698 Handbook of Medicinal Herbs HH2; PH2); Mutagenic (1; AMA; APA); Natriuretic (f; PH2); Nephrotoxic (1; AMA); Sweetener (f; APA); Vasodilator (1; AMA; APA) Indications (Stevia) — Bacteria (f; APA); Diabetes (1; APA; HHB); Hyperglycemia (1; AMA); Hypertony (f; HH2); High Blood Pressure (1; AMA; APA; HH2; PH2); Hyperglycemia (1; APA; PH2; SYN); Inflammation (1; HH2); Swelling (1; HH2); Syndrome X (1; SYN); Water Retention (1; AMA; APA; PH2) Dosages (Stevia) — 1–2 capsules StX (57 mg extract 85% steviosides) with beverage (NH) Contraindications, Interactions, and Side Effects (Stevia) — Class (AHP) No health hazards known with proper use as a sweetener (PH2) AMA (Alternative Medicine Alert) suggests that one byproduct of stevia metabolism may be mutagenic (APA); steviol, a metabolite of stevioside “has been found to be highly mutagenic in several in vitro studies” (AMA 3:13) Insufficient human data exist regarding safety in pregnancy and lactation Hence, “pregnant and lactating patients should avoid stevia” (AMA 3:13) Limited data suggest it may be a contraceptive (APA) Stevioside is “about one hundred times sweeter than sucrose at a 10% concentration” (APA) Liquid leaf extracts significantly decrease plasma glucose levels after overnight fasting in 16 healthy adults (APA) ST JOHN’S-WORT (Hypericum perforatum L.) ++ (Raised from CRC) S Activities (St John’s-Wort) — Analgesic (1; CAN; CRC; EFS); Anticancer (1; MAB); Antibacterial (1; FAD; MAB; PH2; VVG); Antidepressant (2; APA; BGB; CRC; PH2; SHT; WAM); Antidote (1; FNF; MAD); Antiedemic (1; CAN); Antiherpetic (1; MAB); Antiinflammatory (1; APA; FAD; PIP; PH2); Antineuralgic (f; BGB); Antiretroviral (1; APA; FAD); Antiseptic (1; HHB; PH2); Antispasmodic (f; HHB); Antiulcerogenic (1; CAN); Antiviral (2; APA; PH2; SKY; VVG); Anxiolytic (2; PH2; PNC); Aperitif (1; CAN); Astringent (f; CRC; EFS; PNC); COMT Inhibitor (f; MAB); Cholagogue (f; CRC; EFS); Digestive (f; CRC; EFS); Diuretic (f; BGB; DEP; EFS; VVG); Dopaminergic (1; MAB; PH2); Emmenagogue (f; DEM; Handbook of Medicinal Herbs 699 MAD); Expectorant (f; CRC; EFS); GABA-Reuptake Inhibitor (1; MAB); Hemostat (f; DEM; MAD); Hypotensive (1; CAN); Immunostimulant (1; CAN); MAOI (1; KOM; PHR; PH2); Melatoninergic (1; PH2); Nervine (1; EFS; MAB; WAM); Psychotropic (1; CAN); Resolvent (f; CRC); Sedative (1; CAN; FAD; MAD; PH2); Serotoninergic (1; MAB; PH2); SSRI (1; MAB; PHR; PH2); Stimulant (f; CRC); Tonic (1; CAN; CRC; WAM); Tranquilizer (1; CAN; CRC; PNC); Uterotonic (f; EFS); Vasoconstrictor (1; CAN); Vermifuge (f; CEB; CRC; DEP; EFS); Vulnerary (1; APA; MAB; WAM) Indications (St John’s-Wort) — Adenopathy (f; CRC; JLH); Alcoholism (1; MAB); Alopecia (f; CRC); Anorexia (1; CAN); Anuria (f; CRC); Anxiety (2; APA; KOM; PH2; PNC); Apoplexy (f; MAD); Asthma (f; CRC; PH2); Bacteria (1; CRC; FAD; MAB; PH2; VVG); Bite (f; CRC); Bladder Stone (f; CEB); Bleeding (f; CRC; DEM; MAD); Bronchosis (f; CRC; PH2); Bruise (2; APA; BGB; FAD; MAB); Bunion (f; CRC); Burn (2; APA; KOM; MAD; PH2; SHT); Calcification (f; PH2); Cancer (1; CRC; MAB); Cancer, breast (f; JLH); Cancer, lymph (f; JLH); Cancer, ovary (f; JLH); Cancer, stomach (f; JLH); Cancer, uterus (f; JLH); Cardiopathy (f; MAD); Catarrh (f; CRC); Cerebrosis (f; CRC; PH2); Chickenpox (1; MAB); Childbirth (f; CRC); Cholecystosis (f; APA; FAD; PH2); Climacteric (f; MAD); Cold (f; APA; PNC); Cold Sore (1; MAB); Concussion (f; CRC); Congestion (1; APA); Crohn’s Disease (f; CRC); Cough (f; APA; DEM; PNC); Coxalgia (f; CRC; MAD); Cramp (f; APA; HHB; MAD); Cut (f; FAD); Cyanosis (f; MAD); Cystosis (f; CRC); Cytomegalovirus (1; MAB); Depression (2; APA; BGB; CRC; FAD; KOM; PH2; SHT; WAM); Dermatosis (2; APA; PHR; PH2); Diarrhea (f; APA; FAD; MAB; PH2); Duodenosis (f; MAD); Dysentery (f; CRC; FAD; MAB); Dysmenorrhea (f; APA CRC; MAD; PNC); Dyspepsia (2; APA; KOM; PHR; PH2); Dysuria (f; CEB; CRC); Eczema (1; PH2); Endometriosis (f; MAD); Enterosis (f; DEM); Enuresis (f; CRC; MAB; PH2); Epilepsy (f; MAD); Epistaxis (f; DEM); Fever (f; DEM); Fibrososis (f; CAN); Flu (1; CAN); Gas (f; MAD); Gastroduodenosis (1; CAN); Gastrosis (1; CAN; CRC; PH2); Gout (f; MAD; PH2; VVG); Headache (f; CRC; MAD); Hematuria (f; CEB); Hemoptysis (f; CRC; MAD); Hemorrhagia (1; CRC; MAB); Hemorrhoid (1; APA; CRC; HHB; MAD); Hepatosis (1; CAN; MAB; MAD; MAN); Herpes (1; MAB); High Blood Pressure (1; CAN); HIV (1; CAN; JAD); Hydrophobia (f; CRC); Hysteria (f; BGB; CRC; MAB); Immunodepression (1; CAN); Impotence (f; CRC); Induration (f; CRC; JLH); Infection (1; APA; CAN; MAB); Inflammation (1; APA; CRC; FAD; PIP; PH2); Insomnia (1; CAN; CRC; FAD; FNF; MAD; PH2); Jaundice (f; CRC; MAB; MAD); Lumbago (f; MAD); Lymphosis (f; JLH); Mania (1; FNF; MAD); Mastosis (f; CRC; JLH; MAD); Melancholy (1; FNF; MAD); Menopause (1; CAN; MAB); Menorrhagia (f; MAB); Migraine (f; MAD); Myalgia (2; KOM; PHR; PH2; SHT); Neck (f; CRC); Nephrosis (f; APA); Nerve (f; CRC); Nervousness (1; APA; CAN; CRC; FAD; MAD; PH2; PNC); Neuralgia (1; BGB; CAN; MAB); Neurasthenia (f; CRC); Neurofibromatosis (f; MAD); Neurosis (1; BGB; CAN; PH2); Noctambulism (f; MAD); OCD (1; WAF); Oliguria (f; CRC); Otosis (1; SKY); Oxyurid (f; HHB); Pain (1; CAN; CRC; EFS); Paralysis (f; CRC); Parasite (f; MAB); Pertussis (f; CRC); Phthisis (f; CRC); Pulmonosis (f; APA; CEB); Rabies (f; CRC); Radiation (f; AIL); Rheumatism (1; MAB; PH2; PNC); SAD (2; MAB); Sciatica (1; CAN; CRC; MAB); Shingles (1; MAB); Snakebite (f; DEM); Sore (f; CRC; DEM; FAD); Sore Throat (f; CEB); Spine (f; CRC); Sprain (1; BGB; WAM); Staphylococcus (1; PH2); Sterility (f; DEM); Stimulant (f; EFS); Stomatosis (f; CEB); Strain (1; WAM); Streptococcus (1; PH2); Stress (1; CAN); Sunburn (1; AIL); Swelling (1; CAN; CEB; MAB; MAD); Tetanus (f; CRC); Tonsilosis (f; PH2); Tuberculosis (f; CRC); Ulcer (1; CAN; CRC; MAB; MAD); Ulcus cruris (f; MAD); Uterosis (f; JLH; MAD); VD (f; DEM); Viral Hepatitis (1; MAB); Virus (2; APA; PH2; SKY; VVG); Vitiligo (1; CRC; SKY); Water Retention (f; BGB; DEP; EFS; MAD; VVG); Worm (f; CEB; CRC; DEP; EFS; FAD); Wound (2; APA; KOM; PH2; WAM) Dosages (St John’s-Wort) — 2–4 g dry herb (0.2–1 mg hypericin)/day (JAD); 2–5 g dry herb/day (MAB); 2–4 ml liquid herb extract (PNC); 2–4 g dry shoot, or in tea, ×/day (CAN); 1–2 tsp (2–4 S 700 Handbook of Medicinal Herbs g flowers)/cup water 1–2 ×/day for 4–6 wk (APA); 2–4 ml liquid flowering tops extract (1:1 in 25% ethanol) ×/day (CAN); 2–4 ml flowering tops tincture (1:10 in 45% ethanol) ×/day (CAN); 1–2 ml flowering tops tincture ×/day (SKY); 1–2.7 mg/day hypericum (MAB); 0.2–1.0 mg total hypericin (PIP); 500 mg StX (0.2% hypericin) (SKY); (430 mg) capsule (StX with 300 mg certified potency extract with at least 0.3% hypericin in a synergistic base of St John’s-Wort powder) ×/day with a large glass of water (NH) S Contraindications, Interactions, and Side Effects (St John’s-Wort) — Class 2d May potentiate MAOIs (AHP) Active ingredients may be photoactive, especially in fair-skinned people Reichert takes it even more seriously: Although hypericum is not as strong as synthetic MAOIs, patients should still avoid the things usually avoided: high tyramine foods (smoked or pickled), alcoholic beverages, amphetamines, cold and hay fever remedies, narcotics, tryptophan, and tyrosine (I no longer believe this caveat is desirable) Do not take during pregnancy or intense sun exposure (Reichert, 1994; WAM) Commission E reports adverse effect of photosensitivity Other sources report flowering top permitted for external use only; not to be used before exposure to sunlight (AEH) Foster (1996) is moderate, suggesting that St John’s-Wort should not be mixed with synthetic antidepressants Because it may inhibit MAO, taking it with SSRIs, such as Prozac, could cause serious health damage Although side effects have not been reported in clinical studies, range animals eating the plant and then standing in bright sunlight have experienced sunburn or blindness from photosensitization This treatment option should be discussed with your health care provider (Foster, 1996) The Herbal PDR state that photodermatosis in animals usually kicks in after high doses, such as 3000 mg per kg body weight (PHR) CAN cautions that hypericin is phototoxic “Mice given 0.2–0.5 mg of the herb were found to develop severe photodynamic effects Delayed hypersensitivity or photodermatosis has been documented for St John’s-wort, following the ingestion of a herbal tea made from the leaves” (CAN) ESCOP recommends a limited daily intake of mg total hypericin (QRNM, 1997:292) Because of slight uterine activity in vitro, its use in pregnancy and lactation is to be avoided (CAN) No contraindications or drug-drug interactions reported (PIP) A recent Internet message cautions about the potential for serotonin syndrome Symptoms include chills, confusion, fever, myoclonus, hyperactive reflexes, myoclonus, speech difficulties, and sweating Cannot be mixed with an SSRI That is likely to produce serotonin syndrome—severe headache, tachycardia, and diaphoresis—which resembles neuroleptic malignant syndrome (O’Brien, 1998) Recently found to detoxify all the same drugs that grapefruit potentiates It induces cytochrome P3A4 450, which speeds up metabolism of several drugs Nierenberg et al., 1999 kindly remind us that, like synthetic antidepressants, this herbal antidepressant may rarely induce hypomania in manic patients Poorly designed Loma Linda studies (Ondrizek) suggest that hypericum may interfere with fertility But this was based on soaking “skinned human sperm” for 24 hours in hypericum tea as I recall Extracts (St John’s-Wort) — A StX (600 mg wit, 0.24–0.32% hypericin ×/day) produced erythema in light-sensitive patients (AHP) Leaf extracts enhance mouse immune system against Bordetella pertussis and Staphylococcus aureus Novoimanine is most effective against S aureus, with water soluble imanine being more effective than imamine or sulphanilamide Herb extracts are reportedly more active against Escherichia, Shigella, and Staphylococcus than decoctions Catechin and flavonoid containing fractions inhibit the flu virus 83–100% (CAN) Amentoflavone is antiinflammatory and antiulcerogenic (CAN) Total flavonoid fraction is analgesic in mice (CAN) Small amounts of hypericin are tonic and tranquilizing in humans (CAN) Extracts inhibit catechol-o-methyl-transferase at 100 µM, modulate interleukin-6, block corticotropin-releasing hormone, reduce the availability of serotonin receptors (IC50 = 6.2 µg/ml) and the associated inhibition of resorption of serotonin into the cell, and block MAOA and B in vitro and ex vivo, and hypericin raises levels of melatonin, all factors that may contribute to antidepressant activity No statistical evidence was shown in the antiinflammatory activity of the extract and hydrocortisone (QRNM, 1997:292) With rats the IC50 was only 6.2 Handbook of Medicinal Herbs 701 µg/ml for inhibiting synaptosomal serotonin uptake (consistent with doses of 900 mg extract in humans) LD50 = >5000 mg/kg Phototoxic reactions occur in some patients with AIDS given ivn injections of 30–40 mg hypericin “Not suitable for use as daily sedatives of sleep aids Preparations are no more effective than synthetic antidepressants,” but they are extremely well tolerated by the patients In observational studies or >3000 cases, there is ca a 3% incidence of minor side effects, cf 10–25% with modern nontricyclic antidepressants (SHT) In Germany, the costs are about equal (tricyclics = 0.75 a day, hypericum 0.80 a day, cf $2.25 for nontricyclic antidepressants (SHT) STONECROP (Sedum acre L.) ++ Activities (Stonecrop) — Abortifacient (f; HHB); Diuretic (f; MAD); Emetic (f; HHB); Emmenagogue (f; MAD); Hypotensive (1; HHB); Laxative (f; HHB) Indications (Stonecrop) — Adenopathy (f; JLH); Atherosclerosis (f; HHB; MAD); Bleeding (f; HHB); Bright’s Disease (f; MAD); Bronchosis (f; MAD); Burn (f; HHB; PH2); Cancer (f; MAD); Cancer, breast (f; JLH); Cancer, lymph (f; JLH); Cancer, nose (f; JLH); Cancer, skin (f; MAD); Carcinoma (f; JLH); Cardiopathy (f; MAD); Catarrh (f; MAD); Condyloma (f; JLH); Constipation (f; HHB) Corn (f; JLH); Cough (f; PH2); Dermatosis (f; FEL; MAD); Diphtheria (f; HHB; MAD); Dropsy (f; MAD); Dysentery (f; HHB; MAD); Eczema (f; PH2); Edema (f; MAD; PH2); Epilepsy (f; FEL; HHB; MAD); Fever (f; FEL; HH2); Hemorrhoid (f; HHB; MAD); High Blood Pressure (1; HHB; MAD); Hypertony (f; HHB; MAD); Jaundice (f; MAD); Lymphoma (f; JLH); Malaria (f; FEL; HHB); Mastosis (f; JLH); Nephrosis (f; MAD); Pain (f; MAD); Pharyngosis (f; MAD); Proctosis (f; MAD); Prolapse (f; MAD); Rhinosis (f; JLH); Scrofula (f; FEL); Sore (f; HHB; MAD); Sore Throat (f; HHB); Stomatosis (f; HH2; PH2); Swelling (f; MAD); Wart (f; MAD; PH2); Water Retention (f; MAD); Whitlow (f; JLH); Wound (1; MAD; PH2) Dosages (Stonecrop) — g powdered herb/day (MAD); g/day (PH2); tsp/cup water (PH2) Contraindications, Interactions, and Side Effects (Stonecrop) — Not covered (AHP) “Hazards and/or side effects not known for proper therapeutic dosages” (PH2) Not to be used in cases of GI or urinary inflammation (PH2) LD50 of alkaloid mix 50 mg/kg ipr mus (HH2) STONEROOT (Collinsonia canadensis L.) ++ Activities (Stoneroot) — Antilithic (f; PH2); Antioxidant (f; FAD); Antispasmodic (f; APA; HHB); Astringent (1; APA; HHB); Carminative (1; HHB); Deodorant (f; DEM); Depurative (f; DEM); Diaphoretic (f; APA; CAN); Diuretic (1; FAD; PHR; PH2); Emetic (1; APA; DEM; FAD); Litholytic (f; CAN); Panacea (f; DEM); Sedative (f; APA); Stimulant (f; DEM); Stomachic (1; PHR; PH2); Tonic (1; APA; PHR; PH2) Indications (Stoneroot) — Backache (f; DEM); Bladder Stone (f; APA); Bleeding (f; DEM); Boil (f; DEM); BPH (f; AKT); Bruise (f; FAD; HHB); Burn (f; FAD); Calculus (f; PHR; PH2); Cancer (f; JLH); Cancer, tongue (f; JLH); Cardiopathy (f; DEM); Colic (f; DEM); Colitis (f; AKT); Constipation (f; PH2); Cramp (f; APA; HHB); CVI (f; AKT); Cystosis (1; FAD; HHB; PH2); Debility (f; DEM); Diarrhea (f; FAD; PH2); Dropsy (f; FAD; PHR); Dysentery (f; FAD); Dyspepsia (f; FAD); Enterosis (1; PHR; PH2); Fever (f; APA; CAN); Gas (1; HHB); Gastrosis (1; AKT; PHR; PH2); Glossosis (f; JLH); Headache (f; DEM); Hematochezia (f; DEM); Hemorrhoid (f; AKT; APA; FAD; PH2); Inflammation (f; AKT; PH2); Insomnia (f; APA); Kidney Stone (f; APA); Laryngosis (f; AKT; FAD); Leg Ache (f; DEM); Listlessness (f; DEM); Lithuria (f; PH2); Mastosis (f; DEM); Nephrosis (f; CAN; FAD); Nervousness (f; APA); Pulmonosis (f; AKT); Rheumatism S 702 Handbook of Medicinal Herbs (f; DEM); Sore (f; APA; FAD); Sore Throat (f; AKT); Sprain (f; FAD); Stomatosis (f; AKT); Stone (f; CAN); Swelling (f; DEM); Telangiectasia (f; AKT); Varicosis (f; AKT); Water Retention (1; FAD; HHB; PHR; PH2); Wound (f; APA; FAD; HHB) Dosages (Stoneroot) — 1–4 g dry root, or in tea, ×/day (CAN); 1–4 ml liquid root extract (PNC); 1–4 ml liquid root extract (1:1 in 25% ethanol) ×/day (CAN); 30–40 drops 1:2 tincture (fresh whole root) 3–5 ×/day (AKT); 2–8 ml root tincture (1:5 in 40% ethanol) ×/day (CAN); 2–8 ml root tincture (PNC) Contraindications, Interactions, and Side Effects (Stoneroot) — Class (AHP) None listed (PH2) In view of the lack of pharmacological and toxicological data, excessive use, especially during lactation and pregnancy, should be avoided (CAN) Overdose can cause colic, nausea, and pain, irritating the mucus lining of the GI tract, sometimes dizziness and strangury (APA) STORAX (Liquidambar orientalis Mill.) ++ Many responsible authors (e.g., HHB & LAF), when covering species of Liquidambar, e.g., aggregate American Storax and Oriental Storax Distinguishing liquidambar and storax resins seems rather difficult too Hence, I believe that reporting separately would be rather artificial Few people alive can guarantee the taxonomic source of the resin itself And I suspect there are few, if any, chemical analyses based on vouchered specimens, and many more based on aggregates of miscellaneous resins Activities (Storax) — Antidote (f; DAA); Antiinflammatory (1; PH2); Antiseptic (1; DEP; LAF; SKJ); Astringent (f; DEP); Diaphoretic (1; PH2); Expectorant (1; DEP; EFS; FEL; LAF; SKJ); Parasiticide (f; DAA); Pectoral (f; DEP); Scabicide (f; EFS); Stimulant (f; EFS; PH2; SKJ); Suppurative (f; DEP); Tonic (f; DEP); Vulnerary (f; EFS) S Indications (Storax) — Asthma (f; FEL); Bronchosis (f; FEL; PH2); Burn (f; JLH); Cancer (f; DAA; JLH; LAF); Cancer, liver (f; JLH); Cancer, spleen (f; JLH); Cancer, uterus (f; JLH); Catarrh (f; FEL); Cold (f; DAA); Convulsion (f; DAA); Cough (f; FEL; PH2); Dermatosis (f; DEP; HHB; PH2); Epilepsy (f; DAA; PH2); Fever (1; PH2); Frostbite (f; DAA); Gastrosis (; JLH); Gleet (f; FEL); Gonorrhea (f; FEL); Hepatosis (f; JLH); Induration (f; JLH); Inflammation (1; PH2); Itch (f; PH2); Lactose Intolerance (f; PH2); Leprosy (f; PH2); Leukorrhea (f; FEL); Malaria (f; DAA); Mycosis (f; FEL); Orchosis (f; DEP); Parasite (f; DAA); Phthiriasis (f; DEP); Phymata (f; JLH); Polyp (f; JLH); Pulmonosis (f; FEL); Ringworm (f; FEL); Scabies (f; DEP; EFS; FEL; HHB); Sclerosis (f; JLH); Sore (f; FEL; PH2); Sore Throat (f; DEP); Splenosis (f; JLH); Swelling (f; DEP); Syncope (f; PH2); Tinea (f; FEL); Uterosis (f; JLH); VD (f; FEL); Wound (f; DAA; PH2) Dosages (Storax) — 10–20 grains resin (FEL) Contraindications, Interactions, and Side Effects (Storax) — Not covered (AHP) “Health hazards not known with proper therapeutic dosages” (PH2) Ingestion may lead to diarrhea Possibly allergenic (PH2) Broad topical application may lead to transdermal absorption followed by kidney damage (albuminuria or hemorrhagic nephritis) (PH2) STRAWBERRY (Fragaria vesca L.) +++ Synonym: Fragaria insularis Rydb Activities (Strawberry) — Alterative (f; DAD; EFS); Antinitrosaminic (1; JNU); Antioxidant (1; JNU); Antipyretic (f; DAD); Antiseptic (f; DEM); Antitumor (f; JNU); Aphrodisiac (f; JNU); Astringent (1; CEB; EFS; PH2); Catabolic (f; KOM); Depurative (f; CEB; DAD; EFS); Discutient (f; DAD; EFS); Diuretic (f; CEB; EFS; PH2); Laxative (f; EFS); Nervine (f; EFS); Tonic (f; KOM) ... activity of the extract and hydrocortisone (QRNM, 1997:292) With rats the IC50 was only 6.2 Handbook of Medicinal Herbs 701 µg/ml for inhibiting synaptosomal serotonin uptake (consistent with doses of. .. liquid herb extract (PNC); 2–4 g dry shoot, or in tea, ×/day (CAN); 1–2 tsp (2–4 S 700 Handbook of Medicinal Herbs g flowers)/cup water 1–2 ×/day for 4–6 wk (APA); 2–4 ml liquid flowering tops extract... availability of serotonin receptors (IC50 = 6.2 µg/ml) and the associated inhibition of resorption of serotonin into the cell, and block MAOA and B in vitro and ex vivo, and hypericin raises levels of