Dr. Morrow's Body Ache Formula by Nutrition Dynamics, Inc.

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Alopecia areata. Although there has been interest in using oral aconite for alopecia areata, there is insufficient reliable information about the clinical effects of aconite for this purpose.
• Amenorrhea. Although there has been interest in using oral aconite for amenorrhea, there is insufficient reliable information about the clinical effects of aconite for this purpose.
• Asthma. Although there has been interest in using oral aconite for asthma, there is insufficient reliable information about the clinical effects of aconite for this purpose.
• Coronavirus disease 2019 (COVID-19). Although there has been interest in using injectable aconite for COVID-19, there is insufficient reliable information about the clinical effects of aconite for this purpose.
• Diarrhea. Although there has been interest in using oral aconite for diarrhea, there is insufficient reliable information about the clinical effects of aconite for this purpose.
• Heart failure. It is unclear if oral aconite is beneficial in patients with left ventricular failure. Details: Preliminary clinical research in patients with left ventricular failure shows that taking heat processed aconite tuber 1000 mg daily for up to 7 months modestly improves heart and kidney function when compared with placebo (30314).
• Pneumonia. Injectable aconite has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Oral aconite has not been evaluated for this use. Details: A meta-analysis of 20 small, low-quality randomized and non-randomized studies in older Chinese adults with severe pneumonia shows that 77% of patients receiving an injection containing aconite extract 0.1 mg/mL and panax ginseng extract 0.8 mg/mL had improvement in symptoms such as fever, cough, and chest tightness when compared with 61% of those who received standard treatment. This combination injection may also modestly reduce disease severity and the risk of mortality when compared with standard treatment. However, these outcomes were not evaluated in all studies, and dosing regimens were heterogenous, with doses ranging from 60-100 mL daily or twice daily for 7-14 days (110472).
• Raynaud syndrome. Although there has been interest in using oral aconite for Raynaud syndrome, there is insufficient reliable information about the clinical effects of aconite for this purpose. More evidence is needed to rate aconite for these uses.

(Read more about ACONITE)

POSSIBLY EFFECTIVE

• Osteoarthritis. Topical arnica gel might reduce osteoarthritis pain. Details: One open-label clinical trial shows that applying arnica gel (A. Vogel Arnica Gel, Bioforce AG) twice daily for 3 weeks decreases total symptom scores, including pain, stiffness, and restriction-of-function, when compared to baseline (19112). A larger randomized clinical trial shows that applying the same gel is as effective as ibuprofen for reducing the intensity of pain and improving hand function (19108).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acne. Although there is interest in using topical arnica for acne, there is insufficient reliable information about the clinical effects of arnica for this purpose.
• Bleeding. It is unclear if oral arnica reduces bleeding after surgery. Details: A small clinical study in patients undergoing total mastectomy for breast cancer suggests that sublingual treatment with 5 drops of a homeopathic preparation of arnica extract (Arnica 1000 K) three times daily for 6 days might reduce the volume of blood and serum drainage by 95 mL over 5 days when compared with placebo (96769). However, because this product is a dilute homeopathic preparation, there is unlikely to be any arnica in the doses given. There is speculation that the slightly higher mean weight of the patients in the arnica group, rather than any effects of arnica itself, might have led to the statistically significant findings (96768).
• Breast cancer-related hot flashes. Oral homeopathic arnica has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A clinical study in females with non-metastatic breast cancer treated with tamoxifen or an aromatase inhibitor shows that taking a specific homeopathic medicine (Actheane, Laboratories Boiron) daily for 3 months does not reduce hot flashes when compared with placebo. This product contains 4CH each of arnica, black cohosh, bloodroot, and nitroglycerin and 5CH of snake Lachesis muta (103004).
• Bruises. Most small clinical trials show that neither topical nor oral arnica reduces postoperative bruising. Details: Most clinical research shows that topical products containing arnica 10%, as well as homeopathic oral products such as tablets, globules, and capsules, are not effective for reducing postoperative bruising (19107,19119,19120,19121,19122,19123,19124,90611,96769,96772). However, some conflicting research shows benefit. One clinical study shows that applying arnica 20% ointment 0.25 grams twice daily for 2 weeks reduces laser-induced bruising when compared to white petrolatum ointment (19125). Another clinical study shows that applying a specific arnica cream (Arnica Krem 75 g, MediTech) four times daily reduces periorbital bruising in the first week after rhinoplasty when compared with no local treatment (96773). One small study has also evaluated oral homeopathic arnica. In females undergoing a face-lift, taking a specific homeopathic oral arnica product (SinEcch, Alpine Pharmaceuticals) may reduce bruising on postoperative days 1 and 7 when compared with placebo (19124).
• Diabetic retinopathy. Small clinical studies suggest that oral homeopathic arnica may reduce symptoms of diabetic retinopathy. Details: Two preliminary clinical trials in patients with diabetic retinopathy associated with both type 1 and type 2 diabetes shows that taking three pearls of homeopathic arnica 5C orally for 6 months might modestly improve measures of vision when compared with placebo (19110,19111).
• Dry eye. It is unclear if eye drops containing arnica extract can improve dry eye in children. Details: A small observational study in children aged 9-14 years with dry eye disease and allergic conjunctivitis suggests that applying eye drops containing hyaluronic acid 0.2% and arnica extract 0.1% three times daily for four weeks is associated with improvements in subjective and objective measures of dry eye severity when compared to baseline. Improvements in these outcomes were smaller and mostly non-significant in patients using eye drops containing hyaluronic acid only (111421). The validity of these findings is limited by a lack of between-group analysis and randomization.
• Exercise-induced muscle soreness. Small studies suggest that oral homeopathic arnica does not reduce muscle soreness after exercise. It is unclear if topical arnica is beneficial. Details: Despite some conflicting evidence (19135), most clinical research shows that taking homeopathic arnica formulations orally does not prevent delayed-onset muscle soreness (19129,19130,19131,19132,19133). Research on the use of topical arnica formulations is conflicting. One small study in trained athletes shows that using a gel containing 25 mg of dry arnica herb on muscles immediately after a run and then every 4 hours while awake for 5 days improves muscle tenderness and pain by a small amount after 3 days, but not at other time points, when compared with placebo (90612). However, another small study suggests that applying arnica 7% cream (Boiron Group) increases muscle pain following calf raises when compared with placebo (17113).
• Postoperative swelling. It is unclear if topical arnica reduces swelling after surgery. Details: One clinical study shows that applying arnica 10% ointment following blepharoplasty does not reduce postoperative swelling when compared with using a placebo ointment (96772). However, lower quality studies have yielded more promising results. One small clinical study shows that applying a specific arnica cream (Arnica Krem 75 g, MediTech) four times daily reduces swelling by a small amount in the first week after rhinoplasty when compared with no local treatment (96773). The validity of this finding is limited by the lack of a placebo control. A small retrospective study suggests that using a topical homeopathic preparation containing arnica 50M and marsh tea 50M (OcuMend, Cearna Inc.) is associated with reduced postoperative swelling after oculofacial surgery (96770); however, this study is limited by poor design (96771).
• Postoperative pain. Findings related to the use of oral homeopathic arnica are mixed; most studies utilizing a placebo control have yielded negative results. Details: Many small clinical studies show that taking homeopathic arnica preparations orally modestly reduces postoperative pain following tonsillectomy, knee surgery, and carpal tunnel release when compared with baseline or control. Most studies have used homeopathic arnica in dilutions of 30C, 30X, D6, or D4, for up to two weeks postoperatively (19102,19114,19115,19116). In one study, oral homeopathic arnica has been used along with arnica 5% ointment from 72 hours after surgery for up to 2 weeks (19116). The validity of these findings is limited by the lack of a placebo comparator. Studies utilizing a placebo or active control have not yielded positive results. Clinical research in patients recovering from carpal tunnel surgery shows that taking a homeopathic Arnica montana solution by mouth is no more effective than taking placebo for reducing postoperative pain and bruising (19107). Other clinical research shows that taking homeopathic arnica 30C for 5 days after total abdominal hysterectomy does not reduce postoperative pain when compared with placebo and usual treatment (19117). Also, homeopathic arnica D4 is inferior to diclofenac following bunion surgery (109102). Some clinical research in patients recovering from a knee ligament reconstruction shows that a homeopathic solution containing Arnica montana 5 CH, Bryonia alba 5 CH, Hypericum perforatum 5 CH, and Ruta graveolens 3 DH is no more effective than placebo for reducing analgesic use (32413).
• Postoperative recovery. It is unclear if oral homeopathic arnica is beneficial for postoperative recovery. Details: One meta-analysis of small- to moderate-sized clinical trials shows that taking homeopathic arnica does not improve postoperative recovery when compared with controls. Recovery endpoints were combined and included pain, swelling, bruising, wound healing, and others (109061).
• Stroke. A small study suggests that oral homeopathic arnica does not improve outcomes after stroke. Details: Preliminary clinical research shows that taking one tablet of arnica 30C sublingually every 2 hours for six doses doesn't benefit stroke patients (19126). Endpoints included level of consciousness, mobility, incontinence, social performance, and mental state.
• Tooth extraction. It is unclear if oral homeopathic arnica improves symptoms after tooth extraction in adults or children. Details: A small clinical trial in children aged 8-12 years undergoing two sessions of tooth extraction in different parts of the mouth shows that taking homeopathic arnica 30 minutes prior to the procedure, and then 3 times daily for 72 hours, is as effective as taking ibuprofen for reducing patient-reported and operator-assessed pain levels 24 hours after extraction. However, 48 hours after extraction, ibuprofen was more effective. Each child was provided with both arnica and weight-based doses of ibuprofen in a crossover manner while undergoing two sessions of tooth extraction in different parts of the mouth ten days apart (109224). A small observational study in adults undergoing third molar extractions suggests that taking homeopathic arnica 30X (Hyland's Inc.) 4 tablets before the procedure and then 4 tablets four times daily for 4 days after the procedure is associated with less pain, bleeding, and swelling when compared with standard treatment alone (105062). However, the validity of this study is limited by the lack of a placebo control. More evidence is needed to rate arnica for these uses.

(Read more about ARNICA)

LIKELY EFFECTIVE

• Bee sting allergy. Subcutaneous use of bee venom seems to be effective for bee sting desensitization in patients with severe allergy to bee stings. Bee venom immunotherapy provides 98% to 99% protection from systemic reactions to bee stings. Once immunotherapy is stopped, the risk of a systemic reaction over the next 5 to 10 years is about 5% to 15% (6043,6075,6076). Bee venom is an FDA-approved subcutaneous injectable product for the treatment of severe allergies to bee stings (2619).

POSSIBLY INEFFECTIVE

• Multiple sclerosis (MS). Administering live bee stings in graduated doses up to 20 stings given three times weekly does not seem to improve multiples sclerosis. Treatment for 24 weeks does not seem to reduce gadolinium-enhancing lesions on MRI or improve fatigue, disability, or quality of life (13222).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Frozen shoulder. A small clinical study in patients with frozen shoulder shows that receiving bee venom diluted 1:10,000 as injections into acupuncture points twice a week for 8 weeks, as an adjunct to other therapy, improves pain and disability but not range of motion when compared with injection with normal saline. Bee venom injections diluted to 1:30,000 did not improve pain and disability when compared with placebo (96573). One year after receiving bee venom acupuncture, scores on the Shoulder Pain and Disability Index remained improved over placebo in these patients; however, verbal rating scale scores did not differ from placebo (105772).
• Hemiplegic shoulder pain. Pooled analyses of two small clinical studies shows that bee venom acupuncture modestly decreases pain, but does not affect motor function, when compared with control in patients with shoulder pain after stroke (96575,105771).
• Neck pain. In patients with chronic neck pain, receiving 6 sessions of bee venom acupuncture over a 3-week period reduces the impact of the neck pain and improves quality of life more than taking the nonsteroidal anti-inflammatory drug loxoprofen 180 mg orally daily for 3 weeks. Pain intensity and neck disability index decreased similarly with both treatments when compared to baseline (111471).
• Notalgia paresthetica. Preliminary clinical research in a small number of patients with notalgia paresthetica shows that applying a product containing bee venom 0.04% and capsaicin 0.025% to the affected skin daily for 2 weeks reduces pruritus when compared to baseline (102530). A lack of control group limits the validity of these findings. Also, it is unclear if the effects are due to bee venom, capsaicin, or the combination.
• Osteoarthritis. Preliminary clinical research on the use of injected bee venom for the treatment of osteoarthritis is mixed (6045). However, a high-quality clinical trial in patients with osteoarthritis of the knee shows that injecting bee venom 100 mcg intradermally at 15 acupuncture points on the knees and back weekly for 12 weeks reduces knee pain and increases physical function scores when compared with a histamine control injection (102531).
• Parkinson disease. Data on the effect of bee venom in patients with Parkinson disease are conflicting. Preliminary clinical studies in a small number of patients with Parkinson disease, stable on medication for at least four weeks, shows that receiving injections of dilute bee venom into 10 acupuncture points twice weekly, with or without traditional acupuncture, for 8-12 weeks improves motor symptoms, walking speed, quality of life, and ability to perform activities of daily living when compared with baseline, placebo, and/or conventional anti-Parkinson medications alone (95900,96571,102532). However, it is unclear whether bee venom acupuncture provides long-term benefits. Also, other research shows no benefit of bee venom therapy. One clinical study in patients with Parkinson disease shows that receiving a specific bee venom 100 mcg (Alyostal) injection subcutaneously once monthly for 11 months does not improve symptoms when compared with placebo. The researchers speculate that the monthly dose may have been too low to have an effect (96572). Higher quality research is needed to determine the benefits of bee venom, if any, in these patients. More evidence is needed to rate the effectiveness of bee venom for these uses.

(Read more about BEE VENOM)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Anal fissures. Preliminary clinical research shows that topical use of a mixture of honey, olive oil, and beeswax for 12 hours reduces pain, bleeding, and itching associated with anal fissures (34100). It is unclear if these effects are due to beeswax, the other ingredients, or the combination.
• Burns. Preliminary clinical research in individuals with second-degree burns shows that applying a dressing containing a mixture of beeswax, olive oil, and alkanna once daily reduces healing time by almost 4 days, decreases pain during dressing changes, and shortens the duration of hospitalization by about 6 days compared to using a dressing containing nitrofurazone and rifamycin, applied once every 2 days (96328). Other preliminary clinical research shows that using a topical product containing beeswax (Medilixir, Medilixir Pty Ltd) for 14 days decreases the severity of itching, lengthens the time until itch recurrence, and decreases the use of anti-itch medications compared to standard aqueous cream (Biotech Pharmaceuticals Pty Ltd) in individuals experiencing post-burn itch (96329). Poor study designs limit the reliability of the findings.
• Diaper rash. Preliminary clinical research shows that topical use of a mixture of honey, olive oil, and beeswax four times daily for 7 days reduces symptoms of diaper rash by more than 75% (34094). It is unclear if this effect is due to beeswax, the other ingredients, or the combination.
• Hemorrhoids. Preliminary clinical research shows that topical use of a mixture of honey, olive oil, and beeswax for 12 hours reduces pain, bleeding, and itching associated with hemorrhoids (34100). It is unclear if these effects are due to beeswax, the other ingredients, or the combination.
• Oral mucositis. Preliminary clinical research in children with severe chemotherapy-induced mucositis shows that applying of mixture of honey, olive oil-propolis extract, and beeswax topically three times daily until healing or for a maximum of 10 days, along with standard oral care, reduces recovery time by almost 3 days compared to using benzocaine 7.5% gel. However, the mixture does not appear to reduce recovery time compared to benzocaine in patients with moderate chemotherapy-induced mucositis. Additionally, applying honey alone 0.5 grams/kg (maximum 15 grams), appears to be more efficacious for both moderate and severe mucositis than either the honey mixture or benzocaine gel (55245).
• Radiation dermatitis. A small clinical study in patients undergoing radiotherapy shows that applying a topical ointment containing beeswax, olive oil, calendula oil extract, and St. John's wort oil extract to the treated area nightly during radiotherapy and for two weeks post-radiotherapy, while also applying a topical cream containing aloe vera gel, calendula oil extract, and St. John's wort oil extract to the treated area three to four times daily, reduces the intensity of dermatitis and improves quality of life scores when compared to baseline (105769). The validity of these findings is limited by the lack of a comparator group. Additionally, it is unclear if these findings are due to beeswax, other ingredients, or the combination.
• Tinea corporis. Preliminary clinical research shows that topical use of a mixture of honey, olive oil, and beeswax three times daily for 4 weeks achieves clinical response in 75% of patients with tinea corporis (34092). It is unclear if this effect is due to beeswax, the other ingredients, or the combination.
• Tinea cruris. Preliminary clinical research shows that topical use of a mixture of honey, olive oil, and beeswax three times daily for 4 weeks achieves clinical response in 78% of patients with tinea cruris (34092). It is unclear if this effect is due to beeswax, the other ingredients, or the combination.
• Tinea versicolor. Preliminary clinical research shows that topical use of a mixture of honey, olive oil, and beeswax three times daily for 4 weeks achieves clinical response in 86% of patients with tinea versicolor (34092). It is unclear if this effect is due to beeswax, the other ingredients, or the combination. More evidence is needed to rate beeswax for these uses.

(Read more about BEESWAX)

There is insufficient reliable information available about the effectiveness of bryonia.

(Read more about BRYONIA)

There is insufficient reliable information available about the effectiveness of hemp agrimony.

(Read more about HEMP AGRIMONY)

UNSAFE ...when used orally or topically. Aconite root contains toxic alkaloids that are strong, fast-acting poisons that affect the heart and central nervous system, causing severe arrhythmias, reduced consciousness, and death (15499,19669,30294,30300,30301,30303,30309,30334,30335,30336,92276,104514,106706). All species of this plant are dangerous. Severe poisoning has been reported after ingestion of 0.2-2 mg of aconitine, 1 gram of the raw plant, or 6 grams of processed and cured aconite (3490,104514). Even when a processed product is used, aconite can cause toxicity including nausea, vomiting, dizziness, muscle spasms, hypothermia, paralysis of the respiratory system, and heart rhythm disorders (15499). Aconite can also be absorbed through the skin and cause significant toxicity (12).

PREGNANCY AND LACTATION: UNSAFE
when used orally or topically (15499).

(Read more about ACONITE)

POSSIBLY SAFE ...when used orally in amounts commonly found in foods. Arnica has Generally Recognized As Safe (GRAS) status for use as a food flavoring in the US (4912). However, Canadian regulations do not allow its use as a food ingredient (12). ...when used orally in homeopathic dilutions of 30C and up to 5C (19110,19111,19117,19124,19126,96769). ...when used topically on unbroken skin, short-term (12).

LIKELY UNSAFE ...when used orally or when applied topically to broken skin. Arnica is considered poisonous and has caused severe or fatal poisonings (5). Arnica can cause gastroenteritis, muscle paralysis, bleeding, arrhythmia, hypertension, shortness of breath, nausea and vomiting, multi-organ failure, and death (4,5,17,104,19101,19102,19103,19104,19105,19106,19107,19108).

PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally or topically; avoid using (12).

(Read more about ARNICA)

LIKELY SAFE ...when FDA-approved purified bee venom is given by subcutaneous injection by a trained medical professional (2619,6070,96572).

POSSIBLY SAFE ...when applied using stings from live bees. Live bee stings have been safely administered under medical supervision in doses up to 20 bee stings three times weekly for up to 24 weeks (13222). There is insufficient reliable information available about the safety of bee venom when used topically or injected in combination with acupuncture.

PREGNANCY AND LACTATION: POSSIBLY SAFE
when used by subcutaneous injection by a trained medical professional. Significant adverse effects to fetus or mother have not been reported. However, some clinicians decrease maintenance dose by half during pregnancy (2619).

PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used by subcutaneous injection in high doses. High doses of bee venom can increase release of histamine, which can cause uterine contraction (2619); avoid using in high doses.

(Read more about BEE VENOM)

LIKELY SAFE ...when used orally in amounts commonly found in foods. Beeswax has Generally Recognized as Safe (GRAS) status in the US (4912). ...when used orally as a medicinal agent (11)....when used topically (11,55245,96328,96329).

PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of medicinal amounts of beeswax during pregnancy and lactation.

(Read more about BEESWAX)

LIKELY UNSAFE ...when the root or berries are used orally (2,18). Consuming 40 berries might be fatal (18).

CHILDREN: LIKELY UNSAFE
when the root or berries are used orally (2,18). Consuming as few as 15 berries can be fatal in children (18).

PREGNANCY: UNSAFE
when the root is used orally. Bryonia root might have abortifacient effects (2). ...when the berries are used orally (2).

LACTATION: LIKELY UNSAFE
when the root or berries are used orally (2).

(Read more about BRYONIA)

LIKELY UNSAFE ...when products containing hepatotoxic pyrrolizidine alkaloid (PA) constituents are used orally. Repeated exposure to low concentrations of hepatotoxic PAs can cause severe veno-occlusive disease. Hepatotoxic PAs might also be carcinogenic and mutagenic (12841,12842). Tell patients not to use hemp agrimony preparations that are not certified and labeled as hepatotoxic PA-free. ...when products containing hepatotoxic PAs are used topically on abraded or broken skin. Absorption of hepatotoxic PAs through broken skin can lead to systemic toxicities (12841). Tell patients not to use topical hemp agrimony preparations that are not certified and labeled as hepatotoxic PA-free. There is insufficient reliable information available about the safety of using topical PA-free hemp agrimony on unbroken skin.

PREGNANCY: LIKELY UNSAFE
when used orally. Hemp agrimony preparations, containing hepatotoxic pyrrolizidine alkaloid (PA) constituents, might be teratogenic and hepatotoxic (12841,12842). There is insufficient reliable information available about the safety of using hemp agrimony products that do not contain hepatotoxic PAs during pregnancy.

LACTATION: LIKELY UNSAFE
when used orally. Hepatotoxic pyrrolizidine alkaloid (PA) constituents in hemp agrimony are excreted in milk (12841,12842). There is insufficient reliable information available about the safety of using hemp agrimony products that do not contain hepatotoxic PAs during lactation.

(Read more about HEMP AGRIMONY)

ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, combining aconite with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.  Details Higenamine, a constituent of aconite, is thought to have antiplatelet and antithrombotic effects. In an animal model of thrombosis, higenamine inhibited platelet aggregation and reduced the size of thrombus formation (92282).

STIMULANT DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, combining aconite with other stimulant drugs might alter the effects of the stimulant drug or increase the risk of cardiovascular toxicity.  Details Aconite and its constituents have stimulant effects due to agonist activity at beta-2-adrenoreceptors. In cardiac muscle, aconite appears to have a positive inotropic effect and increases heart rate and blood pressure (2634,15499,30296,92282). However, some constituents of aconite can reduce heart rate and blood pressure (15499,30343).

(Read more about ACONITE)

ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Unlikely •  Level of Evidence = D Theoretically, arnica might have additive effects with anticoagulant and antiplatelet drugs. Homeopathic arnica preparations are unlikely to have this interaction.  Details In vitro evidence shows that sesquiterpene lactones in arnica flowers can decrease platelet aggregation (104). However, this effect has not been reported in humans.

(Read more about ARNICA)

(Read more about BEE VENOM)

(Read more about BEESWAX)

(Read more about BRYONIA)

(Read more about HEMP AGRIMONY)

General ...Orally and topically, aconite is generally regarded as unsafe for use. Any benefits of therapy might not outweigh the risk of toxicity.
Most Common Adverse Effects:
All routes of administration: Serious neurologic, cardiovascular, gastrointestinal, and respiratory adverse effects have been reported.

Cardiovascular ...Orally and topically, aconite can cause hypotension, palpitations, chest tightness, pulmonary edema, arrhythmia, bradycardia, tachycardia, sustained or bidirectional ventricular tachycardia, ventricular fibrillation, and Torsade de pointes (558,559,561,562,563,3490,15499,15650,30294,30295)(30300,30305,30323,30336,92276,92277,92278,104514,106706,110473)(112901). Cardioversion has been reported to be ineffective for the reversal of aconite-induced dysrhythmia, but the use of agents such as amiodarone, lidocaine, and magnesium have been successful in some cases (2634,3490,106706,112901).

Gastrointestinal ...Orally, aconite can cause nausea, vomiting, diarrhea, and gastric pain (563,30297,30341,92277,92278). Topically, aconite can cause nausea and vomiting (92276).

Neurologic/CNS ...Orally, aconite can cause weakness, sweating, restlessness, dizziness, numbness, paresthesia, seizures, and reduced consciousness (558,559,561,562,563,3490,15499,15650,30335,30336,30341,92277,92278,104513). Topically, aconite can cause generalized paresthesia, fatigue, sweating, dizziness and tongue numbness (92276).

Ocular/Otic ...Orally, aconite has been reported to cause visual blurring and yellow-green vision with pupil dilation (30319).

Pulmonary/Respiratory ...Orally, aconite overdose can lead to respiratory failure (104513).

Renal ...Orally and topically, aconite can cause hypokalemia and metabolic and/or respiratory acidosis (558,559,561,562,563,3490,15499,15650).

Other ...Orally and topically, aconite has been reported to cause death in both adults and children (559,3490,3491,30301,30334,30341,92276,92278). In one case report, topical application of aconite to an infant led to cardiogenic shock with multi-organ failure and death (92276). Poisoning has been reported in 15 patients after consuming a homemade liquor containing aconite. Patients presented with tongue or extremity numbness, vomiting, dizziness, or heart palpitations, and 5 died (110471). Death has also been reported in individuals who cooked aconite tubers as vegetables or for health purposes (92278).
The first symptoms of aconite poisoning after oral ingestion of the leaves or root usually occur within 10-90 minutes, although toxicity may be delayed until a second or third dose (559,15499,104513,110471). Recovery time from aconite poisoning ranges from 1.5-2 days for mild intoxication to 7-9 days for patients with cardiovascular complications; fatalities in treated patients are about 5% (15499). Treatment of aconite toxicity is typically supportive, although charcoal hemoperfusion has aided in detoxification (15499,106706).

(Read more about ACONITE)

General ...Orally, arnica is unsafe and can cause toxicity. When used in homeopathic amounts, arnica seem to be generally well tolerated. Topically, arnica also seems to be generally well tolerated.
Most Common Adverse Effects:
Orally: Bleeding, gastroenteritis, hypertension, muscle paralysis, nausea and vomiting, shortness of breath.
Topically: Contact dermatitis and irritation.
Serious Adverse Effects (Rare):
Orally: Arrhythmia, coma, multi-organ failure, and death.

Cardiovascular ...Orally, arnica can cause tachycardia or a faster heart rate (11,17113,19101,19102). A 24-year-old female presented to the emergency department with palpitations and vomiting 24 hours after ingesting a cup of tea that reportedly contained arnica flowers picked from her local area of mountainous Southern California. The species was not specified in the article and there was no indication by the authors that any testing had been done to confirm the identity of the plant (90610).

Dermatologic ...Orally, arnica can cause irritation of mucous membranes (11,17113). Topically, arnica can cause contact itchiness, dry skin, and rash (17113). Oral lesions resulted in a woman who used a mouthwash incorrectly by not following dilution instructions. The mouthwash was 70% alcohol and contained arnica and oil of peppermint (19106).

Gastrointestinal ...Orally, arnica can cause stomach pain, nausea, vomiting, and diarrhea (11,17113,19101,19102). Homeopathic arnica has been reported to cause dry mouth (30C) and sore tongue (6C) (19107). A 24-year-old female presented to the emergency department with palpitations and vomiting 24 hours after ingesting a cup of tea that reportedly contained arnica flowers picked from her local area of mountainous Southern California. The species was not specified in the article and there was no indication by the authors that any testing had been done to confirm the identity of the plant (90610).

Musculoskeletal ...Adverse effects after ingesting arnica include muscle weakness (19101). Homeopathic arnica has been reported to result in the feeling of a "throbby" head or neck (19107).

Neurologic/CNS ...Orally, arnica may cause drowsiness, nervousness, and headache (11,17113,19101,19107).

Ocular/Otic ...In a case report, accidental intake of a large amount of a homeopathic Arnica-30 resulted in acute vision loss due to bilateral toxic optic neuropathy (19105).

Psychiatric ...Oral homeopathic arnica (6C) may cause depressed feelings, specifically a feeling of unhappiness (19107).

Pulmonary/Respiratory ...Orally, arnica can cause shortness of breath (11,17113).

(Read more about ARNICA)

General ...Purified bee venom given subcutaneously by a trained medical professional is generally well tolerated when used for diagnosis or immunotherapy of bee sting allergy.
Most Common Adverse Effects:
Parenterally: Dizziness, injection site erythema, itching, nausea and vomiting, swelling, tenderness, urticaria.
Serious Adverse Effects (Rare):
Parenterally: Anaphylaxis, asthma, chest pain or tightness, coagulation abnormalities, confusion, edema, hypotension, laryngeal edema, malaise, palpitations, respiratory distress, somnolence.

Cardiovascular ...Case reports have described stroke, and bradycardia associated with bee venom therapy (96576). Other reported adverse cardiovascular effects include cardiac dysfunction, palpitations, hypotension, and chest pain or tightness (1343,2619,6070,6078,111472,111474).

Dermatologic ...Local adverse effects of parenteral bee venom include erythema, swelling, numbness, pain, and tenderness at the injection site, itching, urticaria, and edema (1343,13222,102531). Bee stings have been associated with eosinophilic foreign body granuloma (111482), and bee venom acupuncture can cause dermatitis, contact urticaria, skin infection with Mycobacterium chelonae (11483), giant dermatofibroma, or chronic folliculitis (96576). A case report describes panniculitis associated with bee venom immunotherapy (96576).

Hematologic ...Bee venom therapy has been associated with coagulation abnormalities including intravascular hemolysis and thrombocytopenia (6046,96576,111474). Bee venom given with acupuncture can cause disseminated intravascular coagulation (6046,96576).

Hepatic ...Two case reports describe hepatotoxicity, including acute icteric hepatitis associated with bee venom acupuncture (96576). Another case report describes hepatitis B reactivation complicated by nephritic syndrome during bee venom immunotherapy (96576).

Immunologic ...Immune-mediated reactions associated with bee venom include rash, itching, generalized hypersensitivity reaction, anaphylaxis, serum sickness reaction, and immune thrombocytopenia 6077,95899,96576,11470). Estimates of the rate of immunologic reactions to various forms of bee venom range from 0.025% to 29% (96576,105770,11470,111475). They occur most frequently when doses are increased rapidly. Females and people with a c-KIT mutation may have more severe and frequent adverse effects (1343,6077,102533,11470). Doses of bee venom associated with adverse effects vary from 0.1 to 2 mL, and anaphylaxis has occurred after 1-24 doses (11470).
Bee venom is also associated with autoimmune disorders, including systemic lupus erythematosus, rheumatoid arthritis, Guillain-Barre syndrome, and pemphigus vulgaris (96574,111473). In a case report, a 68-year-old female developed Guillain-Barré syndrome with progressive quadriplegia ten days after receiving acupuncture with honeybee venom for pain (96573). In another case, a 64-year-old female developed pemphigus foliaceus, involving pruritic, erythematous, erosive skin lesions with crusting and plaques, after bee venom acupuncture twice weekly for 2 months. Immunoglobulin G was detected in the intercellular spaces between keratinocytes. Partial resolution occurred after 2 months of treatment with oral corticosteroids and azathioprine (111473).

Musculoskeletal ...Bee venom can cause rhabdomyolysis (111474). A 63-year-old female who received an accidental injection into the psoas muscle of 2 mL of normal saline containing bee venom diluted in a 1:2000 ratio, experienced severe burning pain at the injection site which persisted for 1 month, with imaging showing inflammation of the muscle. The pain gradually resolved over the following 5 months (11475).

Neurologic/CNS ...Bee venom can cause pain, headache, somnolence, and confusion (1343,2619,6070,6078,96576,111472). It has also been associated with a case of neuralgic amyotrophy (96576).

Pulmonary/Respiratory ...Bee venom has been associated with asthma, hyperventilation, respiratory distress, paralysis of respiratory muscles, and pulmonary or laryngeal edema (1343,2619,6070,6078,96576,111474).

Renal ...Bee venom immunotherapy has been associated with nephrotic syndrome, acute interstitial nephritis, and acute tubular necrosis (96576,111474). A case report describes a 50-year-old male with type 2 diabetes and normal renal function who developed acute kidney injury with combined features of interstitial nephritis and tubular necrosis after being stung by more than 1000 bees. He made a full recovery over several weeks with intermittent hemodialysis (111474).

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General ...Orally, beeswax is well tolerated. Allergic reactions to beeswax are possible in some patients (11).
Topically, beeswax may cause allergic contact dermatitis. In most cases, this reaction is likely caused by the propolis component of beeswax (55245,102517).

Dermatologic ...Topically, beeswax may cause allergic contact dermatitis. In most cases, this reaction is likely caused by the propolis component of beeswax (55245,102517). While this reaction is thought to be rare in the general population, one cross-sectional study found that 18% of patients with a history of cheilitis or facial dermatitis experienced positive reactions to beeswax. While most of these patients also had a positive reaction to a propolis patch test, some did not, suggesting that a substance in beeswax itself may be involved in this sensitization (102517).

Immunologic ...Orally, beeswax may cause allergic reactions (11). Topically, beeswax may cause allergic contact dermatitis. In most cases, this reaction is likely caused by the propolis component of beeswax (102517).

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General ...Orally, bryonia root can cause dizziness, vomiting, convulsions, colic, bloody diarrhea, abortion, nervous excitement, and kidney damage. Large doses of bryonia can cause anuria, collapse, paralysis, and death (2). Bryonia berries can be fatal when taken orally; 40 berries can be fatal in adults, and 15 berries can be fatal in children (18).
Topically, skin contact with fresh bryonia may cause irritation (19).

Dermatologic ...Topically, skin contact with fresh bryonia may cause irritation (19).

Gastrointestinal ...Orally, bryonia root can cause vomiting, colic, and bloody diarrhea (2).

Genitourinary ...Orally, bryonia root can cause abortion (2). Large doses of bryonia can cause anuria and death (2).

Musculoskeletal ...Orally, large doses of bryonia can cause paralysis and death (2).

Neurologic/CNS ...Orally, bryonia root can cause dizziness, convulsions, and nervous excitement (2). Large doses of bryonia can cause paralysis and death (2).

Renal ...Orally, bryonia root can cause kidney damage (2). Large doses of bryonia can cause anuria and death (2).

Other ...Orally, bryonia berries can be fatal. Consuming 40 berries can be fatal in adults and as few as 15 berries can be fatal in children (18).

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General ...Orally, the major concern with hemp agrimony preparations is the hepatotoxic pyrrolizidine alkaloid (PA) content. These constituents are hepatotoxic, pneumotoxic, carcinogenic, and mutagenic (12841,12842). Chronic exposure to other plants containing hepatotoxic PA constituents is associated with veno-occlusive disease (4021,12842). Dietary supplements sold in the US are not required to disclose the amount of PAs they contain (3484); therefore, all oral preparations containing hemp agrimony should be considered potentially unsafe.

Hepatic ...Orally, the major concern with hemp agrimony preparations is the hepatotoxic pyrrolizidine alkaloid (PA) content (12841,12842). Chronic exposure to other plants containing hepatotoxic PA constituents is associated with veno-occlusive disease (4021). Subacute veno-occlusive disease causes vague symptoms with persistent liver enlargement (4021). Symptoms of acute veno-occlusive disease include colicky epigastrium pain, vomiting and diarrhea, and ascites formation within several days. Enlargement and induration of the liver occurs within a few weeks (12842). Dietary supplements sold in the US are not required to disclose the amount of PAs they contain (3484); therefore, all oral preparations containing hemp agrimony should be considered potentially unsafe.

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