-87.
  29. Nadkarni N, D’Cruz S, Sachdev A. Hematemesis due to bitter melon (Momordica charantia) extract-induced gastric ulcerations. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. Jan 2010;29(1):37-38.
  30. Appiah-Opong R, Commandeur JN, Axson C, et al. Interactions between cytochromes P450, glutathione S-transferases and Ghanaian medicinal plants. Food Chem Toxicol. Dec 2008;46(12):3598-3603.
  31. Wang HY, Kan WC, Cheng TJ, Yu SH, Chang LH, Chuu JJ.Differential anti-diabetic effects and mechanism of action of charantin-rich extract of Taiwanese Momordica charantia between type 1 and type 2 diabetic mice. Food Chem Toxicol. 2014 Jul;69:347-56.
  32. Xu J, Cao K, Li Y, et al. Bitter gourd inhibits the development of obesity-associated fatty liver in C57BL/6 mice fed a high-fat diet. J Nutr. 2014 Apr;144(4):475-83.
  33. Sagkan RI. An in vitro study on the risk of non-allergic type-I like hypersensitivity to Momordica charantia. BMC Complement Altern Med. 2013 Oct 26;13:284.
  34. Nivitabishekam SN, Asad M, Prasad VS. Pharmacodynamic interaction of Momordica charantia with rosiglitazone in rats. Chem Biol Interact. 2009 Feb 12;177(3):247-53.
  35. Kwatra D, Venugopal A, Standing D, et al. Bitter melon extracts enhance the activity of chemotherapeutic agents through the modulation of multiple drug resistance. J Pharm Sci. 2013 Dec;102(12):4444-54.
  36. Yang SJ, Choi JM, Park SE, et al. Preventive effects of bitter melon (Momordica charantia) against insulin resistance and diabetes are associated with the inhibition of NF-κB and JNK pathways in high-fat-fed OLETF rats. J Nutr Biochem. 2015 Mar;26(3):234-40.
  37. Somasagara RR, Deep G, Shrotriya S, Patel M, Agarwal C, Agarwal R. Bitter melon juice targets molecular mechanisms underlying gemcitabine resistance in pancreatic cancer cells. Int J Oncol.2015 Apr;46(4):1849-57.
 
https://www.mskcc.org/cancer-care/integrative-medicine/herbs/bitter-melon
 

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EKSTRAK CENDAWAN CORDYCEPS (40%)

Antara khasiat utama cendawan Cordyceps hasil kajian saintifik adalah:
  1. Menangani diabetes.
    Kajian pada binatang menemukan adanya ekstrak polisakarida pada cordyceps yang membantu menurunkan kadar gula darah dengan meningkatkan kepekaan terhadap insulin dan meningkatkan metabolisme glukosa.
  2. Membantu meredakan gangguan pernafasan.
    Penelitian di makmal mendapati, zat-zat yang terkandung pada cordyceps, iaitu cordycepin dan adenosin, dapat menstimulasi kesan penyebaran ion pada saluran nafas. Cordyceps juga menunjukkan peningkatan kapasiti penggunaan oksigen.
  3. Adalah dipercayai Cordyceps dapat digunakan untuk meredakan gejala asma. Namun ia tidak berkesan pada kanak-kanak. Kajian klinik lainnya menemukan tentang manfaat Cordyceps yang mampu untuk meringankan asma, bronkitis, dan penyakit paru obstruktif kronik. Namun cordyceps perlu dikombinasi dengan bahan-bahan lain.
  4. Melawan penuaan. Cordyceps secara tradisional digunakan oleh orang tua untuk menangani kesan penuaan seperti letih yang melampau, kurang bertenaga dan impotensi.
  5. Meningkatkan memori –
    kajian klinik pada tikus juga mendapati penggunaan cordyceps mampu meningkatkan memori dan kemampuan belajar.
  6. Melindungi jantung.
    Di China, kajian pada cordyceps menunjukkan cendawan ini mempunyai manfaat untuk aritmia atau gangguan ritme jantung. Beberapa penelitian menyatakan bahan ini juga dapat meningkatkan fungsi jantung. Namun, masih diperlukan uji klinik yang lebih besar untuk membuktikannya.
  7. Membantu meredakan peradangan. Satu kajian pada sel menemukan cordyceps berpotensi mengurangi peradangan. Pada kajian haiwan, cordyceps ditemukan dapat mengurangi keparahan penyakit lupus, meningkatkan kelangsungan hidup pada kondisi penyakit jantung, dan membuang kesan toksin bakteria streptokokus.
  8. Memperlambat penyakit ginjal. Sebuah penelitian menunjukkan bahawa cordyceps dapat memperlambat fibrosis ginjal pada tikus. Fibrosis ginjal ini adalah penyakit ginjal yang agak merbahaya.
  9. Memperlambat pertumbuhan tumor. Beberapa penelitian terhadap binatang membuktikan bahawa cordyceps dapat merangsang sistem kekebalan tubuh untuk memerangi tumor pada beberapa jenis kanser.
  10. Meningkatkan stamina – sesuai untuk pemain sukan (Lee Chong Wei pemain badminton negara) mengambil Cordyceps seusia remaja.
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Cordyceps
 

Common Names
 
  • Vegetable caterpillar
  • Chinese caterpillar fungus
  • dong chong xia cao
  • semitake
  • hsia ts'ao tung ch'ung
  • yarsha gumba
 
For Patients & Caregivers

How It Works
 
Cordyceps has not been shown to treat or prevent cancer.
Cordyceps, used in traditional Chinese medicine, contains a fungus that grows on caterpillar larvae; both are contained in the product and both are consumed. Cordyceps has not been studied extensively in the laboratory, but existing studies show that cordyceps stimulates many different immune cells when directly applied to them in a test tube. It is not known if cordyceps stimulates the immune system in humans. Other experiments in animals suggest that cordyceps can stimulate progesterone production and reduce kidney toxicity from harsh medications, but scientists are not sure how cordyceps exerts these effects or if they will occur in humans. Studies in kidney transplant patients suggest cordyceps can help improve kidney function.
Cordyceps has “blood thinning” property. It may also reduce blood sugar level.

Purported Uses
 
  • To lower high cholesterol
    No scientific evidence supports this use.
  • To stimulate the immune system
    Laboratory studies show that cordyceps stimulates several aspects of the immune system, but it is not known whether this effect occurs in the human body.
  • To treat kidney failure
    A few studies show that cordyceps may help improve renal function.

Do Not Take If
 
  • You have a myelogenous type cancer such as AML or CML (Cordyceps has been shown to increase proliferation of red blood cell precursor cells. These cells arise from the same lineage as the cells that cause myelogenous cancers).
  • You take insulin or other blood-glucose lowering medications (Cordyceps may have an additive hypoglycemic effect; blood glucose should be monitored).
  • You take a drug that has “blood thinning” activity (Cordyceps may increase the risk of bleeding)
 
For Healthcare Professionals

Scientific Name
 
Ophiocordyceps sinensis (renamed 2007), Cordyceps sinensis, Sphaeria sinensis

Clinical Summary
 
Cordyceps includes the fungus that grows on the larvae of the caterpillar Hepialus armoricanus Oberthuer. Both are contained in the product and both are consumed. Cordyceps is used for a wide range of conditions including fatigue, sexual dysfunction, coughs, and as an adaptogen or immune stimulant. In vitro and animal studies show antitumor (10) (11) (14), radioprotective (12), antiplatelet (19) and antidiabetic effects (15) (16). In addition, cordyceps enhances recovery of mice with taxol-induced leukopenia (13) and increases the cytotoxicity of cisplatin in non-small cell lung cancer cells (17).
Cordyceps products improved renal function and reduced nephropathy in renal transplant patients (18) (21) (23). However, studies on exercise performance in healthy subjects yielded mixed results (22) (24)
Cordyceps may increase the adverse effects of antidiabetic drugs and anticoagulant/antiplatelet drugs. Animal studies showed proliferation of progenitor red blood cells with cordyceps (8). Therefore, it should not be used by those with myelogenous type cancers.
Cordyceps also stimulated testosterone production in mice (9). Whether it exerts similar effects in humans is not known.

Purported Uses
 
  • Chronic obstructive pulmonary disorders
  • Cough
  • Fatigue
  • Nephropathy
  • Diabetes
  • Immunostimulation
  • Sexual dysfunction
  • Strength and stamina

Mechanism of Action
 
Cordyceps stimulates the number of T helper cells, prolongs the survival of lymphocytes, enhances TNF-alpha and interleukin 1 production, and increases the activity of natural killer cells in cultured rat Kupffer cells (3). Enhanced proliferation of erythroid progenitor cell in the bone marrow of mice is also shown (8). One study suggests that cordyceps can stimulate progesterone production in animal cells (5). Another study shows that cordyceps may be effective against tumor celIs by down-regulating MHC class II antigen expression (7). In addition, anecdotal data suggest reduction of cyclosporin and aminoglycoside-induced renal toxicity, although the mechanism of action is not known (4). Cordycepin, an active constituent in cordyceps, inhibits collagen-induced platelet aggregation by lowering calcium ion and thromboxane A2 activities (19).

Herb-Drug Interactions
 
Hypoglycemics / Insulin: Cordyceps may have additive hypoglycemic effect (16) (17).
Anticoagulants / Antiplatelets: Cordyceps inhibits platelet aggregation and may increase the effects of these drugs (19).

References
 

  1. Huang KC. The Pharmacology of Chinese Herbs, 2nd ed. Boca Raton: CRC Press; 1999.
  2. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of a precious ancient Chinese herbal regime: Cordyceps sinensis, Part I. J Altern Complement Med 1998;4:289-303.
  3. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of a precious ancient Chinese herbal regime: Cordyceps sinensis, Part II. J Altern Complement Med 1998;4:429-57.
  4. Xu F, et al. Amelioration of cyclosporin nephrotoxicity by Cordyceps sinensis in kidney-transplant recipients. Nephrol Dial Transplant 1995;10:142-3.
  5. Huang B, et al. Cordyceps sinensis and its fractions stimulate MA-10 mouse Leydig tumor cell steroidogenesis. J Androl 2001;22:831-7.
  6. Nakamura K, et al. Inhibitory effect of Cordyceps sinensis on spontaneous liver metastasis of Lewis lung carcinoma and B16 melanoma cells in syngeneic mice. Jpn J Pharmacol 1999;79:335-41.
  7. Chiu JH, et al. Cordyceps sinensis increases the expression of major histocompatibility complex class II antigens in human hepatoma cell line HA22T/VGH cells. Am J Chin Med 1998;26:59-70.
  8. Li, Y. et. al. Effect of Cordyceps sinensis on erythropoiesis in mouse bone marrow. Chin Med J (Engl). 1993 Apr;106(4):313-6.
  9. Huang YL, Leu SF, Liu BC, et al. In vivo stimulatory effect of Cordyceps sinensis mycelium and its fractions on reproductive functions in male mouse. Life Sci 2004 Jul 16;75(9):1051-62.
  10. Wu WC, Hsiao JR, Lian YY, et al. The apoptotic effect of cordycepin on human OEC-M1 oral cancer cell line. Cancer Chemother Pharmacol. 2007 Jun;60(1):103-11.
  11. Oh JY, Baek YM, Kim SW, et al. Apoptosis of human hepatocarcinoma (HepG2) and neuroblastoma (SKN-SH) cells induced by polysaccharides-peptide complexes produced by submerged mycelial culture of an entomopathogenic fungus Cordyceps sphecocephala. J Microbiol Biotechnol. 2008 Mar;18(3):512-9.
  12. Liu WC, Wang SC, Tsai ML, et al. Protection against radiation-induced bone marrow and intestinal injuries by Cordyceps sinensis, a Chinese herbal medicine. Radiat Res. 2006 Dec;166(6):900-7.
  13. Liu WC, Chuang WL, Tsai ML, et al. Cordyceps sinensis health supplement enhances recovery from taxol-induced leukopenia. Exp Biol Med (Maywood). 2008 Apr;233(4):447-55.
  14. Kubo E, Yoshikawa N, Kunitomo M, et al. Inhibitory effect of Cordyceps sinensis on experimental hepatic metastasis of melanoma by suppressing tumor cell invasion. Anticancer Res. 2010 Sep;30(9):3429-33.
  15. Lo HC, Hsu TH, Tu ST, Lin KC. Anti-hyperglycemic activity of natural and fermented Cordyceps sinensis in rats with diabetes induced by nicotinamide and streptozotocin. Am J Chin Med.2006;34(5):819-32.
  16. Shi B, Wang Z, Jin H, et al. Immunoregulatory Cordyceps sinensis increases regulatory T cells to Th17 cell ratio and delays diabetes in NOD mice. Int Immunopharmacol. 2009 May;9(5):582-6.
  17. Ji NF, Yao LS, Li Y, et al. Polysaccharide of Cordyceps sinensis Enhances Cisplatin Cytotoxicity in Non-Small Cell Lung Cancer H157 Cell Line. Integr Cancer Ther. 2011;10(4):359-67.
  18. Zhang Z, Wang X, Zhang Y, Ye G. Effect of Cordyceps sinensis on Renal Function of Patients with Chronic Allograft Nephropathy. Urol Int. 2011;86(3):298-301.
  19. Cho HJ, Cho JY, Rhee MH, et al. Cordycepin (3’-deoxyadenosine) inhibits human platelet aggregation in a cyclic AMP- and cyclic GMP-dependent manner. Eur J Pharmacol. 2007 Mar 8;558(1-3):43-51.
  20. Zhao K, Li Y, Zhang H. Role of dongchongxiacao (Cordyceps) in prevention of contrast-induced nephropathy in patients with stable angina pectoris. J Tradit Chin Med. 2013 Jun;33(3):283-6.
  21. Ding C, Tian PX, Xue W, et al. Efficacy of Cordyceps sinensis in long term treatment of renal transplant patients. Front Biosci (Elite Ed). 2011 Jan 1;3:301-7.
  22. Chen S, Li Z, Krochmal R, et al. Effect of Cs-4 (Cordyceps sinensis) on exercise performance in healthy older subjects: a double-blind, placebo-controlled trial. J Altern Complement Med. 2010 May;16(5):585-90.
  23. Li Y, Xue WJ, Tian PX, et al. Clinical application of Cordyceps sinensis on immunosuppressive therapy in renal transplantation. Transplant Proc. 2009 Jun;41(5):1565-9.
  24. Parcell AC, Smith JM, Schulthies SS, et al. Cordyceps Sinensis (CordyMax Cs-4) supplementation does not improve endurance exercise performance. Int J Sport Nutr Exerc Metab. 2004 Apr;14(2):236-42.
 

 
Picture

EKSTRAK KAYU MANIS

FUNGSI: membuka saluran darah, 
melancarkan peredaran darah,
meningkatkan aliran darah ke jantung,
mampu menurunkan Glukos dan Kolestrol dalam badan.

Cinnamon
Common Names
  • Cassia
 For Patients & Caregivers

How It Works
 
There is mixed evidence on cinnamon’s ability to lower glucose, cholesterol and triglyceride levels.
Cinnamon refers to several plants native to Southeast Asia. The bark, rich in essential oil, is used as a flavoring agent and as a spice. Cinnamon has a long history of use as an herbal medicine. Laboratory studies have shown that cinnamon has antibacterial, anti-inflammatory, and antioxidant properties. It was also shown to lower blood glucose levels in patients with type 2 diabetes but more studies are needed to confirm such effects.
 
Purported Uses
 
  • Diabetes
    Evidence is mixed: A few clinical trials have shown that cinnamon is beneficial in lowering blood glucose, lipids, and insulin levels; other studies have demonstrated no such effects.
  • Stomach Ulcer
    In one clinical trial, cinnamon extract proved ineffective in eradicating an H. pylori infection.
  • Inflammation
    Laboratory studies showed that cinnamon can reduce inflammation. Human data are lacking.
  • Arthritis
    Cinnamon is used in traditional medicine for arthritis but there is no scientific evidence to support this claim.

Patient Warnings
 
  • Some cinnamon products contain high levels of coumarin, a natural constituent, that can cause liver damage.

Do Not Take If
 
  • Cytochrome P450 substrates: Cinnamon may increase the risk of side effects of these drugs.
  • Hypoglycemics: Cinnamon extract may have an additive effect with blood glucose-lowering medications.
  • Anticoagulants: Because cinnamon has coumarin, it may have additive effects when used with blood-thinning medications.
  • Statins: When taken along with statins, cinnamon has been reported to cause hepatitis.

Side Effects
 
  • Oral lesions were shown to be associated with the use of oral cinnamon products like herbal toothpaste and chewing gum.
  • Occupational allergy has been reported with use of cinnamon.
  • Use of vaginal suppositories containing cinnamon oil resulted in allergic contact dermatitis in an 18-year-old woman.
 
For Healthcare Professionals

Scientific Name
 
Cinnamomum zeylanicum, Cinnamomum aromaticum, Cinnamomum loureiroi, Cinnamomum burmannii

Clinical Summary
 
Cinnamon refers to several plants that belong to the genus Cinnamomum, native to Southeast Asia. The bark, rich in essential oil, is used as a flavoring agent and as a spice. Medicinal uses include appetite stimulation, treatment of arthritis, inflammation, and dyspepsia. In traditional Chinese medicine, cinnamon is used with other herbs in decoctions for cold. In vitro studies have demonstrated that cinnamon has antioxidant (1) (2), anti-inflammatory (3), immunomodulatory (4) (5), antimicrobial (6) and antitumor (7) properties.
Cinnamon has been studied in clinical trials for type 2 diabetes but results are conflicting (8) (9) (10) (11). However, conclusions of a meta analysis and a review suggest improvements in glycemic control with cinnamon and cinnamon extracts in patients with type 2 diabetes (12) (36). In other studies, a cinnamon extract was found effective in reducing dental plaque and gingivitis in healthy adults (32); and topical use of a cinnamon ointment alleviated perineal pain and improved healing of episiotomy incision in postpartum women (33).
Use of cinnamon flavored products has been associated with oral adverse effects (13) (14) (15) (16). Certain cinnamon products are high in coumarin (18) (17) content that can cause hepatotoxicity (19) and can also interact with other drugs (20).

Food Sources
 
Cinnamon bark

Purported Uses
 
  • Diabetes
  • Stomach ulcers
  • Inflammation
  • Arthritis

Mechanism of Action
 
Hydroxycinnamaldehyde, a compound present in cinnamon, exerts anti-inflammatory effects by inhibiting nitric oxide production via inhibition of NF-kappaB (3). Cinnamon also inhibits hepatic HMG-CoA reductase activity (24) and reduces the level of blood lipids in animals and humans (10). In another study, methylhydroxychalcone polymer, isolated from cinnamon, was shown to mimic insulin by activating the insulin receptors (23).
Cinnamon extract binds to estrogen-receptor beta and has a direct stimulatory effect on bone formation (25). The n-hexane extract of cinnamon has antiestrogenic activity (26). In other studies, cinnamon extract was shown to inhibit NFkappaB and AP1 leading to apoptosis (7). It also showed antiangiogenic effects by inhibiting the vascular endothelial growth factor (VEGF) (22).

Contraindications
 
  • Patients taking blood glucose-lowering or blood-thinning medications should use cinnamon extract with caution.
  • Cinnamon was shown to have both estrogenic and antiestrogenic activities in vitro (24) (25). Patients with hormone sensitive disease should use caution.

Adverse Reactions
 
  • Plasma cell gingivitis (PCG) and stomatitis were shown to be associated with the use of oral cinnamon products including toothpaste and chewing gum (13) (15) (16) (27) (34).
  • Occupational allergy has been reported with use of cinnamon (28).
  • Use of vaginal suppositories containing cinnamon oil resulted in allergic contact dermatitis in an 18-year-old woman (29)

Herb-Drug Interactions
 
  • Cytochrome P450 substrates: Cinnamon inhibits cytochrome P450 2C9 and 3A4 and may interfere with the actions of drugs metabolized by these enzyme (31).
  • Hypoglycemics: Cinnamon extract may have an additive effect with blood glucose-lowering medications.
  • Anticoagulants: Because cinnamon has coumarin, it can interact with blood-thinning medications.
  • Statins: When taken along with statins, cinnamon has been reported to cause hepatitis (35).

Herb Lab Interactions
 
  • Cinnamon may lower blood glucose and cholesterol levels but the evidence is mixed (8) (10).
  • Theoretically, cinnamon may increase prothrombin time (30).

References 

  1. Kim SH, Hyun SH, Choung SY. Antioxidative effects of Cinnamomi cassiae and Rhodiola rosea extracts in liver of diabetic mice. Biofactors. 2006;26(3):209-219.
  2. Lin CC, Wu SJ, Chang CH, et al. Antioxidant activity of Cinnamomum cassia. Phytother Res. Aug 2003;17(7):726-730.
  3. Lee SH, Lee SY, Son DJ, et al. Inhibitory effect of 2’-hydroxycinnamaldehyde on nitric oxide production through inhibition of NF-kappa B activation in RAW 264.7 cells. Biochem Pharmacol. Mar 1 2005;69(5):791-799.
  4. Reddy AM, Seo JH, Ryu SY, et al. Cinnamaldehyde and 2-methoxycinnamaldehyde as NF-kappaB inhibitors from Cinnamomum cassia. Planta Med. Sep 2004;70(9):823-827.
  5. Koh WS, Yoon SY, Kwon BM, et al. Cinnamaldehyde inhibits lymphocyte proliferation and modulates T-cell differentiation. Int J Immunopharmacol. Nov 1998;20(11):643-660.
  6. Shahverdi AR, Monsef-Esfahani HR, Tavasoli F, et al. Trans-cinnamaldehyde from Cinnamomum zeylanicum bark essential oil reduces the clindamycin resistance of Clostridium difficile in vitro. J Food Sci. Jan 2007;72(1):S055-058.
  7. Kwon HK, Hwang JS, So JS, et al. Cinnamon extract induces tumor cell death through inhibition of NFkappaB and AP1. BMC Cancer. 2010;10:392.
  8. Blevins SM, Leyva MJ, Brown J, et al. Effect of cinnamon on glucose and lipid levels in non insulin-dependent type 2 diabetes. Diabetes Care. Sep 2007;30(9):2236-2237.
  9. Khan A, Safdar M, Ali Khan MM, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care. Dec 2003;26(12):3215-3218.
  10. Mang B, Wolters M, Schmitt B, et al. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. May 2006;36(5):340-344.
  11. Vanschoonbeek K, Thomassen BJ, Senden JM, et al. Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients. J Nutr. Apr 2006;136(4):977-980.
  12. Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. J Med Food.Sep 2011;14(9):884-889.
  13. Anil S. Plasma cell gingivitis among herbal toothpaste users: a report of three cases. J Contemp Dent Pract. 2007;8(4):60-66.
  14. Endo H, Rees TD. Clinical features of cinnamon-induced contact stomatitis. Compend Contin Educ Dent. Jul 2006;27(7):403-409; quiz 410, 421.
  15. Endo H, Rees TD. Cinnamon products as a possible etiologic factor in orofacial granulomatosis. Med Oral Patol Oral Cir Bucal. Oct 2007;12(6):E440-444.
  16. Kind F, Scherer K, Bircher AJ. Allergic contact stomatitis to cinnamon in chewing gum mistaken as facial angioedema. Allergy. Feb 2010;65(2):276-277.
  17. Lungarini S, Aureli F, Coni E. Coumarin and cinnamaldehyde in cinnamon marketed in Italy: a natural chemical hazard? Food Addit Contam Part A Chem Anal Control Expo Risk Assess. Nov 2008;25(11):1297-1305.
  18. Woehrlin F, Fry H, Abraham K, et al. Quantification of flavoring constituents in cinnamon: high variation of coumarin in cassia bark from the German retail market and in authentic samples from indonesia. J Agric Food Chem. Oct 13 2010;58(19):10568-10575.
  19. Abraham K, Wohrlin F, Lindtner O, et al. Toxicology and risk assessment of coumarin: focus on human data. Mol Nutr Food Res. Feb 2010;54(2):228-239.
  20. Federal Institute for Risk Assessment. Selected Questions about coumarin in cinnamon and other foods. http://www.bfr.bund.de/cd/8487. Accessed February 18, 2008.
  21. Dugoua JJ, Seely D, Perri D, et al. From type 2 diabetes to antioxidant activity: a systematic review of the safety and efficacy of common and cassia cinnamon bark. Can J Physiol Pharmacol. Sep 2007;85(9):837-847.
  22. Lu J, Zhang K, Nam S, et al. Novel angiogenesis inhibitory activity in cinnamon extract blocks VEGFR2 kinase and downstream signaling. Carcinogenesis. Mar 2010;31(3):481-488.
  23. Jarvill-Taylor KJ, Anderson RA, Graves DJ. A hydroxychalcone derived from cinnamon functions as a mimetic for insulin in 3T3-L1 adipocytes. J Am Coll Nutr. Aug 2001;20(4):327-336.
  24. Lee JS, Jeon SM, Park EM, et al. Cinnamate supplementation enhances hepatic lipid metabolism and antioxidant defense systems in high cholesterol-fed rats. J Med Food. Fall 2003;6(3):183-191.
  25. Lee KH, Choi EM. Stimulatory effects of extract prepared from the bark of Cinnamomum cassia blume on the function of osteoblastic MC3T3-E1 cells. Phytother Res. Nov 2006;20(11):952-960.
  26. Kim IG, Kang SC, Kim KC, et al. Screening of estrogenic and antiestrogenic activities from medicinal plants. Environ Toxicol Pharmacol. Jan 2008;25(1):75-82.
  27. Siqueira AS, Santos CC, Cristino MR, et al. Intraoral contact mucositis induced by cinnamon-flavored chewing gum—a case report. Quintessence Int. Oct 2009;40(9):719-721.
  28. Guarneri F. Occupational allergy to cinnamal in a baker. Contact Dermatitis. Nov 2010;63(5):294.
  29. Lauriola MM, De Bitonto A, Sena P. Allergic contact dermatitis due to cinnamon oil in galenic vaginal suppositories. Acta Derm Venereol. Mar 2010;90(2):187-188.
  30. Chase CK, McQueen CE. Cinnamon in diabetes mellitus. Am J Health Syst Pharm. May 15 2007;64(10):1033-1035.
  31. Kimura Y, Ito H, Hatano T. Effects of mace and nutmeg on human cytochrome P450 3A4 and 2C9 activity. Biol Pharm Bull. 2010;33(12):1977-82.
  32. Gupta D, Jain A. Effect of Cinnamon Extract and Chlorhexidine Gluconate (0.2%) on the Clinical Level of Dental Plaque and Gingival Health: A 4-Week, Triple-Blind Randomized Controlled Trial. J Int Acad Periodontol. 2015 Jul;17(3):91-8.
  33. Mohammadi A, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Javadzadeh Y, Fardiazar Z, Effati-Daryani F. Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial. J Integr Med. 2014 Jul;12(4):359-66.
  34. Calapai G, Miroddi M, Mannucci C, Minciullo P, Gangemi S. Oral adverse reactions due to cinnamon-flavoured chewing gums consumption. Oral Dis. 2014 Oct;20(7):637-43.
  35. Brancheau D, Patel B, Zughaib M. Do cinnamon supplements cause acute hepatitis? Am J Case Rep.2015 Apr 29;16:250-4.
  36. Costello RB, Dwyer JT, Saldanha L, Bailey RL, Merkel J, Wambogo E. Do Cinnamon Supplements Have a Role in Glycemic Control in Type 2 Diabetes? A Narrative Review. J Acad Nutr Diet. 2016Nov;116(11):1794-1802.
https://www.mskcc.org/cancer-care/integrative-medicine/herbs/cinnamon
 

Info lanjut kayu manis secara saintifik boleh dilihat di sini:

https://tcmwiki.com/wiki/cinnamon-bark
http://www.webmd.com/diet/supplement-guide-cinnamon
Picture

EKSTRAK BIJI BUAH PEACH

​a mengandungi 5% minyak lemak, yang boleh melincirkan usus dan membantu membuang air besar;
FUNGSI: mempunyai kesan analgesik, anti-radang, anti-bakteria, dan anti-alergi; Amygdalin terkandung di dalamnya berpotensi mencegah batuk, anti-asma, dan kesan anti-fibrosis hati.


PEACH SEEDS
Peach seeds, also known as Tao Ren in Pinyin, are clearly the kernel of peach pits. So, what do peach seeds look like? As a matter of fact, they not only look like almonds, but also taste like almonds. As a result, many people often get them mixed up and think they are the same thing. Of course they are not. And just like almond, it is also edible and has long been loved and eaten since ancient times, thanks to its special taste and flavor. In view of its great contribution on health benefits and high nutritional value, it is also listed as one of top 10 precious healthy foods by holistic diet regimen experts. As one of frequently-used Chinese herbs, it is suitable for general population, especially patients who suffer from high blood sugar or diabetes. As you can see now, what we are going to talk about next is its medicinal uses, instead of how to germinate and plant a peach seed, or something like it.

What is peach seed?
When used as a Chinese medicine, it mainly refers to the ripe seeds of Prunus persica (L.) Batsch or Prunus davidiana (Carr.) Franch. Both of them are plants belonging to the family Rosaceae. Other common names of this herb include seeds of peach, Semen Persicae, Peach Kernel, Semen Pruni Persicae, peach tree seeds, peach pits, peach fruit seeds, and the like. Prunus persica seeds are produced all over China and most of them are cultivated; Prunus davidiana seeds mainly grow wild in provinces of Liaoning, Hebei, Henan, Shandong, Sichuan, and Yunnan. They are usually picked from June to July when the fruits are ripe. The following steps are to remove the flesh and pit shell, take the seeds, peel them, and dry in the sun. Medicinally it is normally used raw or fried.
​
Prunus persica seed is ovate, flat, long, 1.2 to 1.8cm long, 0.8 to 1.2cm wide, and 0.2 to 0.4cm thick. Surface is from yellowish brown to reddish brown and densely covered with granular protrusions. One end is pointed; the central part is enlarged; the other end is blunt, slightly oblique and flat, and with thin edge. The pointed end has shortly linear hilum while the blunt end has slightly darker chalazas that are less obvious and many longitudinal vascular bundles radiating from chalazas. Seed coat is thin, off-white, oily, and with 2 cotyledons. It is nearly odorless but slightly bitter. Prunus davidiana seed is nearly oval, smaller but thicker, about 0.9cm, about 0.7cm wide and about 0.5cm thick.
The seed of a peach contains amygdalin, 24-methylene cycloartanol, citrostadienol, 7-dehydroavenasterol, prunasin, β-sitosterol, campesterol, β-sitosterol-3-O-β-D-glucopyranoside, campesterol-3-O-β-D-glucopyranoside, β-sitosterol3-O-β-D-(6-O-palmityl) glucopyranoside, methyl-β-D-glucopyranoside, methyl-a-D-fructofuranoside, tryptophane, glucose, sucrose, chlorogenic acid, 3-ρ-coumaroylquinic acid, 3-feruloylquinic acid, triolein, and so on. And it also gets 2 isolated protein components, PR-A and PR-B, which have a strong anti-inflammatory and analgesic pharmacological activity. Besides, peach seed oil is rich in unsaturated fatty acids, mainly including oleic acid and linoleic acid.

Peach seeds benefits
Traditional Chinese medicine thinks it is of neutral nature. That’s to say, as a food the ingestion of it won’t let you risk suffering from internal heat. Instead, consuming peach seeds is good for you no matter you are of cold or heat habitus since it plays a certain restrain dilution role.
The most valued healing properties of peach seed in TCM are its effect of promoting blood circulation. Given the fact of backward medical technology in ancient times, dietary therapy or herbs was one of the few available ways that could count on once people suffered from stagnant movement of Qi and blood. And peach seed nut is that one commonly used medically to invigorate the circulation of blood. It is said that it was once so expensive and rare that few people then could afford it. Likewise, it can be applied to treat scarce menstrual flow or even absence of menstruation in women.
Besides, it is also a good aperient since it contains certain of fatty oil, which can help obstructed bowel or indigestion. Eating peach seeds on daily basis can lubricate the intestine, keep the intestine smooth, and improve bowel function. It is worth noting that obstructed bowel is very likely to cause the proliferation of bacteria, and thus lead to intestinal inflammation. That’s to say, appropriate consumption of it is beneficial to intestinal discharge of waste, prevention of intestinal inflammation, and even the treatment of intestinal inflammation.

Modern pharmacological actions of peach kernel
1) Its extracting solution can significantly increase cerebral blood flow, enhance the blood flow in canine femoral arteries, reduce vascular resistance, and improve the hemodynamics;
2) Peach seed extract can improve the animal’s liver surface microcirculation and promote bile secretion;
3) It can obviously prolong the bleeding and clotting time in mice;
4) Its decoction can promote fibrosis and in vitro inhibit thrombosis;
5) It contains 5% fat oil, which can lubricate the intestine and then help defecation;
6) It can promote the uterine contractions and bleeding in woman who has been delivered of a child for the first time;
7) Its decoction and extract have analgesic, anti-inflammatory, anti-bacterial, and anti-allergic effects;
8) Amygdalin contained has antitussive, anti-asthma, and anti-liver fibrosis effects.

Sample peach seed recipes on herbal remedies
The Chinese Pharmacopoeia believes that it is bitter and sweet in flavor and neutral in nature. It goes to meridians of heart, liver, and large intestine. Basic functions include activating blood to remove blood stasis and relaxing bowel. Essential peach seed uses and indications are amenorrhea, dysmenorrhea, mass in the abdomen, injuries, and constipation caused by intestinal dryness. Recommended dosage is from 4.5 to 9 grams in decoction. Other relevant medicinal products also include peach seed supplement, powder, pills, and the like. What’s more, it is used in making carving, basket, beads, and other artwork. Want more tips on how to maximize the health benefits of this herb? Here are the most famous formulas for your reference.

1) Tao Hong Si Wu Tang from Yi Zong Jin Jian (Golden Mirror of Orthodox Medicine). It is formulated with Hong Hua (Safflower), Dang Gui (Dong Quai), Chuan Xiong (lovage), Chi Shao (Red Peonies), etc. to treat amenorrhea and dysmenorrhea caused by blood stasis.
2) Sheng Hua Tang from Fu Qing Zhu Nu Ke (Fu Qing-zhu’s Gynecology). It is combined with Pao Jiang (Prepared Dried Ginger), lovage, etc. to cure postpartum abdominal pain due to stagnation.
3) Gui Zhi Fu Ling Wan from Jin Gui Yao Lue (Essential Prescriptions of the Golden Coffer). It works with Gui Zhi (Ramulus Cinnamomi), Mu Dan Pi (Tree Peony), Red Peonies, etc. to heal abdominal mass in women due to the accumulated stasis.
4) Tao He Cheng Qi Tang from Shang Han Lun (On Cold Damage). It is equipped with Da Huang (rhubarb), Mang Xiao (Glauber’s Salt), cassia twig, etc. to treat severe abdominal mass due to stagnation.
5) Fu Yuan Huo Xue Tang from Yi Xue Fa Ming (Illuminating the Science of Medicine). It is matched with Dong Quai, Safflower, rhubarb, etc. to cure wound, bruises, and pains.
6) Wei Jing Tang from Qian Jin Fang (Thousand golden essential prescriptions). It is used together with Wei Jing (Phragmites Communis Stem), Dong Gua Ren (Winter Melon Seeds), etc. to treat pulmonary abscess.
7) Da Huang Mu Dan Pi Tang from Essential Prescriptions of the Golden Coffer. It is joined with rhubarb, Tree Peony Bark, etc. to cure acute appendicitis.
8) Run Chang Wan from Pi Wei Lun (Treatise on the Spleen and Stomach). It is compatible with Dong Quai, Huo Ma Ren (Hemp Seeds), Gua Lou Ren (Semen Trichosanthis), etc. to heal constipation caused by dry intestine.
9) Shuang Ren Wan from Sheng Ji Zong Lu (Complete Record of Holy Benevolence). It is coupled with Xing Ren (Apricot Seed) to treat cough and asthma.

Medical research on peach pits
Clinically peach seed based remedies are widely used in various conditions, such as schistosomiasis cirrhosis, thrombosis, appendicitis, vasculitis, acute renal failure, acute and chronic nephritis, mental illness, pneumonia, coronary heart disease, and so on.
a) 20 cases of schistosomiasis cirrhosis have been treated with amygdalin, the active ingredients extracted from peach seeds, by 500mg intravenous injection, once every other day. And the significantly improved or improved indicators included fatigue, physical power, weight, hemoglobin, red blood cells, platelets, serum albumin and others; liver reduced more than 3cm in 11 cases (55%); the enlargement of the left lobe of the liver was significantly reduced.
b) 46 cases of cerebral thrombosis caused by Qi deficiency and blood stasis have been treated with Tong Mai Chong Ji, consisting of peach kernel, safflower, angelica root, Szechwan Lovage, etc. And 29 cases were basically cured, 14 cases markedly improved, and 3 cases improved. In addition, 23 cases of patients were found with hypertension and blood pressure was lowered in more than half of them after the treatment.
c) 83 cases of appendicitis have been treated with Er Ren Yi Pi Tang, including peach Kernel, Lindera, Tree Peony, etc. And 76 cases were cured, 6 cases effective, and 1 case invalid. The total efficiency was 98%.

Peach seeds side effects and contraindications
Are peach seeds safe to eat? Actually it won’t kill you easily but a few things still require your special attention before the use. Amygdalin in peach seeds can be broken down into hydrocyanic acid in the body, which first excites and later paralyzes the central nervous system. After all, respiratory paralysis is the main reason responsible for death. In addition, hydrocyanic acid has local anesthetic effect on the skin and has a stimulating effect on the mucous membranes.

Main clinical manifestation of peach seed poisoning are the central nervous system damage, including dizziness, headache, vomiting, palpitations, irritability, followed by unconsciousness, convulsions, and life-threatening respiratory paralysis. In addition, it was also reported to cause skin irritation and skin allergies like rashes. According studies, the poisoning symptoms are mainly caused by improper use or overdose. Hence, controlling the dosage is a must and meanwhile it shouldn’t be taken by children. Besides, use it with care during pregnancy and in cases of blood deficiency, blood dryness, and body fluid deficiency.

References
a) Zhong Yi Za Zhi (Journal of Chinese Medicine), 1986; (6):24;
b) Zhong Xi Yi Jie He Za Zhi (Chinese journal of modern developments in traditional medicine), 1982; (4):212;
c) Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), 1989; 24(10):465.
http://www.chineseherbshealing.com/peach-seeds/
 


Kajian klinikal pada biji buah peach ini boleh di lihat di sini:
https://tcmwiki.com/wiki/semen-persicae
https://www.mdidea.com/products/proper/proper015research.html
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​GLYCYRRHIZAE URALENSIS (EXTRACT)

LYCYRRHIZAE URALENSIS/ Licorice

Common Names
  • Gan cao
  • Sweet root
  • Glycyrrhiza
  • Liquorice
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For Patients & Caregivers

How It Works
 
Licorice may be helpful in treating peptic ulcers, but it has not been shown effective in treating cancer.

In traditional Chinese medicine, licorice is often used in herbal formulas to harmonize the effects of other herbs. Experiments in animals and humans show licorice can mimic the effects of steroid hormones such as aldosterone and estrogen. The substance in licorice that scientists think is responsible for these effects is called glycyrrhizin. However, because glycyrrhizin causes undesirable side effects, it is often removed from licorice products during processing.

Physiologic activity has also been reported for several other compounds in licorice. Isoflavone compounds also mimic estrogens in the human body, and can kill several strains of bacteria and viruses on contact. Other compounds act as blood thinners and inhibit inflammation. In humans, the compound, carbenoxolone, has been used to treat stomach and esophageal ulcers with positive effects. Scientists think that it increases blood flow to and amount of mucus lining the stomach.

Purported Uses

  • To treat bronchitis and chest congestion
    No scientific evidence supports this use.
  • To relieve constipation
    This claim is not backed by research.
  • To treat gastrointestinal disorders such as peptic ulcers
    A substance in licorice called carbenoxolone decreased pain and heartburn and increased healing in patients with peptic ulcers, but major side effects including fluid accumulation, low potassium, and high blood pressure were reported.
  • To treat hepatitis
    Clinical trials in Japan have used a licorice extract containing glycyrrhizin to treat hepatitis B and C, and have shown that glycyrrhizin reduces liver disease. However, there is no proof that deglycyrrhizinated licorice would have the same effect.
  • To reduce inflammation
    Studies in animals support this use, but there is no proof from clinical trials that this effect occurs in humans.
  • To relieve menopausal symptoms
    Studies in animals show that licorice has estrogenic effects, and some of the components of licorice bind estrogen receptors. Human data are lacking.
  • To treat microbial infections
    Studies in animals suggest that licorice has antimicrobial activity, but human data are lacking.
  • To treat prostate cancer
    No scientific evidence supports this use. Licorice is an ingredient in PC-SPES, which has been studied in patients with prostate cancer.

Do Not Take If

  • You take cardiac glycosides: Licorice may increase their effects and cause toxicity.
  • You take insulin: Licorice may have additive effects, possibly causing low blood levels of potassium and high levels of sodium retention.
  • You take warfarin or other blood thinners: Licorice may increase the risk of bleeding.
  • You take MAO-inhibitors (MAOIs): Licorice may have additive effects.
  • You take daunorubicin: Licorice intake can result in increased intracellular concentration of daunorubicin, which may increase its toxic effects.
  • You are taking cytochrome P450 3A and 2D6 substrates: Licorice may increase the risk of side effects of these drugs.
  • You are taking cyclosporine: Licorice greatly reduced the oral bioavailability of cyclosporine by activating P-gp and CYP3A4, which can make it less effective.
  • You are taking cortisol acetate: Licorice increased cortisol availability in tissues, which may increase its side effects.

Side Effects

  • High blood pressure
  • Lethargy
  • Muscle pain
  • Cardiac arrhythmias
  • High sodium retention
  • Low blood levels of potassium
  • Decreased libido in men
  • Suppression of scalp sebum secretion
  • Low blood platelet count

Special Point
 
Due to the adverse reaction profile of licorice, many studies have been performed using the deglycyrrhizinated licorice (DGL) extract that is free of glycyrrhizin.
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Scientific Name
 
Glycyrrhiza glabra, Glycyrrhiza uralensis

Clinical Summary
 
Derived from the root of the plant, licorice has been used as a flavoring and sweetening agent. This herb is also an important component of traditional Chinese medicine used to detoxify and enhance or balance the effects of other components in herbal formulas, and as a tonic, expectorant and a demulcent in Ayurveda. A number of compounds including glycyrrhizin are thought to account for its biologic activity.
In vitro and animal data show that licorice has antibacterial (2) (27), antiviral (48), anticancer (3) (4) (28) (29), anti-inflammatory (30), and hepatoprotective (49) properties. Licorice also demonstrated estrogenic effects (7) (8) (10), reduced cardiotoxicity associated with doxorubicin (31), and improved the antitumor effects of cyclophosphamide (32). However, these effects have not been confirmed in humans.

Licorice demonstrated effectiveness in reducing dyspepsia (1) and hyperlipidemia (33) in clinical studies.

Purported Uses

  • Bronchitis
  • Chest congestion
  • Constipation
  • GI disorders
  • Hepatitis
  • Inflammation
  • Menopausal symptoms
  • Microbial infection
  • Peptic ulcers
  • Primary adrenocortical insufficiency
  • Prostate cancer

Mechanism of Action
 
Glycyrrhizin has been reported to bind to glucocorticoid and mineralocorticoid receptors and exerts its effect via inhibition of 11b-hydroxysteroid dehydrogenase (12). Licorice can reduce serum testosterone by inhibiting 17-hydroxysteriod dehydrogenase (35) (36). Licorice contains isoflavones and other constituents that have estrogen receptor-modulating activities (8) (10). The flavone and liquiritigenin components selectively activate ER-alpha (11).
Licorice demonstrated chemopreventive effects by modulating expression of Bcl-2/Bax proteins, which act as apoptotic regulatory factors (3), and via inhibiting carcinogenesis (4). In another study, licorice inhibited P-glycoprotein (P-gp), resulting in increased intracellular concentration of the chemotherapy agent daunorubicin, which is a substrate of P-gp (34).
The most common side effect of licorice is hypokalemic hypertension, which occurs secondary to inhibition of 11beta-hydroxysteroid dehydrogenase, a renal enzyme responsible for converting cortisol to cortisone. This inhibition results in enhancing the mineralocorticoid effects of cortisol (36) that include sodium retention and excretion of potassium.

Warnings
 
Due to the adverse reaction profile of licorice, many studies have been performed using the deglycyrrhizinated licorice (DGL) extract that is free of glycyrrhizin.

Adverse Reactions
 
Hypertension (16) (45), lethargy, muscle pain, sodium retention, hypokalemia (17) (18) (19) (20) (26) (40) (41), adrenal crisis (21), ventricular fibrillation (22), cardiac arrythmias (23), carpal tunnel syndrome (24), glycyrrhizic acid poisoning (25), leukoderma (42), and thrombocytopenia (43)

Herb-Drug Interactions
 
Cardiac glycosides: Licorice may potentiate toxicity (24).
Insulin: Licorice may have a synergistic effect possibly causing hypokalemia and sodium retention with concomitant use (38) .
Anticoagulants: Licorice may increase the metabolism and clearance of warfarin (19).
MAO-inhibitors (MAOIs): Licorice may potentiate activity of MAOIs (37) (8)
P-Glycoprotein (P-gp) substrates: Licorice inhibited P-gp, resulting in increased intracellular concentration of the chemotherapy agent daunorubicin, which is a substrate of P-gp (34).
Cytochrome P450 substrates: Glycyrrhizin, a major ingredient of licorice, induces CYP3A (39) and CYP2D6 (44), and can affect the intracellular concentration of drugs metabolized by this enzyme.
Cyclosporine: Licorice greatly reduced the oral bioavailability of cyclosporine by activating P-gp and CYP3A4 (46).
Cortisol acetate: Licorice increased cortisol availability in tissues in the hours following oral cortisone acetate administration (47).

References
 

  1. Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion. 2004;69(1):45-52.
  2. Gupta VK, Fatima A, Faridi U, et al. Antimicrobial potential of Glycyrrhiza glabra roots. J Ethnopharmacol. Mar 5 2008;116(2):377-380.
  3. Jo EH, Hong HD, Ahn NC, et al. Modulations of the Bcl-2/Bax family were involved in the chemopreventive effects of licorice root (Glycyrrhiza uralensis Fisch) in MCF-7 human breast cancer cell. J Agric Food Chem. Mar 24 2004;52(6):1715-1719.
  4. Takahashi T, Takasuka N, Iigo M, et al. Isoliquiritigenin, a flavonoid from licorice, reduces prostaglandin E2 and nitric oxide, causes apoptosis, and suppresses aberrant crypt foci development. Cancer Sci. May 2004;95(5):448-453.
  5. De Smet PAGM. Adverse Effects of Herbal Drugs. Vol 3. New York: Springer: 1997.
  6. Lin SH, Yang SS, Chau T, et al. An unusual cause of hypokalemic paralysis: chronic licorice ingestion. Am J Med Sci. Mar 2003;325(3):153-156.
  7. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy (OR): Eclectic Medical Publications; 1998.
  8. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. 1st ed. London: Pharmaceutical Press; 1996.
  9. Blumenthal M, Goldberg A, Brinckmann J, et al. Herbal Medicine, Expanded Commission E Monographs. Austin: American Botanical Council; 2000.
  10. Somjen D, Knoll E, Vaya J, et al. Estrogen-like activity of licorice root constituents: glabridin and glabrene, in vascular tissues in vitro and in vivo. J Steroid Biochem Mol Biol. Jul 2004;91(3):147-155.
  11. Mersereau JE, Levy N, Staub RE, et al. Liquiritigenin is a plant-derived highly selective estrogen receptor beta agonist. Mol Cell Endocrinol. Feb 13 2008;283(1-2):49-57.
  12. Tyler V. Herbs of Choice, the Therapeutical Use of Phytomedicinals. Binghamton: Pharmaceutical Press; 1994.
  13. Miyamura M, Ono M, Kyotani S, et al. [Properties of glycyrrhizin in Kampo extracts including licorice root and changes in the blood concentration of glycyrrhetic acid after oral administration of Kampo extracts]. Yakugaku Zasshi. Mar 1996;116(3):209-216.
  14. Stormer FC, Reistad R, Alexander J. Glycyrrhizic acid in liquorice—evaluation of health hazard. Food Chem Toxicol. Apr 1993;31(4):303-312.
  15. Ichikawa T, Ishida S, Sakiya Y, et al. Biliary excretion and enterohepatic cycling of glycyrrhizin in rats. J Pharm Sci. Jul 1986;75(7):672-675.
  16. Breidthardt T, Namdar M, Hess B. A hypertensive urgency induced by the continuous intake of a herbal remedy containing liquorice. J Hum Hypertens. 2006 Jun;20(6):465-6.
  17. Yasue H, Itoh T, Mizuno Y, Harada E. Severe hypokalemia, rhabdomyolysis, muscle paralysis, and respiratory impairment in a hypertensive patient taking herbal medicines containing licorice. Intern Med. 2007;46(9):575-8.
  18. Mumoli N, Cei M. Licorice-induced hypokalemia. Int J Cardiol. 2008 Mar 14;124(3):e42-4.
  19. Mu Y, Zhang J, Zhang S, Zhou HH, Toma D, Ren S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther. 2006 Mar;316(3):1369-77.
  20. Templin C, Westhoff-Bleck M, Ghadri JR. Hypokalemic paralysis with rhabdomyolysis and arterial hypertension caused by liquorice ingestion. Clin Res Cardiol. 2009 Feb;98(2):130-2.
  21. Isaia GC, Pellissetto C, Ravazzoli M, Tamone C. Acute adrenal crisis and hypercalcemia in a patient assuming high liquorice doses. Minerva Med. 2008 Feb;99(1):91-4.
  22. Gerritsen KG, Meulenbelt J, Spiering W, et al. An unusual cause of ventricular fibrillation. Lancet. 2009 Mar 28;373(9669):1144.
  23. Tacconi P, Paribello A, Cannas A, Marrosu MG. Carpal tunnel syndrome triggered by excessive licorice consumption. J Peripher Nerv Syst. 2009 Mar;14(1):64-5.
  24. Yorgun H, Aksoy H, Sendur MA, et al. Brugada syndrome with aborted sudden cardiac death related to liquorice-induced hypokalemia. Med Princ Pract. 2010;19(6):485-9.
  25. Caubet-Kamar N, Tubery M, Garrouste C, Lauque D, Kamar N. Harmful effect of saline infusion in a patient with glycyrrhizic acid poisoning. CJEM. 2010 May;12(3):224-5.
  26. Støving RK, Lingqvist LE, Bonde RK, Is glycyrrhizin sensitivity increased in anorexia nervosa and should licorice be avoided? Case report and review of the literature. Nutrition. 2010 Aug 24. [Epub ahead of print]
  27. Badr AE, Omar N, Badria FA. A laboratory evaluation of the antibacterial and cytotoxic effect of Liquorice when used as root canal medicament. Int Endod J. 2010 Aug 31.
  28. Kim YH, Shin EK, Kim DH, et al. Antiangiogenic effect of licochalcone A. Biochem Pharmacol. 2010 Oct 15;80(8):1152-9.
  29. Park SY, Lim SS, Kim JK, et al. Hexane-ethanol extract of Glycyrrhiza uralensis containing licoricidin inhibits the metastatic capacity of DU145 human prostate cancer cells. Br J Nutr. 2010 May 21:1-11.
  30. Chandrasekaran CV, Deepak HB, Thiyagarajan P, et al. Dual inhibitory effect of Glycyrrhiza glabra (GutGard™) on COX and LOX products. Phytomedicine. 2010 Sep 21.
  31. Choi HJ, Seon MR, Lim SS, et al. Hexane/ethanol extract of Glycyrrhiza uralensis licorice suppresses doxorubicin-induced apoptosis in H9c2 rat cardiac myoblasts. Exp Biol Med (Maywood). 2008 Dec;233(12):1554-60.
  32. Gol’dberg ED, Amosova EN, Zueva EP, et al. Licorice preparations improve efficiency of chemotherapy and surgical treatment of transplanted tumors. Bull Exp Biol Med. 2008 Feb;145(2):252-5.
  33. Hasani-Ranjbar S, Nayebi N, Moradi L, et al. The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review. Curr Pharm Des. 2010;16(26):2935-47.
  34. Nabekura T, Yamaki T, Ueno K, Kitagawa S. Inhibition of P-glycoprotein and multidrug resistance protein 1 by dietary phytochemicals. Cancer Chemother Pharmacol. 2008 Oct;62(5):867-73.
  35. Armanini D, Mattarello MJ, Fiore C, et al. Licorice reduces serum testosterone in healthy women.Steroids. 2004 Oct-Nov;69(11-12):763-6.
  36. Armanini D, Bonanni G, Mattarello MJ, et al. Licorice consumption and serum testosterone in healthy man. Exp Clin Endocrinol Diabetes. 2003 Sep;111(6):341-3.
  37. Hatano T, Fukuda T, Miyase T, Noro T, Okuda T. Phenolic constituents of licorice. III. Structures of glicoricone and licofuranone, and inhibitory effects of licorice constituents on monoamine oxidase.Chem Pharm Bull (Tokyo). 1991 May;39(5):1238-43.
  38. Eu CH, Lim WY, Ton SH, bin Abdul Kadir K. Glycyrrhizic acid improved lipoprotein lipase expression, insulin sensitivity, serum lipid and lipid deposition in high-fat diet-induced obese rats. Lipids Health Dis. 2010 Jul 29;9:81.
  39. Tu JH, He YJ, Chen Y, et al. Effect of glycyrrhizin on the activity of CYP3A enzyme in humans. Eur J Clin Pharmacol. 2010 Aug;66(8):805-810.
  40. Yorgun H, Aksoy H, Sendur MA, et al. Brugada syndrome with aborted sudden cardiac death related to liquorice-induced hypokalemia. Med Princ Pract. 2010;19(6):485-9.
  41. Pant P, Nadimpalli L, Singh M, Cheng JC. A case of severe hypokalemic paralysis and hypertension. Licorice-induced hypokalemic paralysis. Am J Kidney Dis. 2010 Jun;55(6):A35-7.
  42. Madhogaria S, Ahmed I. Leucoderma after use of a skin-lightening cream containing kojic dipalmitate, liquorice root extract and Mitracarpus scaber extract. Clin Exp Dermatol. 2010 Jun;35(4):e103-5.
  43. Celik M, Karakus A, Zeren C, et al. Licorice induced hypokalemia, edema, and thrombocytopenia. Hum Exp Toxicol. 2012 Dec;31(12):1295-8.
  44. Pandit S, Ponnusankar S, Bandyopadhyay A, Ota S, Mukherjee PK. Exploring the possible metabolism mediated interaction of Glycyrrhiza glabra extract with CYP3A4 and CYP2D6.Phytother Res. 2011 Oct;25(10):1429-34.
  45. Ruiz-Granados ES, Shouls G, Sainsbury C, Antonios T. A salty cause of severe hypertension. BMJ Case Rep. 2012 Feb 25;2012. doi:pii: bcr1220115336. 10.1136/bcr.12.2011.5336.
  46. Hou YC, Lin SP, Chao PD. Liquorice reduced cyclosporine bioavailability by activating P-glycoprotein and CYP 3A. Food Chem. 2012 Dec 15;135(4):2307-12.
  47. Methlie P, Husebye EE, Hustad S, Lien EA, Løvås K. Grapefruit juice and licorice increase cortisol availability in patients with Addison’s disease.Eur J Endocrinol. 2011 Nov;165(5):761-9.
  48. Kuo KK, Chang JS, Wang KC, Chiang LC. Water extract of Glycyrrhiza uralensis inhibited enterovirus 71 in a human foreskin fibroblast cell line. Am J Chin Med. 2009;37(2):383-94.
  49. Huo HZ, Wang B, Liang YK, Bao YY, Gu Y. Hepatoprotective and Antioxidant Effects of Licorice Extract against CCl(4)-Induced Oxidative Damage in Rats. Int J Mol Sci. 2011;12(10):6529-43.
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RHEUM PALMATUM (RHUBARB)

​Common Names
  • Turkish rhubarb
  • Chinese rhubarb
  • Tai huang
  • Da huang
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  • For Patients & Caregivers
  • For Healthcare Professionals
For Patients & Caregivers

How It Works
 
Rhubarb acts as a stimulant laxative, but is not safe to use over long periods of time.

Rhubarb is a perennial herb, the stalks of which are consumed as food. The rhizome and roots are used as laxatives and to treat ulcers, constipation, diarrhea, hypertension, immunosuppression, and cancer in Chinese medicine. In laboratory experiments, rhubard showed biological effects, but scientists are still unsure of how rhubarb works. Chemicals in rhubarb called anthraquinones cause tumor death in mice implanted with some solid tumors. Lindeyin, a chemical found in rhubarb, was found to reduce pain and inflammation in laboratory animals. More studies are needed.

Purported Uses
 
  • To treat cancer
    No scientific evidence supports this use.
  • To reduce the severity of side effects from anticancer therapy
    One study suggested that a rhubarb extract may reduce side effects associated with radiation therapy in lung cancer patients, but further studies are needed to confirm such effects.
  • To relieve constipation
    Rhubarb acts as a laxative, although clinical trials have not tested this use.
  • As a fever reducer
    There is no research to validate this claim.
  • To lower high blood pressure
    One study in China found that low-dose rhubarb could prevent high blood pressure in pregnancy, but there is no other evidence that rhubarb can lower high blood pressure.
  • To suppress the immune system
    Laboratory data shows that rhubarb decreases the activity of isolated immune cells.
  • To reduce inflammation
    No scientific evidence supports this use.
  • To treat infections
    This claim is not backed by research.
  • To treat stomach ulcers
    Rhubarb is often used in traditional Chinese medicine to treat gastrointestinal disturbance, but clinical trials have not been done.

Patient Warnings
 
  • Rhubarb is considered to be a stimulant laxative, and therefore should not be used for more than 7 days without medical supervision.

Do Not Take If
 
  • You are pregnant: Rhubarb may cause stimulation of the uterus and may increase the risk of miscarriage.
  • You have hormone-sensitive cancers such as breast, prostate, cervical, and uterine cancers: Rhubarb may have estrogenic activity.
  • You are taking Cytochrome P450 substrate drugs: Rhubarb may reduce the effectiveness of these drugs.

Side Effects
 
  • A case of acute crystal-induced kidney failure has been reported in a type-1 diabetic patient (with normal excretory renal function) following excessive ingestion of rhubarb.

Special Point
 
  • Rhubarb is one of the herbs found in Essiac tea.
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Scientific Name
 
Rheum palmatum, Rheum officinale

Clinical Summary
 
Rhubarb, a perennial herb, is cultivated in many parts of the world. The stalks are consumed as food, and the rhizome and root are widely used in Chinese medicine for a variety of conditions including cancer, immunosuppression, constipation, diarrhea, gastrointestinal ulcers, and hypertension (1) (3). The anthraquinones and tannins in rhubarb are thought responsible for its laxative and constipating effects, respectively (4), but human data are limited.

Cytotoxic (5), cytostatic (6) (14) and antitumor effects have been reported in cancer cells in vitro and in mice (1).
A rhubarb extract reduced radiation-induced lung toxicity and increased pulmonary function in lung cancer patients (7).

Purported Uses
 
  • Cancer treatment
  • Constipation
  • Fever
  • Hypertension
  • Immunosuppression
  • Inflammation
  • Microbial infection
  • Peptic ulcers

Mechanism of Action
 
When used in very small doses, the tannin content in rhubarb has a constipating effect. At higher doses, however, the hydrolyzed metabolites of emodin and sennidin stimulate the gastrointestinal tract and produce a laxative effect (4); in vitro tests show suppression of TNF, IL-1, and IL-6 production. The actions of anthraquinones on rheinanthrone that is transformed from sennoside A may promote the purgative effects of sennoside A (16).
The anti-inflammatory activity of emodin may mediate rhubarb’s hepatoprotective effects in rats with cholestatic hepatitis (11). Lindeyin, a phenolic gallylglucoside exhibits analgesic and anti-inflammatory activity in animal models. Catechin, epicatechin, procyanidins, and gallylglucose inhibit hyaluronidase in vitro (10) (12).
Aloe-emodin also possesses anti-proliferative activity, inducing cell cycle arrest in cancer cell lines (6). Anthraquinone extracts of rhubarb were shown to induce cytotoxicity in cancer cell lines (5) and tumor necrosis in mice (sarcoma 37, mammary, and Ehrlich) (1), although this has not been demonstrated in humans. Another study showed that emodin inhibits human cancer cell invasiveness by specifically antagonizing the adenosine 5’-triphosphate (ATP)-gated Ca(2+)-permeable channel P2X7 receptor (P2X7R) (17).

Warnings
 
Stimulant laxative products such as rhubarb should not be used for more than 1 week without medical supervision.

Contraindications
 
  • Patients with hormone-sensitive cancers should avoid rhubarb because estrogenic activity has been reported (13).

Adverse Reactions
 
  • A case of acute crystal-induced renal failure has been reported in a type-1 diabetic patient (with normal excretory renal function) following excessive ingestion of rhubarb (18).

Herb-Drug Interactions
 
  • Digoxin: Potassium loss due to stimulant laxative effect can increase potential risk for hypokalemia. (9)
  • Cytochrome P450 substrates: Rhubarb induces CYP3A and CYP2D6 and can affect the intracellular concentration of drugs metabolized by these enzymes (15) (19).

References
 

  1. Mantani N, et al. Rhubarb use in patients treated with Kampo medicine—a risk for gastric cancer?Yakugaku Zasshi 2002;122:403-5.
  2. Huang KC. The Pharmacology of Chinese Herbs, 2nd ed. New York: CRC Press; 1999.
  3. Zhang ZJ, Cheng WW, Yang YM. Study on low-dose of processed rhubarb in preventing pregnancy induced hypertension. Chung-Hua Fu Chan Ko Tsa Chih [Chinese Journal of Obstetrics & Gynecology]1994;29:463-4, 509.
  4. Peigen X, Liyi H, Liwei W. Ethnopharmacologic study of chinese rhubarb. J Ethnopharmacol1984;10:275-93.
  5. Cui XR, Tsukada M, Suzuki N, et al. Comparison of the cytotoxic activities of naturally occurring hydroxyanthraquinones and hydroxynaphthoquinones. Eur J Med Chem. Jun 2008;43(6):1206-1215.
  6. Guo JM, Xiao BX, Liu Q, Zhang S, Liu DH, Gong ZH. Anticancer effect of aloe-emodin on cervical cancer cells involves G2/M arrest and induction of differentiation.Acta Pharmacol Sin. Dec 2007;28(12):1991-1995.
  7. Yu HM, Liu YF, Cheng YF, Hu LK, Hou M. Effects of rhubarb extract on radiation induced lung toxicity via decreasing transforming growth factor-beta-1 and interleukin-6 in lung cancer patients treated with radiotherapy. Lung Cancer. Feb 2008;59(2):219-226.
  8. Newall CA, et al. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press; 1996.
  9. Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical Publishing; 2001.
  10. Tamayo C, et al. The chemistry and biological activity of herbs use in Flor-essence herbal tonic and Essiac. Phytother Res 2000;14:1-14.
  11. Ding Y, Zhao L, Mei H, et al. Exploration of Emodin to treat alpha-naphthylisothiocyanate-induced cholestatic hepatitis via anti-inflammatory pathway. Eur J Pharmacol. Aug 20 2008;590(1-3):377-386.
  12. Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine, Expanded Commission E Monographs. Austin: American Botanical Council; 2000.
  13. Kang SC, Lee CM, Choung ES, et al. Anti-proliferative effects of estrogen receptor-modulating compounds isolated from Rheum palmatum. Arch Pharm Res. 2008 Jun;31(6):722-6.
  14. Li WY, Chan SW, Guo DJ, et al. Water extract of Rheum officinale Baill. induces apoptosis in human lung adenocarcinoma A549 and human breast cancer MCF-7 cell lines. J Ethnopharmacol. 2009 Jul 15;124(2):251-6.
  15. Tang JC, Zhang JN, Wu YT, Li ZX. Effect of the water extract and ethanol extract from traditional Chinese medicines Angelica sinensis (Oliv.) Diels, Ligusticum chuanxiong Hort. and Rheum palmatum L. on rat liver cytochrome P450 activity. Phytother Res. 2006 Dec;20(12):1046-51.
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