Kris Ulland

kris ulland

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Drug Interaction with Herbal Supplements, Part 2

Jan 22, 2020 | Gluten Free, Lifestyle, Nutrition, Vegan, Vegetarian

Drug Interaction with Herbal Supplements, Part 2
(Wrong post went out this morning. I am pulling it back. Here is the right blog that matches the email that went out earlier today!)
In general, it is best to avoid taking drugs at the same time that you take vitamins, herbal remedies or other supplements. When you are prescribed a new drug, read the package insert before you take the first dose or ask the pharmacist what you should know about the drug.
Echinacea is also known as the American Cone Flower, Black Susan, or Purple Coneflower. Echinacea has been used to stimulate the immune system, and is most commonly used in the treatment of the common cold. Most echinacea drug interactions are minor. Echinacea might slow the breakdown (metabolism) of caffeine in your body, and could lead to side effects like jitteriness, headache, or insomnia. Echinacea may also change how the body metabolizes many drugs that go through the liver. These are somewhat complicated interactions that can lead to side effects or reduced effectiveness of your medicine, so always check with your pharmacist.
Evening primrose is a flowering plant known by other names such as Oenothera biennis, scabish, or king’s cureall. Evening primrose oil provides fatty acids used by the body for growth. Evening primrose oil contains gammalinoleic acid that may slow blood clotting and increase the likelihood of bruising or bleeding. If you take drugs or herbs that may have blood thinner effects, check with your health care provider before using evening primrose oil. There can be a minor interaction with Cymbalta, gabapentin, and Zoloft if you regularly take evening primrose.
Valerian has been used to treat insomnia and anxiety. Germany’s Commission E, the authorities that evaluate the use of herbal products in Germany, has approved valerian as an effective mild sedative. There are over 500 possible drug interactions with valerian, so a drug interaction screen is important when using valerian.

Speak with your doctor before combining valerian with:

  • muscle relaxants
  • sleep or anxiety medicines
  • pain killers
  • antidepressants
  • other medicines that cause drowsiness. These drugs may increase drowsiness and dizziness while you are taking valerian.
St. John’s Wort is a popular herbal supplement widely used to help with symptoms of depression. Drug interactions with St. John’s Wort can be numerous and dangerous. Due to the seriousness of many drug interactions, you should consult with your health care provider before using St. John’s Wort. Do not combine St. John’s Wort with these medications:
  • selective serotonin reuptake inhibitors (SSRIs)
  • tricyclic antidepressants (TCAs)
  • monoamine oxidase (MAO) Inhibitors
  • nefazodone
  • triptans for migraine
  • dextromethorphan
  • warfarin
  • birth control pills
  • certain HIV medications

Use of saw palmetto is popular for benign prostatic hypertrophy (BPH), a noncancerous prostate gland enlargement. Evidence suggests that saw palmetto may be effective for mild-to-moderate BPH, but always ask your doctor for advice about this product. Saw palmetto should be avoided with other agents used to treat BPH, such as finasteride (Proscar), unless directed by your doctor. Saw palmetto may also slow blood clotting and may increase the risk for bruising or bleeding if used with certain blood thinners like warfarin. If saw palmetto is combined with estrogens or oral contraceptives, the effectiveness of the hormonal therapies could be reduced.

  • benzodiazepines sedatives and hypnotics
  • some antihistamines
  • opioid analgesics
  • muscle relaxers

Other herbs that can also lead to drowsiness include 5-HTP, kava, and St. John’s Wort. Melatonin may also increase blood sugar and interfere with diabetes medications. As with many herbal products, blood clotting may be affected with use of melatonin with anticoagulants.

Kava is native to the South Pacific and is a member of the pepper family. Kava has been used to improve sleep, decrease anxiety, and reduce nervousness, stress, and restlessness. There are hundreds of drug interactions with kava. Kava should not be used with alcohol or other drugs or herbs that can also cause liver toxicity. The use of buprenorphine (Buprenex, Butrans, Probuphine) with kava can lead to serious side effects such as respiratory distress or coma.

Ginseng is taken to improve the body’s resistance to stress and increase vitality, among other uses. There are many different origins of ginseng, and many types of drug interactions. Long-term use of American ginseng may decrease the effectiveness of the blood thinner, warfarin, and increase the risk for a clot. In general, ginseng should not be used with anticoagulants. Ironically, ginseng also has blood thinner effects itself, and may lead to bleeding. Ginseng may also affect blood pressure treatments and diabetic medications like insulin or oral hypoglycemics.

Feverfew is a member of the daisy family. Feverfew is often used as an herbal remedy to prevent migraine headaches and associated nausea and vomiting. Feverfew may increase the risk of bleeding, especially in people with blood-clotting disorders or people using blood thinners to help prevent clots, for example:
  • aspirin
  • warfarin
  • heparin
  • Plavix (clopidogrel)
  • Pradaxa (dabigitran)
  • Xarelto (rivaroxaban)
  • low molecular weight heparins like enoxaparin or dalteparin.

Ginkgo has been used for symptoms of Alzheimer’s dementia, Parkinson’s disease, and to aid in general memory support, among other uses. Ginkgo may decrease antiviral effects of drugs used in HIV, such as efavirenz or indinavir. Ginkgo can also alter the actions of medicines metabolized through the liver; the list is extensive but includes agents such as omeprazole (Prilosec OTC), fluvastatin (Lescol), and donepezil (Aricept). Avoid ginkgo in patients who take seizure medications, blood thinners or diabetes drugs.

Ginkgo interacts with over 250 drugs!

Goldenseal is a flowering herb that grows in the northeast United States. Common uses for goldenseal include skin infections, for cold and flu symptoms, and to treat diarrhea.There are over 60 possible drug interactions with goldenseal. Two of the more serious interactions occur with certain antipsychotic drugs. Using pimozide or thioridazine with goldenseal is not recommended, as antipsychotic blood levels may rise leading to an irregular heart rhythm. Goldenseal may affect liver enzymes that can alter blood levels of certain drugs.
Garlic is used to reduce cholesterol and triglycerides, to prevent cancer, to lower blood sugar levels, and to reduce menstrual pain, along with its delicious addition to everyday meals. Garlic has been reported to moderately affect blood clotting and blood sugar levels and may affect people who take blood thinning agents like aspirin, warfarin, or clopidogrel (Plavix). Use of garlic supplements with HIV protease inhibitors (PI) may decrease the PI blood levels.

Thyme

Thyme is an evergreen shrub that has been used in medicinal and culinary applications for thousands of years. Thyme is native to the Mediterranean region and certain parts of Africa, and its use dates back to the Egyptian empire.

Thymol is the most active ingredient found in thyme. This organic compound has a wide range of effects on the body, including its ability to prevent fungal and viral infections and reducing strain on the immune system. This is according to a 2007 report published in the Journal of Food Safety.

One of the most well-known and long-standing uses of thyme in traditional medicine is as a respiratory agent. If you are suffering from bronchitis, chronic asthma, congestion, colds, flu, blocked sinuses or seasonal allergies, thyme acts as an expectorant and an anti-inflammatory substance. It eliminates phlegm and mucus from the respiratory tracts, eases inflammation to help breath, and prevents microbial development that can lead to illness.

In fact, a study conducted in Spain showed that thyme extract oils have anti-inflammatory effects. That’s why brewing thyme into a powerful tea is one of the best ways to achieve relief from respiratory ailments.

With one of the highest antioxidant concentrations in any herb, thyme has been used for thousands of years as an overall health booster. The antioxidants found in thyme, including lutein, zeaxanthin, and thymonin, contribute to neutralizing and eliminating free radicals throughout the body, according to a Korea Food Research Institute study. Free radicals are the dangerous by-products of cellular metabolism that can do major damage to your healthy cells by causing cell death or spontaneous mutation. These antioxidants help prevent oxidative stress present in your organs, as well as your neural pathways, heart, eyes, and skin.

The high concentration of iron and other essential minerals in thyme make it ideal for stimulating the production of red blood cells, thereby boosting blood circulation and oxygenation to the essential organ systems of the body. According to the USDA National Nutrient Database, 100 grams of fresh thyme contains 17.45 mg, almost 20% of the recommended daily value of iron.

The rich blend of antioxidants, minerals, and vitamins in thyme have many small effects on the heart, but potassium and manganese are particularly important. Potassium is a vasodilator, meaning that it can reduce the stress on the cardiovascular system by relaxing blood vessels and lowering blood pressure.

A study in the UK found that laboratory rats whose diets were supplemented with thyme oil showed a stronger activity level and higher antioxidant levels during their lifespan. This can extend your life by preventing plaque build up in your arteries and avoiding strokes, heart attacks, and coronary heart diseases.

The concentration of carotenoids and vitamin A found in thyme make it an effective antioxidant agent for your vision health. Carotenoids can neutralize the free radicals in your ocular system and slow the onset of macular degeneration and prevent cataracts.

The high levels of vitamin C found in thyme makes it a natural immune system booster. Vitamin C stimulates the production of white blood cells, which are the first line of defense in the body’s immune system. Vitamin C also plays a crucial part in the production of collagen, which is essential for the creation and repair of cells, muscles, tissues, and blood vessels.

One of the vitamins in thyme (B6) has a powerful effect on certain neurotransmitters in the brain that are directly linked to stress hormones. Regular inclusion of thyme in your diet can help to boost your mood.

For those with a sensitive stomach, high intake of thyme can cause gastrointestinal distress. Having said that, this herb is not known as an allergenic substance and can be consumed regularly in your diet.

How to Buy

Fresh, dried, and powdered thyme are readily available year-round in most markets. If you are lucky enough to be able to grow your own, keep in mind that thyme leaves are sweetest if picked just as the flowers appear.

How to Store

Store fresh thyme wrapped in a tea towel or a breathable bag. I like Ambrosia Flax-Linen bags. Keep thyme in the vegetable crisper drawer of your refrigerator or stand sprigs in a glass of water on the refrigerator shelf.

If you can grow thyme, when it is time to harvest, hang bundles of sprigs upside-down in a warm, dry, airy location for about ten days. Dried thyme can be stored in a cool, dark place, in an airtight container for up to 6 months.

How to Cook

The stems and the leaves of thyme can be used in various dishes, either in whole or dried form. It is usually added to soups and sauces and is used as a flavorful garnish. The leaves can be removed from the stems and ground into a fine spice, or the entire sprig can be added to flavor a larger dish or stew. They can also be brewed into a tea and a decoction can be made with carrier oils or creams to apply topically to the body

When cooking with thyme, be aware that one fresh sprig equals the flavoring power of one-half teaspoon of dried thyme.

As with most leafy dried herbs, be sure to crush the leaves between your hands before adding them to your recipe.
It is preferable to strip the leaves from the stems for your recipes when using either dry or fresh thyme because sometimes the stems can be woody. Either that or throw the whole stem in while it is cooking and remove before serving.

To remove the leaves off the stem, place between the tines of a fork and pull the stem in the opposite direction of the leaf growth.

I also use a stem stripper from Chef’n for kale, chard, collard greens and herbs.

Mushroom Bourguignon

Mellisa Clark/ Image:David Malosh for The New York Times. Food Stylist: Simon Andrews.

4-6 Servings

Ingredients

  • 6 tablespoons vegan butter (Miyoko’s or Earth Balance) or extra-virgin olive oil, plus more as needed
  • 2 pounds mixed mushrooms, such as portobello, cremini, white button, shiitake or oyster, cut into 1-inch chunks (about 10 cups)
  • 8 ounces peeled pearl onions (2 cups), larger ones cut in half (can use frozen pearl onions or substitute with shallots)
  • Kosher salt and freshly ground black pepper
  • 1 large leek or 2 small leeks, white and light green parts, diced (1 1/2 cups)
  • 2 carrots, thinly sliced
  • 3 garlic cloves (2 minced, 1 grated to a paste)
  • 1 tablespoon tomato paste
  • 2 ½ tablespoons all-purpose gluten free flour
  • 1 ½ cups dry red wine (can substitute with red wine vinegar and vegetable broth – 3/4 a cup of each)
  • 1 ½ cups mushroom or vegetable broth
  • 1 tablespoon tamari, plus more to taste
  • 3 large fresh thyme branches or 1/2 teaspoon dried thyme
  • 1 bay leaf
  • 3 to 4 ounces chanterelle or oyster mushrooms, thinly sliced (about 1 cup)
  • Smoked paprika, for serving
  • Polenta, gluten-free noodles or mashed potatoes, for serving
  • Chopped flat-leaf parsley, for serving

Instructions

  1. Add 2 tablespoons vegan butter or oil to a large Dutch oven or pot and set it over medium heat. When the oil is hot, stir in half the mushrooms and half the pearl onions. (If it doesn’t all fit in the pot in one layer, you might have to do this in three batches, rather than two.) Without moving them around too much, cook the mushrooms until they are brown on one side, about 3 minutes. Stir and let them brown on the other side, 2 to 3 minutes more. Use a slotted spoon to transfer mushrooms and onions to a large bowl or plate and sprinkle with salt and pepper. Repeat with another 2 tablespoons butter and the remaining mushrooms and pearl onions, seasoning them as you go.
  2. Reduce heat to medium-low. Add another 1 tablespoon butter or oil to pan. Add leeks and carrot and sauté until the leeks turn lightly golden and start to soften, 5 minutes. Add the 2 minced garlic cloves and sauté for 1 minute longer. Stir in tomato paste and cook for 1 minute. Stir in flour and cook, stirring, for 1 minute, then add wine, broth, 1 tablespoon tamari, thyme and bay leaf, scraping up the brown bits at bottom of pot.
  3. Add reserved cooked mushrooms and pearl onions back to the pot and bring to a simmer. Partly cover the pot and simmer on low heat until carrots and onions are tender and sauce is thick, 30 to 40 minutes. Taste and add more salt and tamari if needed. Stir in the grated garlic clove.
  4. Just before serving, heat a small skillet over high heat and add 1/2 tablespoon butter or oil. Add half of the sliced chanterelles or oyster mushrooms and let cook without moving until they are crisp and brown on one side, 1 to 2 minutes. Flip and cook on the other side. Transfer to a plate and sprinkle with salt and smoked paprika. Repeat with remaining butter and mushrooms. Serve mushroom Bourguignon over polenta, gluten free noodles or mashed potatoes, topped with fried mushrooms and parsley.

Resources

https://www.organicfacts.net/health-benefits/herbs-and-spices/thyme.html
https://journals.lww.com/nutritiontodayonline/fulltext/2016/01000/Thyme__History,_Applications,_and_Overview_of.10.aspx
https://pdfs.semanticscholar.org/02cb/1a62c0714765ed5dee2ef2db16433b617c26.pdf
https://www.tandfonline.com/doi/abs/10.1080/10408398.2018.1477730
https://ro.uow.edu.au/cgi/viewcontent.cgi?article=2450&=&context=hbspapers&=&sei-redir=1&referer=https%253A%252F%252Fscholar.google.com%252Fscholar%253Fhl%253Den%2526as_sdt%253D0%25252C24%2526q%253Dhealth%252Bbenefits%252Bof%252Bthyme%2526btnG%253D#search=%22health%20benefits%20thyme%22
https://onlinelibrary.wiley.com/doi/abs/10.1002/ptr.6109
http://gethealthyct.org/dev/docs/march_05_spices.pdf
http://onlinelibrary.wiley.com/doi/10.1111/j.1745-4565.2007.00063.x/abstract
http://www.tandfonline.com/doi/abs/10.1080/J157v04n01_07
https://www.organicfacts.net/allergies.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345235/
https://www.sciencedirect.com/science/article/pii/S030881460400456X
https://www.organicfacts.net/home-remedies/11-ways-boost-metabolism.html
https://www.organicfacts.net/health-benefits/essential-oils/healthy-skin.html
https://link.springer.com/article/10.1023/A:1008195019618
https://www.sciencedirect.com/science/article/abs/pii/S0047637499000330
https://www.organicfacts.net/health-benefits/essential-oils/thyme-essential-oil.html
http://www.akademiai.com/doi/abs/10.1556/AAlim.2010.0015
https://www.organicfacts.net/home-remedies/home-remedies-cataracts.html
https://www.sciencedirect.com/science/article/pii/S0308814607006814
https://www.sciencedirect.com/science/article/pii/S0306987799909556
https://www.thespruceeats.com/thyme-selection-and-storage-1807818

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