| Ingredients | Amount Per Serving |
|---|---|
|
(Beta-Carotene)
|
900 mcg |
|
Herbs Blend
|
540 mg |
|
(root)
|
|
|
(Bamboo extract)
|
|
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(herb)
|
|
|
(Gynostemma )
(stem and leaf)
|
|
|
(root)
|
|
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(flower)
|
|
|
(leaf)
|
|
|
White Tea Leaf Extract
(leaf)
|
|
|
(herb)
|
|
|
(fruit)
|
|
|
Eucommia Bark Extract
(Eucommia )
(bark)
|
|
|
Fruits & Vegetables Blend
|
690 mg |
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(leaf)
(Moringa)
|
|
|
(head or plant)
|
|
|
(root)
|
|
|
(leaf)
|
|
|
(fruit)
|
|
|
(Fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(white kidney bean)
|
|
|
(leaf)
(Kale)
|
|
|
(florets)
|
|
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(seed)
|
|
|
(root)
(Asparagus)
|
|
|
(leaf)
|
|
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(L-Lysine Hydrochloride)
|
50 mg |
|
(Sodium Hyaluronate)
|
220 mg |
Microcrystalline Cellulose, Stearic Acid, Dicalcium Phosphate, Croscarmellose Sodium, Magnesium Stearate, Silicon Dioxide, Hydroxypropyl Methylcellulose, Polyethylene Glycol
Below is general information about the effectiveness of the known ingredients contained in the product Vegan Collagen Builder. 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
There is insufficient reliable information available about the effectiveness of blackberry.
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
There is insufficient reliable information available about the effectiveness of cilantro.
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
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
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 Vegan Collagen Builder. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when used orally in food amounts. Eating apples and consuming apple juice is safe for most people. Apples are a common food source (3470,3472). However, eating apple seeds should be avoided because they can be toxic (6).
CHILDREN: LIKELY SAFE
when used orally in food amounts.
Eating apples and consuming apple juice is safe for most people. Apples are a common food source (3470,3472).
CHILDREN: POSSIBLY SAFE
when apple pectin is used orally and appropriately, short-term.
Preliminary clinical research suggests that combination products containing apple pectin and German chamomile (Diarrhoesan) are safe when used in infants for up to one week (19705,19706).
PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of apple in amounts greater than those found in foods during pregnancy and lactation; avoid using.
POSSIBLY SAFE ...when used appropriately in healthy individuals. Asparagus racemosus 500 mg daily has been used with apparent safety for 8 weeks in male recreational athletes (106413).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally and appropriately. Beta-carotene supplements are appropriate for certain specific conditions; however, beta-carotene supplementation is not recommended for the general population (4844,6393). There is no tolerable upper intake level (UL) set for beta-carotene. However, doses as low as 20 mg/day have been associated with increased risk of lung and prostate cancer in people who smoke (1371,3359,3937,3959,6393,11786). There is also concern that taking high doses of antioxidants such as beta-carotene might do more harm than good. In several analyses of clinical studies involving smokers and healthy non-smokers, taking beta-carotene supplements alone or in combination with other antioxidants is associated with an increased risk of mortality from all causes (15305,34514,90775).
POSSIBLY UNSAFE ...when used orally in high doses or in people who smoke or have a history of asbestos exposure. Supplemental beta-carotene 20 mg daily for 5-8 years seems to increase the risk of lung cancer, prostate cancer, intracerebral hemorrhage, and cardiovascular and total mortality in people who smoke cigarettes or have a history of high-level exposure to asbestos (1371,3359,3937,3959,6393,11786,34591). There is also concern that taking high doses of antioxidants such as beta-carotene might do more harm than good in the general population. In several analyses of clinical studies involving smokers and healthy non-smokers, taking beta-carotene supplements alone or in combination with other antioxidants is associated with an increased risk of mortality from all causes (15305,34514,90775). Beta-carotene from foods does not seem to have this effect.
CHILDREN: LIKELY SAFE
when used orally and appropriately (4844).
High doses (greater than 60 mg per day) have been used with apparent safety for specific conditions such as erythropoietic protoporphyria (11793).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally and appropriately (4844,6393).
There is insufficient reliable information available about the safety of large doses of beta-carotene in pregnancy and lactation.
LIKELY SAFE ...when used orally and appropriately in amounts commonly found in foods. Bilberry has Generally Recognized As Safe status (GRAS) for use in foods in the US (4912).
POSSIBLY SAFE ...when used orally and appropriately for medicinal purposes. Bilberry fruit extracts have been used with apparent safety in clinical trials at a dose of up to 160 mg daily for up to 6 months (39,40,8139,9739,14280,35472,35510,35512,103190,104192,104195). A higher bilberry extract dose of 1.4 grams daily has been used with apparent safety for up to 4 weeks (104194). Whole bilberries or bilberry juice have also been consumed with apparent safety in quantities of 100-160 grams daily for up to 35 days (35463,91506).
POSSIBLY UNSAFE ...when the leaves are used orally in high doses or for a prolonged period. Death can occur with chronic use of 1.5 gram/kg daily (2).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in the amounts commonly found in foods.
However, there is insufficient reliable information available about the safety of bilberry when used in medicinal amounts during pregnancy and lactation; avoid using.
LIKELY SAFE ...when the fruit is used orally in amounts commonly found in foods (4912). There is insufficient reliable information available about the safety of blackberry fruit or leaf when used in medicinal amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in amounts greater than those found in foods.
LIKELY SAFE ...when used orally and appropriately. Blueberry, as the whole fruit, juice, or in a powder formulation, is safe when consumed in amounts commonly found in foods (13533,92387,92388,92394,96467,97181,99139). There is insufficient reliable information available about the safety of blueberry when used topically or when the leaves are used orally.
CHILDREN: LIKELY SAFE
when used orally and appropriately in amounts commonly found in foods (13533,96465).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (13533,107281).
There is insufficient reliable information available about the safety of blueberry for medicinal use; avoid using.
LIKELY SAFE ...when used orally in food amounts (14145). There is insufficient reliable information available about the safety of broccoli when used in medicinal amounts.
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in food amounts (14145).
There is insufficient reliable information available about the safety of broccoli when used in medicinal amounts during pregnancy and lactation; avoid using.
LIKELY SAFE ...when used orally in amounts commonly found in foods.
POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts (18). ...when used topically and appropriately, short-term. Topical application of cabbage leaves has been general well-tolerated in short-term studies (6781,6782,6783,6784,93671,110558). However, pain, itching, and burning with topical use of cabbage leaves have been reported in some patients leaving cabbage leaf wraps in place for 2-4 hours (93671,93675).
PREGNANCY:
There is insufficient reliable information available about using cabbage in medicinal amounts during pregnancy; avoid using.
LACTATION: LIKELY SAFE
when used topically and appropriately, short-term.
Significant adverse effects have not been reported in short-term studies (6781,6782,6783,6784,93673,93677). There is insufficient reliable information available about using cabbage orally in medicinal amounts during lactation; avoid using.
LIKELY SAFE ...when the flower preparations are used orally or topically and appropriately (4,19779,36931,39503,93552,93557,96647,105088).
PREGNANCY: LIKELY UNSAFE
when used orally; contraindicated due to spermatocide, antiblastocyst, and abortifacient effects.
There is insufficient reliable information available about the safety of calendula when used topically during pregnancy (4).
LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Carrot essential oil, extracts, and food additives have Generally Recognized as Safe (GRAS) status in the US (4912).
POSSIBLY SAFE ...when used orally in medicinal amounts, short-term. Carrot has been used safely in doses of approximately 100 grams three times daily for up to 4 weeks (96308). There is insufficient reliable information available about the safety of carrot when used topically.
CHILDREN: LIKELY SAFE
when used orally in amounts commonly found in foods (4912).
Carrot essential oil, extracts, and food additives have Generally Recognized as Safe (GRAS) status in the US (4912).
CHILDREN: POSSIBLY UNSAFE
when carrot juices are used excessively in nursing bottles for small children.
Excessive use of carrot juice may cause carotenemia and dental caries (25817).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in food (4912).
Carrot essential oil, extracts, and food additives have Generally Recognized as Safe (GRAS) status in the US (4912).
There is insufficient reliable information available about the safety of carrot when used in medicinal amounts during pregnancy and lactation.
LIKELY SAFE ...when used orally in amounts commonly found in foods. There is insufficient reliable information available about the safety of cauliflower when used in medicinal amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in greater amounts than found in foods.
LIKELY SAFE ...when used in food amounts. Cucumbers are a common food source (103382,103385). ...when the extract, fruit, fruit extract, fruit water, juice, seed extract, and seed oil are used topically and appropriately. These ingredients have been shown to be safely used in cosmetic products in levels of 0.4% to 3% (103382,103395).
POSSIBLY SAFE ...when cucumber extract or cucumber seed extract is used orally and appropriately. A specific cucumber extract (Q-Actin) has been used with apparent safety in doses of up to 10 mg twice daily for 6 months (103385). Cucumber seed extract has been used with apparent safety in doses of up to 500 mg daily for 6 weeks (103386). There isn't enough reliable information to know if other cucumber products are safe to use in amounts greater than those found in food.
PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of cucumber in amounts greater than those found in foods; avoid using.
POSSIBLY SAFE ...when used topically and appropriately. Gotu kola has been used safely in a cream or ointment for up to 10 weeks (11072,11073,67372,102792,105329,105335). An emulsion containing gotu kola extract 3% and other ingredients has been applied safely to the skin twice daily for up to 60 days (111571). ...when used orally and appropriately. Gotu kola extract has been used with apparent safety in doses of up to 180 mg daily for up to 12 months or 1000 mg daily for 60 days. Dried gotu kola has been used with apparent safety in doses of up to 2200 mg daily for 4 weeks (6887,11062,11063,11064,11065,11066,11067,11068,11069,11070)(11071,99756,99757,99758,105329,105332,105333). A specific gotu kola extract (Centellicum, Horphag Research Ltd) 450-675 mg daily has been used with apparent safety for up to 6 weeks (99756,99757).
PREGNANCY: POSSIBLY SAFE
when used topically and appropriately (11073,13559).
There is insufficient reliable information available about the safety gotu kola when used orally during pregnancy; avoid using.
LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when guava fruit is consumed as food. Guava fruit has Generally Recognized as Safe (GRAS) status (4912).
POSSIBLY SAFE ...when guava fruit or leaf extract is used orally for medicinal purposes, short-term. Guava fruit has been used with apparent safety at doses of 500-1000 grams daily for 12 weeks (95562). Guava leaf extract has been used with apparent safety at doses of 1 gram daily for 12 weeks or 1.5 grams daily for 3 days (101758,70318). ...when the leaf extract is used topically, short-term. Guava leaf extract has been used safely as a mouth rinse at a dose of 0.15% twice daily for 30 days (101754). Guava leaf extract has been safely used on the skin at a dose of 6% twice daily for 28 days (101757).
PREGNANCY AND LACTATION: LIKELY SAFE
when guava fruit is consumed as food.
There is insufficient reliable information available about the safety of guava fruit or leaf when used for medicinal purposes during pregnancy and lactation.
POSSIBLY SAFE ...when used orally and appropriately, short-term. Hawthorn preparations in doses of up to 1800 mg daily seem to be safe when used for up to 16 weeks. Although hawthorn might be safe for long-term use, current studies have not evaluated safety past 16 weeks (8279,8280,8281,10144,17203,104689). There is insufficient reliable information available about the safety of hawthorn when used topically.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY UNSAFE ...when horsetail products containing thiaminase are used orally, long-term. Thiaminase is an enzyme that destroys thiamine, which could theoretically lead to thiamine deficiency. In Canada, horsetail products are required to be thiaminase-free (105301).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
There is insufficient reliable information available about the safety of hu zhang.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally and appropriately. Supplements standardized to contain hyaluronic acid 70%, in an 80 mg daily dose, have been used daily for up to 3 months with no reports of adverse effects (55742,91779). ...when used topically and appropriately. Hyaluronic acid, in a gel or impregnated gauze, has been safely applied to the skin in clinical trials (7889,7892,104389,108627,108640). ...when eye drop preparations containing up to 0.3% hyaluronic acid are used multiple times per day for up to 3 months (97885,97894,97895,110555).
PREGNANCY:
There is insufficient reliable information available about the safety of hyaluronic acid; avoid using.
LACTATION:
There is insufficient reliable information available about the safety of hyaluronic acid.
It is not known if hyaluronic acid is excreted in breast milk (7890); avoid using.
LIKELY SAFE ...when consumed in amounts commonly found in foods (6,2076).
POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts. Indian gooseberry fruit extract has been used safely in doses of up to 1000 mg daily for up to 6 months, 1500 mg daily for up to 8 weeks, or 2000 mg daily for up to 4 weeks (92515,99238,99240,99241,102855,102857,105352,105354,105356). Indian gooseberry leaf extract has been used with apparent safety at a dose of 750 mg daily for 10 days (99846). ...when used topically and appropriately. An emulsion containing Indian gooseberry extract 3% and other ingredients has been applied safely to the skin twice daily for up to 60 days (111571).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when used orally and appropriately, short-term. Tea containing jiaogulan 3 grams has been taken twice daily with apparent safety for up to 3 months (94054,95519,95520). Jiaogulan extract has been used with apparent safety at a dose of up to 450 mg daily for up to 4 months (7069,7070,57056,94058,100961,106651). An in vitro study suggests that low, medium, and high doses of jiaogulan polysaccharides are safe in a model of the human intestinal epithelial barrier (110700).
PREGNANCY: POSSIBLY UNSAFE
when used orally.
Ginsenoside Rb1, which is identical to the jiaogulan constituent gypenoside 3, has teratogenic effects in animal models; avoid using (10447).
LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used in amounts commonly found in foods. There is insufficient reliable information available about the safety of kale when used orally in medicinal amounts.
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods.
There is insufficient reliable information available about the safety of kale when used orally in medicinal amounts; avoid use.
LIKELY SAFE ...when used in amounts commonly found in foods. Lemon has Generally Recognized as Safe (GRAS) status in the US (4912).
POSSIBLY SAFE ...when inhaled in amounts used for aromatherapy, short-term. Lemon essential oil has been used with apparent safety as aromatherapy for up to 2 weeks in clinical research (93475,98128,98129). There is insufficient reliable information available about the safety of lemon when used topically, or when used orally or intranasally in medicinal amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available.
Avoid using in amounts greater than those typically found in foods.
POSSIBLY SAFE ...when used orally in doses up to 3000 mg daily for up to one year (1114,1119,1120,90642,104104), or up to 6000 mg daily for up to 8 weeks (90644,90645). ...when used topically and appropriately, short-term (11051).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when used orally. Mangosteen has been used with apparent safety at a dose of up to 560 mg daily for 12 weeks (110127). It has also been used with apparent safety in combination with Sphaeranthus indicus (Meratrim, Laila Nutraceuticals) or Indian cassia (Cindura, Laila Nutraceuticals), for a total dose of 800 mg daily for up to 16 weeks (97876,97878,97879,101079). ...when used topically as a single dose. Mangosteen pericarp 4% gel has been applied once along the gum line with apparent safety (97875).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally in food amounts. The leaves, fruit, and seeds are commonly used in foods (16341,16344,90573).
POSSIBLY SAFE ...when moringa leaf or seed is used orally and appropriately in medicinal amounts, short-term. Tablets and capsules containing up to 30 grams of moringa leaf powder have been used daily with apparent safety in clinical studies lasting up to 6 months (20578,90572,90572,97209,97210). A dried moringa seed kernel powder has also been used with apparent safety in doses of 3 grams twice daily for 3 weeks (19278). ...when moringa leaf extract is used topically and appropriately. Moringa leaf extract 2% has been used 3 times daily with apparent safety in a clinical trial lasting 3 months (112640).
POSSIBLY UNSAFE ...when moringa root or root bark are used orally. Moringa root contains spirochin, a potentially toxic alkaloid, while moringa root bark contains stimulant alkaloids similar to ephedrine. Although spirochin has not been studied in humans, animal data shows that it can cause nerve paralysis (63764).
CHILDREN: POSSIBLY SAFE
when moringa leaf is used orally and appropriately, short-term.
Powdered dried moringa leaf has been used with apparent safety in doses of 15 grams twice daily for up to 2 months (90576).
PREGNANCY: POSSIBLY SAFE
when the leaf is used orally during the second or third trimesters, short-term.
Moringa leaf powder or extract 500 mg daily for up to 4 months has been used with apparent safety during the second and third trimesters (105469,105471,105472,110645). There is insufficient reliable information available about the safety of using moringa leaf by mouth during the first trimester.
PREGNANCY: POSSIBLY UNSAFE
when the root, bark, or flower are used orally.
Traditionally, moringa root bark and gum from moringa trunk bark have been used to induce abortion. When taken orally along with black peppercorns to induce abortion, moringa root bark may cause fatality (63764). Animal research shows that moringa flower can cause uterine contractions (94634); however, this has not been assessed in humans.
There is insufficient reliable information about the safety of using moringa seed during pregnancy; avoid using.
LACTATION: POSSIBLY SAFE
when moringa leaf is used orally, short-term.
Moringa leaf powder or extract 2 grams daily has been used during lactation with apparent safety for up to 4 months (20578,90571,90573,105471,105472). There is insufficient reliable information available about the safety of using other parts of moringa during lactation; avoid using.
POSSIBLY SAFE ...when used orally and appropriately. Most research has evaluated a specific Phaseolus vulgaris (white kidney bean) extract (Phase 2, Pharmachem Labs), which appears to be safe in doses of up to 3 grams daily for 2-3 months (12186,15518,26157,29926). Other Phaseolus vulgaris (white kidney bean) extracts also seem to be safe in doses of 0.9-2.4 grams daily when used for up to 3 months (10633,104875).
POSSIBLY UNSAFE ...when large amounts of fresh Phaseolus vulgaris husks are ingested. Raw Phaseolus vulgaris husks contain lectins that can cause gastrointestinal upset. Cooking destroys the lectins (18).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally and appropriately in amounts commonly found in foods.
POSSIBLY SAFE ...when the seed or seed oil is used orally and appropriately in medicinal amounts, short-term. Pumpkin seed has been used with apparent safety in a dose of up to 10 grams daily for up to 12 months (92383). Pumpkin seed oil has been used with apparent safety in a dose of up to 400 mg daily for up to 6 months (92378). There is insufficient reliable information available about the safety of pumpkin seed oil when used topically.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using amounts greater than those found in food.
LIKELY SAFE ...when the fruit is used orally in amounts commonly found in foods (13622).
POSSIBLY SAFE ...when the fruit is used orally and appropriately in medicinal amounts (6481,9796). There is insufficient reliable information available about the safety of red raspberry leaf when used orally or topically.
PREGNANCY: LIKELY SAFE
when the fruit is used orally in amounts commonly found in foods (13622).
PREGNANCY: POSSIBLY SAFE
when red raspberry leaf is used orally and appropriately in medicinal amounts during late pregnancy under the supervision of a healthcare provider.
Red raspberry leaf is used by nurse midwives to facilitate delivery. There is some evidence that red raspberry leaf in doses of up to 2.4 grams daily, beginning at 32 weeks' gestation and continued until delivery, can be safely used for this purpose (6481,9796). Make sure patients do not use red raspberry leaf without the guidance of a healthcare professional.
PREGNANCY: LIKELY UNSAFE
when red raspberry leaf is used orally in medicinal amounts throughout pregnancy or for self-treatment.
Red raspberry leaf might have estrogenic effects (6180). These effects can adversely affect pregnancy. Tell pregnant patients not to use red raspberry leaf at any time during pregnancy without the close supervision of a healthcare provider.
LACTATION: LIKELY SAFE
when the fruit is used orally in amounts commonly found in foods (13622).
There is insufficient reliable information available about the safety of red raspberry leaf; avoid using.
LIKELY SAFE ...when used orally and appropriately in amounts commonly found in foods (7135,10470,92135). It is estimated that the average dietary intake of silicon is 20-50 mg daily (110029); however, there is currently no established recommended dietary allowance or tolerable upper intake level for silicon (7135,92136,95009,110029).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (7135,10470).
It is estimated that the average dietary intake of silicon is 20-50 mg daily (110029). There is insufficient reliable information available about the safety of silicon when used in larger, medicinal amounts; avoid using.
LIKELY SAFE ...when used in amounts commonly found in foods.
POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts. Spinach has been used with apparent safety at a dose of 5 grams daily for up to 12 weeks (96856).
CHILDREN: LIKELY SAFE
when consumed in the amounts commonly found in foods by children older than 4 months of age (18).
CHILDREN: LIKELY UNSAFE
when used orally in infants under 4 months old; the high nitrate content of spinach can cause methemoglobinemia (18).
There is insufficient reliable information available about the safety of spinach in children when used in medicinal amounts.
PREGNANCY AND LACTATION: LIKELY SAFE
when used in amounts commonly found in foods; avoid medicinal amounts.
POSSIBLY SAFE ...when used orally and appropriately. Stinging nettle root 360-600 mg has been used safely for up to 1 year (5093,11230,15195,76406,96744). ...when used topically and appropriately (12490).
PREGNANCY: LIKELY UNSAFE
when used orally due to possible abortifacient and uterine-stimulant effects (4,6,19).
LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when the fruit is used in amounts commonly found in foods. ...when tart cherry fruit, fruit juice, or fruit juice concentrate is used orally in supplemental amounts for up to 3 months (17403,93149,93151,93152,93153,93154,93156,93157,93158,93160)(93161,93168,93179,105633).
POSSIBLY SAFE ...when tart cherry fruit extract or powder is used orally, short term. Cherry fruit extract or freeze-dried cherry powder up to 500 mg daily for up 7 days has been used with apparent safety (93157,93158,105631). There is insufficient reliable information available about the safety of tart cherry stem when used orally.
PREGNANCY AND LACTATION: LIKELY SAFE
when the fruit is consumed in typical food amounts.
There is insufficient reliable information available about the safety of tart cherry fruit or stem when used in medicinal amounts; avoid using.
Below is general information about the interactions of the known ingredients contained in the product Vegan Collagen Builder. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of aliskiren.
 Details
Pharmacokinetic research shows that coadministration of apple juice 200 mL along with aliskiren 150 mg decreases the bioavailability of aliskiren by 63% (17670). Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney (7046,94413). It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
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Theoretically, consuming apple juice with antidiabetes drugs might interfere with blood glucose control.
Details
Clinical research suggests that consuming apples or drinking apple juice can raise blood glucose levels, with the effects of drinking apple juice being more significant than consuming apples (31699).
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Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Details
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients (31680).
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Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of atenolol.
Details
Pharmacokinetic research shows that coadministration of apple juice 600-1200 mL decreases levels of atenolol by 58% to 82% in a dose-dependent manner (17999). Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney (7046). It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
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Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of fexofenadine.
Details
Pharmacokinetic research shows that coadministration of apple juice 400-1200 mL along with fexofenadine 60-120 mg decreases bioavailability of fexofenadine by up to 78% (7046,94413). Coadministration with smaller quantities of apple juice (150 mL or less) does not appear to affect the bioavailability of fexofenadine (94421). Apple juice seems to inhibit organic anion transporting polypeptide (OATP), which is involved in drug uptake in the gut, liver, and kidney (7046,94413). It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
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There is some concern that concomitant consumption of apple juice might decrease oral absorption and blood levels of lithium.
Details
In one case report, a patient had an undetectable serum lithium level when lithium citrate was administered with apple juice. When lithium was administered with an alternative beverage, the lithium level became detectable and the patient demonstrated clinical improvement (105342).
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Concomitant consumption of apple juice can significantly decrease oral absorption and blood levels of OATP substrates.
Details
Research shows that consuming apple juice inhibits OATP, which reduces bioavailability of oral drugs that are substrates of OATP (7046,17605). Fexofenadine, atenolol, and aliskiren are substrates of OATP. Clinical research shows that coadministration of apple juice decreases bioavailability of fexofenadine by up to 78% (7046,94413), aliskiren by 63% (17670), and atenolol by up to 82% (17999). These effects appear to increase with larger quantities of apple juice. It is thought that apple juice might affect OATP for only a short time. Therefore, separating drug administration and consumption of apple juice by at least 4 hours might avoid this interaction (17603,17604).
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Theoretically, asparagus racemosus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Details
Animal studies show that asparagus racemosus root has diuretic effects when used in high doses (106417). This effect has not been reported in humans.
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Theoretically, Asparagus racemosus root could reduce excretion and increase levels of lithium.
Details
Animal research suggests that Asparagus racemosus root has diuretic properties when used in high doses (106417). Therefore, it might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Beta-carotene might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
Details
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (beta-carotene, vitamin C, vitamin E, and selenium) along with niacin and simvastatin attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease (7388,11537). It is not known whether this adverse effect is due to a single antioxidant such as beta-carotene, or to the combination. It also is not known whether it will occur in other patient populations.
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Theoretically, bilberry fruit extract might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Details
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Theoretically, bilberry leaf or fruit extract may increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
Animal research suggests that bilberry leaf extract might have blood glucose-lowering activity (1264). Also, one small clinical trial in patients with type 2 diabetes shows that taking bilberry fruit extract 470 mg as a single dose prior to an oral glucose tolerance test lowers plasma glucose levels when compared with placebo (91507).
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Theoretically, bilberry fruit extract might decrease levels of drugs metabolized by CYP2E1.
Details
Animal research shows that exposure to small concentrations of bilberry extract in drinking water for around one month increased CYP2E1 activity by 31%. However, exposure over a 2-month period did not increase CYP2E1 activity (103191). This effect has not been reported in humans.
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Theoretically, bilberry fruit extract might reduce the efficacy of erlotinib.
Details
In vitro research suggests that bilberry fruit extract and its constituents, delphinidin and delphinidin-3-O-glucoside, inhibit the activity of erlotinib (97031). This interaction has not been reported in humans.
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Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
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Theoretically, blueberry juice might increase blood levels of buspirone.
Details
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone (92385).
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Theoretically, blueberry juice might increase blood levels of flurbiprofen.
Details
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen (92385).
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Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP1A2.
Details
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Theoretically, broccoli might reduce the levels and effects of drugs metabolized by CYP2A6.
Details
Pharmacokinetic research in humans shows that eating 500 grams of broccoli daily for 6 days increases CYP2A6 activity by 135% to 550%. Induction of CYP2A6 activity is attributed to its glucosinolate constituents (19608).
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Cabbage might increase clearance and reduce the effects of acetaminophen.
Details
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation (3952).
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Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
Animal and in vivo research suggests that cabbage might have hypoglycemic effects (25424).
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Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.
Details
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Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.
Details
A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases levels of some drugs metabolized through glucuronide conjugation (3952).
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Cabbage might increase clearance and reduce the effects of oxazepam.
Details
A small clinical study shows that daily consumption of cabbage and brussels sprout decreases oxazepam levels by as much as 17%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation (3952).
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Theoretically, cabbage might decrease the anticoagulant effects of warfarin.
Details
Cabbage contains vitamin K. If consumed in large quantities, cabbage might decrease the anticoagulant effects of warfarin (19).
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Theoretically, calendula might have additive effects when used with CNS depressants, although this appears to be unlikely.
Details
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Preliminary clinical evidence suggests that eating cruciferous vegetables, including broccoli, cauliflower, daikon radish sprouts, and cabbage, can increase cytochrome P450 1A2 (CYP1A2) activity by 14% to 27% (26193). Theoretically, cauliflower might increase the clearance and decrease the effects of drugs metabolized by CYP1A2. Some drugs metabolized by CYP1A2 include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
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In vitro research suggests that extracts of cilantro can inhibit platelet aggregation (26583). Theoretically, cilantro might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs. Some of these drugs include aspirin, clopidogrel (Plavix), nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
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Evidence from in vitro research suggests that coriandrin, a constituent of cilantro, has photosensitizing effects (46228). Theoretically, concomitant use with photosensitizing drugs might increase photosensitivity. Some drugs that cause photosensitivity include amitriptyline (Elavil), quinolones (Ciprofloxacin, others), sulfa drugs (Septra, Bactrim, others), and tetracycline.
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Theoretically, cucumber seed might have additive effects with antidiabetes drugs and may increase the risk of hypoglycemia.
Details
Animal research shows that cucumber seed extract can decrease blood glucose levels (103391). Monitor blood glucose levels closely.
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Theoretically, taking gotu kola might increase the sedative effects of CNS depressants.
Details
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Theoretically, taking gotu kola with hepatotoxic drugs might have additive adverse effects.
Details
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Theoretically, concomitant use with antidiabetes drugs might have additive effects and increase the risk of hypoglycemia. Animal research shows that guava leaf extract or guava fruit can have hypoglycemic effects (101781). Monitor blood glucose levels closely. Medication dose adjustments may be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (Diabeta, Glynase PresTab, Micronase), insulin, metformin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
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Theoretically, hawthorn may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Details
In vitro and animal research shows that hawthorn can inhibit platelet aggregation (95528,95529,95530,95531). However, its effect in humans is unclear. One observational study shows that patients taking hawthorn shortly before undergoing coronary artery bypass graft (CABG) surgery or valve replacement surgery have a 10% incidence of postoperative bleeding, compared with 1% in those who never consumed hawthorn extract (95527). However, clinical research shows that taking a specific preparation of dried hawthorn leaves and flowers (Crataesor, Soria Natural Lab) 800 mg three times daily for 15 days does not affect platelet aggregation or levels of thromboxane B2, the metabolite of thromboxane A2, in healthy humans (54664).
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Theoretically, concomitant use might cause additive effects on blood pressure and heart rate.
Details
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Theoretically, concomitant use might cause additive coronary vasodilation and hypotensive effects.
Details
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Theoretically, hawthorn might potentiate the effects and adverse effects of digoxin.
Details
Hawthorn appears to improve cardiac output (12595); however, hawthorn does not appear to affect digoxin pharmacokinetics (19249). Case reports suggest that at least one species of hawthorn root extract (Crataegus mexicana) may produce adverse effects similar to digoxin and can cross-react with digoxin assays, leading to falsely elevated plasma digoxin levels (113112,113113).
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Theoretically, concomitant use might cause additive coronary vasodilatory effects.
Details
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Theoretically, concomitant use might result in additive vasodilation and hypotension.
Details
Hawthorn might inhibit PDE-5 and cause vasodilation (12595).
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Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.
Details
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Theoretically, taking horsetail with diuretic drugs might increase potassium loss and the risk of hypokalemia.
Details
Laboratory research shows that various species of horsetail have diuretic properties (13574,13575). Due to its diuretic effects, there has been concern that taking horsetail along with potassium-depleting diuretics might increase the risk for hypokalemia. However, pharmacokinetic research in humans shows that taking horsetail 900 mg daily for 4 days does not affect urinary excretion of electrolytes, including potassium and sodium, despite having a diuretic effect similar to taking hydrochlorothiazide 25 mg daily (92288). It is unclear if taking horsetail for a longer duration would affect electrolyte levels. Until more is known, use with caution.
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Theoretically, horsetail might decrease the levels and clinical effects of efavirenz.
Details
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral regimen that included efavirenz. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing horsetail, the viral loads became undetectable in both cases. The exact mechanism of this interaction is unknown (97573). It is also unclear if this interaction is specific to efavirenz or if it is related to various components of antiretroviral therapy.
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Theoretically, horsetail might increase the levels and adverse effects of lithium.
Details
Animal research suggests that horsetail has diuretic properties (13574). Theoretically, due to these potential diuretic effects, horsetail might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.
Details
In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral therapy. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing the supplement, the viral loads became undetectable in both cases. The exact mechanism of these interactions is unknown (97573). It is also unclear if these interactions are specific to NRTIs or if they are related to various components of antiretroviral therapy.
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Theoretically, hu zhang might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Details
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Theoretically, hu zhang might increase the effects and adverse effects of carbamazepine.
Details
In animals, blood and tissue levels of carbamazepine were increased when given in combination with hu zhang. It is thought that increased levels of carbamazepine are due to cytochrome P450 3A4 (CYP3A4) inhibition (101418). This interaction has not been reported in humans.
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Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A1.
Details
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Theoretically, hu zhang might increase levels of drugs metabolized by CYP1A2.
Details
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP1A2 enzyme (21733). This interaction has not been reported in humans.
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Theoretically, hu zhang might increase levels of drugs metabolized by CYP1B1.
Details
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP1B1 enzyme (70834). This interaction has not been reported in humans.
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Theoretically, hu zhang might increase levels of drugs metabolized by CYP2C19.
Details
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP2C19 enzyme (70896). This interaction has not been reported in humans.
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Theoretically, hu zhang might increase levels of drugs metabolized by CYP2E1.
Details
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP2E1 enzyme (7864,70896). Also, a pharmacokinetic study shows that taking resveratrol 500 mg daily for 10 days prior to taking a single dose of chlorzoxazone 250 mg increases the maximum concentration of chlorzoxazone by about 54%, the area under the curve of chlorzoxazone by about 72%, and the half-life of chlorzoxazone by about 35% (95824). Chlorzoxazone is used as a probe drug for CYP2E1.
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Theoretically, hu zhang might increase levels of drugs metabolized by CYP3A4.
Details
Hu zhang contains the constituent resveratrol. In vitro research shows that resveratrol might inhibit the CYP3A4 enzyme (7864,70896). However, a clinical study in adults with NAFLD found that adding resveratrol 3000 mg daily for 8 weeks did not necessitate dose adjustments to any established medications metabolized by CYP3A4 (91327).
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Theoretically, hu zhang might competitively inhibit the effects of estrogen replacement therapy.
Details
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Theoretically, Indian gooseberry may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs; however, research is conflicting.
Details
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking Indian gooseberry 500 mg along with clopidogrel 75 mg or ecosprin 75 mg, as a single dose or for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg or ecosprin 75 mg alone (92514). Until more is known, use caution when taking Indian gooseberry in combination with anticoagulant/antiplatelet drugs.
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Taking Indian gooseberry with antidiabetes drugs might increase the risk of hypoglycemia.
Details
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Theoretically, Indian gooseberry may increase the risk of bleeding if used with aspirin; however, research is conflicting.
Details
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with ecosprin 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus ecosprin 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with ecosprin 75 mg alone (92514).
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Theoretically, Indian gooseberry may increase the risk of bleeding if used with clopidogrel; however, research is conflicting.
Details
Clinical research shows that taking Indian gooseberry 500 mg as a single dose or twice daily for 10 days reduces platelet aggregation by about 24% to 36%, increases bleeding time by about 3.8-5.9 seconds, and increases clotting time by about 9.8-12.7 seconds when compared to baseline. However, taking a single dose of Indian gooseberry 500 mg along with clopidogrel 75 mg, or taking a combination of Indian gooseberry 500 mg twice daily plus clopidogrel 75 mg once daily for 10 days, does not significantly reduce platelet aggregation or increase bleeding time or clotting time when compared with clopidogrel 75 mg alone (92514).
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Theoretically, jiaogulan might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Details
In vitro research suggests that jiaogulan has antiplatelet effects (7071).
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Theoretically, jiaogulan might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
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Theoretically, jiaogulan might decrease the effectiveness of immunosuppressive therapy.
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Theoretically, taking itraconazole capsules or tablets with a beverage containing lemon might increase the levels and clinical effects of itraconazole.
Details
In one case report, dissolving itraconazole tablets in a small amount of specific beverages containing lemon prior to administration increased the level of itraconazole in a lung transplant patient. In this case, the increased bioavailability was desirable and was likely due to improved tablet dissolution in the acidic beverage (110781).
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Theoretically, lysine may reduce the effects of 5-HT4 agonists.
Details
Animal research suggests that L-lysine is a partial serotonin receptor 4 (5-HT4) antagonist and inhibits diarrhea induced by the 5-HT4 agonist, 5-hydroxytryptophane (19400).
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Theoretically, concomitant use of mangosteen with anticoagulant or antiplatelet drugs may increase the risk of bleeding.
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Theoretically, concomitant use of mangosteen with donepezil might increase the effects of donepezil.
Details
Animal research shows that concomitant use of an aqueous extract of mangosteen pericarp with donepezil increases brain concentrations of donepezil at 4 hours by 64% without associated effects on systemic exposure (106791).
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Theoretically, moringa might have additive effects when used with antidiabetes drugs; however, research is conflicting.
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Theoretically, moringa might decrease the levels and clinical effects of CYP1A2 substrates.
Details
In vitro research shows that moringa extract induces CYP1A2 enzymes (111404).
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Theoretically, moringa might increase or decrease levels of CYP3A4 substrates.
Details
Some in vitro research suggests that moringa inhibits cytochrome P450 3A4 (CYP3A4) (20576). However, other in vitro research suggests that moringa extract induces CYP3A4 enzymes (111404). A pharmacokinetic study in patients with HIV shows no change in the pharmacokinetics of nevirapine, which is partially metabolized by CYP3A4, when administered concomitantly with moringa leaf powder 1.85 grams daily for 14 days (97209).
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Theoretically, moringa leaf can antagonize the effects of levothyroxine.
Details
Animal research suggests that moringa aqueous leaf extract might reduce serum triiodothyronine (T3) concentrations by inhibiting the peripheral conversion of thyroxine (T4) to T3 (16348).
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Moringa leaf is unlikely to have a clinically significant interaction with nevirapine.
Details
Nevirapine is partially metabolized by cytochrome P450 3A4 (CYP3A4). In vitro evidence suggests that moringa inhibits CYP3A4 (20576). However, a pharmacokinetic study in patients with HIV shows no change in nevirapine pharmacokinetics when administered concomitantly with moringa leaf powder 1.85 grams daily for 14 days (97209).
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Theoretically, moringa leaf extract might increase the levels and clinical effects of P-glycoprotein substrates.
Details
In vitro research shows that moringa leaf extract inhibits renal P-glycoprotein transport activity (107850). So far, this reaction has not been reported in humans.
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Theoretically, Phaseolus vulgaris might increase the risk of hypoglycemia when taken with antidiabetes drugs.
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Pumpkin might reduce excretion and increase levels of lithium.
Details
Pumpkin is thought to have diuretic properties (92383). Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Details
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor (96300). This interaction has not been reported in humans.
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Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
Details
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea (96299).
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Spinach contains vitamin K, which can interfere with the activity of warfarin.
Details
In human research, although eating spinach with one meal does not result in coagulation test results outside the therapeutic range, daily consumption for one week necessitates dose adjustment of warfarin (19600). Individuals using anticoagulants should consume a consistent daily amount of spinach to maintain the effect of anticoagulant therapy (19).
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Theoretically, stinging nettle might have additive effects with antidiabetes drugs.
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Theoretically, combining stinging nettle with diuretic drugs may have additive effects.
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Theoretically, stinging nettle might reduce excretion and increase levels of lithium.
Details
Animal research suggests that stinging nettle has diuretic and natriuretic properties, which could alter the excretion of lithium (76402). The dose of lithium might need to be decreased.
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There is some concern that stinging nettle might decrease the effects of anticoagulant drugs such as warfarin.
Details
Stinging nettle contains a significant amount of vitamin K (19). When taken in large quantities, this might interfere with the activity of warfarin.
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Below is general information about the adverse effects of the known ingredients contained in the product Vegan Collagen Builder. 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, apple fruit is well tolerated.
Apple seeds, which contain cyanide, may cause serious adverse effects when consumed in large amounts.
Most Common Adverse Effects:
Orally: Bloating, flatulence.
Serious Adverse Effects (Rare):
Orally: Allergic reactions, including anaphylaxis. Ingestion of large amounts of apple seeds may cause cyanide poisoning, leading to death.
Gastrointestinal ...Orally, apple products, including whole apples, apple puree, and apple juice, may cause bloating and flatulence in some people (104184).
Immunologic ...Patients allergic to other fruits in the Rosaceae family, including apricot, almond, plum, peach, pear, and strawberry, can also be allergic to apples (7129). Rarely, the allergy has resulted in anaphylaxis (94425).
Other ...Orally, ingestion of large amounts of apple seeds, which contain hydrogen cyanide (HCN), may cause cyanide poisoning, leading to death. One death is attributed to ingestion of a cupful of apple seeds. To release cyanide, seeds must be hydrolyzed in the stomach, and several hours may elapse before poisoning symptoms occur (6).
General ...No adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.
General
...Orally, beta-carotene is well-tolerated when used in appropriate amounts.
Most Common Adverse Effects:
Orally: Belching, orange skin (temporary).
Serious Adverse Effects (Rare):
Orally: Increased cardiovascular mortality and cancer risk in smokers and other specific patient populations.
Cardiovascular ...Orally, beta-carotene 20 to 30 mg daily seems to increase cardiovascular mortality by 12% to 26% in people who smoke (2642,3949,108641). Smokers and people with a history of asbestos exposure should not use beta-carotene supplements. In males who smoke and have had a prior myocardial infarction (MI), the risk of fatal coronary heart disease increases by as much as 43% with beta-carotene 20 mg daily (3937). These adverse effects do not seem to occur in people who eat foods high in beta-carotene content (1440,2657).
Dermatologic ...High oral doses of beta-carotene in foods or supplements can cause yellow or orange skin pigmentation called carotenoderma (11786,34572,34594,91382,108641). In clinical trials, the incidence of carotenoderma has been reported to be up to 15.8% (34626).
Gastrointestinal ...Orally, beta-carotene may cause belching (34572,34594).
Ocular/Otic ...In a case report, treatment with a high dose of beta-carotene and canthaxanthin for more than 6 years resulted in the development of glistening bright yellow crystalline deposits around the maculae. This resulted in a slight decrease in visual acuity and adaptation to the dark (34641).
Oncologic ...Smokers and people with a history of asbestos exposure should not use beta-carotene supplements. Beta-carotene in doses of 20 mg per day for 5-8 years has been associated with an increased risk of lung and prostate cancer and increased total mortality in people who smoke cigarettes (21 or more daily), and in people with a history of high-level asbestos exposure (3959,6393,11303,11786,104467,108641). These adverse effects do not seem to occur in people who eat foods high in beta-carotene content (1440,2657). There is also concern that beta-carotene might increase the risk of adverse outcomes in non-smokers. In one large-scale population study, males who took a multivitamin more than 7 times per week and who also took a separate beta-carotene supplement had a significantly increased risk of developing advanced prostate cancer (15607).
Pulmonary/Respiratory ...Clinical research shows that taking beta-carotene 20 mg daily, alone or along with vitamin E 50 mg daily, increases the risk of common colds by 21% to 25% in individuals participating in heavy exercise at leisure. However, it does not appear to affect the risk of common cold in individuals who participate in heavy activity at work (34508).
Other ...Analysis of studies in smokers and non-smokers suggests that taking beta-carotene supplements alone or in combination with other antioxidants increases the risk of mortality from all causes (15305).
General
...Orally, bilberry fruit, juice, and extracts seem to be well tolerated.
Most Common Adverse Effects:
Orally: Dark-colored stools, flatulence, and gastrointestinal discomfort.
Gastrointestinal
...In one small clinical trial, mild-to-moderate flatulence was reported in 33% of patients taking sieved bilberries and concentrated bilberry juice (91506).
However, the patients in this study had ulcerative colitis, and the study lacked a control group, limiting the validity of this finding. In another small clinical study of males with age-related cognitive impairment, temporary adverse gastrointestinal (GI) effects were reported in 13% of patients drinking a combination of bilberry and grape juice. However, the adverse GI effect rate was identical in patients drinking a placebo juice (110641). A post-marketing surveillance report of 2295 patients using bilberry extract (Tegens) found that 1% of patients complained of GI discomfort and less than 1% experienced nausea or heartburn (35500).
Theoretically, fresh bilberry fruit may have laxative effects. One clinical trial noted an increased frequency of bowel movements following the administration of a combination formulation containing aerial agrimony parts, cinnamon quills, powdered bilberry fruit, and slippery elm bark (35462). It is unclear if these effects were due to bilberry, other ingredients, or the combination.
Other ...Orally, bilberry may cause discoloration of feces and the tongue. In one study, a dark-bluish to black discoloration of both the feces and the tongue was observed following consumption of sieved bilberries and concentrated bilberry juice. In one patient, a slight discoloration of the teeth has also been observed (91506). In another study, 50% of patients reported dark green stools after taking bilberry extract 700 mg twice daily for 4 weeks (104194).
General ...Blackberry fruit is commonly consumed as a food without reports of adverse effects. However, a thorough evaluation of safety outcomes for blackberry when used as a medicine has not been conducted.
General
...Orally, blueberry is generally well tolerated.
Most Common Adverse Effects:
Orally: Constipation, diarrhea, nausea, and vomiting with freeze-dried blueberries.
Gastrointestinal ...Orally, freeze-dried blueberries may cause constipation, diarrhea, nausea, and vomiting. In one clinical trial, 26% of patients taking freeze-dried blueberries 50 grams daily dropped out in the first week of the study due to gastrointestinal complaints (107278).
General ...Broccoli is well tolerated when consumed as food. A thorough evaluation of safety outcomes when broccoli is taken as medicine has not been conducted.
Dermatologic ...Topically, allergic reactions to broccoli have caused contact dermatitis (14158).
Gastrointestinal ...Orally, loose stools, diarrhea, abdominal pain, and abdominal cramping have been reported following intake of broccoli seed and sprout extracts, particularly at high doses (114753).
Hepatic ...In one case report, a 56-year-old adult developed elevated transaminases, with alanine aminotransferase (ALT) 5. 8 times above normal, aspartate aminotransferase (AST) 2.4 times above normal, and gamma-glutamyl transpeptidase (GGT) 5.1 times above normal. This was thought to be related to the consumption of 800 mL of broccoli juice daily over a 4-week period. Values returned to normal 15 days after cessation of juice consumption (96191).
Immunologic ...Topically, allergic reactions to broccoli have caused contact dermatitis (14158).
General ...Topically, cabbage leaf seems to be well-tolerated.
Dermatologic ...Some preliminary clinical research shows that application of cabbage leaf wraps to knee joints for at least 2 hours daily for 4 weeks is generally well-tolerated. Of the 27 patients using cabbage leaf wraps in this study, one patient reported an itching and burning sensation during the application. This patient was later found to have shingles, which may explain the adverse event (93671). However, in another case, a patient applying fresh Savoy cabbage leaves on his knee to reduce joint pain reported pain and burning after 4 hours of use. Skin patch and prick tests did not indicate an allergic reaction, and the patient's lesion improved with wet dressings, topical antibiotics, and oral antibiotics (93675).
Immunologic ...Topically, cabbage may cause contact dermatitis (93675). Allergic reactions to cabbage-related vegetables are rare. However, anaphylactic reactions to broccoli and cauliflower have been reported. Because the surface proteins believed to cause allergic reactions to brocolli are also found in cabbage, some patients allergic to brocolli or other vegetables in the Brassicaceae family may also be allergic to cabbage (92516).
Other ...Topical application of cabbage leaves to the breasts has been reported to stain clothes and put off an unpleasant smell (6781,6782).
General
...Orally and topically, calendula is generally well tolerated.
Serious Adverse Effects (Rare):
All ROAs: Allergic reactions.
Dermatologic ...Topically, a preparation containing calendula powder 0. 1% resulted in inflammation around the wound to which it was applied (96647). Burning sensation, itching, redness, and scaling were reported rarely in patients applying a combination of calendula, licorice, and snail secretion filtrate to the face. The specific role of calendula is unclear (110322).
Immunologic ...Orally, calendula can cause allergic reactions. Topically, calendula can cause eczematous allergic reactions. Calendula-specific patch testing is recommended prior to usage to determine allergenic potential. Testing is particularly necessary in individuals sensitive to the Asteraceae/Compositae family (10691,11458,96647). Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs. A preparation containing calendula powder 0.1% resulted in hives in a patient with a ragweed allergy (96647). Despite the widespread use of calendula and the occurrence of allergies to other family members, there has been only one report of anaphylaxis (11152).
General
...Orally, carrot is well tolerated when consumed as a food.
It also seems to be generally well-tolerated when consumed as a medicine. Some people are allergic to carrot; allergic symptoms include anaphylactic, cutaneous, respiratory, and gastrointestinal reactions such as hives, swelling of the larynx, asthma, or diarrhea (25820,93606,106560). In infants, excessive consumption of carrot products in nursing bottles has been reported to cause extensive caries in the primary teeth (25817).
Topically, carrot has been associated with a case of phytophotodermatitis (101716).
Dental ...Orally, feeding carrot juice to infants, with or without sugar- or acid-containing beverages, has been reported to damage teeth and cause dental caries (25817).
Dermatologic ...Orally, excessive consumption of carrots or carrot-containing products can cause yellowing of the skin, which results from increased beta-carotene levels in the blood (25817). Carrots may cause allergic reactions in some patients. Allergic responses to carrot-containing foods include skin reactions such as hives, erythema, swelling, and/or papules (25820,96306).
Gastrointestinal ...Orally, carrots may cause allergic reactions in some patients. Allergic responses to carrot-containing foods can include gastrointestinal symptoms, such as diarrhea (25820).
Immunologic
...Orally, carrots may cause allergic reactions in some patients (25820,96306,106560).
Allergic responses to carrot-containing foods can include skin reactions such as hives, erythema, swelling, and/or papules (25820,96306). For one patient, treatment of skin lesions resolved after a month of oral antihistamines and topical steroids, and avoiding further contact with carrot (96306). Allergic responses to carrot-containing foods can also include gastrointestinal symptoms, such as diarrhea, and respiratory symptoms, such as swelling of the larynx or asthma (25820). In one case, a patient with a history of allergic rhinitis and asthma who had been successfully treated with subcutaneous immunotherapy and was tolerant of consumption of raw and cooked carrots developed rhinoconjunctivitis when handling carrots. Inhalation of dust particles and aerosols produced by food processing activities and containing allergens from the peel and pulp of carrots is thought to have sensitized the airway, producing a distinct form of respiratory food allergy in which there are typically no symptoms with ingestion (106560).
Topically, a female runner developed phytophotodermatitis, which was considered possibly associated with the inclusion of carrot in a sunscreen (Yes To Carrots Daily Facial Moisturizer with SPF 15; Yes to, Inc.) (101716).
Psychiatric ...Compulsive carrot eating is a rare condition in which the patient craves carrots. According to one case report, withdrawal symptoms include nervousness, cravings, insomnia, water brash, and irritability (25821).
General ...Orally, no adverse effects have been reported when cauliflower is used medicinal amounts; however, a thorough evaluation of safety outcomes has not been conducted.
General ...Topically, cilantro has been reported to cause contact dermatitis (46230). In sensitive individuals, it has also been reported to cause anaphylaxis (92663).
Dermatologic ...Topically, cilantro may cause contact dermatitis, with symptoms including hives or itching (46230).
Endocrine ...Orally, cilantro extract has been associated with a case of endocrine toxicity. A case report describes severe diarrhea, stomach pain, skin darkness, depressed mood, amenorrhea, and dehydration following consumption of 200 mL of a 10% cilantro extract for 7 days (10635).
Immunologic ...Cilantro can cause anaphylaxis in some patients. One case report describes a 52 year-old man who experienced diffuse urticaria following a single ingestion of cilantro, followed by severe angioedema of the face, urticaria, and laryngeal edema following a second ingestion of cilantro. Treatment consisted of treatment with intravenous methylprednisolone, diphenhydramine, and famotidine (92663).
General
...Orally, cucumber is well tolerated in food amounts.
Cucumber extract and seed extract also seem to be well tolerated. Topically, the extract, fruit, fruit extract, fruit water, juice, seed extract, and seed oil of cucumber are well tolerated.
Most Common Adverse Effects:
Topically: Allergic eczema, erythema, irritation.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis.
Dermatologic ...Topically, mild redness and irritation have occurred rarely (103382).
Immunologic
...Orally, anaphylaxis with dizziness, vomiting, trouble breathing, and itching, occurring 5 minutes after eating a partially peeled cucumber, has been reported in a 76-year-old woman (103382,103384).
Topically, allergic eczema related to exposure to cucumber leaves and stems has been reported in a greenhouse worker (103382,103393).
General
...Orally and topically, gotu kola seems to be well tolerated.
Most Common Adverse Effects:
Orally: Gastric irritation and nausea.
Topically: Eczema.
Serious Adverse Effects (Rare):
Orally: Hepatotoxicity.
Dermatologic ...Topically, gotu kola may cause eczema (10277,10278). Also, gotu kola can cause allergic contact dermatitis, characterized by erythema, itching, papules, and a burning sensation (4,6887,9789,52875,52887,52896,52902). One specific gotu kola product (Blasteostimulina,Almirall, S. A.) has been reported to cause allergic contact dermatitis. However, not all patients with reactions to this product are sensitive to gotu kola; some patients are sensitive to neomycin, another ingredient in the product (52875). Madecassol ointment (Rona Laboratories Limited) is another gotu kola product that has resulted in allergic contact dermatitis. Controlled testing suggests that this product can cause this adverse effect in about 8% of patients (9789). Centellase cream has also caused allergic contact dermatitis in at least two cases (52887,52888).
Gastrointestinal ...In some patients, gotu kola can extract cause gastrointestinal upset and nausea (780,6887,52894).
Hepatic
...There is concern that gotu kola may cause liver toxicity in some patients.
There are at least four case reports of hepatotoxicity associated with gotu kola; however, hepatotoxic contaminants cannot be ruled out, as laboratory analysis was not conducted on the products used. Additionally, the doses of gotu kola used in these cases were not reported (13182,92506). In a clinical trial where liver function was monitored, taking gotu kola 120 mg daily for 6 months was not associated with changes in liver function (11065).
In one case of hepatotoxicity, a 61-year-old female developed elevated liver transaminase and total bilirubin levels after taking gotu kola tablets for 30 days. Liver biopsy showed granulomatous acute hepatitis. Months later, the patient took gotu kola again and developed elevated liver transaminases after 2 weeks. In another case, a 52-year-old female developed symptoms of hepatitis and increased liver transaminases after taking gotu kola for 3 weeks. Biopsy indicated chronic hepatitis and granulomas, areas of necrosis, and cirrhotic transformation. Liver function normalized after discontinuation of gotu kola. In a third case, a 49-year-old female developed symptoms of hepatitis after taking gotu kola for 2 months. Biopsy revealed granulomatous hepatitis. Liver function normalized after discontinuation of gotu kola (13182). In a fourth case, a 15-year-old female taking an unknown dose of gotu kola and lymecycline for 6 weeks for acne experienced acute liver failure with abdominal pain and vomiting, as well as elevated liver transaminases, bilirubin, international normalized ratio (INR), and prothrombin. Liver function returned to normal after both products were discontinued (92506).
Immunologic ...Topically, gotu kola can cause allergic contact dermatitis, characterized by erythema, itching, papules, and a burning sensation (4,6887,9789,52875,52887,52896,52902). One specific gotu kola product (Blasteostimulina, Almirall, S. A.) has been reported to cause allergic contact dermatitis in some patients. However, not all patients who react to this product are sensitive to gotu kola; some are sensitive to neomycin, another ingredient in the product (52875). Madecassol ointment (Rona Laboratories Limited) is another gotu kola product that has resulted in allergic contact dermatitis. Controlled testing suggests that this product can cause this adverse effect in about 8% of patients (9789). Centellase cream has also caused allergic contact dermatitis in at least two cases (52887,52888).
Psychiatric ...A case of night eating syndrome has been reported for a 41-year-old female who had been taking a gotu kola tincture (dose not specified) for 2 years. Symptoms resolved after gotu kola use was discontinued (52878).
General ...Orally, guava leaf extract may cause transient abdominal pain or nausea (101782). Topically, guava leaf extract may cause contact dermatitis (95560).
Dermatologic ...Topically, guava leaf extract may cause contact dermatitis and worsen atopic dermatitis. Exacerbation of atopic dermatitis has been reported for a 17-year-old male who added tea bags containing guava leaf 30 grams to his bath to help treat his condition. His eczema worsened after bathing with the guava tea bags and improved after discontinuation of use. Based on laboratory testing, the exacerbation of eczema was attributed to positive skin reactions of the patient to a protein and tannins found in guava leaf extract (95560).
Gastrointestinal ...Orally, transient abdominal pain or nausea has been reported in a clinical trial (101782).
General
...Orally, hawthorn seems to be well tolerated when used appropriately.
Topically, no adverse effects have been reported, although a thorough evaluation of safety outcomes has not been conducted.
Serious Adverse Effects (Rare):
Orally: Multiorgan hypersensitivity reactions resulting in acute renal failure have been reported rarely.
Cardiovascular
...Orally, tachycardia (with facial pains) of uncertain relationship to hawthorn was reported in a multicenter clinical trial (54640).
Palpitations (19244) were reported in three patients in a large surveillance trial of 3,664 patients with cardiac failure (54692) and in 11 patients with congestive heart failure (CHF) in a literature review of 5,577 patients (19247). Circulation failure has been reported in two patients with CHF in a literature review of 5,577 patients (19247). Incidences of hospitalization, hospitalization due to CHF, worsening of CHF, angina, and atrial fibrillation have also been reported with the use of hawthorn extract WS 1442 (Crataegutt forte), although it is unclear if these events are related to hawthorn supplementation or existing CHF (19222). In clinical trials, chest pain (8281), short-term increases in blood pressure (19240), and other non-specific heart problems (17203) have also been reported following the use of various hawthorn preparations (e.g. WS 1442, Korodin).
Orally, severe bradycardia, bradypnea, and Mobitz type 1 second degree heart block have been reported in a 16-year-old female who consumed Hawthorn root extract. Blood tests indicated plasma digoxin levels in the therapeutic range, despite no history of digoxin use. Medical treatment for digoxin cardiotoxicity did not improve symptoms. Symptoms gradually normalized over 3 days after discontinuation of the product (113112). Similarly, a 40-year-old female presented with bradycardia and elevated plasma digoxin levels after taking hawthorn root extract 196 mg daily for 2 days with no history of digoxin use. Symptoms resolved within 24 hours (113113).
Dermatologic ...Orally, erythematous rash has been reported in patients with CHF in a literature review of 5,577 patients (19247). Non-specific rashes and itching (19222,19243) as well as toxiderma from the fruits of hawthorn (54670) have also been reported.
Gastrointestinal ...Orally, rare abdominal discomfort of uncertain relationship to hawthorn has been reported in a large clinical trial, surveillance study, case reports, and a literature review (19247,54640,54692,113112). Digestive intolerance (19241), diarrhea (19243,113112), flatulence (8281), gastroenteritis (8281), increased bowel movements (19243), obstipation (8281), mild and rare nausea (10144,19247,19244), vomiting (113112), nutritional and metabolic problems (17203), and other non-specific gastrointestinal effects (19222), have also been reported. Furthermore, gastrointestinal hemorrhage has been reported in two patients with CHF in a literature review of 5,577 patients (19247).
Musculoskeletal ...In clinical trials, arthritis (8281), back pain (8281), weakness (19243), and other non-specific musculoskeletal effects (19222) have been reported following the use of various hawthorn preparations g. WS 1442, CKBM-A01). Additionally, in a case report, myalgia has been reported following use of hawthorn root extract (113113).
Neurologic/CNS ...Orally, headache and dizziness/vertigo were reported in 2 patients in a large surveillance trial of 3,664 patients with cardiac failure (54692), in 15 patients with CHF as reported in a literature review of 5,577 patients (19247), in a varying number of clinical trial participants (8281,19222,19244), and in case reports (113112,113113). Incidences of fainting (19222), fever (17203), and infrequent, mild and transient sleepiness have also been reported (19221,54692).
Psychiatric ...Orally, agitation was reported in a large surveillance trial of 3,664 patients with cardiac failure (54692).
Pulmonary/Respiratory ...Orally, bronchitis has been reported following the use of hawthorn extract WS 1442 (8281), and bradypnea has been reported following the use of hawthorn root extract (113112).
Renal ...A case of multiorgan hypersensitivity reaction and acute renal failure following the consumption of C. orientalis has been reported (54654).
Other ...Flu-like syndrome (8281) and other non-specific infections have been reported following the use of the hawthorn extract WS 1442 (17203,19222). Hawthorn has also been reported to cause nosebleeds (8281,10144).
General
...There is limited clinical research evaluating the safety of horsetail.
Most Common Adverse Effects:
Orally: Abdominal distension, increased bowel movements, and nausea.
Dermatologic ...In one case report, a patient developed seborrheic dermatitis after topical application of horsetail, requiring treatment with local epinephrine and oral antihistamines. The nicotine component of horsetail was determined to be the likely cause of this reaction (13563).
Gastrointestinal ...Orally, horsetail has been associated with mild gastrointestinal side effects including abdominal distension, increased frequency of bowel movements, and nausea (55576). Orally, chronic consumption of horsetail infusion has been associated with acute pancreatitis. In a case report, a 56-year-old female presenting with recurrent mild acute pancreatitis every 6-7 months, previously thought to be drug-induced, discontinued ingesting horsetail infusions. The patient had a history of bilateral adrenal gland removal and was being treated for hypertension, dyslipidemia, and hormone replacement, and then self-medicated with horsetail infusions. After discontinuing horsetail infusions, there were no further recurrences of pancreatitis during a 14-month follow-up (97574).
Hepatic ...In one case report, a patient with asymptomatic hepatitis B developed symptomatic liver failure following consumption of boiled horsetail juice 500 mL daily for 2 weeks. Liver enzymes returned to normal following discontinuation of the juice (92291). It is not known if the horsetail juice was contaminated or mixed with other ingredients.
Immunologic ...Horsetail has been associated with cross-allergenicity with carrots (13577).
Renal ...There are at least 4 case reports of hyponatremia thought to be at least partially associated with horsetail consumption. In one case report, an elderly patient who had taken oral horsetail 15 mg daily for 10 years presented with hyponatremia and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) secondary to reduced oral intake and nausea for the previous 2 days. Horsetail was thought to be a contributing factor. The patient's symptoms resolved after 5 days of treatment with oral sodium chloride and fluid restriction (108851).
Other ...Crude horsetail contains thiaminase, which can cause thiamine deficiency with prolonged consumption. Canadian Equisetum arvense products are required to be certified as free from thiaminase-like activity (55579,105301). In one case report, the development of autism in a child exposed to both horsetail and alcohol during pregnancy was thought to be caused by thiamine deficiency attributed to this combination (92292). However, it is not known if other genetic or environmental factors were involved in the development of this condition in utero.
General ...There is currently a limited amount of information on the adverse effects of hu zhang.
General
...Orally and topically, hyaluronic acid appears to be well tolerated.
Most Common Adverse Effects:
Topically: Eczema, erythema, itching, wound hemorrhage, wound infection (e.g., erysipelas).
Dermatologic
...The use of needle-free devices to inject hyaluronic acid for cosmetic purposes has been reported to cause serious injury, and in some cases permanent harm, to the skin, lips, and eyes (108613).
Topically, hyaluronic acid application has been reported to cause eczema, erythema, itching, wound hemorrhage, and wound infection (e.g., erysipelas) (108628,108640).
Ocular/Otic ...Ocular pain has been reported rarely in patients using eye drops containing up to 0. 3% hyaluronic acid (97885).
General ...Orally, Indian gooseberry seems to be well tolerated.
Dermatologic ...Orally, itching has been reported by one individual in a clinical trial (105354).
Gastrointestinal ...Orally, epigastric discomfort or dyspepsia have been reported by up to four individuals in clinical trials (105354,105356).
Hepatic ...In clinical research, increased serum glutamic pyruvic transaminase (SGPT) levels, with otherwise normal liver function, occurred in patients taking Ayurvedic formulations containing ginger, Tinospora cordifolia, and Indian gooseberry, with or without Boswellia serrata. The SGPT levels normalized after discontinuing the treatments (89557). It is unclear if these hepatic effects were due to Indian gooseberry or other ingredients contained in the formulations.
Musculoskeletal ...Orally, musculoskeletal pain has been reported by three individuals in a clinical trial (105354).
Neurologic/CNS ...Orally, fatigue has been reported by one individual in a clinical trial (105354).
Pulmonary/Respiratory ...Orally, breathlessness has been reported by one individual in a clinical trial (105354).
General
...Orally, jiaogulan seems to be well tolerated when used for up to 4 months.
Most Common Adverse Effects:
Orally: Diarrhea and nausea.
Gastrointestinal ...Orally, jiaogulan may cause diarrhea and nausea (6,106651). Dry mouth has also been reported with oral jiaogulan use (106651).
Neurologic/CNS ...Orally, jiaogulan may cause dizziness and insomnia (106651).
General ...Orally, kale is generally well tolerated when consumed in amounts commonly found in foods. No adverse effects have been reported with medicinal use. However, a thorough evaluation of safety outcomes has not been conducted.
General
...Orally, lemon is well tolerated in amounts commonly found in foods.
A thorough evaluation of safety outcomes has not been conducted on the use of larger amounts.
Most Common Adverse Effects:
Orally: Epigastralgia and heartburn with the regular consumption of fresh lemon juice.
Dermatologic ...Topically, the application of lemon oil might cause photosensitivity, due to furocoumarin derivative content. This occurs most often in fair-skinned people (11019).
Gastrointestinal ...Orally, fresh lemon juice, taken as 60 mL twice daily, has been reported to cause gastrointestinal disturbances in 37% of patients in one clinical trial, compared with 8% of patients in the placebo group. Specifically, of the patients consuming lemon juice, 21% experienced heartburn and 8% experienced epigastralgia, compared to 1% and 3%, respectively, in the placebo group (107489).
General
...Orally and topically, lysine is generally well tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, diarrhea, and dyspepsia.
Gastrointestinal ...Orally, lysine has been reported to cause diarrhea and abdominal pain, including dyspepsia (1114,1115,1116,1118,1120).
Renal ...There is one case report of oral lysine use associated with tubulointerstitial nephritis progressing to chronic renal failure in a 44-year old female (1121).
General
...Orally, mangosteen is generally well tolerated.
Topically, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.
Serious Adverse Effects (Rare):
Orally: Lactic acidosis.
Dermatologic ...Orally, mangosteen extract up to 560 mg daily has been reported to cause skin rash. It is not known if this side effect was related to mangosteen (97877).
Gastrointestinal ...Orally, mangosteen extract up to 560 mg daily has been reported to cause constipation, abnormal stool, abdominal discomfort, abdominal bloating, salivation, nausea and vomiting, and diarrhea. It is not known if these side effects were related to mangosteen (97877).
Neurologic/CNS ...Orally, mangosteen extract up to 560 mg daily has been reported to cause mild tiredness, headache, dizziness, and malaise. It is not known if these side effects were related to mangosteen (97877).
Pulmonary/Respiratory ...Orally, mangosteen extract up to 560 mg daily has been reported to cause dry throat, flu-like symptoms, cough, and nasal congestion. It is not known if these side effects were related to mangosteen (97877).
Renal ...Orally, mangosteen extract up to 560 mg daily has been reported to cause abnormal urination. It is not known if this side effect was related to mangosteen (97877). In one case report, a patient with chronic kidney disease and metabolic syndrome consumed mangosteen juice daily for 12 months and later presented with severe lactic acidosis. The juice was reported to contain 250 mg of mangosteen with 25 mg alpha-mangostin per ounce. Alpha-mangostin appears to inhibit mitochondrial function, disrupting the electron transport chain and adenosine triphosphate (ATP) production, causing accumulation of reactive oxygen species and inducing apoptosis. Researchers speculate that these effects might have led to lactic acidosis in this patient (16399).
Other ...Orally, mangosteen extract up to 560 mg daily has been reported to cause weight loss. It is not known if this side effect was related to mangosteen (97877).
General
...Orally and topically, moringa leaf and seed seem to be well tolerated.
Orally, moringa root and root bark might be unsafe. However, a thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Transient diarrhea.
Serious Adverse Effects (Rare):
Orally: Allergic reactions, including anaphylaxis, have been reported.
Cardiovascular ...Orally, a case of bilateral pulmonary embolism after a 5-month history of taking moringa leaf extract is reported in a 63-year-old female without other risks for venous thromboembolism. The patient recovered with standard anticoagulant treatment. Researchers speculate that possible procoagulant effects of moringa may have played a role in this event (110644).
Dermatologic ...Orally, Stevens-Johnson syndrome has been linked to the consumption of moringa leaves. A 53-year-old male presented with fever and generalized maculopapular rash 14 hours after eating food containing moringa leaves. Painful oral ulcers developed by the next day. The patient also reported a similar episode of oral ulcers after eating food containing moringa leaves three months earlier. The patient was treated with oral prednisolone and omeprazole and recovered within two weeks. Researchers speculate that the immunomodulatory effects of moringa may have played a role in this reaction (99876). There are also cases of fixed food eruption to moringa. In one case, suspected fixed food eruption occurred on the trunk and face of a 60-year-old female, reoccurring 8 hours after self reintroduction (112641).
Gastrointestinal ...Orally, moringa leaf powder can cause diarrhea. In a clinical trial, taking moringa leaf powder 8 grams daily resulted in transient diarrhea in 4 of 16 patients (25%) (105470).
Immunologic ...Orally, cases of anaphylaxis are reported after ingestion of young moringa leaves and seedpods. In these cases, positive skin-prick testing confirmed moringa as the causative allergen. The patients recovered after standard treatment (110597,110643). There are also cases of fixed food eruption to moringa. In one case, suspected fixed food eruption occurred on the trunk and face of a 60-year-old female, reoccurring 8 hours after self reintroduction (112641).
General
...Orally, Phaseolus vulgaris extract seems to be well tolerated.
Most Common Adverse Effects:
Orally: Constipation, diarrhea, flatulence, nausea, stomach pain, and vomiting.
Serious Adverse Effects (Rare):
Orally: Hypersensitivity reactions, including anaphylaxis, in sensitive individuals.
Dermatologic ...Topically, Phaseolus vulgaris may cause contact dermatitis in sensitive individuals. A case of occupational contact dermatitis characterized by pruritus, erythema, eczema, and dyspnea has been reported for a 41-year-old farmer who handled the green parts of Phaseolus vulgaris (29920).
Gastrointestinal ...Orally, an extract of the Phaseolus vulgaris variety white kidney bean, as well as alpha-amylase inhibitors isolated from Phaseolus vulgaris, might cause nausea, vomiting, diarrhea, flatulence, constipation, satiety, and stomach pains (11265,18223,29925,104874). Also, white kidney bean extract, taken orally along with carob gum, may cause constipation, flatulence, soft stools, and reduced levels of vitamin B12 and folic acid (10633). Consuming large amounts of raw or undercooked Phaseolus vulgaris beans or extract can cause nausea, vomiting, diarrhea, and gastroenteritis due to the content of phytohaemagglutinin, a plant protein lectin (18223,29916,93082). Cooking usually destroys lectins (18).
Immunologic ...Orally, Phaseolus vulgaris may cause hypersensitivity reactions, including anaphylaxis, in sensitive individuals. A case of severe anaphylactic shock requiring epinephrine and steroid treatment has been reported for a 23-year-old following ingestion of cooked kidney beans, a variety of Phaseolus vulgaris. The causative agents were reported to be phaseolin (vicilin) and phytohaemagglutinin (29918). Also, a case of angioedema resulting from type I hypersensitivity has been reported for a one-year-old child following inhalation of vapors from or ingestion of cooked white beans, another variety of Phaseolus vulgaris (29919).
General
...Orally, pumpkin products are generally well tolerated.
Most Common Adverse Effects:
Orally: Abdominal discomfort, diarrhea, nausea, and vomiting.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis.
Dermatologic ...There are two case reports of adult females developing substantial transient hair loss 1-3 weeks after consumption of a meal containing either bitter-tasting pumpkin or undefined squash. This adverse effect was attributed to a high concentration of cucurbitacin, which is commonly found in wild pumpkins (104535).
Gastrointestinal ...Orally, pumpkin seed oil has been reported to cause mild abdominal discomfort in clinical trials (5093,92378). There are also two case reports of adults developing severe nausea, vomiting, and diarrhea following consumption of a meal containing either bitter-tasting pumpkin or undefined squash. These adverse effects were attributed to a high concentration of cucurbitacin, which is commonly found in wild pumpkins (104535).
Immunologic
...Orally, pumpkin seed oil and pumpkin pulp have been reported to cause anaphylactic reactions in children and adults.
A case review highlights 4 cases of anaphylaxis in children (3 from pumpkin pulp, 1 from pumpkin seeds), and 7 cases in adults (1 from pumpkin flesh, 6 from pumpkin seeds). Symptoms of anaphylaxis include urticaria, angioedema of the lips or face, dyspnea, dysphagia, and oropharyngeal itching and swelling. A case report describes a 2-year-old male presenting with urticaria, swollen lips, and increased dyspnea 10 minutes after ingesting pumpkin seeds. The patient was found to have elevated allergen-specific immunoglobulin E (IgE) and a positive skin-prick test for pumpkin seeds. Symptoms resolved after treatment with epinephrine, systemic glucocorticoids, salbuterol, and antihistamines (107843).
There may also be concern for allergic reaction due to inhalation or topical exposure. One case report describes an 8-year-old child developing anaphylaxis while carving a pumpkin; another highlights that inhalation of pumpkin seed flour may have potentiated anaphylaxis in 3 individuals following the ingestion of pumpkin seeds (107843). Further research is necessary to assess the relationship between anaphylaxis and route of administration.
General
...Orally, red raspberry fruit is well tolerated.
There is currently a limited amount of information on the adverse effects of red raspberry leaf.
Most Common Adverse Effects:
Orally: Diarrhea, gastrointestinal upset, and epigastric pain. However, these adverse effects do not commonly occur with typical doses.
Dermatologic ...A liquid containing red raspberry leaf cell culture extract 0. 0005%, vitamin C 20%, and vitamin E 1% (Antioxidant and Collagen Booster Serum, Max Biocare Pty Ltd.) has been reported to cause mild tingling and skin tightness (102355). It is unclear if these effects are due to red raspberry leaf, the other ingredients, or the combination.
Gastrointestinal ...Orally, red raspberry may cause gastrointestinal upset, diarrhea, and epigastric pain (112127).
Pulmonary/Respiratory ...A case of occupational asthma due to the inhalation of red raspberry powder has been reported for a 35-year-old female. Symptoms included wheezing and shortness of breath (70370).
General
...Orally, silicon in the amounts found in food and water is not associated with adverse effects.
Serious Adverse Effects (Rare):
Inhaled: Crystalline silicon dioxide in the form of quartz dust found in industrial and occupational settings is associated with an increased risk of diseases such as silicosis, tuberculosis, chronic bronchitis, chronic obstructive pulmonary disease (COPD), lung cancer, glomerulonephritis, vasculitis, and rheumatoid arthritis.
Cardiovascular ...Case control studies have shown that occupational exposure to silicon dioxide-containing compounds may cause vasculitis (75114). Patients with occupational pulmonary silicosis may develop microscopic polyangiitis (inflammation of the blood vessels in the nose, sinuses, throat, lungs, and kidneys, also known as Wegener's granulomatosis).
Dermatologic ...Occupational silica exposure may be a risk factor for scleroderma, particularly in males (75099).
Genitourinary
...Limited reports in humans indicate that long-term use of large amounts of antacids containing magnesium trisilicate may be associated with urolithiasis and silicon-containing stones (11760,11861,75075,75103).
However, fewer than 30 cases associated with antacids containing silicates have been reported, despite these products being commercially available since the 1930s. Although exceptionally rare, silicon dioxide kidney stones can also occur without magnesium trisilicate ingestion (11556). Their formation is caused by an acidic urinary pH. In at least one case, urine alkalinization resulted in resolution of the symptoms (75075).
Case-control studies have shown that occupational exposure to silicon dioxide is related to antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (75114). High silicon levels in patients undergoing chronic hemodialysis have been associated with nephropathy (75089).
Hepatic ...High silicon levels in patients undergoing chronic hemodialysis have been associated with liver disease (75089).
Musculoskeletal ...High silicon levels in patients undergoing chronic hemodialysis have been associated with bone disease (75089). A meta-analysis suggests that the risk of rheumatoid arthritis is elevated with occupational exposure to silicon dioxide (75078).
Neurologic/CNS ...High silicon levels in patients undergoing chronic hemodialysis have been associated with neuropathy (75089).
Pulmonary/Respiratory ...Occupational exposure to crystalline silicon dioxide dust is associated with an increased risk of pulmonary diseases such as silicosis, tuberculosis, chronic bronchitis, chronic obstructive pulmonary disease (COPD), and lung cancer (75076,75081,75084,75114). Patients with occupational pulmonary silicosis may develop microscopic polyangiitis (inflammation of the blood vessels in the nose, sinuses, throat, lungs, and kidneys, also known as Wegener's granulomatosis). Meta-analyses suggest that occupational exposure to silicon dioxide increases the risk of lung cancer (75085,75095,75115). An analysis of 19 studies shows that lung cancer risk is approximately 2 times higher for those with silicosis (75115). It is not clear whether silicon dioxide is carcinogenic in the absence of silicosis (75083).
General
...Orally, spinach is well tolerated when consumed as a food.
Serious Adverse Effects (Rare):
Orally: In infants under 4 months of age, methemoglobinemia has been reported.
All routes of administration: Allergies in sensitive individuals.
Dermatologic ...Topically, contact dermatitis has been reported from spinach in a 54-year-old female farmer (41757).
Gastrointestinal ...Bagged spinach has been linked to Escherichia coli outbreaks, sometimes causing severe gastrointestinal symptoms and even death (75846,75847,75849,75851,96858).
Hematologic ...Orally, spinach ingestion by infants under 4 months of age can cause methemoglobinemia, due to its high nitrate content (75802,75858,75860,75861,75862).
Immunologic ...Orally, topically, and via inhalation, spinach has been reported to cause allergic reactions in sensitive individuals (75870,96859).
Pulmonary/Respiratory ...Lung inflammation associated with allergic alveolitis has been reported after inhalation of spinach powder (75871). The powder has also been reported to induce occupational asthma in a spinach factory worker (75833).
General
...Orally, stinging nettle seems to be generally well tolerated.
Most Common Adverse Effects:
Orally: Constipation, diarrhea.
Topically: Contact with the raw plant causes itching, rash, and stinging.
Dermatologic ...Topically, fresh stinging nettle leaves and stalk can cause localized rash, itching, and stinging (12490,76399,76412,76414,76417,76428,76448,96746). Usually, short exposure to stinging nettle results in a transient urticarial reaction and a stinging sensation which may persist for more than 12 hours (76399,76414,76417,96746). In one report, a patient placed a fresh stinging nettle leaf on the tongue to suck out the sap of the leaf. Severe tongue edema, pain, and urticaria developed within 5 minutes. Symptoms continued for several hours after the leaf was removed (15197). In another case report, a young couple intoxicated with methamphetamine fell and laid in a stinging nettle bush for 20 minutes, after which urticaria and pain continued for 2-3 weeks, and a heightened sensitivity to cold persisted for several months (96746).
Endocrine
...A case of gynecomastia has been reported for a 33-year-old male who consumed stinging nettle tea 2 cups daily for one month prior to symptom onset.
The condition subsided one month after discontinuing stinging nettle tea (76410).
There have been two cases of galactorrhea associated with the consumption of stinging nettle for one month (76410,108902). In one case, a 33-year-old female consuming stinging nettle tea showed high levels of estradiol and low levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH). The levels of these hormones normalized 6 weeks after discontinuing stinging nettle tea (76410). In the other case report describing a 30-year-old female self-treating with stinging nettle 500 mg daily, hormone levels were not reported; however, a mammogram showed scattered areas of fibroglandular density and benign-appearing calcifications. This patient had complete resolution of symptoms 1 week after discontinuation of stinging nettle (108902).
Gastrointestinal ...Orally, stinging nettle root can cause gastrointestinal complaints, including diarrhea and constipation (1,7,11230). Stinging nettle above ground parts may cause mild gastrointestinal discomfort when taken on an empty stomach (7035). Stinging nettle juice may cause diarrhea (1). One patient taking a combination product containing stinging nettle root extract and pygeum bark extract (Prostatonin, Pharmaton) experienced continual gastrointestinal pain and hyperperistalsis. It is not clear if this effect was due to stinging nettle or pygeum (70230).
Genitourinary ...There is a case report of decreased ejaculatory volume associated with an herbal blend product containing stinging nettle root extract, saw palmetto extract, pumpkin seed oil extract, lemon bioflavonoid extract, and beta-carotene (5093). It is unclear if this was due to stinging nettle, other ingredients, or the combination.
Hepatic ...A case of idiosyncratic drug-induced liver disease (DILI) is reported in a 36-year-old female who presented with abdominal pain after 1 month of taking an herbal liver detox tea containing stinging nettle and other ingredients. Remarkable laboratory values included elevated liver enzymes, alkaline phosphatase, and total bilirubin. The patient received a loading dose of N-acetylcysteine and was hospitalized for 12 days (112178). However, it is unclear if the adverse effect was due to the stinging nettle, other ingredients, or the combination.
Other ...Orally, stinging nettle root can cause sweating (1,7).
General
...Tart cherry is generally well tolerated when consumed as whole fruit, juice concentrate, or seed extracts.
Most Common Adverse Effects:
Orally: Abdominal pain, asthenia, gastrointestinal upset, loose stools.
Endocrine ...One case of hyperglycemia after drinking a specific blend of tart cherry and apple juices ) has been reported (93160).
Gastrointestinal ...In a clinical study, 29% of children who consumed 75 mL of tart cherry juice concentrate twice daily for 2 weeks reported abdominal pain (112815). Two cases of loose stools after consumption of 90 whole tart cherries, and one case of gastrointestinal disturbance after drinking 10.5 ounces of tart cherry concentrate (Cherrish, Cherrish Corp.) twice daily for 14 days have been reported (93186,93192). One case of gastrointestinal symptoms after drinking a specific blend of tart cherry and apple juice (Sour cherry juice, Cherrypharm Inc.) has been reported (93160).
Immunologic ...One case of a skin reaction possibly due to cherry allergy after drinking a specific blend of tart cherry and apple juice ) has been reported (93160).
Musculoskeletal ...In a clinical study, 31% of children who consumed tart cherry juice concentrate 75 mLl twice daily for 2 weeks reported asthenia (112815).
