| Ingredients | Amount Per Serving |
|---|---|
|
(Manihot esculenta )
(root)
|
140 mg |
|
Citrus Bioflavonoid Complex
|
110 mg |
|
(Triticum aestivum )
|
100 mg |
|
(Mentha x piperita )
(leaf)
|
50 mg |
|
(Rosa canina )
(fruit)
|
50 mg |
|
(Malpighia glabra )
(fruit)
|
10 mg |
|
(Dioscorea villosa )
(root)
|
10 mg |
|
Proprietary Plant Enzyme Blend
|
139 mg |
|
Amylase
|
|
|
Glucoamylase
|
|
|
Cellulase
|
|
|
(Lipase Note: 2 sources )
|
|
|
Alpha-Galactosidase
(AGS)
|
|
|
Diastase
|
|
|
Hemicellulase
|
|
|
Invertase
|
Vegetable Capsule (Form: Cellulose, and Water), Phytase
Below is general information about the effectiveness of the known ingredients contained in the product SvG. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product SvG. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
POSSIBLY SAFE ...when acerola fruit is used orally and appropriately. Acerola fruit contains an average of 2000 mg vitamin C per 100 grams of fruit, although this content varies widely. Acerola fruit should be consumed in amounts that do not provide more vitamin C than the tolerable upper intake level (UL) of 2000 mg per day for adults (4844).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in amounts greater than found in foods.
LIKELY SAFE ...when used orally in food amounts that have been processed appropriately to remove cyanogenic glycosides. Cassava flour that contains no more than 10 ppm of cyanide is considered safe by the World Health Organization (25869,26585). Grating and crushing are considered to be appropriate processing methods to remove cyanide from bitter or sweet cassava root. Sweet cassava may be processed by boiling, steaming, baking, or frying (25841,26585). Boiling, steaming, baking, or frying are not considered to be sufficient processing methods to remove cyanide from bitter cassava (26585).
POSSIBLY UNSAFE ...when used orally in food amounts that have not been processed appropriately to remove cyanogenic glycosides. Regularly consuming uncooked cassava or cassava that has not been processed appropriately, especially as part of a protein-deficient diet, increases exposure to cyanogenic glycosides (25844). Heap fermentation or sun drying are not considered to be appropriate processing methods for removing cyanide from bitter or sweet cassava root (26585). Boiling, steaming, baking, or frying are not considered to be appropriate processing methods for removing cyanide from bitter cassava (26585). There is insufficient reliable information available about the safety of using cassava in medicinal amounts.
CHILDREN: POSSIBLY SAFE
when used orally in food amounts.
Cassava is commonly consumed as a food with apparent safety. However, regular cassava consumption by children has been associated with inadequate intake of vitamin A, zinc, and iron (26175). Also, cassava may contain cyanogenic glycosides, and children are at a higher risk of cyanide poisoning from cassava compared to adults (25843).
CHILDREN: POSSIBLY UNSAFE
when used orally as a food in large quantities.
Epidemiological research has found that children who eat more than 700 grams of cassava daily may have a higher risk of developing konzo, a paralytic disease, than those who eat less than 150 grams daily (25860).
PREGNANCY: POSSIBLY UNSAFE
when used orally as a food, especially in large quantities.
Animal research suggests that consuming milled cassava powder as 80% of the diet during the first 15 days of pregnancy can cause teratogenic effects, including intrauterine growth restriction, limb defects, and abnormally small brain (microencephaly) (26171). Also, epidemiological evidence suggests that pregnant women who regularly consume dietary cassava in the form of gari during pregnancy have higher levels of thiocyanate, which has negative effects on fetal birthweight, compared to those who do not consume cassava (26172). ...when applied intravaginally. Inserting 2-3 cm of cassava stalk into the vagina has been used to induce abortion and labor (26174).
LACTATION: POSSIBLY UNSAFE
when used orally in food amounts, especially in large quantities.
Excess consumption of cassava during lactation may increase the risk of exposing the infant to thiocyanate, which can negatively affect thyroid function in the infant (26586).
LIKELY SAFE ...when used orally and appropriately with lactose-containing foods. Lactase has Generally Recognized as Safe (GRAS) status in the US when prepared from Candida pseudotropicalis or Kluyveromyces lactis (104108,104109). Lactase has been used safely in doses up to 9900 international units (IU) and up to 13,500 food chemical codex (FCC) units (2371,2372,2373,106669).
CHILDREN: LIKELY SAFE
when used orally and appropriately with lactose-containing foods.
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally and appropriately with lactose-containing foods.
There is insufficient reliable information available about the safety of lipase.
CHILDREN: POSSIBLY UNSAFE
when recombinant human bile salt-stimulated lipase (rhBSSL) is used orally by premature infants.
Adding rhBSSL to infant formula or pasteurized breast milk increases the risk for serious gastrointestinal adverse effects in premature infants (101940).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when peppermint oil is used orally, topically, or rectally in medicinal doses. Peppermint oil has been safely used in multiple clinical trials (3801,3804,6190,6740,6741,10075,12009,13413,14467,17681)(17682,68522,96344,96360,96361,96362,96363,96364,96365,99493).
POSSIBLY SAFE ...when peppermint leaf is used orally and appropriately, short-term. There is some clinical research showing that peppermint leaf can be used safely for up to 8 weeks (12724,13413). The long-term safety of peppermint leaf in medicinal doses is unknown. ...when peppermint oil is used by inhalation as aromatherapy (7107). There is insufficient reliable information available about the safety of using intranasal peppermint oil.
CHILDREN: POSSIBLY SAFE
when used orally for medicinal purposes.
Enteric-coated peppermint oil capsules have been used with apparent safety under medical supervision in children 8 years of age and older (4469).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (96361).
There is insufficient information available about the safety of using peppermint in medicinal amounts during pregnancy or lactation; avoid using.
LIKELY SAFE ...when rose hip extract is used orally in the amounts found in foods. Rose hip extract has Generally Recognized as Safe (GRAS) status in the US (4912). ...when rose hip from Rosa canina is used orally and appropriately in medicinal amounts. A specific formulation of rose hip powder from Rosa canina (LitoZin/i-flex, Hyben Vital), taken in doses of up to 2.5 grams (5 capsules) twice daily, has been safely used for up to 6 months (17416,71641,71646,71658,71660,71661,104557). Rose hip powder from Rosa canina, 40 grams daily mixed in apple juice, has been used safely for up to 6 weeks (18104). Rose hip powder from Rosa canina, 500 mg twice daily for 20 days, has also been safely used (97938).
POSSIBLY SAFE ...when rose hip from Rosa damascena is used orally and appropriately in medicinal amounts. Rose hip extract from Rosa damascena has been used safely in doses of 200 mg every 6 hours for 3 days (104555). There is insufficient reliable information available about the safety of medicinal amounts of rose hip from other Rosa species. There is also insufficient reliable information available about the safety of rose hip when used topically.
PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of rose hip when used orally or topically in medicinal amounts; avoid using in amounts greater than those found in foods.
LIKELY SAFE ...when consumed in amounts commonly found in foods (5286).
POSSIBLY SAFE ...when wheatgrass juice is taken orally and appropriately in medicinal amounts. Wheatgrass juice 60-100 mL daily has been used safely for up to 18 months (11165,85601,104878,104879). ...when wheatgrass cream is used topically. Wheatgrass 10% cream has been used safely for up to 6 weeks (85602). There is insufficient reliable information available about the long-term safety of wheatgrass when used medicinally.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when used orally. A dose of 50 mg (containing 8 mg diosgenin) has been used with apparent safety for 12 weeks (12,96724). ...when used topically. A wild yam cream has been used with apparent safety for 3 months (10989).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
Below is general information about the interactions of the known ingredients contained in the product SvG. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of alkylating agents.
 Details
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as alkylating agents (391). In contrast, other researchers theorize that antioxidants might make alkylating chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells (14012,14013). More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.
|
Theoretically, concomitant use of acerola with aluminum salts might increase the amount of aluminum absorbed.
Details
Acerola contains vitamin C. It is thought that vitamin C chelates aluminum, keeping it in solution and available for absorption (10549,10550,10551). In people with normal renal function, urinary excretion of aluminum likely increases, making aluminum retention and toxicity unlikely (10549). However, patients with renal failure who take aluminum-containing compounds, such as phosphate binders, should avoid acerola in doses that provide more vitamin C than the recommended dietary allowances.
|
Theoretically, the antioxidant effects of acerola might reduce the effectiveness of antitumor antibiotics.
Details
Acerola contains vitamin C, an antioxidant. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics (391). In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells (14012,14013). More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.
|
Theoretically, acerola might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Details
Acerola contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels (3046). However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion (10588,10589). The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and aspirin is unlikely.
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Theoretically, concomitant use of acerola with estrogens might increase estrogenic effects.
Details
Acerola contains vitamin C. Increases in plasma estrogen levels of up to 55% have occurred under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products (129,130,11161). It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall (129,11161). When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements (11161).
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Theoretically, acerola might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Details
Acerola contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption (11566). This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time (9804,9806). Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant (9805,9806,11566,11567). The vitamin C content of acerola is typically about 2000 mg per 100 grams. Thus, a clinically significant interaction between acerola and warfarin is unlikely.
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Evidence from human and animal research suggests that cassava root has marked antithyroid effects, particularly if poorly processed or if consumed as part of a protein-deficient diet (25846,25848,25849,25850,25851,25852). Also, clinical research shows that consuming boiled cassava leaves 200 grams twice daily for 9 days significantly reduces levels of the thyroid hormones triiodothyronine and thyroxine (25847). Theoretically, cassava may alter thyroid function, reduce thyroid hormone levels, and interfere with thyroid hormone-replacement therapy.
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Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.
Details
In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction (11784). An interaction between peppermint oil and cyclosporine has not been reported in humans.
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Theoretically, peppermint might increase the levels of CYP1A2 substrates.
Details
In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2 (12479,12734). However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference (96359).
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Theoretically, peppermint might increase the levels of CYP2C19 substrates.
Details
In vitro research shows that peppermint oil inhibits CYP2C19 (12479). So far, this interaction has not been reported in humans.
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Theoretically, peppermint might increase the levels of CYP2C9 substrates.
Details
In vitro research shows that peppermint oil inhibits CYP2C9 (12479). So far, this interaction has not been reported in humans.
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Theoretically, peppermint might increase the levels of CYP3A4 substrates.
Details
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Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of alkylating agents but might also reduce the oxidative damage caused by certain alkylating agents.
Details
Rose hip contains vitamin C. The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa (391). In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells (14012,14013). Further, some animal research suggests that the antioxidant effects of rose hip might attenuate cyclophosphamide-induced testicular toxicity (111413). More evidence is needed to determine what effect, if any, antioxidants found in rose hip, such as vitamin C, have on the effectiveness and adverse effects of chemotherapy.
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Theoretically, rose hip might increase the amount of aluminum absorbed from aluminum compounds.
Details
Rose hip contains vitamin C. Theoretically, vitamin C increases the absorption of aluminum. Concomitant use might increase aluminum absorption, but the clinical significance of this is unknown (3046). Administer rose hip two hours before or four hours after antacids.
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Theoretically, rose hip might reduce the effectiveness of anticoagulant or antiplatelet drugs.
Details
In vitro and animal research suggests that a constituent of rose hip, rugosin E, can induce platelet aggregation (71653). This has not been shown in humans. Theoretically, concomitant use of rose hip might reduce the effectiveness of antiplatelet or anticoagulant drugs.
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Theoretically, the antioxidant effects of rose hip might reduce the effectiveness of antitumor antibiotics.
Details
Rose hip contains the antioxidant vitamin C. There is concern that antioxidants might reduce the activity of chemotherapy drugs that generate free radicals, such as antitumor antibiotics (391). In contrast, other researchers theorize that antioxidants might make antitumor antibiotic chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells (14012,14013). More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on antitumor antibiotic chemotherapy.
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Theoretically, rose hip might reduce the clearance of aspirin; however, its vitamin C content is likely too low to produce clinically significant effects.
Details
Rose hip contains vitamin C. It has been suggested that acidification of the urine by vitamin C can decrease the urinary excretion of salicylates, increasing plasma salicylate levels (3046). However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion (10588,10589). The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and aspirin is unlikely.
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Theoretically, rose hip might increase blood levels of estrogens.
Details
Rose hip contains vitamin C. Increases in plasma estrogen levels of up to 55% have occured under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products (129,130,11161). It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall (129,11161). When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. However, increases in plasma estrogen levels may occur when women who are deficient in vitamin C take supplements (11161).
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Theoretically, rose hip might increase blood levels of lithium.
Details
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Theoretically, rose hip might reduce the effectiveness of warfarin; however, its vitamin C content is likely too low to produce clinically significant effects.
Details
Rose hip contains vitamin C. High doses of vitamin C may reduce the response to warfarin, possibly by causing diarrhea and reducing warfarin absorption (11566). This occurred in two people who took up to 16 grams daily of vitamin C, and resulted in decreased prothrombin time (9804,9806). Lower doses of 5-10 grams daily of vitamin C can also reduce warfarin absorption, but this does not seem to be clinically significant (9805,9806,11566,11567). The vitamin C content of rose hip is typically about 500 mg per 100 grams. Thus, a clinically significant interaction between rose hip and warfarin is unlikely.
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Theoretically, taking wheatgrass with antidiabetes drugs might lower blood glucose levels and increase the risk of hypoglycemia.
Details
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Theoretically, wheatgrass might decrease the levels and clinical effects of CYP1A2 substrates.
Details
In vitro research shows that wheatgrass induces CYP1A2 enzymes (111404).
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Theoretically, wild yam might increase or decrease the effects of estrogen.
Details
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Below is general information about the adverse effects of the known ingredients contained in the product SvG. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, acerola seems to be well tolerated.
However, a thorough evaluation of safety outcomes has not been conducted.
Serious Adverse Effects (Rare):
Orally: Acerola has been linked with one case of anaphylaxis and one case of rectal obstruction.
Gastrointestinal ...Osmotic diarrhea and gastrointestinal upset have been reported with doses of vitamin C greater than the tolerable upper intake level (UL) of 2000 mg daily (4844). Theoretically this could occur with large doses of oral acerola. A case report describes rectal obstruction with mass consisting of partially digested acerola fruits in a 5-year-old child who had ingested an unknown quantity of fruits daily for 7 days. The child presented with vomiting, abdominal pain and distension, tenesmus, constipation, and dehydration, and required surgical disimpaction (93205).
Immunologic ...There is a case report of a 37 year old man who developed a pruritic rash, dyspnea, and tachycardia 5 minutes after drinking a mixture of apple and acerola juices. He had a history of hay fever, oral allergy symptoms with avocado, celery, walnut, and curry, and contact urticaria with latex, but tolerated apples and apple juice. IgE antibodies to acerola were identified in the patient's serum. Ultimately, cross-reactivity between a latex protein and acerola was determined (93206).
General ...Orally, cassava may cause cyanide poisoning. Cassava, especially the bitter variety, contains cyanogenic glycosides. If not removed during processing, these constituents are converted to cyanogens. Symptoms of cyanide poisoning can include vomiting, nausea, stomach pains, and diarrhea, as well as dizziness, weakness, and headache. (26585). Cassava intake has also been associated with an increased risk of hypothyroidism and endemic goiter. This adverse effect is attributed to cyanogens, which can disrupt thyroid hormone production by decreasing iodine absorption (25841,25843,25844). The risk of these adverse effects is especially high for patients who consume cassava as part of a protein-deficient diet (25841,25843,25844). Consumption of cassava that has not been processed to remove the cyanogens has also been associated with an increased risk of developing paralytic diseases, tropical pancreatitis, and tropical ataxic neuropathy (25844,25854,25856,25859,25860,25861,25863,25864). Rarely, cassava has been reported to cause allergic reaction (99802,99806,99807).
Endocrine
...Orally, cassava has been associated with an increased risk of hypothyroidism and endemic goiter, particularly when consumed after poor processing or along with a protein-deficient diet (25846,25850,25852).
Cassava, especially the bitter varieties, contains cyanogenic glycosides. If not removed during processing, these constituents are converted to cyanogens, which disrupt thyroid hormone production by decreasing iodine absorption (25841,25843,25844). In humans, consuming boiled cassava leaves 200 grams twice daily can decrease serum levels of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) after only 9 days (25847).
There is also some concern that people who regularly consume cassava may have an increased risk of developing tropical pancreatitis, a form of pancreatitis that is primarily seen in tropical countries. However, this association has not been consistently observed (25854,25856).
Gastrointestinal ...Orally, cassava can cause cyanide poisoning. Cassava, especially the bitter varieties, contains cyanogenic glycosides. If not removed during processing, these constituents are converted to cyanogens. Gastrointestinal symptoms of cyanide poisoning can include vomiting, nausea, stomach pains, and diarrhea (26585).
Immunologic ...Rarely, cases of IgE-mediated allergic reaction have been reported after consumption of cassava. Reactions have included generalized urticaria, angioedema, respiratory distress, dry cough, and anaphylaxis. To date, all patients with confirmed cassava allergy also had an existing, confirmed latex allergy. It is hypothesized that cassava allergy results from primary sensitization to latex (99802,99806,99807).
Neurologic/CNS ...Orally, cassava can cause cyanide poisoning. Cassava, especially the bitter variety, contains cyanogenic glycosides. If not removed during processing, these constituents are converted to cyanogens. Neurological symptoms of cyanide poisoning include dizziness, weakness, and headache (26585). Evidence from case-control studies suggests that ingestion of wild or unprocessed cassava is associated with an increased risk of paralytic diseases, including spastic paraparesis, ataxic neuropathy, and konzo. People who consume wild or unprocessed cassava along with a protein-deficient diet seem to be at a particularly increased risk for these effects (25844,25859,25860,25861,99804). Although konzo is primarily a paralytic disease, children diagnosed with konzo have also demonstrated reduced mental and motor function (99805). Furthermore, children who have not been diagnosed with konzo but who live in a region where konzo is endemic demonstrate impairment in neurocognition and motor proficiency when compared with children in non-endemic regions. This suggests that there may be a subclinical form of the condition that causes neurocognitive complications (99805).
Ocular/Otic ...Orally, long-term consumption of wild or unprocessed cassava has been associated with the development of optic neuropathy and tropical ataxic neuropathy, presenting as loss of vision and hearing, particularly in protein-malnourished populations. Both of these conditions are attributed to cassava-induced cyanide overload (25863,25864,26585).
General ...Orally, lactase is generally well tolerated.
Immunologic ...A case of lactase-induced contact dermatitis and immunoglobulin E (IgE)-mediated allergic rhinoconjunctivitis has been reported in a worker exposed to powdered lactase. Allergy to lactase was confirmed by prick test, open application test, and chamber challenge test (96348).
General
...No adverse effects have been reported in adults.
However, a thorough evaluation of safety outcomes has not been conducted.
Serious Adverse Effects (Rare):
Orally: Gastrointestinal adverse effects, such as necrotizing enterocolitis, when recombinant human bile salt-stimulated lipase is used in premature infants.
Gastrointestinal ...Orally, when added to the formula or pasteurized breast milk consumed by premature infants, recombinant human bile salt-stimulated lipase (rhBSSL) can cause gastrointestinal adverse effects, including abdominal distension, flatulence, constipation, colic, abdominal pain, gastroenteritis, vomiting, regurgitation, and rectal bleeding (101940). Premature infants receiving rhBSSL also had a slightly higher rate of necrotizing enterocolitis (NEC) when compared with those receiving placebo. After review by a panel of experts, it was determined that the rate of confirmed or suspected NEC in infants consuming rhBSSL was 3.3%, compared with 0.5% in those receiving placebo. Although this rate of NEC is lower than the historical rate of occurrence in premature infants (11%), a possible increased risk for NEC cannot be ruled out (101940).
General
...Orally, topically, or rectally, peppermint oil is generally well tolerated.
Inhaled,
peppermint oil seems to be well tolerated. Intranasally, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted. Orally, peppermint leaf seems to be well tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, anal burning, belching, diarrhea, dry mouth, heartburn, nausea, and vomiting.
Topically: Burning, dermatitis, irritation, and redness.
Dermatologic
...Topically, peppermint oil can cause skin irritation, burning, erythema, and contact dermatitis (3802,11781,31528,43338,68473,68457,68509,96361,96362).
Also, a case of severe mucosal injury has been reported for a patient who misused an undiluted over the counter mouthwash that contained peppermint and arnica oil in 70% alcohol (19106).
In large amounts, peppermint oil may cause chemical burns when used topically or orally. A case of multiple burns in the oral cavity and pharynx, along with edema of the lips, tongue, uvula, and soft palate, has been reported for a 49-year-old female who ingested 40 drops of pure peppermint oil. Following treatment with intravenous steroids and antibiotics, the patient's symptoms resolved over the course of 2 weeks (68432). Also, a case of chemical burns on the skin and skin necrosis has been reported for a 35-year-old male who spilled undiluted peppermint oil on a previous skin graft (68572). Oral peppermint oil has also been associated with burning mouth syndrome and chronic mouth ulceration in people with contact sensitivity to peppermint (6743). Also, excessive consumption of mint candies containing peppermint oil has been linked to cases of stomatitis (13114).
Gastrointestinal ...Orally, peppermint oil can cause heartburn, nausea and vomiting, anal or perianal burning, abdominal pain, belching, dry mouth, diarrhea, and increased appetite (3803,6740,6741,6742,10075,11779,11789,17682,68497,68514)(68532,68544,96344,96360,102602,104219,107955). Enteric-coated capsules might help to reduce the incidence of heartburn (3802,4469,6740,11777). However, in one clinical study, a specific enteric-coated formulation of peppermint oil (Pepogest; Nature's Way) taken as 180 mg three times daily was associated with a higher rate of adverse effects when compared with placebo (48% versus 31%, respectively). Specifically, of the patients consuming this product, 11% experienced belching and 26% experienced heartburn, compared to 2% and 12%, respectively, in the placebo group (107955). A meta-analysis of eight small clinical studies in patients with irritable bowel syndrome shows that taking enteric-coated formulations of peppermint oil increases the risk of gastroesophageal reflux symptoms by 67% when compared with a control group (109980). Enteric-coated capsules can also cause anal burning in people with reduced bowel transit time (11782,11789).
Genitourinary ...Orally, a sensitive urethra has been reported rarely (102602).
Hepatic ...One case of hepatocellular liver injury has been reported following the oral use of peppermint. Symptoms included elevated liver enzymes, fatigue, jaundice, dark urine, and signs of hypersensitivity. Details on the dosage and type of peppermint consumed were unavailable (96358).
Immunologic ...One case of IgE-mediated anaphylaxis, characterized by sudden onset of lip and tongue swelling, tightness of throat, and shortness of breath, has been reported in a 69-year-old male who consumed peppermint candy (89479). An allergic reaction after use of peppermint oil in combination with caraway oil has been reported in a patient with a history of bronchial asthma (96344). It is not clear if this reaction occurred in response to the peppermint or caraway components.
Neurologic/CNS ...Orally, headache has been reported rarely (102602).
Ocular/Otic ...Orally, peppermint has been reported to cause blurry vision (3803).
General
...Orally, rose hip from Rosa canina is well tolerated.
Rose hip from Rosa damascena also seems to be well tolerated. A thorough evaluation of safety outcomes has not been conducted for rose hip derived from other species.
Most Common Adverse Effects:
Orally: Flatulence, loose stools.
Dermatologic ...Orally, one case of mild urticaria has been reported in a clinical trial for a patient taking a specific rose hip powder product (LitoZin/i-flex, Hyben Vital) 2. 5 grams twice daily (71646).
Gastrointestinal
...Orally, gastrointestinal reactions have been reported.
These include abdominal cramps, acid reflux, constipation, diarrhea, flatulence, nausea, vomiting, gastrointestinal obstruction, esophagitis, heartburn, acid reflux, and water brash. However, in most cases, these adverse effects occurred at the same frequency in patients taking placebo (15,18104,71641,71646,97938).
Rose hip powder is a source of vitamin C. Osmotic diarrhea and gastrointestinal upset have been reported with doses of vitamin C greater than the tolerable upper intake level (UL) of 2000 mg daily (4844). However, most rose hip products contain only 500 mg of vitamin C per 100 grams.
Genitourinary ...Orally, a few mild cases of frequent voiding have been reported in clinical trials. However, the frequency of occurrence does not seem to differ from those taking placebo (71641,71646).
Immunologic ...When inhaled in the workplace, rose hip dust has caused mild to moderate anaphylaxis (6).
Neurologic/CNS ...Orally, vertigo and headache have been reported rarely (97938).
Ocular/Otic ...A case of keratoconjunctivitis secondary to contact with rose hip has been reported. The adverse effect was attributed to irritant hairs found on the fruit of rose hip. Symptoms resolved after treatment with topical prednisolone 1% eye drops (71642).
General
...Orally, wheatgrass is generally well tolerated.
Most Common Adverse Effects:
Orally: Allergic reactions, anorexia, constipation, nausea.
Gastrointestinal ...Orally, wheatgrass may cause nausea, anorexia, and constipation (11165).
Immunologic ...Wheat can cause allergic reactions in sensitive individuals. Due to the prevalence of this allergy in the general population, wheat and wheat products, such as wheatgrass, are classified as major food allergens in the United States (105410).
General
...Orally, wild yam is generally well tolerated.
Most Common Adverse Effects:
Orally: Fever, headache, upset stomach, and vomiting.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis.
Gastrointestinal ...Orally, wild yam can cause upset stomach and vomiting, especially at higher doses (12,86450).
Hematologic ...In one case report, a 55-year-old female with protein S deficiency and systemic lupus erythematosus (SLE) had temporary vision loss in the left eye from hemiretinal vein thrombosis 3 days after taking a combination phytoestrogen product containing wild yam 276 mg, dong quai 100 mg, red clover 250 mg, and black cohosh 250 mg (13155). It is unclear if wild yam contributed to this event.
Immunologic ...There are three case reports of anaphylaxis after ingestion of cooked wild yam (96722).
Neurologic/CNS ...Orally, wild yam can cause headache and fever, especially at higher doses (86450).
