MediHerb Product Catalogue 2015 by Integria Healthcare

Product Catalogue 2015 Quality is Our Passion

MediHerb速 Product Catalogue 2015

www.mediherb.com.au

Freeway Office Park, 2728 Logan Road PO Box 4854, Eight Mile Plains, QLD 4113, AUSTRALIA Practitioner Customer Service: 1300 654 336 Practitioner Fax Orders: 1300 654 844 Email: orders@integria.com Online Ordering: www.myintegria.com

Exclusive New Zealand Distributor for MediHerb

www.proherb.co.nz Unit 2/3 Dalziel Place PO Box 19796, Woolston, Christchurch 8241, NEW ZEALAND Toll Free Phone: 0800 553 556 Fax: 03 381 2256 Email: sales@proherb.co.nz

Established by Practitioners for Practitioners

A Pioneering Vision of Herbal Therapy “MediHerb was born out of my desire

We are passionate about partnering with you to give your patients health solutions that work Unique quality manufacturing, means consistent clinical outcomes Highest quality products, formulated by Kerry Bone to get the best results for your patients World class education from leading clinicians to keep you informed

for efficacious herbal therapy. This

Thorough and balanced research information that is relevant to your clinical practice

remains the driving force behind

Clinical support advice from experienced, practicing clinicians

every aspect of the company from raw material sourcing, manufacturing, quality assurance and research through

How to Order MediHerb Products

to our world class education programs. I am proud and grateful to be associated with a company that provides such unparalleled support for the profession. I believe that by

Australia

New Zealand

recommending MediHerb you are not only giving the best possible products to your patients, you are also investing in

delivering health and wellbeing

the future of natural medicine.”

Professor Kerry Bone MediHerb Co-Founder and Director of Research and Development

Exclusive New Zealand Distributor for MediHerb®

Telephone Orders: 1300 654 336 Fax Orders: 1300 654 844 Clinical Support: 1300 211 171 Email Orders: orders@integria.com Online Orders: www.myintegria.com Mail Orders: Integria Healthcare PO Box 4854, Eight Mile Plains QLD 4113 Australia

Telephone Orders: Toll Free 0800 553 556 Fax Orders: 03 381 2256 Email Orders: sales@proherb.co.nz Mail Orders: ProHerb Ltd PO Box 19796, Woolston Christchurch 8241 New Zealand

Practitioner Details (Please record your personal details here for easy reference)

Integria Account Name and Number:_________________________________________________________________________________________________________________________________________________________

MyIntegria Website Password:___________________________________________________________________________________________________________________________________________________________________

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(Please note the password is case sensitive)

Disclaimer: This product catalogue details products for practitioner dispensing only. Distribution is limited to those persons defined in Section 2.1 of the Therapeutic Goods Advertising Code. Copyright: Copyright in the information available in this product catalogue is owned by MediHerb © 2015 MediHerb. All rights reserved.

www.mediherb.com.au

Table of Contents Product Information

GlucoBalance tablets

Activated Beet-Greens powder .................25

Golden Seal tablets .....................................48

St John’s Wort tablets

Active Mag-Cal tablets ...............................26

Gymnema tablets .......................................49

ThyAdren Support tablets

Adrenal Complex tablets ............................26

.............................48

Slippery Elm 400mg capsules ...................67 .....................68

.......................................69

Hawthorn tablets ........................................49

ThyroCo tablets

Albizia Complex tablets ..............................27

Herbal Throat Spray ....................................50

Tissue Regenex tablets

.............27

Andrographis Complex tablets

.............................67

.........................69 .............................70

HiPep tablets ................................................50

Tribulus Forte tablets

Astragalus Complex tablets .......................28

Horsechestnut Complex tablets

...........51

Ubiquinol Forte capsules ............................70

Bacopa Complex tablets ............................28

Joint Defence tablets

.............................51

Valerian Complex tablets.............................71

............................................52

Vital Woman tablets ...................................72

........................29

Bacto-Cand GI capsules

Bilberry tablets ............................................29 ...................30

Boswellia Complex tablets

Broncafect tablets and Phytosynergist® liquid ................................31 ®

Calcium Bone Complex powder . ..............32 Cascara Complex tablets ............................32 Cat’s Claw Forte tablets ..............................33 Chaste Tree tablets

................................33

Clivers Complex tablets ..............................34 Coleus Forte tablets ....................................35 Cramplex tablets .........................................35 Cranberry Complex tablets ........................36 .........................36

Curcuma Active tablets

DiGest tablets ..............................................37 Echinacea Premium tablets

..................38

EFA Essentials capsules . .............................41 EndoFem tablets .........................................41 Evening Primrose Oil capsules ..................41 Everyday B Multi tablets

.......................42

Everyday Balance Protein powder ............43 Eyebright Complex tablets .........................44 Fe-Max Iron Tonic Phytosynergist® liquid ................................44

Kava tablets

LivCo tablets ...............................................52

Vitanox® tablets

Livton® Complex tablets

Wild Yam Complex tablets

.......................53

...................73

LymphoLytix tablets ....................................53

Withania & Ginseng tablets .......................74

Mega Mag powder

Withania Complex tablets

................................54

Methyl Factors tablets ................................55 Mexican Valerian tablets ............................55 Nervagesic tablets ......................................55 NeuroSom tablets

..................................56

Nevaton® tablets .........................................56 Omega-3 Forte capsules P2-Detox powder

.......................57

...................................58

Phellodendron Forte tablets ......................58 PhytoRegenex tablets ................................59 Poly-C powder

........................................60

PolyFem tablets ...........................................60 Probiotica capsules .....................................61 ProstaCo capsules ........................................61

. ...................75

Wormwood Complex tablets .....................76 Zinc Protect tablets .....................................77 Single Herbal Liquid Extracts .................78 Topical Products ........................................83

Indexes Botanical Herb Name Index ....................107 Common Herb Name Index ....................105 Excipient Glossary .......................................88 Ingredient Index ..........................................91

Resources

PulmaCo tablets ..........................................62

Text Books......................................................89

Rehmannia Complex tablets

................62

Herb/Drug Interaction Chart . ..................109

ResCo® tablets & Phytosynergist® liquid . 63

How to Order & Account Information .......Inside Back Cover

Rhodiola & Ginseng tablets

..................64

Rhodiola & Schisandra tablets ...................64

Fe-Plex tablets .............................................45

Saligesic tablets............................................65

FibroFem tablets ..........................................45

Sheep Sorrel Combination tablets ............65

Garlic Forte tablets

.................................46

Siberian Ginseng tablets ............................66

Ginkgo Forte tablets

..............................47

Products with this logo are part of the

.....................................73

Silymarin tablets

MediHerb Philosophy ................................... 2 MediHerb Practitioner Resources ..............84

....................................66

range

www.mediherb.com.au

MediHerb Philosophy Co-founded in 1986 by Professor Kerry Bone, MediHerb is the

to see patients in their own clinics every week so they are

first choice for health care professionals in herbal products in

in touch with current health issues. This means that we

Australia, New Zealand, USA, Canada, South Africa and the

know from our own hands-on experience how the MediHerb

United Kingdom.

products work and can provide health care professionals

A key part of MediHerb’s success is that it has over 20

and their patients with guidance and education. MediHerb’s

herbalists and naturopaths in various areas of the organisation.

mission is to provide high quality treatment solutions to health

These health care professionals, including Kerry Bone, continue

care professionals.

products also contain therapeutic dosages of MediHerb premium quality herbal ingredients. MediHerb nutritional products deliver nutrients and quality herbs providing optimal results.

Redefining Quality

Total Commitment to Quality In the words of MediHerb’s co-founder, Professor Kerry Bone: “Our passion at MediHerb is to provide the optimum treatment solutions by combining the time-honoured wisdom of traditional knowledge with sound clinical experience and the rigour of scientific research. This quest can only be attained by the total commitment to quality and continuous improvement, which permeates every aspect of our endeavours”. All MediHerb nutritional products are subject to rigorous testing, ensuring a high quality product. Several of the

Product Catalogue

MediHerb’s commitment to quality is evidenced in every aspect of our business, from the rigorous sourcing and testing of raw materials and the in-depth research and development of herb active constituents and therapeutic applications, to the development of manufacturing and extraction processes that have revolutionised the herbal products industry. For over 25 years, MediHerb has not only demonstrated an unwavering commitment to quality in herbal products, we have redefined it. We believe that our unique approach to quality sets a standard for herbal products that is unsurpassed in the world today.

Quality Issues with Herbs Working with herbs to consistently manufacture high quality products is not easy as plants are naturally complex and the quality of a finished product can vary enormously, presenting MediHerb with continual challenges. These challenges are numerous, and include the inherent biological and chemical variability of herbs, the influences on quality of growing, harvesting, drying and storage, extraction of the herb, stability and the ultimate problem of defining quality in a meaningful way. Not all herbs contain the same levels of active constituents. Not all herbs are grown or harvested or dried or stored in the same way. Not all herb growers’, suppliers’, or manufacturers’ standards are the same and not all methods to determine quality are the same.

Sourcing of Herbs MediHerb is the largest purchaser and processing plant of herbs in Australia and since the beginning we have actively

supported Australian and New Zealand herb growers. Our priority is to source herbs from local growers as much as possible and assist with technical support on how best to grow herbs. This support includes information on:

1. Where the threatened status of a herb is specific to a region or country, MediHerb does not acquire the herb from that region or country, eg Bearberry in parts of South-East Europe

Varietal selection Climatic and soil requirements Time of harvest Harvesting techniques Drying parameters

2. MediHerb uses cultivated herb sources of threatened herbs, where available, eg our Golden Seal is always from a cultivated source

Storage requirements post-drying Providing feedback to growers on herb quality By working with herb growers in this way, we have been able to increase the level of knowledge and awareness of issues affecting herb quality. (A comprehensive Herb Grower’s Information Kit is available in Australia from Practitioner Customer Service, call 1300 654 336 or in New Zealand from ProHerb Customer Service, call Toll-Free 0800 553 556.) Wherever possible we aim to source organically grown and wildcrafted herbs, and also work with growers to help cultivate endangered species, for example Golden Seal. We are very fortunate in Australia and New Zealand to have healthy soils and a wonderful climate for herb growing, as a result MediHerb source products from local growers where ever possible. We continue to work with local growers to ensure this proportion is increased in coming years. We also source herbs from overseas where the climatic conditions and specific handling requirements are the optimum, for example Devil’s Claw from the Kalahari Desert and Cat’s Claw from Peru. It is particularly important for these

indigenous communities who depend on the income of the herb crops for their wellbeing that they understand the quality issues and how best to grow or sustainably harvest the herb. Together we can ensure that they will sell their crops and provide income for their community.

Our Policy on Endangered and Threatened Medicinal Plants MediHerb takes steps to avoid medicinal plants becoming classified as endangered species and has developed a system of identifying and classifying the ‘threat’ to particular herbs. ‘Threatened’ is not an official classification, it is determined by MediHerb based on information received from independent, reliable sources such as CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora), TRAFFIC (Wildlife Trade Monitoring Network) and United Plant Savers. When a wildcrafted herb is classified as ‘threatened’ by MediHerb, steps are taken immediately to find alternatives to overcome or reduce the threat.

“ We work with herb growers to improve knowledge and awareness of issues affecting herb quality”

MediHerb Philosophy

Listed below are guidelines MediHerb has developed to reduce the threat of extinction of medicinal plants:

3. Where no cultivated source is available, MediHerb seeks to establish cultivation in conjunction with herb growers, eg Black Cohosh, False Unicorn Root 4. If 2 and 3 are not options, MediHerb then investigates the wildcrafting techniques and protocols to ensure they are conducted sustainably and ethically, eg Devil’s Claw 5. In certain cases, substitution of the threatened herb with a medicinally interchangeable species will be possible. This option requires technical and Research and Development involvement, eg Arnica 6. MediHerb actively promotes using alternate herbs in place of endangered herbs by educating health professionals, eg using Shatavari and Wild Yam rather than False Unicorn (see MediHerb Professional Review No 77, at www.mediherb.com.au) 7. Where a threatened or endangered herb is part of a tablet or liquid formulation, MediHerb will reformulate the product to include a different herb 8. When a herb is listed in CITES Appendix II and a cultivated source is not available, MediHerb ceases to use that herb and deletes the product from the range, eg Pygeum

For further information on endangered medicinal plants visit: www.cites.org www.traffic.org www.unitedplantsavers.org

Peter Purbrick Purchasing Manager since 1987

www.mediherb.com.au

Quality Assurance of Herbs (Identity and Purity)

Raw Material is sourced from quality herb suppliers worldwide

Pre-shipment sample requested

Samples sent to lab for:

Chromatography

Also tested for:

Identification (TLC fingerprint)

Method used to separate the phytochemicals in a herbal extract into individual components

Macro/microscopic analysis

Validation (species, plant part) Efficacy (actives, phytochemical profile)

Pesticides/heavy metals Aflatoxins Microbial levels

Thin Layer Chromatography (TLC):

High Performance Liquid Chromatography (HPLC):

The liquid extract is spotted onto a silica gel plate which is then placed into a trough containing solvent. The solvent then separates the extract into a series of bands (phytochemicals) characteristic to the plant

The herbal extract is injected into a liquid stream which is carried onto a column and separated into its various constituents. These are then detected when they exit the column. Normally with PhotoDiode Array (PDA) which measures the absorption spectrum of each chemical constituent. However, not all constituents can be seen by PDA and therefore Evaporative Light Scattering Detection (ELSD) and Mass Spectrometry (MS) are also used to detect compounds such as saponins

Gas Chromatography (GC): This method works only for volatile chemicals. The herbal extract is inserted into a hot injector block and the volatile constituents pass onto the heated column which separates the constituents based on their boiling point. The existing chemicals are then burnt in a flame and the resultant electric signal is detected

Mass Spectrometry (MS) Method used to separate the phytochemicals in a herbal extract into individual components

Order is placed ONLY IF the above quality criteria have been met

Order arrives Quarantined Samples taken

Product Catalogue

To Lab: All QA procedures detailed above are repeated on the purchased batch samples

When, and only when, all aspects of quality control of the raw material are confirmed, will the manufacture of MediHerb products begin. A herb is sent back if it does not comply

Before any herb is purchased, a sample of the batch being offered for sale is analysed by the Quality Control Laboratory and compared to the quality criteria specified by MediHerb. At this point, we regularly reject herbs as only the herbs that meet or exceed the strict quality criteria are purchased. When we receive the purchased batch of herb, it is sampled according to a statistically valid sampling plan and then subjected to the same battery of tests as the pre-purchase sample. Only if the herb passes this second set of tests is the batch accepted into the factory for further processing. Depending upon the specific herb, the quality assurance process includes testing herbs for: Colour Aroma Texture Content of specified actives Thin Layer Chromatography fingerprinting Microbial levels Amount of extraneous matter Pesticides and herbicides

agent, in order to imitate anthocyanins (the quality marker responsible for the blue colour in ripe Bilberries) (www. mediherb.com.au/media/681449/ bilberryposter.pdf). Adulteration of Crataegus monogyna (Hawthorn), Vitex agnus-castus (Chaste Tree) and Turnera diffusa (Damiana) extracts with rutin Our stringent testing regimes guard against: Substitution of species: one herb may be substituted for another less costly herb Adulteration of herbs: a high quality and expensive herb may have a cheaper herb or even a pharmaceutical mixed in with it Poor quality of herbs: herbs can vary enormously in quality and this means the effect you and your patients feel, can vary enormously This ensures that the herbs approved for use in MediHerb products are of the correct species, are the correct plant part, have the correct active constituent profile and are free from contamination. Therefore you as the clinician can rest assured that the MediHerb product contains exactly what it says on the label.

Heavy metals

Substitution – Safety Considerations

Aflatoxins

Substitution of Scutellaria lateriflora (Skullcap) was a prominent issue in 2002 due to an Australian product being implicated in the death of a patient. The product contained Kava and two other herbs, one of these was meant to be Skullcap. However when the product was analysed by the TGA it was found not to contain Skullcap. For this reason the TGA initiated a safety recall on this product and other Skullcap products from that same practitioner company. In addition they also recalled other Skullcap products on the market. This is significant because substitution of Skullcap with the hepatotoxic herb Germander (Teucrium spp.) is well known and has been implicated in cases of liver damage in the literature. MediHerb became aware of this problem many years ago and established stringent quality procedures to ensure that our Skullcap products would always be authentic. In his capacity as a member of TMEC (Traditional Medicines

Over the years, we have found many issues relating to quality, for example: Substitution of Scutellaria lateriflora (Skullcap) with other Scutellaria spp. Replacement of Scutellaria lateriflora (Skullcap) with Teucrium spp. (Germander) Adulteration of Hydrastis canadensis (Golden Seal) Centella asiatica (Gotu Kola) substituted for Bacopa monnieri (Bacopa) Substitution of Stephania tetrandra by Aristolochia spp., which has the potential to cause kidney failure Samples of Andrographis paniculata (Andrographis) upon testing at MediHerb, revealed to have no andrographolide content (the active constituent) Samples of Vaccinium myrtillus (Bilberry) upon testing at MediHerb, were found to contain a colouring

Evaluation Committee) the forerunner of CMEC (Complementary Medicines Evaluation Committee), Kerry Bone alerted the TGA to the potential harm that could arise from this substitution. As a result the TGA took action in the 1990s to ensure that manufacturers only used authentic Skullcap. They conducted widespread testing of Skullcap products and found many products did not contain Skullcap as claimed. The fact that this substitution may have arisen again, particularly in the context of the case of liver damage, is cause for serious concern. The substitution of Stephania tetrandra with Aristolochia spp. has been widespread in the herbal market with safety alerts being issued by the TGA, FDA (USA) and MHRA (England). This followed the more than 70 cases of renal failure in Belgium associated with a weight-loss product that mistakenly contained a species of Aristolochia instead of Stephania. This inadvertent substitution is believed to have been due to the similarity of the Chinese common name: Aristolochia fangchi (Guang Fang Ji) and Stephania tetrandra (Fang Ji). Stephania is an important herb with good antiinflammatory activity linked to the bisbenzylisoquinoline alkaloid known as tetrandrine. MediHerb research evaluated by HPLC eight samples of herb labelled as Stephania tetrandra. Of these samples only one was believed to be Stephania; five samples contained aristolochic acids and were more likely to be Aristolochia; the remaining two samples contained neither aristolochic acids or tetrandrine, and were probably either Clematis spp. or Akebia spp. Based on this survey, the risk involved in the commercially available Stephania herb was evaluated as being too high to warrant its inclusion in the product range.

MediHerb Philosophy

Quality Assurance of Herbs (Identity and Purity)

Hydrastis canadensis

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Substitution – Efficacy Through our research we have demonstrated that the alkylamide rich roots of Echinacea angustifolia and to a lesser extent E. purpurea have a modulatory effect on the immune system. However, when market surveillance was performed in June 2008 of 4 Australian professional products of Echinacea tablets and capsules, none were found to have appropriate levels of alkylamides. Echinacea is broadly used to describe all manner of preparations of the purple cone flower plant: different plant parts and different species, but also different quality levels. Commercial Wild Yam extracts available for use as raw materials are often not Dioscorea villosa but instead Dioscorea opposita (Chinese Yam Root) which has a different phytochemical profile and therefore a different clinical action. In addition to species substitution, it is widely misconstrued that Dioscorea villosa contains diosgenin and many products have this as a statement on their labels. However it does not contain diosgenin, but rather the diosgenin precursors. Traditionally Dioscorea villosa was believed to contain predominantly dioscin, however, the origin of this assignment is unclear (dioscin is a steroidal glycoside precursor of diosgenin). Research undertaken by MediHerb and Associate Professor James De Voss from the University of Queensland has found Wild Yam harvested traditionally in autumn contains only very small amounts of dioscin, not the predominance as previously thought. The major saponin found in the autumn harvested roots were in fact the furostanolbased saponins, methylparvifloside

and methylprotodeltonin. While the spirostanol-based saponins, Zingiberensis saponin I and deltonin were the major saponins for samples harvested in summer. Further research work continues. It is alarming that such a widely used herb is so misunderstood and substituted. Cat’s Claw (Uncaria tomentosa) has two chemotypes, the preferred chemotype contains only pentacyclic oxindole alkaloids (POAs) speciophylline, mitraphylline, pteropodine, isomitraphylline and isopteropodine; the other chemotype, contains the tetracyclic oxindole alkaloids (TOAs) rhynchophylline and isorhynchophylline in addition to the POAs. Traditionally only the POA chemotype was used therapeutically. This preference for the POA chemotype of Cat’s Claw has been backed up by scientific research. MediHerb tests each batch of Cat’s Claw to determine only the preferred POA chemotype is used to manufacture our Cat’s Claw products. Golden Seal (Hydrastis canadensis) is very expensive and has always been in short supply. As a result, substitution by other species is common. The herbs typically substituted are: Coptis chinensis, Indian Barberry (Berberis aristata), and Oregon Grape (Berberis aquifolium). These species do not contain hydrastine; they contain only berberine and berberine-related compounds. They do, however, produce an extract of the same colour as Golden Seal. The berberine from Golden Seal and the herbs listed above is a potent antibacterial agent. However, it is the hydrastine that is believed responsible for the unique trophorestorative effects of Golden Seal upon mucous membranes. Similarly, the hair roots of Golden Seal, which have lower levels of hydrastine than

“ Our stringent testing regimes guard against substitution, adulteration and poor quality”

Product Catalogue

Uncaria tomentosa

the rhizome, are sold as the root and rhizome, which provides lower efficacy. The presence of hydrastine and the differentiation of adulterants is easily determined by HPLC. MediHerb only purchases cultivated Golden Seal, due to the report issued by CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora) that the herb is endangered in its native habitat. This is a very common example of substitution of a less costly herb which greatly affects efficacy.

Substitution – Cost A very common case of substitution is with the herb Tribulus terrestris (Tribulus) due to the very high cost of the raw material. Bulgarian clinical trials utilised a Tribulus extract characterised at 45% furanosterolic saponins by UV-Vis spectrometry, with the plant part being the above ground portion (leaves and stem). Many Chinese and Indian sources typically specify the fruit analysed at 40% by gravimetry – not the accepted plant part nor analytical method. This discrepancy is easily overlooked and the price differential between the two extracts makes the genuine Bulgarian material economically unviable for some patients. MediHerb has extensively investigated Tribulus and in 2002 presented a scientific poster on the comparison of the spectrophotometric and HPLC-ELSD analytical methods, highlighting the variability found in raw herbs of different origins (www. mediherb.com.au/media/773555/ TribulusPoster.pdf). It was shown that only by HPLC could an accurate quantification of the true constituents of the herb be performed. Herbal material from Bulgaria and Slovakia were the only sources found to have the same phytochemical profile

Protodioscin Slovakian Tribulus Herb

Australian Tribulus Herb

Indian Tribulus Fruit

Storage and Handling of Herbs After approval by the Quality Assurance process, all herbs are transferred to our refrigerated warehouse, which is maintained at a constant 15°C and 40% humidity. Refrigerated storage, although expensive to maintain, avoids the need for any pesticides to be used for insect control. This ensures our organic herbs remain organic and that all our herbs remain free of insect contamination prior to processing. Herbs are handled and processed at every stage with the utmost care. For example, herbs are milled in preparation for extraction under very low temperature cryogenic conditions to protect against excessive heating, which can damage the fragile active components.

Quality of Extraction

he became increasingly frustrated with the poor quality of herbal extracts available at that time and the resulting effects for his patients. By applying his scientific training he developed a unique method of extraction, termed 1:2 Cold Percolation. Word of these high quality herbal products spread and requests were soon received from health care professionals for supply around Australia and so MediHerb was born. MediHerb is available throughout New Zealand from ProHerb based in Christchurch. ProHerb have been the exclusive distributor since 1991. Paul Mitchell, the founder, is a qualified Herbalist and regularly conducts seminars and workshops. We share the same philosophy of commitment to quality products and excellent service.

Unique Extraction: 1:2 Cold Percolation Process The MediHerb 1:2 Cold Percolation method is unlike other herbal extraction processes; no heat or concentration is used, both of which may cause damage to the delicate plant material. The greatest care is taken to prevent any contamination from outside sources throughout the extraction process: All extraction equipment is designed and built from stainless steel Air used in the manufacturing complex is thoroughly cleaned using pharmaceutical standard filtering units In addition to the herb itself, we use only two other raw materials in manufacturing our herbal extracts, ethanol and purified water. Both are chosen very carefully to ensure the most efficacious product and meet pharmaceutical standard specifications.

MediHerb was co-founded by Kerry Bone, a first class honours graduate of Melbourne University who won the Masson Memorial Prize as Australia’s top Chemistry student. Whilst working as a research scientist, Kerry studied naturopathy at the Southern School of Natural Therapies for two years before deciding to relocate to the UK to study phytotherapy in-depth. Upon completing the four-year Diploma in Phytotherapy from the world renowned School of Phytotherapy in England, he returned to Australia to practice. However

All process water used in extraction is purified by reverse osmosis. First, it is filtered through numerous filter beds to remove particulate matter and organic compounds, then passed through reverse osmosis cartridges to remove the ionic materials before finally passing through an ultra-fine filter. The water produced is very low in all contaminants – organic, ionic and particulate – and is tested to comply with the British Pharmacopoeia specification for purified water BP2014. MediHerb only uses ethanol that complies with the British Pharmacopoeia specification for ethanol, BP2014. Ethanol is essential to extract the full phytochemical profile of the plant, this cannot be achieved using water or glycerol alone. Ethanol has been used for hundreds of years in herbal extraction and old herbal texts discuss steeping herbs in wine over long periods. The human liver is naturally conditioned to metabolise small amounts of ethanol from ripe fruit and naturally fermented food. Any toxic effects from ethanol are dose-related and there is minimal risk of potential ethanol toxicity with herbal extracts due to the low daily dosage required. The usual recommended dose of most 1:2 herbal extracts is only 5 mL three times per day and in 5 mL there is approximately the same amount of ethanol as of a standard glass of beer or wine.

MediHerb Philosophy

as the clinically-trialled extract. There was also a significant difference between the phytochemical profile of the fruit (the part used in Asia) compared with the leaves and stems (clinical trials). Only the leaves and stems from Tribulus plants of Bulgaria or Slovakia contain any amount of the active marker compound, protodioscin.

Through our scientific analysis MediHerb has chosen specific ethanol percentages for each herb to maximise the quality, for example 25% ethanol extracts of St Mary’s Thistle will not contain any silymarin because it is insoluble at this concentration.

1:2 Cold Percolation – no heat or concentration, therefore no damage to the herb’s constituents Silybum marianum

www.mediherb.com.au

MediHerb Manufacturing Processes & Quality Control for Herbs This Chart follows on from the Quality Assured Sourcing of Herbs Chart on page 4

Cool room storage of herbs for quality assurance Minimises degradation of actives, control of insects, ideal storage condition for raw materials whose actives can degrade

Raw material milled under cryogenic conditions so no heat can affect the phytochemicals

Proprietary Cold Percolation A unique slow process over 7â&#x20AC;&#x201C;10 days known ONLY to MediHerb, developed by Kerry Bone, to extract the full spectrum of compounds of the herb without causing damage or degradation

Liquid Extracts The majority of our liquid extracts are made as 1:2 liquid extracts as this is the most effective method to extract the full phytochemical profile in a convenient dosage unit. However we also make liquid extracts with other ratios depending on the optimum extraction of the individual herb

Samples sent to the QA Laboratory where they are analysed for phytochemical profile, level of actives, consistency, verification of original herb with no deterioration or degradation. This is the third round of testing performed. When the extract meets all criteria

Bottled for Sale

Product Catalogue

The MediHerb Quantified Activity (QA) program aims to establish meaningful quality guidelines for the manufacture of herbal extracts. It is a system for ensuring the production of consistent quality extracts with guaranteed minimum levels of active constituents. To date, MediHerb has quantified the activity of over 70 herbs through this program. To our knowledge such a program has never been undertaken in Australia, nor has it been matched anywhere in the world. The constituents chosen as ‘quality indicators’ are carefully selected under the guidance of Kerry Bone and represent the most up-to-date scientific knowledge available. The process of developing Quantified Activity extracts is complex and involves many steps. However, once the constituents are selected and the quantified activity levels are set, the main focus is to ensure the supply of consistent quality raw material and the retention of the constituents throughout the manufacturing process. It is important to point out that Quantified Activity extracts are not purified single constituent extracts. They are whole extracts of carefully selected whole herbs, manufactured using the MediHerb 1:2 Cold Percolation process, and still contain the complex range of active constituents from the raw herb.

The Echinacea QA Story Echinacea is MediHerb’s earliest quality story and a good example to explain the Quantified Activity program. When MediHerb first started manufacturing in 1986 there was confusion in the global herbal industry over what constituted authentic Echinacea. Echinacea angustifolia and E. purpurea were routinely being substituted by unsuspecting manufacturers with another herb, Parthenium integrifolium. The substitution was made possible due to the uncanny physical similarity of

the roots of Parthenium and especially Echinacea purpurea. The solution implemented by MediHerb to guarantee supply of authentic Echinacea led to the development of the “Quantified Activity” program which exposed the Parthenium/Echinacea substitution and helped establish MediHerb’s credibility in the herbal industry. The earliest methods employed by MediHerb to assess herb quality and identity relied on a trained herbalist checking the herb’s physical appearance, colour, odour and taste. Taste was of particular importance because of the insight it gave into the herb’s chemistry. Traditionally, the test for Echinacea quality was the ability of the root to cause an intense tingling sensation in the mouth when chewed. The substitution of Parthenium integrifolium for Echinacea was successful only if appearance was checked and taste was not. When chewed, Parthenium root did not cause any tingling sensation in the mouth. The components which cause the tingling sensation from Echinacea are called alkylamides. So, one very simple solution was to taste the roots! As MediHerb developed more sophisticated analyses, thin layer chromatography (TLC) was adopted which allowed the gross aspects of Echinacea’s chemistry or its “chemical finger-print” to be compared to a certified reference sample from the correct species. However, TLC mainly demonstrates if a compound is present, but not its quantity.

handling parameters to ensure optimum retention of the alkylamides. Internally, MediHerb established protocols to ensure optimum retention and stability of alkylamides during all phases of the production process; from receipt of the raw material to completion of the finished product. Alkylamides are very delicate compounds and are easily damaged or lost during processing, hence developing these protocols took many years to conclude. From these exacting analyses MediHerb was able to establish our standard for acceptance of Echinacea raw material based on alkylamide content. The task then was to work with herb growers to ensure that we were able to consistently source the herb according to our specification. Using our validated 1:2 Cold Percolation process we could then be confident that we would always extract a known amount of alkylamides along with all the other active compounds in every batch. Thus ensuring a consistent quality product with “Quantified Activity”, every batch, every time.

MediHerb Philosophy

Quality Guaranteed – The MediHerb ‘Quantified Activity’ Program

The research into Echinacea continues today and our most recent efforts are aimed at further improving quality and efficacy, and understanding how Echinacea works (see page 16 for further information on this ground-breaking research).

MediHerb understood that alkylamides were important for the efficacy of Echinacea and began to investigate methods to quantify the alkylamides along with other important compounds such as cichoric acid. At the time there was no published test methodology for alkylamides and the process of developing the high performance liquid chromatography (HPLC) methodology took MediHerb a number of years. Once armed with the HPLC methodology for identifying quality in terms of alkylamide content, MediHerb worked with Echinacea growers to determine appropriate growing conditions and

Echinacea purpurea

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Quantified Activity and Standardisation At times, we receive a herb that has higher levels than our minimum specification, so you as the practitioner receive that higher level of activity. We never dilute to meet a minimum specification. Herein lies the difference between Quantified Activity and standardisation. With standardisation, extracts with an active level that exceeds the specified standard would then be diluted to fall within that standard. (For more information on standardisation view the MediHerb Professional Library at www.mediherb.com.au) With the MediHerb Quantified Activity program, we have linked together all of the possible parameters that can affect product and extract quality and can guarantee that a high quality, efficacious extract will be produced every time.

Standardised Extracts: A Balanced Perspective In those cases where there is strong clinical data supporting the use of a particular standardised extract, MediHerb has adopted that standard and dosage approach for its tablet products. A good example is Ginkgo biloba. There is considerable controversy and misinformation over the use of standardised extracts. Many of these are in fact full spectrum galencial extracts, made by traditional extraction with ethanol and water, which are merely produced to a consistent quality marker (or markers). No adulteration of the extract has taken place and isolated phytochemicals have not been added to the extract. Good examples of these

are Devil’s Claw, St John’s Wort and Horsechestnut. In addition, MediHerb’s extensive quality control procedures are capable of detecting adulterated or “spiked” extracts. Such extracts are never used in MediHerb products. For more information on this complex topic see Kerry Bone’s articles (Modern Phytotherapist Vol 6, No 1 & 2 at www.mediherb.com.au).

bloodstream of humans after oral doses of the two products). A marker compound is a characteristic compound used to represent the quality standard for a standardised extract – it is often, but, not necessarily, one of the pharmacologically active compounds.

Hypericum perforatum

Phytoequivalence Phytoequivalence is a concept that was developed in Germany in the mid-1990s, and means that one herbal extract matches, or is equivalent to, another herbal extract, more specifically to one of the clinically-proven extracts. It is somewhat of a misnomer as phytoequivalence really means chemical equivalence, ie that the two extracts have the same chemical profile. But it was also intended to mean more than that. Extracts that are phytoequivalent should be able to demonstrate the same pharmacological or physiological activity when ingested by humans. This is however difficult to demonstrate (for example, it could be done by showing the similarity of the levels of marker compounds (or their derivatives) in the

High Performance Liquid Chromatography

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phytoequivalence = extracts that are physiologically equivalent

At the very least a match of the chemical profile, such as a chromatographic fingerprint, which outlines the full chemical spectrum of the extract is required. Comparison with the reference (clinically-proven) extract should indicate the presence of all major constituents, and the same levels of marker compounds and similar levels of all other measurable constituents. It is important to realise that phytoequivalence is not demonstrated by just comparing the level of only one or two marker compounds. Obtaining a good chromatographic fingerprint (usually by high performance liquid chromatography (HPLC)) for investigating phytoequivalence for a herb depends on several factors: A good extraction method to obtain almost all the pharmaceutically active compounds A chromatogram with good separation A representative concentration profile of the bioactive components detected by a proper detector Bulgarian clinical trials have shown that Tribulus herb (aerial parts) extract rich in protodioscin enhances libido and fertility and alleviates menopausal symptoms. If a Tribulus product is made from the root or fruit of the plant, or is sourced from anywhere else other than Eastern Europe, it will probably contain low levels of protodioscin and so will be quite different to the clinically-proven Bulgarian standardised extract. This is despite what might be claimed on the label for such products because often inferior methods of analysis have been used to measure

the furostanol saponins (which includes the marker compound, protodioscin), such as gravimetric or colorimetric techniques. The phytoequivalence and quality of Tribulus products is best assessed by HPLC.

Tribulus terrestris

In a paper published in 2004, researchers from China compared 18 fingerprints of Ginkgo biloba extracts purchased from pharmaceutical stores, companies and collected from producing areas of China. All of these samples were supposed to meet the standard for flavonoids measured by ultraviolet spectroscopy. Standardised extract of Ginkgo from Europe was the clinicallyproven extract used as the reference for phytoequivalence. The samples looked similar in the HPLC chromatograms, however further statistical analysis of this data indicated problems with three samples. A peak in two samples around the retention time of 10 minutes was much higher than the peak in the standardised Ginkgo extract, and was found to be the flavonoid rutin which had been added (in order to meet the old, UV spectroscopy standard). Inferior clinical results might well have been obtained using these non-phytoequivalent extracts.

It’s a different way to make tablets – which is why we call it the MediHerb way. So what do we do that is different?

While the MediHerb cold percolation 1:2 liquid extracts are used for manufacturing our tablet range, there are on occasion some high quality extracts available from specialist extract manufacturers. In this case, we still apply the MediHerb stringent quality analysis at every step of the purchasing and manufacturing process to ensure our product is of MediHerb quality. For example, there are many St John’s Wort extracts available for purchase but of varying quality, MediHerb would only consider purchasing an extract if it exceeded our quality standards.

Firstly and perhaps most importantly, our unique cold percolation 1:2 liquid extracts are used in the manufacture of the MediHerb tablet range which means they are very potent. Many other herbal tablets/capsules are made from powdered dried herbs or poor quality dried extracts which means they are far less potent.

As with the MediHerb liquid herbal extracts, our tablets are manufactured to pharmaceutical standards. Each batch of tablets is tested for disintegration, friability, weight uniformity, and where relevant, for active constituents. However, it is only by ongoing research and control of all stages of the manufacturing process from

Secondly, our tablet production process has been the focus of extensive research and development to ensure that the finished tablet is the same quality as the liquid extract, and that the full phytochemical profile has been retained.

RAW HERB/EXTRACT f LIQUID f TABLET

From our research, we have found that the optimal method of herb processing involves the evaporation of the ethanol and water at low temperatures under vacuum. This important step minimises the exposure of the delicate chemicals in the herbal matrix to the damaging effects of heat and oxidation. The MediHerb tableting process takes this one step further to actually specify the optimal parameters employed during the evaporation and drying processes for each of the active constituents of the final tablet.

MediHerb tablets must legally disintegrate in less than 30 minutes. This means that even patients with poor digestion can quickly and easily absorb our tablets for maximum efficacy.

Quality in Tableting “The MediHerb Way”

MediHerb Philosophy

phytoequivalence = demonstrated similarity of all phytochemical constituents (all constituents present and at the right concentration)

MediHerb goes to great lengths using sophisticated analytical methodology to ensure that products such as standardised Ginkgo 2:1 liquid extract, Ginkgo Forte, Tribulus Forte and Saligesic tablets are phytoequivalent to the clinically-trialled products.

that MediHerb has been able to produce high quality tablet formulations, producing tablets with high active constituents that still comply to pharmaceutical standards.

Ginkgo biloba

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Full Spectrum Extracts Mean Greater Efficacy but Lower Herb Equivalents per Tablet

a result, a dry extract made from this liquid can only be manufactured with a 3:1 dry extract concentration factor. Adding 500 mg of this MediHerb extract into a tablet means we can only claim (3 x 500 mg) 1,500 mg of Scutellaria baicalensis dry root.

Practitioners often compare herb equivalence on tablet labels in an effort to gauge the most effective formula for their patients. However, herb equivalence can be quite misleading when comparing potency of products. The process of standardisation can encourage an approach to manufacturing herbal extracts that only focuses on the one active constituent or marker compound whilst ignoring the remaining phytochemical profile of the herb. As we know herbs contain a wide variety of phytochemicals in an inert matrix of vegetable matter (eg cellulose). When a herb is extracted with a solvent, the resulting phytochemicals that are extracted will depend upon the type of solvent employed. Generally the insoluble matrix components will be left behind. By using a combination of solvents, one can very selectively extract an individual compound or one group of compounds. However this begs the question as to whether the process produces a herbal product or a product bordering on a pharmaceutical, because the phytochemical profile of the raw herb and the ratio of active constituents to marker compounds can be greatly altered. One example of this is the use of Scutellaria baicalensis (Baical Skullcap) extracts, which only contain baicalin and do not contain any of the other 20 or more of its flavonoid constituents. These other constituents are typical of Baical

Scutellaria baicalensis

Skullcap, the most important of these being wogonin-7-O-glucuronide, oroxylin A-7-O-glucuronide, baicalein, wogonin and oroxylin A. Sources of Baical Skullcap extract used in some herbal tablets contain greater than 95% baicalin, this means that less than 5% of the material is something other than baicalin. This is no longer a herbal extract and is rather a purified phytochemical. These extracts are typically claimed to be a 20:1 dry extract and as such 500 mg of this extract placed into a tablet means the manufacturer or marketer of the product would be able to claim (20 x 500 mg) 10,000 mg of Scutellaria baicalensis dry root.

Tablet disintegration apparatus

“All tablets must disintegrate in the stomach in under 30 minutes (with the exception of entericcoated tablets)”

In contrast, the extract produced by extraction of Baical Skullcap with 45% ethanol contains a very high level of solids material and a full complement of the many flavonoid components. As

What was left out in these extracts to produce this product? Baicalin Other Flavonoids: oroxylin A-7-O-glucuronide wogonin-7-O-glucuronide oroxylin A wogonin

Baicalein

Baical Skullcap "Full Spectrum Extract"

Baical Skullcap Extract 95% Baicalin

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This product would not pass the criteria set by MediHerb, as it does not contain the full phytochemical profile expected for Baical Skullcap.

MediHerbâ&#x20AC;&#x2122;s Unique Tableting Process When Using Our Liquid Extracts

Quality Control Analysis As per Quality Chart on page 4 PASS

FAIL REJECT

Liquid Extract 1:2 proprietary Cold Percolation

Low Temperature

Vacuum Concentrater Turns liquid extract into concentrate and removes ethanol. This process ensures no damage to the delicate active constituents

MediHerb Philosophy

Herb

Quality Control Analysis As per Quality Chart on page 4 PASS

FAIL REJECT

Granulation Low Temperature

Vacuum Oven

Quality Control Analysis As per Quality Chart on page 4 PASS

FAIL REJECT

Milled to tiny granules and mixed with hypoallergenic tablet excipients

Tablet Punch Presses tablet and either hypromellose coating or enteric coating is applied

Quality Control Analysis As per Quality Chart on page 4 PASS

FAIL REJECT

Bottled for Sale

Total Process takes 1 Month

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Quality Assurance of MediHerb Nutritional Range Commitment to Quality MediHerb’s renowned commitment to quality, safety and efficacy extends across the MediHerb range of nutritional products. First and foremost, the practitioner can be assured that our Quality Assurance Manager defines the requirements of laboratory testing required for each product and personally authorises the release for sale. Independent TGA certified laboratories that have expertise in nutritional assays conduct the analysis of the products. Should the products for some reason not meet our exacting quality standards, they are rejected just as the MediHerb herbal products are.

Safety in the Formulation Safety is high on the agenda when it comes to MediHerb nutritional product formulation. Any ingredient that is considered for inclusion in a particular product must go through a thorough assessment of its safety and toxicology. From this perspective, we assess how much of this nutrient is found in the food supply, the appropriate forms and the amounts used in any scientific research on that ingredient. Strict standards are also predetermined to ensure only quality materials from reputable sources are used and that there is adequate data available on its stability.

Tablet machine

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Synergy and Efficacy Every MediHerb nutritional product has been carefully formulated by Kerry Bone and our team of naturopaths and nutritional experts. Considerable research and development goes into each formulation, to ensure today’s practitioners can be confident of meeting their patients’ needs. From our own experience, we fully understand the necessity for products that meet a genuine health need and work quickly to resolve it. To help achieve this, we take into account the patient – who may have an established nutrient deficiency or a diet that may be devoid in certain nutrients. We also look at the health conditions and diseases most prevalent today. Our goal is to combine a blend of nutrients into a product that addresses a specific health issue, such as cardiovascular health, improved blood glucose control or enhanced joint health. Because we focus on the inclusion of nutrients, MediHerb nutritional products may not appear to have the highest levels of individual nutrients – but each product will contain all the right cofactors. Herbs are also included in MediHerb nutritional products, where we feel they may add further therapeutic benefit. These inclusions are the same quality MediHerb herbal extracts used in our herbal product range and of course are at therapeutic dosages.

For all MediHerb nutritional products, the MediHerb mission is to provide safe, high quality, bioavailable nutritional products that will support modern health needs. This fundamental principle drives MediHerb to research extensively, then translate credible scientific evidence into nutritional products that work. Your patients can have the utmost confidence that the product they are taking contains exactly what is on the label, utilises the best forms and combinations of nutrients to achieve the desired effect, and has the MediHerb quality guarantee.

For over 25 years MediHerb has been a pioneer, dedicated to the research and development of premium quality professional products. We are extremely fortunate to have an outstanding team of people in Research and Development and Quality Control: over 14 scientists including two chemistry PhDs, a biochemistry PhD, two herbalists, nine chemists, and a dietician. Together the team has diverse industry experience in food and herbal products, university research, drug analysis in hospitals, pharmaceuticals, quality assurance, technical writing and clinical nutrition. Based at the Integria Healthcare head office and laboratories, the Research and Development team closely collaborate with the University of Queensland, Griffith University, Southern Cross University and University of New England.

Professor Kerry Bone

Associate Professor Hans Wohlmuth

B. Sc. (Chemistry) Honours, Dip. Phyt.

PhD (Pharmacognosy), BSc (Biology)

Kerry, as the co-founder of MediHerb and Director of Research and Development, is the innovation driver and quality guardian. Globally renowned for his herbal expertise both as a researcher and clinician, Kerry is Adjunct Professor at the New York Chiropractic College. A published author of six authoritative herbal text books used by naturopathic schools across the world, and thousands of referenced articles, Kerry is undoubtedly leading the herbal profession into the future.

Hans joined the company early in 2014 as Research and Development Manager. He spent the previous 16 years at Southern Cross University, where he taught pharmacognosy and complementary medicine, established the Medicinal Plant Herbarium and co-founded the Herbal Authentication Service. Hans is an active researcher and has published some 50 scientific articles on medicinal plants, natural products and complementary medicine. Hans is a member of the Therapeutic Goods Administration’s (TGA) Advisory Committee on Complementary Medicines, (TGA is Australia’s equivalent to FDA (the Food and Drug Administration) and serves on the Advisory Board of the American Botanical Council. He also has editorial roles with several journals including the Australian Journal of Herbal Medicine and Advances in Integrative Medicine.

The research team is led by Professor Kerry Bone and Associate Professor Hans Wohlmuth and assisted by MediHerb’s technical writer, Michelle Morgan.

Associate Professor Reg Lehmann

MediHerb Philosophy

The Science of Botanicals: MediHerb Research

B. App. Sc. (Chemistry), Ph.D. (Organic Chemistry), Grad. Dip. Management

The HPLC combined with mass spectrometry (MS) is used to identify chemicals by their mass/ charge ratio and fragmentations

Ultra-violet-visible spectrophotometers are routinely used in MediHerb’s herbal analysis

Since 1996, Reg has been responsible for a variety of areas at MediHerb: Quality Assurance, Production, Technical and Research. His background includes the brewing industry, and since 1994 he has been working in the herbal field. In his present position, Reg is focusing on improving the quality (thus efficacy) and GMP compliance of our products in the manufacturing area of the business. Reg is regarded as a leading phytochemist around the world and has been invited to present at numerous international scientific conferences. In recognition of the collaborative work undertaken with the University of Queensland, Reg has been recognised with the position of Adjunct Associate Professor within the School of Molecular and Microbial Sciences. Reg’s current position is the Manufacturing Technical Services Manager.

Michelle Morgan B. Sc. (Chemistry), D.H.M.

Michelle has worked in the scientific field as a laboratory technician for many years and has spent over three years as a Quality Assurance Chemist. Since 1995 Michelle has worked at MediHerb as a Technical Writer responsible for information gathering and organising technical publications. She assisted in the research and writing of several herbal medicine text books including the awardwinning The Essential Guide to Herbal Safety, published by Elsevier in 2005. Michelle is a qualified herbalist.

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MediHerb Herbal Research Objectives

New Product Development Process

The research group is committed to the development of efficacious herbal therapies. This involves three major areas of focus, which are all interconnected:

MediHerb has a rigorous new product development process, which ensures that the appropriate steps are undertaken when investigating the introduction of a new product. By reviewing all the relevant information available regarding the therapeutic outcome, we are seeking to develop a short list of key herbs and nutrients which are then subjected to closer analysis. This involves detailed examination of the:

Formulation of efficacious herbal solutions to meet patients’ needs Validating the efficacy of herbal formulas by clinical trials and in vitro research Researching the phytochemistry of medicinal plants It is by combining phytochemical, biochemical, clinical and traditional herbal knowledge that MediHerb can continue to produce high quality products, which meet the changing needs of the market. The Research Laboratory is well equipped with gas chromatographs (GC), thin layer chromatography (TLC), ultra-violetvisible (UV-Vis) spectrophotometers, high performance thin layer chromatography (HPTLC) and high performance liquid chromatographs (HPLC). The HPLCs are equipped with photo diode array (PDA), evaporative light scattering detectors (ELSD) and sophisticated mass spectrometer (MS) detectors. Access to nuclear magnetic resonance (NMR) and infra-red (IR) spectrometers, polarimeters, gas chromatographs with mass spectrometer detection and HPLC with MS/MS capabilities is available at The University of Queensland campus.

Clinical outcomes Phytochemistry/Biological activity Analytical methodology Continuity of supply Economic sustainability Synergy of the final formula Cost to the patient Practicality of final dose formulation Once the prototype formulation is agreed upon, MediHerb may undertake a controlled human trial to prove the efficacy and safety of the product. This may either be a full clinical trial or may be an open trial in conjunction with our experienced clinicians (feedback trial). Products with well-documented evidence of traditional use are often subjected to the feedback trial. For more novel formulations that do not have significant traditional use, a full clinical trial evaluation may be performed.

The Research and Development team works closely with herbalists and naturopaths within the company and with a board of leading Australian and international herbalists on product development. This ensures that MediHerb has taken the best of science, traditional knowledge and current clinical knowledge to make the most therapeutic herbal and nutritional solutions relevant to your clinical practice.

Thin layer chromatography plays an important role in herb identification.

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Clinical Trials at MediHerb MediHerb invests significantly into the future of herbal medicine and our profession by funding clinical trials. MediHerb has a reputation for its extensive depth of scientific knowledge and is often approached by research groups to collaborate on projects investigating herbal therapies. MediHerb assesses each of these requests closely and applies stringent criteria to assess viability. The trial must fit with MediHerb’s philosophy of superior quality, innovative, and holistic herbal solutions, and must be conducted at a reputable research establishment. MediHerb does not fund or involve itself with research that utilises animals as human models.

The MediHerb Echinacea Research Story Introduction The most well-known herbal support for the immune system is Echinacea. But many patients and health care professionals are confused as to the best way to use this herb. There are many Echinacea products available which differ according to plant species (E. angustifolia, E. purpurea or E. pallida or combinations of these), plant part (root, leaves or seeds or combination of these), quality markers (alkylamides, polysaccharides or caffeic acid conjugates such as cichoric acid) and dosage. Underlying this diversity of preparations is a lack of consensus over what phytochemicals are responsible for Echinacea’s immune activity, and only a rudimentary understanding of the exact mode of action of this herb on immune function. However, recent research, in which the MediHerb scientific team has played a key role, has provided some answers to these key questions. In particular the alkylamides, the unique and characteristic phytochemicals found

Historical Context Before discussing the exciting new research developments for Echinacea, its use as an immune herb needs to be understood in its historical context. Information about the value of Echinacea first came from Native American tribes. Their use of Echinacea was then adopted by the Eclectics, a group of practitioners who were prominent around the late 19th and early 20th Centuries in the United States. By 1921 Echinacea (specifically the root of E. angustifolia) was by far the most popular treatment prescribed by the Eclectics.1 The Eclectics used Echinacea for about 50 years and accumulated extensive clinical experience in its use. The best sources of such uses are King’s American Dispensatory2 and Ellingwood.3 What is also important to note is that Echinacea’s reputation as an immune support herb came from the solid traditional data generated by the Eclectics on only one form of Echinacea: a fluid extract of the dried root of E. angustifolia extracted in a high percentage of alcohol. We can call this a “traditional Echinacea extract” and, because it was extracted in a high percentage of alcohol, the term “lipophilic extract” (fat-loving) is also relevant. In particular, the Eclectics defined good quality Echinacea root “as imparting a persistent tingling sensation” which is a clear reference to alkylamide levels as a quality indicator.2 In Europe during the 1930s the German herbalist Madaus used E. purpurea as he was more successful at growing this species. His interest in homoeopathy led him to use the stabilised juice of fresh E. purpurea tops. This remains the most popular form of Echinacea in Germany today (and contains very low levels of alkylamides). We can call this style of product a “hydrophilic extract” (waterloving) of Echinacea. Naturally German scientists were interested to investigate how these new hydrophilic extracts of Echinacea might work in the body and undertook a search for active components. Polysaccharides possessing immunological activity

were isolated from the aerial parts of E. purpurea.4 Some clinicians and scientists then mistakenly applied this research to the very different lipophilic or traditional Echinacea preparations, and came to the conclusion that they were inferior because of their low or absent content of polysaccharides. (The low levels of polysaccharides in traditional Echinacea extracts are due to the low starting levels in the root and the fact that high levels of alcohol do not effectively extract these water-loving molecules.) However, many herbal clinicians remained unconvinced. A key aspect of modern phytotherapy is a respect for traditionallygenerated knowledge and this suggested that a lipophilic extract of E. angustifolia root was the preferred form. Some felt that the concept of polysaccharides failed to explain what was unique about Echinacea and expressed concerns about the low oral bioavailability of these large, polar compounds.5 So what was clearly needed was a different understanding of Echinacea, especially of the phytochemicals important for the activity of traditional Echinacea products and their mode of action on the immune system.

What is Active Must First be Absorbed It can be concluded from both traditional use and clinical studies that Echinacea acts on the immune system at various sites in the body. Hence for Echinacea to exert this influence, the active phytochemicals must be absorbed in significant quantities in the bloodstream. Accordingly MediHerb undertook both test tube (in vitro) and clinical (pharmacokinetic) research to understand which of the key phytochemicals in Echinacea were absorbed.

The Caco-2 Intestinal Absorption Model A particular strain of human colon cells (Caco‑2) can be grown in a test tube to form a tight layer of single cells (a monolayer). This can serve as a model of absorption by the human digestive tract. The test components are placed on one side of the monolayer and after a period of time anything that has been transported across to the other side of the monolayer is sampled and measured.

Echinacea purpurea

When the MediHerb scientists carried out this research using the Echinacea Premium extract (made from the roots of E. angustifolia and E. purpurea) they found that:

MediHerb Philosophy

mostly in the roots of E. angustifolia and E. purpurea have been shown to be the best choice as markers of immune activity.

All the alkylamides were transported across the Caco-2 monolayer The caffeic acid derivates were not transported This Caco-2 work by MediHerb and collaborators is published as: Matthias et al in the Journal of Clinical Pharmacy and Therapeutics 2004; 29: 7-13. Another paper entitled “Bioavailability of Echinacea constituents: Caco-2 monolayers and pharmacokinetics of the alkylamides and caffeic acid conjugates” was published as: Matthias et al in Molecules 2005; 10: 1242-1251.

Absorption in Human Volunteers These results from the Caco-2 model were confirmed in a human pharmacokinetic study. Basically, volunteers took four tablets of Echinacea Premium with a meal and the levels of any detectable Echinacea phytochemicals were measured in their blood. It was only alkylamides that could be detected in the blood after taking Echinacea Premium. There were no caffeic acid conjugates found and no degradation products of these or the alkylamides. This work was published in August 2005 by MediHerb and collaborators as: Matthias A et al in Life Sciences 2005; 77: 2018-2029.

The Importance of Liver Metabolism Only alkylamides were found in human plasma after ingestion of Echinacea Premium tablets, but the levels were quite variable and first pass liver metabolism was suspected as influencing

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this observation. (First pass metabolism is the rapid degradation by the liver as the products from digestion first pass through the liver on their way to the general circulation). The alkylamides mainly found in E. purpurea were found to be rapidly degraded by human liver microsomes. In contrast the alkylamides mainly found in E. angustifolia were much more slowly degraded. Interestingly, it was discovered that the latter type of alkylamide actually slowed down the rate of degradation of the former type of alkylamide. This protective effect of the E. angustifolia alkylamide is a highly novel finding and it was deduced that the presence of only relatively small proportions of this compound will result in a product with enhanced bioavailability. This is a strong justification for the combination of E. angustifolia root with E. purpurea root, as in Echinacea Premium. A patent has been applied for to protect this very important finding. This work has been published as: Matthias A et al in ChemicoBiological Interactions 2005; 155: 62-70.

Echinacea Premium: Liquid versus Tablets One question that is often asked is whether herbs work better as liquids or tablets. MediHerb tablets are likely to work just as well as liquids because they are made using extracts (not the powdered herb) and are formulated to pharmaceutical standards to ensure rapid disintegration. This was verified in a clinical study which compared equivalent doses of Echinacea Premium in liquid or in tablet form.

The total amount of alkylamides absorbed into the bloodstream was essentially the same for both products This work has been published as: Matthias A et al. Comparison of Echinacea alkylamide pharmacokinetics between liquid and tablet preparations. Phytomedicine 2007; 14(9): 587-590. To our knowledge it is the first study of this kind (comparing the bioavailability of equivalent doses of a herbal liquid against a tablet) ever undertaken.

Product Catalogue

What is Absorbed Must be Active The research undertaken by the MediHerb team has established that alkylamides are the only phytochemicals which are bioavailable from traditional lipophilic extracts of Echinacea root. In addition combining E. angustifolia with E. purpurea will enhance the alkylamide bioavailability of the latter and there is no difference (in terms of alkylamide bioavailability) between the tablet and liquid forms of Echinacea Premium. The next question to be answered was whether the alkylamides do have an effect on the immune system. The MediHerb research team in collaboration with other scientists undertook test tube research to investigate such activity. The key findings of these studies were that: Echinacea did not activate the immune system in the absence of any immunological challenge The Echinacea alkylamides tended to modulate the immune responses of macrophages and T cells, toning the response down in the face of a strong stimulus, hence helping the immune system to operate more efficiently This macrophage work was published as Stevenson LM et al in Molecules 2005; 10: 1279-1285 and the T cell study in Fitoterapia 2008; 79(1): 53-58. A significant discovery, first presented at a major international conference, was the observation by two separate research teams that the immune effects of Echinacea may be mediated by the interaction of Echinacea alkylamides with cannabinoid receptors. A Swiss research team found that an in vitro immunemodulating effect of a lipophilic Echinacea extract (and individual alkylamides) on monocytes/macrophages could be neutralised by the presence of agents which block CB2 cannabinoid receptors.6 Bauer, in collaboration with US scientists, found that alkylamides from Echinacea bound to both CB1 and CB2 cannabinoid receptors.7 In particular, certain alkylamides exhibited selectivity for CB2 receptors.

Taken together, these developments first presented at the conference suggest the hypothesis that the alkylamides are largely responsible for the systemic immune effects of Echinacea lipophilic extracts and that this immune modulating activity is (at least in part) due to the interaction of alkylamides with cannabinoid receptors, specifically CB2 CB1 receptors are highly localised in the central nervous system (CNS) and are believed to primarily modulate behaviour, while CB2 receptors predominate in immune tissues outside the CNS, especially the spleen, and are believed to modulate immune function.8 Cannabinoid receptors are remarkably preserved across the animal kingdom which suggests they play an important developmental and physiological role.9,10 Much of the immune activity of the cannabinoid system appears to be mediated by the cytokine network. Cytokines include the interleukins (IL-3, IL-6, etc), tumour necrosis factor alpha (TNFα) and the interferons (IFN). The Swiss team mentioned above has followed on from this ground-breaking research and shown that certain Echinacea alkylamides bind strongly to CB2 receptors.11 In addition they have shown that alkylamides also exert additional effects on immune cells which are independent of CB2.11 Their research has been particularly insightful into one aspect of the mode of action of Echinacea alkylamides.12 A lipophilic extract of Echinacea purpurea strongly stimulated TNFα mRNA synthesis in peripheral monocytes, but not TNFα protein production. In other words, the Echinacea-induced new TNFα transcripts (mRNA) were not translated into TNFα itself. When monocytes are treated with LPS (lipopolysaccharide or endotoxin, a powerful stimulator of the immune system) TNFα protein production is substantially increased. However, co-incubation of monocytes with LPS

Investigation over a longer time-span revealed that the lipophilic Echinacea extract, via interaction with CB2 receptors, modulated and prolonged TNFα production following immune stimulation.

The results of this study suggest that Echinacea works more as a modulator or facilitator of the immune response, rather than as an immune stimulant In resting monocytes it prepares them for a quicker immune response by inducing TNFα mRNA. However, in overstimulated monocytes (as in the case of LPS) it first reduces and then extends their response in terms of TNFα production. In particular, these key findings challenge the mythology that traditional Echinacea extracts will “overstimulate and wear out” the immune system if taken continuously.

Clinical Effects on Immune Function To further understand the effects of Echinacea Premium at a clinical level, a small study was undertaken to investigate its effects on heat shock proteins and whole blood parameters. Healthy volunteers were dosed with two Echinacea Premium tablets daily for two weeks, with assessment at the beginning and the end of the trial. Positive results were References Wagner H. Herbal immunostimulants. Z Phytother 1996; 17(2): 79-95

Felter HW, Lloyd JU. King’s American Dispensatory. 18th Edn, 3rd revision. First published 1905, reprinted Eclectic Medical Publications, Portland, 1983.

Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy. Eclectic Medical Publications, Portland, 1993.

Bauer R, Wagner H. In Wagner H, Farnsworth NR eds. Economic and Medicinal Plant Research, Vol 5, Academic Press, London, 1991.

Melchart D, Clemm C, Weber B et al. Polysaccharides isolated from Echinacea purpurea herba cell cultures to counteract undesired effects of chemotherapy – a pilot study. Phytother Res 2002; 16: 138‑142

evident, with increased heat shock protein levels (hsp70) and increased white cell counts. (Heat shock proteins are molecular chaperones which modulate the immune response). This work was published as: Agnew LL et al in Journal of Clinical Pharmacy and Therapeutics 2005; 30: 363-369. Further work is planned to further evaluate these effects in a much larger study. This increase in white cell count for Echinacea Premium ties in well with research from the team of Dr Miller in Canada, which has shown (in experimental models) that E. purpurea root boosts the number and function of natural killer (NK) cells (a class of white blood cell).13

The Story Continues Adults travelling return from Australia to America, Europe or Africa on commercial flights via economy class took MediHerb Echinacea Premium tablets or placebo in a randomised, double-blind trial. Treatment began 2 weeks before flying overseas and finished 2 weeks after returning to Australia. The dose was one tablet twice daily, increasing to 2 tablets twice daily whilst flying. Participants were allowed to take a sick dose (3 tablets twice daily) if cold- or flu-like symptoms occurred. The sick dose could only be taken for up to 8 consecutive days or twice for 4 days during the whole travel period. Echinacea Premium was found to reduce the incidence of respiratory symptoms. The research (by Tiralongo E et al) has been published (Evid Based Complement Alternat Med; 2012; 2012:

Gertsch J, Schoop R, Kuenzle U et al. Alkylamides from Echinacea purpurea potently modulate TNFalpha gene expression: Possible role of cannabinoid receptor CB2, NF-κB, P38, MAPK and JNK pathways. International Congress on Natural Products Research, Phoenix, Arizona USA, July 31-August 4, 2004, Lecture O: 9

role in the immune response. Eur J Biochem 2000; 267(16): 4917-4927

Woelkart K, Xu W, Makriyannis A et al. The endocannabinoid system as a target for alkamides from Echinacea roots. International Congress on Natural Products Research, Phoenix, Arizona USA, July 31-August 4, 2004, Poster P: 342

Ralevic V. Cannabinoid modulation of peripheral autonomic and sensory neurotransmission. Eur J Pharmacol 2003; 472(1-2): 1-21

Salzet M, Breton C, Bisogno T et al. Comparative biology of the endocannabinoid system possible

Fride E. The endocannabinoid-CB receptor system: Importance for development and in pediatric disease. Neuro Endocrinol Lett 2004; 25(1-2): 24-30

Raduner S, Majewska A, Chen J-Z et al. Alkylamides from Echinacea Are a New Class of Cannabinomimetics. J Biol Chem 2006; 281(2): 1419214206

Gertsch J, Schoop R, Kuenzle U et al. Echinacea alkylamides modulate TNF-α gene expression via cannabinoid receptor CB2 and multiple signal transduction pathways. FEBS Letters 2004; 577(3): 563-569

A New Understanding of Echinacea

MediHerb Philosophy

and Echinacea extract resulted in a strong inhibition of this effect of LPS. This is consistent with the findings of the MediHerb research team.

The research on Echinacea Premium by the MediHerb scientists has made a substantial contribution to a new understanding of lipophilic extracts of Echinacea. It can be concluded from this research that: Alkylamides must be used as the markers of quality and activity The root of Echinacea is the preferred plant part, since it is highest in alkylamides The preferred species of Echinacea are E. angustifolia and E. purpurea since they contain high levels of alkylamides (compared to E. pallida) Echinacea must be extracted using an alcohol percentage sufficiently high to efficiently extract the alkylamides One potential way in which the bioavailable alkylamides modulate the immune response is by interacting with CB2 receptors Echinacea root (rich in alkylamides) also boosts the white cell count The traditional way Echinacea was used has been validated by scientific research at the cutting edge of modern immunology

Miller SC. Echinacea: a miracle herb against aging and cancer? Evidence in vivo in mice. eCAM 2005; 2(3): 309-314

Links to Echinacea Scientific Posters: www.mediherb.com.au/media/773546/invitro_echinacea-poster.pdf www.mediherb.com.au/media/775284/HSP70_poster.pdf www.mediherb.com.au/media/773552/pharmacokinetics_poster.pdf www.mediherb.com.au/media/773549/permeability_poster.pdf

www.mediherb.com.au

417267) and can be freely downloaded (http://www.hindawi.com/journals/ ecam/2012/417267/).

NIH/MediHerb Bacopa Clinical Trial

Further research is underway or planned in collaboration with Australian and European scientists: Evaluation of the mechanism of immune effects in preparation in collaboration with the University of New England and Southern Cross University Collaboration with researchers at Swiss Federal Institute of Technology and the University of Graz to further investigate the cannabinoid receptor findings

Another NIH funded trial is to investigate the use of Brahmi (Bacopa monnieri) for cognitive enhancement in an ageing population in collaboration with the Oregon Health & Science University. The principal investigator in this project, Dr Carlo Calabrese, approached MediHerb to supply a phytochemically characterised product and matching placebo for use in the trial (Calabrese C et al. Journal of Alternative Complement Medicine 2008; 14(6): 707-713).

NIH/MediHerb Echinacea Clinical Trial Our research collaborations extend to the United States where we have a large scale National Institutes of Health (NIH) funded project to examine the efficacy of MediHerb’s Echinacea Premium tablets for the alleviation of the common cold. This project is a double-blind, placebocontrolled trial among the patients of the Verona Family Medicine Clinic, USA. This valuable trial will provide further evidence of efficacy that has already been demonstrated by a three-arm trial completed at the National College of Naturopathic Medicine in 1998. This earlier trial compared Echinacea Premium (standardised for alkylamides) to an adaptogen formula containing Korean Ginseng, Withania and Astragalus, and placebo in the prevention of winter colds over a three month period (MacIntosh A et al. AANP Convention, Coeur d’ Arlene, 1999). Those taking Echinacea Premium had a statistically significant (p = 0.03) decrease in winter infections when compared to placebo. The placebo group averaged an infection rate of 10% whereas the Echinacea group infection rate dropped to 2% at day 70. Ex vivo evidence of the efficacy of MediHerb Echinacea Premium for boosting immune function has also been obtained by researchers at the Royal Melbourne Institute of Technology (Francis A et al. Australian Neuroscience Society, Melbourne, 2000).

For more information on the National Institutes of Health (NIH) see www.nih.gov.

More Trials MediHerb has also donated herbal medicines and matching placebos for other clinical trials. We are able to offer a uniquely integrated service to trial investigators: research-driven product quality and manufacturing; pharmaceutical standard GMP; packaged products with blinding completed and all relevant documentation. Some of these trials include: Several trials show the efficacy of Kava, eg for the treatment of Generalised Anxiety Disorder (Sarris J et al. J Clin Psychopharmacol In Press) and chronic anxiety (Sarris J et al. Psychopharmacology 2009; 205(3): 399-407) and it’s safety (eg Sarris J et al. Phytother Res In Press). Valerian Complex for sleep problems in older adults (Royal Melbourne Institute of Technology) Formulated product for ADHD (Royal Melbourne Institute of Technology) Horsechestnut for venous leg ulcers (University of South Australia) Cognition enhancement in healthy students (University of Tasmania) Formulated product for menopause (Royal Melbourne Institute of Technology) Mexican Valerian for sleep difficulties in children with intellectual deficits (Royal Melbourne Institute of Technology) (Francis A, Dempster R. Phytomedicine 2002; 9(4): 273-279)

Bacopa monnieri

Clinical Feedback Trials Clinical feedback trials involve our practitioners in the development and validation of new products prior to launch. By working together we are able to gather valid clinical data in a timely and cost-effective manner. Feedback trials were completed for Saligesic (a highly potent willow bark product for the symptomatic relief of lower back pain) and Cramplex (a formulated product for the symptomatic relief of dysmenorrhoea) prior to their launch. The data generated from these trials is depicted in the graphs and clearly demonstrates their efficacy. Saligesic Feedback Trial Results 15

0 time

3 week

Worst Pain

Background Pain

8 7 6 5 4 3 2 1 Prior to trial Worst Pain

Product Catalogue

Painkiller Usage

Cramplex Feedback Trial Results

6 week

First menstrual cycle

Second menstrual cycle

Background Pain

Painkiller Usage

False Unicorn

Understanding the complexities of the phytochemicals within herbs is fundamental to quality and efficacy. Once these are defined and identified through extensive laboratory analysis, quality assurance procedures can be established to ensure that the same premium quality raw material is consistently used.

A unique steriodal saponin has been identified in Chamaelirium luteum (False Unicorn) that is not found in any other medicinal herb. This unique phytochemical could be the key to False Unicorn’s therapeutic effect.

A complicating factor of phytochemical analysis is the concept of marker and active compounds:

In Traditional Chinese Medicine, the roots of Paeonia lactiflora (Paeonia) are typically bleached. Investigation into the affect of bleaching the roots has shown that the active constituent paeoniflorin, is modified into a stable new compound paeoniflorin sulfonate.

A marker is a characteristic phytochemical found in a herb plant that is chosen to represent a quality standard An active is a phytochemical that is important for a given therapeutic effect of a herb A marker compound may or may not be responsible for any therapeutic efficacy of the herb. A vast amount of phytochemical data has been compiled on various plant species from around the world, but there is a relative scarcity of data relating to the identification of active constituents. This is partly due to the often observed finding that the therapeutic action of a herb is due to the synergy of multiple phytochemicals, rather than just one isolated component. MediHerb, in conjunction with the University of Queensland, is currently involved in a research project investigating the phytochemical profile of poorly-defined medicinal plants. This ground-breaking research has already provided some interesting data on widely used herbs whose phytochemical profile has previously been poorly understood, for example:

Dioscorea villosa

Paeonia

The elucidation of the structure has been published in Tetrahedron Letters 2005; 46: 2615-2618 and the HPLC method to allow identification of this modification by other manufacturers has appeared in Phytochemical Analysis 2006; 17: 251-254.

Wild Yam The phytochemical profile of Wild Yam is based on scientific literature from the 1940s. MediHerb undertook a project in conjunction with Associate Professor James De Voss, Chemistry Department, University of Queensland to investigate the phytochemistry. It is widely misconstrued that Dioscorea villosa contains diosgenin and many products have this as a statement on their labels. However it does not contain diosgenin, but rather the diosgenin precursors. Traditionally Dioscorea villosa was believed to contain predominantly dioscin, however, the origin of this assignment is unclear (dioscin is a steroidal glycoside

Chamaelirium luteum

MediHerb Philosophy

Phytochemical Investigations

precursor of diosgenin). Commercially available Dioscorea villosa is in the form of dried roots, usually harvested at the end of summer or autumn when the plant is dying back to its rootstock. It was found that these roots contained only very small amounts of dioscin, not the predominance as previously thought. The major saponin found in the autumn harvested roots were in fact the furostanolbased saponins, methylparvifloside and methylprotodeltonin. While the spirostanol-based saponins, Zingiberensis saponin I and deltonin were the major saponins for samples harvested in summer. Further work continues. It is alarming that such a widely used herb is so misunderstood and commonly substituted.

Shatavari

Prior to 2005, Shatavari was not on the Register of Therapeutic Goods which meant that it was only available in liquid extract form to practitioners. MediHerb recognised the clinical importance of Shatavari also being available in a tablet. MediHerb undertook a two year process Major Saponins of Dioscorea villosa to prepare the required TGA submission, Major Saponins of Dioscorea villosa Major Saponins of Dioscorea villosa which required careful investigation into the phytochemistry of Shatavari to be conducted. MediHerb’s collaboration with the 4-6 research group of Associate Professor Compounds 1-2 Compounds Major Saponins of Dioscorea villosa Compounds 1-2 Compounds 4-6 De Voss from the Chemistry Department R= of the University of Queensland R= R= R= revealed that the structures of the main saponins were incorrectly reported in 1 – Methylparvifloside 2 – Methylprotodeltonin Compounds 1-2 Compounds 4-6 4 – Zingiberensis saponin I or glucosidodeltonin 5 – Deltonin 2 – Methylprotodeltonin 1 – Methylparvifloside the literature. Three research papers 5 – Deltonin 4 – Zingiberensis saponin I or glucosidodeltonin R= have been accepted for publication: R= R= Tetrahedron Letters 2006; 47: 6965R= 6969 & 8683-8687 and Phytochemistry 2 – Methylprotodeltonin 1 – Methylparvifloside 6 – Dioscin 2008; 69(3): 796-804. 5 – Deltonin 4 – Zingiberensis saponin I or glucosidodeltonin 6 – Dioscin

www.mediherb.com.au 6 – Dioscin

Garlic

Anthelmintic Herbs

It is now considered to be a requirement for publication of clinical trials that the phytochemical constituents of the formulation be known and they must be included in the submission. Variations in phytochemical constituents is believed to be responsible for the varied clinical results obtained in many trials. An analysis of Garlic trials (Lawson LD et al. J Agric Food Chem 2001; 49(5): 2592‑2599) has linked the efficacy of Garlic formulations to those containing a high level of allicin release. However, in many early trials this information was not provided, either because it was not available or was proprietary.

A project investigating the phytochemical characterisation of herbs with anthelmintic activity was conducted in conjunction with the Chemistry Department of the University of Queensland and the Department of Primary Industries. This project involved a PhD student and a postdoctoral researcher and targeted the identification of herbs with high anthelmintic activity and the constituents of those herbs responsible for this activity. The results of this research led to the reformulation of MediHerb’s Wormwood Complex tablets.

Formation of Allicin from Alliin upon crushing Garlic

Research programs on the growing and post-harvest handling of herbs have been undertaken at a range of academic institutions, most with the support of the Australian Government under the Rural Industries Research and Development Corporation (RIRDC) grant scheme. These projects look at the importance of varietal selection, soil and climatic conditions, harvest time, post-harvest drying methods and storage in herb quality and efficacy. Projects under the RIRDC scheme have included three-year PhD research grants for the optimisation of Echinacea purpurea (in conjunction with the University of Newcastle), a study of Matricaria recutita (Chamomile) at the University of Tasmania, and examination of Valeriana officinalis (Valerian) at the University of Newcastle. Another project has recently been completed in collaboration with the Research Institute of Agroecology in Slovakia, investigating

Alliin

Alliinase

Allicin

Agronomic Research

Caffeoylquinic Acids

Flavonoids

Optimised Harvest

Pre-Research

Product Catalogue

the optimal growth conditions for Tribulus terrestris (Tribulus). Many smaller projects have centred on the optimisation of other herbs within the MediHerb range. One such example is Cynara scolymus (Globe Artichoke). Globe Artichoke contains a mixture of caffeoylquinic acids and flavonoids that contribute to its clinical effect. These were found to be quite variable in the raw materials sourced by MediHerb. A research project was initiated to investigate the causes of the variability, looking at varietal differences, geographical effects, harvest parameters, and post-harvest handling. It was found that by optimising the post-harvest handling of the Globe Artichoke leaves it was possible to increase the level of desirable phytochemicals by a factor of six.

Cynara scolymus

By optimising the post-harvest handling of Globe Artichoke the levels of phytochemicals were increased by a factor of six

In Australia, herbal and nutritional products are regulated by the Therapeutic Goods Administration (TGA), part of the Federal Government. This is the same body and standard applied to pharmaceutical manufacturing. The TGA conducts regular audits of MediHerb’s manufacturing facility to ensure Pharmaceutical GMP compliance. In practice, however, herbal manufacturing under pharmaceutical GMP is more complex than for conventional drugs because of the extra complexity conferred by the varying constituents present in the herb’s biological matrix.

Quality in the Laboratory – Good Laboratory Practice

MediHerb Philosophy

The Quality Control and Research and Development laboratories are legally required to comply with the Australian standards of Good Laboratory Practice (GLP) under the Therapeutic Goods Act. GLP means adherence to strict criteria such as:

MediHerb Philosophy

Quality through Pharmaceutical Good Manufacturing Practice

Test method reliability: validation and control Instrument calibration and maintenance programs Reagent and standard quality control Authorised materials and product specifications Quality, integrity and authenticity of data

The pharmaceutical code of ‘Good Manufacturing Practice’ (GMP) is a quality assurance program that ensures:

Over 20 years of compliance with pharmaceutical GMP and Therapeutic Goods Administration requirements further underscores

Validated equipment and processes Documented processes and systems Detailed records of each stage of manufacturing of each and every batch of product Control of the manufacturing environment, air and water Control of manufacturing materials, via quarantine, segregation and reconciliation Stability testing of goods offered for sale Documentation of customer complaints

our own dedication to making high quality products. At MediHerb our world-leading understanding of all these quality issues ensures that the practitioner ALWAYS receives high quality therapeutic clinical solutions.

That’s the guarantee of the MediHerb Philosophy.

“ Manufacturing through Pharmaceutical Good Manufacturing Practice ensures quality”

www.mediherb.com.au

Product Information Body Systems Legend

Kerry Bone’s Essentials

Whole Life Vitality

The Kerry Bone’s Essentials range includes the top 30 herbal products that Kerry Bone uses most often in his clinical practice. This collection of essentials shows how simple effective herbal medicine can be.

These products are core products in our comprehensive Whole Life Vitality patient programs which have been designed by health experts and leading naturopaths. Whole Life Vitality – Eating for Health is an effective weight management program. Whole Life Vitality – Detox for Health is a complete detoxification program. For more information on the Whole Life Vitality programs see page 86.

The products in this catalogue are categorised by body system for your easy reference. To order a full Body Systems Index Wall Chart, contact Customer Service. Musculoskeletal Endocrine General Male Endocrine Urinary System Skin Nervous System Respiratory Cardiovascular & Circulation Digestive System Female Endocrine Immune

“Our passion at MediHerb is to provide optimum treatment solutions by combining the time-honoured wisdom of traditional knowledge with sound clinical experience and the rigour of scientific research.” Professor Kerry Bone

Products with this logo are part of the

range

These are the top 30 herbal formulations that Kerry Bone uses in his clinical practice. For more information on Kerry Bone’s Essentials visit www.mediherb.com.au

Product Catalogue

240 g Powder Nutritional Function The pleasant tasting powder Activated Beet-Greens contains beetroot, which contains inorganic nitrate; the edible algae Spirulina and Chlorella; kale, kiwifruit as well as the herbs Withania, Turmeric and Green Tea. Also present are blueberry powder, Grape seed, Blackcurrant seed and skin, and Acerola Cherry which is high in vitamin C. This combination of ingredients provides many nutrients including amino acids, vitamins and minerals. Activated BeetGreens is naturally sweetened with thaumatin.

Each 8g serve contains: Protein

1.8 g

Fat, total

<1 g

– saturated

<1 g

Carbohydrate

5.2 g

– sugars

2.6 g

Sodium

34 mg

Vitamin A (as betacarotene) (48% RDI*)

362.4 RE

Vitamin B12 (100% RDI*)

2 μg

Vitamin C (134% RDI*)

53.7 mg

Iron (25% RDI*)

3 mg

Nitrate (from beetroot)

50 mg

Beta vulgaris root powder

50.1 g

Vitis vinifera & Ribes nigrum extract equiv. fresh seed & skin

6.1 g

Withania somnifera extract equiv. dry root

3.75 g

Curcuma longa extract equiv. dry rhizome

1.9 g

Actinidia deliciosa extract & powder equiv. fresh fruit

1.4 g

Chlorella pyrenoidosa cracked cell powder

Spirulina maxima whole plant powder

Camellia sinensis extract equiv. dry leaf

600 mg

Malpighia glabra extract equiv. dry fruit

270 mg

Brassica oleracea var. acephala powder

200 mg

Vaccinium corymbosum juice powder

105 mg

Usage

Directions:

Use Activated Beet-Greens daily as a supplementary food to: Support energy, performance, stamina, endurance and general health Provide nutrients for energy metabolism and reduction of fatigue Help protect cells from free radicals Contains Beetroot which is high in nitrate. Nitrate has been shown to support cardiovascular health Activated Beet-Greens is low in sodium. A diet low in sodium reduces blood pressure Provide amino acids Complement a nutritious diet Contribute to normal cognitive function, normal immune system function, normal blood formation and normal homocysteine metabolism (due to content of vitamins A, B12 and C, and iron) This food is not a sole source of nutrition and should be consumed in conjunction with a nutritious diet.

Adults: Mix 2 teaspoons (8 grams) in water or juice once daily. Alternatively 2 teaspoons can be sprinkled onto fruit, yoghurt or mixed in with a smoothie. Contains no artificial colours, flavouring or preservatives.

Product Information

Activated BeetGreens Powder

Contraindications and Cautions Contraindicated in patients taking warfarin, as the Algae, Kale and Kiwifruit may contain vitamin K. Contraindicated in those with allergy to Kiwifruit. Until more information is available, Nrf2/AREinducing herbs should not be taken at least 48 hours either side of each chemotherapy or radiotherapy treatment. Red-coloured urine and/or faeces, a harmless side effect of ingesting Beetroot, may occur. Discontinue at least 7 days prior to general anaesthesia.

Additional Therapy Rhodiola & Ginseng or Adrenal Complex to improve stress adaptation. Consider Hawthorn tablets for cardiovascular support. P2-Detox powder to support the normal phase II detoxification processes in the liver. Garlic Forte tablets or Phellodendron Forte tablets to assist in the maintenance of normal/healthy cholesterol or lipid levels in healthy individuals. Bacopa Complex to relieve the stress of study or work. Vitanox® or PhytoRegenex tablets for antioxidant support.

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Active Mag-Cal 60 Tablets Mode of Action Magnesium is essential for muscular relaxation in skeletal and smooth muscle. Calcium and magnesium are required for tooth and bone hardness. Vitamin D helps regulate calcium levels in the blood and increases the active absorption of calcium for optimal bone integrity.

Each tablet contains: Magnesium phosphate (equiv. to Magnesium 47.5 mg)

230 mg

Magnesium orotate dihydrate (equiv. to Magnesium 13.2 mg)

200 mg

Magnesium amino acid chelate (equiv. to Magnesium 30 mg)

150 mg

(Total elemental Magnesium 90.7 mg) Calcium phosphate (equiv. to Calcium 37.5 mg)

100 mg

Calcium citrate hydrate (equiv. to Calcium 21.1 mg)

100 mg

Calcium hydrogen phosphate (equiv. to Calcium 11.7 mg)

50 mg

(Total elemental Calcium 70.3 mg) Potassium phosphate-dibasic (equiv. to Potassium 45 mg)

100 mg

Manganese amino acid chelate (equiv. to Manganese 5 mg)

50 mg

Zinc gluconate (equiv. to Zinc 4 mg)

30 mg

Ascorbic acid (Vitamin C)

50 mg

Pyridoxine hydrochloride (equiv. to Vitamin B6 41.01 mg)

50 mg

Cholecalciferol (Vitamin D3 100 IU)

2.5 mcg

Indications Supplementation with magnesium may help to provide relief from muscular cramps, migraine and premenstrual tension caused by magnesium deficiency. Prevention/treatment of magnesium and calcium deficiencies. May help relieve premenstrual symptoms such as fluid retention and mood changes. Beneficial during times of stress

Contraindications and Cautions Contraindicated in hyperparathyroidism, chronic kidney disease and calcium kidney stones. Patients taking digoxin should have calcium blood levels monitored closely. If taking tetracycline or quinolone antibiotics, biphosphonates (osteoporosis drugs) or thyroid hormone, separate doses by at least two hours. Vitamin supplements should not replace a balanced diet. This product contains pyridoxine hydrochloride which may be dangerous when used in large amounts or for a long time. Discontinue 7 days prior to general anaesthesia.

Adrenal Complex 60 Tablets Mode of Action Licorice and Rehmannia are used traditionally to support the healthy functioning of the adrenal glands, helping to provide a healthy response to temporary stress. They have also been used traditionally for their anti-inflammatory properties.

Product Catalogue

Dosage and Administration Adults: 1 tablet 3 times daily.

Additional Therapy For relief of joint swelling and joint inflammation consider the addition of Joint Defence tablets. Boswellia Complex tablets to relieve joint inflammation. Cramplex tablets to help provide symptomatic relief from dysmenorrhoea. Consider Mega Mag powder if additional magnesium is required. Review patientâ&#x20AC;&#x2122;s dietary and lifestyle habits, which contribute to calcium and magnesium loss or decreased absorption ie smoking, intake of caffeine, refined sugars, alcohol. Encourage weight-bearing exercise at a minimum of 20â&#x20AC;Żminutes daily.

Each tablet contains: Glycyrrhiza glabra (Licorice) extract equivalent to dry root

1.75 g

Rehmannia glutinosa (Rehmannia) extract equivalent to dry rhizome

750 mg

Indications Traditionally used in Western Herbal Medicine to provide support when experiencing temporary stress. Traditionally used in Western Herbal Medicine to support healthy functioning of the adrenal glands.

Contraindications and Cautions Due to Licorice: contraindicated in hypertension (including women who are prone to hypertension in pregnancy), oedema and in those taking thiazide or loop diuretics; not recommended during pregnancy, except at the lowest dosage for short periods; caution is advised in patients receiving prednisolone by injection and in those with elevated liver enzymes taking immunosuppressives. Licorice may reduce side effects of potassium sparing diuretics such as spironolactone. Avoid long-term use in patients taking antihypertensive medications, digoxin and other potassium depleting drugs. Caution is advised in patients taking cilostazol. Place patients on a high potassium diet. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-3 times daily.

Additional Therapy Combine with ThyAdren Support tablets where adrenal support is indicated. Everyday B Multi tablets, Vital Woman tablets or Rhodiola & Ginseng tablets may be beneficial at times of increased physical or mental demand. Combines well with Echinacea Premium tablets or Andrographis Complex tablets for immune support. Consider ThyroCo tablets to support healthy thyroid function in physically and mentally challenging circumstances. Combine with Valerian Complex or Mexican Valerian tablets for relief of sleeplessness, or Kava tablets to help relieve mild anxiety.

Albizia Complex 60 Tablets Mode of Action The combined action of these herbs is antiallergic and anti-inflammatory, reducing both the allergic response and its inflammatory consequence. Albizia has been used in Ayurvedic medicine to relieve the symptoms associated with allergy and inflammation of the respiratory tract and skin.

Each tablet contains: Albizia lebbeck (Albizia) extract equivalent to dry stem bark

800 mg

Scutellaria baicalensis (Baical Skullcap) extract equivalent to dry root

800 mg

Tanacetum parthenium (Feverfew) extract equivalent to dry herb

50 mg

Indications Relief of the symptoms of allergies. Traditionally used to relieve the symptoms of allergy and inflammation of the skin.

Contraindications and Cautions Caution is advised in patients taking statin drugs and losartan. Contraindicated in those with a known hypersensitivity to Feverfew, parthenolide or other members of the Compositae family. Discontinue 7 days prior to general anaesthesia.

Additional Therapy To assist the mucous membranes of the upper respiratory tract combine with Eyebright Complex tablets. To help maintain healthy skin combine with Clivers Complex tablets. Consider Echinacea Premium tablets for immune support. Consider Nigella 1:2 liquid extract.

Dosage and Administration

Albizia Complex Product Information

Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily. For seasonal allergies start treatment 4 to 6 weeks before expected onset.

For relief of the symptoms of allergies

Scutellaria baicalensis

Andrographis Complex 60 Tablets Mode of Action Andrographis has been traditionally used for relief of flu, cough and sore throat. It also is a bitter and liver tonic. Andrographis extracts standardised for andrographolide may relieve the symptoms of uncomplicated upper respiratory tract infection. This product contains a mixture of alkylamides, a class of Echinacea compounds which are constituents identified as bioavailable (present in plasma after ingestion) as demonstrated in a human phase I trial. These alkylamides may help reduce the incidence of winter colds. Holy Basil has been used traditionally as a tonic and for relief of common cold, fever and flu.

Each tablet contains: Andrographis paniculata (Andrographis) extract equivalent to dry leaf

2.0 g

Ocimum tenuiflorum (Holy Basil) extract equivalent to dry herb

500 mg

Echinacea purpurea (Echinacea) extract equivalent to dry root

300 mg

Echinacea angustifolia (Echinacea) extract equivalent to dry root

200 mg

Ocimum tenuiflorum (Holy Basil) herb essential oil

10 mg

standardised to contain andrographolide 50 mg

containing alkylamides 2.0 mg from both Echinacea extracts

Indications When taken soon after exposure, or at the first sign of symptoms may provide support for and relief of the symptoms of colds, flu and mild upper respiratory infections. Traditionally used for the relief of the fever of flu. Traditionally used to help maintain appetite and digestion. Traditionally used as a liver tonic.

Contraindications and Cautions Contraindicated in pregnancy. Echinacea is contraindicated in patients taking immunosuppressant medication (eg transplant patients). Short-term therapy only is suggested in this instance. Caution is advised in patients receiving midazolam by injection. The risk of allergic reaction to Echinacea is very small, especially when preparations of the root are used (as these are free of pollen). Discontinue 7 days prior to general anaesthesia. Not to be used in children under two years of age without medical advice.

Additional Therapy For further immune support combine with Echinacea Premium tablets or Zinc Protect tablets. For relief of symptoms associated with dry, sore throats consider Herbal Throat Spray. Combine with Poly-C Powder which may help reduce severity and duration of colds. For relief of the symptoms of upper respiratory catarrh, hay fever and sinusitis consider Eyebright Complex tablets. See Echinacea information on page 39

Dosage and Administration Adults: 1 tablet 2-4 times daily. Dosage can be increased to 6Â tablets daily temporarily for acute conditions. Children 6-12 years: 1 tablet 1-2 times daily.

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Andrographis Complex

May provide support for the symptoms of colds and flu

Astragalus Complex 60 Tablets Mode of Action The combined effect of these herbs makes this a predominantly adaptogenic and tonic formula providing support for the immune system. Astragalus Complex is well suited to long-term use. The best effects are most often seen after 3 months of use.

Each tablet contains: Astragalus membranaceus (Astragalus) extract equivalent to dry root

850 mg

Eleutherococcus senticosus (Siberian Ginseng) extract equivalent to dry root

750 mg

Echinacea purpurea (Echinacea) extract equivalent to dry root

650 mg

standardised to contain syringaresinol diglucosides (as eleutherosides) 600 mcg

Indications Temporary relief of coughs. Relief of mucous congestion. Assists in the maintenance or improvement of general well‑being. Beneficial during times of stress. Astragalus is used traditionally to build up vitality.

Contraindications and Cautions Discontinue during any acute infectious illness or fever, since the tonic and warming properties of Astragalus and Siberian Ginseng may aggravate the illness. The risk of allergic reaction to Echinacea is very small, especially if preparations of the root are used since these are free of pollens. Echinacea is contraindicated in patients taking immunosuppressant medication (eg transplant patients). Short-term therapy only is suggested in this instance. Caution is advised in patients receiving midazolam by injection. Discontinue 7 days prior to general anaesthesia.

Bacopa Complex

Dosage and Administration Adults: 1 tablet 2-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Additional Therapy Combines well with Withania Complex tablets to help increase stamina and endurance. Combine with Siberian Ginseng tablets to enhance the body’s adaptation to stress and build up general vitality.. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Poly-C Powder may assist during times of increased physical stress. Combine with Cat’s Claw Forte tablets or Activated Beet-Greens powder to support the immune system.

Each tablet contains: Bacopa monnieri (Bacopa) extract equivalent to dry herb

3.75 g

Schisandra chinensis (Schisandra) extract equivalent to dry fruit

660 mg

Eleutherococcus senticosus (Siberian Ginseng) extract equivalent to dry root

500 mg

Rosmarinus officinalis (Rosemary) herb top flowering essential oil

10 mg

standardised to contain bacosides calculated as bacoside A 37.5 mg

60 Tablets Mode of Action Bacopa, Siberian Ginseng and Schisandra provide a tonic action for the whole body and the nervous system in particular. Rosemary leaf has been traditionally used to provide support for the liver.

standardised to contain syringaresinol diglucosides (as eleutherosides) 400 mcg

Indications Helps relieve the stress of study or work. Assists in the maintenance or improvement of general well‑being.

Contraindications and Cautions Bacopa Complex should be discontinued during the treatment of any acute infectious illness. As Schisandra has been used traditionally to induce labour, is contraindicated in pregnancy, except at birth. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-3 times daily.

Product Catalogue

Additional Therapy Ginkgo Forte tablets to assist cognitive function. Consider Rhodiola & Ginseng tablets or Withania & Ginseng tablets for stress. Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Poly-C Powder may assist during times of increased mental stress. Consider Activated Beet-Greens powder or PhytoRegenex tablets to help aid cognitive function. Consider Nervagesic tablets to promote sleep. See Schisandra Quality Issues on page 53

Each capsule contains: Phellodendron amurense (Phellodendron) extract equivalent to dry stem bark

1.6 g

Andrographis paniculata (Andrographis) extract equivalent to dry whole plant

1.0 g

Anise (Pimpinella anisum) fruit essential oil

125 mg

Oregano (Origanum vulgare) leaf essential oil

75 mg

standardised to contain berberine 36 mg

60 Capsules Mode of Action Contains herbs traditionally used to support healthy intestinal function and for immune support.

standardised to contain andrographolide 10 mg

Additional Therapy

Indications Supports healthy intestinal and immune function.

Contraindications and Cautions Contraindicated in pregnancy and lactation. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration

Combine with Slippery Elm 400mg capsules to encourage a healthy intestinal environment. Combines well with Golden Seal tablets and Probiotica capsules. For additional immune support consider Echinacea Premium tablets. Consider Vitanox速 tablets for antioxidant support.

Adults: 1-2 capsules 3 times daily. Children 6-12 years: 1 capsule 2-3 times daily. Enteric coated capsules. (Take capsule whole, do not break or crush.)

In vitro Antimicrobial Activity by Essential Oils & Herbs The in vitro antimicrobial activity of Oregano and Anise essential oils and extract of Andrographis was assessed by an independent laboratory at Charles Sturt University in 2007. The test microorganisms included two yeasts (Candida albicans, Candida glabrata) and four bacteria (Enterococcus faecalis, Escherichia coli (E. coli), Klebsiella pneumonia, Salmonella spp. serotype Monschaui). All of these organisms are commonly found in the human intestinal flora. The compounds were suitably prepared in broth to a concentration of 0.1 w/v (weight per volume). The test organisms were prepared, added to a broth containing each compound and allowed to incubate for a period of 3 hours. Colony count was then performed after 48 hours for yeasts and 24 hours for bacteria. Assays were performed in triplicate. The effect of each compound on the microbial growth of the test organisms is outlined in the Table. A value of 0 means there were no colonies left after 3 hours. Values over 100 are possible because the organism may have grown faster over the 3 hour time period than the controls. The emulsifier used in the preparation of the essential oils made a small contribution to their antimicrobial effect.

Microorganism

Product Information

Bacto-Cand GI

Key findings were:

Mean Growth (%) Oregano (essential oil)

Anise (essential oil) 29

Candida albicans

Candida glabrata

Enterococcus faecalis

Escherichia coli

Klebsiella pneumonia

0.3

Salmonella spp. (serotype: Monschaui)

Oregano essential oil completely inhibited the growth of all organisms. Anise essential oil significantly inhibited the growth of all organisms, with the effect on Candida albicans less than that for the other organisms which were almost completely inhibited.

Table 1. Colony count as a percentage of controls.

Bilberry

Each tablet contains: Vaccinium myrtillus (Bilberry) extract equivalent to fresh fruit

6.0 g

standardised to contain anthocyanosides 21.6 mg

60 Tablets Mode of Action During World War II, bilberry jam was reportedly consumed by RAF pilots to improve their night vision.

Indications Supports healthy eye function. May assist peripheral circulation. Maintains health of capillaries.

Contraindications and Cautions Very high doses (> 100 mg anthocyanins/day) should be used cautiously in patients with haemorrhagic disorders and in those taking warfarin or antiplatelet drugs. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Additional Therapy Combines well with Ginkgo Forte tablets to support peripheral circulation. Consider Curcuma Active tablets, Vitanox速 tablets or Methyl Factors tablets for additional antioxidant support. Consider Tissue Regenex tablets for tissue healing support. Consider Saffron 1:20 tincture. See Bilberry Quality Issues on page 30

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Bilberry Quality Issues In 2003 MediHerb received samples of Vaccinium myrtillus or bilberry fruit extracts which differed in behaviour to that normally received. The standard method of determining the anthocyanin content at this time was a spectrophotometric assay. Using this method, anthocyanin levels of two extracts were found to be 25% as claimed by the manufacturers. When high-performance liquid chromatography (HPLC) was used, however, one extract was found to contain 9% anthocyanins probably not derived from V. myrtillus but from another species as well as an adulterant chemical. This adulterant was subsequently identified, using HPLC, mass spectroscopy, and nuclear magnetic resonance, as amaranth (3-hydroxy-4-[(4-sulfo-1-naphthalenyl)azo]-2,7naphthalenedisulfonic acid trisodium salts) a synthetic dark red dye. It was evident that when deliberate adulteration occurs in an extract, a spectrophotometric assay is inadequate to accurately determine the levels of compounds such as anthocyanins. This has led to a change in the standard method of analysis for bilberry extracts to a more sophisticated method of analysis, (HPLC with photodiode array detection) to counter this form of adulteration. The results of this discovery by the MediHerb team were published (Journal of Agricultural Chemistry and Food Science 2006: 54: 7378-7382) and led to regulators around the world to review accepted test methods for Bilberry. The British Pharmacopoiea also changed the method of analysis for Bilberry as a result of this discovery.

Vaccinium myrtillus HPLC profile of Bilberry

Poor Quality (Hydrolysed) Bilberry

Good quality Bilberry extract

Boswellia Complex

Each tablet contains: Boswellia serrata (Boswellia) extract equivalent to dry gum oleoresin

1.9 g

Curcuma longa (Turmeric) extract equivalent to dry rhizome

2.0 g

Mode of Action

Apium graveolens (Celery) extract equivalent to dry fruit

1.0 g

Research has shown that the anti‑inflammatory properties of Boswellia resin are due to compounds known as boswellic acids which reduce the formation of leukotrienes by inhibiting the enzyme 5-lipoxygenase. This action is supported by Ginger and Celery Seed which have been traditionally used to provide temporary relief of the symptoms of arthritis and gout.

Zingiber officinale (Ginger) extract equivalent to dry rhizome

300 mg

60 Tablets

standardised to contain boswellic acids 180 mg standardised to contain curcuminoids 76 mg

Indications Temporary relief of the pain and inflammation of mild arthritis, mild osteoarthritis and mild rheumatism. Boswellic acids from Boswellia help reduce the formation of leukotrienes by inhibiting the enzyme 5-lipoxygenase.

Contraindications and Cautions Daily doses of dried Ginger in excess of 4 g are contraindicated in patients who are already taking blood-thinning drugs such as warfarin or aspirin or who have increased risk of haemorrhage. In these patients, at doses of Ginger below this, and due to the presence of Turmeric, exercise caution. Contraindicated in patients taking nifedipine. Ginger should be used cautiously in patients taking antacids (it may decrease the effectiveness since ginger increases gastric secretory activity) or phenprocoumon. Caution in patients taking talinolol. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-4 times daily. Children 2-12 years: 1 tablet 1-2 times daily.

Product Catalogue

Additional Therapy Rehmannia Complex tablets and/or Joint Defence tablets may provide additional relief from arthritic symptoms. Consider Celery Seed 1:2 liquid extract. Add EFA Essentials capsules or Omega-3 Forte capsules, which may shift the balance of eicosanoids produced to those with anti-inflammatory activity. Consider Curcuma Active tablets, as curcumin has demonstrated anti-inflammatory and anti-arthritic activity and down-regulates numerous inflammatory mediators. For relief of pain use Saligesic tablets together with Boswellia Complex tablets. Consider Vitanox® tablets for antioxidant support. Consider Tissue Regenex tablets for tissue healing and antioxidant support. Consider Adrenal Complex tablets for herbs used traditionally to support adrenal function. For relief of joint stiffness and pain combine with PhytoRegenex tablets. Consider LymphoLytix to relieve mild inflammation.

60 Tablets

Broncafect Phytosynergist® liquid 200 mL Mode of Action This combination of herbs has soothing, expectorant and antispasmodic activity.

Each tablet contains: Glycyrrhiza glabra (Licorice) extract equivalent to dry root

750 mg

Asclepias tuberosa (Pleurisy Root) extract equivalent to dry root

375 mg

Echinacea purpurea (Echinacea) extract equivalent to dry root

375 mg

Marrubium vulgare (White Horehound) extract equivalent to dry herb

180 mg

Zingiber officinale (Ginger) extract equivalent to dry rhizome

180 mg

Thymus vulgaris (Thyme) herb flowering essential oil

10 mg

Each 5 mL dose contains: Glycyrrhiza glabra (Licorice) extract equivalent to dry root

1.0 g

Asclepias tuberosa (Pleurisy Root) extract equivalent to dry root

500 mg

Echinacea angustifolia (Echinacea) extract equivalent to dry root

500 mg

Thymus vulgaris (Thyme) extract equivalent to dry leaf

500 mg

Marrubium vulgare (White Horehound) extract equivalent to dry herb

250 mg

Zingiber officinale (Ginger) extract equivalent to dry rhizome

250 mg

Indications Contains herbs traditionally used for relief of the symptoms of bronchitis. Temporary relief of cough due to bronchial congestion and irritation. Provides Echinacea as immune supportive therapy for the relief of the symptoms of colds and mild upper respiratory tract infections.

Contraindications and Cautions

Asclepias tuberosa

Due to Licorice: contraindicated in hypertension (including women who are prone to hypertension in pregnancy), oedema and in those taking thiazide or loop diuretics; caution is advised in patients receiving prednisolone by injection. Licorice may reduce side effects of potassium sparing diuretics such as spironolactone. Avoid long-term use in patients taking antihypertensive medications, digoxin and other potassium depleting drugs. Place patients on a high potassium diet. Ginger should be used cautiously in patients taking antacids (it may decrease the effectiveness as ginger increases gastric secretory activity). The risk of allergic reaction to Echinacea is very small, especially if preparations of the root are used since these are free of pollens. Contraindicated in patients taking immunosuppressant medication (eg transplant patients). Short-term therapy only is suggested in this instance. Caution is advised in patients receiving midazolam by injection. Discontinue 7 days prior to general anaesthesia.

Product Information

Broncafect® tablets

Dosage and Administration Broncafect® tablets Adults: 1 tablet 4-8 times daily. Children 6-12 years: 1 tablet 1-4 times daily. This product is intended for short-term use. Broncafect Phytosynergist® liquid Adults: 5 mL with water or juice 3 times daily. In acute febrile conditions take with hot water and increase dose to 6 times daily. Children 6-12 years: 2.5 mL with water or juice 3 times daily. Not to be used in children under two years of age without medical advice.

Additional Therapy Combine with Andrographis Complex tablets for relief of respiratory infections, or Poly-C Powder for immune support. For relief of symptoms associated with dry, sore throats consider Herbal Throat Spray. Combine with PulmaCo tablets for the relief of symptoms associated with spasmodic conditions of the respiratory tract. For additional respiratory support and relief combine with hot Peppermint or Ginger tea.

Additional Contraindications and Cautions: Broncafect tablets Caution is advised in patients taking cilostazol or phenprocoumon. Daily doses of dried Ginger in excess of 4 g are contraindicated in patients who are already taking blood-thinning drugs such as warfarin or aspirin or who have increased risk of haemorrhage. In these patients, at doses of Ginger below this exercise caution. Contraindicated in patients taking nifedipine.

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Calcium Bone Complex 240 g Powder Mode of Action Multinutrient blend to support healthy bone tissue. The calcium citrate used in Calcium Bone Complex has a significantly greater absorption rate than carbonates. Kudzu is a natural source of isoflavones.

Each 6g dose contains: Pueraria lobata (Kudzu) extract equivalent to dry root

1.0 g

Calcium citrate (equivalent to Calcium 631.8 mg)

3.0 g

Magnesium phosphate (equivalent to Magnesium 266 mg)

968 mg

Zinc amino acid chelate (equivalent to Zinc 10 mg)

50 mg

Manganese amino acid chelate (equivalent to Manganese 2 mg)

20 mg

Inulin

500 mg

Silica - colloidal anhydrous (equivalent to Silicon 20 mg)

42.8 mg

Borax (equivalent to Boron 1 mg)

8.8 mg

Cholecalciferol (Vitamin D3 400 IU)

10 mcg

Phytomenadione (Vitamin K)

350 mcg

Indications Provides vitamins, minerals and co-factors which strengthen bone, help maintain bone health andhelp support bone mineralisation. Calcium supplementation may be of assistance in the prevention and/or treatment of osteoporosis. May help meet the calcium needs of mature women.

Contraindications and Cautions

Dosage and Administration Adults: Take one 6 g dose (two level scoops as supplied) two times daily.

Additional Therapy Consider Tissue Regenex tablets for tissue healing support. Combine with Wild Yam Complex tablets for relief of menopausal symptoms.

Contraindicated in hyperparathyroidism, sarcoidosis, renal impairment, calcium kidney stones and hormone-sensitive conditions (eg female reproductive cancers, fibroids, endometriosis). Contraindicated in patients taking calcium channel blockers and should only be taken by those on warfarin, cardiac glycosides or thiazide diuretics under close medical supervision and monitoring. If taking tetracycline or quinolone antibiotics, biphosphonates (osteoporosis drugs) or thyroid hormone, separate doses by at least two hours. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Cascara Complex 60 Tablets Mode of Action The combined action of compounds in Cascara Complex is a gentle laxative effect with reduced tendency to griping or colic.

Each tablet contains: Frangula purshiana (Rhamnus purshianus, Cascara) extract equivalent to dry stem bark

560 mg

Rumex crispus (Yellow Dock) extract equivalent to dry root and rhizome

375 mg

Taraxacum officinale (Dandelion) extract equivalent to dry root

375 mg

Anethum graveolens (Dill) seed essential oil

15 mg

Matricaria chamomilla (German Chamomile) flower essential oil

2 mg

Indications Laxative, assists in the relief of constipation. Relieves gastrointestinal symptoms related to constipation. Liver tonic, assists digestion and healthy digestive function.

Contraindications and Cautions Do not use when abdominal pain, nausea or vomiting are present, or if diarrhoea develops. Use with caution during pregnancy and lactation. Not for prolonged use or in excessive dosage. Avoid high doses in patients taking antiarrhythimic drugs and potassium depleting medications. Maintain patients on a high potassium diet and ensure adequate hydration. Use in children under 12 years is not recommended. The risk of allergic reaction to Chamomile oil is low, including in those with known hypersensitivity to Chamomile or to other plants in the Compositae family. Discontinue 7 days prior to general anaesthesia.

Product Catalogue

Dosage and Administration Adults: 1 tablet 3-4 times daily.

Additional Therapy Combine with Slippery Elm 400mg capsules to assist gastrointestinal tract health. Probiotica capsules to maintain healthy intestinal microflora. Consider Silymarin tablets as a supportive tonic for the liver. Consider Bacto-Cand GI capsules for healthy intestinal function. See Chamomile Quality Issues on page 37

Cat’s Claw Forte

Each tablet contains: Uncaria tomentosa (Cat’s Claw) extract equivalent to dry bark

2.1 g

standardised to contain pentacyclic oxindole alkaloids 6.0 mg

60 Tablets Cat’s Claw is used in traditional Peruvian medicine. It has tonic and restorative properties.

Indications

Additional Therapy

May assist with relief of inflammatory symptoms. Used traditionally to support the body’s natural defence system. Cat’s Claw is regarded as a tonic and restorative.

Contraindications and Cautions Do not use during pregnancy. Caution is advised in patients taking HIV protease inhibitors. Diarrhoea (temporary) has been reported. If it persists for more than 48 hours medical referral is indicated. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-3 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Combines well with Echinacea Premium tablets or Andrographis Complex tablets for additional immune system support. Combine with Astragalus Complex tablets to promote vitality. Consider Sheep Sorrel Combination tablets to support well-being. Consider Poly-C Powder as vitamin C may help reduce the severity and duration of cold symptoms. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Boswellia Complex tablets for additional anti-inflammatory activity. Consider Curcuma Active tablets, as curcumin has demonstrated anti-inflammatory activity and down-regulates numerous inflammatory mediators. Consider Activated Beet-Greens powder daily as a supplementary food to provide amino acids and contribute to normal immune system function.

Cat’s Claw Quality Issues Cat’s Claw (Uncaria tomentosa) is a herb traditionally used by the Asháninka Indians of Peru. The tribe recognised two different types of this plant (one was used therapeutically and the other was never used). This difference has been verified phytochemically and two chemotypes have been identified: the preferred chemotype contains only pentacyclic oxindole alkaloids (POAs) speciophylline, mitraphylline, pteropodine, isomitraphylline and isopteropodine; the other chemotype, which was never used, contains the tetracyclic oxindole alkaloids (TOAs) rhynchophylline and isorhynchophylline in addition to the POAs. The preference for the POA chemotype of Cat’s Claw has been validated by scientific research. MediHerb tests each batch of Cat’s Claw to determine that only the preferred chemotype is used to manufacture our Cat’s Claw products. The upper trace of herb, labelled A, shown below was rejected by our quality assurance testing as it contained the TOAs. The bottom trace of herb, labelled B, contains very low levels of TOA and was accepted.

Product Information

Mode of Action

Isopteropodine

Isorhynchophylline

Pteropodine

Rhynchophylline

Uncarine F

Uncaria tomentosa

Isomitraphylline

Speciophylline

Mitraphylline

Tetracyclic oxindole alkaloids

B Pentacyclic oxindole alkaloids

Chaste Tree

Each tablet contains: Vitex agnus-castus (Chaste Tree) extract equivalent to dry fruit

90 Tablets Mode of Action Chaste Tree helps maintain normal physiology in women.

Indications Relief of premenstrual syndrome (PMS) characterised by breast tenderness, abdominal bloating, swelling of fingers or ankles, mild anxiety and mild irritability. Relief of the symptoms caused by irregularities of the menstrual cycle.

Contraindications and Cautions Chaste Tree may aggravate pure spasmodic dysmenorrhoea not associated with premenstrual syndrome (PMS). Use cautiously in pregnancy and only in the early stages for treatment of insufficient corpus luteal function. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults and children over 12 years: 1 tablet 1-4 times daily.

500 mg

Additional Therapy For menstrual pain combine with Cramplex tablets. Consider PolyFem tablets for normal ovarian function, FibroFem tablets to support normal menstruation and EndoFem tablets to support normal healthy endometrial tissue. Consider Mega Mag powder or Active Mag-Cal tablets for premenstrual tension caused by magnesium deficiency. Consider Evening Primrose Oil capsules, Omega-3 Forte capsules or EFA Essentials capsules as a source of essential fatty acids. For more mature women combine with Wild Yam Complex tablets. May be combined with Livton® Complex tablets, LivCo® tablets or P2-Detox powder when indicated for liver support. See Chaste Tree Quality Issues on page 34

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Vitexilactone Vitetrifolin D Rotundifuran

Chaste Tree Quality Issues

Chaste Tree (Vitex agnus-castus) contains three important classes of phytochemicals: iridoid glycosides (such as agnuside and aucubin), flavonoids (such as casticin) and diterpenoids (such as vitexilactone, rotundifuran and vitetrifolin D). It is believed that the diterpenoids are the more important of these constituents and therefore MediHerb has developed analytical methods for the determination of these constituents and manufactures extracts containing high levels of these diterpenoids, but not at the expense of other vital components. Agnuside

Vitexilactone Vitetrifolin D Rotundifuran

Top Line: MediHerb Chaste Tree Tablets Second Line: Product X Third Line: Product Y

Vitex agnus-castus Agnuside

Clivers Complex 60 Tablets Mode of Action The wholistic interpretation of many skin problems is that they are caused by an inability of the eliminative organs to cope adequately with both exogenous and endogenous toxins. The herbs contained in Clivers Complex are used for the symptomatic relief of eczema. Traditionally, depurative and alterative herbs were used to aid the elimination of wastes from the body.

Each tablet contains: Galium aparine (Clivers) extract equivalent to dry herb

360 mg

Smilax ornata (Sarsaparilla) extract equivalent to dry root & rhizome

360 mg

Berberis aquifolium (Oregon Grape) extract equivalent to dry root & rhizome

360 mg

Arctium lappa (Burdock) extract equivalent to dry root

270 mg

Rumex crispus (Yellow Dock) extract equivalent to dry root

270 mg

Indications Helps maintain healthy skin. Relief of the symptoms of eczema and psoriasis.

Contraindications and Cautions Use with caution in pregnancy. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Product Catalogue

Additional Therapy Consider Albizia Complex tablets where there is skin inflammation and symptoms associated with allergies. Consider EFA Essentials capsules for disorders where inflammatory eicosanoids play a role. Consider adding Rehmannia Complex tablets for herbs traditionally used for relief of skin conditions such as eczema, urticaria and inflamed skin. Consider P2-Detox powder to provide compounds to support normal phase II detoxification processes. Combine with Poly-C Powder to support minor wound healing. Consider Tissue Regenex tablets for tissue healing. Add Cascara Complex tablets to promote elimination and provide a cleansing effect on the bowel.

Coleus Forte

Each tablet contains: Coleus forskohlii (Coleus) extract equivalent to dry root

5.61 g

standardised to contain forskolin 18.7 mg

Indications

60 Tablets

Supports a lifestyle approach to weight management. Coleus root has been traditionally used to support cardiovascular function.

Contraindications and Cautions Contraindicated in hypotension. Since forskolin may potentiate many drugs, Coleus should be used cautiously in patients taking prescribed medication, this applies especially to hypotensive and antiplatelet drugs. Coleus may cause an altered response to antiplatelet and anticoagulant drugs and patients taking these drugs should be monitored. Given the potential for forskolin to stimulate gastric acid, caution is also advised in patients with peptic ulceration and reflux. Discontinue 7 days prior to general anaesthesia.

Additional Therapy Consider Everyday Balance Protein Powder and Gymnema tablets or GlucoBalance tablets as part of a kilojoule-controlled eating plan. Combine with Hawthorn tablets and Garlic Forte tablets for cardiovascular system support. Consider Hawthorn Leaves 1:2 liquid extract. Combine with ThyroCo tablets to help maintain normal thyroid function. Consider ThyAdren Support tablets for thyroid and adrenal support. Consider Astragalus Complex tablets or PhytoRegenex tablets where stress is indicated.

Dosage and Administration

Cramplex 40 Tablets Mode of Action Combines five herbs traditionally known as analgesic, antispasmodic, circulatory stimulant and anti-inflammatory.

Product Information

Adults: 1 tablet 2-3 times daily.

Each tablet contains: Corydalis ambigua (Corydalis) extract equivalent to dry tuber

600 mg

Zingiber officinale (Ginger) extract equivalent to dry rhizome

400 mg

Rubus idaeus (Raspberry) extract equivalent to dry leaf

400 mg

Dioscorea villosa (Wild Yam) extract equivalent to dry root & rhizome

400 mg

Viburnum opulus (Cramp Bark) extract equivalent to dry stem bark

400 mg

Indications Traditionally used for relief of menstrual pain, menstrual cramping and symptoms of dysmenorrhoea. Traditionally used for the symptomatic relief of tension headache. Cramp Bark is traditionally used for the relief of cramping pain of smooth muscle.

Contraindications and Cautions Discontinue if pregnancy occurs. Daily doses of dried Ginger in excess of 4 g are contraindicated in patients who are already taking blood-thinning drugs such as warfarin or aspirin or who have increased risk of haemorrhage. In these patients, at doses of Ginger below this exercise caution. When prescribing Ginger caution is advised in patients with gallstones. Contraindicated in patients taking nifedipine. Ginger should be used cautiously in patients taking antacids (it may decrease the effectiveness since ginger increases gastric secretory activity) or phenprocoumon. Discontinue 7 days prior to general anaesthesia.

Additional Therapy Combine with St Johnâ&#x20AC;&#x2122;s Wort tablets for the nervous system. Consider Mega Mag powder or Active Mag-Cal tablets for relief of conditions caused by magnesium deficiency. Combine with Chaste Tree tablets for PMS. Consider FibroFem tablets to support normal menstruation, Nervagesic tablets to relieve pain associated with menstruation, and EndoFem tablets to support normal healthy endometrial tissue. Consider Fe-Max Iron Tonic PhytosynergistÂŽ liquid or Fe-Plex tablets as a supplement to compensate for loss of iron from bleeding. Diet should increase essential fatty acids (eg Evening Primrose Oil capsules, Omega-3 Forte capsules or EFA Essentials capsules), reduce saturated fats, eliminate refined foods, sugar, dairy products, methylxanthines (coffee and chocolate) and increase fresh fruits, vegetables, proteins and whole grains. See Wild Yam Quality Issues on page 74

Dosage and Administration Adults: 3-4 tablets 2 times daily. The mode of action of these herbs suggests that they should be taken 2 to 3 days before the period is due to start and during days 1 and 2 of the period.

8 7 6 5

Cramplex Feedback Trial Results A feedback trial was completed for Cramplex prior to its launch. The data generated from the trial is depicted in the graph and clearly demonstrates the efficacy of Cramplex.

4 3 2 1 0

Prior to trial Worst Pain

First menstrual cycle

Second menstrual cycle

Background Pain

Painkiller Usage

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Cranberry Complex 60 Tablets Mode of Action Cranberry Complex has a soothing activity on the urinary tract.

Each tablet contains: Vaccinium macrocarpon (Cranberry) juice concentrate equivalent to fresh fruit

2.5 g

Crateva nurvala (Crataeva) extract equivalent to dry stem bark

1.0 g

Arctostaphylos uva-ursi (Bearberry) extract equivalent to dry leaf

500 mg

Agathosma betulina (Barosma betulina, Buchu) leaf essential oil

12 mg

Indications Relief of the pain and burning sensation associated with cystitis. Cranberry may inhibit the adherence of bacteria to the urinary tract.

Contraindications and Cautions Contraindicated in pregnancy and lactation. High doses of Cranberry may interact with warfarin. Caution is advised in patients taking midazolam. Due to the tannins in this product, it should be consumed at least 2 hours away from ingestion of mineral supplements. Consider medical referral for pain/ irritation that persists for more than 48 hours. The presence of blood in the urine warrants immediate medical attention. Discontinue 7 days prior to general anaesthesia.

Curcuma Active

Dosage and Administration Adults: Subacute: 1 tablet 3-4 times daily. Acute: 2 tablets 3-4 times daily.

Additional Therapy May be combined with Echinacea Premium tablets or Andrographis Complex tablets for immune support. Combines well with ProstaCo capsules for urinary tract problems in mature men. Consider Nettle Root 1:2 liquid extract.

Each tablet contains: Curcumin phospholipid complex

500 mg

containing curcumin 90 mg

60 Tablets Mode of Action Curcumin is the active component of the rhizome of Turmeric (Curcuma longa). ‘Curcumin’ is often used as shorthand for the total curcuminoids, namely curcumin, demethoxycurcumin and bisdemethoxycurcumin – usually curcumin is the majority component. The absorption of total curcuminoids formulated with phosphatidylcholine (phospholipid) is up to 29-times higher than that of unformulated curcuminoids. This number (the relative absorption) depends on the dosage. For example, at a dosage of 2 tablets per day of curcumin phospholipid complex, the relative absorption was 27 times higher than that of unformulated curcuminoids. Curcumin has demonstrated antioxidant, anti-inflammatory and anti-arthritic activity and down-regulates numerous inflammatory mediators.

Indications Clinically trialled for the symptomatic relief of mild arthritis and to provide temporary relief of arthritic pain. Clinically trialled to increase joint mobility associated with arthritis and reduce joint swelling and inflammation associated with mild arthritis. May assist in the management of mild osteoarthritis, providing symptomatic relief and temporary relief of the pain. Turmeric has been used traditionally in Ayurvedic medicine to treat liver disorders, poor digestion, inflammation, arthritis, fevers, menstrual problems and skin disorders.

Contraindications and Cautions Despite Turmeric and curcumin having low toxicity, caution is advised (due to the increased bioavailability) for the use of curcumin phospholipid complex in pregnancy, women wishing to conceive and patients taking prescribed medications, such as those with a narrow therapeutic window and/or antiplatelet or anticoagulant drugs. Monitoring is advised for patients taking anti-inflammatory drugs, as reduced dosage of the drug may be possible. Contraindicated in obstruction of the biliary tract and caution is advised in gallstones. Discontinue 7 days prior to general anaesthesia.

Curcuma Active Bioavailable Curcumin A new generation of bioavailable curcumin. Backed by human clinical trials* from the brand you trust.

*References available on request

Product Catalogue

Dosage and Administration Adults: 1-2 tablets daily.

Additional Therapy Consider Cat’s Claw Forte tablets to support the body’s natural defence system. Consider P2-Detox powder to provide compounds to support normal phase II detoxification processes. Combine with Saligesic tablets for symptomatic pain relief. Consider Bilberry tablets to support eye health. Consider Horsechestnut Complex tablets to support peripheral circulation, and/or Tissue Regenex tablets to reduce swelling in conditions of mildly reduced circulation. Consider Poly-C Powder as a source of citrus bioflavonoids. Combine with Silymarin tablets for additional antioxidant activity. Consider GlucoBalance tablets to provide support for healthy blood glucose levels in healthy individuals.

60 Tablets Mode of Action The combined action of these five herbs is to enhance digestive processes by stimulating appetite, increasing digestive secretions, thus improving the breakdown of food. Bitters also assist the body to maintain normal immune function in the digestive system.

Each tablet contains: Silybum marianum (St Mary’s Thistle) extract equivalent to dry seed

2.1 g

Taraxacum officinale (Dandelion) extract equivalent to dry root

500 mg

Citrus reticulata (Chen Pi) extract equivalent to dry fruit peel

500 mg

Gentiana lutea (Gentian) extract equivalent to dry root

100 mg

Zingiber officinale (Ginger) extract equivalent to dry rhizome

100 mg

Mandarin oil coldpressed (Citrus reticulata)

12.5 mg

Chamomile oil German (Matricaria chamomilla)

5 mg

The coating of this tablet contains a quantity of Gentian to provide a bitter taste as swallowed.

Indications

Additional Therapy

Aids digestion. May enhance appetite and relieve sluggish dyspepsia.

Contraindications and Cautions Caution is advised for patients with hyperacidity, gastric inflammation or gastric ulceration and those with elevated liver enzymes taking immunosuppressives. The risk of allergic reaction to Chamomile oil is low, including in those with known hypersensitivity to Chamomile or to other plants in the Compositae family. Discontinue 7 days prior to general anaesthesia.

Probiotica capsules to maintain healthy intestinal microflora. Combine with Slippery Elm 400mg capsules to assist gastrointestinal tract health. Livton® Complex tablets for additional liver support. GlucoBalance tablets to support healthy blood sugar levels. Use with Wormwood Complex tablets to support healthy bowel function. Consider Bacto-Cand GI capsules for healthy intestinal function. See St Mary’s Thistle Quality Issues on page 66

Dosage and Administration Adults: 1 tablet 3 times daily, 15 minutes before meals. Children 6-12 years: 1 tablet daily 15 minutes before meals.

Product Information

DiGest

Chamomile Quality Issues German or true Chamomile (Matricaria chamomilla) contains a range of essential oil components and high levels of flavonoids. A wide variation in the levels of these constituents is found between different chemical races or varieties of Chamomile. Some varieties do not contain any α-bisabolol which is an important active component. MediHerb has selected a variety of Chamomile which is very high in α-bisabolol for use in our Chamomile liquid extracts and Cascara Complex tablets. The level of α-bisabolol is determined by Gas Chromatography (GC) in all batches of raw material and finished product manufactured by MediHerb, thus assuring safety and efficacy. The GC profile of Chamomile Essential Oil is identified in Cascara Complex, DiGest and HiPep tablets. Roman Chamomile (Chamaemelum nobile = Anthemis nobilis) can be adulterant in, or substituted for, true Chamomile and should be avoided due to allergic reactions.

Matricaria chamomilla

-bisabolol

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Echinacea Premium

Each tablet contains: Echinacea angustifolia (Echinacea) extract equivalent to dry root

600 mg

Echinacea purpurea (Echinacea) extract equivalent to dry root

675 mg

containing alkylamides 2.9 mg containing alkylamides 1.7 mg

60 Tablets 120 Tablets Mode of Action Echinacea is a supporting therapy for mild upper respiratory complaints. May assist by reducing the severity and lead to earlier resolution of symptoms of mild upper respiratory infections, colds and flu. This product contains alkylamides, a class of Echinacea compounds that contribute to phagocyte-enhancing activity.

Indications Relief of the symptoms of colds, flu and other mild upper respiratory infections. May reduce the incidence of mild upper respiratory tract infections.

Contraindications and Cautions The risk of allergic reaction to Echinacea is very small, especially if preparations of the root are used since these are free of pollens. Echinacea is contraindicated in patients taking immunosuppressant medication (eg transplant patients). Short-term therapy only is suggested in this instance. Caution is advised in patients receiving midazolam by injection. Discontinue 7 days prior to general anaesthesia. Not to be used in children under two years of age without medical advice.

Additional Therapy Combines well with Andrographis Complex tablets, Zinc Protect tablets or Poly-C Powder for additional immune support. For relief of irritation or inflammation of the oral and pharyngeal mucosa consider Herbal Throat Spray. Consider Albizia Complex tablets for support with allergies. Consider Probiotica capsules to assist in maintaining and restoring intestinal microflora after treatment with antibiotics. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Combine with PhytoRegenex tablets for health and well-being. See Echinacea Premium 1:2 liquid extract on page 80

Dosage and Administration Adults: 1 tablet 2-3 times daily. Children 6-12 years: 1 tablet 1-2 times daily. Dosage may be increased for acute conditions, as directed.

Kerryâ&#x20AC;&#x2122;s number one favourite herb

Product Catalogue

Beyond Comparison

MediHerb Echinacea products are market leaders based on the most up-to-date science and the best of traditional wisdom. In November 2014, independent testing of nine Australian Echinacea liquids and 4 tablet products showed that MediHerb Echinacea Premium tablets and liquid extracts are higher in alkylamides (both 2-ene and 2,4-diene alkylamides), which are clinically proven active constituents. The testing was conducted by an independent analytical

laboratory holding a licence issued by the Therapeutic Goods Administration.

Product Information

MediHerb has developed specialised knowledge in the manufacture and testing of Echinacea products over the past 20 years. This includes a PhD study, extensive analytical method development, development of harvesting, drying and storage protocols to maximise retention of actives and a successful clinical trial.

2-ene alkylamides are only found in Echinacea angustifolia and are an important measure of quality. MediHerb’s research has found that 2-ene alkylamides improve the bioavailability of 2,4-diene alkylamides in Echinacea purpurea. This means that the alkylamides in MediHerb’s unique blend, Echinacea Premium, are available to the body, resulting in a better effect on the immune system. MediHerb’s Echinacea Premium formula is patented in Australia, New Zealand and the UK with a patent applied for in the USA to protect this important finding.

Echinacea Tablet Product Comparison

Monoene

6.00 5.00

Echinacea Tablet Product Comparison

4.00

Diene 3.00

Total Alkylamides

Tablets required to meet 1 Echinacea Premium

1.00 4.40

5.62

0.00

(Label Claim 4.6mg)

6.00 mg/tablet alkylamides

Product

mg/tablet alkylamides

Echinacea Tablet Products

2.00

MediHerb Echinacea Premium

1.22

Product A

0.00

0.69

Product B

0.00

Monoene 0.02

Product C

0.00

Product D

0.00

MediHerb Echinacea Premium

Product A

Diene

0.02

314

0.01

668

0.00

n/a

0.69

Product B

Product C

Product D

5.00 4.00 3.00 2.00 1.00 0.00 MediHerb Echinacea Premium

Monoene

Product A

Product B

Product C

Product D

Diene

Echinacea Liquid Products Echinacea Liquid Product Comparison 5.00 4.50

Alkylamides Echinacea Liquid Product Comparison

3.50

4.50

2.50

4.00

2.00 1.50 1.00 0.50 0.00 MediHerb MediHerb MediHerb Echinacea E. angustifolia E. purpureaa Premium 1:2 1:2 1:2

Monoenes

Monoene = protects against degradation

5.00

3.00

Dienes

Product A

Product B

Product C

Product D

mg/mL alkylamides

4.00

3.50

Diene = immune active

3.00 2.50 2.00

1.50 Product E 1.00

Product F

Product G

Product H

Product I

0.50

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0.00 MediHerb MediHerb MediHerb Echinacea E. angustifolia E. purpureaa Premium 1:2 1:2 1:2

Product A

Product B

Product C

Product D

Product E

Product F

39 Product G

Produc H

The Science of Echinacea – MediHerb’s Research Kerry Bone has always believed that a key aspect of modern phytotherapy is a respect for traditionally-generated knowledge. E. angustifolia root however is very expensive and was cost prohibitive for many of his patients. To overcome this, Kerry developed Echinacea Premium, a particular blend of E. angustifolia and E. purpurea roots. In 2003 MediHerb began an extensive research project which was designed to identify the bioavailable components of Echinacea Premium and how they exert an effect on the immune system.

What is Active Must First Be Absorbed Which of the key phytochemicals in Echinacea Premium are absorbed and therefore bioavailable? From MediHerb’s in vitro and pharmacokinetic research we know: O NLY alkylamides could be detected in the blood after taking Echinacea Premium. No caffeic acid conjugates, degradation products of these or the alkylamides were found1 The alkylamides mainly in E. purpurea were found to be rapidly degraded by human liver microsomes In contrast the alkylamides mainly in E. angustifolia were much more slowly degraded Interestingly, the alkylamides from E. angustifolia actually slowed down the rate of degradation of the alkylamides from E. purpurea

The presence of only relatively small proportions of the E. angustifolia alkylamides will result in a product with enhanced bioavailability due to their protective effect This is a strong justification for the combination of E. angustifolia root with E. purpurea root, as in the Echinacea Premium. A patent has been applied for to protect this very important finding2 The total amount of alkylamides absorbed into the bloodstream was essentially the same for both Echinacea Premium tablets and Echinacea Premium 1:2 liquid3

Once Absorbed is it Active? The key findings of recent studies on Echinacea and alkylamide’s effects on the immune system are that: Echinacea does not activate the immune response in the absence of any immunological challenge (in vitro research)4 The Echinacea alkylamides tended to modulate the immune response of macrophages and T cells in vitro, toning the response down in the face of a strong stimulus4,5 These results, combined with the fact that alkylamides are the only phytochemicals which are bioavailable from traditional lipophilic extracts of Echinacea root (such as ethanolic liquid extracts)1, suggests that the alkylamides are largely responsible for the systemic immune effects of Echinacea lipophilic extracts

This immune modulating activity may (at least in part) due to the interaction of alkylamides with cannabinoid receptors, specifically CB2 (in vitro research) 6-8 Echinacea Premium alters the expression of heat shock protein 70 (hsp70) in leucocytes and increased white cell count in healthy volunteers.8 E. purpurea root boosted the number and function of natural killer (NK) cells (a class of white blood cell) in mice10

A New Understanding of Echinacea The research on Echinacea Premium by the MediHerb scientists has made a substantial contribution to a new understanding of lipophilic extracts of Echinacea. It can be concluded from this research that: Alkylamides must be used as the markers of quality and activity The root of Echinacea is the preferred plant part, since it is highest in alkylamides The preferred species of Echinacea are E. angustifolia and E. purpurea since they contain high levels of alkylamides (compared to E. pallida) Echinacea must be extracted using an alcohol percentage sufficiently high to efficiently extract the alkylamides The synergistic blend of E. angustifolia and E. purpurea alkylamides in Echinacea Premium potentiate each other for greater therapeutic potential One potential way in which the bioavailable alkylamides modulate the immune response is by interacting with CB2 receptors Echinacea root (rich in alkylamides) also boosts the white cell count The traditional way Echinacea was used has been validated by scientific research at the cutting edge of modern immunology

REFERENCES 1 Matthias A et al. Life Sciences 2005; 77: 2018-2029 2 Matthias A et al. Chemico-Biological Interactions 2005, 155: 62-70 3 Matthias A et al. Phytomedicine 2007; 14(9): 587-590 4 Stevenson LM et al. Molecules 2005; 10: 1279-1285 5 Matthias A et al. Fitoterapia 2008; 79(1): 53-58 6 Gertsch J, Schoop R, Kuenzle U et al. Alkylamides from Echinacea purpurea potently modulate TNF-alpha gene expression: Possible role of cannabinoid receptor CB2, NF-κB, P38, MAPK and JNK pathways. International Congress on Natural Products Research, Phoenix, Arizona USA, July 31-August 4, 2004, Lecture O: 9 7 Woelkart K, Xu W, Makriyannis A et al. The endocannabinoid system as a target for alkamides from Echinacea roots. International Congress on Natural Products Research, Phoenix, Arizona USA, July 31-August 4, 2004, Poster P:342 8 Matthias A, Lehmann RP, Bone KM. Echinacea in Health – Risks and Benefits. In: Watson, R, Preedy V (eds). Botanical Medicine in Clinical Practice. CABI, Wallingford, UK, 2008, pp 683-689. 9 Agnew LL et al. Journal of Clinical Pharmacy and Therapeutics 2005; 30: 363-369 10 Miller SC. eCAM 2005; 2(3): 309-314

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For more information on the Echinacea Research Project see page 16

Each capsule contains: Oenothera biennis (Evening Primrose) seed oil

500 mg

Natural Fish Oil

500 mg

d-alpha-Tocopherol (natural Vitamin E 50 IU)

38.46 mg

standardised to contain gamma-linolenic acid (GLA) 50 mg

120 Capsules Mode of Action Evening Primrose Oil (EPO) contains the omega-6 essential fatty acid GLA. Fish Oil contains the omega-3 essential fatty acids EPA and DHA. Intake of a combination of EPO and Fish Oil may increase blood levels of the essential fatty acids DGLA (dihomogamma-linolenic acid, a metabolite obtained from GLA), EPA and DHA. This effect is not achieved by ingesting either EPO or Fish Oil alone. An increase in blood levels of DGLA, EPA and DHA may shift the balance of eicosanoids produced to those with anti-inflammatory activity.

EndoFem 60 Tablets Mode of Action This product contains herbs with lymphatic, astringent and antispasmodic activity.

containing Omega-3 marine triglycerides 150 mg as eicosapentaenoic acid (EPA) 90 mg and docosahexaenoic acid (DHA) 60 mg

Indications To promote healthy essential fatty acid levels in healthy individuals. May shift the balance of eicosanoids to those with anti-inflammatory activity.

Contraindications and Cautions Ingredients in this product are derived from seafood. Persons who are allergic to seafood should exercise extreme caution. Caution is advised in patients with a tendency to oesophageal reflux and those with poor digestion and compromised gallbladder function. Concerns have been raised in the literature of the 1980s regarding concomitant use of evening primrose oil and phenothiazines. High doses of evening primrose oil may cause mild headache and nausea. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Adults and Children over 12 years: 1-2 capsules 3â&#x20AC;Żtimes daily.

Additional Therapy Consider Hawthorn tablets for cardiovascular system support. Consider Hawthorn Leaves 1:2 liquid extract and/or Globe Artichoke 1:2 liquid extract. Combine with Chaste Tree tablets for relief of premenstrual syndrome. Consider Boswellia Complex tablets for temporary relief of inflammatory disorders where leukotrienes play a role. Cramplex tablets to help provide symptomatic relief from dysmenorrhoea. For additional omega-3 support combine with Omega-3 Forte capsules. See Fatty Acids Pathway on page 57

Each tablet contains: Angelica polymorpha (A. sinensis, Dong Quai) extract equivalent to dry root

826 mg

Paeonia lactiflora (Paeonia) extract equivalent to dry root

824 mg

Alchemilla vulgaris (Ladies Mantle) extract equivalent to dry herb

650 mg

Calendula officinalis (Calendula) extract equivalent to dry flower

400 mg

Indications To support healthy endometrial tissue.

Contraindications and Cautions Due to Dong Quai, contraindicated in the first trimester of pregnancy, especially in higher doses. Exercise caution in severe menorrhagia. Dong Quai may potentiate the effect of warfarin. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily.

Formulated by Francesca Naish, Natural Fertility Management and MediHerb.

Evening Primrose Oil

Dosage and Administration

Product Information

EFA Essentials

Additional Therapy Consider Echinacea Premium tablets or Astragalus Complex tablets for immune system support. Consider Chaste Tree tablets for relief of the symptoms caused by irregularities of the menstrual cycle. Consider P2-Detox powder to provide compounds to support normal phase II detoxification processes. Cramplex tablets for symptomatic relief of dysmenorrhoea. Add EFA Essentials capsules or Omega-3 Forte capsules, which may shift the balance of eicosanoids produced to those with anti-inflammatory activity. For additional relief of muscle spasm consider Mega Mag powder or Active Mag-Cal tablets. Everyday B Multi tablets to maintain optimum levels of vitamins and minerals during times of increased need. For reproductive, antioxidant and nutritional support consider Vital Woman tablets.

Each capsule contains: Oenothera biennis (Evening Primrose) seed oil

1.0 g

standardised to contain gamma-linolenic acid (GLA) 100 mg

120 Capsules Mode of Action The essential fatty acid (GLA) found in Evening Primrose oil is essential for proper balance of prostaglandin metabolism.

Indications To promote a healthy balance of prostaglandins and leukotrienes.

Contraindications and Cautions High doses can cause mild headache and nausea. Long-term use may potentiate the risk of arachidonate build-up in the treatment of rheumatoid arthritis. Concerns have been raised in the literature of the 1980s regarding concomitant use of evening primrose oil and phenothiazines. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 capsule 3 times daily.

Additional Therapy Combines well with Chaste Tree tablets for PMS. Boswellia Complex tablets for relief of joint inflammation. Cramplex tablets to help provide symptomatic relief from dysmenorrhoea. Consider EFA Essentials capsules for a combination of omega-3 and omega-6 fatty acids. For a source of omega-3 fatty acids, consider Omega-3 Forte capsules.

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Everyday B Multi

60 Tablets 120 Tablets Mode of Action The B group vitamins are essential for the healthy function of the nervous system and may be beneficial at times of increased physical or mental demand. They support production of cellular energy, and aid carbohydrate, protein, and fat metabolism. The iron, B12 plus vitamin B6 are required as cofactors for the production of neurotransmitters in the body. These are essential to maintain a healthy nervous system. Increased intake of folate, vitamin B6 and B12 have been found to regulate homocysteine.

Each tablet contains: Retinyl palmitate (Vitamin A 750mcg RE) Thiamine nitrate (Vitamin B1) Riboflavine sodium phosphate Riboflavine (Vitamin B2) Nicotinic acid Nicotinamide Calcium pantothenate Pyridoxal 5-phosphate monohydrate (Activated Vitamin B6) Pyridoxine hydrochloride (Vitamin B6) Cyanocobalamin (Vitamin B12) Calcium folinate (equiv. to folinic acid 250 mcg) Folic acid Ascorbic acid (Vitamin C) Cholecalciferol (Vitamin D3 100 IU) d-alpha-Tocopheryl acid succinate (natural Vitamin E 35 IU) Biotin (Vitamin H) Menaquinone 7 (Vitamin K2) Citrus bioflavonoids extract Betacarotene (natural source) Choline bitartrate Inositol Lysine hydrochloride Cysteine hydrochloride Zinc gluconate (equiv. to Zinc 8 mg) Calcium hydrogen phosphate (equiv. to Calcium 12 mg) Magnesium phosphate (equiv. to Magnesium 7 mg) Potassium phosphate-monobasic (equiv. to Potassium 15 mg) High molybdenum yeast (equiv. to Molybdenum 60 mcg) Borax (equiv. to Boron 2 mg) Ferrous fumarate (equiv. to Iron 5 mg) Manganese amino acid chelate (equiv. to Manganese 50 mcg) Selenomethionine (equiv. to Selenium 100 mcg) Chromium nicotinate (equiv. to Chromium 10 mcg) Potassium iodide (equiv. to Iodine 38 mcg) Copper gluconate (equiv. to Copper 6 mcg)

Indications

1.39 mg 50 mg 13.69 mg 30 mg 5 mg 100 mg 100 mg 15.67 mg 50 mg 100 mcg 347.2 mcg 250 mcg 75 mg 2.5 mcg 28.9 mg 50 mcg 5 mcg 30 mg 3 mg 50 mg 30 mg 35 mg 21.7 mg 61.2 mg 51.6 mg 33.9 mg 52.2 mg 30 mg 17.6 mg 16 mg 500 mcg 248 mcg 83 mcg 50 mcg 43 mcg

Contraindications and Cautions

Beneficial during times of stress. Helps maintain optimum levels of vitamins and minerals during times of increased need. May assist in times of overindulgence including those caused by cigarettes, alcohol, caffeine, and poor diet. Nutrient deficiencies may also occur as a result of intensive exercise. Source of iron. Iron is necessary for the formation of haemoglobin which transports oxygen to the tissues. To help regulate normal homocysteine levels in healthy individuals.

Everyday B Multi

This product contains selenium which is toxic in high doses. A daily dose of 150 mcg for adults of selenium from dietary supplements should not be exceeded. Selenium-containing products are not suitable for use by children under the age of 15 years. Patients who had a baby with a neural tube defect/spina bifida should seek specific medical advice. When taken in excess of 3000 mcg retinol equivalents, vitamin A can cause birth defects. Patients who are pregnant or considering becoming pregnant should consult their doctor or pharmacist before taking vitamin A supplements. If you are pregnant, or considering becoming pregnant, do not take vitamin A supplements without consulting your doctor or pharmacist. The recommended daily amounts of vitamin A from all sources is 700 mcg retinol equivalents for women and 900 mcg retinol equivalents for men. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults and children over 15 years: 1 tablet daily.

High potency B multivitamin with essential minerals and nutrients

Product Catalogue

Additional Therapy Consider Bacopa Complex tablets to relieve stress of study or work. Combine with Siberian Ginseng tablets or Withania Complex to enhance the body’s adaptation to stress. Consider Garlic Forte tablets for vascular protective effects, and Hawthorn tablets to support the cardiovascular system. Nevaton® tablets or Withania Complex for additional nervous system support. Valerian Complex tablets to promote sleep and relieve nervous tension. Consider Methyl Factors tablets to provide nutritional support for the regulation of homocysteine levels

Usage

Cautions

Use Everyday Balance daily as a supplementary food to: Provide complete protein, rich in amino acids. Complement a nutritious diet. Provides protein to aid satiety and aid in weight management when used in conjunction with a kilojoulecontrolled eating plan combined with appropriate exercise. This food is not a sole source of nutrition and should be consumed in conjunction with a nutritious diet.

Contains milk-derived ingredients. Not suitable for children under 15 years of age or pregnant women: Should only be used under medical or dietetic supervision. Additional protein in the diet increases the body’s need for water, drink at least 2 litres of water daily.

500 g Powder

Directions:

Nutritional Function

Adults: Mix 25 grams of powder (2 rounded tablespoons) into 240 mL of water, non-fat milk, soy milk or an appropriate alternative. Mix in a shaker or blender. For increased thickness, add a couple of ice cubes and blend. Consume 1 serve daily, either as an in-between meal, a protein complement to a main meal, or as directed. Contains no artificial colours, flavours or sweeteners.

Provides a comprehensive source of complete protein with very high biological value (BV), rich in immunoglobulin proteins and fortified with additional glutamine to maintain a positive nitrogen balance. Low in sugar and low in glycaemic index.

Additional Products Consider GlucoBalance tablets for maintenance of normal/ healthy blood glucose levels and Gymnema tablets which may help reduce appetite. Everyday B Multi tablets or Vital Woman tablets to maintain optimum levels of vitamins and minerals during times of increased need. Consider Vitanox® tablets to provide antioxidants. Siberian Ginseng tablets or Withania Complex tablets to relieve physical stress.

Everyday Balance Smooth Vanilla Nutrition Information Servings Per Package = 20 Serving Size = 25 g Average Quantity

Per 25 g serve made up with 240 mL skim milk

Per Serving

Per 100 g

Energy

422 kJ

1,687 kJ

782 kJ

Protein

16.1 g

64.5 g

24.7 g

Fat – Total

1.3 g

5.3 g

1.5 g

– Saturated

0.7 g

2.9 g

0.9 g

Carbohydrate – Total

3.6 g

14.6 g

15.6 g

2.5 g

10 g

14.5 g

Xylitol

– Sugars

1.5 g

Dietary Fibre

1.1 g

4.2 g

1.1 g

50 mg

200 mg

156 mg

72 mg

290 mg

372 mg

Sodium Calcium

(7.2% RDI*)

Product Information

Everyday Balance Protein Powder

*RDI – Recommended Dietary Intake Ingredients: Whey protein concentrate (52%)/whey protein isolate blend (18%), l-glutamine (6%), xylitol (6%), fructose (6%), natural vanilla flavour (5%), thickener (guar gum) (3%), inulin (2%), lecithin (2%).

Typical Amino Acid Profile

Per Serving

Per 100 g

Alanine

834 mg

3,335 mg

Arginine

439 mg

1,755 mg

1,828 mg

7,313 mg

Aspartic acid Cystine

585 mg

2,340 mg

4,074 mg

16,296 mg

Glycine

263 mg

1,053 mg

Histidine

293 mg

1,170 mg

1,638 mg

6,552 mg

Methionine

351 mg

1,404 mg

Phenylalanine

556 mg

2,223 mg

Proline

658 mg

2,633 mg

Serine

658 mg

2,633 mg

Threonine

775 mg

3,101 mg

Tryptophan

351 mg

1,404 mg

Tyrosine

614 mg

2,457 mg

Per Serving

Per 100 g

921 mg

3,686 mg

2,091 mg

8,366 mg

818 mg

3,276 mg

Glutamine

Lysine

Typical Branched Chain Amino Acids (BCAA) Profile Isoleucine Leucine Valine

Typical Protein Profile

Per Serving

Per 100 g

Alpha-lactoglobulin

2,208 mg

8,333.5 mg

Beta-lactoglobulin

6,757 mg

27,027 mg

Proteose Peptone 5

1,068 mg

4,270.5 mg

Glycomacropeptide

2,984 mg

11,934 mg

Immunoglobulin

936 mg

3,744 mg

Albumin

176 mg

702 mg

Other Proteins

497 mg

1,989 mg

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Eyebright Complex 60 Tablets Mode of Action The traditional uses of the five herbs in Eyebright Complex are primarily focused on the mucous membranes of the upper respiratory tract. This formula also contains Echinacea which provides support for the immune system.

Each tablet contains: Euphrasia officinalis (Eyebright) extract equivalent to dry herb

650 mg

Solidago virgaurea (Golden Rod) extract equivalent to dry herb

650 mg

Echinacea purpurea (Echinacea) extract equivalent to dry root

370 mg

Hydrastis canadensis (Golden Seal) extract equivalent to dry root and rhizome

125 mg

Capsicum annuum (Cayenne) extract equivalent to dry fruit

10 mg

Indications Relief of the symptoms of upper respiratory catarrh, colds, hay fever and sinusitis.

Contraindications and Cautions Use with caution in the first trimester of pregnancy. The risk of allergic reaction to Echinacea is very small, especially if preparations of the root are used since these are free of pollens. Echinacea is contraindicated in patients taking immunosuppressant medication (eg transplant patients). Short-term therapy only is suggested in this instance. Caution is advised in patients receiving midazolam by injection. Caution in those taking theophylline as Cayenne may increase its absorption and bioavailability. Discontinue 7 days prior to general anaesthesia.

Additional Therapy Combine with Albizia Complex tablets to relieve the symptoms of allergies. Consider Echinacea Premium tablets and Poly-C Powder for additional immune support. Consider Echinacea Premium Blend 1:2 liquid extract and/or Pelargonium 1:5 liquid extract. For additional support to the mucous membranes of the upper respiratory tract combine with Herbal Throat Spray. Vitanox® tablets for antioxidant activity. See Golden Seal Quality Issues on page 49 See Echinacea information on page 39

Dosage and Administration Hydrastis canadensis

Fe-Max Iron Tonic Phytosynergist® liquid 200 mL Mode of Action Contains bioavailable iron amino acid chelate (iron bisglycinate) which may be better tolerated by the GIT reducing the risk of gastrointestinal complaints associated with other forms of iron. Other herbs and nutrients are included to help to enhance iron absorption and maintain healthy blood.

Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily. For seasonal respiratory symptoms start treatment 4 to 6 weeks before expected onset.

Each 5 mL dose contains: Withania somnifera (Withania) extract equivalent to dry root

1.2 g

Urtica dioica (Nettles) extract equivalent to dry leaf

500 mg

Codonopsis pilosula (Codonopsis) extract equivalent to dry root

500 mg

Glycyrrhiza glabra (Licorice) extract equivalent to dry root

500 mg

Zingiber officinale (Ginger) extract equivalent to dry rhizome

50 mg

Iron amino acid chelate (equiv. to Iron 5 mg)

25 mg

Riboflavine (Vitamin B2)

2.5 mg

Pyridoxine hydrochloride (Vitamin B6)

2.5 mg

Cyanocobalamin (Vitamin B12)

1.5 mcg

In a base which includes glycerol, Vitamin C and juice concentrates of grape, beetroot, apple, pear, carrot and lemon.

Indications Blood tonic, can assist in maintaining normal blood. Iron is necessary for the formation of haemoglobin which is essential for the transportation of oxygen to the body tissues. Assists the maintenance or improvement of general well‑being.

Contraindications and Cautions Contraindicated in haemochromatosis. Due to Licorice: caution is advised in those with elevated liver enzymes taking immunosuppressives; contraindicated in hypertension and oedema. If taking levodopa, levothyroxine, methyldopa, penicilamine, quinolones, tetracyclines, bisphosphonates, and cholestyramine, separate doses by at least two hours. Allopurinol, can increase liver storage of iron and should not be used in conjunction with iron supplements. Vitamin supplements should not replace a balanced diet. Not for the treatment of iron deficiency conditions. Discontinue 7 days prior to general anaesthesia.

Product Catalogue

Dosage and Administration Adults: 5 mL with water or juice 3 times daily.

Additional Therapy Everyday B Multi tablets for additional support in maintaining normal blood. Consider Withania 2:1 liquid extract. DiGest tablets for enhanced digestive function. Chaste Tree tablets or liquid extract to help relieve PMS symptoms. Siberian Ginseng tablets or Rhodiola & Ginseng tablets may provide support during times of fatigue and declining capacity for work and concentration. See Withania Quality Issues on page 75

60 Tablets Mode of Action Contains more bioavailable iron amino acid chelate (iron bisglycinate) which may be better tolerated by the GIT reducing the risk of gastrointestinal complaints associated with other forms of iron. Other nutrients such as vitamin B12, folic acid and vitamin C help to enhance iron absorption and maintain normal blood. Withania and Codonopsis are traditionally used as tonics.

Each tablet contains: Withania somnifera (Withania) extract equivalent to dry root

750 mg

Codonopsis pilosula (Codonopsis) extract equivalent to dry root

500 mg

Ascorbic acid (Vitamin C)

120 mg

Iron amino acid chelate (equiv. to Iron 12 mg)

60 mg

Thiamine hydrochloride (equiv. to Vitamin B1 4.45 mg)

5 mg

Riboflavin Sodium Phosphate (equivalent Vitamin B2 5 mg)

6.75 mg

Pyridoxal 5-phosphate (equiv. to Vitamin B6 5 mg)

7.5 mg

Folic acid

95 mcg

Cyanocobalamin (Vitamin B12)

100 mcg

Indications Blood tonic, can assist in maintaining normal blood. Iron is necessary for the formation of haemoglobin which is essential for the transportation of oxygen to the body tissues. For the prevention and treatment of vitamin B group, vitamin C and folic acid deficiencies. Assists the maintenance of general well‑being.

Contraindications and Cautions Contraindicated in haemochromatosis. If taking levodopa, levothyroxine, methyldopa, penicilamine, quinolones, tetracyclines, bisphosphonates, and cholestyramine, separate doses by at least two hours. Allopurinol, can increase liver storage of iron and should not be used in conjunction with iron supplements. Not for the treatment of iron deficiency conditions. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

FibroFem 75 Tablets Mode of Action This product contains herbs used traditionally to have a tonic influence upon the uterus and circulatory system.

Dosage and Administration Adults: 1 tablet 2 times daily.

Additional Therapy Everyday B Multi tablets for additional blood tonic activity. Consider Withania 2:1 liquid extract. DiGest tablets for enhanced digestive function. Chaste Tree tablets to help PMS. Siberian Ginseng tablets or Rhodiola & Ginseng tablets may provide support during times of fatigue and declining capacity for work and concentration. See Withania Quality Issues on page 75

Product Information

Fe-Plex

Each tablet contains: Paeonia lactiflora (Paeonia) extract equivalent to dry root

640 mg

Capsella bursa-pastoris (Shepherd’s Purse) extract equivalent to dry herb

640 mg

Achillea millefolium (Yarrow) extract equivalent to dry herb

320 mg

Thuja occidentalis (Thuja) extract equivalent to dry leaf

200 mg

Indications To support normal menstruation.

Contraindications and Cautions Contraindicated in pregnancy and lactation. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 4-5 times daily. The dose may be increased to 2 tablets 3-4 times daily for acute conditions.

Additional Therapy Consider Chaste Tree tablets for relief of the symptoms caused by irregularities of the menstrual cycle. Add EFA Essentials capsules or Omega-3 Forte capsules, which may shift the balance of eicosanoids produced to those with anti-inflammatory activity. Consider P2-Detox powder to provide compounds to support normal phase II detoxification processes. Consider Boswellia Complex tablets. Vitanox® tablets for antioxidant protection. Consider Vital Woman tablets for nutritional support. See Paeonia Quality Issues on page 46

Formulated by Francesca Naish, Natural Fertility Management and MediHerb.

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Paeonia Quality Issues Paeonia lactiflora is a widely used herb in Traditional Chinese Medicine and as is common in this modality, herbs are often treated in many different ways to produce a more palatable or efficacious product. The therapeutically important plant part is the root of the plant, which as it occurs naturally is approximately 1 to 2 cm round cylindrical roots, varying in colour from off-white to pinky-brown. Much of the paeonia root which used in commerce is in the form of pure white root slices, which have been treated by sulphiting agents to preserve the plant material’s appearance, by reduction of enzymatic browning. This treatment also has the side effect of reacting with the main bioactive compound from Paeonia (paeoniflorin – a complex monoterpene glycoside) and forming a stable new compound sodium paeoniflorin sulfonate. This is readily seen by HPLC where the peak from paeoniflorin is absent in the herb which has been treated by sulphiting (bottom trace), whereas it is the major component in the untreated herb (top trace).

Sodium paeoniflorin sulfonate

Paeoniflorin

Paeonia lactiflora

Garlic Forte

Each tablet contains: Allium sativum (Garlic) extract equivalent to fresh bulb

3.6 g

standardised to alliin 12 mg

60 Tablets Mode of Action Contains stabilised alliin which is converted to allicin in the intestines. Garlic has broad antibacterial activity. Garlic also assists in the maintenance of peripheral circulation.

Indications Featured in most traditional herbal medicine systems, including Western, Chinese and Ayurvedic, for the symptomatic relief of upper respiratory tract infections and catarrhal conditions. Aids in the maintenance of peripheral circulation. May help to support normal blood pressure in healthy individuals. Supportive to dietary measures to help maintain normal blood lipid levels in healthy individuals. Garlic has demonstrated vascular protective effects as the body ages.

Contraindications and Cautions Garlic should be used with caution in patients taking antiplatelet or anticoagulant drugs for doses 3 g or greater of fresh garlic per day unless under close supervision. Caution is advised for patients taking HIV protease inhibitors such as saquinavir. Garlic intake should be discontinued 10 days before surgery. Not to be used in children under two years of age without medical advice.

Dosage and Administration Adults: 1 tablet 1-2 times daily. Children 6-12 years: 1 tablet daily. Enteric coated tablets. (Take tablet whole, do not break or crush.)

Additional Therapy Combine with Slippery Elm 400mg capsules or Probiotica capsules to encourage a healthy intestinal environment. Combines well with Echinacea Premium tablets, Poly-C Powder, or Andrographis Complex tablets for relief of symptoms of colds and upper respiratory infections. Consider Phellodendron Forte tablets to assist in the maintenance of cholesterol within the normal range in healthy individuals. Consider Ubiquinol Forte capsules to help maintain cardiovascular health, in particular, supporting heart health. Consider Activated Beet-Greens, Coleus Forte tablets or Hawthorn tablets for cardiovascular support. Consider GlucoBalance tablets which may assist carbohydrate, lipid and protein metabolism. Livton® Complex tablets as a liver tonic. Coleus Forte tablets or Hawthorn tablets for cardiovascular support. Consider Globe Artichoke 1:2 liquid extract or Hawthorn Leaves 1:2 liquid extract. Consider PhytoRegenex tablets which may assist peripheral circulation.

Garlic Quality Issues

Allium sativum

Product Catalogue

Alliin (an odourless amino acid) is naturally found in garlic cloves but is rapidly converted to allicin (a strong smelling volatile sulfide) when exposed to the enzyme alliinase in the presence of water or when the garlic clove is crushed – as shown below by the absence of the alliin peak in the HPLC trace on the right hand side. Allicin is rather unstable and is the precursor to a range of sulfur containing compounds including, diallylsulfides, ajoenes and vinyldithiins. It is important that quality products take this enzymatic process into account since there is strong published evidence for garlic preparations standardised this way. Therefore alliin must be present together with the correct amount of alliinase in the tablet to allow full conversion to allicin. Furthermore, because stomach acid can degrade the activity of alliinase, quality products should be enterically coated to protect the enzyme. That is why all MediHerb Garlic Forte tablets are enterically coated and tested not only for the level of alliin but for its conversion into allicin, “its allicin-releasing ability”.

Formation of Allicin from Alliin Alliinase

Alliin

Reaction of alliin in Garlic powder with alliinase to form allicin as shown by HPLC

Allicin Peak due to alliin has disappeared due to conversion to allicin

Each tablet contains: Ginkgo biloba (Ginkgo) extract equivalent to dry leaf

60 Tablets Mode of Action Ginkgo is a potent inhibitor of the pro-inflammatory compound platelet activating factor (PAF) and may assist with peripheral circulation and cognitive function in healthy individuals. Ginkgo has demonstrated antioxidant activity.

Indications May assist peripheral circulation. Helps improve walking distance by maintaining peripheral circulation. May assist in the management of tinnitus. Enhances flow properties of blood. May assist cognitive function in normal healthy people. Support healthy eye function. Antioxidant support.

Contraindications and Cautions Caution in patients taking antiplatelet/anticoagulant drugs, antipsychotics such as haloperidol, anticonvulsants, HIV non-nucleoside transcriptase inhibitors, pioglitazone or glipizide. Caution is advised in patients taking metformin at doses greater than 1 g/day of the drug. Reduce dose of haloperidol or metformin if necessary in conjunction with prescribing physician. Increasing the intake of vitamin B6 may be advisable for patients taking anticonvulsants. Doses of standardised Ginkgo (50:1) extract greater than 240 mg/day, equivalent to more than 12 g/day of dried leaf may interact with benzodiazepines, omeprazole and tolbutamide. Contraindicated in patients taking nifedipine when the dose of standardised Ginkgo (50:1) extract is greater than 240 mg/day, equivalent to more than 12 g/day of dried leaf. Caution is advised in these patients at lower doses of Ginkgo. Discontinue 7 days prior to general anaesthesia.

Ginkgo Quality Issues

Ginkgo biloba

3.0 g

standardised to contain ginkgo flavonglycosides 14.7 mg standardised to contain ginkgolides & bilobalide 3.6 mg

The ginkgo flavonglycosides (ginkgo flavone glycosides) of Ginkgo biloba, comprising quercetin, kaempferol and isorhamnetin are the phytochemicals most often referred to as indicators of quality and efficacy. However, these compounds are mainly marker compounds which are used to identify the extract. The therapeutically active ingredients are believed to include the ginkgolides and bilobalide, which cannot be tested by normal HPLC methods. They require more sophisticated methods of detection such as Refractive Index (RI), Evaporative Light Scattering Detectors (ELSDs) or Mass Spectrometry (MS). MediHerb uses ELSD detection to accurately quantify the levels of these therapeutically important phytochemicals. The other important group of phytochemicals from Ginkgo are the ginkgolic acids (C13:0, C15:1 and C17:1 on the third figure). These compounds have been identified as contact allergens. The maximum level of ginkgolic acids in Ginkgo biloba extracts has been set by the European authorities at 5 ppm. Many poor quality extracts contain levels of ginkgolic acids many orders of magnitude higher than this recommended maximum.

Dosage and Administration Adults and children over 12 years: 1 tablet 1-4 times daily.

Additional Therapy Combines well with Hawthorn tablets to assist in the maintenance of peripheral circulation. Methyl Factors tablets for extra antioxidant support and to help maintain healthy blood. Consider Ubiquinol Forte capsules to help maintain cardiovascular health,in particular, supporting heart health. Consider using Withania & Ginseng tablets as a tonic for older adults (except where high blood pressure occurs). Bacopa Complex tablets to relieve stress of study or work. Vitanox® tablets for additional support. Consider Rosemary 1:2 liquid extract. Horsechestnut Complex tablets for additional peripheral circulation support. Consider Tissue Regenex tablets for tissue healing support. Combine with Omega-3 Forte capsules. Consider Garlic Forte tablets for vascular protective effects as the body ages. Consider Rhodiola & Ginseng tablets or PhytoRegenex tablets for support as the body ages.

Product Information

Ginkgo Forte

HPLC detection of ginkgo flavonglycosides (ginkgo flavone glycosides)

Quercetin

Kaempferol

HPLC detection of ginkgo flavonglycosides (ginkgo flavone glycosides)

Quercetin

Isorhamnetin Kaempferol

Quercetin

Kaempferol Isorhamnetin

HPLC detection of ginkgo flavonglycosides (ginkgo flavone glycosides)

Isorhamnetin

LC – ELSD detection of bilobalide and ginkgolides Bilobalide

Ginkgolides

LC – ELSD detection of bilobalide and ginkgolides Bilobalide

Ginkgolides

Bilobalide

Ginkgolides

LC – ELSD detection of bilobalide and ginkgolides

Ginkgolic acids by HPLC

C15:1

Ginkgolic acids by HPLC

C15:1

C13:0 C15:1

C17:1

C13:0

C17:1

C13:0

C17:1

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GlucoBalance

60 Tablets Mode of Action Chromium and other nutrients (such as vitamins B3, B5, B6 and minerals manganese and zinc) assist glucose utilisation. Chromium is an essential mineral involved in carbohydrate, lipid and protein metabolism. Chromium may assist glucose homoeostasis. Gymnema has been used in Ayurvedic tradition to help maintain healthy blood sugar levels.

Each tablet contains: Chromic chloride (equiv. to Chromium 209 mcg)

1.07 mg

Chromium nicotinate (equiv. to Chromium 14 mcg)

117 mcg

(Total elemental Chromium 223 mcg) Gymnema sylvestre (Gymnema) extract equivalent to dry leaf

3.2 g

Zinc gluconate (equiv. to Zinc 15 mg)

114.85 mg

Magnesium phosphate (equiv. to Magnesium 22 mg)

106.49 mg

Manganese amino acid chelate (equiv. to Manganese 2 mg)

20 mg

Selenomethionine (equiv. to Selenium 8 mcg)

19.87 mcg

Nicotinamide

50 mg

Nicotinic acid

20 mg

Calcium pantothenate

100 mg

Pyridoxine hydrochloride (equiv. to Vitamin B6 41.14 mg)

50 mg

Cyanocobalamin (Vitamin B12)

150 mcg

standardised to contain gymnemic acids 50 mg

Indications Traditionally used to help maintain normal/healthy blood glucose levels in healthy individuals. Gymnema has been traditionally used to help reduce sweet cravings and decrease appetite.

Contraindications and Cautions Particular care should be exercised where the patient is taking insulin or oral hypoglycaemic drugs. Nicotinic acid may cause a temporary flushing reaction in sensitive individuals. To minimise the chance of this occurring, always follow label recommendations of taking only one tablet at any one time, preferably with food. For sensitive individuals, it could prove beneficial to start with one tablet daily and gradually increase to the full dose over a period of 3 to 4 weeks as tolerance to nicotinic acid generally builds over a short period of time. This product contains selenium which is toxic in high doses. A daily dose of 150 mcg for adults of selenium from dietary supplements should not be exceeded. Selenium-containing products are not suitable for use by children under the age of 15 years. Vitamin supplements should not replace a balanced diet. This product contains pyridoxine hydrochloride, which may be dangerous when used in large amounts or for a long time. Contains zinc which may be dangerous if taken in large amounts or for a long time. Discontinue 7 days prior to general anaesthesia.

Golden Seal

Dosage and Administration Adults: 1 tablet only 2-3 times daily with meals. Do not exceed this recommended dosage.

Additional Therapy Diet and lifestyle are of paramount importance. Avoidance of excessive saturated fat in the diet and reduction of cholesterol and triglyceride levels helps reduce the incidence of circulatory complications. Combine with Garlic Forte tablets to maintain healthy blood lipid levels in healthy individuals. Consider Globe Artichoke 1:2 liquid extract. Consider Vitanox® tablets to provide antioxidants. Withania Complex tablets for adaptogenic and tonic activity and to provide nervous system support. ThyroCo tablets for thyroid support where indicated. Methyl Factors tablets for antioxidant support and nutrients to help maintain healthy blood. Coleus Forte tablets and Everyday Balance Protein Powder to support a lifestyle approach to weight management. Consider Curcuma Active tablets for antioxidant support. Consider Phellodendron Forte tablets to assist in the maintenance of cholesterol within the normal range in healthy individuals. Consider Ubiquinol Forte tablets to help maintain cardiovascular health, in particular, supporting heart health.

Each tablet contains: Hydrastis canadensis (Golden Seal) extract equivalent to dry root & rhizome

60 Tablets Mode of Action Traditionally used to soothe inflamed membranes as a bitter stomachic (to sharpen appetite and aid digestion) and as a general tonic. Golden Seal contains the alkaloid berberine.

Indications Helps relieve the symptoms of catarrh by its soothing action on the mucous membranes. Traditionally used to soothe the mucous membranes of the digestive tract. May be used for the treatment of mild digestive disorders. Relief or treatment of diarrhoea.

Contraindications and Cautions Berberine may reinforce the effects of other drugs which displace the protein binding of bilirubin. Rather than possible uterine-contracting effects, this activity might explain the traditional contraindication for berberine-containing herbs in pregnancy. Contraindicated during lactation. Caution in patients taking midazolam. If diarrhoea persists for more than 6 hours in infants under 6 months, 12 hours in children under 3 years, 24 hours in children aged 3 – 6 years or 48 hours in adults and children over 6 years, seek medical advice. Discontinue 7 days prior to general anaesthesia.

Product Catalogue

500 mg

Dosage and Administration Adults: 1 tablet 2-3 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Additional Therapy Consider Eyebright Complex tablets, ResCo® tablets or Phytosynergist® liquid, or Broncafect® tablets or Phytosynergist® liquid for respiratory system support. Combine with DiGest tablets for additional digestive support. Consider Methyl Factors tablets to provide methylating nutrients. Bacto-Cand GI capsules for healthy intestinal function. See Golden Seal Quality Issues on page 49

Golden Seal Quality Issues Golden Seal (Hydrastis canadensis) is an endangered herb and as a result is very expensive and often substituted by other herbs. The substituted herbs usually contain the substance berberine which provides the yellow colour, but they do not contain hydrastine which is unique to Golden Seal. Only HPLC enables this differentiation to be made. MediHerb only buys cultivated Golden Seal to ensure sustainability of the herb long term. MediHerb tests each batch of Golden Seal raw material and finished product to ensure the claimed levels of hydrastine and berberine are present. Using HPLC, MediHerb is able to clearly differentiate true Golden Seal from other berberine containing herbs. The table demonstrates the difference between the various berberine containing species. The top trace is an example of substitution where a professional product being sold in Australia as Indian Golden Seal matched the trace of Coptis chinensis.

Hydrastine

Berberine

PRACTITIONER LIQUID (Indian Golden Seal)

Hydrastis canadensis Coptis chinenis

Berberis aquifolium

Gymnema

Each tablet contains: Gymnema sylvestre (Gymnema) extract equivalent to dry leaf standardised to contain gymnemic acids 100 mg

6.4 g

60 Tablets Mode of Action Traditionally known in India as ‘Gurmar’ meaning, sugar destroying. This may be because chewing Gymnema leaf has an antisweet activity.

Indications May help reduce sweet craving and decrease appetite.

Contraindications and Cautions Particular care should be exercised where the patient is taking insulin or oral hypoglycaemic drugs. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 1-2 times daily.

Hawthorn

Product Information

Hydrastis canadensis

Additional Therapy Livton® Complex tablets for healthy digestive function and liver tonic. DiGest tablets for enhanced digestive function. Consider Methyl Factors tablets to provide methylating nutrients. Consider GlucoBalance tablets to provide support for healthy blood glucose levels in healthy individuals. Everyday B Multi tablets or Vital Woman tablets to maintain optimum levels of vitamins and minerals during times of increased need. Diet and lifestyle are of paramount importance. Avoidance of excessive saturated fat in the diet and reduction of cholesterol and triglyceride levels helps reduce the incidence of circulatory complications. Coleus Forte tablets and Everyday Balance Protein Powder as part of a lifestyle approach to weight management. Consider Curcuma Active tablets for antioxidant support. Consider Phellodendron Forte tablets to assist in the maintenance of cholesterol within the normal range in healthy individuals.

Each tablet contains: Crataegus monogyna (Hawthorn) extract equivalent to dry herb flowering top standardised to contain vitexin-2-rhamnoside 6.68 mg

1.06 g

90 Tablets Mode of Action Contains the potent antioxidant oligomeric procyanidins (OPCs) or catechin polymers, which support healthy cardiovascular function and assist in the maintenance of peripheral circulation.

Indications Supports the cardiovascular system and circulatory functions. Assists in the maintenance of peripheral circulation.

Contraindications and Cautions May potentiate the action of hypotensive medication and digoxin. Due to the tannins in this product, it should be consumed at least 2 hours away from ingestion of mineral supplements. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-3 times daily. Children 5-12 years: 1 tablet 1-2 times daily.

Additional Therapy Combines well with Ginkgo Forte tablets to assist peripheral circulation. Consider Curcuma Active tablets or Vitanox® tablets for antioxidant support. Activated Beet-Greens powder or Coleus Forte tablets for cardiovascular system support and EFA Essentials capsules or Omega-3 Forte capsules for fatty acid supplementation. Methyl Factors tablets and Everyday B Multi tablets to provide nutrients involved in the regulation of normal homocysteine levels. Consider Active Mag-Cal tablets or Mega Mag Powder for additional magnesium. Consider PhytoRegenex tablets to aid peripheral circulation. Consider Ubiquinol Forte tablets to help maintain cardiovascular health, in particular, supporting heart health.

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Herbal Throat Spray 25 mL Mode of Action This formula contains herbs traditionally used to provide anti-inflammatory, anaesthetic, demulcent, antiseptic, astringent and vulnerary actions for local relief of minor oral and throat problems.

Each 4 sprays (500 mcL) contains: Althaea officinalis (Marshmallow) extract equivalent to dry root

40 mg

Salvia fruticosa (Sage) extract equivalent to dry herb

30 mg

Calendula officinalis (Calendula) extract equivalent to dry flower

10 mg

Echinacea angustifolia (Echinacea) extract equivalent to dry root

10 mg

Commiphora myrrha (Myrrh) stem bark oleoresin dry

1 mg

Syzgium aromaticum (Clove) flower bud essential oil

1.25 mcL

Indications

Additional Therapy

Relief of symptoms (including inflammation and pain) associated with dry, sore throats. Relief of irritation or inflammation of the oral and pharyngeal mucosa including laryngitis and tonsillitis. Relieves symptoms of mouth ulcers, gum abrasions and inflamed gums. Freshens the breath.

Combine with Broncafect速 tablets or ResCo速 tablets for cough and symptomatic relief of catarrh. For additional immune support combine with Echinacea Premium tablets or Andrographis Complex tablets. Consider Echinacea Premium Blend 1:2 liquid extract and/or Pelargonium 1:5 liquid extract. To assist the mucous membranes of the upper respiratory tract combine with Eyebright Complex tablets or Albizia Complex tablets. Poly-C Powder to help reduce the severity of symptoms of colds.

Contraindications and Cautions Not suitable for children under 2 years of age. Contraindicated in those with allergy to plants of the Compositae (daisy) family and allergy to Clove or eugenol. Contains ethanol and hydroxybenzoates. Discontinue 7 days prior to general anaesthesia.

See Echinacea information on page 39

Dosage and Administration Adults: 4 sprays into the mouth every 1-2 hours as required. Children 6-12 years: 1-2 sprays into the mouth every 1-2 hours as required. Not to be used in children under 2 years of age without medical advice.

HiPep

Each tablet contains: Glycyrrhiza glabra (Licorice) extract equivalent to dry root

3.42 g

Matricaria chamomilla (Chamomile) extract equivalent to dry flower

600 mg

Filipendula ulmaria (Meadowsweet) extract equivalent to dry herb

500 mg

Matricaria chamomilla (Chamomile) flower essential oil

5 mg

containing glycyrrhizinic acid not more than 1%

60 Tablets Mode of Action Contains herbs traditionally used for their anti-inflammatory activity. Deglycyrrhizinised licorice has been found clinically to have mucoprotective activity.

Indications Relief of indigestion. For the symptomatic relief of heartburn.

Contraindications and Cautions If symptoms of reflux persist refer the patient to their physician. Meadowsweet should be avoided by persons hypersensitive to salicylates. Contraindicated in cases of known allergy to Chamomile. Caution in cases of known sensitivity to plants of the Compositae family. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 3-5 tablets daily. Children 6-12 years: 2 tablets daily. Take after meals for oesophageal reflux and before meals for gastric and duodenal problems.

Matricaria chamomilla

Product Catalogue

Additional Therapy Slippery Elm 400mg capsules to relieve the symptoms of gastritis and heartburn. Siberian Ginseng tablets if stress is a contributing factor. Add EFA Essentials capsules or Omega-3 Forte capsules, which may shift the balance of eicosanoids produced to those with anti-inflammatory activity. Consider Golden Seal tablets, traditionally used to soothe the mucous membranes of the digestive tract. Consider Boswellia Complex tablets or Curcuma Active tablets. See Chamomile Quality Issues on page 37

60 Tablets Mode of Action The herbs in this formulation may assist in blood circulation.

Each tablet contains: Aesculus hippocastanum (Horsechestnut) extract equivalent to dry seed

1.2 g

Ginkgo biloba (Ginkgo) extract equivalent to dry leaf

1.5 g

Ruscus aculeatus (Butcher’s Broom) extract equivalent to dry root & rhizome

800 mg

standardised to contain escin 38 mg

standardised to contain ginkgo flavonglycosides 7.5 mg standardised to contain ruscogenin 20 mg

Indications Supportive therapy for the relief of pain, heaviness, cramps, itching and swelling in the legs. Traditionally used for the relief of symptoms of the discomfort of haemorrhoids and varicose veins. Assists in the maintenance of peripheral circulation.

Contraindications and Cautions Caution in patients taking aspirin, warfarin, cilostazol, antipsychotics such as haloperidol, HIV non-nucleoside transcriptase inhibitors or anticonvulsants. Reduce dose of haloperidol if necessary in conjunction with prescribing physician. Increasing the intake of vitamin B6 may be advisable for patients taking anticonvulsants. May cause gastric upset in some patients. Contains sugars. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults and children over 12 years: 1 tablet 2-3 times daily with food. Enteric coated tablets. (Take tablet whole, do not break or crush.)

Additional Therapy Tissue Regenex tablets for tissue healing support. Combines well with Bilberry tablets to support peripheral circulation. Consider Ubiquinol Forte capsules to help maintain cardiovascular health, in particular, supporting heart health. Combine with LymphoLytix for additional relief of swelling in the legs. Consider Garlic Forte tablets for vascular protective effects as the body ages. Consider Hawthorn tablets for cardiovascular system support. Active Mag-Cal tablets may assist cramps due to magnesium deficiency. Consider Rhodiola & Ginseng tablets to support the body as it ages. See Ginkgo Quality Issues on page 47

Joint Defence 60 Tablets Mode of Action Supplementation of glucosamine and chondroitin sulfate in combination provides key proteoglycans, which helps to maintain and protect joint cartilage. Boswellia has been traditionally used in Ayurvedic medicine for rheumatic disorders and has anti-inflammatory action. Antioxidant trace minerals such as manganese, copper, zinc and selenium may help to modulate inflammation.

Product Information

Horsechestnut Complex

Each tablet contains: Glucosamine hydrochloride

500 mg

Chondroitin sulfate – bovine

300 mg

Boswellia serrata (Boswellia) extract equivalent to dry gum oleoresin

973 mg

Ascorbic acid (Vitamin C)

50 mg

Manganese amino acid chelate (equiv. to Manganese 5 mg)

50 mg

Zinc gluconate (equiv. to Zinc 6.8 mg)

50 mg

Borax (equiv. to Boron 950 mcg)

8.38 mg

Copper gluconate (equiv. to Copper 464 mcg)

3.57 mg

Selenomethionine (equiv. to Selenium 8 mcg)

20 mcg

standardised to contain boswellic acids 90 mg

Indications May help reduce joint inflammation and swelling, and help increase joint mobility associated with mild osteoarthritis. Temporary relief of the pain of mild rheumatoid arthritis and osteoarthritis.

Contraindications and Cautions Extreme caution is advised in those allergic to seafood. This product contains selenium which is toxic in high doses. A daily dose of 150 mcg for adults of selenium from dietary supplements should not be exceeded. Selenium-containing products are not suitable for use by children under the age of 15 years. Caution in pregnancy (mucopolysaccharides may inhibit angiogenesis). Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration

Additional Therapy Boswellia Complex tablets may provide additional relief of joint inflammation and Rehmannia Complex tablets may provide additional relief from arthritic symptoms. Consider Curcuma Active tablets, as curcumin has demonstrated anti-inflammatory and anti-arthritic activity and down-regulates numerous inflammatory mediators. Add EFA Essentials capsules or Omega-3 Forte capsules, which may shift the balance of eicosanoids produced to those with anti-inflammatory activity. Consider Celery Seed 1:2 liquid extract. For stronger analgesic activity combine with Saligesic tablets. Vitanox® tablets for additional antioxidant support. Tissue Regenex tablets for additional tissue healing support. Consider Adrenal Complex tablets for adrenal support. Consider LymphoLytix to relieve bruising and tissue swelling.

Adults: 1 tablet 3 times daily.

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Kava

Each tablet contains: Piper methysticum (Kava) extract equivalent to dry root

3.2 g

containing kavalactones 50 mg

60 Tablets Kava has been traditionally used in the Pacific Islands in the form of a decoction (water extract) with sedative and spasmolytic activities, to relax the mind, body and nerves and induce sleep.

Indications Helps relieve nervous tension, stress and mild anxiety. Relief of sleeplessness and insomnia. Relief of muscular aches and pains.

Contraindications and Cautions Not for prolonged use. Children under 12 and those who are pregnant or nursing are not recommended to use Kava. In rare cases Kava has been linked to liver damage. Caution is advised in patients taking central nervous system depressants. Contraindicated in patients taking L-dopa and antiparkinson drugs. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-3 times daily.

Additional Therapy Combines well with Valerian Complex tablets to promote relaxation and encourage sleep. Combine with NeuroSom tablets to help relieve insomnia. Consider Nevaton® tablets, St John’s Wort tablets or Everyday B Multi tablets to provide a tonic to support the nervous system and ease the effects of occasional stress. Consider Nervagesic tablets to promote sleep. Consider Adrenal Complex tablets for adrenal support. Consider HiPep tablets for the symptomatic relief of heartburn. Consider Active Mag-Cal tablets which may help relieve the symptoms associated with nervous tension, stress and mild anxiety. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need.

Kava Quality Issues

Piper methysticum

LivCo®

water

100

Kava is derived from the rootstock of the sterile cultivated species of Piper methysticum. The psychosedative property of Kava has been attributed to the kavalactones, a group of structurally related lipophilic lactones. These compounds can represent 3 to 20% by weight of the dried rootstock, depending on the age of the plant and the specific cultivar. The majority of the Kava used commercially in the world is in the form of a high ethanol or other organic solvent extract, which extracts little more than the kavalactones and has reported potential hepatoxicity concerns. The Therapeutic Goods Administration (TGA) allows water extracted or plain unextracted root to be sold in Australia. Traditionally Kava beverages are prepared by chewing or pounding the root to produce a cloudy, milky mash, which is then consumed orally. It is known that extraction with different solvents affects the phytochemical profile of the extract. MediHerb investigated the difference in bioavailability of the water extract of Kava and the 96% ethanol extract using the Caco-2 monolayer model. The kavalactones (as kawain) were found to be potentially bioavailable as they all crossed the membrane quite readily with the exception of one kavalactone (yangonin). The water extract of Kava was only slightly less bioavailable than the ethanol extract. Therefore the clinical effect of the water extract of Kava would be similar to that of an ethanol extract, with fewer hepatotoxicity concerns.

ethanol

standard

80 70

% apical

Mode of Action

60 50 40 30 20 10 0 0

Kawain % apical average data Time water ethanol 10 11 11 20 21 22 30 30 31 60 59 59 90 80 81 120 87 89 150 92 95

160

standard 12 23 33 61 84 91 97

Each tablet contains: Silybum marianum (St Mary’s Thistle) extract equivalent to dry seed

2.1 g

Schisandra chinensis (Schisandra) extract equivalent to dry fruit

1.0 g

Rosmarinus officinalis (Rosemary) extract equivalent to dry leaf

500 mg

standardised to contain flavanolignans calculated as silybin 24 mg

60 Tablets

120

Time (min)

Mode of Action The combination of Chinese and European traditional herbs in LivCo® aids digestion and supports the liver. A healthy liver assists the clearance of metabolites and xenobiotics from the body.

Indications Liver tonic. Assists in the relief of indigestion and flatulence. Aids, assists or helps in the maintenance or improvement of general well-being.

Contraindications and Cautions Schisandra is contraindicated in pregnancy, except at birth. In anaemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements. Caution is advised in patients taking immunosuppressive drugs, especially those with elevated liver enzymes; and do not take at the same time. Caution in patients taking metronidazole and ornidazole. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Additional Therapy P2-Detox powder to provide compounds to support normal phase II detoxification processes and which may aid fat metabolism in the liver. Combines well with Clivers Complex tablets for the relief of the symptoms of skin complaints. Vitanox® tablets for antioxidant support. Consider Everyday B Multi tablets for nutritional support during times of overindulgence. Consider Activated Beet-Greens powder to help protect cells from free radicals. See St Mary’s Thistle Quality Issues on page 66 See Schisandra Quality Issues on page 53

Product Catalogue

Schisandra Quality Issues Schisandra is a well known Chinese herb, however it is not well known that two species of Schisandra are used in TCM, the phytochemical profile of each being very different. Schisandra chinensis (northern Schisandra) is the preferred species in TCM and by Western health care professionals. It contains compounds called schisandrins (schisandrin, gomisin A, deoxyschisandrin, gomisin N and wuweizizu C) which are believed responsible for the therapeutic effects. Southern Schisandra, Schisandra spenanthera, (see Product X in the trace) is considered inferior due to lower levels of schisandrins, however it is often used interchangeably with Schisandra chinensis. Manufacturers therefore need to be very careful to avoid substitution with Schisandra spenanthera. The species are readily distinguishable morphologically and by HPLC. Schisandra HPLC comparison of good quality product with poor quality product Schisandrin Deoxyschisandrin

Gomisin A

Gomisin N

Wuweizizu C

Schisandra chinensis MediHerb Standard

Livton® Complex

Each tablet contains: Silybum marianum (St Mary’s Thistle) extract equivalent to dry seed

7.0 g

Cynara scolymus (Globe Artichoke) extract equivalent to dry leaf

800 mg

Taraxacum officinale (Dandelion) extract equivalent to dry root

400 mg

Bupleurum falcatum (Bupleurum) extract equivalent to dry root

300 mg

Chionanthus virginica (Fringe Tree) extract equivalent to dry stem bark

160 mg

standardised to flavanolignans calculated as silybin 80 mg

60 Tablets Mode of Action The combined actions of the five herbs in Livton® Complex help maintain healthy digestion and liver function.

Indications Helps maintain healthy digestive function. Supportive tonic for the liver and liver function. Helps maintain healthy gallbladder function.

Contraindications and Cautions Use cautiously in pregnancy. Globe Artichoke is contraindicated in blockage of the gallbladder. In anaemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements. Not to be taken at the same time with immunosuppressive drugs, and caution is advised in those with elevated liver enzymes taking immunosuppressive drugs. Caution in patients taking metronidazole, ornidazole and nifedipine. Discontinue 7 days prior to general anaesthesia.

LymphoLytix

Dosage and Administration Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Additional Therapy Consider Cascara Complex tablets to assist with constipation. Consider Phellodendron Forte tablets to assist in the maintenance of cholesterol within the normal range in healthy individuals. DiGest tablets for further digestive support by stimulating appetite and increasing digestive secretions. See St Mary’s Thistle Quality Issues on page 66

Each tablet contains: Vitis vinifera (Grape Seed) extract equivalent to dry seed

4.8 g

Zingiber officinale (Ginger) extract equivalent to dry root

150 mg

Bromelains

100 mg

Ascorbic acid (Vitamin C)

25 mg

Quercetin dihydrate

250 mg

standardised to contain procyanidins (OPCs) 38 mg

120 Tablets Mode of Action This combination helps reduce mild inflammation, possibly by reducing inflammatory mediators; supports healthy capillaries, minor wound healing and connective tissue formation. It also contains antioxidant nutrients and botanicals.

Product Information

Product X

Indications Relieves bruising, swelling and pain that result from soft tissue trauma, sports injury and surgery. Relieves mild inflammation.

Contraindications and Cautions Contraindicated in those with allergy to pineapple. May increase bioavailability of antibiotics and cyclosporin. Monitor patients taking anticoagulants. Vitamin supplements should not replace a balanced diet. Discontinue at least 7 days prior to general anaesthesia.

Dosage and Administration

Additional Therapy Consider Curcuma Active tablets for additional anti-inflammatory support. Consider Tissue Regenex tablets for additional support for soft tissue injuries. Combine with Horsechestnut Complex tablets to relieve swelling in the legs and to further support peripheral circulation. For relief of joint inflammation consider Joint Defence and Boswellia Complex tablets. Consider St John’s Wort tablets to help relieve nerve pain. Consider Activated Beet Greens powder to help reduce tiredness and fatigue.

Adults: 2 tablets, 3 times daily.

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Mega Mag

150 g Powder 300 g Powder Mode of Action Magnesium is necessary for skeletal and smooth muscle contraction. The B group vitamins support the body’s energy production. Contains the metabolically active forms of vitamin B2 (riboflavine sodium phosphate), vitamin B6 (pyridoxal 5-phosphate) and folic acid (calcium folinate). Calcium folinate (folinic acid) bypasses the biochemical steps normally required by folic acid. Also provides antioxidant nutrients including selenium and zinc.

Each 5 g dose contains: Magnesium amino acid chelate (equiv. to Magnesium 225 mg) Magnesium citrate (equiv. to Magnesium 80 mg) Magnesium orotate dihydrate (equiv. to Magnesium 10 mg) (Total elemental Magnesium 315 mg) Calcium citrate hydrate (equiv. to Calcium 50 mg) Potassium citrate (equiv. to Potassium 50 mg) Zinc ascorbate (equiv. to Zinc 5 mg) (equiv. to Ascorbic acid 27 mg) Chromium nicotinate (equiv. to Chromium 50 mcg) Chromic chloride (equiv. to Chromium 50 mcg) (Total elemental Chromium 100 mcg) Molybdenum trioxide (equiv. to Molybdenum 60 mcg) Selenomethionine (equiv. to Selenium 25 mcg) Thiamine hydrochloride (Vitamin B1) Riboflavine sodium phosphate (Activated Vitamin B2) (equiv. to riboflavin 10 mg) Nicotinamide (Vitamin B3) Calcium pantothenate (Vitamin B5) Pyridoxal 5-phosphate monohydrate (Activated Vitamin B6) (equiv. to pyridoxine 10 mg) Calcium Folinate (equiv. to folinic acid 250 mcg) Cyanocobalamin (Vitamin B12) Ascorbic acid (Vitamin C) (Total Vitamin C 100 mg) d-alpha-Tocopheryl acid succinate (natural Vitamin E 24 IU) Tocopherols concentrate – mixed (low-alpha type) (natural Vitamin E 26 IU) Dunaliella salina extract equivalent to fresh cell (equiv. to carotenoids calculated as betacarotene 835 mcg)

R,S-Alpha lipoic acid Glutamine Taurine Levocarnitine Creatine monohydrate

Indications Prevention and treatment of magnesium deficiency. Relief of cramps and spasms caused by magnesium deficiency. Nutritional support for energy production. May provide support for the structural integrity of bone. Magnesium and chromium assist in maintaining normal regulation of blood glucose levels in healthy individuals.

Contraindications and Cautions Caution is advised in pregnant women, nursing mothers and those with renal or hepatic failure should seek the advice of their health care practitioner before taking any amino acids and creatine supplements. This product contains selenium which is toxic in high doses. A daily dose of 150 mcg for adults of selenium from dietary supplements should not be exceeded. Selenium containing products are not suitable for use by children under the age of 15 years. If taking tetracycline or quinolone antibiotics, biphosphonates (osteoporosis drugs) or thyroid hormone, separate doses by at least two hours. Vitamin supplements should not replace a balanced diet. Contains pyridoxine hydrochloride which may be dangerous when used in large amounts or for a long period of time. If used long term ensure other nutrients are sufficiently supplemented in the diet. Discontinue at least 7 days prior to general anaesthesia.

1.13 g 518 mg 152 mg 237 mg 138 mg 33 mg 400 mcg 255 mcg 90 mcg 63 mcg 38 mg 13.15 mg 50 mg 160 mg 15.65 mg 270 mcg 200 mcg 73 mg 20 mg 20 mg 20.8 mg 20 mg 500 mg 500 mg 100 mg 500 mg

Dosage and Administration Adults: Take 5 grams of powder (1 level metric teaspoon) mixed in 50-100 mL of water or juice, once daily, preferably with a meal.

Additional Therapy Everyday B Multi tablets may be beneficial at times of increased physical or mental demand. Consider Everyday Balance Protein Powder, taken either pre or post physically strenuous activities. Joint Defence tablets may provide relief of joint immobility or pain and Boswellia Complex tablets may provide additional relief for joint inflammation. Combine with Rhodiola & Ginseng tablets or Withania Complex tablets for adaptation to stress. Everyday B Multi tablets or Vital Woman tablets may help maintain optimum levels of vitamins and minerals during times of increased need. Valerian Complex tablets to promote sleep and relieve nervous tension. Consider GlucoBalance tablets which may help to maintain normal healthy blood glucose levels. Poly-C Powder and Vitanox® tablets for additional antioxidant activity. Review patient’s dietary and lifestyle habits which contribute to the loss or decreased absorption of magnesium, vitamins B and C, ie smoking, intake of caffeine, refined sugars and alcohol.

Mega Mag Powder

Relief of muscular cramps and spasms 54

Product Catalogue

Each tablet contains: Camellia sinensis (Green Tea) extract equivalent to dry leaf

4.0 g

Choline bitartrate

300 mg

Calcium Folinate equivalent to folinic acid 250 mcg

347 mcg

Pyridoxine hydrochloride (Vitamin B6) (equiv. to pyridoxine 30 mg)

37.6 mg

Pyridoxal 5-phosphate monohydrate (Activated Vitamin B6) (equiv. to pyridoxine 20 mg)

31.35 mg

Cyanocobalamin (Vitamin B12)

1.0 mg

Folic acid

250 mcg

standardised to contain catechins 80 mg

60 Tablets Mode of Action Contains methylating factors: folic acid, vitamin B12, vitamin B6 and choline. These methylating factors play a key role in DNA methylation (which influences the expression of genes) because they influence the supply of methyl groups and consequently the biochemical pathways of methylation processes (such as the trans-methylation pathway). Also contains the metabolically active forms of vitamin B6 (pyridoxal 5-phosphate) and folic acid (calcium folinate). Calcium folinate (folinic acid) bypasses the biochemical steps normally required by folic acid. Low levels of folate, vitamin B6 and vitamin B12 in the body are associated with increased tissue levels of homocysteine. Green Tea provides antioxidant support.

Mexican Valerian

Indications Help the regulation of normal homocysteine levels. Can assist in maintaining normal blood. Blood tonic. Source of antioxidants that help maintain health and well‑being.

Contraindications and Cautions Contains 12 mg of caffeine per tablet. Contains pyridoxal 5-phosphate and pyridoxine hydrochloride which may be dangerous if used in large amounts or for a long time. Patients should be advised to stop taking this medication if they experience tingling, burning or numbness and see their healthcare practitioner as soon as possible. In anaemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements. Caution in patients taking immunosuppressive drugs such as cyclosporin, and do not take at the same time. Caution in patients taking statin drugs. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet daily.

Additional Therapy Consider Vitanox® tablets and Poly-C Powder to complement antioxidant support. Consider Garlic Forte tablets for vascular protective effects, and Hawthorn tablets or Ubiquinol Forte capsules to support the cardiovascular system. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. NeuroSom tablets may provide relief from the symptoms of mind anxiety. Combine with PhytoRegenex tablets to aid the maintenance of general health and well‑being.

Each tablet contains: Valeriana edulis (Mexican Valerian) equivalent to dry root & rhizome

50 Tablets Mode of Action Used traditionally as a mild sedative.

Indications Relief of sleeplessness. Symptomatic relief of anxiety.

Contraindications and Cautions May very rarely cause overstimulation in some individuals. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-3 times daily. Children 3-12 years: ½-1 tablet daily.

Nervagesic 60 Tablets Mode of Action Contains herbs with analgesic and sedative activities.

Product Information

Methyl Factors

1.0 g

Additional Therapy Combine with Nevaton® tablets for nervous tension and stress. Combine with Valerian Complex tablets for additional relief of sleeplessness. Consider Active Mag-Cal tablets which may help relieve the symptoms associated with PMS. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Kava tablets may provide relief from the symptoms of anxiety and help promote restful sleep. Consider Nervagesic tablets to promote sleep.

Each tablet contains: Eschscholzia californica (Californian Poppy) extract equiv to dry herb flowering

800 mg

Corydalis turtschaninovii (Corydalis) extract equivalent to dry tuber

800 mg

Piscidia piscipula (Jamaica Dogwood) extract equivalent to dry stem bark

400 mg

Indications Traditionally used to relieve mild neuralgia and pain of sciatica. Traditionally used to relieve pain associated with menstruation. Traditionally used to promote sleep. Traditionally used to relieve muscular cramps and spasm.

Contraindications and Cautions Caution is advised for women wishing to conceive. Contraindicated in pregnancy, bradycardia and cardiac insufficiency. Not recommended during lactation. Discontinue 7 days prior to general anaesthesia.

Additional Therapy Consider Curcuma Active or Boswellia Complex tablets for temporary relief of the pain and inflammation of mild arthritis. Consider Saligesic tablets for symptomatic relief of musculoskeletal low back pain. For additional support combine with Valerian Complex or NeuroSom tablets to encourage sleep, or Cramplex tablets for symptomatic relief of dysmenorrhoea. St John’s Wort tablets also may help relieve nerve pain, mild neuralgia and sciatica. Consider Mega Mag powder for relief of muscular cramps and spasms. Consider Adrenal Complex tablets for adrenal support.

Dosage and Administration Adults: Take 2 tablets 2 times daily.

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NeuroSom 60 Tablets Mode of Action Contains herbs and nutrients with mild anxiolytic and sedative activities, to promote relaxation of mind and body and to promote restful sleep.

Each tablet contains: Melissa officinalis (Lemon Balm) extract equivalent to dry herb top

650 mg

Ziziphus jujuba var. spinosa (Zizyphus) extract equivalent to fresh seed

638.8 mg

Magnolia officinalis (Magnolia) extract equivalent to dry stem bark

593.2 mg

Lavandula angustifolia (Lavender) essential oil

10 mg

Pyridoxine hydrochloride (Vitamin B6)

20 mg

Magnesium citrate (equiv. to Magnesium 40 mg)

258 mg

Indications

Dosage and Administration

Contains herbs: Melissa officinalis which has been used in Traditional Western Herbal Medicine for restlessness, irritability and insomnia. Traditionally used in Herbal Medicine as a mild sedative and/or sleep aid (hypnotic).

Adults: 2 tablets 1-2 times daily.

Additional Therapy For additional support combine with Valerian Complex tablets or Nervagesic to promote relaxation and encourage sleep, or Kava tablets to help relieve mild anxiety. Consider Nervagesic tablets to promote sleep. Consider Nevaton® tablets, St John’s Wort tablets or Everyday B Multi tablets to provide additional tonic support for the nervous system and to ease the effects of occasional stress. Consider Vital Woman tablets as nutritional support. Combine with Rhodiola & Ginseng tablets or Withania Complex tablets to help cope with stress. Combine with DiGest tablets for enhanced digestive function.

Contraindications and Cautions Contains pyridoxine hydrochloride which may be dangerous when used in large amounts or for a long period of time. Caution is advised in pregnancy. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Nevaton®

Each tablet contains: Hypericum perforatum (St John’s Wort) extract equivalent to dry herb flowering top

750 mg

Schisandra chinensis (Schisandra) extract equivalent to dry fruit

675 mg

Turnera diffusa (Damiana) extract equivalent to dry leaf

625 mg

Scutellaria lateriflora (Skullcap) extract equivalent to dry herb

500 mg

standardised to contain hypericin 413 mcg

60 Tablets Mode of Action A powerful St John’s Wort product reinforced by other herbs with complementary activity traditionally used as a nervine tonic.

Indications Helps relieve nervous unrest and irritability and beneficial during times of stress. Symptomatic relief of mood swings. Relief of sleeplessness.

Contraindications and Cautions

Hypericum perforatum

May cause hyperaesthesia in some sensitive individuals especially when combined with a high exposure to sunlight. St John’s Wort is not advisable in cases of known photosensitivity. Patients taking high doses should avoid excessive exposure to sunlight and UV radiation. St John’s Wort affects the way some prescription medicines work. Concurrent administration of high doses of St John’s Wort is contraindicated with the following drugs: warfarin, digoxin, immunosuppressive drugs such as cyclosporin, indinavir (HIV protease inhibitor), nevirapine (HIV non-nucleoside transcriptase inhibitor) docetaxel by injection, phenprocoumon, nifedipine, methadone, finasteride, clozapine, cancer chemotherapeutic drugs such as irinotecan and calcium channel antagonists such as verapamil. Caution is advised in patients taking other drug medications, including combined oral contraceptives. Consume at least 2 hours away from ingestion of mineral supplements. As Schisandra has been used traditionally to induce labour, contraindicated in pregnancy, except at birth. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Product Catalogue

Additional Therapy Valerian Complex tablets for relief of insomnia. Consider Everyday B Multi tablets, Mega Mag powder or Active Mag-Cal tablets for nutritional support during times of stress. Kava tablets may provide relief from the symptoms of mild anxiety and help promote restful sleep. Siberian Ginseng tablets or Rhodiola & Ginseng tablets may provide support during times of fatigue and declining capacity for work and concentration. Consider Adrenal Complex tablets or ThyAdren Support tablets for adrenal support. Consider Nervagesic tablets to promote sleep. See St John’s Wort Quality Issues on page 68 See Schisandra Quality Issues on page 53

Omega-3 Forte

Each capsule contains: Concentrated Omega-3 triglycerides – fish

1.0 g

d-alpha-Tocopherol (natural Vitamin E 39 IU)

26.2 mg

Tocopherols concentrate – mixed (low alpha type)

10 mg

as eicosapentaenoic acid (EPA) 350 mg and docosahexaenoic acid (DHA) 230 mg

Mode of Action Fish oil may produce an elevation of blood levels of the essential fatty acids EPA and DHA. An increase in blood levels of EPA and DHA may shift the balance of eicosanoids produced to those with anti-inflammatory activity. Elevated blood levels of EPA and DHA have been associated with healthy triglyceride levels. This product also contains the antioxidant vitamin E (as mixed natural tocopherols).

Indications

Dosage and Administration Adults: 1 capsule 2-3 times daily.

Fish oil may produce an elevation of blood levels of the essential fatty acids EPA and DHA Elevated blood levels of EPA and DHA have been associated with healthy triglyceride levels. Provides omega-3 fatty acids to help maintain or improve general well-being.

Additional Therapy Consider Garlic Forte tablets, Coleus Forte tablets, Hawthorn tablets for cardiovascular system support. Consider Hawthorn Leaves 1:2 liquid extract and/or Globe Artichoke 1:2 liquid extract. Joint Defence tablets, Boswellia Complex tablets or Curcuma Active tablets to help relieve mild arthritic pain. Consider Poly-C Powder, Zinc Protect tablets and Vitanox® tablets for additional antioxidant support. Combine with EFA Essentials capsules for additional omega-3 and omega-6 support.

Contraindications and Cautions Ingredients in this product are derived from seafood. Persons who are allergic to seafood should exercise extreme caution. Use with caution in individuals being treated with warfarin because of fish oil’s possible anti-thrombotic effects. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Fatty Acids: Definition & Metabolism Polyunsaturated fatty acids (PUFAs) contain two or more double (unsaturated) bonds. They are classified by the position of the double bond nearest to the methyl end of the molecule and include omega-3 and omega-6 fatty acids (abbreviated to n-3 and n-6 fatty acids respectively). Linoleic acid (LA) is the most common n-6 fatty acid and it occurs in many vegetable oils. The most important n-3 fatty acids are alpha-linolenic acid (ALA) which occurs in green leafy vegetables, linseed, nuts, some vegetable oils, and the main fatty acids from oily fish: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). As the body cannot synthesise LA or ALA they are referred to as essential and must be obtained from the diet. PUFAs are components of cell membranes (influencing fluidity and flexibility), help maintain the water impermeability of the skin, are used for energy generation/storage and eicosanoid formation. LA and ALA are understood to be metabolised in the liver to form longer-chain fatty acids as indicated in the diagram below. The chain length of the fatty acid increases down the pathway. LA is converted to GLA and then through to AA. ALA is converted (to a lesser extent) to EPA and DHA. As the conversions involving the desaturase enzymes are unreliable and restricted, a significant increase in serum DGLA levels is better achieved by increasing intake of GLA. Similarly for the conversion of ALA to EPA, and EPA to DHA. An increase in the levels of EPA and DHA is best achieved by intake of both these fatty acids.

AA = arachidonic acid ALA = alpha-linolenic acid DGLA = dihomo-gamma-linolenic acid DHA = docosahexaenoic acid EPA = eicosapentaenoic acid GLA = gamma-linolenic acid LA = linoleic acid n-3 fatty acid = omega-3 fatty acid n-6 fatty acid = omega-6 fatty LT = leukotrienes PGE = prostaglandin

n-6 fatty acids

n-3 fatty acids

ALA

delta-6-desaturase

GLA

delta-5-desaturase

Product Information

60 Capsules 120 Capsules

EPA

DGLA PGE1

delta-4-desaturase delta-5-desaturase

DHA AA lipoxygenase

cyclooxygenase

lipoxygenase

cyclooxygenase

PGE2

LT4

PGE3

LT5

Pathways of n-6 and n-3 fatty acid metabolism (selected fatty acids and enzymes shown)

Omega-3 Forte

High Potency, High Quality High levels of EPA and DHA Neutral taste technology Pharmaceutical-grade omega-3 concentrate from food-grade fish body oil Based on anchovy and sardines sustainably sourced from the clean waters of the Pacific Ocean

Contains an emulsifier to enhance digestion Mixed natural tocopherols and d-alpha-Tocopherol Fewer capsules required for optimum omega-3 dose Better compliance

Stringent purity limits for all environmental toxins (heavy metals, dioxins, PCBs) and peroxides

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P2-Detox

Each 4 g dose contains: Brassica oleracea var. italica (Broccoli) extract equivalent to fresh sprout

7.0 g

Curcuma longa (Turmeric) extract equivalent to dry rhizome

2.13 g

160 g Powder

Glutamine

750 mg

Mode of Action

Glycine

500 mg

Taurine

500 mg

Cysteine hydrochloride (equiv. to Cysteine 125 mg)

181 mg

Methionine

125 mg

Choline bitartrate

250 mg

Inositol

200 mg

Potassium sulfate (equiv. to Potassium 67 mg)

150 mg

standardised to contain curcuminoids 81 mg

The phytonutrients in Broccoli sprouts support phase II liver detoxification and turmeric has antioxidant activity. Antioxidant support is also provided by glycine and the sulfur-containing amino acid taurine. Adequate supply of glutamine, cysteine, methionine and taurine is essential to help maintain glutathione preoxidase levels. These amino acids, and the inorganic sulfur from potassium sulphate act as conjugating substances and may support in phase II detoxification. Choline and inositol may help to support liver function by aiding fat metabolism.

Indications

Dosage and Administration

Supportive of the normal phase II detoxification processes in the liver. May help to support liver function by aiding fat metabolism in the liver. Provides antioxidant action through liver function support.

Contraindications and Cautions Caution is advised during lactation and in patients with low thyroid function. Exercise caution in patients with haemorrhagic disorders and in those taking warfarin or antiplatelet drugs. Until more information is available regarding the expression of Nrf2 in cancer, do not take at last 48 hours either side of each chemotherapy or radiotherapy treatment. Discontinue at least 7 days prior to general anaesthesia.

Phellodendron Forte

Adults: Take 4 grams of powder (1 level metric teaspoon) mixed in 50-100 mL of water or juice, 1-2 times daily, preferably with a meal.

Additional Therapy Combines well with Silymarin tablets as a supportive tonic for liver function. Consider LivCo® tablets for additional liver support or Vitanox® tablets to provide antioxidants. Poly-C Powder for additional antioxidant activity. Methyl Factors tablets and Everyday B Multi tablets to provide nutrients involved in homocysteine regulation. Consider Activated Beet-Greens to help protect cells from free radicals.

Each tablet contains: Phellodendron amurense stem bark

8.8 g

standardised to berberine 200 mg

60 Tablets Mode of Action Phellodendron amurense contains berberine, which has been shown in vitro to display antimicrobial properties on a range of bacteria. Berberine exerts anti-inflammatory activity.

Indications

Dosage and Administration

May assist in the maintenance of cholesterol within the normal range in healthy individuals Berberine exerts anti-inflammatory activity Relief or treatment of diarrhea

Contraindications and Cautions Contraindicated in pregnancy, lactation and patients taking immunosuppressive drugs. Caution is warranted in betathalassaemia, unconjugated hyperbilirubinaemia and those with obstructed bile ducts. Not advisable in jaundiced neonates. Monitor patients who tend to experience constipation. Discontinue 7 days prior to general anaesthesia.

Adults: 1 to 2 tablets daily. 5 tablets daily for the maintenance of healthy cholesterol levels

Additional Therapy GlucoBalance or Gymnema tablets to help decrease appetite PolyFem tablets to support normal ovarian function Silymarin or LivCo® tablets as supportive liver tonics

Phellodendron Forte High dose of berberine to support healthy cholesterol levels

Product Catalogue

Each tablet contains: Fallopia japonica (Polygonum cuspidatum, Giant Knotweed) extract equivalent to dry root

8.0 g

standardised to resveratrol 36 mg

60 Tablets

Vitis vinifera (Grapeseed) extract equivalent to dry seed standardised to contain Procyanidins (of Vitis vinifera) 38 mg

4.8 g

Mode of Action The herbs in this formulation provide adaptogenic, general tonic and antioxidant activities.

Silybum marianum (St Maryâ&#x20AC;&#x2122;s Thistle) extract equivalent to dry seed

4.2 g

Ginkgo biloba (Ginkgo) extract equivalent to dry leaf

1.5 g

Panax ginseng (Korean Ginseng) extract equivalent to dry root

250 mg

standardised to flavanolignans calculated as silybin 48 mg standardised to ginkgo flavonglycosides 7.4 mg standardised to ginkgolides & bilobalide 1.8 mg

standardised to ginsenosides calculated as Rg1, Re, Rb1, Rc, Rb2 & Rd 4.2 mg

Indications Assists in the maintenance of general well-being. Supports healthy cognitive function. May improve stress adaptation. Supports mental and physical performance, especially during times of tiredness or stress. May assist peripheral circulation.

Contraindications and Cautions Discontinue during an acute infection or fever. Contraindicated in patients taking phenelzine. Caution is advised in patients with high blood pressure and those taking central nervous system stimulants, insulin or oral hypoglycaemic drugs (including pioglitazone or glipizide), metronidazole, ornidazole, nifedipine, aspirin, warfarin, cilostazol, antipsychotics such as haloperidol, anticonvulsants, HIV non-nucleoside transcriptase inhibitors. Caution is advised in patients taking metformin at doses greater than 1 g/day of the drug. Reduce dose of haloperidol or metformin if necessary in conjunction with prescribing physician. Increasing the intake of vitamin B6 may be advisable for patients taking anticonvulsants. Not to be taken at the same time with immunosuppressive drugs, and caution is advised in those with elevated liver enzymes taking immunosuppressive drugs. This formulation should be consumed at least 2 hours away from ingestion of mineral supplements (including iron supplements). In anaemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements. Discontinue at least 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-4 times daily.

Additional Therapy Combines well with GlucoBalance tablets for maintenance of normal healthy blood glucose levels in healthy individuals. Use with Bacopa Complex tablets or Siberian Ginseng tablets to help relieve the stress of study or work. Consider Garlic Forte tablets for vascular protective effects as the body ages. Consider Poly-C Powder for additional antioxidant support. Boswellia Complex tablets to support healthy joints. Horsechestnut Complex tablets for additional peripheral circulation support. Garlic Forte tablets which is supportive to dietary measures to maintain healthy blood lipid levels. Consider Activated Beet-Greens powder or Ubiquinol Forte to support cardiovascular health. Consider Calcium Bone Complex powder to assist in the prevention and/or treatment of osteoporosis.

Product Information

PhytoRegenex

See Ginkgo Quality Issues on page 47 See St Maryâ&#x20AC;&#x2122;s Thistle Quality Issues on page 66 See Korean Ginseng Quality Issues on page 76

PhytoRegenex

Essential Support for Health and Well-being Provides a multifaceted approach to good health by supporting: Cognitive function Mental and physical performance Liver health Peripheral circulation Ability to cope with stress

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Poly-C Powder 200 g Powder Mode of Action Poly-C Powder has wide ranging antioxidant effects that support health and well-being in a variety of ways. Vitamin C plays a role in the maintenance of healthy epithelial cells and is involved in minor wound healing. It may also support healthy immune function and resistance to infection. Resveratrol (from Polygonum cuspidatum) combined with alpha lipoic acid further adds to the antioxidant effects of vitamin C.

Each 4 g dose contains: Ascorbic acid (Vitamin C)

1.77 g

Sodium ascorbate (equiv. to Vitamin C 265 mg)

300 mg

Calcium ascorbate dihydrate (equiv. to Vitamin C 230 mg)

280 mg

Magnesium ascorbate monohydrate (equiv. to Vitamin C 68 mg)

80 mg

Zinc ascorbate monohydrate (equiv. to Vitamin C 65 mg)

80 mg

(Total Vitamin C 2.4 g) Fallopia japonica (Giant Knotweed) extract equivalent to dry root

7.5 g

Citrus bioflavonoids extract

96 mg

Hesperidin

96 mg

Rutin

96 mg

Quercetin

48 mg

R,S-Alpha lipoic acid

50 mg

standardised to contain resveratrol 15 mg

Indications For vitamin C supplementation when dietary intake is inadequate and for those with increased needs including smokers, athletes, pregnant and lactating women. May help reduce the severity and duration of the symptoms of colds and other mild infections. Nutritional support for minor wound healing and healthy skin. May be beneficial during times of increased mental and physical stress.

Contraindications and Cautions Large doses of vitamin C may cause gastrointestinal complaints such as nausea or diarrhoea in sensitive individuals (due to the osmotic effects of unabsorbed ascorbic acid). Individuals with pre-existing kidney stone disease or a history of renal insufficiency should exercise caution in the use of higher than RDI amounts of vitamin C. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

PolyFem 60 Tablets Mode of Action This product contains herbs to support ovarian function.

Together with Echinacea Premium tablets or Andrographis Complex tablets for additional support for colds and mild upper respiratory infections. Consider Echinacea Premium Blend 1:2 liquid extract and/or Pelargonium 1:5 liquid extract. Add Astragalus Complex tablets to promote vitality. For relief of symptoms associated with dry, sore throats consider Herbal Throat Spray. Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Tissue Regenex tablets for additional tissue healing support.

852 mg

Glycyrrhiza glabra (Licorice) extract equivalent to dry root

847 mg

Actaea racemosa (Cimifuga racemosa, Black Cohosh) extract equivalent to dry root

300 mg

Thuja occidentalis (Thuja) extract equivalent to dry leaf

250 mg

standardised to contain glycyrrhizinic acid 12.1 mg

Contraindications and Cautions

Product Catalogue

Additional Therapy

Paeonia lactiflora (Paeonia) extract equivalent to dry root

Contains herbs used traditionally to support normal ovarian function.

Adults: Take 4 grams of powder (1 level metric teaspoon) mixed in 50-100 mL of water or juice, 1-2 times daily, preferably with meals. Children 6-12 years: Take 1 gram of powder (Âź teaspoon) mixed in 50-100 mL of water or juice, 1-2 times daily, preferably with meals. Not to be used in children under two years of age without medical advice. Please note: this product contains extracts from herbal and fruit sources that may not dissolve easily in liquid. Always use a dry spoon. Keep lid tightly sealed when not in use and store in a cool, dry place. Naturally sweetened using Stevia rebaudiana.

Each tablet contains:

Indications

Formulated by Francesca Naish, Natural Fertility Management and MediHerb.

Dosage and Administration

Black Cohosh may harm the liver in some individuals. If the patient is experiencing yellowing of the skin or whites of the eyes, dark urine, nausea, vomiting, unusual tiredness, weakness, stomach or abdominal pain, and/or loss of appetite, the patient should stop using this product and see their doctor. Contraindicated in pregnancy and lactation. Due to Licorice: caution is advised in those with elevated liver enzymes taking immunosuppressives; contraindicated in hypertension and oedema and in those taking thiazide or loop diuretics. Caution is advised in patients taking statin drugs. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily.

Additional Therapy Consider Chaste Tree tablets for relief of the symptoms caused by irregularities of the menstrual cycle. Consider Tribulus Forte tablets to support the health and function of the reproductive system of women. Consider GlucoBalance tablets for maintenance of normal/ healthy blood glucose levels in healthy individuals and Gymnema tablets which may help reduce appetite. Consider Phellodendron Forte tablets to assist in the maintenance of cholesterol within the normal range in healthy individuals. Consider P2-Detox powder to provide compounds to support normal phase II detoxification processes.

Probiotica

Each capsule contains: Probiotic powder blend containing:

60 Capsules Mode of Action Probiotics strengthen, maintain and restore a healthy balance of intestinal microflora.

Lactobacillus acidophilus LA-5

5 billion CFU

Bifidobacterium animalis lactis BB-12

5 billion CFU

Indications May assist to maintain a healthy balance of microorganisms during times of stress. Helps restore intestinal microflora pre- and post-antibiotic treatment. To help maintain normal intestinal microflora when travelling.

Dosage and Administration Adults: 1 capsule 1-2 times daily.

Additional Therapy Combines well with Bacto-Cand GI capsules, Slippery Elm 400mg capsules and Golden Seal tablets to support gastrointestinal function. Combines well with Garlic Forte tablets and Vitanox速 tablets. Consider combining with Cascara Complex tablets to assist in the relief of constipation. Siberian Ginseng tablets if stress is a contributing factor.

Contraindications and Cautions

ProstaCo

Product Information

This product contains ingredients sourced from dairy products. The lactose content is negligible and therefore this product would be suitable for most lactose-intolerant people. However, trace amounts of dairy protein may be present. Contains sugars (sucrose & glucose). Discontinue 7 days prior to general anaesthesia.

Each capsule contains: Serenoa repens (Saw Palmetto) liposterolic extract equivalent to dry fruit

1.07 g

Crateva nurvala (Crataeva) extract equivalent to dry bark

900 mg

Urtica dioica (Nettle Root) extract equivalent to dry root

666 mg

containing Serenoa repens fatty acids 96 mg

60 Capsules Mode of Action Contains herbs to assist with the relief of medically-diagnosed benign prostatic hyperplasia symptoms such as urinary hesitancy, intermittency or urgency.

Indications For the relief of symptoms of medically-diagnosed benign prostatic hyperplasia and associated micturition disorders.

Contraindications and Cautions Contains lactose. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration

Additional Therapy Combine with Cranberry Complex tablets which may help reduce the adherence of bacteria to the urinary tract. Consider Zinc Protect tablets for zinc supplementation and antioxidant support. Consider Echinacea Premium tablets for immune support. Diet should be high in foods containing phytoestrogens such as soy products, whole grains and seeds.

Adults: 1 capsule 3 times daily.

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PulmaCo

Each tablet contains: Curcuma longa (Turmeric) extract equivalent to dry rhizome

1.0 g

standardised to contain curcuminoids 38 mg

60 Tablets

Ginkgo biloba (Ginkgo) extract equivalent to dry leaf standardised to contain ginkgo flavonglycosides 4.9 mg

1.0 g

Mode of Action Has a range of expectorant, spasmolytic, bronchodilatory and mucolytic activity used in traditional herbal systems.

Justicia adhatoda (Adhatoda) extract equivalent to dry leaf

750 mg

Scutellaria baicalensis (Baical Skullcap) extract equivalent to dry root

500 mg

Grindelia camporum (Grindelia) extract equivalent to dry herb

300 mg

Foeniculum vulgare (Fennel) fruit essential oil

5 mg

Indications For relief of symptoms associated with spasmodic conditions of the respiratory tract. Traditionally used for the relief of cough.

Contraindications and Cautions Contraindicated in pregnancy due to Adhatoda. Caution in patients taking aspirin, warfarin, cilostazol, statin drugs, antipsychotics such as haloperidol, HIV non-nucleoside transcriptase inhibitors or anticonvulsants. Reduce haloperidol if necessary in conjunction with prescribing physician. Increasing the intake of vitamin B6 may be advisable for patients taking anticonvulsants. Discontinue 7 days prior to general anaesthesia. Not to be used in children under two years of age without medical advice.

Dosage and Administration

Additional Therapy Echinacea Premium tablets for immune support. Andrographis Complex tablets for the relief of the symptoms of upper respiratory tract infections. For support of the upper respiratory tract combine with Eyebright Complex tablets. Consider Albizia Complex tablets for relief of symptoms of allergies. Andrographis Complex tablets for the relief of cough and sore throat. Herbal Throat Spray for relief of sore and inflamed throat and symptoms of mouth ulcers and inflamed gums. See Ginkgo Quality Issues on page 47

Adults: 1 tablet 3 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Rehmannia Complex 60 Tablets Mode of Action Herbs used traditionally for the relief of inflamed joints and skin.

Each tablet contains: Rehmannia glutinosa (Rehmannia) extract equivalent to dry root

350 mg

Bupleurum falcatum (Bupleurum) extract equivalent to dry root

700 mg

Hemidesmus indicus (Hemidesmus) extract equivalent to dry root

500 mg

Tanacetum parthenium (Feverfew) extract equivalent to dry herb

165 mg

Indications May help reduce joint inflammation and swelling, and increase joint mobility associated with mild arthritis. Systematic relief of migraine. Bupleurum has been used in Traditional Chinese Medicine as a liver tonic. Several of the herbs in this formula have been used traditionally for the relief of skin conditions such as eczema, urticaria and inflamed skin.

Contraindications and Cautions Contraindicated in individuals with a known hypersensitivity to Feverfew, parthenolide or other members of the Compositae family. Doses during pregnancy should be kept to a maximum of 300 mg per day of Feverfew (dried herb). Discontinue 7 days prior to general anaesthesia.

Product Catalogue

Dosage and Administration Adults: 1 tablet 2-4 times daily. Children under 12 years: 1 tablet 1-3 times daily.

Additional Therapy For further relief of the symptoms of mild arthritis use Boswellia Complex tablets or Joint Defence tablets. Combine with Astragalus Complex tablets to build up vitality. Consider Curcuma Active tablets or Vitanox速 tablets for antioxidant support. Consider Adrenal Complex tablets for adrenal support.

60 Tablets

ResCo Phytosynergist® liquid 200 mL Mode of Action ResCo® products contain herbs traditionally used in Western herbal medicine for their expectorant, antispasmodic and anticatarrhal activity and are soothing to inflamed bronchial mucosa. ResCo® tablets also contain Thyme essential oil. Elecampane in ResCo Phytosynergist® liquid has been used for its antitussive action.

Each tablet contains: Glycyrrhiza glabra (Licorice) extract equivalent to dry root

500 mg

Verbascum thapsus (Mullein) extract equivalent to dry leaf

470 mg

Grindelia camporum (Grindelia) extract equivalent to dry herb

280 mg

Euphorbia hirta (Euphorbia) extract equivalent to dry herb

280 mg

Zingiber officinale (Ginger) extract equivalent to dry rhizome

180 mg

Thymus vulgaris (Thyme) herb flowering essential oil

12 mg

Foeniculum vulgare (Fennel) fruit essential oil

12 mg

Each 5 mL dose contains: Glycyrrhiza glabra (Licorice) extract equivalent to dry root

1.0 g

Verbascum thapsus (Mullein) extract equivalent to dry leaf

625 mg

Euphorbia hirta (Euphorbia) extract equivalent to dry herb

372.5 mg

Grindelia camporum (Grindelia) extract equivalent to dry herb

372.5 mg

Inula helenium (Elecampane) extract equivalent to dry root

372.5 mg

Zingiber officinale (Ginger) extract equivalent to dry rhizome

250 mg

Foeniculum vulgare (Fennel) fruit essential oil

15 mcL

Indications Relief of symptoms of catarrh and temporary relief of cough due to bronchial irritation by relieving mucous congestion and soothing bronchial airways. Temporary relief of bronchial cough.

Contraindications and Cautions Both Products: Due to Licorice: caution is advised in those with elevated liver enzymes taking immunosuppressives; contraindicated in hypertension and oedema. Ginger should be used cautiously in patients taking antacids (it may decrease the effectiveness due to an increase in gastric secretory activity). Contains glucose. Discontinue 7 days prior to general anaesthesia. Not to be used in children under two years of age without medical advice. Additional Contraindications and Cautions: ResCo Phytosynergist® liquid Not recommended during pregnancy, except at the lowest dosage for short periods. Contraindicated in women who are prone to hypertension in pregnancy) and those taking thiazide or loop diuretics.

Product Information

ResCo® tablets

Dosage and Administration ResCo® tablets: Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily. ResCo Phytosynergist® liquid: Adults: 5 mL with juice or water 3 times daily. Children 6-12 years: 2.5 mL with juice or water 3 times daily.

Additional Therapy Echinacea Premium tablets or Poly-C Powder (which contains vitamin C) for immune support. Combine with PulmaCo tablets for the relief of symptoms associated with spasmodic conditions of the respiratory tract. For relief of symptoms associated with dry, sore throats consider Herbal Throat Spray. Consider Albizia Complex tablets for relief of symptoms of allergies.

ResCo®

Relieves mucous congestion and other symptoms of catarrh. Temporary relief of bronchial cough

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Rhodiola & Ginseng 60 Tablets Mode of Action Rhodiola & Ginseng are traditionally used to enhance healthy physical and mental performance. Both herbs function as adaptogens.

Each tablet contains: Rhodiola rosea (Rhodiola) extract equivalent to dry root

600 mg

Panax ginseng (Korean Ginseng) extract equivalent to dry root

500 mg

standardised to contain phenylpropanoid glycosides calculated as rosavin, rosarin and rosin 4.5 mg standardised to contain salidroside 1.5 mg standardised to contain ginsenosides calculated as Rg1, Re, Rb1, Rb2 , Rc & Rd 8.4 mg

Indications

Additional Therapy

May improve stress adaptation. May provide support during times of fatigue and declining capacity for work and concentration. Assists in the maintenance or improvement of general wellbeing.

Use with Bacopa Complex tablets or Siberian Ginseng tablets to help relieve the stress of study or work. ThyAdren Support tablets for thyroid and adrenal support. To promote relaxation and encourage sleep use with Valerian Complex tablets or NeuroSom tablets. For nervous system support combine with St John’s Wort tablets. Combine with Tribulus Forte tablets to support normal physiology in mature men. Consider Adrenal Complex tablets for additional adrenal support. Consider Activated Beet-Greens to provide nutrients for energy metabolism and reduction of fatigue.

Dosage and Administration

See Korean Ginseng Quality Issues on page 76

Adults: 1 tablet 2-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Rhodiola & Schisandra 60 Tablets Mode of Action These herbs are used traditionally to help enhance physical and cognitive performance.

Each tablet contains: Rhodiola rosea (Rhodiola) extract equivalent to dry root

3.0 g

Schisandra chinensis (Schisandra) extract equivalent to dry fruit

660 mg

standardised to contain phenylpropanoid glycosides calculated as rosavin, rosarin and rosin 4.5 mg standardised to contain salidroside 1.5 mg

Indications

Additional Therapy

Helps to improve physical and mental responses in states of fatigue. Helps relieve stress and may improve stress adaptation. Supports vitality. Helps promote healthy cognitive function. Assists in the maintenance or improvement of general wellbeing.

Contraindications and Cautions As Schisandra has been used traditionally to induce labour, contraindicated in pregnancy except at birth. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Combines well with St John’s Wort 1.8g, Nevaton, NeuroSom or Kava tablets for relief of nervous tension. Consider Adrenal Complex tablets for adrenal support and ThyroCo tablets for thyroid support. Combine with Siberian Ginseng tablets further support the body’s adaptation to stress and to support immune function. Consider Activated Beet-Greens as a supplementary food to support stamina and endurance and to provide nutrients for energy metabolism and reduction of fatigue. Combine with Valerian Complex, Kava or Nervagesic tablets to promote sleep. Consider Ubiquinol Forte capsules to also relieve the sensation of fatigue. Combine with Tribulus Forte to helps maintain general well-being in men and women. See Schisandra Quality Issues on page 53

Rhodiola Quality Issues Rhodiola rosea (Sedum roseum) is commonly referred to as Golden Root or Roseroot and grows in dry sandy ground at high altitudes in the arctic regions of Europe and Asia. The freshly cut root has a rose-like odour that has led to its botanical name and one of its common names. The root has been used for centuries in the traditional medicines of Russia and Scandinavia. There are however 16 common species of Rhodiola growing in the Eurasian area. Of these, 11 have been tested in animal studies, but only R. rosea and to a far lesser extent R. crenulata have been assessed in human trials. Most of the Rhodiola species have been reported to contain the marker compound salidroside and this was originally used to standardise extracts of Rhodiola rosea. After more than a decade of research, however, it was shown that the chemical composition of R. rosea root is, in fact, different to the other species of the genus Rhodiola. Using newly developed methods of analysis, it was shown that R. rosea root contains three cinnamyl alcohol-vicianosides: rosavin, rosin, and rosarin that are specific to this species. They are collectively termed rosavins. HPLC offers a ready method to differentiate true Rhodiola rosea from the other species offered on the market. The two major rosavins found are rosavin and rosarin, with only very low quantities of rosin. HPLC trace of Rhodiola rosea Rosavin Rosarin

Product Catalogue

Saligesic

Each tablet contains: Salix purpurea (Willow) extract equivalent to dry stem bark

8.0 g

standardised to contain salicin 60 mg

60 Tablets Dosage and Administration

Temporary relief of the pain of mild osteoarthritis and mild rheumatoid arthritis. Symptomatic relief of musculoskeletal low back pain.

Contraindications and Cautions Willow Bark is contraindicated in those with allergy or sensitivity to salicylates and is also contraindicated in glucose-6-phosphate dehydrogenase-deficient patients (in this condition salicylic acid causes haemolytic anaemia). Use with caution during lactation as salicylates excreted in breast milk may cause rashes in babies. Caution is advised in patients taking warfarin. Discontinue 7 days prior to general anaesthesia.

Adults: 1-2 tablets twice daily. Children 6-12 years: ½-1 tablet 1-2 times daily.

Additional Therapy Boswellia Complex tablets, Joint Defence tablets or Curcuma Active tablets for additional relief of mild arthritic pain Combine with St John’s Wort tablets for relief of pain of mild neuralgia and sciatica. Feverfew tablets for symptomatic relief of mild migraine headache. Cramplex tablets for symptomatic relief of dysmenorrhoea. Valerian Complex tablets which may promote sleep and relieve nervous tension. Consider Adrenal Complex tablets for adrenal support. Consider Lympholytix to relieve pain that may result from soft tissue trauma or sports injury.

Willow Bark Quality Issues Willow Bark has been used for thousands of years to support musculoskeletal system health, but in recent times has fallen from favour due to inconsistent therapeutic outcomes. European clinical trials using a particular type of Willow Bark extract have demonstrated excellent results. The Willow Bark extracts used in the clinical trials were standardised to the marker compound salicin, however there are other salicin esters in Willow Bark such as salicortin, 2’-O-acetylsalicortin, fragilin and tremulacin, together with other components which are important for this herb. MediHerb Salgesic contains the extract used in the European clinical trials.

Product Information

Indications

Willow Bark extract used in European clinical trials & in Saligesic

Salicin

Salix purpurea

Sheep Sorrel Combination 90 Tablets Mode of Action Traditionally used to support the body’s own cleansing processes. The herbs in this product are the same as those in the herbal mixture popularised in the 1920s by Rene Caisse, a Canadian nurse, working to improve quality of life in her patients. The recipe for this mixture is said to have been originally formulated by an indigenous healer.

Each tablet contains: Arctium lappa (Burdock) extract equivalent to dry root

242 mg

Rumex acetosella (Sheep Sorrel) extract equivalent to dry herb

130 mg

Ulmus rubra (Slippery Elm) dry stem bark powder

32 mg

Rheum palmatum (Rhubarb) extract equivalent to dry root

8 mg

Indications Helps maintain general well-being.

Contraindications and Cautions No known contraindications. Prolonged use may cause serious bowel problems. Patients are advised to drink plenty of water. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3 times daily.

Additional Therapy Combines well with Astragalus Complex tablets, Echinacea Premium tablets, Activated Beet-Greens and Cat’s Claw Forte tablets for immune support. Vitanox® tablets for antioxidant activity. Consider Everyday B Multi tablets for optimal levels of vitamins and minerals during times of increased need. Methyl Factors tablets as a source of antioxidants that help maintain health and well-being. Poly-C Powder which may support healthy immune function and resistance to infection.

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Siberian Ginseng

Each tablet contains: Eleutherococcus senticosus (Siberian Ginseng) extract equivalent to dry root standardised to contain syringaresinol diglucosides (as eleutherosides) 950 mcg

1.25 g

60 Tablets Mode of Action Used in traditional Chinese medicine to reinforce qi and calm the nerves and later popularised by Russian scientists for its use as a tonic and adaptogen.

Indications May enhance the body’s resistance to stress, provide support when fatigued and improve general well-being. May provide support as capacity for work and concentration declines. To help relieve the stress of study or work. Supports immune function.

Contraindications and Cautions No known contraindications. Siberian Ginseng is best not used during the acute phase of infections. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-4 times daily. Children 6-12 years: 1 tablet 1-3 times daily.

Silymarin

Additional Therapy Consider Echinacea Premium tablets and Poly-C Powder if using for immune support. Withania Complex tablets for improvement of general well‑being and for nervine tonic activity. Curcuma Active tablets or Methyl Factors tablets as a source of antioxidants that help maintain health and well-being. Consider Everyday B Multi tablets or Vital Woman tablets to maintain optimum levels of vitamins and minerals during times of increased need. Consider Rhodiola & Ginseng tablets during times of stress when the capacity for work and concentration declines. Consider Adrenal Complex tablets for additional adrenal support. Consider Cat’s Claw Forte tablets, which have been used traditionally to support the body’s natural defence system. Consider Phellodendron Forte tablets to assist in the maintenance of cholesterol within the normal range in healthy individuals. Consider Activated Beet-Greens powder to provide nutrients for energy metabolism and reduction of fatigue.

Each tablet contains: Silybum marianum (St Mary’s Thistle) extract equivalent to dry seed standardised to contain flavanolignans calculated as silybin 168 mg

14.7 g

60 Tablets Mode of Action St Mary’s Thistle and its active constituents collectively known as silymarin, are the most studied natural medicines with a proven beneficial effect on the tone of the liver.

Indications Supportive tonic for the liver and liver function. Helps maintain normal/healthy liver function. As an antioxidant herb which scavenges free radicals. Traditionally used for symptomatic relief of non-specific dyspepsia. For the symptomatic relief of overindulgence.

Contraindications and Cautions In anaemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements. Not to be taken at the same time with immunosuppressive drugs, and caution is advised in those with elevated liver enzymes taking immunosuppressive drugs. Caution in patients taking metronidazole, ornidazole, insulin or oral hypoglycaemia drugs, talinolol and nifedipine. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-3 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Additional Therapy Combines well with Livton® Complex tablets, LivCo® tablets or P2‑Detox powder for further support. Combine with Everyday B Multi tablets or GlucoBalance tablets to provide nutrients important for carbohydrate, protein and fat metabolism. Garlic Forte tablets to support dietary measures to maintain healthy blood lipid levels in healthy individuals. Consider Curcuma Active tablets or Vitanox® tablets for antioxidant support. Consider Phellodendron Forte tablets to assist in the maintenance of cholesterol within the normal range in healthy individuals.

St Mary’s Thistle Quality Issues St Mary’s Thistle (Silybum marianum) contains a range of flavanolignans (silybin A and B, silychristin, silydianin, isosilybin and 2,3‑dehydro derivatives) collectively called silybin or silymarin, as well as simple flavonoids such as taxifolin. Flavanolignans are important indicators of quality and efficacy. The flavanolignans are often measured analytically by the non-specific and less accurate 2,4-dinitrophenylhydrazine colourimetric method, which also reacts with any ketonic compounds, which includes the flavonoid taxifolin. MediHerb has developed a High Performance Liquid Chromatographic method to allow the individual levels of the flavanolignans to be accurately measured, and determine a value for these which is not inflated by the presence of simple flavonoids.

Silybum marianum

Product Catalogue

Slippery Elm 400mg

Each vege capsule contains: Ulmus rubra (Slippery Elm) stem bark powder

Indications

120 Capsules Mode of Action Slippery Elm provides demulcent and nutritive actions. It is a source of both water-soluble and water-insoluble fibre which swells upon contact with water providing a protective effect.

400 mg

Additional Therapy

Relief of the symptoms, pain and discomfort of gastritis. For the symptomatic relief of heartburn. Assists in maintaining healthy gastrointestinal function.

Consider HiPep tablets for additional relief of the symptoms of heartburn. Combines well with Bacto-Cand GI capsules, Probiotica capsules and Golden Seal tablets to support lower gastrointestinal function or flora. Consider Garlic Forte tablets and/or Vitanox® tablets. Consider Cascara Complex tablets to assist in the relief of constipation. Consider DiGest tablets to assist digestion.

Contraindications and Cautions Contraindicated in intestinal obstruction. Take with plenty of water to reduce the risk of oesophageal obstruction. Consume at least 2 hours away from ingestion of medication. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration

St John’s Wort

Each tablet contains: Hypericum perforatum (St John’s Wort) extract equivalent to dry herb flowering top

60 Tablets Mode of Action High potency tablet containing standardised St John’s Wort extract. St John’s Wort is recognised worldwide as the most reliable herb to relieve nervous tension, stress, mild anxiety and sleeplessness.

1.8 g

standardised to contain hypericin derivatives calc. as hypericin 1.05 mg standardised to contain flavonoid glycosides 18 mg

Indications Helps relieve nervous tension and stress. May help manage mood swings and irritability. Relief of sleeplessness. Help relieve mild anxiety. May help relieve nerve pain, mild neuralgia and sciatica.

Contraindications and Cautions May cause hyperaesthesia in some sensitive individuals especially when combined with a high exposure to sunlight. St John’s Wort is not advisable in cases of known photosensitivity. Patients taking high doses should avoid excessive exposure to sunlight and UV radiation. St John’s Wort affects the way some prescription medicines work. Concurrent administration of high doses of St John’s Wort is contraindicated with the following drugs: warfarin, digoxin, immunosuppressive drugs such as cyclosporin, indinavir (HIV protease inhibitor), nevirapine (HIV non-nucleoside transcriptase inhibitor), phenprocoumon, nifedipine, methadone, finasteride, cancer chemotherapeutic drugs such as irinotecan and calcium channel antagonists such as verapamil. Caution is advised in patients taking other drug medications, including combined oral contraceptives. Consume at least 2 hours away from ingestion of mineral supplements. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration

Product Information

Adults: 2-3 vege capsules 2-3 times daily. Children 6-12 years: 1-2 vege capsules 1-2 times daily.

Adults: 1 tablet 2-3 times daily.

Additional Therapy Combine with Echinacea Premium tablets for immune support. Combine with Nevaton® tablets, Mega Mag powder or Active Mag-Cal tablets for additional help with relief of stress. Consider Nervagesic to relieve mild neuralgia and pain of sciatica. Valerian Complex tablets for relief of insomnia or nervous irritability. Consider Everyday B Multi tablets or Vital Woman tablets to maintain optimum levels of vitamins and minerals during times of increased need. Methyl Factors tablets as a source of antioxidants that help maintain health and well-being. Consider Rhodiola & Ginseng tablets which may improve stress adaptation. Combine with Kava tablets for additional support of mild anxiety and to promote restful sleep. Consider Adrenal Complex tablets for additional benefits during times of stress and adrenal support. See St John’s Wort Quality Issues on page 68

St John’s Wort

Helps relieve nervous tension and stress

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St John’s Wort Quality Issues St John’s Wort is comprised of a wide range of phytochemicals of which the naphthodiantrones (consisting mainly of hypericin and psuedohypericin) are characteristic, while several other constituents are found across a very wide variety of plant species: eg chlorogenic acid, flavonoids and biapigenins. Studies have shown that hypericin administered with flavonoid glycosides caused an increase in the bioavailability of hypericin. St John’s Wort extracts containing the flavonoid glycosides but devoid of hypericin and hyperforin have been shown to be pharmacologically active in model systems. Additionally extracts devoid of hyperforin have been proven effective in clinical trials as have extracts containing hyperforin. In the graph, all extracts contained the same level of napthodianthrones (hypericins), however a wide range of variation was shown for the other constituents when analysed by HPLC – Some extracts having very low levels of all the phytochemicals you would expect in a good quality extract of Hypericum perforatum. MediHerb recognises the importance of all the other constituents, particularly the OPCs and flavonoids and tests all of its products using the techniques which allow the identification of these components.

Hypericum perforatum

ThyAdren Support

60 Tablets Mode of Action L-tyrosine is a precursor for the synthesis of the catecholamines epinephrine, norepinephrine, dopamine and the thyroid hormone thyroxine. Contains nutrient antioxidants including vitamin C and E. Contains nutrient antioxidants including vitamin C and E. Contains the metabolically active forms of vitamin B2 (riboflavine sodium phosphate), vitamin B6 (pyridoxal 5-phosphate) and folic acid (calcium folinate). Calcium folinate (folinic acid) bypasses the biochemical steps normally required by folic acid. B vitamins support the body’s energy production.

Each tablet contains: Rehmannia glutinosa (Rehmannia) extract equivalent to dry root

400 mg

Tyrosine

500 mg

Ascorbic acid (Vitamin C)

50 mg

Thiamine hydrochloride (Vitamin B1)

50 mg

Nicotinamide

50 mg

Calcium pantothenate

75 mg

Pyridoxal 5-phosphate monohydrate (Activated Vitamin B6) (equiv. to pyridoxine 10 mg)

15.67 mg

Pyridoxine hydrochloride (equiv. to Vitamin B6 20.54 mg)

25 mg

d-alpha-Tocopheryl acid succinate (equiv. to Vitamin E 12.1 IU)

10 mg

Riboflavin sodium phosphate (Activated Vitamin B2) (equiv. to riboflavin 3 mg)

4.11 mg

Calcium folinate (equiv. to folinic acid 50 mcg)

69 mcg

Cyanocobalamin (Vitamin B12)

1 mg

Cholecalciferol (Vitamin D3 400 IU)

10 mcg

Zinc ascorbate monohydrate (equiv. to Zinc 15.1 mg)

100 mg

Potassium iodide (equiv. to Iodine 120 mcg)

157 mcg

Selenomethionine (equiv. to Selenium 50 mcg)

125 mcg

Indications

Dosage and Administration

Provides iodine and tyrosine - key components of the thyroid hormones thyroxine (T4) and tri-iodothyonine (T3), which regulate the body’s production of energy and stimulate basal metabolism. Beneficial during times of stress and may improve stress adaptation. Helps to support healthy adrenal function.

Adults: 1 tablet 2 times daily.

Contraindications and Cautions This product contains selenium which is toxic in high doses. A daily dose of 150 mcg for adults of selenium from dietary supplements should not be exceeded. Selenium containing products are not suitable for use by children under the age of 15 years. Vitamin supplements should not replace a balanced diet. If taking tetracycline or quinolone antibiotics, biphosphonates (osteoporosis drugs) or thyroid hormone, separate doses by at least two hours. Contains zinc which may be dangerous if taken in large amounts or for a long time. Discontinue at least 7 days prior to general anaesthesia.

Product Catalogue

Additional Therapy Everyday B Multi tablets may be beneficial at times of increased physical or mental demand. Vital Woman tablets may assist with relief from stress and tension and support the nutritional needs of women. Combine with Withania Complex tablets to enhance stamina, endurance and adaptation to stress. ThyroCo tablets for thyroid support where indicated. Consider Coleus Forte tablets and Everyday Balance Protein Powder to support a weight management plan. Vitanox® tablets for antioxidant activity. Consider Rhodiola & Ginseng tablets or Siberian Ginseng tablets to provide support during times of fatigue and stress when the capacity for work and concentration declines. Consider Astragalus Complex tablets to promote vitality. Consider Adrenal Complex tablets for additional adrenal support.

ThyroCo

Each tablet contains: Fucus vesiculosus (Bladderwrack) extract equivalent to whole plant

437.5 mg

containing iodine 250 mcg

Bacopa monnieri (Bacopa) extract equivalent to dry herb standardised to contain bacosides calculated as bacoside A 10 mg

1.0 g

Mode of Action Contains herbs used traditionally in Ayurvedic medicine to support the thyroid and as general and nervine tonics.

Withania somnifera (Withania) extract equivalent to dry root

250 mg

Indications Contains iodine which may assist the body in achieving normal basal metabolism and normal production of thyroid hormones. Withania has been used in Ayurvedic tradition to provide energy and vigour eg for those recovering from illness and loss of muscular energy. Bacopa has been used traditionally as a tonic that may help intellectual function. Helps the body adapt to physically and mentally challenging circumstances.

Contraindications and Cautions Contraindicated in hyperthyroidism and related cardiac problems. Contraindicated in patients taking thyroid replacement therapy (thyroxine). Contraindicated in pregnancy and lactation. Bladderwrack may interact with hyperthyroid medication. Discontinue 7 days prior to general anaesthesia.

Tissue Regenex

Dosage and Administration Adults: 1 tablet daily.

Additional Therapy Everyday B Multi tablets may be beneficial at times of increased physical or mental demand. Vital Woman tablets may support the nutritional needs of women. Combine with Siberian Ginseng tablets or Rhodiola & Ginseng tablets which may provide support during times of fatigue and to enhance adaptation to stress. Consider Rehmannia Complex tablets. Add Astragalus Complex tablets to promote vitality. Vitanox速 tablets or Methyl Factors tablets as a source of antioxidants. Consider Adrenal Complex tablets for adrenal support. See Withania Quality Issues on page 75

Each tablet contains: Vitis vinifera (Grape Seed) extract equivalent to dry seed

3.6 g

standardised to contain procyanidins 25.5 mg

60 Tablets

Product Information

120 Tablets

Centella asiatica (Gotu Kola) extract equivalent to dry leaf standardised to contain triterpene derivatives 50 mg

2.5 g

Mode of Action A combination of herbs and nutrients providing support for tissue healing and normal development of connective tissue (including collagen) and epithelial tissue by supporting blood flow particularly microcirculation. Tissue Regenex tablets may also provide support in reducing swelling, improving capillary filtration and providing antioxidant activity.

Ginkgo biloba (Ginkgo) extract equivalent to dry leaf

1.0 g

Ascorbic acid

105 mg

Zinc gluconate (equiv. to Zinc 12 mg)

86 mg

standardised to contain ginkgo flavonglycosides 4.9 mg standardised to contain ginkgolides & bilobalide 1.2 mg

Indications May assist in relieving symptoms of poor circulation such as swelling, heaviness and tingling Gotu Kola is used in traditional herbal medicine to aid wound healing Supports the formation of connective tissue such as collagen Helps to support a healthy immune system

Contraindications and Cautions Contraindicated in known allergy to Gotu Kola. Caution in patients taking aspirin, warfarin, cilostazol, antipsychotics such as haloperidol, HIV non-nucleoside transcriptase inhibitors or anticonvulsants. Reduce dose of haloperidol if necessary in conjunction with prescribing physician. Increasing the intake of vitamin B6 may be advisable for patients taking anticonvulsants. If taking tetracycline or quinolone antibiotics, biphosphonates (osteoporosis drugs) or thyroid hormone, separate doses by at least two hours. This formulation contains procyanidins and should be consumed at least 2 hours away from ingestion of other mineral supplements (including iron supplements). Contains zinc which may be dangerous if taken in large amounts or for a long period. Vitamin supplements should not replace a balanced diet. Discontinue at least 7 days prior to general anaesthesia.

Additional Therapy Consider Poly-C Powder, Zinc Protect tablets and Vitanox速 tablets for extra antioxidant activity. Horsechestnut Complex tablets for additional peripheral circulation support. Combine with Joint Defence tablets and/or Boswellia Complex tablets may help relieve joint inflammation. Together with Echinacea Premium tablets or Andrographis Complex tablets for immune system support. Consider Everyday Balance Protein Powder, which is fortified with l-glutamine and provides complete protein. Consider Adrenal Complex tablets for adrenal support. Consider LymphoLytix to relieve bruising and tissue swelling. Consider Calcium Bone Complex powder to help maintain bone health and bone mineralisation. See Ginkgo Quality Issues on page 47

Dosage and Administration Adults: 1 tablet 3-4 times daily. Children: 6-12 years: 1 tablet 1-2 times daily.

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Tribulus Forte

Each tablet contains: Tribulus terrestris (Tribulus) extract equivalent to dry herb (aerial parts) standardised to contain furostanol saponins as protodioscin 110 mg

13.5 g

60 Tablets Mode of Action The action of Tribulus Forte is to support the health and function of the reproductive system of men and women.

Indications

Additional Therapy

Balances and supports normal male physiology and function. Helps maintain general well-being in men and women.

Contraindications and Cautions Use with caution in pregnancy. Steroidal saponin-containing herbs such as Tribulus are best kept to a minimum in patients with pre-existing cholestasis. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 1-3 times daily.

Combine with Rhodiola & Ginseng tablets or Withania Complex tablets in times of stress. Combine with Wild Yam Complex tablets for menopausal symptoms. Chaste Tree tablets to help support female reproductive health. Consider Zinc Protect tablets to help replenish zinc status in men. Combines well with ProstaCo capsules for symptomatic relief of urinary problems associated with medically diagnosed benign prostatic hyperplasia in mature men. Combine with PhytoRegenex tablets to aid mental and physical performance.

Tribulus Quality Issues Tribulus terrestris is a herb which is endemic to many different geographical zones, from the Mediterranean regions, India, China, South Africa and Australia. Research undertaken by MediHerb has shown that the phytochemical profile of the herb varies depending upon the geographical origin and the plant part utilised. Only herb sourced from the Central European regions of Bulgaria and Slovakia have been found to contain protodioscin, which is an important indicator of quality and efficacy. Additionally only the leaves and stem of the plant contain protodioscin, the fruit does not contain this phytochemical. MediHerb has undertaken this research to ensure that our Tribulus product is of the correct phytochemical profile to ensure phytoequivalence with the Bulgarian clinical trials and therefore optimal therapeutic outcome.

Tribulus terrestris

Protodioscin Slovakian Tribulus Herb

Australian Tribulus Herb

Indian Tribulus Fruit

Ubiquinol Forte

Each capsule contains: Ubiquinol-10

30 Capsules Mode of Action Ubiquinol is an active form of Coenzyme Q10 in the body. Ubiquinol supports energy production in the cell, protects the cell membrane and may help reduce the oxidation of LDL-cholesterol. Ubiquinol is more bioavailable than standard CoQ10.

Indications Helps maintain cardiovascular health, in particular, supporting heart health. To help replenish reduced CoQ10 levels in those taking cholesterol-lowering medication (statins). May relieve the sensation of fatigue. Helps to recycle and regenerate Vitamin E and C Helps to protect the oxidation of LDL-cholesterol

Contraindications and Cautions Monitoring of patients taking warfarin is advised. Discontinue 7 days prior to general anaesthesia.

Product Catalogue

150 mg

Dosage and Administration Adults: 1 capsule daily.

Additional Therapy Combines well with Hawthorn tablets to support the cardiovascular system and circulatory functions. In addition to dietary measures, consider combining with Garlic Forte tablets to help maintain normal blood lipid levels in healthy individuals. Consider Ginkgo Forte to enhance the flow properties of blood. Consider Siberian Ginseng tablets to provide support when fatigued. Consider PhytoRegenex to support mental and physical performance, especially during times of tiredness or stress.

Each tablet contains: Valeriana officinalis (Valerian) extract equivalent to dry root & rhizome

700 mg

Ziziphus jujuba var. spinosa (Zizyphus) extract equivalent to dry seed

900 mg

Passiflora incarnata (Passionflower) extract equivalent to dry herb

500 mg

Standardised to contain Valerenic acids calculated as hydroxy/acetoxyvalerenic acid & valerenic acid 1.12 mg

60 Tablets Mode of Action Contains herbs traditionally used as mildly sedative, relaxant and anxiolytic.

Indications My assist in reducing time taken to fall asleep. Traditionally used to relieve nervous tension and irritability. Mild anxiety. May help relieve the stress of study or work.

Contraindications and Cautions Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 2-4 times daily. For sleeping difficulties take 1 hour before bedtime. Dose may be repeated during the night.

Additional Therapy Consider St John’s Wort tablets or Nevaton® tablets to help relieve sleeplessness and nervous unrest. Consider Nervagesic tablets to promote sleep. Consider Kava tablets which also provide relief from mild anxiety. Active Mag-Cal tablets for relief of magnesium-related stress and sleep disturbance. Consider Silymarin tablets to support healthy liver function. Consider Ginkgo Forte tablets or PhytoRegenex tablets which may assist cognitive function.

Valerian Quality Issues Valerian (Valeriana officinalis) contains Valerenic acids (predominantly acetoxyvalerenic and valerenic acids and low levels of hydroxyvalerenic acid) and valepotriates (valtrate and isovaltrate). While other common medicinal species of valeriana may contain the valepotriates they contain little valerenic acids. MediHerb has developed a High Performance Liquid Chromatography analytical method to determine the levels of valerenic acids and valepotriates in Valerian. This method can also determine the level of the baldrinals (valtrate degradation products) which are an indicator of poor quality herb. By using this analytical method on Valerian 1:2 liquid extract and Valerian Complex tablets, MediHerb assures that these products contain high levels of valerenic acids and valepotriates, with no baldrinals.

Product Information

Valerian Complex

Valeriana officinalis

Passionflower Quality Issues There are over 500 species of Passionflower, which includes the edible passionfruit and varieties grown for their characteristic flowers. The preferred medicinal species is Passiflora incarnata which is native to the Americas and has many common names, including ‘Maypop’ and ‘Purple Passionflower’. The original forms of this plant have flowers varying in colour from pale lavender through to dark violet. There is also a white-flowered form which appears in the wild, as well as in cultivation, and is sold as P. incarnata “Alba”. During routine analysis in the MediHerb Research Laboratory it became evident that there were two different phytochemical profiles of Passionflower being encountered. The samples varied in the flavonoid constituents which are among the proposed therapeutically active components. In conjunction with Southern Cross University it was determined that the different flavonoid profiles were related to the colour of the flowers (purple or white). The clinical evidence for Passionflower is derived from European clinical trials and the corresponding phytochemical profiles have been published. By using LC/MS it was determined that these profiles matched that of the purple-flowered form. Two of the peaks are consistent between the two different forms, however, the remaining 8 or more flavonoids are different. Without using at least HPLC, or ideally LC/MS, this differentiation is easily missed and the inappropriate form might be used.

Passiflora incarnata

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Vital Woman

Each tablet contains: Fallopia japonica (Polygonum cuspidatum, Giant Knotweed) extract equivalent to dry root

2.0 g

Asparagus racemosus (Shatavari) extract equivalent to dry root Vitex agnus-castus (Chaste Tree) extract equivalent to dry fruit Retinyl palmitate (Vitamin A 304 mcg retinol equivalents) Thiamine hydrochloride (Vitamin B1) Riboflavine (Vitamin B2) Nicotinamide Calcium pantothenate Pyridoxine hydrochloride (Vitamin B6) Cyanocobalamin (Vitamin B12) Folic acid Ascorbic acid (Vitamin C) Cholecalciferol (Vitamin D3 1000 IU) d-alpha-Tocopheryl acid succinate (natural Vitamin E 50 IU) Tocopherols concentrate â&#x20AC;&#x201C; mixed (low alpha type) Biotin (Vitamin H) Phytomenadione (Vitamin K1) Choline bitartrate Inositol Calcium hydrogen phosphate (equiv. to Calcium 60 mg) Magnesium amino acid chelate (equiv.to Magnesium 30 mg) Iron amino acid chelate (equiv. to Iron 5 mg) Borax (equiv. to Boron 3 mg) Zinc amino acid chelate (equiv. to Zinc 5 mg) Manganese amino acid chelate (equiv. to Manganese 2 mg) Chromic chloride (equiv. to Chromium 250 mcg) Potassium iodide (equiv. to Iodine 299 mcg) Molybdenum trioxide (equiv. to Molybdenum 100 mcg) Selenomethionine (equiv. to Selenium 50 mcg)

1.2 g 250 mg 556 mcg 50 mg 30 mg 50 mg 50 mg 50 mg 150 mcg 500 mcg 100 mg 25 mcg 41.3 mg 20 mg 150 mcg 30 mcg 25 mg 25 mg 258.2 mg 150 mg 50 mg 26.5 mg 25 mg 20 mg 1.3 mg 391 mcg 150 mcg 124.2 mcg

standardised to contain resveratrol 10 mg

60 Tablets Mode of Action The herbs and nutrients in Vital Woman support the normal physiology of women of all ages from adolescence to senior years. Contains Asparagus racemosus which is used in Ayurveda as a female tonic.

Indications Traditionally used as a tonic for women. For nutritional support during preconception or pregnancy. Relief of premenstrual syndrome, especially associated breast tenderness. Helps maintain optimum levels of vitamins and minerals during times of increased need.

Contraindications and Cautions A daily dose of 150 mcg for adults of selenium from dietary supplements should not be exceeded. Patients who have had a baby with a neural tube defect/spina bifida should seek specific medical advice. Contains vitamin K, which may affect some medications. This product contains a low dose of Chaste Tree and is not advised during late pregnancy on theoretical grounds. However the product is appropriate for women wishing to conceive and no problems in early pregnancy would be anticipated with its use. Chaste Tree may aggravate pure spasmodic dysmenorrhoea not associated with premenstrual syndrome. Due to the presence of vitamin A, do not exceed recommended dosage if pregnant, or considering becoming pregnant. When taken in excess of 3000 micrograms retinol equivalents, vitamin A can cause birth defects. The recommended daily amount of vitamin A from all sources is 700 micrograms retinol equivalents for women and 900 micrograms retinol equivalents

Vital Woman

Essential support for women of all ages

Product Catalogue

for men. Vitamin supplements should not replace a balanced diet. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults and children over 15 years: 1 tablet daily.

Additional Therapy Combine with Rhodiola & Ginseng tablets or Withania Complex tablets for stress. Consider PolyFem tablets for normal ovarian function, FibroFem tablets to support normal menstruation and EndoFem tablets to support normal healthy endometrial tissue. Combine with LivCoÂŽ tablets or P2-Detox powder to support liver function. Mega-Mag powder or Active Mag-Cal tablets for premenstrual tension caused by magnesium deficiency. Consider Wild Yam Complex tablets to support menopausal symptoms. Cramplex tablets for relief of menstrual pain, cramping and symptoms of dysmenorrhoea. Combine with additional Chaste Tree tablets if required for premenstrual syndrome.

Each tablet contains: Vitis vinifera (Grape Seed) extract equivalent to dry seed

6.0 g

Camellia sinensis (Green Tea) extract equivalent to dry leaf

4.17 g

Curcuma longa (Turmeric) extract equivalent to dry rhizome

2.0 g

Rosmarinus officinalis (Rosemary) extract equivalent to dry leaf

1.0 g

standardised to contain procyanidins 42.5 mg

60 Tablets Mode of Action A combination of extracts from herbs with high antioxidant activity.

standardised to contain catechins 83.35 mg

standardised to contain curcuminoids 76 mg

Indications Protects and maintains healthy capillaries. Potent antioxidant formulation. May assist in promoting general health.

Contraindications and Cautions Contains 12.5 mg of caffeine per tablet. For women wishing to conceive or pregnant women, green tea may reduce the bioavailability of folate. More information is needed as to the extent of this activity. Contraindicated in patients taking sunitinib, unless taken at least 4 hours apart. Exercise caution in patients with haemorrhagic disorders and in those taking warfarin or antiplatelet drugs. Caution also in patients taking statin drugs and sildenafil. This formulation should be consumed at least 2 hours away from ingestion of mineral supplements (including iron supplements). In anaemia and cases where iron supplementation is required, do not take simultaneously with meals. Caution in patients taking immunosuppressive drugs, and do not take at the same time. Until more information is available regarding the expression of Nrf2 in cancer, do not take at last 48 hours either side of each chemotherapy or radiotherapy treatment. Discontinue 7 days prior to general anaesthesia.

Wild Yam Complex 60 Tablets Mode of Action These herbs, including the Ayurvedic female tonic Shatavari, combine to provide a formulation which helps relieve the symptoms of menopause and provides nervine tonic activity.

Dosage and Administration Adults: 1 tablet 1-2 times daily.

Additional Therapy Ginkgo Forte tablets to enhance flow properties of blood and assist peripheral circulation. Combines well with Hawthorn tablets to assist circulation. Horsechestnut Complex tablets for supportive therapy for relief of pain, heaviness, cramps, itching and swelling in the legs. Consider Poly-C Powder or Methyl Factors tablets to assist general well-being. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Tissue Regenex tablets for additional tissue healing support. Consider Adrenal Complex tablets for adrenal support. For additional antioxidant support combine with PhytoRegenex tablets.

Product Information

Vitanox®

Each tablet contains: Dioscorea villosa (Wild Yam) extract equivalent to dry root & rhizome

400 mg

Asparagus racemosus (Shatavari) extract equivalent to dry root

400 mg

Actaea racemosa (Cimifuga racemosa, Black Cohosh) extract equivalent to dry root

100 mg

Hypericum perforatum (St John’s Wort) extract equivalent to dry herb flowering top

600 mg

Salvia fruticosa (Sage) extract equivalent to dry herb

290 mg

Panax ginseng (Korean Ginseng) extract equivalent to dry root

75 mg

standardised to contain hypericin derivatives calculated as hypericin 333 mcg

standardised to contain ginsenosides calculated as Rg1, Re, Rb1, Rc, Rb2 & Rd 1.3 mg

Indications Herbs traditionally used to relieve menopausal conditions, including excessive perspiration and dry vagina. Herbs traditionally used to balance and support normal female physiology and function. Assists in the maintenance of women’s general well‑being.

Contraindications and Cautions Contraindicated in pregnancy due to the presence of Sage. St John’s Wort affects the way some prescription medicines work. Concurrent administration of high doses of St John’s Wort is contraindicated with the following drugs: warfarin, digoxin, immunosuppressive drugs such as cyclosporin, indinavir (HIV protease inhibitor), nevirapine (HIV nonnucleoside transcriptase inhibitor), docetaxel by injection, phenprocoumon, nifedipine, methadone, finasteride, clozapine, cancer chemotherapeutic drugs such as irinotecan and calcium channel antagonists such as verapamil. Caution is advised in patients taking other drug medications, including combined oral contraceptives. Consume at least 2 hours away from ingestion of mineral supplements. May cause hyperaesthesia in some sensitive individuals especially when combined with a high exposure to sunlight. St John’s Wort is not advisable in cases of known photosensitivity. Patients taking high doses should avoid excessive exposure to sunlight and UV radiation. Best avoided in patients with oestrogen-dependent tumours such as breast cancer, until more information is available regarding possible oestrogenic activity of the product. Caution in patients with pre-existing cholestasis. In very rare cases black cohosh has been associated with liver failure. If you are experiencing yellowing of the skin or whites of the eyes, dark

urine, nausea, vomiting, unusual tiredness, weakness, stomach or abdominal pain, and/or loss of appetite, you should stop using this product and see your doctor. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily.

Additional Therapy Consider Tribulus Forte tablets to support the health and function of the reproductive system of women. Consider Valerian Complex tablets for relief of sleeplessness. Methyl Factors tablets as a source of antioxidants that help maintain health and well-being. For additional nutritional support consider Vital Woman tablets. Consider Adrenal Complex tablets for adrenal support. Consider ThyAdren Support tablets for thyroid and adrenal support. Combine with PhytoRegenex tablets for health and well-being. Consider Zizyphus 1:2 liquid extract. Consider Calcium Bone Complex powder to help meet the calcium needs of mature women. See Wild Yam Quality Issues on page 74 See St John’s Wort Quality Issues on page 68 See Korean Ginseng Quality Issues on page 76

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Wild Yam Quality Issues

Dioscorea villosa

There are some 600 species of Yam in the genus Dioscorea, many of them are wild species that flourish in damp woodlands and thickets. Dioscorea villosa, also known as Colic Root or Wild Yam, is a twining, tuberous vine native to eastern North America. The roots initially taste starchy, but soon after are bitter and acrid, nothing like the taste of Yam or Sweet Potato grown for the dinner table. Commercial Wild Yam extracts available for use as raw materials are often not Dioscorea villosa but instead Dioscorea opposita (Chinese Yam Root) which has a different phytochemical profile. It is widely misconstrued that Dioscorea villosa contains diosgenin and many products have this as a statement on their labels. However it does not contain diosgenin, but rather the diosgenin precursors. Traditionally Dioscorea villosa was believed to contain predominantly dioscin, however, the origin of this assignment is unclear (dioscin is a steroidal glycoside precursor of diosgenin). The phytochemical profile of Wild Yam is poorly-defined and based on scientific literature from the 1940s. MediHerb undertook a project in conjunction with Associate Professor James De Voss, Chemistry Department, University of Queensland to investigate the phytochemistry. Commercially available Dioscorea villosa is in the form of dried roots, usually harvested at the end of summer or autumn when the plant is dying back to its rootstock. It was found that these roots contained only very small amounts of dioscin, not the predominance as previously thought. The major saponin found in the autumn harvested roots were in fact the furostanol-based saponins, methylparvifloside and methylprotodeltonin, while the spirostanol-based saponins, Zingiberensis saponin I and deltonin were the major saponins for samples harvested in summer. The autumn storage saponins differ from the summer saponins by the presence of an extra glucose at the C-26 position of the diosgenin base structure. The two main compounds found in commercial material – harvested in autumn – are significantly different from dioscin by having an extra one or two glucose residues in methylprotodeltonin and methylparvifloside respectively. All of these compounds have been reported from other Disocorea species, however, the profile of saponins was different in the other species.

Major Saponins of Dioscorea villosa

Compounds 1-2

1 – Methylparvifloside 4 – Zingiberensis saponin I or glucosidodeltonin

Withania & Ginseng 60 Tablets

Compounds 4-6

2 – Methylprotodeltonin 5 – Deltonin

6 – Dioscin

Each tablet contains: Withania somnifera (Withania) extract equivalent to dry root

600 mg

Panax ginseng (Korean Ginseng) extract equivalent to dry root

125 mg

standardised to contain ginsenosides calculated as Rg1, Re, Rb1, Rc, Rb2 & Rd 2.10 mg

Mode of Action The combined action of these herbs is predominantly tonic and adaptogenic, making this an ideal formula for all forms of stress.

Indications Assists in the maintenance or improvement of general well-being. Promotes endurance and stamina. Beneficial during times of stress.

Contraindications and Cautions Korean Ginseng is best not used during acute infections. Contraindicated in patients taking phenelzine. Caution is advised in patients with high blood pressure and those taking central nervous system stimulants, insulin or oral hypoglycaemic drugs, nifedipine and warfarin. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-4 times daily. Children 6-12 years: 1 tablet 1-2 times daily.

Additional Therapy Combines well with Bacopa Complex tablets to help relieve the stress of study and work. Consider Ginkgo Forte tablets which may assist cognitive function. Consider Astragalus Complex tablets to promote vitality. Consider ThyroCo tablets to help maintain normal thyroid function. Consider Everyday B Multi tablets or Vital Woman tablets to maintain optimum levels of vitamins and minerals during times of increased need. Consider Active Mag-Cal tablets which may help relieve stress. ThyAdren Support tablets for additional thyroid and adrenal support. Consider Adrenal Complex tablets for adrenal support. Consider Cat’s Claw Forte tablets to support the body’s natural defence system. Consider Ubiquinol Forte tablets to help relieve the sensation of fatigue. See Withania Quality Issues on page 75 See Korean Ginseng Quality Issues on page 76

Product Catalogue

60 Tablets Mode of Action These herbs have been used traditionally for general tonic, nervine tonic and adaptogenic activity as well as supporting the adrenal cortex.

Each tablet contains: Withania somnifera (Withania) extract equivalent to dry root

950 mg

Glycyrrhiza glabra (Licorice) extract equivalent to dry root

750 mg

Scutellaria lateriflora (Skullcap) extract equivalent to dry herb

470 mg

Panax ginseng (Korean Ginseng) extract equivalent to dry root

100 mg

standardised to contain ginsenosides calculated as Rg1, Re, Rb1, Rc, Rb2 & Rd 1.68 mg

Indications

Additional Therapy

Assists in the maintenance or improvement of general well‑being. Skullcap, Korean Ginseng and Withania are used traditionally for general tonic, nervine tonic and adaptogenic activity. Korean Ginseng assists well-being whilst under stress. Licorice has been used traditionally used to support the adrenal cortex.

Siberian Ginseng tablets or Poly-C Powder which may also be beneficial during stressful periods. Valerian Complex tablets or Mexican Valerian tablets for relief of sleeplessness. St John’s Wort tablets to help relieve nervous tension and stress. Rhodiola & Ginseng tablets to provide support during times of fatigue. Ubiquinol Forte capsules to help relieve the sensation of fatigue. Activated Beet-Greens to provide nutrients for energy metabolism and reduction of fatigue. Consider Tribulus Forte tablets. Consider Everyday B Multi tablets to maintain optimum levels of vitamins and minerals during times of increased need. Consider Mega Mag powder or Active Mag-Cal tablets to help with stress. ThyAdren Support tablets for thyroid and adrenal support. Combine with Vital Woman tablets during times of stress to maintain well-being. Consider Adrenal Complex tablets for additional adrenal support. Consider Cat’s Claw Forte tablets to support the body’s natural defence system.

Contraindications and Cautions Due to Licorice: caution is advised in those with elevated liver enzymes taking immunosuppressives: contraindicated in hypertension (including women who are prone to hypertension in pregnancy), and oedema and in those taking thiazide or loop diuretics not recommended during pregnancy, except at the lowest dosage for short periods. Korean Ginseng is best not used during acute infections. Contraindicated in patients taking phenelzine. Caution is advised in patients taking central nervous system stimulants, insulin or oral hypoglycaemic drugs, nifedipine and warfarin. Discontinue 7 days prior to general anaesthesia.

Dosage and Administration Adults: 1 tablet 3-6 times daily. Children 6-12 years: 1 tablet 2-3 times daily.

Product Information

Withania Complex

Helps the body adapt to the changes of everyday life

Withania Quality Issues Withania (Withania somnifera) is an Indian (Ayurvedic) herb which contains a group of therapeutically important steroidal compounds referred to collectively as withanolides. Withania contains more than fifty withanolides which vary greatly depending upon the geographic location and plant part. The withanolide profile and content is a key determinant of Withania quality and efficacy. Liquid Chromatography/Mass Spectrometry (LC/MS) is the method of choice for characterising such a wide range of similar compounds and unequivocably identifying key major components such as withaferin A and withanolide A. This technique is used routinely in the MediHerb Quality Control Laboratories to identify and analyse Withania and other saponin-containing herbs.

Withaferin A

Withanolide A

Int. Int.

471

200e3

417

150e3

100e3

100e3 435

Withania somnifera

435 453

50e3

399

453

50e3

503

471

299

0e3

113

100

145

150

171 191

200

222

245

250

267

285

307

300

347 361

350

375

391

400

449

450

485

515 537 553 567 583 597 616

500

550

600

640

664 681

650

719

700

752 766

797

750

m/z

0e3 102 122 100

145

150

170

196

200

229

251

250

281

311

300

341

363

350

417 391 407

400

485

449 503

450

500

525

549

550

573

597

600

645

650

674

706

700

732 751 767 781

750

m/z

HPLC detection of Withanolides Withaferin A

Withanolide A

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Wormwood Complex 60 Tablets Mode of Action These herbs and essential oil complement each other in a formulation providing anthelmintic and carminative activity.

Each tablet contains: Artemisia absinthium (Wormwood) extract equivalent to dry herb

100 mg

Stemona sessilifolia (Stemona) extract equivalent to dry root

1.0 g

Juglans nigra (Hulls of Black Walnut) extract equivalent to dry fruit hull

100 mg

Clove Bud Oil (Syzygium aromaticum)

20 mg

Indications

Additional Therapy

Traditionally these herbs have therapeutic activity useful in the elimination of parasitic worms from the gut and to ease symptoms of flatulence and colic.

Contraindications and Cautions Contraindicated in pregnancy and lactation, not advisable for children under 2 years of age. Contraindicated in those with known sensitivity to Wormwood or other members of Compositae family. Discontinue 7 days prior to general anaesthesia.

Combine with Bacto-Cand GI capsules or Slippery Elm 400mg capsules to encourage a healthy intestinal environment. After completing the Wormwood Complex tablet treatment, consider Probiotica capsules to assist in maintaining healthy intestinal microflora. Echinacea Premium tablets or Andrographis Complex tablets for immune support. Consider DiGest tablets to help increase digestive secretions. Consider Garlic Forte tablets.

Dosage and Administration Adults: 4-6 tablets daily for 10 days. Cease treatment for 10 days, then repeat 4 tablets daily for 10 days. Not advisable for children under 2 years of age. Children 2-6 years: 1-2 tablets daily for 10 days. Cease treatment for 10 days, then repeat 1-2 tablets daily for 10 days. Children 6-12 years: 2-3 tablets daily for 10 days. Cease treatment for 10 days, then repeat 2-3 tablets daily for 10 days.

Korean Ginseng Quality Issues Panax ginseng is a widely used and misunderstood herb. Traditionally the main root of the plant has been preferred for therapeutic use. The other parts of the plant such as the root hairs, leaves, leafstalks, etc are considered inferior and are never used medicinally in the East. However, many herb traders will sell the other plant parts as they are substantially cheaper than the main root. The major marker compounds used to characterise Panax ginseng are the ginsenosides which occur in all parts of the plant and if you were to only consider total ginsenosides the main root is not the highest in content.The importance is in the ratio of specific ginsenosides. The European clinical studies were undertaken on extracts manufactured from the main root of Panax ginseng which have a particular ratio of ginsenosides. To achieve the clinical results obtained traditionally and supported by clinical trials it is important to use raw material from the correct plant part and the correct species. This is readily achievable using HPLC which easily distinguishes the different preparations.

% Content

Panax ginseng

Leaves Leafstalks Stem Main root Lateral roots Root hairs Main root dry extract

Rg1 1.078 0.327 0.292 0.379 0.406 0.376 1.4

Re 1.524 0.141 0.070 0.153 0.668 1.512 2.1

Rf — — — 0.092 0.203 0.150 0.6

Rg2 — — — 0.023 0.090 0.249 0.6

Rb1 0.184 — — 0.342 0.850 1.351 2.9

Rc 0.736 0.190 — 0.190 0.738 1.349 1.9

Rg1 Rd Rb2 Rg2

Korean Ginseng leaf dry extract Rc

Rb1

Korean Ginseng root dry extract KOREPE

Product Catalogue

Rb2 0.553 — 0.397 0.131 0.434 0.780 2.4

Rd 1.113 0.107 — 0.038 0.143 0.381 1.5

Total 5.188 0.765 0.759 1.348 3.532 6.148 13.4

60 Tablets Mode of Action Zinc is an essential mineral used throughout the body for many functions. Betacarotene (pro-vitamin A) and vitamins C and E work with zinc to support structural integrity of the skin and may be of assistance in the healing of minor wounds. The combination of nutrients in this formula supports the antioxidant defence mechanism of the body and helps maintain normal healthy immune function. This product also provides key nutrients such as zinc and vitamin B6 that are required as cofactors for the production of neurotransmitters in the body, which are essential to maintain a healthy nervous system.

Each tablet contains: Zinc amino acid chelate (equiv. to Zinc 18 mg)

90 mg

Zinc ascorbate (equiv. to Zinc 12 mg)

79.5 mg

(equiv. to Ascorbic acid 64.2 mg)

(Total elemental Zinc 30 mg) Ascorbic acid (Vitamin C)

50 mg

(Total Vitamin C 114.2 mg) d-alpha Tocopheryl acid succinate (equiv. to Vitamin E 50 IU)

41.3 mg

Pyridoxine hydrochloride (equiv. to Vitamin B6 32.9 mg)

40 mg

Betacarotene (natural source)

2 mg

Manganese amino acid chelate (equiv. to Manganese 2 mg)

20 mg

Selenomethionine (equiv. to Selenium 26 mcg)

65 mcg

Indications For zinc supplementation. To help replenish zinc status, especially for those with increased needs including adolescents, pregnant and lactating women, the elderly, athletes and vegetarians. Aids in the maintenance of healthy skin and other epithelial cells. Zinc, vitamin C and vitamin E may help to promote minor wound healing (cuts, scratches, abrasions).

Contraindications and Cautions This product contains selenium which is toxic in high doses. A daily dose of 150 mcg for adults of selenium from dietary supplements should not be exceeded. Selenium-containing products are not suitable for use by children under the age of 15 years. Vitamin supplements should not replace a balanced diet. If taking tetracycline or quinolone antibiotics, biphosphonates (osteoporosis drugs) or thyroid hormone, separate doses by at least 2 hours. Contains zinc which may be dangerous if taken in large amounts or for a long period. Discontinue 7 days prior to general anaesthesia.

Additional Therapy Combines well with Echinacea Premium tablets, Andrographis Complex tablets or Astragalus Complex tablets for additional immune system support. Consider Vitanox速 tablets to complement antioxidant support and protect and maintain capillary health. Combines well with Bilberry tablets for eye health support. For relief of symptoms associated with dry, sore throats consider Herbal Throat Spray. Add Astragalus Complex tablets to promote vitality. Consider Everyday B Multi tablets or Vital Woman tablets to help maintain optimum levels of vitamins and minerals during times of increased need. Tissue Regenex tablets for additional skin healing support.

Product Information

Zinc Protect

Dosage and Administration Adults: 1 tablet daily.

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Liquid Extracts Liquid Extracts

Taste

Liquid herbal preparations are widely used in herbal practice around the world because of their considerable advantages:

Extracts based on alcohol often have strong characteristic tastes, which can be reduced or in many cases overcome by use of flavouring agents, such as Licorice extract, in formulations. When taking a liquid extract we recommend that a 5 mL dose be diluted with at least 10 mL of water or fruit juice. This can easily be swallowed in one mouthful, minimising the contact time in the mouth. The aftertaste will be further reduced by rinsing the mouth immediately after with a glass of water or fruit juice. In addition, patients take their cues from the practitioner and we have observed better compliance when the practitioner has a positive attitude to the taste.

Ease of making a unique formulation for each patient Involve minimal pharmaceutical processing and therefore faithfully reflect the chemical characteristics of the original plant material Confer considerable dosage flexibility, eg lower dose for children, varied doses in acute situations Are easy to absorb and well suited to patients with immature or poor digestive processes For more information on the MediHerb extraction process, please see page 7

Product Catalogue

Quantified Activity = Quality Assured = QA Liquids can be either standardised, in which case they guarantee a certain and consistent level of specific key constituents or, as is the case for many of MediHerb’s extracts, each batch can be quantified for activity with the result stated on the label. One of the important points in delivering an effective product is consistency of quality from batch to batch. It is a common point of confusion, and therefore critical to note, that these MediHerb “Quantified Activity” extracts are not purified single constituents. They are extracts of the whole herb and still contain the broad range of active constituents of the raw herbal material. For more information on Quantified Activity please see page 9

QA = Quantified Activity S = Standardised See page 10 for further details.

Botanical Name

Extract Ratio

Plant Part

Weekly Dosage (mLs)

Adhatoda

Justicia adhatoda

1:2

Leaf

10 to 25

Agrimony

Agrimonia eupatoria

1:2

Herb

15 to 30

Albizia

Albizia lebbeck

1:2

Bark

25 to 60

Aloes Resin

Aloe spp.

1:10

Resin

10 to 30

Andrographis

Andrographis paniculata

1:2

Herb

20 to 40

Arnica

Arnica montana

1:5

Flower

Not for internal use

Astragalus

Astragalus membranaceus

1:2

Root

30 to 60

Bacopa

Bacopa monniera

1:2

Herb

35 to 90

Baical Skullcap

Scutellaria baicalensis

1:2

Root

30 to 60

Baptisia

Baptisia tinctoria

1:2

Root

8 to 20

Barberry

Berberis vulgaris

1:2

Bark

20 to 40

Bearberry

Arctostaphylos uva-ursi

1:2

Leaf

30 to 60

Beth Root

Trillium erectum

1:2

Root

10 to 30

Bilberry

Vaccinium myrtillus

1:1

Fruit

20 to 40

Black Cohosh QA

Actaea racemosa, Cimicifuga racemosa, contains a minimum of 15 mg/mL triterpene glycosides as 27-deoxyactein

1:2

Root

10 to 20

Black Walnut (Hulls)

Juglans nigra

1:10

Hulls

10 to 40

Bladderwrack

Fucus vesiculosus

1:1

Whole Plant

30 to 60

Blue Cohosh

Caulophyllum thalictroides

1:2

Root

10 to 20

Blue Flag

Iris versicolor

1:2

Root

20 to 40

Buchu

Agathosma betulina, Barosma betulina

1:2

Leaf

15 to 30

Bugleweed

Lycopus spp.

1:2

Herb

15 to 40

Bupleurum

Bupleurum falcatum

1:2

Root

25 to 60

Burdock

Arctium lappa

1:2

Root

10 to 25

Butcher’s Broom

Ruscus aculeatus

1:2

Root

25 to 50

Butternut

Juglans cinerea

1:2

Bark

25 to 50

Calendula

Calendula officinalis

1:2

Flower

10 to 30

Calendula (low alcohol 25%)

Calendula officinalis

1:2

Flower

10 to 30

Californian Poppy

Eschscholzia californica

1:2

Herb

20 to 40

Cascara

Frangula purshiana, Rhamnus purshianus

1:2

Bark

20 to 55

Cat’s Claw QA

Uncaria tomentosa, contains a minimum of 1.5 mg/mL pentacyclic oxindole alkaloids

1:2

Inner bark

30 to 75

Cayenne

Capsicum spp.

1:3

Fruit

0.5 to 3

Celery Seed QA

Apium graveolens, contains a minimum of 10 mg/mL phthalides as butylphthalide and sedanenolide

1:2

Fruit

30 to 60

Chamomile

Matricaria chamomilla

1:2

Flower

20 to 40

Chaste Tree

Vitex agnus-castus

1:2

Fruit

6 to 30

Chen Pi (Mandarin Peel)

Citrus reticulata

1:2

Fruit peel

25 to 50

Cinnamon Quills

Cinnamomum cassia

1:2

Bark

20 to 40

Clivers

Galium aparine

1:2

Herb

25 to 50

Codonopsis

Codonopsis pilosula

1:2

Root

30 to 60

Coleus QA

Coleus forskohlii, contains a minimum of 2.5 mg/mL forskolin

1:1

Root

40 to 90

Corn Silk

Zea mays

1:1

Style and stigma

15 to 40

Corydalis

Corydalis ambigua

1:2

Tuber

25 to 60

Couch Grass

Elymus repens

1:1

Rhizome

20 to 40

Cramp Bark

Viburnum opulus

1:2

Bark

5 to 30

Crataeva

Crataeva nurvala

1:2

Bark

40 to 100

Common Name A

Liquid Extracts

www.mediherb.com.au

Botanical Name

Extract Ratio

Plant Part

Weekly Dosage (mLs)

Damiana

Turnera diffusa

1:2

Leaf

20 to 40

Dan Shen

Salvia miltiorrhiza

1:2

Root

25 to 50

Dandelion Leaves

Taraxacum officinale

1:1

Leaf

40 to 80

Dandelion Root

Taraxacum officinale

1:2

Root

20 to 40

Devilâ&#x20AC;&#x2122;s Claw

Harpagophytum procumbens

1:2

Root

40 to 80

Dong Quai

Angelica sinensis

1:2

Root

30 to 60

Echinacea Angustifolia Root QA

Echinacea angustifolia, contains a minimum of 1.6 mg/mL alkylamides

1:2

Root

20 to 40

Echinacea Purpurea Root QA

Echinacea purpurea, contains a minimum of 1.0 mg/mL alkylamides

1:2

Root

20 to 40

Echinacea Purpurea Glycetract

Echinacea purpurea

1:3

Root

30 to 60

Echinacea Premium Blend QA

60% Echinacea purpurea root 1:2 and 40% Echinacea angustifolia root 1:2, contains a minimum of 1.5 mg/mL alkylamides

1:2

Root

20 to 40

Echinacea Regular Blend

40% Echinacea angustifolia root 1:2 and 60% Echinacea purpurea fresh plant

1:2 and F/P

Root and flowering top

15 to 40

Elder Flowers

Sambucus nigra

1:2

Flower

15 to 40

Elecampane

Inula helenium

1:2

Root

20 to 40

Euphorbia

Euphorbia hirta

1:2

Herb

5 to 12

Eyebright

Euphrasia officinalis

1:2

Herb

15 to 30

False Unicorn

Chamaelirium luteum

1:2

Root

15 to 40

Fennel

Foeniculum vulgare

1:2

Fruit

20 to 40

Fenugreek

Trigonella foenum-graecum

1:2

Seed

15 to 30

Feverfew QA

Tanacetum parthenium, contains a minimum of 0.3 mg/mL parthenolide

1:5

Leaf

7 to 14

Flavouring Mixture

Glycyrrhiza glabra 1:1, Foeniculum vulgare 1:2, Stevia rebaudiana 1:2 with essential oil of orange and lemon

N/A

5 to 20

Fringe Tree

Chionanthus virginica

1:2

Stem bark

20 to 40

Gentian

Gentiana lutea

1:2

Root

5 to 15

Ginger

Zingiber officinale

1:2

Rhizome

5 to 15

Ginkgo Biloba S

Ginkgo biloba, contains 9.6 mg/mL ginkgo flavone glycosides

2:1

Leaf

21 to 28

Globe Artichoke

Cynara scolymus

1:2

Leaf

20 to 55

Goatâ&#x20AC;&#x2122;s Rue

Galega officinalis

1:2

Herb

30 to 60

Golden Rod

Solidago virgaurea

1:2

Herb

20 to 40

Golden Seal (cultivated) QA

Hydrastis canadensis, contains a minimum of 8.0 mg/mL hydrastine and 8.0 mg/mL berberine

1:3

Root and rhizome

15 to 30

Golden Seal (cultivated)

Hydrastis canadensis

1:5

Root and rhizome

25 to 50

Gotu Kola S

Centella asiatica, contains 20 mg/mL triterpenes

1:1

Herb

15 to 40

Gravel Root

Eupatorium purpureum

1:2

Root

15 to 30

Greater Celandine

Chelidonium majus

1:2

Herb

7 to 15

Grindelia

Grindelia camporum

1:2

Herb

10 to 20

Gymnema

Gymnema sylvestre

1:1

Leaf

25 to 75

Hawthorn Berries QA

Crataegus monogyna

1:2

Fruit

10 to 50

Hawthorn Leaves QA

Crataegus monogyna

1:2

Leaf and flower

10 to 30

Hemidesmus

Hemidesmus indicus

1:2

Root

25 to 60

Hops

Humulus lupulus

1:2

Strobile

10 to 20

Common Name D

Product Catalogue

Botanical Name

Extract Ratio

Plant Part

Weekly Dosage (mLs)

Horsechestnut

Aesculus hippocastanum

1:2

Seed

15 to 35

Horseradish

Armoracia rusticana

1:2

Root

25 to 50

Horsetail

Equisetum arvense

1:2

Herb

15 to 40

Piscidia piscipula

1:2

Bark

20 to 40

Kava S

Piper methysticum, contains a minimum of 10 mg/mL of kavalactones

1:1

Root

42 to 84

Korean Ginseng S

Panax ginseng, contains 10.5 mg/mL ginsenosides with Rg1 & Rb1 greater than or equal to 0.4 by HPLC

1:2

Main root

7 to 40

Ladies Mantle

Alchemilla vulgaris

1:2

Herb

25 to 50

Lavender

Lavandula angustifolia

1:2

Flower

15 to 30

Lemon Balm

Melissa officinalis

1:2

Herb

20 to 40

Licorice

Glycyrrhiza glabra

1:1

Root

15 to 40

Licorice High Grade QA

Glycyrrhiza glabra, contains a minimum of 30 mg/mL glycyrrhizin

1:1

Root

10 to 30

Lime Flowers

Tilia cordata

1:2

Flower

15 to 30

Marshmallow Root

Althaea officinalis

1:5

Root

20 to 40

Marshmallow Root Glycetract

Althaea officinalis

1:5

Root

20 to 40

Meadowsweet

Filipendula ulmaria

1:2

Herb

20 to 40

Mexican Valerian

Valeriana edulis

1:2

Root and rhizome

10 to 30

Mistletoe

Viscum album

1:2

Herb

20 to 40

Motherwort

Leonurus cardiaca

1:2

Herb

15 to 25

Mullein

Verbascum thapsus

1:2

Leaf

30 to 60

Myrrh

Commiphora molmol, Commiphora myrrha

1:5

Resin

10 to 30

Nettle Leaf

Urtica dioica

1:2

Leaf

15 to 40

Nettle Root

Urtica dioica

1:2

Root

30 to 60

Nigella

Nigella sativa

1:2

Seed

28 to 84

Oats Green

Avena sativa

1:2

Herb

20 to 40

Oats Seed

Avena sativa

1:1

Seed

20 to 40

Olive Leaves

Olea europaea

1:2

Leaf

25 to 50

Oregon Grape

Berberis aquifolium

1:2

Root and rhizome

25 to 50

Paeonia

Paeonia lactiflora

1:2

Root

30 to 60

Pasque Flower

Anemone pulsatilla

1:2

Herb

3 to 10

Passionflower

Passiflora incarnata

1:2

Herb

15 to 40

Pelargonium

Pelargonium sidoides

1:5

Root

20 to 40

Peppermint QA

Mentha x piperita, contains a minimum of 1.2 mg/mL of menthol

1:2

Leaf

10 to 30

Pleurisy Root

Asclepias tuberosa

1:2

Root

10 to 20

Poke Root

Phytolacca americana, Phytolacca decandra

1:5

Root

1 to 5

Prickly Ash

Zanthoxylum clava-herculis

1:2

Bark

10 to 30

Propolis

not applicable

1:5

Resin

10 to 40

Artemisia annua

2:1

Herb

10 to 25

Common Name H

J Jamaica Dogwood

Liquid Extracts

Q Qing Hao

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Botanical Name

Extract Ratio

Plant Part

Weekly Dosage (mLs)

Raspberry Leaves

Rubus idaeus

1:2

Leaf

30 to 100

Red Clover Flowering Tops

Trifolium pratense

1:2

Flowering herb top

10 to 40

Red Clover Flowers

Trifolium pratense

1:2

Flower

10 to 40

Rehmannia

Rehmannia glutinosa

1:2

Root

30 to 60

Rhodiola S

Rhodiola rosea, contains 3.0 mg/mL rosavins and 1.0 mg/mL salidroside

2:1

Root

20 to 40

Ribwort

Plantago lanceolata

1:2

Leaf

20 to 40

Rosemary QA

Rosmarinus officinalis, contains a minimum of 1.2 mg/mL of essential oil

1:2

Leaf

15 to 30

Saffron

Crocus sativus

1:20

Stigma

10 to 25

Sage QA

Salvia fruticosa, contains a minimum of 0.64 mg/mL of essential oil

1:2

Herb

15 to 30

Sarsaparilla

Smilax ornata

1:2

Root and rhizome

20 to 40

Saw Palmetto

Serenoa repens

1:2

Fruit

15 to 30

Schisandra

Schisandra chinensis

1:2

Fruit

25 to 60

Senna Pods

Senna alexandrina

1:2

Fruit

10 to 40

Shatavari

Asparagus racemosus

1:2

Root

30 to 60

Shepherd’s Purse

Capsella bursa-pastoris

1:2

Herb

20 to 40

Siberian Ginseng S

Eleutherococcus senticosus, contains 0.5 mg/mL eleutheroside E

1:2

Root

15 to 55

Skullcap

Scutellaria lateriflora

1:2

Herb

15 to 30

Squaw Vine

Mitchella repens

1:2

Whole plant

20 to 40

St John’s Wort QA

Hypericum perforatum, contains a minimum of 0.2 mg/mL hypericin

1:2

Flowering herb top

15 to 40

St John’s Wort High Grade QA

Hypericum perforatum, contains a minimum of 0.4 mg/mL hypericin

1:2

Flowering herb top

15 to 40

St Mary’s Thistle QA

Silybum marianum, contains a minimum of 19 mg/mL silymarin

2:1

Fruit

30 to 60

St Mary’s Thistle Glycetract QA

Silybum marianum, contains a minimum of 25 mg/mL silymarin

1:1

Fruit

30 to 60

Sundew

Drosera longifolia

1:5

Herb

10 to 20

Thuja

Thuja occidentalis

1:5

Leaf

10 to 20

Thyme QA

Thymus vulgaris, contains a minimum of 2.4 mg/mL of thymol/carvacrol

1:2

Leaf

15 to 40

Tienchi Ginseng

Panax notoginseng

1:2

Root

25 to 60

Tribulus S

Tribulus terrestris, contains 30 mg/mL of furostanol saponins as protodioscin

2:1

Herb (Aerial Parts)

50 to 100

True Unicorn

Aletris farinosa

1:2

Root

12 to 40

Turmeric

Curcuma longa

1:1

Rhizome

35 to 100

Valerian

Valeriana officinalis

1:2

Root

15 to 40

Vervain

Verbena officinalis

1:2

Herb

20 to 40

Violet Leaves

Viola odorata

1:2

Leaf

12 to 25

White Horehound

Marrubium vulgare

1:2

Herb

15 to 40

Wild Cherry

Prunus serotina

1:2

Bark

15 to 30

Wild Yam QA

Dioscorea villosa, contains a minimum of 15 mg/mL steroidal saponins

1:2

Root and rhizome

20 to 40

Willow Bark

Salix spp.

1:2

Bark

25 to 50

Willow Herb

Epilobium parviflorum

1:2

Herb

20 to 40

Withania S

Withania somnifera, contains a minimum of 4.0 mg/mL of withanolides

2:1

Root

10 to 30

Common Name R

Product Catalogue

Botanical Name

Extract Ratio

Plant Part

Weekly Dosage (mLs)

Wood Betony

Stachys betonica, Stachys officinalis

1:2

Herb

15 to 30

Wormwood

Artemisia absinthium

1:5

Herb

5 to 20

Yarrow

Achillea millefolium

1:2

Herb

15 to 40

Yellow Dock

Rumex crispus

1:2

Root

15 to 30

Ziziphus jujuba var. spinosa

1:2

Seed

40 to 80

Common Name W

Z Zizyphus

QA = Quantified Activity S = Standardised See page 9 for further details.

For more information and detailed herbal monographs, please visit the MediHerb Professional Library at www.mediherb.com.au

Vitamin E Cream Base 500 g

Liquid Extracts

Topical Products

Contains: Contains 2% vitamin E. The base primarily consists of almond oil, copha, glycerol and various waxes (no petroleum, lanolin, beeswax or paraffin).

Indications Excellent emulsifying base with a high capacity to absorb liquid herbal extracts to make a variety of herbal creams.

How to Make Herbal Creams using MediHerb Vitamin E Cream Base The MediHerb Vitamin E Cream Base is a high quality, non-irritant, neutral cream base that is capable of incorporating herbal extracts, volatile and infused oils without losing its emulsion. It is important when using the cream to use aseptic techniques so we advise the following:

Wash hands with soap and water and dry thoroughly before using the cream. Use a sterile instrument to take the cream from the container and transfer to a sterile container. Store the cream below 30째C and away from direct sunlight.

Herbal Cream Recipes Calendula Plus Cream Propolis 1:10 Myrrh 1:5 Calendula 1:2 (low alcohol) Vitamin E Cream Base

Horsechestnut Cream 5 mL 5 mL 5 mL 100 g

Directions: Combine all ingredients and stir thoroughly until a smooth consistency is obtained. As the tinctures and extracts are incorporated without the removal of alcohol, the resultant cream will sting if applied to broken skin.

Horsechestnut 1:2 Yarrow 1:2 Vitamin E Cream Base

Lemon Balm Cream 7 mL 8 mL 100 g

Lemon Balm 1:2 Vitamin E Cream Base

100 mL 100 g

Directions: Take Lemon Balm 1:2 and reduce on a low heat (ideally over a water bath) to 15 to 20 mL, which can take up to 60 minutes. Pour this concentrate while hot onto Vitamin E Cream Base and mix thoroughly.

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Nutritional & Phytotherapist’s Perspectives These publications provide website users with more clinical and technical information in a concise format. Like the rest of our Professional Library, the Nutritional Perspective and the Phytotherapist’s Perspective can be searched by: H erb – common or botanical name (eg ‘green tea’ or ‘Camellia sinensis’) Phytochemical (eg ‘resveratrol’ or ‘flavonoids’) V itamin, mineral, trace element or nutritional supplement (eg ‘vitamin C’, ‘iron’, ‘chromium’ or ‘glucosamine’) Condition (eg ‘fatigue’) Topic (eg ‘quality issues’) Activity (eg ‘anti-inflammatory’ or ‘joint support’) The Nutritional Perspective features current scientific presentation of nutrition and nutritional supplements with application to specific conditions. It also includes important clinical information such as synergy (or antagonism) of nutrients, dietary considerations and relevant safety issues. References

Actions, Indications and Safety

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Mechanism of Action: Cardiac Function

Interactions

Treatment with CoQ10 has been found to: increase the CoQ10 level in heart tissues (atrial trabeculae and cardiac mitochondria); improve the efficiency of mitochondrial energy production (in atrial trabeculae); and improve posthypoxic myocardial contractile function. In this randomised trial, patients undergoing cardiac surgery received 300 mg/day of CoQ10 or placebo for about 14 days preoperatively. Trabeculae from right atrial appendages were excised and examined.31 Results from earlier, small studies confirm CoQ10 (100 mg/day) treatment improved the CoQ10 content of myocardial tissue30,125 and improved myocardial ATP in patients with cardiomyopathy.30

no change in INR (one patient);

In one small, randomised, double-blind, placebo-controlled trial involving patients undergoing coronary artery bypass graft surgery, CoQ10 levels in plasma and cardiac tissue increased after treatment with CoQ10 (150 mg/day), but there was no effect on skeletal muscle from the chest wall. There was no significant difference for the cardiac tissue CoQ10 level in patients on statins compared to those not taking statins. Participants received the CoQ10-containing product for 4 weeks.126

A small, placebo-controlled, crossover trial involving patients with chronic heart failure due to ischaemic heart disease, found that treatment with CoQ10 (300 mg/day) resulted in significant improvement in left ventricle contractility in dysfunctional segments located in noninfarcted areas served by stenotic arteries (where hibernation and/or chronic stunning is likely to occur). Dobutamine stress echocardiography was used to assess this. The improvement in contractive function suggests that chronic postischaemic stunned cells improve or normalise their metabolism and function. This may not be the only action involved, as CoQ10 also improved endothelial function.127

Extensive clinical experience suggests that the best response is achieved in congestive heart failure when CoQ10 is begun early in the course of the disease, while the myocytes are still viable (although weak), before there is permanent loss of myocytes and the development of an increasingly thin and fibrotic myocardium.2,128

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Structurally CoQ10 is similar to vitamin K,131 and hence has the potential to reduce the response to warfarin.

There are several case reports of a possible interaction between CoQ10 and warfarin. In 7 patients a range of responses occurred:132

transient increase in INR (one patient);

no change in INR (one patient), but decrease in INR in 2 patients (30 mg/day CoQ10); reduced response to warfarin (2 patients).

There is additional information from clinical studies, and although not conclusive, it suggests that monitoring of INR (international normalised ratio) is required for patients taking warfarin and CoQ10.132 In a randomised, crossover study in 21 patients stabilised on warfarin, CoQ10 (100 mg/day) for 4 weeks did not alter the INR or the required dose of warfarin. A longitudinal study found a significantly increased risk of selfreported bleeding in patients taking warfarin and CoQ10. No interaction between warfarin and the high plasma CoQ10 levels achieved from treatment with ubiquinol was observed in four patients with congestive heart failure (see Table 1 above),2 although if measured, INR values were not reported.

Serum CoQ10 levels increased substantially when high doses of anabolic steroids were taken by athletes.133 The potential clinical consequences of this are not known – for example, whether side effects would occur if high doses of CoQ10 were combined with high doses of these steroids.

High dose vitamin E ingested along with CoQ10 may interfere with CoQ10 absorption and thus result in lower plasma CoQ10 levels.134 In a group receiving CoQ10 (200 mg/day) and vitamin E (700 mg/day), the increase in plasma CoQ10 was only half of that observed in the CoQ10 group.135

Actions

Safety

General Safety

Studies have demonstrated that CoQ10 has low toxicity in animals and no genotoxic potential. Published clinical trials indicate that CoQ10 does not cause serious side effects. Dose-escalation trials have been conducted in 17 Parkinson’s disease patients for 2 weeks and 31 patients with amyotrophic lateral sclerosis for 8 months: CoQ10 was safe and well tolerated at doses up to 3000 mg/day. Plasma levels of CoQ10 plateaued at 2400 mg/day. Experimental and clinical data indicates that CoQ10 supplementation does not affect endogenous biosynthesis of CoQ10 or cause accumulation or rebound deficiency of CoQ10 in tissues after discontinuing intake.129 Reports of nausea and other adverse gastrointestinal effects from clinical trials have not been causally linked to CoQ10 because no dose-response relationship was found – the adverse effects are no more common at daily doses of 1200 mg than at 60 mg.130 The following gastrointestinal side effects were observed for a daily dose of 30 mg in 5143 patients: epigastral discomfort in 20 patients (0.39%), loss of appetite in 12 (0.23%), nausea in 8 (0.16%) and diarrhoea in 6 (0.12%).26

Involved in energy production in cells: cofactor in the mitochondrial electron transport chain and essential for production of ATP.

May help protect the cell membrane and prevent peroxidation of plasma lipids.

Indications Adjunctive treatment for cardiovascular disease, particularly where improved heart function is required.

Pravst I, Zmitek K, Zmitek J. Crit Rev Food Sci Nutr 2010; 50(4): 269-280 Langsjoen PH, Langsjoen AM. Biofactors 2008; 32(1-4): 119-128 Langsjoen H, Langsjoen P, Langsjoen P et al. Mol Aspects Med 1994; 15(Suppl): S165-S175 4 Hosoe K, Kitano M, Kishida H et al. Regul Toxicol Pharmacol 2007; 47(1): 19-28 5 Miles MV, Horn P, Miles L et al. Nutr Res 2002; 22: 919–929 6 Evans M, Baisley J, Barss S et al. J Funct Foods 2009: 1(1): 65-73 7 Anon. Br J Cardiol 2010; 17(6): 263 8 Miyamae T, Seki M, Naga T et al. Redox Rep 2013; 18(1): 12-19 9 Safarinejad MR, Safarinejad S, Shafiei N et al. J Urol 2012; 188(2): 526-531 10 Mezawa M, Takemoto M, Onishi S et al. Biofactors 2012; 38(6): 416-421 11 Zlatohlavek L, Vrablik M, Grauova B et al. Neuro Endocrinol Lett 2012; 33(Suppl 2): 98-101 12 Alf D, Broja J, Juesten N et al. Seventh Conference of the International Coenzyme Q10 Association, Seville, Spain, 2012, p 57. 13 Bloomer RJ, Canale RE, McCarthy CG et al. Oxid Med Cell Longev 2012; 2012: 465020 14 Ryo K, Ito A, Takatori R et al. Clin Biochem 2011; 44(8-9): 669-674 15 Shoko D, Fujii K, Kurihara T. Rinsyo Iyaku 2008; 24: 233-238 16 Schmelzer C, Niklowitz P, Okun JG et al. IUBMB Life 2011; 63(1): 42-48 17 Fotino AD, Thompson-Paul AM, Bazzano LA et al. Am J Clin Nutr 2013; 97(2): 268-275 18 Stocker R, Macdonald P. Am J Clin Nutr 2013; 97(2): 233-234 19 Kumar A, Kaur H, Devi P et al. Pharmacol Ther 2009; 124(3): 259-268 20 Kato T, Yoneda S, Kako T et al. Int J Clin Pharmacol Ther Toxicol 1990; 28(3): 123-126 21 Singh RB, Neki NS, Kartikey K et al. Mol Cell Biochem 2003; 246(1-2): 75-82 22 Kumar A Kaur H, Mohan V. Fourth Conference of the International Coenzyme Q10 Association, LA, USA, 2005, pp 69-70. 23 Gao L, Mao Q, Cao J et al. Atherosclerosis 2012; 221(2): 311-316 24 Playford DA, Watts GF, Croft KD et al. Atherosclerosis 2003; 168(1): 169-179 25 Fujioka T, Sakamoto Y, Mimura G. Tohoku J Exp Med 1983; 141(Suppl): 453-463 26 Tanaka J, Tominaga R, Yoshitoshi M et al. Ann Thorac Surg 1982; 33(2): 145-151 27 Chello M, Mastroroberto P, Romano R et al. Ann Thorac Surg 1994; 58(5): 1427-1432 28 Taggart DP, Jenkins M, Hooper J et al. Ann Thorac Surg 1996; 61(3): 829-833 29 Chen YF, Lin YT, Wu SC. J Thorac Cardiovasc Surg 1994; 107(1): 242-247 30 Judy WV, Stogsdill WW, Folkers K. Clin Investig 1993; 71(8, Suppl): S155-S161 31 Rosenfeldt F, Marasco S, Lyon W et al. J Thorac Cardiovasc Surg 2005; 129(1): 25-32 32 Makhija N, Sendasgupta C, Kiran U et al. J Cardiothorac Vasc Anesth 2008; 22(6): 832-839 33 Pepe S, Marasco SF, Haas SJ et al. Mitochondrion 2007; 7(Suppl): S154-S167 34 Ho MJ, Bellusci A, Wright JM. Cochrane Database Syst Rev 2009; (4): CD007435 35 Rosenfeldt FL, Haas SJ, Krum H et al. J Hum Hypertens 2007; 21(4): 297-306 36 Chapidze G, Kapanadze S, Dolidze N et al. Georgian Med News 2005; (118): 20-25 37 Singh RB, Niaz MA. Int J Cardiol 1999; 68(1): 23-29 38 Mabuchi H, Nohara A, Kobayashi J et al. Atherosclerosis 2007; 195(2): e182-e189 39 Bargossi AM, Grossi G, Fiorella PL et al. Mol Aspects Med 1994; 15(Suppl): s187-s193 40 Palomäki A, Malminiemi K, Solakivi T et al. J Lipid Res 1998; 39(7): 1430-1437 41 Cicero AF, Derosa G, Miconi A et al. Biomed Pharmacother 2005; 59(6): 312-317 42 Długosz A, Ku´zniar J, Sawicka E et al. Int Urol Nephrol 2004; 36(2): 253-258 43 Shojaei M, Djalali M, Khatami M et al. Iran J Kidney Dis 2011; 5(2): 114-118 44 Littarru GP, Tiano L. Mol Biotechnol 2007; 37(1): 31-37 45 Mohr D, Bowry VW, Stocker R. Biochim Biophys Acta 1992; 1126(3): 247-254 46 Folkers K, Brown R, Judy WV et al. Biochem Biophys Res Commun 1993; 192(1): 241-245 47 Lockwood K, Moesgaard S, Yamamoto T et al. Biochem Biophys Res Commun 1995; 212(1): 172-177 48 Lockwood K, Moesgaard S, Folkers K. Biochem Biophys Res Commun 1994; 199(3): 1504-1508 49 Rusciani L, Proietti I, Paradisi A et al. Melanoma Res 2007; 17(3): 177-183 50 Lesser GJ, Case D, Stark N et al. J Support Oncol 2013; 11(1): 31-42 51 Sachdanandam P. Biofactors 2008; 32(1-4): 151-159 52 Cordero MD, Santos-García R, Bermejo-Jover D et al. Clin Biochem 2012; 45(6): 509-511 53 Cordero MD, Cano-García FJ, Alcocer-Gómez E et al. PLoS One 2012; 7(4): e35677 54 Cordero MD, Alcocer-Gómez E, de Miguel M et al. Mitochondrion 2011; 11(4): 623-625 55 Cordero MD, Alcocer-Gómez E, de Miguel M et al. Antioxid Redox Signal In Press 56 Rozen TD, Oshinsky ML, Gebeline CA et al. Cephalalgia 2002; 22(2): 137-141 57 Sándor PS, Di Clemente L, Coppola G et al. Neurology 2005; 64(4): 713-715 58 Hershey AD, Powers SW, Vockell AL et al. Headache 2007; 47(1): 73-80 59 Slater SK, Nelson TD, Kabbouche MA et al. Cephalalgia 2011; 31(8): 897-905 60 Folkers K, Morita M, McRee J Jr. Biochem Biophys Res Commun 1993; 193(1): 88-92 61 Barbieri B, Lund B, Lundström B et al. Biofactors 1999; 9(2-4): 351-357 62 Hernández-Ojeda J, Cardona-Muñoz EG, Román-Pintos LM et al. J Diabetes Complications 2012; 26(4): 352-358 63 Dzugkoev SG, Kaloeva MB, Dzugkoeva FS. Bull Exp Biol Med 2012; 152(3): 364-366 64 Henriksen JE, Andersen CB, Hother-Nielsen O et al. Diabet Med 1999; 16(4): 312-318 65 Andersen CB, Henriksen JE, Hother-Nielsen O et al. Mol Aspects Med 1997; 18(Suppl): S307-S309 66 Eriksson JG, Forsén TJ, Mortensen SA et al. Biofactors 1999; 9(2-4): 315-318 1 2 3

67 Lim SC, Lekshminarayanan R, Goh SK et al. Atherosclerosis 2008; 196(2): 966-969 68 Hodgson JM, Watts GF, Playford DA et al. Eur J Clin Nutr 2002; 56(11): 1137-1142 69 Nadjarzadeh A, Sadeghi MR, Amirjannati N et al. J Endocrinol Invest 2011; 34(8): e224-e228 70 Nadjarzadeh A, Shidfar F, Amirjannati N et al. Andrologia In Press 71 Safarinejad MR. Int Urol Nephrol 2012; 44(3): 689-700 72 Safarinejad MR. J Urol 2009; 182(1): 237-248 73 Balercia G, Buldreghini E, Vignini A et al. Fertil Steril 2009; 91(5): 1785-1792 74 Balercia G, Mosca F, Mantero F et al. Fertil Steril 2004; 81(1): 93-98 75 Lewin A, Lavon H. Mol Aspects Med 1997; 18(Suppl): S213-S219 76 Safarinejad MR. Int J Impot Res 2010; 22(5): 298-309 77 Ostman B, Sjödin A, Michaëlsson K et al. Nutrition 2012; 28(4): 403-417 78 Rosenfeldt F, Hilton D, Pepe S et al. Biofactors 2003; 18(1-4): 91-100 79 Linnane AW, Zhang C, Yarovaya N et al. Ann N Y Acad Sci 2002; 959: 396-411 80 Bonetti A, Solito F, Carmosino G et al. J Sports Med Phys Fitness 2000; 40(1): 5157 81 Porter DA, Costill DL, Zachwieja JJ et al. Int J Sports Med 1995; 16(7): 421-427 82 Laaksonen R, Fogelholm M, Himberg JJ et al. Eur J Appl Physiol Occup Physiol 1995; 72(1-2): 95-100 83 Kalén A, Appelkvist EL, Dallner G. Lipids 1989; 24(7): 579-584 84 Wada H, Goto H, Hagiwara S et al. J Am Geriatr Soc 2007; 55(7): 1141-1142 85 Miles MV, Horn PS, Tang PH et al. Clin Chim Acta 2004; 347(1-2): 139-144 86 Liu J, Wang L, Zhan SY et al. Cochrane Database Syst Rev 2011; (12): CD008150 87 Storch A, Jost WH, Vieregge P et al. Arch Neurol 2007; 64(7): 938-944 88 Villalba JM, Parrado C, Santos-Gonzalez M et al. Expert Opin Investig Drugs 2010; 19(4): 535-554 89 Kaufmann P, Thompson JL, Levy G et al. Ann Neurol 2009; 66(2): 235-244 90 Spurney CF, Rocha CT, Henricson E et al. Muscle Nerve 2011; 44(2): 174-178 91 Folkers K, Simonsen R. Biochim Biophys Acta 1995; 1271(1): 281-286 92 Mizuno M, Quistorff B, Theorell H et al. Mol Aspects Med 1997; 18(Suppl): S291-S298 93 Skough K, Krossén C, Heiwe S et al. J Rehabil Med 2008; 40(9): 773-775 94 Quinzii CM, DiMauro S, Hirano M. Neurochem Res 2007; 32(4-5): 723-727 95 Montero R, Pineda M, Aracil A et al. Cerebellum 2007; 6(2): 118-122 96 Emmanuele V, López LC, Berardo A et al. Arch Neurol 2012; 69(8): 978-983 97 Haas RH. Mitochondrion 2007; 7(Suppl): S136-S145 98 Stacpoole PW. Mitochondrion 2011; 11(5): 679-685 99 Migliore L, Molinu S, Naccarati A et al. Mutagenesis 2004; 19(1): 43-49 100 Teran E, Hernandez I, Nieto B et al. Int J Gynaecol Obstet 2009; 105(1): 43-45 101 Ahn JH, Yoo MH, Lee HJ et al. Clin Otolaryngol 2010; 35(6): 486-489 102 Safarinejad MR, Shafiei N, Safarinejad S. Br J Nutr In Press 103 Fujimoto S, Kurihara N, Hirata K et al. Clin Investig 1993; 71(8 Suppl): S162-S166 104 Forester BP, Zuo CS, Ravichandran C et al. J Geriatr Psychiatry Neurol 2012; 25(1): 43-50 105 Folkers K. J Dent Health 1992; 42: 258-263 106 Watts TL. Br Dent J 1995; 178(6): 209-213 107 Littarru GP, Langsjoen P. Mitochondrion 2007; 7(Suppl): S168-S174 108 Hargreaves IP, Duncan AJ, Heales SJ et al. Drug Saf 2005; 28(8): 659-676 109 Deichmann R, Lavie C, Andrews S. Ochsner J 2010; 10(1): 16-21 110 Marcoff L, Thompson PD. J Am Coll Cardiol 2007; 49(23): 2231-2237 111 Bookstaver DA, Burkhalter NA, Hatzigeorgiou C. Am J Cardiol 2012; 110(4): 526-529 112 Mabuchi H, Nohara A, Kobayashi J et al. Curr Drug Ther 2007; 2(1): 39-51 113 Miyake Y, Shouzu A, Nishikawa M et al. Arzneimittelforschung 1999; 49(4): 324-329 114 Folkers K, Langsjoen P, Willis R et al. Proc Natl Acad Sci USA 1990; 87(22): 8931-8934 115 Silver MA, Langsjoen PH, Szabo S et al. Am J Cardiol 2004; 94(10): 1306-1310 116 Felker GM. J Am Coll Cardiol 2010; 56(15): 1205-1206 117 Mortensen SA. J Am Coll Cardiol 2011; 57(14): 1569 118 McMurray JJV. J Am Coll Cardiol 2011; 57(14): 1569 119 Deichmann RE, Lavie CJ, Dornelles AC. Phys Sportsmed 2012; 40(4): 88-95 120 Conklin KA. Integr Cancer Ther 2005; 4(2): 110-130 121 Roffe L, Schmidt K, Ernst E. J Clin Oncol 2004; 22(21): 4418-4424 122 Stargrove MB, Treasure J, McKee DL. Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies. Mosby Elsevier, St Louis, Missouri, 2008. 123 Takahashi N, Iwasaka T, Sugiura T et al. J Cardiovasc Pharmacol 1989; 14(3): 462-468 124 Rosenfeldt FL, Mijch A, McCrystal G et al. Int J STD AIDS 2005; 16(12): 827-829 125 Folkers K, Vadhanavikit S, Mortensen SA. Proc Natl Acad Sci USA 1985; 82(3): 901-904 126 Keith M, Mazer CD, Mikhail P et al. Nutr Metab Cardiovasc Dis 2008; 18(2): 105-111 127 Belardinelli R, Mucaj A, Lacalaprice F et al. Eur Heart J 2006; 27(22): 2675-2681 128 Langsjoen PH, Langsjoen AM. Biofactors 1999; 9(2-4): 273-284 129 Hidaka T, Fujii K, Funahashi I et al. Biofactors 2008; 32(1-4): 199-208 130 Hathcock JN, Shao A. Regul Toxicol Pharmacol 2006; 45(3): 282-288 131 Bhagavan HN, Chopra RK. Mitochondrion 2007; 7(Suppl): S78-S88 132 Williamson E, Driver S, Baxter K (eds). Stockley’s Herbal Medicines Interactions. Pharmaceutical Press, London, Chicago, 2009. 133 Karila T, Laaksonen R, Jokelainen K et al. Metabolism 1996; 45(7): 844-847 134 Kaikkonen J, Tuomainen TP, Nyyssonen K et al. Free Radic Res 2002; 36(4): 389-397 135 Kaikkonen J, Nyyssönen K, Tomasi A et al. Free Radic Res 2000; 33(3): 329-340

The Phytotherapist’s Perspective features phytotherapy articles written by Kerry Bone and Michelle Morgan, and includes: No significant clinical changes in vital signs, haematology, prothrombin time, activated partial thromboplastin, urinalysis or blood chemistry were observed in healthy volunteers prescribed ubiquinol (90–150 mg/day) for 4 weeks. There were no significant differences between placebo and ubiquinol treatment with regard to incidence of adverse events.4

To replenish plasma CoQ10 diminished by use of statin drugs. Prevention and treatment of atherosclerosis. To improve lipid profiles.

To support recovery and improve outcomes after heart surgery. Fibromyalgia, male infertility, migraine. Adjunctive treatment for cancer.

To support well-being and dry mouth in the healthy elderly. To reduce the risk of pre-eclampsia.

Cautions and Contraindications

Monitoring of patients taking warfarin is advised. High doses of vitamin E may reduce absorption of CoQ10.

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S elected articles written by Kerry Bone for the Townsend Letter for Doctors and Patients. M onographs detailing technical and clinical information on specific herbs written by Kerry Bone and Michelle Morgan.

a nutritional perspective Ubiquinol: Bioavailable Coenzyme Q10 By Michelle Morgan

Key Points at a Glance Coenzyme Q10

à improved muscle strength in muscular dystrophy (90–540 mg/day)

also known as ubiquinone

Ubiquinol: Bioavailable CoQ10

synthesised in the body; small amounts from diet exists in the body as oxidised form (ubiquinone) or reduced form (ubiquinol) and these substances interconvert à for example, when CoQ10 is ingested, it is to a large extent converted to ubiquinol cofactor in enzyme systems related to energy conversion in cells (mitochondrial oxidative phosphorylation, and is necessary for ATP production); also helps protect cell membranes known however to have low bioavailability à bioavailability depends on the formulation: solubilised forms better absorbed than standard, non-solubilised forms plus 2 electrons and 2H+

Ubiquinone (oxidised)

Ubiquinol (reduced)

Ubiquinol participates in the series of reactions resulting in phosphorylation of ADP

Energy from food plus phosphate

Energy for cells minus phosphate

ADP minus 2 electrons and 2H+

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Ubiquinol: Clinical Results improved heart function and outcomes in congestive heart failure (334–900 mg/day) à results superior to CoQ10, probably due to better absorption à best results probably achieved when treatment (CoQ10 or ubiquinol) begun early, while myocytes are still viable also clinically demonstrated to improve:

Potential Uses: CoQ10 Trials clinical trials using CoQ10 may provide applications for ubiquinol in addition to improving poor heart function, CoQ10 at doses of up to 200 mg/day had beneficial effects:

à fatigue and possibly cholesterol metabolism in fibromyalgia (100 mg/day) à semen parameters in male infertility (200 mg/day)

à in ischaemic heart disease and cardiac surgery

à plasma CoQ10 levels and reduce muscle pain in statin users (preliminary results; 60 mg/day)

à on lipid profile (results mixed in those also taking statin drugs) and additional effects in atherosclerosis (e.g. reduced plasma lipoperoxides)

à physical performance in elite athletes, mixed results in exercise-trained individuals (300 mg/day)

à by reducing risk of cardiovascular disease and pre-eclampsia à in patients taking statin drugs: replenished plasma CoQ10 levels

à glycosylated haemoglobin in type 2 diabetics (200 mg/day)

à symptoms of dry mouth, vitality and mood in the healthy elderly (100 mg/day) à LDL-cholesterol levels in healthy volunteers (150 mg/day)

à on immune function à by reducing chromosomal damage in mitochrondrial disease à on physical performance in muscular dystrophy and chronic lung disease à by reducing side effects of drugs, especially in cancer patients other notable effects: à inhibited peroxidation of lipids present in the circulation (300 mg/day) à prevented migraine (150–300 mg/day)

Safety CoQ10 has very low toxicity and is well tolerated at doses up to 3000 mg/day. Taking it as a supplement does not affect the body’s ability to synthesise CoQ10. CoQ10 does not accumulate in the body. It is not advisable to take high doses of vitamin E with CoQ10, and monitoring is advised for patients taking warfarin.

à improved symptoms of fibromyalgia (300 mg/day), diabetic neuropathy (400 mg/day) Not for Public Distribution. For Professional Use Only.

a phytotherapist’s perspective High-Dose Berberine: Focus on Dyslipidaemia & Diabetes By Michelle Morgan

Key Points at a Glance Berberine an alkaloid present in several herbs including the bark of Phellodendron amurense extensively studied, including clinical trials for doses of berberine greater than 500 mg/day à administered in tablet form, usually as berberine hydrochloride, after having been originally extracted from plant sources major actions: à hypoglycaemic and hypolipidaemic activity at daily doses of berberine of 500 mg or more (commonly 900 mg or more) à antiarrhythmic activity at daily doses of berberine of 1200 mg or more a detrimental effect on probiotic flora is not expected at these doses of berberine

Caution is warranted in beta-thalassaemia, unconjugated hyperbilirubinaemia and those with obstructed bile ducts. Not advisable in jaundiced neonates. Best to avoid combining concomitantly with tannins.

Clinical Studies various therapeutic effects for berberine at doses of up to 1000 mg/day in: à hypercholesterolaemia, metabolic syndrome, diabetes (including those with hyperlipidaemia), acute coronary syndrome, intestinal syndrome caused by radiotherapy hypoglycaemic and/or hypolipidaemic effects for berberine at doses of more than 1000 mg/day in: à liver disorders (and improved liver function), polycystic ovary syndrome (and improved body composition), diabetes, dyslipidaemias beneficial effects for berberine at doses of more than 1000 mg/day also in:

Diabetes, hyperlipidaemia, metabolic syndrome.

A n assortment of other articles outlining herbs suitable for use in specific conditions. Key constituents, quality issues, therapeutic activity and clinical studies are often a feature of these articles.

à in healthy volunteers: ranging from similar to 1.3 times greater than solubilised products; substantially greater than non-solubilised, e.g. 4.3 times greater, although coingredients may also play a part à confirmed in critically ill patients with heart failure, and the improved plasma levels correlated with clinical improvement

May be up to 4.3 times more bioavailable

ATP

Indications

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ubiquinol found to be more bioavailable than CoQ10, depending on the form

Adjunctive therapy in polycystic ovary syndrome and liver disorders.

Safety Extremely low oral toxicity. Some mild gastrointestinal discomfort observed, including at doses of 900–1000 mg/day, particularly constipation – sometimes required reducing the dose to 500–600 mg/day. Contraindicated in pregnancy and lactation. Interacts with immunosuppressive drugs such as cyclosporin and tacrolimus, although impact may be reduced if not taken simultaneously.

à congestive heart failure (symptom improvement and antiarrhythmic activity), healthy volunteers (vascular health), lung cancer patients receiving radiotherapy mechanism of action for hypoglycaemic and hypolipidaemic activity explored experimentally and not known conclusively, but the following was observed in diabetics treated with berberine (1000 mg/day): à increase in insulin receptor on lymphocytes à improved insulin sensitivity, possibly due to reduced inflammation à improved metabolism of free fatty acids

O O Berberine

N+ OCH3 OCH3

Phellodendron Amurense

Not for Public Distribution. For Professional Use Only.

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Liquid Prescriber’s Guide

MediHerb Dispensing Labels

Our Liquid Prescriber’s Guide is a detailed reference of all MediHerb liquid herbal extracts, indexed by herb (botanical and common names) and body system; set out in an easy to use format.

MediHerb has dispensing labels for your herbal medicines, which are inexpensive and give your herbal formulas a professional appearance. The labels cover all the essential information from expiry date, dosage required, additional instructions as well as space for you to personalise the label with your practice stamp.

Horseradish 1:2

Root

23%

Kava 1:1

Major Actions

Armoracia rusticana

Plant parts used: Ethanol content:

Standardised

Botanical Name:

Anticatarrhal, mucolytic, warming (circulatory stimulant), antimicrobial.

Piper methysticum

Plant parts used:

Major Indications

Upper respiratory catarrh, sinusitis.*

To aid digestion.*

To support a healthy urinary tract.*

Hoarseness (as a syrup – see note in Dosage and Administration).*

Major Actions Sedative (mild), antispasmodic, analgesic (mild), local anaesthetic.

Root

Ethanol content:

Major Indications

Actives:

10 mg/mL of kavalactones

Relief of nervous tension, sleeplessness.~ Relief of stress.‡

Contraindicated in pre-existing liver damage or liver diseases. Due to possible dopamine antagonism, kava should be used cautiously in elderly patients and in those with Parkinson’s disease. Not for prolonged use. Those who are pregnant or nursing are not recommended to use kava. In rare cases kava has been linked to liver damage. Discontinue 7 days prior to general anaesthesia. Refer to the MediHerb Herb-Drug Interaction chart for potential interactions.

High doses are best avoided in pregnancy, peptic ulcer and hypothyroidism. Not advised in children under 4 years, and in lactation. Should not be taken in doses exceeding the maximum therapeutic range in the long term (due to constituents). Discontinue 7 days prior to general anaesthesia. Refer to the MediHerb Herb-Drug Interaction chart for potential interactions.

Dosage and Administration

25–50 mL/week

42–84 mL/week

Note: Instead of a syrup, consider using the liquid extract with Flavouring Mixture, and if necessary, dilute with sterilised water.

Botanical Name:

Equisetum arvense

Major Actions

Herb

Diuretic, astringent.

Ethanol content:

23%

Major Indications

Traditionally Kava beverages are prepared by chewing or pounding the root to produce a cloudy, milky mash, which is then consumed orally. It is known that extraction with different solvents affects the phytochemical profile of the extract.

Support healthy elimination via the kidneys.*

Relief of the pain and burning sensation associated with cystitis.*

MediHerb investigated the difference in bioavailability of the water extract of Kava and the 96% ethanol extract using the Caco-2 monolayer model. The kavalactones (as kawain) were found to be potentially bioavailable as they all crossed the membrane quite readily with the exception of one kavalactone (yangonin). The water extract of Kava was only slightly less bioavailable than the ethanol extract. Therefore the clinical effect of the water extract of Kava would be similar to that of an ethanol extract, with fewer hepatotoxicity concerns.

Support for inflammations of the urinary tract; bedwetting.*

Contraindications and Cautions Advise patients: If pain or irritation associated with cystitis persists for more than 48 hours, consult your doctor. The presence of blood in the urine warrants immediate medical attention. Professional supervision is suggested for pregnancy and lactation. Discontinue 7 days prior to general anaesthesia. Refer to the MediHerb Herb-Drug Interaction chart for potential interactions.

The MediHerb Liquid Prescriber’s Guide is an essential resource for any health care professional seeking to make an informed choice. Botanical Name:

Piscidia piscipula Bark

Ethanol content:

60%

Kawain % apical average data

water

100

Dosage and Administration

ethanol

Time

standard

15–40 mL/week

% apical

0 0

120

160

Time (min)

Piper methysticum

ethanol standard

50 40 30 20 10

Major Actions

Analgesic, antispasmodic, sedative.

water

Jamaica Dogwood 1:2

Plant parts used:

Quick and easy to use Smart and professional Includes all essential information Fits bottle sizes from 100 mL to 500 mL

Kava Quality Issues

Horsetail 1:2

Plant parts used:

Relief of sore throat, headache, muscular tension.~

Contraindications and Cautions

Product Information

Botanical Name:

11 22 31 59 81

12 23 33 61 84

120

150

Major Indications

Relief of neuralgia, headache, sleeplessness.* Relief of nervous tension, anxiety.*

Kava

Contraindications and Cautions

STILL making your patients happy!

Contraindicated in pregnancy, lactation, bradycardia and cardiac insufficiency. Caution is advised for women wishing to conceive. Discontinue 7 days prior to general anaesthesia. Refer to the MediHerb Herb-Drug Interaction chart for potential interactions.

Dosage and Administration 20–40 mL/week

Liquid Prescriber’s Guide

~ traditional use (Pacific Islands) ‡ clinical study/trial (uncontrolled)

* traditional use (Western herbal medicine)

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Prescription Pads Improve your compliance with MediHerb’s Prescription Quick and easy to patients’ use

Wall Charts Wall Charts We have havethree threewall wallcharts charts available in your clinic. We available forfor useuse in your clinic. Top 40 Dispensary Essentials & Body Systems

Index

liquids for your dispensary. The remaining This index highlights the top 40 essential body system for your easy reference. liquid extracts are categorised by primary

Body Systems Legend

& Body Systems Index

Musculoskeletal of the approximate because values are only Salisbury’s can be used. These Kerry Bone recommend a number of methods MediHerb and 2 years. doses for children and maturation. for children under For calculating during growth and Fried’s Rule changes that occur rather than age complex metabolic it is based on weight over 2 years as Rule for children

Top 40 Dispensary Essentials

Children’s Dosage

Salisbury Rule

Adhatoda Agrimony Albizia

Justicia adhatoda

1:2

Agrimonia eupatoria

1:2

Albizia lebbeck

1:10

Aloe spp.

1:2

Andrographis paniculata

1:5 1:2

Aloes Resin Andrographis

B Bacopa Baical Skullcap

10 to 30

45%

20 to 40

Flower

45%

Root

23%

Devil’s Claw

8 to 20 20 to 40

1:2

45%

Berberis vulgaris uva-ursi Arctostaphylos

Barberry Bearberry

Black Cohosh QA

Buchu

Bupleurum Burdock Butcher’s Broom

1:2 1:2

Calendula officinalis

Calendula alcohol)

Californian Poppy Cat’s Claw QA

25 to 50

1:2 1:2

Ginger

1:2

Inner bark

30 to 75

Ginkgo Biloba S

Fruit

60%

0.5 to 3

1:3

Globe Artichoke

Fruit

60%

30 to 60

1:2

Goat’s Rue

Garlic

Golden Rod Golden Seal (cultivated) QA

Flower

60%

20 to 40

1:2 1:2

Flower

60%

20 to 40

Fruit

60%

6 to 30

1:2

Fruit peel

45%

25 to 50

1:2

Gotu Kola S

Bark

70%

20 to 40

1:2

Gravel Root

25 to 50

Greater Celandine

30 to 60

Grindelia

40 to 90

Gymnema

15 to 40

Golden Seal (cultivated)

Shepherd’s Purse Siberian Ginseng S Skullcap

1:2 1:2

Urtica dioica

1:2

Nigella sativa

Olea europaea

Olive Leaves

Berberis aquifolium

Oregon Grape

1:2

Herb

23%

30 to 60

1:2

Herb

45%

20 to 40

1:2

Solidago virgaurea

Root and rhizome

45%

15 to 30

1:3

Root and rhizome

45%

25 to 50

1:5

Herb

45%

15 to 40

1:1 1:2

Root

1:2

20 to 40

23%

20 to 40

45%

10 to 30

Herb

45%

20 to 40

Herb

23%

15 to 25

23%

30 to 60

Sundew

Leaf

90%

10 to 30

Resin

Paeonia lactiflora

Paeonia

Anemone pulsatilla

Pasque Flower

Passiflora incarnata Pelargonium sidoides

Passionflower

contains a minimum Mentha x piperita, of menthol of 1.2 mg/mL

Pelargonium Peppermint QA

Asclepias tuberosa Phytolacca americana

Pleurisy Root

45%

15 to 30

Poke Root

45%

7 to 15

Prickly Ash

Herb

60%

Propolis

Herb

10 to 20

1:2

Leaf

25 to 75

1:1

23%

Zanthoxylum clava-herculis

Herb

1:2

45%

1:2 1:2 1:2 1:2 1:2

Digestive System

Tienchi Ginseng

28 to 84

N/A

1:2

contains a minimum Thymus vulgaris, of thymol/carvacrol of 2.4 mg/mL

Thyme QA

30 to 60

60%

Tribulus S

1:1 QA10 to 20 St Mary's Thistle Glycetract 45% Root 1:2 1 to 5 Mixture 45% Flavouring Root 1:5 10 to 30 45% Bark 1:2 10 to 40 90% Resin 1:5

1:2

Thuja occidentalis

15 to 40

23%

Seed

Turmeric

V Valerian Vervain Violet Leaves

W White Horehound Wild Cherry Wild Yam QA Willow Bark Willow Herb Withania S Wood Betony Wormwood

20 to 50

Nervous System

St Mary's Thistle 1:1 QA

Respiratory

Tribulus 2:1 S

Cardiovascular & Circulation

Turmeric 1:1

Digestive System

Wild Yam 1:2 QA

Female Endocrine

Bacto-Cand GI

Withania 2:1 S

Immune

Boswellia Complex

1:2 Bupleurum officinalis Valeriana officinalis Verbena Butternut 1:2 Viola odorata Cascara 1:2

Chen Pi vulgare Peel) 1:2 Marrubium (Mandarin

45%

20 to 40

Fruit

45%

15 to 30

Fruit

45%

25 to 60

Fruit

45%

10 to 40

Root

45%

30 to 60

Herb

23%

20 to 40

Root

45%

15 to 55

Herb

45%

15 to 30

23%

20 to 40

45%

15 to 40

S = Standardised

Cat's Claw 1:2 QA Echinacea Angustifolia Root 1:2 QA

Bacopa 1:2 Californian Poppy 1:2

Feverfew 1:5 QA

Corydalis 1:2

Hemidesmus 1:2

Damiana 1:2

Lime Flowers 1:2

60% 45%

Endocrine General

15 to 40

Bladderwrack 1:1 50 to 100

Coleus 1:1 QA

Bugleweed 1:2

Fenugreek 1:2

45%

12 to 40 Cinnamon Quills 1:2

Goat's Rue 1:2

60%

35 to 100 Codonopsis 1:2

Nigella 1:2

45%

15 to 40

23%

20 to 40

60%

12 to 25

1:2 QA Root and Rosemary1:2 serotinaLeaves 1:1 Prunus Dandelion rhizome contains a minimum Dioscorea villosa, Senna Pods 1:2 1:2 steroidal saponins Bark 15 mg/mL of Fennel 1:2 Wormwood 1:5 spp. Tree 1:2 Herb Fringe Salix 1:2 parviflorum Root Epilobium 2:1 Garlic 1:1 F/P contains a minimum Withania somnifera, of withanolides Herb of 4.0 mg/mL 1:2 Herb Stachys officinalis 1:5 Artemisia absinthium

Lavender 1:2

Immune

23%

30 Root 1:2 15 toBeth

60%

40 Cohosh 1:2 20 to Blue

45%

False 50 25 to

Unicorn 1:2

23%

to 40 Mantle 1:2 20 Ladies

45%

to 30 Flower 1:2 10 Pasque

45%

15 to 30

45%

5 to 20

Herb

45%

15 to 40

Root

23%

15 to 30

Mexican Valerian 1:2 Oats Green 1:2 Oats Seed 1:1 Saffron 1:20

Vervain 1:2 Wood Betony 1:2

Respiratory

Willow Herb 1:2

Nettle Root 1:2

Raspberry Leaves 1:2

Blue Flag 1:2

Red Clover Flowering Tops 1:2

Burdock 1:2

Red Clover Flowers 1:2

Clivers 1:2

Sarsaparilla 1:2

Nettle Leaf 1:2

Yellow Dock 1:2

Musculoskeletal

Sage 1:2 QA Squaw Vine 1:2

Arnica 1:5

True Unicorn 1:2

Willow Bark 1:2

Poke Root 1:5

Elecampane 1:2

Ribwort 1:2

Euphorbia 1:2

Sundew 1:5

Golden Rod 1:2

Thyme 1:2 QA

Grindelia 1:2

Violet Leaves 1:2

Horseradish 1:2

White Horehound 1:2

Mullein 1:2

Wild Cherry 1:2

Urinary System Crataeva 1:2

Buchu 1:2

Gravel Root 1:2

Fe-Max Iron Tonic

Golden Seal

Horsechestnut Complex

Albizia Complex Broncafect® Eyebright Complex

Active Mag-Cal Bacopa Complex

Personalises Prescription Padsyour patients’ consultation and encourages their

Golden Seal

return

Herbal Throat Spray PulmaCo ResCo®

Everyday B Multi

PhytoRegenex

Ginkgo Forte

Saligesic

Cat’s Claw Forte

Kava

Tissue Regenex

Echinacea Premium

Evening Primrose Oil

Skin

Mexican Valerian

Garlic Forte

FibroFem

Nervous System

Joint Defence

Omega-3 Forte

Astragalus Complex Bacto-Cand GI

EFA Essentials EndoFem

PhytoRegenex Probiotica

Mega Mag

Andrographis Complex

Chaste Tree Cramplex

Phellodendron Forte

Methyl Factors Omega-3 Forte Phellodendron Forte

Respiratory

Active Mag-Cal Boswellia Complex Cramplex Curcuma Active

LivCo® Livton® Complex P2-Detox

Everyday Balance Protein Powder Rich Chocolate Everyday Balance Protein Powder Smooth Vanilla

Immune

Female Endocrine

HiPep

Couch Grass 1:1

Garlic Forte

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Withania Complex

Everyday Balance Protein Powder Rich Chocolate Everyday Balance Protein Powder Smooth Vanilla

Horsetail 1:2

Corn Silk 1:1

Fe-Plex

Musculoskeletal

ThyroCo Withania & Ginseng

DiGest

Bearberry 1:2

Hawthorn

Clinical Support: 1300 211 171

Adrenal Complex Coleus Forte

Siberian Ginseng ThyAdren Support

Bacto-Cand GI Cascara Complex

Activated Beet-Greens Bilberry

CholestaHealth Curcuma Active

Pleurisy Root 1:2

Devil's Claw 1:2

Endocrine General

GlucoBalance Gymnema Rhodiola & Ginseng

Digestive System

Cardiovascular Grape 1:2 Oregon & Circulation

Adhatoda 1:2

Cardiovascular System Digestive Lungs Urinary System

Skin

Valerian 1:2

Yarrow 1:2

Male Endocrine

Female Endocrine

15 to 40

23%

Jamaica Dogwood 1:2

Propolis 1:5 Thuja 1:5

25 to 60

60%

Hops 1:2

Myrrh 1:5

10 to 20

60%

Digestive System Female Endocrine

patient compliance with your prescribed medicine, dietary and lifestyle advice. That’s why MediHerb’s Prescription Pads have Fitsbeen bottledesigned sizes fromfor 100 mL to 500 mL practitioners to record their prescriptions and advice for their patient, and the next appointment. Includes all essential information

Nervous System

Elder Flowers 1:2

10 to 20

60%

Root

Skin Nervous System Respiratory Cardiovascular & Circulation

Vitanox® Wild Yam Complex Withania Complex

Echinacea Purpurea Root 1:2 QA

30 to 60

<5%

Leaf

1:2

Endocrine General

Urinary System

ThyAdren Support ThyroCo Tissue Regenex Tribulus Forte

System

Digestive Lungs Urinary System

Baptisia 1:2

Male Endocrine

St John’s Wort

Livton® Complex Mega Mag NeuroSom Omega-3 Forte P2-Detox

Cardiovascular Poly-C Powder Rehmannia Complex

Baical Skullcap 1:2

Musculoskeletal

Rhodiola & Ginseng Silymarin

Kava

Chaste Tree

Echinacea Premium Everyday B Multi

Ginkgo Forte GlucoBalance

Albizia 1:2

30 to 60

70%

Leaf

1:2

Peppermint 1:2 QA Herb 1:2 Qing Hao 1:2 Bark 1:2

Horsechestnut Complex Joint Defence

Garlic Forte

Immune

15 to 40

60%

1:5

Root 1:2 Marshmallow Root Glycetract 1:5Herb 1:2 1:2Leaf Meadowsweet 1:2

Body Systems Legend

Andrographis Complex

15 to 30

Marshmallow Root 1:5

Achillea millefolium

Kerry Bone’s Essentials

Curcuma Active

60%

Root and rhizome

Herb Panax notoginseng 2:1 of (Aerial contains 30 mg/mL Tribulus terrestris, as protodioscin parts) furostanol saponins Gentian 1:2 Aloes Resin 1:10 Root 1:2 1:2 Greater Celandine farinosa1:2 Rhizome AletrisBarberry 1:1

Walnut Curcuma Blacklonga (Green Hulls) 1:10

QA = Quantifed Activity

Zizyphus 1:2

This index highlights Kerry Bone’s 30 essential formulated products for your dispensary. The remaining products are categorised by body system for your easy reference.

10 to 25

60%

Herb

1:2

Skin

St John's Wort High Grade 1:2 QA

1:2 Saw15Palmetto to 30

Stigma

1:2

Flowering 1:2 contains a minimumMistletoe 1:2 herb top perforatum, 1:2 Hypericum Agrimony hypericin Flowering of 0.2 mg/mL 1:2 a minimumMotherwort 1:2herb top Bilberry 1:1 contains Hypericum perforatum, hypericin 1:2Fruit of 0.4 mg/mL 1:1 Olive Leaves 1:2 Butcher's Broom contains a minimum Silybum marianum, silymarin Prickly Ash 1:2 Fruit 1:3 of 19 mg/mL Cayenne 1:1 a minimum marianum, contains SilybumDan Shepherd's Purse 1:2 Shen 1:2 Herb of 25 mg/mL silymarin 1:5 Tienchi Ginseng 1:2 1:2 longifolia DroseraHorsechestnut

Thuja

23%

Root

Urinary System

Skullcap 1:2

Schisandra 1:2

1:2

Whole 1:2 Cardiovascular & Circulation plant

Mitchella repens

Leaf

Male Endocrine

Siberian Ginseng 1:2 S

20 to 40

Scutellaria lateriflora

St John’s Wort High Grade QA St Mary’s Thistle QA St Mary’s Thistle Glycetract QA

60%

Root and rhizome

Shatavari 1:2

20 to 40

Rhodiola 2:1 S

60%

Leaf

1:2

Capsella bursa-pastoris senticosus, contains Eleutherococcus E 0.5 mg/mL eleutheroside

St John’s Wort QA

20 to 40

Herb

1:1

Avena sativa

Oats Seed

Asparagus racemosus

Dispensary Essentials Alternatives True Unicorn

20 to 40 23% Herb 20 to 40 23% Seed 25 to 50 45%1:2 Leaf Low Alcohol 1:2 Calendula 25 to 50 23% Root and 1:2 Echinacea Regular Blend 1:2 & F/P rhizome Echinacea Purpurea Glycetract 1:3 30 to 60 45% Seal 1:5 1:2 GoldenRoot 3 to 10 23% Herb 1:2 Hawthorn Berries 1:2 QA 15 to 40 45% Herb 1:2 20 to 40 Licorice 1:1 20% Root 1:5 10 to 30 Wort 1:2 QA45% St John'sLeaf 1:2

1:2 Avena sativa

Oats Green

Galega officinalis

1:5

Urtica dioica

Cynara scolymus

1:2

Commiphora myrrha

Nigella

20 to 55

1:2

Leonurus cardiaca Verbascum thapsus

Nettle Root

21 to 28

60%

Hydrastis canadensis

1:2 Viscum album

Nettle Leaf

5 to 15

50%

1:2

Valeriana edulis

5 to 15

90%

Leaf

Root

1:2 Filipendula ulmaria

Myrrh

45%

Leaf

1:5

Althaea officinalis

Mullein

40 to 80

45%

Rhizome

Root

1:5 Althaea officinalis

Motherwort

20 to 40

45%

Root

2:1

Senna spp.

Squaw Vine

Tilia cordata

Mistletoe

5 to 20

27%

Stem bark

1:2

Chelidonium majus

Shatavari

15 to 30

Mexican Valerian

7 to 14

60%

Leaf

1:2

contains 20 mg/mL Centella asiatica, triterpenes Eupatorium purpureum

Senna Pods

10 to 30

45%

Meadowsweet

15 to 30

45%

Seed

N/A

of contains a minimum Hydrastis canadensis, and 8.0 mg/mL 8.0 mg/mL hydrastine berberine

Schisandra

15 to 40

20%

Glycetract

20 to 40

60%

Fruit

Bulb 1:1 (fresh weight)

1:2

23%

Serenoa repens Schisandra chinensis

Saw Palmetto

20 to 40

20%

Flower

Marshmallow Root Marshmallow Root

15 to 40

45%

Root

1:2

Zingiber officinale ginkgo contains 9.6 mg/mL Ginkgo biloba, flavone glycosides

45%

Leaf

Smilax ornata

Sarsaparilla

15 to 30

45%

Root

1:2

to 60

30 1:2 Rehmannia

23%

Root

of contains a minimum Salvia fruticosa, essential oil 0.64 mg/mL of

Sage QA

25 to 50

60%

Root

1:1

Dosage (mLs)

Pelargonium 1:5

Root

2:1

Crocus sativus

Saffron

7 to 40

23%

Herb

1:1

15 to 30

45%

Herb

1:5

Gentiana lutea

60%

Flower

1:2

1:2 Passionflower Weekly

Ethanol %

1:2

1:20

S 42 to 84

Herb

1:2

contains a minimum Glycyrrhiza glabra, of 30 mg/mL glycyrrhizin

Lime Flowers

5 to 12

60%

Herb

1:2

Allium sativum

Gentian

20 to 55

Rosemary QA

20 to 40

60%

Main root

1:2

Melissa officinalis Glycyrrhiza glabra

Licorice High Grade QA

20 to 40

60%

Root

1:2

Chionanthus virginica

20 to 40

Ribwort

Dong Quai 1:2

Root

1:2

Lavandula angustifolia

Lemon Balm

15 to 40

23%

Flower

1:2

Trigonella foenum-graecum contains a minimum Tanacetum parthenium, parthenolide of 0.3 mg/mL vulgare 1:1, Foeniculum oil Glycyrrhiza glabra 1:2 with essential 1:2, Stevia rebaudiana of orange and lemon

Fringe Tree

10 to 30

60%

25 to 50

to 40 Dandelion 23%Root 1:215

Bark

1:1

Rehmannia glutinosa rosavins 1:1 3.0 mg/mL rosea, contains Gymnema Rhodiola salidroside and 1.0 mg/mL lanceolata Leaves 1:2 QA Hawthorn Plantago contains a minimum Rosmarinus officinalis, oil mg/mL 1:1ofSessential Kava of 1.2

Alchemilla vulgaris

Lavender

Licorice

Root and flowering top

1:2 and F/P 1:2

Fenugreek

10 to 30

23%

Ladies Mantle

15 to 40

57%

Golden Seal 1:3 QA Gotu Kola 1:1 S

Rhodiola S

Plant Part

Extract Ratio

Botanical Name

Rehmannia

15 to 35

Herb

1:2

Korean Ginseng S

20 to 40

1:2

Flavouring Mixture

25 to 50

45%

1:2

of contains a minimum Piper methysticum, 10 mg/mL kavalactones contains 10.5 mg/mL Panax ginseng, Rg1 & Rb1 greater than ginsenosides with HPLC by or equal to 0.4

Kava S

30 to 60

60%

Dosage (mLs)

1:2

Piscidia piscipula

20 to 40

<5%

Root

Paeonia 1:2

Globe Artichoke 1:2 Common Name

Chaste Tree 1:2

Equisetum arvense

Jamaica Dogwood

20 to 40

60%

Root

Chamaelirium luteum Foeniculum vulgare

Feverfew QA

10 to 25

23%

Bark

of contains a minimum and Apium graveolens, as butylphthalide 10 mg/mL phthalides sedanenolide Matricaria chamomilla a minimum Chamomile chamomilla, contains Grade Matricaria α-bisabolol Chamomile High of 0.4 mg/mL QA Vitex agnus-castus Chaste Tree Citrus reticulata Chen Pi (Mandarin Peel) cassia Cinnamomum Cinnamon Quills Galium aparine Clivers Codonopsis pilosula Codonopsis contains a minimum Coleus forskohlii, forskolin Coleus of 2.5 mg/mL QA Zea mays Corn Silk

30 to 60

60%

Root

Euphorbia hirta

Fennel

25 to 60

90%

Herb

Frangula purshiana

40 to 80

45%

Root

1:2

Inula helenium

False Unicorn

15 to 40

23%

Flower

1:2

Armoracia rusticana

23%

Root

1:3

Sambucus nigra

15 to 30

45%

Flower

1:2

Celery Seed QA

Endocrine General

Licorice High Grade 1:1 QA

Ginkgo Biloba 2:1 S

High Grade 1:2 QA Chamomile Ethanol % Weekly

Plant Part

35% SeedCramp Bark 23% Root

Lemon Balm 1:2

Ginger 1:2

dose 1:2 child’s Cohosh

Calendula 1:2

Aesculus hippocastanum

Horsetail

20 to 40

23%

Root

1:2

Euphrasia officinalis

Eyebright

20 to 40

23%

Bark

1:2

Capsicum spp.

Cayenne

Euphorbia

10 to 20

45%

Root

1:2

contains a minimum alkaloids Uncaria tomentosa, pentacyclic oxindole of 1.5 mg/mL

Cascara

Elecampane

30 to 60

Horseradish

40 to 80

23%

Root

1:2

and purpurea root 1:2 1:2, contains 60% Echinacea angustifolia root 40% Echinacea mg/mL alkylamides 1.5 a minimum of 1:2 and angustifolia root 40% Echinacea plant purpurea fresh 60% Echinacea

Elder Flowers

10 to 40

23%

Root

1:2 Calendula officinalis Eschscholzia californica

= Black x adult dose

Extract Ratio

Korean Ginseng 1:2 S

Eyebright 1:2

dose

result by adult

in months Age ___________ 150

1:2

Horsechestnut

25 to 50

45%

Leaf

1:2

Echinacea purpurea

Echinacea Regular Blend

10 to 20

60%

Root

1:2 1:2

20 to 40

60%

Herb

Leaf

1:2

Ruscus aculeatus

10 to 30

70%

Root

1:2

Arctium lappa Juglans cinerea

Butternut

* multiply this

Astragalus 1:2

÷ 150*

age in months

Botanical Name

20 to 40

60%

Root

1:2

contains a minimum Echinacea angustifolia, alkylamides of 1.6 mg/mL contains a minimum Echinacea purpurea, alkylamides of 1.0 mg/mL

Echinacea Purpurea Glycetract Echinacea Premium Blend QA

30 to 60

23%

Root

1:2

Lycopus spp. Bupleurum falcatum

Bugleweed

60%

Whole plant

1:2 Iris versicolor Agathosma betulina

Blue Flag

60%

Green hulls

1:10 1:1

Caulophyllum thalictroides

Blue Cohosh

23%

Root

1:2

Fucus vesiculosus

Bladderwrack

60%

Fruit

1:1

Juglans nigra

Black Walnut Hulls

45%

Root

1:2

Vaccinium myrtillus of contains a minimum Actaea racemosa, glycosides as 15 mg/mL triterpene 27-deoxyactein

Bilberry

Leaf

1:2

Trillium erectum

Beth Root

Echinacea Purpurea Root QA

30 to 60

60%

Bark

1:2

Angelica sinensis

Dong Quai Echinacea Angustifolia Root QA

35 to 90

60%

Root

1:1

Taraxacum officinale spp. Harpagophytum

Dandelion Root

30 to 60

23%

Root

Baptisia

Calendula (low

Dandelion Leaves

Not for internal use

Herb

1:2

Salvia miltiorrhiza Taraxacum officinale

Dan Shen

25 to 60

23%

Herb

1:2

Scutellaria baicalensis

Leaf

1:2 Turnera diffusa

Damiana

15 to 30

23%

Resin

1:2 Bacopa monniera Baptisia tinctoria

Echinacea Premium Blend 1:2 QA

1:2 Andrographis 2 years old) under

Fried’s Rule (Children

2 years)

percentage of

This gives the

Common Name

Weekly Dosage (mLs)

Ethanol %

Plant Part

Extract Ratio

Botanical Name

10 to 25

45%

Bark

Astragalus membranaceus

Astragalus

Common Name

Weekly Dosage (mLs)

Herb

Arnica montana

Arnica

45%

Leaf

1:2

Celery Seed 1:2 QA

Ethanol %

Plant Part

Extract Ratio

Botanical Name

Common Name

(Children over

less than 30kg) # 2 (if weight is weight (kg) x greater than 30kg) 30 (if weight is weight (kg) + the adult dose

Chart

Herbal Liquid Dosage

Pads. last and most important link in the healing chain is Smart andThe professional

Nervagesic

Improve your patients’ compliance with MediHerb’s Records all treatment details thus improving patient Prescription Pads. The last and most important link in the compliance Our Body BodySystems SystemsChart Chartcategorises categorises liquids the Top 40healing chain Our ourour liquids intointo the Top is patient compliance with your prescribed natural medicine, your practice and your profession liquid extracts. The downinto into bodymedicine,Promotes 40 liquid extracts. Theremaining remainingliquids liquids are are broken broken down dietary and lifestyle advice. That’s why MediHerb’s systems. body systems. Prescription Pads have been designed for practitioners to Our Herbal HerbalLiquid LiquidDosage Dosage Chart contains an alphabetical listingrecord their prescriptions and advice for their patient, and the Our Chart contains an alphabetical of the key information on each liquid – common name, botanicalnext appointment. listing of the key information on each liquid – common name, plant part, extract ratio, dosage and alcohol percentage. name, botanical name, plant part, extract ratio, dosage and Our Kerry Bone’s Essentials and Body Systems Index alcohol percentage. Crataeva

Elymus repens

Viburnum opulus

Herb

Root

45%

1:1

Root

60%

1:1

Style and stigma

23%

1:2

Tuber

45%

1:1

Rhizome

23%

1:2

Bark

30%

1:2

Bark

23%

25 to 60

20 to 40

Hawthorn Berries QA Hawthorn Leaves QA

5 to 30

Hemidesmus

40 to 100

Hops

Grindelia camporum

Gymnema sylvestre

contains a minimum (OPCs) Crataegus monogyna, oligomeric procyanidins of 4.0 mg/mL contains a minimum Crataegus monogyna, procyanidins (OPCs) of 10 mg/mL oligomeric Hemidesmus indicus Humulus lupulus

1:2

Fruit

1:2

Leaf and flower

1:2

Root

1:2

Strobile

Qing Hao

45%

10 to 50

45%

10 to 30

45%

25 to 60

60%

10 to 20

662

Order Online:

a.com www.myintegri

Rubus idaeus

Raspberry Leaves

Red Clover Flowering Tops Red Clover Flowers

30 to 100

Leaf 1:2 130023%26510662 to 40 Phone: Flowering 23%

1:2

Trifolium pratense

1:2

herb top Flower

23%

Yarrow

1:2

Yellow Dock Online: www.myintegria.com Order 1:2

10 to 40

Zizyphus

Rumex crispus

Ziziphus jujuba

Seed

23%

Silymarin

PhytoRegenex

40 to 80

Clinical Support:

Sheep Sorrel Combination

Vital Woman

Wormwood Complex

Nevaton®

Valerian Complex

Tribulus Forte

Zinc Protect

Clivers Complex

Vitamin E Cream Base

St John’s Wort

ProstaCo

Wormwood Complex

Wild Yam Complex

NeuroSom

Male Endocrine

Rehmannia Complex

Tribulus Forte

Vitanox®

Poly-C Powder

PolyFem

Slippery Elm 400mg

Ubiquinol Forte

var. spinosa

Trifolium pratense

Withania & Ginseng

Zinc Protect

Urinary System

Withania Complex

Phone: 1300 265 662

Crataeva nurvala

Phone: 1300 265

Artemisia annua

1300 211 171

.com.au www.mediherb

Cranberry Complex

Order Online: www.myintegria.com

Clinical Support: 1300 211

171

www.mediherb.com.au

highlights Kerry Bone’s 30 essential formulated products for your

Our Kerry Bone’s Essentials and Body Systems Index dispensary. The remaining products are categorised by body highlights Kerry Bone’s 30 essential formulated products for system for your easy reference. your dispensary. The remaining products are categorised by body system for your easy reference.

Patient Brochures

Attractive full colour patient brochures are available for display Patient Brochures in your clinic. These professional brochures help to explain Attractive colour patient brochures are available for and MediHerbfull products and assist with patient confidence display in your clinic. These professional brochures help to compliance. explain MediHerb products and assist with patient confidence Quality is our Passion and compliance.

Whole Life Vitality – Eating for Health Ingredients:

2 tsp (8 g) of Activated Beet-Greens Powder 2 tbsp of Everyday Balance Smooth Vanilla Protein Powder

½ cup of cold water

MediHerb is the trusted name in by professional herbal medicine. Founded internationally-respected herbal expert, Professor Kerry Bone, our mission from the beginning has been to provide health care professionals with premium quality

Nervagesic or milk

Combine all ingredients in a shaker, shake and serve.

Alternatively, add ice cubes and your favourite berries, combine in a blender until smooth and serve.

natural treatment solutions. Activate d Beet-Greens

Activated Beet-Greens natural medicine products can have dramatic Profession MediHerb ally Recommended the guidance effects on health when used under positive Concentra ted Nutrition Our products are of a qualified health care professional. we recognise available only through practitioners, because in providing the level of skill and education involved is dedicated to the best possible health care. MediHerb together with delivering extensive education programs, help health care research and technical information, to Activated Beet-Greens and the best care. is a best high products quality, concentrated professionals give you the supplement to a nutritious diet. Use it daily as a supplementary food to: Support energy, performance, stamina, endurance and general health

Compelling Benefits

Nervagesic

MediHerb is the trusted name in professional herbal medicine. Founded by internationally-respec ted herbal expert Professor Kerry Bone, our mission from the beginning has been to provide health care professionals with premium quality natural treatment solutions. MediHerb products can have dramatic positive effects on health when used under the guidance of a qualified health care professional. Our products are available only through practitioners, because we recognise the level of skill and education involved in providing the best possible health care. MediHerb is dedicated to delivering extensive education programs, together with research and technical information, to help health care professionals give you the best products and the best care.

More patient brochures coming soon! Natural Pain Relief

Provide nutrients for energy metabolism and reduction of fatigue Help protect cells from free radicals

Provide amino acids Complement a nutritious diet Contribute to normal cognitive function, normal immune system function, normal blood formation and normal homocysteine metabolism (due .au to content of vitamins www.mediherb.com A, B12 and C, and iron)

Relieve mild neuralgia and pain of sciatica Relieve pain associated with menstruation Promote sleep Relieve muscular cramps and spasm

Activated Berry Smoothie Ingredients:

2 tsp (8 g) of Activated Beet-Greens Powder 2 tbsp of Everyday Balance Smooth Vanilla Protein Powder ½ cup of cold water or milk Preparation:

Quality is our Passion

Combine all ingredients in a shaker, shake and serve.

Alternatively, add ice cubes and your favourite berries, combine in a blender until smooth and serve.

natural treatment solutions.

natural medicine products can have dramatic Activated MediHerbBeet-Greens the guidance on health when used under

positive effects Professionally Recommended Our products are of a qualified health care professional. we recognise Concentrated Nutrition available only through practitioners, because

A natural approach to pain relief www.mediherb.com .au

Nourish | Strengthen | Cleanse Get your daily dose

of vitality

Activated Beet-Greens

Californian Poppy, Nervagesic is an innovative formula combining herbal ingredients are Corydalis and Jamaican Dogwood. These traditionally used to:

Nervagesic

Contains Beetroot which is high in shown to support cardiovascular nitrate. Nitrate has been health Activated Beet-Greens is low in sodium. A diet low in sodium reduces blood pressure

Compelling Benefits

MediHerb products can have dramatic positive effects on health when used under the guidance of a qualified health care professional. Our products are available only through practitioners, because we recognise the level of skill and education involved in providing the best possible health care. MediHerb is dedicated to delivering extensive education programs, together with research and technical information, to help health care professionals give you the best products and the best care.

Whole Life Vitality – Eating for Health in providing the level of skill and education involved is dedicated to the best possible health care. MediHerb together with delivering extensive education programs, care

Nervagesic

and technical information, to help health researchBenefits Compelling products and the best care. professionals give you the best

Activated Beet-Greens is a high quality, concentrated supplement to a nutritious diet. Use it daily as a supplementary food to:

Whole Life Vitality – Detox for Health Natural Pain Relief

Support energy, performance, stamina, endurance and general health

Provide nutrients for energy metabolism and reduction of fatigue

Compelling Benefits Californian Poppy, Nervagesic is an innovative formula combining herbal ingredients are Corydalis and Jamaican Dogwood. These traditionally used to:

Help protect cells from free radicals Contains Beetroot which is high in nitrate. Nitrate has been shown to support cardiovascular health

Nervagesic

Activated Beet-Greens is low in sodium. A diet low in sodium reduces blood pressure

Relieve mild neuralgia and pain of sciatica

Provide amino acids

Relieve pain associated with menstruation

Complement a nutritious diet

Promote sleep

Contribute to normal cognitive function, normal immune system om.au function, normal bloodwww.mediherb.c formation and normal homocysteine metabolism (due to content of vitamins A, B12 and C, and iron)

Activated Beet-Greens Relieve muscular cramps and spasm

A natural approach to pain relief

MediHerb in New Zealand, has four Practitioner Consultants.

Records all treatment details thus improving This dedicated team of professionals consists of experienced patient compliance.

herbalists and naturopaths many of whom are in clinical practice

Promotes natural medicine, your practice andaround Australia and and teach at natural medicine colleges your profession. New Zealand.

The Practitioner Account Managers are available for practitioner treatment protocols, practice management, natural medicine

Activated Beet-Greens

Whole Life Vitality – Detox for Health Preparation:

There are Practitioner Account Managers that cover every state

Personalises your patients’ consultation and and territory in Australia. ProHerb, the exclusive distributor for encourages their return.

Yourvisits Practitioner to keep youAccount up-to-dateManagers with the MediHerb product range,

Nervagesic

Activated Berry Smoothi e

Your Practitioner Account Managers

Practitioner Resources

Cramp Bark

Practitioner Resources

Couch Grass

1:2

Corydalis ambigua

Corydalis

23%

Nourish | Strengthen | Cleanse Get your daily dose of vitality

There are Practitioner Account Managers that cover every research and any other area of your practice that you would like state and territory in Australia. ProHerb, the exclusive support with. distributor for MediHerb in New Zealand, also has Practitioner Consultants. This dedicated team of professionals consists of experienced herbalists and naturopaths many of whom are in If you would like to order any of the materials listed above clinical practice.

or arrange an appointment with your local Practitioner

The Practitioner Account Managers are available for Account Manager please call: practitioner visits to keep you up-to-date with the MediHerb Australia – Integria Healthcare and MH Enhance product range, treatment protocols, practice Practitioner Customer Service: 1300 654 336 management, natural medicine research and any other area New Zealand ProHerb Customer Service of your practice that you –would like support with.

Toll Free Phone: 0800 553 556

www.mediherb.com.au

More patient brochures coming soon!

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MediHerb Dispensing Labels

If you would like to order any of the materials listed above or arrange an appointment with your

The Whole Life Vitality programs are comprehensive patient plans that have been designed by health experts and leading naturopaths. They address two common issues for modern patients: weight management and detoxification. The Whole Life Vitality programs have been designed to assist practitioners by delivering a professional, easy-to-follow patient plan that will deliver results.

Patient Programs Your guide to eating and exercising for weight loss, better blood sugar and long-term health and well-being.

Whole Life Vitality – Eating for Health A lifestyle program that helps you feel and look great! It is not a diet but rather a healthy way of eating to help maintain health over the long term. It emphasises delicious, nutritious meals in conjunction with regular exercise and the recommended nutritional and herbal supplements. The program focuses on weight loss without the need for a highly restrictive diet which is often associated with low compliance and rebound weight gain.

Integria Healthcare 8 Clunies Ross Court PO Box 4854, Eight Mile Plains, QLD 4113, AUSTRALIA Phone: 1300 265 662

Unit 2/3 Dalziel Place PO Box 19796, Woolston, Christchurch 8241, NEW ZEALAND Toll Free Phone: 0800 553 556

www.mediherb.com.au

9 326434 010509

Program Manual

This brochure is printed on Revive Pure Silk 100% Recycled which is Certified Carbon Neutral and FSC 100% Recycled. The pulp used is Process Chlorine Free and is manufactured by an ISO 14001 certified mill.

Brought to you by

Whole Life Vitality – Detox for Health An effective, short-term detoxification plan that addresses both liver and gut health. The program focuses on fresh juices, organic foods combined with the recommended herbal and nutritional supplements. In conjunction with gentle exercise and detoxification techniques, the program will support the body’s natural detoxification processes. It is a complete program to boost your patients’ vitality and well-being. Both programs provide professional materials to assist delivery to your patients:

A safe, simple, practitioner-supervised detox program specially designed to kick-start your return to optimal health and well-being.

Patient Manual The comprehensive program manuals do all the work for you. They detail the programs, diet plan and provide lifestyle and exercise advice. They also contain menu plans, recipes and a patient diary.

Practitioner Resources These kits contain advice on delivery of the programs and additional information on the recommended supplements as well as detailed research and clinical information.

Integria Healthcare 8 Clunies Ross Court PO Box 4854, Eight Mile Plains, QLD 4113, AUSTRALIA Phone: 1300 265 662

Unit 2/3 Dalziel Place PO Box 19796, Woolston, Christchurch 8241, NEW ZEALAND Toll Free Phone: 0800 553 556

www.mediherb.com.au

9 326434 010493

Program Manual

Brought to you by

Patient Brochures Attractive, professional brochures are available to display and promote the programs in your clinic.

The detailed information and professional presentation of these programs ensures patient compliance. For more information on Whole Life Vitality contact Customer Service: Australia – Integria Healthcare Customer Service: 1300 654 336 New Zealand – ProHerb Toll Free Phone: 0800 553 556

Product Catalogue

Email: orders@integria.com Email: sales@proherb.co.nz

Clinical Support & Seminars

B.HSc., N.D.

Berris is an experienced naturopath with over 23 years in clinical practice. She runs a busy clinic in Brisbane where she treats a wide range of conditions including female reproductive issues; autoimmune disease, particularly involving the thyroid; immune depletion; fatigue, and nervous system conditions. Berris is a well-known presenter at complementary medicine seminars throughout Australia, New Zealand, South Africa and the United Kingdom. She has a strong interest in herbal safety, particularly herb-drug interactions and is co-author of the Adverse Herb-Drug Interaction chapter in The Essential Guide to Herbal Safety by Simon Mills and Kerry Bone, published in 2005.

MediHerb Clinical Support Line The MediHerb Clinical Support Line is a commitment to supporting practitioners with advice on all aspects of natural medicine. MediHerb’s Clinical Support Line Consultants are knowledgeable naturopaths with many years of clinical and teaching experience and are available to answer questions on: Treatment Protocols Herb/drug interactions Adverse reactions Safety of herbal medicine in pregnancy and lactation Information on specific MediHerb products and their actions Guidelines for establishing a natural medicine dispensary MediHerb’s Clinical Support Line Consultants are well attuned to the everyday problems and challenges that can arise in clinic. They are up-to-date with the latest research and clinical applications of natural medicine.

Clinical Support Consultant – Rose Cornelissen MHSC c, ND. DBM.

Rose’s expertise has developed over 25 years as a naturopath and herbalist. This has involved extensive private practice and mentoring, as well as hands-on experience in growing, medicine making and cultural practice in both Eastern and Western countries. She has also held academic positions in herbal medicine at naturopathic universities, facilitated herbal outreach programs to remote communities, conducted regular radio segments on naturopathic health, and performed MediHerb practitioner and undergraduate support. Rose has a special interest in the interdependence of traditional practice and evidence based medicine. This includes current self-adjusting demands on the profession and how to improve successful patient outcomes, especially in chronic disease and ageing.

MediHerb’s Clinical Support Line is available for practitioners Monday to Friday. To speak to a Clinical Support Consultant please call: Australia – MediHerb Clinical Support Phone: 1300 211 171

Practitioner Resources

Clinical Support Consultant – Berris Burgoyne

New Zealand – ProHerb Clinical Support Toll Free Phone: 0800 553 556

Seminars for Qualified Health Care Professionals MediHerb regularly conducts professional seminars throughout the world with experienced speakers such as Kerry Bone, Angela Hywood, Rob Santich, Berris Burgoyne and Lee Carroll. These seminars combine the best of traditional knowledge with the latest scientific research. Visit www.mediherb.com.au for an up‑to‑date seminar schedule.

Her postgraduate work in herbal medicine is part of a commitment to lifelong learning, critical appraisal and improving inter-professional dialogue around prevention and disease treatment.

www.mediherb.com.au

Excipient Glossary Tablet Excipients MediHerb uses a range of low allergenic and pharmaceutical grade excipients in the manufacture of its tablet range. These excipients are carefully chosen using experience gained from over 10 years of manufacturing herbal tablets and are necessary to aid the manufacturing process, stability, disintegration and to allow ease of swallowing.

Calcium Hydrogen Phosphate

Hypromellose (Cellulose Derivative)

Calcium hydrogen phosphate is the binder or filler which actually holds the tablet together and allows it to be compressed to form a tablet. It also assists in formulation flow and resists the uptake of moisture, thus reducing the risk of poor stability.

Hypromellose is used as a film coating agent on most MediHerb tablets. It is applied as a thin inert layer and has four important actions:

Cellulose Cellulose acts with calcium hydrogen phosphate as the binder that holds the tablet together. It also works to assist with tablet disintegration.

Silica Silica is used as a glidant to assist with the flow properties of the tablet powder as it travels through the tablet machine. Good flow characteristics are crucial to the manufacture of tablets with consistent weight and active content. Silica is also used to increase the hardness of the tablet to ensure they are robust enough to handle coating, packaging and transport.

Sodium Starch Glycollate Due to the high proportion of herb used in the MediHerb tablets, an aid to disintegration is required to ensure that the tablets disintegrate in less than 30 minutes. Sodium starch glycollate performs this function best for the high potency tablets manufactured by MediHerb.

Magnesium Stearate â&#x20AC;&#x201C; Vegetable Origin Most tablets need some form of lubrication to assist in the removal of the tablet from the tableting machine die. Magnesium stearate of vegetable origin is the most effective ingredient for this purpose.

Orange Oil Pressed oil from orange peel is used as a flavour masker.

1. The thin layer makes the tablet much more resistant to dust formation in the packaging. 2. When the tablet surface is wetted in the mouth a lubricant, mucilaginous layer is formed on the tablet which facilitates swallowing. 3. The inert layer acts to hide any unpleasant odours or tastes that are found in many herbal tablets. 4. It aids in enhancing the stability of the product by forming a barrier to the external environment.

Enteric Coating A number of MediHerb tablets have a specialised enteric coating which makes the tablets acid resistant. This is important for some herbs which can cause gastric discomfort and for herbs whose actives are damaged by stomach acid. Enterically coated tablets pass through the high acid environment of the stomach safely and then dissolve once they reach the pH neutral environment of the small intestine.

Solubility Test Enterically coated tablets must be stable for 2 hours in dilute hydrochloric acid and then dissolve within 1 hour when placed in pHâ&#x20AC;Ż7â&#x20AC;Żbuffer.

Effervescent Factors The following ingredients are used in effervescent powders to adjust the pH and give the product fizz. Calcium carbonate is a naturally occurring mineral, found as the following minerals and rocks: aragonite, calcite, chalk, limestone, marble and travertine. Citric acid (anhydrous) is naturally occurring in plants and animals. Potassium and sodium bicarbonates are naturally occurring inorganic minerals.

Product Catalogue

Herbal Medicine Text Books

Principles and Practice of Phytotherapy – Second Edition Modern Herbal Medicine The first edition of Principles and Practice of Phytotherapy is well known as the leading text of herbal medicine in naturopathic and herbal colleges throughout the world. Now the longawaited second edition brings a complete revision of the material in the first text including: 5 0 fully up-to-date evidence-based monographs including 7 new herbs: Gotu Kola, Willow Bark, Bugleweed, Butcher’s Broom, Boswellia, Myrrh and Tribulus. New insights on herbal management of approximately 100 modern disease states. A comprehensive revision of vital safety data, including an extensive herb-drug interaction chart addressing key safety issues to help the reader differentiate between false and real concerns.

Practitioner Resources

By Kerry Bone and Simon Mills

E xtensive coverage of vital new topics such as asthma, atopic dermatitis, acne, fibromyalgia, inflammatory bowel disease, insulin resistance, migraine headaches and prostate cancer, to name a few. This valued text was exhaustively researched and carefully compiled by Kerry Bone and Simon Mills, who have more than 60 years of combined experience in clinical practice, education, manufacturing and research. This text is a must-have resource for any herbal medicine practitioner or student.

Winner of the 2013 James A Duke Excellence in Botanical Literature Award

www.mediherb.com.au

The Essential Guide to Herbal Safety Edited by Kerry Bone and Simon Mills The first accurate and comprehensive book on herbal safety – a must for all health care professionals!

Winner of the 2005 James A. Duke Botanical Literature Award

PHY TOTHER APY ESSENTIALS:

This innovative new book presents an extensive discussion of the principles of herbal safety and the current major issues relating to this important area. Leading international experts contribute to the book providing a wealth of information on issues such as quality, interactions, adverse reactions, toxicity, allergy, contact sensitivity and idiosyncratic reactions. In March 2006, the American Botanical Council (ABC) announced that The Essential Guide to Herbal Safety was the recipient of the James A. Duke Botanical Literature Award which honours the singular, outstanding contribution by a book to the knowledge and understanding of medicinal and aromatic plants.

Phytotherapy Essentials: Healthy Children By Rob Santich and Kerry Bone

Optimising Children’s Health with Herbs

Healthy Children has been written with the special needs of children in mind. The benefits, risks and requirements for herbal therapy in children differ from those in adults. This book outlines the key principles that govern herbal practice for this special patient group. A well-researched text, written by Rob Santich and Kerry Bone who together have almost 50 years of clinical practice, this book provides a comprehensive treatise on the common health problems encountered by children. Sound, practical information based on clinical experience as well as evidence-based research, provides a balanced and authoritative approach to children’s health.

The Ultimate Herbal Compendium By Kerry Bone A Desktop Guide for Herbal Prescribers The Ultimate Herbal Compendium is a reliable ready reference designed for the busy health practitioner. It contains up-to-date easily found information on a wide range of herbs and conditions, including doses for herbs in tablet form as well as liquids. Careful research of all the available herbal information combined with Kerry Bone’s 25 years of clinical practice ensures that all valid herbal treatment options can be considered.

A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient By Kerry Bone This highly practical guide explains in-depth how to use and blend liquid extracts for optimum results making it a must for all herbal medicine practitioners and students. Monographs of 125 popular herbs used in the form of liquid extracts provide the herbal clinician with accessible and clinically relevant information. The monographs have been specifically designed for use in the clinic with an emphasis on providing the essential information in an easy to read format and outlines traditional use and the most up-to-date pharmacological and clinical studies. This guide is comprehensively referenced and contains appendices for thorough explanations, indices of herb and herb action as well as complete glossaries and a table of recommended dosages.

If you would like to order any of the books listed above, contact: Australia – Integria Healthcare Customer Service: 1300 654 336 Email: orders@integria.com Web orders: www.myintegria.com New Zealand – ProHerb Customer Service Toll Free Phone: 0800 553 556 Email: sales@proherb.co.nz

Product Catalogue

Ingredient Index The ingredient index lists all active ingredients used in MediHerb products. Products are listed in the following order: liquid extracts, single herb tablets, complex tablets, capsules or powders, Phytosynergist liquid, dried herbs and topical products.

Herb Botanical Name/Nutrient Name

Product

Page

Yarrow 1:2

FibroFem tablets

Black Cohosh 1:2

PolyFem tablets

Achillea millefolium Actaea racemosa, Cimifuga racemosa

Wild Yam Complex tablets

Actinidia deliciosa

Activated Beet-Greens powder

Adhatoda vasica, Justicia adhatoda

Adhatoda 1:2

PulmaCo tablets

Horsechestnut 1:2

Horsechestnut Complex tablets

Buchu 1:2

Cranberry Complex tablets

Agrimonia eupatoria

Agrimony 1:2

Albizia lebbeck

Albizia 1:2

Albizia Complex tablets

Ladies Mantle 1:2

EndoFem tablets

Aletris farinosa

True Unicorn 1:2

Allium sativum

Garlic Forte tablets

Aloe spp.

Aloes Resin 1:10

Alpha lipoic acid (R,S-Alpha lipoic acid)

Mega Mag powder

Poly-C Powder

Marshmallow Root 1:5

Marshmallow Root Glycetract 1:5

Herbal Throat Spray

Andrographis 1:2

Andrographis Complex tablets

Bacto-Cand GI capsules

Anemone pulsatilla

Pasque Flower 1:2

Anethum graveolens

Cascara Complex tablets

Angelica sinensis, Angelica polymorpha

Dong Quai 1:2

EndoFem tablets

Celery Seed 1:2

Boswellia Complex tablets

Burdock 1:2

Clivers Complex tablets

Sheep Sorrel Combination tablets

Bearberry 1:2

Cranberry Complex tablets

Armoracia rusticana

Horseradish 1:2

Arnica montana

Arnica 1:5

Artemisia absinthium

Wormwood 1:5

Wormwood Complex tablets

Artemisia annua

Qing Hao 2:1

Asclepias tuberosa

Pleurisy Root 1:2

Broncafect速 tablets and Phytosynergist速 liquid

Aesculus hippocastanum Agathosma betulina, Barosma betulina

Alchemilla vulgaris

Althaea officinalis

Andrographis paniculata

Apium graveolens Arctium lappa

Arctostaphylos uva-ursi

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Indexes

Herb Botanical Name/Nutrient Name

Product

Page

Active Mag-Cal tablets

Everyday B Multi tablets

Fe-Plex tablets

Joint Defence tablets

LymphoLytix tablets

Mega Mag powder

Poly-C Powder

ThyAdren Support tablets

Tissue Regenex tablets

Vital Woman tablets

A Ascorbic acid (Vitamin C)

Zinc Protect tablets

Fe-Max Iron Tonic Phytosynergist速 liquid

Shatavari 1:2

Vital Woman tablets

Wild Yam Complex tablets

Astragalus 1:2

Astragalus Complex tablets

Oats Green 1:2

Oats Seed 1:1

Bacopa 1:2

Bacopa Complex tablets

ThyroCo tablets

Baptisia tinctoria

Baptisia 1:2

Barosma betulina, Agathosma betulina

Buchu 1:2

Cranberry Complex tablets

Oregon Grape 1:2

Clivers Complex tablets

Berberis vulgaris

Barberry 1:2

Beta vulgaris

Activated Beet-Greens powder

Betacarotene (natural source)

Activated Beet-Greens powder

Everyday B Multi tablets

Poly-C Powder

Zinc Protect tablets

Bifidobacterium animalis lactis BB-12

Probiotica capsules

Biotin (Vitamin H)

Everyday B Multi tablets

Vital Woman tablets

Everyday B Multi tablets

Poly-C Powder

Calcium Bone Complex powder

Everyday B Multi tablets

Joint Defence tablets

Vital Woman tablets

Boswellia Complex tablets

Joint Defence tablets

Activated Beet-Greens powder

P2-Detox powder

Asparagus racemosus

Astragalus membranaceus Avena sativa

B Bacopa monniera, Bacopa monnieri

Berberis aquifolium

Bioflavonoids (citrus extract) Boron (Borax)

Boswellia serrata Brassica oleracea (Broccoli) Bupleurum falcatum

Calcium ascorbate (Vitamin C)

Product Catalogue

Bupleurum 1:2

Livton速 Complex tablets

Rehmannia Complex tablets

Poly-C Powder

Herb Botanical Name/Nutrient Name

Product

Page

Active Mag-Cal tablets

Calcium Bone Complex powder

Mega Mag powder

Everyday B Multi tablets

Mega Mag powder

Methyl Factors tablets

ThyAdren Support tablets

Active Mag-Cal tablets

Everyday B Multi tablets

Vital Woman tablets

Everyday B Multi tablets

GlucoBalance tablets

Mega Mag powder

ThyAdren Support tablets

Vital Woman tablets

Calcium phosphate

Active Mag-Cal tablets

Calendula officinalis

Calendula 1:2

Calendula (low alcohol 25%)

EndoFem tablets

Herbal Throat Spray

Activated Beet-Greens powder

Calcium citrate hydrate

Calcium folinate

Calcium hydrogen phosphate

Calcium pantothenate (Vitamin B5)

Camellia sinensis

Capsella bursa-pastoris Capsicum annuum, Capsicum spp.

Methyl Factors tablets

Vitanox® tablets

Shepherd’s Purse 1:2

FibroFem tablets

Cayenne 1:3

Eyebright Complex tablets

Caulophyllum thalictroides

Blue Cohosh 1:2

Centella asiatica

Gotu Kola 1:1

Tissue Regenex tablets

Chamaelirium luteum

False Unicorn 1:2

Chelidonium majus

Greater Celandine 1:2

Chionanthus virginica

Fringe Tree 1:2

Livton® Complex tablets

Chlorella pyrenoidosa

Activated Beet-Greens powder

Cholecalciferol (Vitamin D3)

Active Mag-Cal tablets

Calcium Bone Complex powder

Everyday B Multi tablets

ThyAdren Support tablets

Vital Woman tablets

Everyday B Multi tablets

Methyl Factors tablets

P2-Detox powder

Vital Woman tablets

Chondroitin sulfate – bovine

Joint Defence tablets

Chromic chloride

Everyday B Multi tablets

GlucoBalance tablets

Mega Mag powder

Vital Woman tablets

Everyday B Multi tablets

GlucoBalance tablets

Mega Mag powder

Choline bitartrate

Chromium nicotinate

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Indexes

Herb Botanical Name/Nutrient Name

Product

Page

Black Cohosh 1:2

PolyFem tablets

Wild Yam Complex tablets

Cinnamomum cassia

Cinnamon Quills 1:2

Citrus reticulata

Chen Pi 1:2

C Cimicifuga racemosa, Actaea racemosa

DiGest tablets

Citrus spp.

Flavouring Mixture

Codonopsis pilosula

Codonopsis 1:2

Fe-Plex tablets

Fe-Max Iron Tonic Phytosynergist速 liquid

Coleus 1:1

Coleus Forte tablets

Myrrh 1:5

Herbal Throat Spray

Concentrated Omega-3 triglycerides - fish

Omega-3 Forte capsules

Copper gluconate

Everyday B Multi tablets

Joint Defence tablets

Corydalis 1:2

Cramplex tablets

Corydalis turtschaninovii

Nervagesic tablets

Crataegus monogyna

Hawthorn Berries 1:2

Hawthorn Leaves 1:2

Hawthorn tablets

Crataeva 1:2

Cranberry Complex tablets

ProstaCo capsules

Creatine monohydrate

Mega Mag powder

Crocus sativus

Saffron 1:20

Curcuma longa

Turmeric 1:1

Activated Beet-Greens powder

Boswellia Complex tablets

P2-Detox powder

Coleus forskohlii Commiphora myrrha

Corydalis ambigua

Crataeva nurvala, Crateva nurvala

PulmaCo tablets

Vitanox速 tablets

Curcumin phospholipid complex

Curcuma Active tablets

Cyanocobalamin (Vitamin B12)

Everyday B Multi tablets

Fe-Plex tablets

GlucoBalance tablets

Mega Mag powder

Methyl Factors tablets

ThyAdren Support tablets

Vital Woman tablets

Fe-Max Iron Tonic Phytosynergist liquid 速

Cynara scolymus Cysteine Hydrochloride

Globe Artichoke 1:2

Livton速 Complex tablets

Everyday B Multi tablets

P2-Detox powder

EFA Essentials capsules

Omega-3 Forte capsules

D d-alpha-Tocopherol (natural Vitamin E)

Product Catalogue

Herb Botanical Name/Nutrient Name

Product

Page

Everyday B Multi tablets

Mega Mag powder

ThyAdren Support tablets

Vital Woman tablets

Zinc Protect tablets

Mega Mag powder

Omega-3 Forte

Vital Woman tablets

Wild Yam 1:2

Wild Yam Complex tablets

D d-alpha-Tocopheryl acid succinate (natural Vitamin E)

Tocopherols concentrate – mixed (low-alpha type)

Dioscorea villosa

Cramplex tablets

Drosera longifolia

Sundew 1:5

Dunaliella salina

Mega Mag powder

Echinacea Angustifolia Root 1:2

Echinacea Premium Blend 1:2

Echinacea Purpurea Root 1:2

Echinacea Purpurea Glycetract 1:3

Echinacea Regular Blend 1:2

Echinacea Premium tablets

Andrographis Complex tablets

Echinacea spp.

Astragalus Complex tablets

Broncafect® tablets and Phytosynergist® liquid

Eyebright Complex tablets

Herbal Throat Spray

Siberian Ginseng 1:2

Siberian Ginseng tablets

Astragalus Complex tablets

Bacopa Complex tablets

Elymus repens

Couch Grass 1:1

Epilobium parviflorum

Willow Herb 1:2

Equisetum arvense

Horsetail 1:2

Eschscholzia californica

Californian Poppy 1:2

Nervagesic tablets

Eupatorium purpureum

Gravel Root 1:2

Euphorbia hirta

Euphorbia 1:2

Eleutherococcus senticosus

Euphrasia officinalis

ResCo tablets and Phytosynergist liquid

Eyebright 1:2

Eyebright Complex tablets

PhytoRegenex tablets

Poly-C Powder

Indexes

F Fallopia japonica, Polygonum cuspidatum

Vital Woman tablets

Ferrous fumarate (Iron)

Everyday B Multi tablets

Filipendula ulmaria

Meadowsweet 1:2

HiPep tablets

EFA Essentials capsules

Omega-3 Forte capsules

Fennel 1:2

Fish Oil (natural) Foeniculum vulgare

PulmaCo tablets

ResCo® tablets and Phytosynergist® liquid

Flavouring Mixture

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Herb Botanical Name/Nutrient Name

Product

Page

Everyday B Multi tablets

Fe-Plex tablets

Methyl Factors tablets

Vital Woman tablets

Cascara 1:2

F Folic acid

Frangula purshiana, Rhamnus purshianus

Cascara Complex tablets

Fructose

Everyday Balance Protein Powder (Smooth Vanilla)

Fucus vesiculosus

Bladderwrack 1:1

ThyroCo tablets

Galega officinalis

Goat’s Rue 1:2

Galium aparine

Clivers 1:2

Clivers Complex tablets

Gentian 1:2

DiGest tablets

Ginkgo Biloba 2:1

Ginkgo Forte tablets

Horsechestnut Complex tablets

PhytoRegenex tablets

PulmaCo tablets

Tissue Regenex tablets

Glucosamine hydrochloride

Joint Defence tablets

Glutamine

Everyday Balance Protein Powder (Smooth Vanilla)

Mega Mag powder

P2-Detox powder

Glycine

P2-Detox powder

Glycyrrhiza glabra

Licorice 1:1

Licorice High Grade 1:1

Gentiana lutea Ginkgo biloba

Grindelia camporum

Adrenal Complex tablets

Broncafect® tablets and Phytosynergist® liquid

HiPep tablets

PolyFem tablets

ResCo® tablets and Phytosynergist® liquid

Withania Complex tablets

Fe-Max Iron Tonic Phytosynergist® liquid

Flavouring Mixture

Grindelia 1:2

PulmaCo tablets

ResCo® tablets and Phytosynergist® liquid

Guar gum

Everyday Balance Protein Powder (Smooth Vanilla)

Gymnema sylvestre

Gymnema 1:1

Gymnema tablets

GlucoBalance tablets

Harpagophytum procumbens

Devil’s Claw 1:2

Hemidesmus indicus

Hemidesmus 1:2

Rehmannia Complex tablets

Hesperidin

Poly-C Powder

Humulus lupulus

Hops 1:2

Product Catalogue

Herb Botanical Name/Nutrient Name

Product

Page

Golden Seal (cultivated) 1:3

Golden Seal (cultivated) 1:5

Golden Seal tablets

Eyebright Complex tablets

St John’s Wort 1:2

St John’s Wort High Grade 1:2

H Hydrastis canadensis

Hypericum perforatum

St John’s Wort tablets

Nevaton® tablets

Wild Yam Complex tablets

Everyday B Multi tablets

P2-Detox powder

Vital Woman tablets

I Inositol

Inula helenium

Elecampane 1:2

ResCo® Phytosynergist® liquid

Calcium Bone Complex powder

Everyday Balance Protein Powder (Smooth Vanilla)

Iris versicolor

Blue Flag 1:2

Iron (Ferrous fumarate)

Everyday B Multi tablets

Fe-Plex tablets

Inulin

(Iron amino acid chelate)

Vital Woman tablets

Fe-Max Iron Tonic Phytosynergist liquid

Juglans cinerea

Butternut 1:2

Juglans nigra

Black Walnut Hull 1:10

Wormwood Complex tablets

Adhatoda 1:2

PulmaCo tablets

Lactobacillus acidophilus LA-5

Probiotica capsules

Lavandula x intermedia

Lavender 1:2

Lavandula angustifolia

NeuroSom tablets

Lecithin

Everyday Balance Protein Powder (Smooth Vanilla)

Leonurus cardiaca

Motherwort 1:2

Levocarnitine

Mega Mag powder

Lycopus spp.

Bugleweed 1:2

Lysine hydrochloride

Everyday B Multi tablets

Active Mag-Cal tablets

Mega Mag powder

Vital Woman tablets

Magnesium ascorbate monohydrate (Vitamin C)

Poly-C Powder

Magnesium citrate

Mega Mag powder

NeuroSom tablets

Active Mag-Cal tablets

Mega Mag powder

Active Mag-Cal tablets

Calcium Bone Complex powder

Everyday B Multi tablets

GlucoBalance tablets

NeuroSom tablets

Justicia adhatoda, Adhatoda vasica

M Magnesium amino acid chelate

Magnesium orotate dihydrate Magnesium phosphate

Magnolia officinalis

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Indexes

Herb Botanical Name/Nutrient Name

Product

Page

Malpighia glabra

Activated Beet-Greens powder

Manganese amino acid chelate

Active Mag-Cal tablets

Calcium Bone Complex powder

Everyday B Multi tablets

GlucoBalance tablets

Joint Defence tablets

Vital Woman tablets

Zinc Protect tablets

Marrubium vulgare Matricaria chamomilla

Melissa officinalis

White Horehound 1:2

Broncafect速 tablets and Phytosynergist速 liquid

Chamomile 1:2

Cascara Complex tablets

DiGest tablets

HiPep tablets

Lemon Balm 1:2

NeuroSom tablets

Mentha x piperita

Peppermint 1:2

Methionine

P2-Detox powder

Mitchella repens

Squaw Vine 1:2

Molybdenum (high molybdenum yeast)

Everyday B Multi tablets

Molybdenum trioxide

Mega Mag powder

Vital Woman tablets

Natural vanilla flavour

Everyday Balance Protein Powder (Smooth Vanilla)

Natural Fish Oil

EFA Essentials capsules

Omega-3 Forte capsules

Everyday B Multi tablets

GlucoBalance tablets

Mega Mag powder

ThyAdren Support tablets

Vital Woman tablets

Everyday B Multi tablets

GlucoBalance tablets

Nigella 1:2

Ocimum tenuiflorum

Andrographis Complex tablets

Oenothera biennis

Evening Primrose Oil capsules

EFA Essentials capsules

Olea europaea

Olive Leaves 1:2

Origanum vulgare

Bacto-Cand GI capsules

Paeonia 1:2

EndoFem tablets

FibroFem tablets

PolyFem tablets

Korean Ginseng 1:2

PhytoRegenex tablets

Rhodiola & Ginseng tablets

Wild Yam Complex tablets

Withania & Ginseng tablets

Withania Complex tablets

Nicotinamide (Vitamin B3)

Nicotinic acid (Vitamin B3) Nigella sativa

P Paeonia lactiflora

Panax ginseng

Product Catalogue

Herb Botanical Name/Nutrient Name

Product

Page

Panax notoginseng

Tienchi Ginseng 1:2

Passiflora incarnata

Passionflower 1:2

Valerian Complex tablets

Pelargonium sidoides

Pelargonium 1:5

Phellodendron amurense

Bacto-Cand GI capsules

Phellodendron Forte tablets

Phytolacca americana, Phytolacca decandra

Poke Root 1:5

Phytomenadione (Vitamin K1)

Calcium Bone Complex powder

Everyday B Multi tablets

Vital Woman tablets

Pimpinella anisum

Bacto-Cand GI capsules

Piper methysticum

Kava 1:1

Kava tablets

Jamaica Dogwood 1:2

Nervagesic tablets

Plantago lanceolata

Ribwort 1:2

Polygonum cuspidatum, Fallopia japonica

PhytoRegenex tablets

Poly-C Powder

Vital Woman tablets

Potassium citrate

Mega Mag powder

Potassium iodide

Everyday B Multi tablets

ThyAdren Support tablets

Vital Woman tablets

Potassium phosphate-dibasic

Active Mag-Cal tablets

Potassium phosphate-monobasic

Everyday B Multi tablets

Potassium sulfate

P2-Detox powder

Propolis

Propolis 1:5

Prunus serotina

Wild Cherry 1:2

Pueraria lobata

Calcium Bone Complex powder

Pyridoxine hydrochloride (Vitamin B6)

Active Mag-Cal tablets

Everyday B Multi tablets

Fe-Plex tablets

GlucoBalance tablets

Mega Mag powder

Methyl Factors tablets

NeuroSom tablets

ThyAdren Support tablets

Vital Woman tablets

Piscidia piscipula

Zinc Protect tablets

Fe-Max Iron Tonic Phytosynergist速 liquid

Fe-Plex tablets

Mega Mag Powder

Methyl Factors tablets

ThyAdren Support tablets

Quercetin

Poly-C Powder

Quercetin dihydrate

LymphoLytix tablets

Rehmannia 1:2

Adrenal Complex tablets

Rehmannia Complex tablets

ThyAdren Support tablets

Pyridoxal 5-phosphate (Activated Vitamin B6)

Indexes

R Rehmannia glutinosa

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Herb Botanical Name/Nutrient Name

Product

Page

Everyday B Multi tablets

Vital Woman tablets

Cascara 1:2

Cascara Complex tablets

Rheum palmatum

Sheep Sorrel Combination tablets

Rhodiola rosea

Rhodiola 2:1

Rhodiola & Ginseng tablets

Rhodiola & Schisandra tablets

Ribes nigrum

Activated Beet-Greens powder

Riboflavine (Vitamin B2)

Everyday B Multi tablets

Fe-Plex tablets

Mega Mag powder

ThyAdren Support tablets

R Retinyl palmitate (Vitamin A) Rhamnus purshianus, Frangula purshiana

Riboflavine sodium phosphate (Activated Vitamin B2)

Rosmarinus officinalis

Vital Woman tablets

Fe-Max Iron Tonic Phytosynergist® liquid

Everyday B Multi tablets

Fe-Plex tablets

Mega Mag Powder

ThyAdren Support tablets

Rosemary 1:2

Bacopa Complex tablets

LivCo tablets

Vitanox® tablets

Raspberry Leaves 1:2

Cramplex tablets

Rumex acetosella

Sheep Sorrel Combination tablets

Rumex crispus

Yellow Dock 1:2

Cascara Complex tablets

Clivers Complex tablets

Butcher’s Broom 1:2

Horsechestnut Complex tablets

Poly-C Powder

Willow Bark 1:2

Saligesic tablets

Sage 1:2

Wild Yam Complex tablets

Herbal Throat Spray

Salvia miltiorrhiza

Dan Shen 1:2

Sambucus nigra

Elder Flowers 1:2

Schisandra chinensis

Schisandra 1:2

Bacopa Complex tablets

Rubus idaeus

Ruscus aculeatus Rutin

S Salix purpurea, Salix spp. Salvia fruticosa

LivCo tablets

Nevaton® tablets

Rhodiola & Schisandra tablets

Baical Skullcap 1:2

Albizia Complex tablets

PulmaCo tablets

Scutellaria baicalensis

Scutellaria lateriflora

100

Product Catalogue

Skullcap 1:2

Nevaton® tablets

Withania Complex tablets

Herb Botanical Name/Nutrient Name

Product

Page

Everyday B Multi tablets

GlucoBalance tablets

Joint Defence tablets

Mega Mag powder

ThyAdren Support tablets

Vital Woman tablets

Zinc Protect tablets

Senna alexandrina

Senna Pods 1:2

Serenoa repens

Saw Palmetto 1:2

ProstaCo capsules

St Mary’s Thistle 2:1

St Mary’s Thistle 1:1 Glycetract

Silymarin tablets

S Selenium (Selenomethionine)

Silybum marianum

DiGest tablets

LivCo® tablets

Livton® Complex tablets

PhytoRegenex tablets

Sarsaparilla 1:2

Clivers Complex tablets

Sodium ascorbate (Vitamin C)

Poly-C Powder

Solidago virgaurea

Golden Rod 1:2

Smilax ornata

Eyebright Complex tablets

Spirulina maxima

Activated Beet-Greens powder

Stachys betonica, Stachys officinalis

Wood Betony 1:2

Stemona sessilifolia

Wormwood Complex tablets

Stevia rebaudiana

Flavouring Mixture

Syzygium aromaticum

Wormwood Complex tablets

Herbal Throat Spray

Feverfew 1:5

Albizia Complex tablets

Rehmannia Complex tablets

Mega Mag powder

P2-Detox powder

Dandelion Leaves 1:1

Dandelion Root 1:2

Cascara Complex tablets

Tanacetum parthenium

Taurine Taraxacum officinale

Thiamine hydrochloride (Vitamin B1)

DiGest tablets

Livton® Complex tablets

Fe-Plex tablets

Mega Mag powder

ThyAdren Support tablets

Vital Woman tablets

Thiamine nitrate (Vitamin B1)

Everyday B Multi tablets

Thuja occidentalis

Thuja 1:5

FibroFem tablets

PolyFem tablets

Thymus vulgaris

Tilia cordata

Thyme 1:2

Broncafect® tablets and Phytosynergist® liquid

ResCo® tablets

Lime Flowers 1:2

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Indexes

101

Herb Botanical Name/Nutrient Name

Product

Page

Mega Mag powder

Omega-3 Forte capsules

Vital Woman tablets

Tribulus 2:1

Tribulus Forte tablets

Red Clover flowering tops 1:2

Red Clover flowers 1:2

Trigonella foenum-graecum

Fenugreek 1:2

Trillium erectum

Beth Root 1:2

Turnera diffusa

Damiana 1:2

T Tocopherols concentrate – mixed (low alpha type)

Tribulus terrestris Trifolium pratense

Nevaton tablets

ThyAdren Support tablets

Ubiquinol-10

Ubiquinol Forte capsules

Ulmus rubra

Slippery Elm 400mg capsules

Sheep Sorrel Combination tablets

Cat’s Claw 1:2

Cat’s Claw Forte tablets

Nettle Leaf 1:2

Nettle Root 1:2

Tyrosine

Uncaria tomentosa Urtica dioica

ProstaCo capsules

Fe-Max Iron Tonic Phytosynergist liquid

Vaccinium corymbosum

Activated Beet-Greens powder

Vaccinium macrocarpon

Cranberry Complex tablets

Vaccinium myrtillus

Bilberry 1:1

Bilberry tablets

Mexican Valerian 1:2

Mexican Valerian tablets

Valerian 1:2

Valerian Complex tablets

Valeriana edulis Valeriana officinalis Verbascum thapsus

Mullein 1:2

ResCo® tablets and Phytosynergist® liquid

Verbena officinalis

Vervain 1:2

Viburnum opulus

Cramp Bark 1:2

Cramplex tablets

Viola odorata

Violet Leaves 1:2

Viscum album

Mistletoe 1:2

Vitamin A

Everyday B Multi tablets

Fe-Plex tablets

Mega Mag powder

(Retinyl palmitate)

Vitamin B1 (Thiamine hydrochloride)

ThyAdren Support tablets

Fe-Max Iron Tonic Phytosynergist liquid ®

(Thiamine nitrate)

Vitamin B2 (Riboflavine)

102

Product Catalogue

Everyday B Multi tablets

Fe-Plex tablets

Mega Mag powder

ThyAdren Support tablets

Fe-Max Iron Tonic Phytosynergist® liquid

Herb Botanical Name/Nutrient Name

Product

Page

Everyday B Multi tablets

GlucoBalance tablets

Mega Mag powder

ThyAdren Support tablets

Everyday B Multi tablets

GlucoBalance tablets

Everyday B Multi tablets

GlucoBalance tablets

ThyAdren Support tablets

Active Mag-Cal tablets

Everyday B Multi tablets

Fe-Plex tablets

GlucoBalance tablets

Mega Mag powder

Methyl Factors tablets

ThyAdren Support tablets

Vitamin B3 (Nicotinamide)

(Nicotinic acid)

Vitamin B5 (Calcium pantothenate)

Vitamin B6 (Pyridoxine hydrochloride)

Vitamin B12 (Cyanocobalamin)

Vitamin C

(Ascorbic acid)

Zinc Protect tablets

Fe-Max Iron Tonic Phytosynergist速 liquid

Everyday B Multi tablets

Fe-Plex tablets

GlucoBalance tablets

Mega Mag powder

Methyl Factors tablets

ThyAdren Support tablets

Fe-Max Iron Tonic Phytosynergist速 liquid

Active Mag-Cal tablets

Everyday B Multi tablets

Fe-Plex tablets

Joint Defence tablets

LymphoLytix tablets

Mega Mag powder

Poly-C Powder

ThyAdren Support tablets

Zinc Protect tablets

Fe-Max Iron Tonic Phytosynergist速 liquid

(Calcium ascorbate monohydrate)

Poly-C Powder

(Magnesium ascorbate)

Poly-C Powder

(Sodium ascorbate)

Poly-C Powder

(Zinc ascorbate)

Mega Mag powder

Poly-C Powder

Active Mag-Cal tablets

Calcium Bone Complex powder

Everyday B Multi tablets

ThyAdren Support tablets

EFA Essentials capsules

Everyday B Multi tablets

Mega Mag powder

Omega-3 Forte capsules

ThyAdren Support tablets

Zinc Protect tablets

Vitamin E Cream Base

Vitamin D3 (Cholecalciferol)

Vitamin E

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Indexes

103

Herb Botanical Name/Nutrient Name

Product

Page

Vitamin H (Biotin)

Everyday B Multi tablets

Vitamin K1 (Phytomenadione)

Calcium Bone Complex powder

Vitamin K2 (Menaquinone 7)

Everyday B Multi tablets

Vitex agnus-castus

Chaste Tree 1:2

Chaste Tree tablets

Vital Woman tablets

Activated Beet-Greens powder

LymphoLytix tablets

PhytoRegenex tablets

Tissue Regenex tablets

Vitanox tablets

Whey protein concentrate/whey protein isolate blend

Everyday Balance Protein Powder (Smooth Vanilla)

Withania somnifera

Withania 2:1

Activated Beet-Greens powder

Fe-Plex tablets

ThyroCo tablets

Withania & Ginseng tablets

Vitis vinifera

Withania Complex tablets

Fe-Max Iron Tonic Phytosynergist® liquid

Everyday Balance Protein Powder (Smooth Vanilla)

Zanthoxylum clava-herculis

Prickly Ash 1:2

Zea mays

Corn Silk 1:1

Zinc (Zinc gluconate)

Active Mag-Cal tablets

Everyday B Multi tablets

GlucoBalance tablets

Joint Defence tablets

Tissue Regenex tablets

Calcium Bone Complex powder

Vital Woman tablets

Zinc Protect tablets

Mega Mag powder

Zinc Protect tablets

Poly-C Powder

ThyAdren Support tablets

Ginger 1:2

X Xylitol

(Zinc amino acid chelate)

(Zinc ascorbate) (Zinc ascorbate monohydrate)

Zingiber officinale

Ziziphus jujuba var. spinosa

104

Product Catalogue

Boswellia Complex tablets

Broncafect® tablets and Phytosynergist® liquid

Cramplex tablets

DiGest tablets

LymphoLytix tablets

ResCo® tablets and Phytosynergist® liquid

Fe-Max Iron Tonic Phytosynergist® liquid

Zizyphus 1:2

NeuroSom tablets

Valerian Complex tablets

Index of Herb Common Names Botanical Name

Common Name

Botanical Name

Acerola

Malpighia glabra

Corn Silk

Zea mays

Adhatoda

Adhatoda vasica, Justicia adhatoda

Corydalis

Corydalis ambigua, Corydalis turtschaninovii

Agrimony

Agrimonia eupatoria

Couch Grass

Elymus repens

Albizia

Albizia lebbeck

Cramp Bark

Viburnum opulus

Aloe Vera

Aloe spp.

Cranberry

Vaccinium macrocarpon

Andrographis

Andrographis paniculata

Crataeva

Crataeva nurvala, Crateva nurvala

Anise, Aniseed

Pimpinella anisum

Arnica

Arnica montana

Damiana

Turnera diffusa

Astragalus

Astragalus membranaceus

Dan Shen

Salvia miltiorrhiza

Dandelion

Taraxacum officinale

B Bacopa

Bacopa monniera, Bacopa monnieri

Devil’s Claw

Harpagophytum procumbens

Baical Skullcap

Scutellaria baicalensis

Dill Seed

Anethum graveolens

Baptisia

Baptisia tinctoria

Dong Quai

Angelica sinensis, Angelica polymorpha

Barberry

Berberis vulgaris

Bearberry

Arctostaphylos uva-ursi

Echinacea

Echinacea angustifolia, Echinacea purpurea

Beet

Beta vulgaris

Elder Flower

Sambucus nigra

Beth Root

Trillium erectum

Elecampane

Inula helenium

Bilberry

Vaccinium myrtillus

Euphorbia

Euphorbia hirta

Black Cohosh

Actaea racemosa, Cimicifuga racemosa

Evening Primrose

Oenothera biennis

Blackcurrant

Ribes nigrum

Eyebright

Euphrasia officinalis

Black Walnut

Juglans nigra

Bladderwrack

Fucus vesiculosus

False Unicorn

Chamaelirium luteum

Blue Cohosh

Caulophyllum thalictroides

Fennel

Foeniculum vulgare

Blue Flag

Iris versicolor

Fenugreek

Trigonella foenum-graecum

Blueberry

Vaccinium corymbosum

Feverfew

Tanacetum parthenium

Boswellia

Boswellia serrata

Fringe Tree

Chionanthus virginica

Broccoli

Brassica oleracea

Buchu

Agathosma betulina, Barosma betulina

Garlic

Allium sativum

Bugleweed

Lycopus spp.

Gentian

Gentiana lutea

Bupleurum

Bupleurum falcatum

Giant Knotweed

Fallopia japonica, Polygonum cuspidatum

Burdock

Arctium lappa

Ginger

Zingiber officinale

Butcher’s Broom

Ruscus aculeatus

Ginkgo

Ginkgo biloba

Butternut

Juglans cinerea

Globe Artichoke

Cynara scolymus

Goat’s Rue

Galega officinalis

C Calendula

Calendula officinalis

Golden Rod

Solidago virgaurea

Californian Poppy

Eschscholzia californica

Golden Seal

Hydrastis canadensis

Cascara

Frangula purshiana, Rhamnus purshianus

Gotu Kola

Centella asiatica

Cat’s Claw

Uncaria tomentosa

Grape Seed

Vitis vinifera

Cayenne

Capsicum spp., Capsicum annuum

Gravel Root

Eupatorium purpureum

Celery Seed

Apium graveolens

Greater Celandine

Chelidonium majus

Chamomile

Matricaria chamomilla

Green Tea

Camellia sinensis

Chaste Tree

Vitex agnus-castus

Grindelia

Grindelia camporum

Chen Pi

Citrus reticulata

Gymnema

Gymnema sylvestre

Chlorella

Chlorella pyrenoidosa

Cinnamon Quills

Cinnamomum cassia

Hawthorn

Crataegus monogyna

Clivers

Galium aparine

Hemidesmus

Hemidesmus indicus

Clove

Syzygium aromaticum

Holy Basil

Ocimum tenuiflorum

Codonopsis

Codonopsis pilosula

Hops

Humulus lupulus

Coleus

Coleus forskohlii

Horsechestnut

Aesculus hippocastanum

Horseradish

Armoracia rusticana

Horsetail

Equisetum arvense

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Indexes

Common Name

105

Common Name

Botanical Name

J Jamaica Dogwood

Botanical Name

S Piscidia piscipula

Saffron

Crocus sativus

Sage

Salvia fruticosa

Kava

Piper methysticum

Sarsaparilla

Smilax ornata

Kiwi Fruit

Actinidia deliciosa

Saw Palmetto

Serenoa repens

Korean Ginseng

Panax ginseng

Schisandra

Schisandra chinensis

Kudzu

Pueraria lobata

Senna

Senna alexandrina

Shatavari

Asparagus racemosus

L Ladies Mantle

Alchemilla vulgaris

Sheep Sorrel

Rumex acetosella

Lavender

Lavandula angustifolia

Shepherd’s Purse

Capsella bursa-pastoris

Lemon Balm

Melissa officinalis

Siberian Ginseng

Eleutherococcus senticosus

Licorice

Glycyrrhiza glabra

Skullcap

Scutellaria lateriflora

Lime Flowers

Tilia cordata

Slippery Elm

Ulmus rubra

Spirulina

Spirulina maxima

Marshmallow Root

Althaea officinalis

Squaw Vine

Mitchella repens

Meadowsweet

Filipendula ulmaria

Stemona

Stemona sessilifolia

Mexican Valerian

Valeriana edulis

St John’s Wort

Hypericum perforatum

Mistletoe

Viscum album

St Mary’s Thistle

Silybum marianum

Motherwort

Leonurus cardiaca

Sundew

Drosera longifolia

Mullein

Verbascum thapsus

Myrrh

Commiphora myrrha

Thuja

Thuja occidentalis

Thyme

Thymus vulgaris

N Nettle

Urtica dioica

Tienchi Ginseng

Panax notoginseng

Nigella

Nigella sativa

Tribulus

Tribulus terrestris

True Unicorn

Aletris farinosa Curcuma longa

O Oats

Avena sativa

Turmeric

Olive leaf

Olea europaea

Oregano

Origanum vulgare

Valerian

Valeriana officinalis

Oregon Grape

Berberis aquifolium

Vervain

Verbena officinalis

Violet

Viola odorata

P Paeonia

Paeonia lactiflora

Pasque Flower

Anemone pulsatilla

White Horehound

Marrubium vulgare

Passionflower

Passiflora incarnata

Wild Cherry

Prunus serotina

Pelargonium

Pelargonium sidoides

Wild Yam

Dioscorea villosa

Peppermint

Mentha x piperita

Willow Bark

Salix purpurea, Salix spp.

Phellodendron

Phellodendron amurense

Willow Herb

Epilobium parviflorum

Pleurisy Root

Asclepias tuberosa

Withania

Withania somnifera

Poke Root

Phytolacca americana, Phytolacca decandra

Wood Betony

Stachys betonica, Stachys officinalis

Prickly Ash

Zanthoxylum clava-herculis

Wormwood

Artemisia absinthium

Psyllium

Plantago psyllium

Q Qing Hao

Artemisia annua

106

Common Name

Achillea millefolium

Yellow Dock

Rumex crispus

Raspberry

Rubus idaeus

Red Clover

Trifolium pratense

Rehmannia

Rehmannia glutinosa

Rhodiola

Rhodiola rosea

Rhubarb

Rheum palmatum

Ribwort

Plantago lanceolata

Rosemary

Rosmarinus officinalis

Product Catalogue

Yarrow

Zizyphus

Ziziphus jujuba var. spinosa

Index of Herb Botanical Names Common Name

Botanical Name

Common Name

Achillea millefolium

Yarrow

Cinnamomum cassia

Cinnamon Quills

Actaea racemosa, Cimicifuga racemosa

Black Cohosh

Citrus reticulata

Chen Pi

Actinidia deliciosa

Kiwi Fruit

Codonopsis pilosula

Codonopsis

Adhatoda vasica, Justicia adhatoda

Adhatoda

Coleus forskohlii

Coleus

Aesculus hippocastanum

Horsechestnut

Commiphora molmol

Myrrh

Agathosma betulina, Barosma betulina

Buchu

Corydalis ambigua, Corydalis turtschaninovii

Corydalis

Agrimonia eupatoria

Agrimony

Crataegus monogyna

Hawthorn

Albizia lebbeck

Albizia

Crataeva nurvala, Crateva nurvala

Crataeva

Alchemilla vulgaris

Ladies Mantle

Curcuma longa

Turmeric

Aletris farinosa

True Unicorn

Cynara scolymus

Globe Artichoke

Allium sativum

Garlic

Aloe spp.

Aloe Vera

Dioscorea villosa

Wild Yam

Althaea officinalis

Marshmallow Root

Drosera longifolia

Sundew

Andrographis paniculata

Andrographis

Anemone pulsatilla

Pasque Flower

Echinacea angustifolia, Echinacea purpurea

Echinacea

Anethum graveolens

Dill Seed

Eleutherococcus senticosus

Siberian Ginseng

Angelica sinensis, Angelica polymorpha

Dong Quai

Elymus repens

Couch Grass

Apium graveolens

Celery Seed

Epilobium parviflorum

Willow Herb

Arctium lappa

Burdock

Equisetum arvense

Horsetail

Arctostaphylos uva-ursi

Bearberry

Eschscholzia californica

Californian Poppy

Armoracia rusticana

Horseradish

Eupatorium purpureum

Gravel Root

Arnica montana

Arnica

Euphorbia hirta

Euphorbia

Artemisia absinthium

Wormwood

Euphrasia officinalis

Eyebright

Artemisia annua

Qing Hao

Asclepias tuberosa

Pleurisy Root

Fallopia japonica, Polygonum cuspidatum

Giant Knotweed

Asparagus racemosus

Shatavari

Filipendula ulmaria

Meadowsweet

Astragalus membranaceus

Astragalus

Foeniculum vulgare

Fennel

Avena sativa

Oats

Frangula purshiana, Rhamnus purshianus

Cascara

Fucus vesiculosus

Bladderwrack

B Bacopa monniera, Bacopa monnieri

Bacopa

Baptisia tinctoria

Baptisia

Galega officinalis

Goat’s Rue

Barosma betulina, Agathosma betulina

Buchu

Galium aparine

Clivers

Berberis aquifolium

Oregon Grape

Gentiana lutea

Gentian

Berberis vulgaris

Barberry

Ginkgo biloba

Ginkgo

Beta vulgaris

Beet

Glycyrrhiza glabra

Licorice

Boswellia serrata

Boswellia

Grindelia camporum

Grindelia

Brassica oleracea

Broccoli

Gymnema sylvestre

Gymnema

Bupleurum falcatum

Bupleurum

Harpagophytum procumbens

Devil’s Claw

Calendula officinalis

Calendula

Hemidesmus indicus

Hemidesmus

Camellia sinensis

Green Tea

Humulus lupulus

Hops

Capsella bursa-pastoris

Shepherd’s Purse

Hydrastis canadensis

Golden Seal

Capsicum annuum, Capsicum spp.

Cayenne

Hypericum perforatum

St John’s Wort

Caulophyllum thalictroides

Blue Cohosh

Centella asiatica

Gotu Kola

Inula helenium

Elecampane

Chamaelirium luteum

False Unicorn

Iris versicolor

Blue Flag

Chelidonium majus

Greater Celandine

Chlorella pyrenoidosa

Chlorella

Chionanthus virginica

Fringe Tree

Cimicifuga racemosa, Actaea racemosa

Black Cohosh

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Indexes

Botanical Name

107

Botanical Name

Common Name

Botanical Name

Common Name

Juglans cinerea

Butternut

Salix purpurea, Salix spp.

Willow Bark

Juglans nigra

Black Walnut

Salvia miltiorrhiza

Dan Shen

Justicia adhatoda, Adhatoda vasica

Adhatoda

Salvia fruticosa

Sage

Sambucus nigra

Elder Flower

L Lavandula angustifolia, Lavandula x intermedia

Lavender

Schisandra chinensis

Schisandra

Leonurus cardiaca

Motherwort

Scutellaria baicalensis

Baical Skullcap

Lycopus spp.

Bugleweed

Scutellaria lateriflora

Skullcap

Senna alexandrina

Senna

M Malpighia glabra

Acerola

Serenoa repens

Saw Palmetto

Marrubium vulgare

White Horehound

Silybum marianum

St Mary’s Thistle

Matricaria chamomilla

Chamomile

Smilax ornata

Sarsaparilla

Melissa officinalis

Lemon Balm

Solidago virgaurea

Golden Rod

Mentha x piperita

Peppermint

Spirulina maxima

Spirulina

Mitchella repens

Squaw Vine

Stachys betonica, Stachys officinalis

Wood Betony

Stemona sessilifolia

Stemona Clove

O Ocimum tenuiflorum

Holy Basil

Syzygium aromaticum

Oenothera biennis

Evening Primrose

Olea europaea

Olive leaf

Tanacetum parthenium

Feverfew

Origanum vulgare

Oregano

Taraxacum officinale

Dandelion

Thuja occidentalis

Thuja

P Paeonia lactiflora

Paeonia

Thymus vulgaris

Thyme

Panax ginseng

Korean Ginseng

Tilia cordata

Lime Flowers

Panax notoginseng

Tienchi Ginseng

Tribulus terrestris

Tribulus

Passiflora incarnata

Passionflower

Trifolium pratense

Red Clover

Pelargonium sidoides

Pelargonium

Trigonella foenum-graecum

Fenugreek

Phellodendron amurense

Phellodendron

Trillium erectum

Beth Root

Phytolacca americana, Phytolacca decandra Poke Root

Turnera diffusa

Damiana

Pimpinella anisum

Anise, Aniseed

Piper methysticum

Kava

Ulmus rubra

Slippery Elm

Piscidia piscipula

Jamaica Dogwood

Uncaria tomentosa

Cat’s Claw

Plantago lanceolata

Ribwort

Urtica dioica

Nettle

Plantago psyllium

Psyllium

Polygonum cuspidatum, Fallopia japonica

Giant Knotweed

Vaccinium corymbosum

Blueberry

Prunus serotina

Wild Cherry

Vaccinium macrocarpon

Cranberry

Pueraria lobata

Kudzu

Vaccinium myrtillus

Bilberry

Valeriana edulis

Mexican Valerian

R Rehmannia glutinosa

Rehmannia

Valeriana officinalis

Valerian

Rhamnus purshianus, Frangula purshiana

Cascara

Verbascum thapsus

Mullein

Rheum palmatum

Rhubarb

Verbena officinalis

Vervain

Rhodiola rosea

Rhodiola

Viburnum opulus

Cramp Bark

Ribes nigrum

Blackcurrant

Viola odorata

Violet

Rosmarinus officinalis

Rosemary

Viscum album

Mistletoe

Rubus idaeus

Raspberry

Vitex agnus-castus

Chaste Tree

Rumex acetosella

Sheep Sorrel

Vitis vinifera

Grape Seed

Rumex crispus

Yellow Dock

Ruscus aculeatus

Butcher’s Broom

Withania somnifera

Withania

108

Product Catalogue

Zanthoxylum clava-herculis

Prickly Ash

Zea mays

Corn Silk

Zingiber officinale

Ginger

Ziziphus jujuba var. spinosa

Zizyphus

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109

Potential Interaction

Potentiation of bleeding.

Statin drugs eg atorvastatin

HDI Chart

May potentiate increase in liver enzymes, specifically ALT.

Black Cohosh Actaea racemosa (Cimicifuga racemosa)

Warfarin

Bilberry Vaccinium myrtillus

Drugs that displace the protein binding of bilirubin eg phenylbutazone

May potentiate effect of drug on displacing bilirubin.

May decrease drug levels.

Rosuvastatin

BarberryC Berberis vulgaris

May increase drug levels.

Losartan

Baical Skullcap Scutellaria baicalensis

Drug

Case report.8

Herb Alone Antiplatelet activity observed in healthy volunteers (173 mg/day of bilberry anthocyanins).4 Case report of postoperative bleeding (bilberry extract undefined).5 Herb or Constituent and Drug Uncontrolled trial (600 mg/day of bilberry anthocyanins + 30 mg/day of vitamin C for 2 months then reduced maintenance dose) of 9 patients taking anticoagulant drugs – treatment reduced retinal haemorrhages without impairing coagulation.6 Case report (patient reported to consume “large amounts of bilberry fruits every day for five years”).7

Herb Alone Theoretical concern based on in vitro data (displaced bilirubin from albumin) and in animals with high dose of berberine by injection (reduced bilirubin serum protein binding).3

Clinical study with healthy volunteers using 150 mg/day of isolated constituent (baicalin).2

Monitor (low level of risk).

Monitor at high doses (> 100 mg/day anthocyanins, low level of risk).

Monitor (low level of risk).

Monitor (low level of risk).B

Monitor (low level of risk at typical doses).

Recommended Action

A recommended action is suggested on a risk assessment of the information in the Basis of Concern. In these examples:  It is recommended that St John’s wort is contraindicated in patients taking cancer chemotherapeutic drugs.  In the case of gliclazide, because the trial found little effect on a clinically-relevant outcome, the potential interaction is considered low risk and a caution is recommended: the patient should be monitored, through the normal process of repeat consultations. For more information on the process used to assess the herb-drug interaction research (and why some research is not included), how the risk of interaction is assessed, with worked examples from the chart: go to www.mediherb.com.au and view the Herb-Drug Interaction Chart under the ‘Education’ tab, look for the link to ‘Prescribing Guidelines & Assessment of Risk’.

Clinical trial with healthy volunteers (water-based extract,A dried herb equivalent: 12 g/day).1

Basis of Concern

The chart is read from left to right. The information in the Basis of Concern column provides the evidence for the information in the Potential Interaction column. For example, clinical studies found that administration of St John’s wort resulted in decreased levels of cancer chemotherapeutic drugs. (Italicised words represent the information in the Herb-Drug Interaction chart below.) Sometimes more details are provided in the Basis of Concern column. For example, in a clinical study with healthy volunteers administration of St John’s wort resulted in increased clearance of the hypoglycaemic drug gliclazide, and so may reduce the drug’s efficacy, however, glucose and insulin response to glucose loading was unchanged.

How to Read the Chart

Potential Herb-Drug Interactions for Commonly Used Herbs*

110

Product Catalogue

May add to effect of drug.

Thyroid replacement therapies eg thyroxine

Case report, in a patient with cirrhosis being evaluated for a liver transplant.13

Theoretical concern based on deliberations of German Commission E.

Case report.

May alter response to drug.

May potentiate effects of drug.

Antiplatelet and anticoagulant drugs

Hypotensive medication

Prescribed medication

Coleus Coleus forskohlii

Thyroxine

May reduce serum levels of thyroxine.

May increase absorption and drug level.

Theophylline

Celery Seed Apium graveolens

May cause drug-induced cough.

ACE inhibitor

Theoretical concern based on ability of forskolin to activate increased intracellular cyclic AMP in vitro.23

Theoretical concern based on ability of high doses of forskolin and standardised Coleus extract to lower blood pressure in normotensive and hypertensive animals.19,20 Clinical data from weight management trials: no effect on blood pressure in three trials, trend toward lower blood pressure in one small study.21,22 No experimental or clinical studies conducted with hypotensive medication.

Theoretical concern initially based on in vitro antiplatelet activity of active constituent forskolin, and in vivo antiplatelet activity in an animal model (oral doses: standardised Coleus extract and forskolin).17 More recent in vivo animal research: standardised Coleus extract reduced the anticoagulant activity of warfarin.18

Case reports.16

Clinical study (healthy volunteers, chilli-spiced meal). Absorption and drug level lower than during fasting.

Case report (topical capsaicin). Theoretical concern since capsaicin depletes substance P.14 15

Theoretical concern linked to a case report where “kelp” caused hyperthyroidism in a person not taking thyroxine.10

Theoretical concern, no cases reported.

Basis of Concern

Cayenne (Chilli Pepper) Capsicum spp. (See also Polyphenol-containing herbs)

HIV protease inhibitors

May increase drug level.

Should not be administered concurrently with preparations containing thyroid hormone.12

Thyroid hormones

Cat’s Claw Uncaria tomentosa

May interfere with administration of diagnostic procedures using radioactive isotopes.11

Radioactive iodine

Bugleweed Lycopus virginicus, Lycopus europaeus

May decrease effectiveness of drug due to natural iodine content.9

Potential Interaction

Hyperthyroid medication eg carbimazole

Bladderwrack Fucus vesiculosus

Drug

Monitor (low level of risk).

Monitor (very low level of risk).

Monitor (low level of risk).

Monitor (very low level of risk).

Monitor (low level of risk).

Contraindicated.

Monitor (low level of risk).

Contraindicated unless under close supervision.

Recommended Action

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111

Potential Interaction

May increase side effects of drug.

May alter INR (most frequently increase).

Simvastatin

Warfarin

May potentiate effect of drug.

Warfarin

May increase bleeding tendency.

May potentiate effect of drug.

Phenothiazines

HDI Chart

May decrease effectiveness of drug.

Evening Primrose Oil Oenothera biennis

Decreases drug levels when drug administered intravenously.G

Midazolam

Reports of worsening epilepsy in schizophrenics. No causal association demonstrated and no effect observed in later trials.52

Clinical study (E. purpurea root, 1.6 g/day).51

Theoretical concern based on immune-enhancing activity of Echinacea. No cases reported.

Clinical trial (E. purpurea root; HIV-infected patients): no effect overall, but some patients showed a decrease by as much as 40%. All maintained an undetectable viral load. (Patients were also taking a low dose of ritonavir.)48

HIV protease inhibitors eg darunavir May decrease drug levels.

May decrease effectiveness of drug.49,50

Clinical trial (E. purpurea root; HIV-infected patients): no effect overall, but large interindividual variability occurred (from near 25% decreases to up to 50% increases in drug concentrations). All maintained an undetectable viral load.47

Case reports: increased INR and PT;45 increased INR and widespread bruising.46

Case report (purpura) with very few details.44 Unlikely to occur.

Case reports: increased INR.41-43

Clinical trial with healthy volunteers.40

Case reports (where reported the dosage was often high: up to 2000 mL/day, juice strength undefined; 1.5–2 quarts (1420–1893 mL)/day of cranberry juice cocktail; 113 g/day, cranberry sauce).27-35 Clinical trials: no significant effect found in atrial fibrillation patients (250 mL/day cranberry juice cocktail),36 in patients on warfarin for a variety of indications (8 oz (236 mL)/day cranberry juice cocktail),37 but increase was observed in healthy volunteers (juice concentrate equivalent to 57 g of dry fruit/day).38 No alteration of prothrombin time in patients on stable warfarin therapy (480 mL/day cranberry juice)39 or of thromboplastin time in healthy volunteers (600 mL/day cranberry juiceF).25 See also note D.

Case report (355–473 mL/day cranberry juice drink (7% juice), rated as ‘possible’ interaction).26

Clinical trials with healthy volunteers: effect on drug levels conflicting – increased (double-strength juiceD, 240 mL tds; defined as a weak interactionE)24 and no effect (cranberry juice,F 200 mL tds).25

Basis of Concern

HIV non-nucleoside transcriptase inhibitors eg etravirine: May alter drug levels.

Immunosuppressant medication

Antiretroviral drugs

Echinacea Echinacea angustifolia, Echinacea purpurea

Warfarin

Dong Quai Angelica sinensis, Angelica polymorpha

Warfarin

Devil’s Claw Harpagophytum spp.

May decrease drug levels.

Midazolam

Dan Shen Salvia miltiorrhiza

May increase drug levels.

Midazolam

Cranberry Vaccinium macrocarpon

Drug

Monitor (very low level of risk).

Monitor (medium level of risk) when drug administered intravenously.

Contraindicated.

Monitor (low level of risk).

Monitor (very low level of risk).

Contraindicated.

Monitor (medium level of risk).

Monitor (low level of risk at typical doses).

Monitor (low level of risk).

Recommended Action

112

Product Catalogue

Potential Interaction

Decreases drug level.

HIV protease inhibitors

Clinical study (1 g/day, dried ginger) in healthy volunteers and hypertensive patients.80

Warfarin: Increased risk of spontaneous bleeding.

May produce a synergistic antiplatelet effect.

Concern based on antiplatelet activity and potential to inhibit thromboxane synthetase. Herb Alone Clinical studies: inhibition of platelet aggregation (5 g, divided single dose, dried ginger) in healthy volunteers,73 and coronary artery disease patients (10 g, single dose, dried ginger),74 but no effect in healthy volunteers (2 g, single dose, dried ginger),75 or coronary artery disease patients (4 g/day, dried ginger);74 inhibition of platelet thromboxane production in healthy volunteers (5 g/day, fresh ginger).76 Herb and Drug Case report: bleeding (ginger dosage undefined).77 No pharmacokinetic or pharmacodynamic effect demonstrated in a clinical trial with healthy volunteers (3.6 g/day, dried ginger).78 Epidemiological study: ginger (as a complementary medicine) was significantly associated with an increased risk of self-reported bleeding in patients taking warfarin.79 These results should be viewed cautiously (see note J).

Phenprocoumon: May increase effectiveness of drug.

Antiplatelet and anticoagulant drugs

Nifedipine

Case report (dosage undefined): increased INR.72

May decrease effectiveness of drug.

Theoretical concern since ginger increases gastric secretory activity in vivo (animals).49

Saquinavir: Two clinical studies (garlic extract, standardised for allicin content) with healthy volunteers69,70 – large variability (in one study,70 decrease (15%) was not significant). Ritonavir-boosted atazanavir: Case report (6 stir-fried garlic cloves three times per week).71

Concern may be overstated, as antiplatelet/anticoagulant drugs are often coadministered eg aspirin and warfarin. Herb Alone Case reports of increased bleeding tendency with high garlic intake. In three of the four cases the bleeding occurred after surgery.53-56 Anecdotal: garlic taken shortly before testing interferes with platelet aggregation in control subjects.57 Single-dose studies, and studies demonstrating a beneficial effect on disordered function, including for example, in atherosclerosis, are excluded. Clinical studies (3 g/day or less of fresh garlic): inhibited platelet aggregation in three trials† (about 2.4–2.7 g/day, patients and healthy volunteers),58-60 but no effect on platelet aggregation in one trial† (about 1.8 g/day, patients);61 decreased serum thromboxane in one trial (3 g/day, healthy volunteers)62. † See note H. Clinical studies (4.2–5 g/day of fresh garlic, patients and healthy volunteers): no effect on platelet aggregation, fibrinogen level, prothrombin time, whole blood coagulation time.63-65 Clinical studies (8–10 g/day of fresh garlic, healthy volunteers): inhibited platelet aggregation and increased clotting time.66,67 Herb and Drug Aspirin: No published studies. Clopidogrel: Garlic tablet (“odorless”, dose undefined) added to improve drug therapy, reduced platelet hyperactivity in two patients.57 Warfarin: Two cases of increased INR and clotting times, very few details (garlic pearls, garlic tablets: dosage undefined).68 Clinical trial: no effect in healthy volunteers (enteric-coated tablets equivalent to 4 g/day of fresh garlic).38

Basis of Concern

Antacids

Ginger Zingiber officinale

Aspirin: May increase bleeding time. Clopidogrel: May potentiate effect of drug. Warfarin: May potentiate effect of drug. Large doses could increase bleeding tendency.

Antiplatelet and anticoagulant drugs

Garlic Allium sativum (See also Hypoglycaemic herbs)

Drug

Contraindicated.

Monitor at doses equivalent to < 4 g/day dried ginger (very low risk). Contraindicated unless under close supervision at doses equivalent to > 4 g/day dried ginger.

Monitor at doses equivalent to < 4 g/day dried ginger (low level of risk).

Monitor (low level of risk).

Monitor (medium level of risk).

Monitor at doses equivalent to ≥ 3 g/day fresh garlic (low level of risk). Stop taking at least one week before surgery.

Recommended Action

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113

HDI Chart

Atorvastatin – See Statin drugs below

Monitor (medium level of risk).

Case report.108

HIV non-nucleoside transcriptase inhibitors eg efavirenz: May decrease drug levels.

Prescribe cautiously. Reduce drug if necessary in conjunction with prescribing physician. Monitor (low level of risk).

Randomised, controlled trials (Ginkgo 50:1 extract: 120–360 mg/day, equivalent to 6–18 g/day of dried leaf).103-106

Monitor (low level of risk).

Monitor (medium level of risk). Increasing the intake of vitamin B6 may be advisable for patients taking anticonvulsants.L

Recommended Action

Clinical study with healthy volunteers (Ginkgo 50:1 extract: 240 mg/day, equivalent to 12 g/day of dried leaf) found an increase in plasma levels, due to large interindividual variability, not considered to be of clinical importance. (The drug’s pharmacokinetics are known for considerable intra- and interindividual variability.)107

May potentiate the efficiency of drug in patients with schizophrenia.

Antipsychotic medication eg haloperidol, olanzapine, clozapine

Concern based on antiplatelet activity. Bleeding events associated with Ginkgo alone or in combination with these and other drugs have been reported but a causal relationship was not established conclusively. Although a retrospective population-based study found risk of haemorrhage was associated with elderly patients (65 years or older) who were taking Ginkgo alone.85 Herb Alone Rare case reports of bleeding.86-88 Meta-analysis of randomised, placebo-controlled trials (healthy volunteers and patients): results indicate standardised Ginkgo extract does not increase the risk of bleeding.89 Randomised, 5-year trial (elderly participants; Ginkgo 50:1 extract, 240 mg/day, equivalent to 12 g/day of dried leaf): no significant difference in incidence of haemorrhagic events.90 Herb and Drug Retrospective population-based study in Taiwan: the relative risk of haemorrhage associated with the use of Ginkgo extract combined with drugs (clopidogrel, cilostazol, ticlopidine, warfarin) was not significant.85 See also note M. Aspirin: Case reports (2, bleeding;86 one, extensive bruising after a fall – although possibly high Ginkgo dose (400 mg/day, undefined)).91 Clinical studies: no additional effect on platelet function, platelet aggregation or bleeding time.92-94 Cilostazol: Clinical studies with healthy volunteers (Ginkgo extract (undefined): single dose 120 mg) – bleeding time prolonged; no change in platelet aggregation or clotting time, and no significant correlation between prolongation of bleeding time and inhibition of platelet aggregation;95 no effect on pharmacokinetics or bleeding time, the increase in platelet aggregration was not significant (Ginkgo extract (undefined): 160 mg/day).96 Clopidogrel: Case report (bruising and bleeding).97 Clinical study with healthy volunteers (Ginkgo extract (undefined): single dose 120 mg) – no effect on platelet aggregation, bleeding times.95 Ticlopidine: Case report (bleeding).87 Clinical studies: no significant additional effect on bleeding time or platelet aggregation (Ginkgo 50:1 extract: single dose 80 mg, equivalent to 4 g of dried leaf; healthy volunteers),98 and at the higher dose (120 mg/day) did not affect drug levels;99 increased inhibitory response of platelets to testing with two agonists (ie antiplatelet effect) for drug and herb compared with drug alone, although effect was small and statistical and clinical signficance is unknown (Ginkgo extract (undefined): 160 mg/day; pilot study of patients who had an acute ischaemic stroke or transient ischaemic attack).100 Warfarin: Case report (bleeding).86 Clinical studies (healthy volunteers and patients): no additional effect on INR, platelet aggregation, coagulation parameters or plasma drug level.78,101,102

Case reports, two with well-controlled epilepsy,81 others anecdotal and uncertain.82-84

Basis of Concern

HIV integrase inhibitors eg raltegravir: May alter drug levels

Prolongation of bleeding and/or increased bleeding tendency.

Antiplatelet and anticoagulant drugs

Antiretroviral drugs

May decrease the effectiveness of drug.

Potential Interaction

Anticonvulsant medication eg carbamazepine, sodium valproate

GinkgoK Ginkgo biloba

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Potential Interaction

May decrease drug levels.

May increase drug levels.

Statin drugs

Talinolol

Tolbutamide: May decrease effectiveness of drug.

Omeprazole

Clinical trials with healthy volunteers: nonsignificant reduction in glucose-lowering effect of drug (Ginkgo 50:1 extract: 360 mg/day, equivalent to 18 g/day of dried leaf);111 pharmacokinetics not altered (Ginkgo 50:1 extract: 240 and 360 mg/day).111,113

Pioglitazone: May increase drug level.

Clinical trial with healthy volunteers.122

Atorvastatin: Clinical study with healthy volunteers (Ginkgo 50:1 extract: 360 mg/day, equivalent to 18 g/day of dried leaf). No pharmacodynamic effect was observed.120 Simvastatin: Clinical study with healthy volunteers (Ginkgo 50:1 extract: 240 mg/day, equivalent to 12 g/day of dried leaf) – drug levels decreased, but active metabolite drug levels not affected. Pharmacodynamics (cholesterol lowering) of the drug not significantly affected, although trend towards lowering of LDL-cholesterol efficacy observed.121

Clinical trials with healthy volunteers found conflicting results on drug levels: decreased (Ginkgo 50:1 extract: 280 mg/day, equivalent to 14 g/day of dried leaf);119 and no effect (Ginkgo 50:1 extract: 240 mg/day, equivalent to 12 g/day of dried leaf).113

Clinical studies: mixed results found for mean plasma drug level – increase (120 mg/day, equivalent to 6 g/day of dried leaf)117 and no effect (240 mg/day, equivalent to 12 g/day of dried leaf).118 However, at the higher dose, maximal plasma drug level and heart rate was increased with adverse drug reactions for participants with highest plasma drug levels (headache, dizziness, hot flushes).118

Clinical trial with healthy volunteers (Ginkgo 50:1 extract: 120 mg/day, equivalent to 6 g/day of dried leaf).116

Metformin: May enhance effectiveness of drug.

May increase drug levels or side effects.

Clinical trial: elimination half-life was increased at doses of metformin 850 mg, three times a day. Effect not significant at doses to 500 mg, twice a day. Ginkgo 50:1 extract was administered as a single dose of 120 mg, equivalent to 6 g of dried leaf.114

Glipizide: May cause hypoglycaemia.

Hypoglycaemic drugs

Nifedipine

Observation from aborted trial: hypoglycaemia occurred in volunteers with normal glucose tolerance within 60 minutes.114 Ginkgo 50:1 extract was administered as a single dose of 120 mg, equivalent to 6 g of dried leaf.115

May alter drug level.

Alprazolam: Clinical trial in healthy volunteers found no effect (Ginkgo 50:1 extract: 240 mg/day, equivalent to 12 g/day of dried leaf).109 Diazepam: Clinical trial in healthy volunteers found no effect (Ginkgo 50:1 extract: 240 mg/day, equivalent to 12 g/day of dried leaf).110 Midazolam: Clinical trials in healthy volunteers found conflicting results on drug levels: increased (defined as a weak interactionE; Ginkgo 50:1 extract: 360 mg/day, equivalent to 18 g/day of dried leaf),111 decreased (Ginkgo 50:1 extract: 240 mg/day, equivalent to 12 g/day of dried leaf)112 and no effect (Ginkgo 50:1 extract: 240 mg/day, equivalent to 12 g/day of dried leaf).113

Basis of Concern

Benzodiazepines

GinkgoK Ginkgo biloba (continued)

Drug

Monitor (low level of risk).

Monitor at doses < 240 mg/day, equivalent to < 12 g/day of dried leaf (medium level of risk). Contraindicated for higher doses.

Monitor (low level of risk).

Monitor at doses of metformin > 1 g/day (medium level of risk). Reduce drug if necessary in conjunction with prescribing physician.

Monitor (low level of risk).

Recommended Action

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Potential Interaction

May increase drug level.

Midazolam Clinical trial (defined as a weak interactionE).123

Herb Alone Theoretical concern based on in vitro data (displaced bilirubin from albumin) and in animals with high dose of berberine by injection (reduced bilirubin serum protein binding).3

Basis of Concern

May decrease absorption.

May increase drug levels.

May increase bioavailability of drug.

May increase plasma level and side effect of drug.

May reduce bioavailability of drug.

May inhibit effect of drug: decreased INR.

Folate

Immunosuppressives

Sildenafil

Statin drugs eg simvastatin

Sunitinib

Warfarin Case report (brewed green tea: 0.5–1 gallon/day).131

Case report (effect appeared dose-dependent). Considering the pharmacokinetic data (interaction in mice), the authors recommended avoiding green tea intake or leaving an interval of 4 hours between beverage and drug intake.130

One case reported of muscle pain (side effect). Pharmacokinetic evaluation indicated green tea (1 cup) increased the bioavailability of simvastatin in this patient.129

Clinical study with healthy volunteers (2 g, single dose, green tea powder containing 60 mg catechins). Blood pressure and electrocardiogram were unchanged.128

Case report (patient was a CYP3A4 poor metabolizer).127

Clinical study with healthy volunteers.126 Clinical significance unclear, as was a one-day study (ie not ongoing administration), with 50 mg of green tea catechins administered before, during and up to 2 hours after folate (for a total of 250 mg of catechins).

Theoretical concern based on initial in vitro data and in vivo animal study (green tea constituent: EGCG reduced tumour cell death induced by drug).124 However, a further in vivo animal study found EGCG was not antagonistic to the activity of the drug.125 See note N.

May increase effectiveness of drug.

Hypotensive drugs

HDI Chart

May increase effectiveness of drug.

Digoxin

Controlled trials where drugs known to be taken by all or many heart disease patients: blood pressure decreased significantly (2 trials),135,136 decreased nonsignificantly (1 trial)137 and was unchanged (1 trial).138 Significant decrease in blood pressure observed in diabetics taking hypotensive drugs (1 trial).139

Clinical studies indicate a (beneficial) synergistic effect.132,133 Pharmacokinetics not affected in a clinical study (healthy volunteers).134

Hawthorn Crataegus monogyna, Crataegus laevigata (C. oxyacantha) (See also Tannin-containing herbs)

May decrease efficacy of drug.

Boronic acid-based protease inhibitors eg bortezomib

Green Tea Camellia sinensis (See also Polyphenol-containing herbs and Tannin-containing herbs)

May potentiate effect of drug on displacing bilirubin.

Drugs which displace the protein binding of bilirubin eg phenylbutazone

Golden SealC Hydrastis canadensis

Drug

Monitor (low level of risk).

Monitor (very low level of risk).

Contraindicated, unless taken at least 4 hours apart.

Monitor (low level of risk).

Monitor (medium level of risk).

If taken simultaneously, may need to increase dose of folate. The effect may be relatively small – more information is required.

Contraindicated at high doses (around 600 mg/day EGCG or 1 g/day green tea catechins).P More information required for doses below this level.

Monitor (low level of risk).

Recommended Action

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Potential Interaction

Basis of Concern

Antihypertensive medications including nifedipine

Theoretical concern since hypertension is a feature of GAS. Clinical significance unclear.49 Assessment of 316 hospital patients found Korean ginseng to have a contrary effect only in a very small percentage: blood pressure increase in 5% of hypertensives; increase in 3% and decrease in 2% of normotensives; decrease in 6% of hypotensives.164 No information on concurrent medications. Note for clinical trial data below: Acute, single-dose trials excluded. High doses used in several trials. Herb Alone Clinical trials: no significant effects found in healthy volunteers,165,166 those with metabolic syndrome,167 type 2 diabetes168 or glaucoma,169 although baseline blood pressure may be a factor.167 Herb and Drug Clinical trials: decreased blood pressure in essential hypertension,170 and coronary artery disease171 but no effect in white coat hypertension170 and essential hypertension.172 Clinical trial.117

Nifedipine: May increase drug levels.

Case reports.160,161 Although, kava is unlikely to be responsible for central dopaminergic antagonism (experimental model)162 and kava reduced parkinsonism induced by neuroleptic drugs (observational study, psychiatric patients).163

Theoretical concern based on deliberations of German Commission E12 and the anxiolytic activity of kava.49 Two apparent case reports (kava + benzodiazepines (alprazolam, flunitrazepam)).156,157 Clinical trials with healthy volunteers: no additional side effects observed for kava (extract containing 240 mg/day of kava lactones) + benzodiazepine (bromazepam),150 and kava (extract containing 210 mg/day of kava lactones) + alcohol.159 Clinical study with healthy volunteers: no effect on pharmacokinetic parameters of midazolam (extract provided 253 mg/day of kava lactones).123

In uncontrolled trials, high dose, long-term administration of Gymnema extract (equivalent to 10–13 g/day dried leaf) reduced insulin and hypoglycaemic drug requirements in diabetics.140,141 Hypoglycaemic effects of fenugreek (15–100 g/day dried and/or defatted seed) observed in type 1 and type 2 diabetics including those on therapeutic and subtherapeutic doses of hypoglycaemic drugs.142-147 No effect on glucose or insulin responses in women with PCOS treated with metformin and fenugreek (concentrated extract, equivalent to about 10 g/day dried and fresh seed).148 Hypoglycaemic effects observed in many well-controlled clinical trials for psyllium (10.2–15 g/day, more than 6 weeks) in type 2 diabetics. Drug dosage adjustments were not required.149-152 See also note Q. In one small, uncontrolled trial, nearly 70% of type 1 diabetics experienced hypoglycaemic episodes. Reductions in insulin dosage may have been required had the trial been of longer duration (10.8 g/day of husk, about 1 week).153 (There is also clinical evidence that high fibre diets (10–60 g/day) worsen control of type 2 diabetes in patients who are poorly controlled with oral hypoglycaemic drugs.154) Several trials have found no effect for garlic on blood glucose in type 2 diabetes, although in a double-blind, placebo-controlled trial (using enteric-coated tablets), a reduction in the dosage of oral hypoglycaemic drugs was required (these patients had fasting blood glucose above 8.0 mmol/L).155

General: May decrease effectiveness of drug.

Possible dopamine antagonist effects.

L-dopa and other Parkinson’s disease treatments

Korean Ginseng Panax ginseng

Potentiation of drug effects.

May potentiate hypoglycaemic activity of drug.

CNS depressants eg alcohol, barbiturates, benzodiazepines

Kava Piper methysticum

Hypoglycaemic drugs including insulin

Hypoglycaemic herbs e g Gymnema sylvestre, goat’s rue (Galega officinalis), fenugreek (Trigonella foenum-graecum), psyllium (Plantago ovata, P. psyllium, P. indica) (See also Ginkgo, Korean Ginseng, St John’s Wort, St Mary’s Thistle)

Drug

Monitor (low level of risk).

Monitor (very low level of risk).

Contraindicated unless under close supervision.

Monitor (low level of risk).

Prescribe cautiously and monitor blood sugar regularly. Warn patient about possible hypoglycaemic effects. Reduce drug if necessary in conjunction with prescribing physician.

Recommended Action

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Potential Interaction

May potentiate adverse effect possibly by altered metabolism.

May potentiate hypoglycaemic activity of drug.50

May cause side effects such as headache, sleeplessness, tremor.

May decrease drug level.

Potentiation of drug possible.

HIV integrase inhibitors eg raltegravir

Hypoglycaemic drugs including insulin

MAO inhibitors eg phenelzine

Midazolam

Sildenafil

192,193

Theoretical concern based on in vitro studies which show ginseng increases nitric oxide release from corpus cavernosum tissue.

Clinical study with healthy volunteers (extract providing about 45 mg/day of ginsenosides).191

Case reports.188-190

Theoretical concern based on clinically observed hypoglycaemic activity of ginseng in newly diagnosed type 2 diabetics.183 Clinical significance unclear. No effect on insulin sensitivity or beta-cell function after very high doses in newly diagnosed type 2 diabetics or those with impaired glucose tolerance.184 Korean red ginseng (2.7 g/day) reduced the requirement for insulin in about 40% of diabetics in a small uncontrolled trial.185 No adverse effects in three trials of type 2 diabetics well controlled with diet and/or oral hypoglycaemic drugs.168,186,187

Case report (elevated liver enzymes: probable causality, dosage unknown).182

Theoretical concern since CNS stimulation is a feature of GAS. Clinical significance unclear.

Monitor (very low level of risk).

Monitor (low level of risk).

Contraindicated.

Monitor (low level of risk).

May potentiate activity, if potassium deficiency resulting from long-term laxative abuse is present.

May increase potassium depletion.

Cardiac glycosides

Potassium-depleting agents eg thiazide diuretics, corticosteroids, licorice root (Glycyrrhiza glabra)

HDI Chart

May affect activity if potassium deficiency resulting from long-term laxative abuse is present.

Antiarrhythmic agents

German Commission E and ESCOP recommendation.12,194

Avoid excessive doses of laxatives. Maintain patients on a high potassium diet.

Monitor (low level of risk at normal doses).

Avoid excessive doses of laxatives. Maintain patients on a high potassium diet.

Laxative (anthraquinone-containing) herbs e g aloe resin (Aloe barbadensis, Aloe ferox), senna (Cassia spp.), cascara (Frangula purshiana, Rhamnus purshianus), yellow dock (Rumex crispus)

May potentiate effects of drug.49

CNS stimulants

Case report (hepatotoxicity; probable causality).181

Monitor (low level of risk).

Herb and Drug One case reported (decreased INR)176 but clinical significance unclear. No effect demonstrated in three clinical trials (healthy volunteers and patients) for INR, prothrombin time and platelet aggregation.177-179 Although the design of the trials has been criticised. See note R.180

Warfarin: May decrease effectiveness of drug.

May potentiate adverse effect possibly by altered metabolism.

Monitor (very low level of risk).

Recommended Action

Herb Alone Two epidemiological studies in Korea: long-term intake (3â&#x20AC;&#x201C;5 years) prolonged plasma clotting times (APTT),173,174 and decreased platelet aggregation.173 (Dosage in Korea is generally high.) Clinical trial (healthy volunteers): inhibited platelet aggregation, but no effect on coagulation (PT, APTT).175

Basis of Concern

General: May potentiate effects of drug.

Cancer chemotherapeutic drugs eg imatinib

Antiplatelet and anticoagulant drugs

Korean Ginseng Panax ginseng (continued)

Drug

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Product Catalogue

– if heart, liver, or kidney function is impaired, – in elderly patients, – in pregnant women, – in those who have received an organ transplant, – in those with a genetic disorder that disturbs normal biochemical functions.

These patients need to be monitored on a frequent, regular basis.

 Exercise great caution when prescribing herbs for patients taking drugs:

 Exercise great caution when prescribing herbs for patients taking drugs with a narrow therapeutic window. These drugs may become dangerously toxic or ineffective with only relatively small changes in their blood concentrations. Examples include digoxin, warfarin, antirejection (immunosuppressive) drugs, many anti-HIV drugs, theophylline, phenytoin and phenobarbital. These patients need to be monitored on a frequent, regular basis.

Monitor (medium level of risk). Place patients on a high potassium diet.

Avoid long-term use at doses > 100 mg/day glycyrrhizin unless under close supervision.U Place patients on a high potassium diet.

Avoid long-term use at doses > 100 mg/day glycyrrhizin unless under close supervision.R Place patients on a high potassium diet.

Recommended Action

Reference and further reading: Mills S, Bone K (eds). The Essential Guide to Herbal Safety. Churchill Livingstone, USA, 2005.

 Interactions may be dose related for the herb and the drug, for example, St John’s wort and digoxin.

 Carefully monitor the effects of drugs such as antihypertensives and antidiabetic drugs when combining with herbal remedies. The herbs may make them more or less effective. In the ideal situation the dose of the drug could be adjusted.

 Stop all herbs approximately 1 week before surgery. St Mary’s thistle may help reduce the toxic after-effects of anaesthetic drugs, so it can be taken up to the day before, and then again, after surgery.

 Critical drugs should be taken at different times of the day from herbs (and food) to reduce chemical or pharmacokinetic interactions. They should be separated by at least 1 hour, preferably more.

 Care should be exercised with patients who exhibit long-term use of laxative herbs or potassium-losing diuretics.

Case report (patient taking 150 mg/day of glycyrrhizin). Serum potassium levels were stable prior to administration of drug.206

Case report (patient consumed licorice herbal medicine (200–240 mg/day glycyrrhizin)). Drug dosage was reduced, leading to pseudoaldosteronism.205 See note V.

ACE-inhibitor: May mask the development of pseudoaldosteronism.

May cause hypokalaemia, which can potentiate the toxicity of the drug.

When consumed in high doses, licorice can cause pseudoaldosteronism and high blood pressure. Herb or Constituent Alone Hypertension demonstrated in case reports, usually from long-term intake and/or very high dose.195 Hypokalaemic paralysis reported (184 mg/day of glycyrrhizin for 2 months), although hypertension was mild, possibly due to coexisting sodium wasting related to uropathy from prostate cancer.196 Clinical studies (up to 200 g/day of licorice): dose-dependent relationship found between licorice and increase in blood pressure, more pronounced effect in hypertensive patients than in normotensive volunteers, adverse effect greater in women, and effect shown for dose as low as 50 g/day of licorice (75 mg/day of glycyrrhetinic acid = 130 mg/day of glycyrrhizinS) taken for 2 weeks.197-199 Other studies show variation of effects on blood pressure (see note T) – renal function may be a factor.200 The increase in blood pressure after taking glycyrrhetinic acid (874 mg/day of glycyrrhizin) was more pronounced in salt-sensitive than salt-resistant volunteers.201 Clinical study to establish a no-effect level for glycyrrhizin (healthy female volunteers): significant results (e.g. blood pressure, serum potassium and aldosterone) compared to controls found for daily dose of 4 mg/kg (220–332 mg/day) taken for 8 weeks, but no effect at lower doses of 1–2 mg/kg (55–166 mg/day) of glycyrrhizin.202 Herb and Drug Case reports (licorice tea, 3 L/day; patient still hypertensive despite treatment with drugs;203 decoction of Chinese herbs containing 5 g licorice, taken for 14 days).204

Basis of Concern

General: May decrease effectiveness of drug.

Potential Interaction

Herb-Drug Interaction Chart: General Prescribing Guidelines

Cilostazol

Antihypertensive medications other than diuretics

Licorice Glycyrrhiza glabra

Drug

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Potential Interaction

Digoxin

Corticosteroids

HDI Chart

Herb Alone Hypokalaemia demonstrated in case reports and clinical studies, usually from long-term intake and/or very high dose, however effect has been demonstrated in sensitive individuals at low doses (licorice containing 100 mg/day of glycyrrhizin). Side effects would be common at 400 mg/day of glycyrrhizin.195,223,224 Herb and Drug Case report (patient taking herbal laxative containing licorice (1.2 g/day) and rhubarb (Rheum spp., 4.8 g/day)). In addition to digoxin, patient was also taking a potassium-depleting diuretic.225

Avoid long-term use at doses > 100 mg/day glycyrrhizin unless under close supervision.U Place patients on a high potassium diet.

Monitor (low level of risk at normal doses) when drug administered intravenously.

Herbal Constituent and Drug Two clinical studies with healthy volunteers (oral administration of glycyrrhizin or glycyrrhetinic acid;S prednisolone administered intravenously): increased drug level221 and increased prednisolone/prednisone ratioX in urine and plasma.222 Dosage was high: 200 mg/day glycyrrhizin,221 and 400 mg/day glycyrrhetinic acid (= 700 mg/day glycyrrhizin).222

Prednisolone: May potentiate the action or increase level of drug.

May cause hypokalaemia which can potentiate the toxicity of the drug.

Monitor (very low level of risk at normal doses).

Recommended Action

Inhibition of the enzyme 11beta-HSD2 by glycyrrhizin leads to an increased level of cortisol in the kidney. This does not happen in the liver. The plasma half-life of cortisol may be prolonged when herb and drug are coadministered, but drug concentrations remain normal, possibly because of a concomitant fall in cortisol production.207 Prolonged half-life of cortisol may suggest the potential for licorice to prolong clearance (and hence, activity) of the drug. (Studies involving patients with Addison’s disease or on haemodialysis are not listed here.) Herb or Constituent Alone Clinical studies with healthy volunteers198,200,208-214 and patients with essential hypertension198 (ongoing oral administration): increase in urinary excretion of cortisol, but no significant change in plasma cortisol198,200,208-214 (although plasma cortisone decreased)208,209,215 and diurnal variation of plasma cortisol was unaffected.211 Dosage was high: 100–200 g/day of licorice candy (containing glycyrrhizin or glycyrrhetinic acid equivalent to 262–2440 mg/day of glycyrrhizinS),198,210,211,214 3.5 g/day of licorice tablets (containing 266 mg/day of glycyrrhizin),212 4.8 g/day of licorice extract (containing glycyrrhetinic acid = 587 mg/day of glycyrrhizin),213 225 mg/day glycyrrhizin,208 glycyrrhetinic acid (= 227–874 mg/day glycyrrhizin).200,209 Clinical study with healthy volunteers and hypertensive patients (single dose, placebo-controlled; oral administration of glycyrrhetinic acid equivalent to 874 mg/day of glycyrrhizinS): increased plasma cortisol/cortisone ratio (due mostly to a decrease in plasma cortisone); salivary cortisol increased.216 Clinical study with healthy volunteers (topical application of a cream containing glycyrrhetinic acid): no effect on plasma cortisol.217 Herb or Constituent and Drug Clinical studies: increased plasma half-life of cortisol (oral administration of licorice candy (200 g/day, containing 580 mg/day glycyrrhizin) + intravenous cortisol to 7 healthy volunteers;210 oral administration of glycyrrhetinic acid = 227 mg/day of glycyrrhizinS + oral cortisol to 2 volunteers).218,219 See also Note W. Ex vivo study (skin samples from healthy volunteers and patients with psoriasis and eczema; glycyrrhetinic acid and drug topically applied): activity of hydrocortisone potentiated by glycyrrhetinic acid.220

Basis of Concern

Cortisol: May potentiate the action (rather than increase level of drug).

Licorice Glycyrrhiza glabra (continued)

Drug

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Product Catalogue

Potential Interaction

May decrease drug level.

May result in excessive potassium loss.

Omeprazole

Potassium-depleting drugs other than thiazide and loop diuretics eg corticosteroids, stimulant laxatives

May slow or reduce absorption of drugs.

Theoretical concern based on absorbent properties of marshmallow root.

Herb Alone Hypokalaemia demonstrated in case reports and clinical studies, usually from candy intake (high dose), however effect has been demonstrated in sensitive individuals at low doses (licorice containing 100 mg/day of glycyrrhizin). Side effects would be common at 400 mg/day of glycyrrhizin.195,223

Clinical study with healthy volunteers (potassium salt of glycyrrhizin, equivalent to 287 mg/day of glycyrrhizin).238

Clinical study with healthy volunteers (potassium salt of glycyrrhizin, equivalent to 287 mg/day of glycyrrhizin).237

May potentiate effects of drug.

Theoretical concern based on in vivo animal study demonstrating anticoagulant activity (dosage unavailable).239

Warfarin

May inhibit effect of drug: decreased INR.

Two case reports (menthol cough drops: 8–10 per day;240 6 per day.)241 Assuming the cough drops contained 5–10 mg of menthol, this is a dosage of about 30–100 mg/day of menthol.

Peppermint Mentha x piperita (See also Tannin-containing herbs)

Warfarin

Meadowsweet Filipendula ulmaria (See also Tannin-containing herbs)

Prescribed medication

Marshmallow Root Althaea officinalis

May decrease drug level.

Midazolam

Population pharmacokinetic study with 112 Chinese adult renal transplant recipients: clearance of sirolimus decreased in those patients with abnormal ALT values who were taking herbal formulations containing glycyrrhizin (route and dosage unknown).236

Monitor (low level of risk at normal doses of herb).

Monitor (very low level of risk).

Take at least 2 hours away from medication.

Avoid long-term use at doses > 100 mg/day glycyrrhizin unless under close supervision.U Place patients on a high potassium diet.

Monitor (low level of risk at normal doses).

Monitor (medium level of risk) in hepatically-impaired patients.

Contraindicated unless under close supervision at doses > 40 mg/day glycyrrhizin.

Herb or Constituent Alone Hypokalaemia demonstrated in case reports and clinical studies, usually from long-term intake and/or very high dose,195,223,224 however effect has been demonstrated in patients for ongoing treatment with herbal medicines containing glycyrrhizin at doses of 80–240 mg/day.227 Herb and Drug Case reports, usually from long-term intake and/or very high dose,203,223,228-234 however effect has been demonstrated for ongoing treatment of glycyrrhizin as low as 80 mg/day.227 Clinical trial (candy containing 40 mg/day of glycyrrhizin): decreased plasma potassium, with 20% of healthy volunteers hypokalaemic in the first week.235

Thiazide and loop (potassiumdepleting) diuretics: The combined effect of licorice and the drug could result in excessive potassium loss.12

May decrease drug clearance.

Monitor (low level of risk at normal doses).

Recommended Action

Clinical study: in women with PCOS addition of licorice extract (containing about 463 mg/day glycyrrhizin) reduced side effects related to the diuretic activity of drug.226

Basis of Concern

Spironolactone (potassium-sparing diuretic): Reduce side effects of drug.

Immunosuppressives eg sirolimus

Diuretics

Licorice Glycyrrhiza glabra (continued)

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Potential Interaction

May potentiate effect of drug on displacing bilirubin.

Herb Alone Theoretical concern based on in vitro data (displaced bilirubin from albumin) and in animals with high dose of berberine by injection (reduced bilirubin serum protein binding).3

Basis of Concern

Monitor (low level of risk).

Recommended Action

Inhibition of non-haem ironZ absorption.

Iron

Clinical study (included herb teas (German chamomile, vervain, lime flower, peppermint; all 3 g/300 mL), beverages (eg black tea, coffee, cocoa)): effect dependent on polyphenol content (per serving: 20-400 mg).243 See also note AA. Timing of intake may be important. See also note BB. Epidemiological study (United States): 1 cup/week of coffee associated with 1% lower serum ferritin in the elderly.244 Epidemiological study (China): effect for eating chilli on serum ferritin in women not significant.245 Mixed results in other studies (healthy volunteers): rosemary (32.7 mg of polyphenols)246 and cayenne (high dose: 14.2 g, fresh weight,CC containing 25 mg polyphenols)247 caused inhibition; chamomile248 and turmeric (2.8 g, fresh weight, containing 50 mg polyphenols)247 did not. See also note DD. Results for green tea have been conflicting: two studies found no effect (healthy volunteers and those with anaemia),249,250 two studies (healthy volunteers) found an effect.246,251 Drinking green tea (1:100, 1 L/day) lowered serum ferritin in women with low levels of ferritin (< 25 mcg/L) at baseline. No effect in other women or men (vegetarians and omnivores), and no effect on iron status parameters.252 Two epidemiological studies (French and Japanese populations) found mixed results for serum ferritin and haemoglobin, although risk of iron depletion or anaemia was not increased.253,254 Clinical study (150–300 mg/day EGCG): decreased absorption in healthy women with low iron stores administered together with iron. Results significant only at higher dosage.255 Concentrated extract of St Mary’s thistle reduced iron absorption in haemochromatosis patients.256

Three case reports, in transplant patients (2 L/day of herbal tea; 1-1.5 L/day of chamomile tea; ‘large quantities’ of fruit tea containing hibiscus extract, and a drink containing black tea). Confirmed by rechallenge in one case, but no signs of rejection.242

May decrease absorption of drug.

Inhibition of non-haem iron absorption.

May decrease absorption of drug.

Digoxin

Iron

Lithium

HDI Chart

Decreases plasma drug level.

Carbamazepine

Case report (psyllium husk),269 and clinical study with healthy volunteers (psyllium husk).270 Hydrophilic psyllium may prevent lithium from ionising.

Iron from Test Meal Clinical studies: absorption decreased by 8% (5 g/day for 2 meals, psyllium undefined) in healthy volunteers;263 no effect overall in type 2 diabetics, although significant differences among participants (14 g/day, for 6 weeks, psyllium undefined).264 Iron from Diet Clinical studies: no change in serum iron in two trials with patients (6 g/day, for 4-5 weeks, psyllium undefined;265 maximum tolerated dose, generally less than 25 g/day, for 4 months, psyllium husk);266 iron absorption decreased in non-anaemic adolescent girls, but iron balance was positive (25 g/day, for 3 weeks, psyllium husk);267 slight decrease in plasma iron in obese patients without effects on other iron parameters during first period of treatment (30 days), without further modification on long-term treatment of 6 months (6 g/day, psyllium undefined).268

Decreased bioavailability found for digoxin and ‘crude’ (undefined) dietary fibre,259 but no effect was found on digoxin levels in two clinical studies (psyllium husk).260,261 Slight decrease in absorption (15%) found in healthy volunteers when psyllium huskEE (15 g) and digoxin taken concomitantly but when given 30 minutes apart the decrease was much smaller (3%).262

Clinical study (psyllium husk),257 although no adverse effect observed in one case report.258

Psyllium Plantago ovata, Plantago psyllium, Plantago indica (See also Hypoglycaemic herbs)

Decreases drug levels, due to impaired absorption or increased metabolism.

Immunosuppressives eg cyclosporin

Take at least 2 hours away from medication.

In anaemia and where iron supplementation is required, do not take simultaneously with meals or iron supplements.

Take at least 2 hours away from medication.

In anaemia and where iron supplementation is required, do not take simultaneously with meals or iron supplements.

Monitor (medium level of risk). Also advisable not to take simultaneously.

Polyphenol-containingY or Flavonoid-containing herbs e specially cayenne (Capsicum annuum), chamomile (Matricaria chamomilla), cocoa, green tea (Camellia sinensis), lime flowers (Tilia cordata), rosemary (Rosmarinus officinalis), St Mary’s thistle (Silybum marianum), vervain (Verbena officinalis) (See also Tannin-containing herbs)

Drugs that displace the protein binding of bilirubin eg phenylbutazone

PhellodendronC Phellodendron amurense

Drug

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Product Catalogue

Potential Interaction

Basis of Concern

May increase drug levels.

May accelerate clearance from the body.

May increase drug levels.

Midazolam

Prescribed medication

Talinolol

Prescribed medication

Slippery Elm Bark Ulmus rubra

Digoxin

May slow or reduce absorption of drugs.

May increase plasma drug levels.

Siberian Ginseng Eleutherococcus senticosus

May increase drug levels.

Immunosuppressives

Schisandra Schisandra chinensis

Antiplatelet and anticoagulant drugs

May potentiate effect of drug.

May decrease efficacy of drug.

Thyroxine

Saw Palmetto Serenoa repens

May slow or reduce absorption of drugs.

Prescribed medication

Theoretical concern based on absorbent properties of slippery elm.

Case report: apparent increase in plasma level, but herb probably interfered with digoxin assayJJ (patient had unchanged ECG despite apparent digoxin concentration of 5.2 nmol/L).287 In a later clinical trial no effect observed on plasma concentration.288

Increased drug level and decreased clearance found in healthy volunteers, given S. chinensis extract, providing 33.75 mg/day of deoxyschisandrinHH.122

Theoretical concern based on in vivo animal studies demonstrating enhanced phase I/II hepatic metabolism.285,286

Increased drug level (defined as a moderate interactionE), increase in sleeping time and increase in mild to moderate adverse effects found in healthy volunteers, given S. chinensis extract, providing 22.5 mg/day of deoxyschisandrinHH.284

Sirolimus: Observations in some liver transplanted recipients. Clinical study: markedly increased drug levels in healthy volunteers280 given S. sphenanthera extract, providing 67.5 mg/day of deoxyschisandrinHH. Tacrolimus: Observations in some renal and liver transplanted recipients. Clinical studies: markedly increased drug levels in healthy volunteers281 and transplant recipients,282,283 given S. sphenanthera extract, providing 67.5 mg/day of deoxyschisandrinHH.

Herb Alone Case report (haemorrhage during surgery).276 Clinical trials: reduced intraoperative bleeding from transurethral resection of the prostate procedure with preoperative use of liposterolic extract (2 trials); blood loss not different when compared with drug treatment (1 trial).277 Herb and Drug Case reports (2): increased INR (warfarin + simvastatin,278 aspirin + clopidogrel;279 â&#x20AC;&#x201C; in the first case, the interaction may have been due to the vitamin E also present in the preparation;278 in the second case, six times the usual dose of extract was taken).

Clinical study: decreased efficacy found in 12 hypothyroid patients consuming dietary fibre (one patient: whole grain cereal + psyllium laxative); some patients stabilised by decreasing or removing the fibre from their diet.274 Clinical study (healthy volunteers, 3.4 g/day, for 4 days, psyllium husk): decrease in absorption not significant.275

Theoretical concern based on absorbent properties of psyllium. No effect found on absorption or prothrombin time in healthy volunteers when psyllium husk (14 g) and warfarin were taken concomitantly.271 Case report (adrenal crisis in stable patient with adrenal insufficiency; psyllium coadministered with steroid drugs).272 In a crossover trial, psyllium husk (6 g) was administered with orlistatFF three times a day and found to reduce the subsequent side effects. Single dose of psyllium (12 g) at bedtime was also effective in reducing the side effects.273

Psyllium Plantago ovata, Plantago psyllium, Plantago indica (See also Hypoglycaemic herbs) (continued)

Drug

Take at least 2 hours away from medication.

Monitor (very low level of risk).

Monitor (low level of risk at normal doses).

Monitor (medium level of risk).

Monitor (medium level of risk at normal doses).

Monitor (low level of risk at normal doses).

Monitor (very low level of risk).

Take as many hours apart as possible. May require dose reduction or cessation of herb.

Take at least 2 hours away from medication,GG except for orlistat which may be taken at the same time.

Recommended Action

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Potential Interaction

Basis of Concern

Decreases drug levels.

May decrease effectiveness of drug.

May decrease drug levels.

Cancer chemotherapeutic drugs eg irinotecan, imatinib

Clozapine

Digoxin

Docetaxel (intravenous)

Finasteride

HDI Chart

Decreases drug levels.

Warfarin: Decreases drug levels and INR.

Calcium channel antagonists

Case reports (decreased INR (nine cases), increased INR (three cases)).304-306 Clinical study with healthy volunteers (decreased drug level and INR).177

Phenprocoumon: Decreases plasma drug levels.

Decreases drug levels, and is probably dependent upon the hyperforin content.307

Clinical study.303

Clopidogrel: May potentiate effects of drug.

Antiplatelet and anticoagulant drugs

Benzodiazepines

Clinical studies: increased responsiveness (decreased platelet aggregation or improved residual platelet reactivity) in hyporesponsive volunteers and patients,298-301 possibly via the formation of the active metabolite (CYP3A4 activity was increased), thus providing a beneficial effect in these patients. This is a complex situation, with the meaning of clopidogrel resistance/hyporesponsiveness debated.298,302

Decreases drug levels.

Antihistamine eg fexofenadine

Clinical study with healthy volunteers.324 Case report: PSA level elevated (due to decreased efficacy of drug?) in patient with benign prostatic hyperplasia.325

Clinical study with cancer patients:323 effect on pharmacokinetics probably not clinically relevant (eg plasma levels decreased by only 6%); drug-induced side effects were also reduced. See also Note MM.

Clinical studies (several studies showed decrease, one study showed no effect)308,320-322 but effect is dependent upon dose of herb and the hyperforin content.322

Case report.319

Clinical studies.315-318

Contraindicated.

Contraindicated at doses equivalent to > 1 g/day dried herb, especially for high-hyperforin extracts.

Contraindicated.

Monitor (low level of risk).

Quazepam: Decreased drug levels, but no effect on pharmacodynamics (sedation).312 Nifedipine: Clinical studies. Verapamil: Clinical study.314

Hyperforin-rich extracts: Monitor (medium level of risk). Low-hyperforin extracts: Monitor (low level of risk).

Midazolam: Clinical studies, effect not regarded as clinically relevant for low (< 1 mg/day) hyperforin extracts.297,307,310,311

117,313

Monitor (medium level of risk).

Contraindicated.

In patients with known clopidogrel resistance: Monitor (medium level of risk). In other patients: Monitor (risk is unknown).

Monitor (medium level of risk).

Monitor (low level of risk).

Monitor (medium level of risk).

Recommended Action

Alprazolam: Mixed results for drug levels in two clinical studies (similarly low amount of hyperforin, ~4 mg/day) â&#x20AC;&#x201C; no effect (dried herb equivalent: 1.1 g/day)308 and decrease.309

Clinical studies.296,297

Theoretical concern. An open clinical trial demonstrated no effect on carbamazepine pharmacokinetics in healthy volunteers.293 Case report: increase in seizures in patient taking several antiepileptic drugs, two of which are not metabolised by cytochrome P450.294 Clinical study (healthy volunteers; clinical significance unclear): increased excretion of a mephenytoin metabolite in extensive metabolizers, but not in poor metabolizers.295 See note LL.

May decrease drug levels via CYP induction.290-292

Anticonvulsants eg carbamazepine, mephenytoin, phenobarbitone, phenytoin

Clinical study.

Decreases drug levels.289

Amitriptyline

St Johnâ&#x20AC;&#x2122;s WortKK Hypericum perforatum (See also Tannin-containing herbs)

Drug

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Product Catalogue

Potential Interaction

Basis of Concern

May decrease drug levels.

Decreases drug levels, possibly inducing withdrawal symptoms.

May decrease efficacy.

May potentiate effects of drug.

May decrease drug levels.

May increase metabolism and reduce effectiveness of drug.

Decreases drug levels.

Potentiation effects possible in regard to serotonin levels.

Ivabradine

S-Ketamine (oral)

Methadone

Methylphenidate

Morphine (oral)

Omeprazole

Oral contraceptives

Oxycodone

SSRIs eg paroxetine, trazodone, sertraline and other serotonergic agents eg nefazodone, venlafaxine

Two clinical studies (healthy volunteers): no effect on pharmacokinetics,308,310 but there was an increased incidence of hypoglycaemia in the trial using hyperforin-rich extract (33 mg/day).310

Tolbutamide: May affect blood glucose.

Decreases drug levels.

Clinical study with healthy volunteers: no effect, and glucose and insulin response to glucose loading were unchanged.329

Repaglinide: May alter metabolism of drug.

Immunosuppressives

Clinical study with healthy volunteers, but glucose and insulin response to glucose loading were unchanged.

Gliclazide: May reduce efficacy of drug by increased clearance. 329

Hypoglycaemic drugs

346

Case reports: clinical significance unclear.361-366

Monitor (very low level of risk).

Monitor (medium level of risk).

Hyperforin-rich extracts: Monitor (medium level of risk). Low-hyperforin extracts: Monitor (very low level of risk).

Clinical significance unclear. Cases of Breakthrough bleeding reported which was attributed to increased metabolism of drug. unwanted pregnancies have been reported.351-353 Contradictory results for effect on bioavailability, hormone levels and ovulation demonstrated in three clinical studies, although some breakthrough bleeding occurred.354-356 In one clinical trial an extract low in hyperforin did not affect plasma contraceptive drug levels or cause breakthrough bleeding.357 Clinical trial: clearance of levonorgestrel at emergency contraceptive doses increased (not statistically significant).358 Clinical study: antiandrogenic effect of contraceptive not affected.359 Clinical trial with healthy volunteers.360

Monitor (low level of risk).

Clinical trial.350 304,330

Monitor (medium level of risk).

Clinical study (healthy volunteers): pain scores were decreased when morphine co-administered with standardised extract at a dose of herb below those used to obtain an antidepressant or analgesic effect. The effect was dependent hypericin content, but not hyperforin. The authors suggest the herb may be able to decrease the dose of morphine while obtaining the same analgesic effect. 349

Monitor (low level of risk).

Contraindicated.

Monitor (medium level of risk).

Contraindicated especially for highhyperforin extracts.

Monitor (low level of risk).

Monitor (very low level of risk).

Monitor (low level of risk).

Contraindicated.

Recommended Action

Case report,348 but clinical significance unclear.

Case reports. 347

Clinical study with healthy volunteers. No pharmacodynamic effect was observed (eg analgesic effect not altered).

Clinical trial with healthy volunteers. No pharmacodynamic effect was observed.345

Cyclosporin: Case reports,330-338 case series,339,340 clinical studies.297,341 Interaction is dependent upon the hyperforin content.333,341 Tacrolimus: Case report and clinical studies.342-344

Clinical study.327

Decreases drug levels.

HIV protease inhibitors eg indinavir

Case report.326

Decreases drug levels.

HIV non-nucleoside transcriptase inhibitors eg nevirapine

St Johnâ&#x20AC;&#x2122;s WortKK Hypericum perforatum (See also Tannin-containing herbs) (continued)

Drug

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125

Potential Interaction

Basis of Concern

May decrease drug levels.

Decreases drug levels.

May decrease drug levels (but with wide interindividual variability).NN

Talinolol

Theophylline

Voriconazole

Zolpidem 375

Clinical study (healthy volunteers).

Clinical study.374

Case report.372 No effect observed in clinical study.373

Clinical study with healthy volunteers.371

Atorvastatin: Clinical study, serum LDL-cholesterol increased by 0.32 mmol/L which corresponds to a decrease in effect of drug in patients by about 30%. Serum total cholesterol was also increased.367 Pravastatin: Clinical study, no effect on plasma level in healthy volunteers.368 Rosuvastatin: Case report.369 Simvastatin: Two clinical studies, decrease in drug levels in healthy volunteers,368 and small increases in serum total cholesterol and LDL-cholesterol in patients.370

May decrease absorption of drug, by increasing clearance.

May delay the absorption rate of drug. Clinical study with healthy volunteers (silymarin: 280 mg/day), but bioavailability unchanged.385

May increase drug levels.

Metronidazole

Nifedipine

Ornidazole

Talinolol

HDI Chart

May reduce efficacy of drug by inhibiting metabolism.

Losartan

Clinical study with healthy volunteers (silymarin: 420 mg/day).

387

Clinical study with healthy volunteers (silymarin: 140 mg/day).386

Clinical study with healthy volunteers (silymarin: 140 mg/day).384

Clinical study (healthy volunteers; clinical significance unclear): inhibited metabolism of drug; the inhibition was greater in those of a particular CYP2C9 genotype (silymarin: 420 mg/day).383 See note PP.

Population pharmacokinetic study with 112 Chinese adult renal transplant recipients: clearance of sirolimus decreased in those patients with abnormal ALT values who were taking silymarin formulations (route and dosage unknown).236

May decrease drug clearance.

Immunosuppressives eg sirolimus

Controlled trials: improved glycaemic control and reduced insulin requirements in patients with type 2 diabetes and cirrhosis (silymarin: 600 mg/day),376 although insulin requirements unchanged in another trial (silymarin: 200 mg/day);377 improved glycaemic control in diabetics treated with hypoglycaemic drugs (silymarin: 200 and 600 mg/day),378,379 improved blood glucose, blood insulin and insulin resistance in PCOS patients treated with metformin (silymarin: 750 mg/day);380 but no effect on glucose metabolism in NAFLD patients including those with insulin resistance (silymarin: 280 and 600 mg/day).381,382

May improve insulin sensitivity.

Hypoglycaemic drugs including insulin

St Maryâ&#x20AC;&#x2122;s ThistleK Silybum marianum (See also Polyphenol-containing herbs)

May decrease effect and/or drug levels.

Statin drugs

St Johnâ&#x20AC;&#x2122;s WortKK Hypericum perforatum (See also Tannin-containing herbs) (continued)

Drug

Monitor (low level of risk).

Monitor (medium level of risk).

Monitor (low level of risk).

Monitor (medium level of risk).

Monitor (low level of risk).

Monitor (medium level of risk) in hepatically-impaired patients.

Prescribe cautiously and monitor blood sugar regularly. Warn patient about possible hypoglycaemic effects. Reduce drug if necessary in conjunction with prescribing physician.

Monitor (low level of risk).

Monitor (medium level of risk).

Monitor (low level of risk).

Monitor (medium level of risk).

Monitor blood cholesterol regularly (medium level of risk).

Recommended Action

126

Product Catalogue

Potential Interaction

Basis of Concern

Recommended Action

Clinical study with healthy volunteers (300 mg/day of curcuminoids).402

May potentiate effects of drug.

Theoretical concern expressed by US Pharmacopeial Convention.403 However a clinical study found no potentiation with alcohol.404 Case report of adverse effect with benzodiazepine drug (lorazepam)405 – herb dosage undefined but likely high (tablet contained valerian and passionflower (Passiflora incarnata)). Alprazolam: Clinical study in healthy volunteers found no effect on drug levels (extract provided 11 mg/day total valerenic acids).406

May potentiate effects of drug.

Herb Alone Clinical study observed very mild but statistically significant antiplatelet activity (extract containing 240 mg/day of salicin).407

Monitor (low level of risk).

Monitor (very low level of risk).

ACE: angiotensin-converting enzyme; ALT: alanine transaminase, also known as glutamic pyruvic transaminase (GPT); AMP: adenosine monophosphate; APTT: activated partial thromboplastin time; AUC: area under the plasma/serum concentration-time curve (measures extent of absorption); CNS: central nervous system; CYP: cytochrome P450; ECG: electrocardiogram/graph; EGCG: epigallocatechin gallate; GAS: ginseng abuse syndrome; HIV: human immunodeficiency virus; 11beta-HSD2: 11beta-hydroxysteroid dehydrogenase type 2; IDA: iron deficiency anaemia; INR: international normalised ratio; LDL: low density lipoprotein; NAFLD: nonalcoholic fatty liver disease; OPC: oligomeric procyanidin; PCOS: polycystic ovary syndrome; PSA: prostate specific antigen; PT: prothrombin time; SSRI: selective serotonin reuptake inhibitors; tds: three times per day; >: greater than; ≥: greater than or equal to; <: less than.

ABBREVIATIONS

Contraindicated: Do not prescribe the indicated herb. Monitor: Can prescribe the indicated herb but maintain close contact and review the patient’s status on a regular basis. Note that where the risk is assessed as medium, self-prescription of the herb in conjunction with the drug is not advisable.

CODE FOR RECOMMENDED ACTION

Warfarin

Willow Bark Salix alba, Salix daphnoides, Salix purpurea, Salix fragilis (See also Tannin-containing herbs)

CNS depressants or alcohol

Monitor at high doses (≥ 300 mg/day curcumin, low level of risk).

Take at least 2 hours away from food or medication.

Clinical studies with healthy volunteers: results conflicting for effect on zinc (undefined tea,401 black tea251 consumed at or immediately after food).

Zinc: May reduce absorption from food.

May decrease drug levels.

Take at least 2 hours away from food or medication.

Clinical studies in healthy volunteers, administration during or immediately following the meal243,388-395 (black tea, typical strength: 0.8–3.3 g/100 mL;243,388-394 sorghumQQ (0.15% tannins)393), and in women with iron deficiency anaemia396 (black tea: 1–2 x 150 mL of 1:100 infusion containing 78 mg of tannins per 150 mL).396 Iron absorption reduced to a greater extent in those with iron deficiency anaemia (IDA).396 However, the results from single test meals may exaggerate the effect of iron inhibitors and enhancers.397 Effects were not significant in a 14-day study.251 Cases of IDA resistant to treatment: heavy black tea drinkers (2 cases, 1.5–2 L/day).398,399 Epidemiological studies (12, to 2002) found mixed results, but some evidence of an association between drinking black tea and poor iron status.397 Clinical study in patients with haemochromatosis (black tea: 250 mL with meal).400

Iron: May reduce absorption of nonhaem ironZ from food.

Valerians Mexican Valerian (Valeriana edulis), Valerian (Valeriana officinalis)

Talinolol

TurmericC Curcuma longa

Minerals, especially iron

Tannin-containing or OPC-containing herbs e g agrimony (Agrimonia eupatoria), bearberry (Arctostaphylos uva-ursi), grape seed extract (Vitis vinifera), green tea (Camellia sinensis), hawthorn (Crataegus spp.), lemon balm (Melissa officinalis), meadowsweet (Filipendula ulmaria), peppermint (Mentha x piperita), Pelargonium (Pelargonium sidoides), pine bark (Pinus massoniana), raspberry leaf (Rubus idaeus), sage (Salvia fruticosa), St John’s wort (Hypericum perforatum), willow bark (Salix spp.), willow herb (Epilobium parviflorum) (See also Polyphenol-containing herbs)

Drug

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M. Analysis of over 320 000 patients in a German adverse drug reaction reporting system (1999-2002) found no increase in prevalence of bleeding during Ginkgo intake compared to periods without Ginkgo in those taking anticoagulant or antiplatelet

L. Ginkgotoxin (4’-O-methylpyridoxine) is present in substantial amounts in Ginkgo seed, and convulsions arising from ingestion of Ginkgo seed have been documented in Japan (infants are particularly vulnerable). Ginkgotoxin is known to inhibit vitamin B6 phosphorylation, which may lead to increased neuronal excitability.414 Poisoning by ginkgotoxin can be counteracted by vitamin B6,414 in cases of poisoning it is administered by intravenous injection.415,416 Ginkgotoxin is present in very small amounts in standardised Ginkgo leaf extracts,417 but is below the detection limits in human plasma after oral doses (240 mg of 50:1 extract, equivalent to 12 g of dried leaf).418 According to the manufacturer, despite the extensive use of this special extract (more than 150 million daily doses per year for more than two decades) no cases of epileptic seizure have been attributed to this extract.418 (Ginkgo preparations associated with the above case reports were undefined.) Strictly speaking this is a potential adverse effect (rather than a herb-drug interaction) as there is no pharmacokinetic data indicating an interaction for coadministration of Ginkgo and anticonvulsants in humans. An interaction is suggested though, because Ginkgo has been found to induce CYP2C19 activity (see entry for omeprazole), an enzyme involved in the metabolism of some anticonvulsants.

K. Information is provided for specialised and/or concentrated extract, rather than galenical form of herb.

J. There may have been variation in patients’ interpretations (of bleeding) and the significant association between ginger use and bleeding was based on 7 self-reported events in 25 users.413

H. These four trials used tablets containing a concentrated, standardised extract. A dosage of 900 mg/day of dry extract was equivalent to about 2.7 g/day of fresh garlic,411 and was said to provide 12 mg/day of alliin,58,66 although there is some doubt as to the amount of allicin released from this brand of tablet from around 1995 to 2000.412

G No effect overall when midazolam was administered orally: oral clearance and area under the drug concentration-time curve were unchanged.

F. The cranberry ‘juice’ administered was similar in concentration to a reference cranberry ‘juice’ containing about 25% cranberry juice,410 but with a higher concentration of anthocyanins, and lower in catechins and organic acids. See also note D.

E. Refer to Prescribing Guidelines & Assessment of Risk (available on www.mediherb.com.au) for definition of the extent of this interaction.

D. Single-strength (freshly squeezed, 100%) cranberry juice is highly acidic and astringent, making it unpalatable. For this reason, cranberry juice is usually diluted and sweetened (often known as cranberry juice drink). Cranberry juice cocktail usually contains 25% cranberry juice, although can be up to 35%. Cranberry juice drinks contain about 10% cranberry juice. Cranberry sauce is about half the strength of cranberry juice cocktail, about the same strength as juice drinks. Cranberry juice can be concentrated to a dry powder (unsweetened and usually up to 25:1) and used in tablets and capsules. Juices can be prepared by diluting juice concentrates yielding a concentrated juice (eg doublestrength juice, at twice the strength of single-strength, squeezed juice). It is likely that unless defined, cranberry juice referred to in case reports and clinical studies is juice drink containing around 10% cranberry juice.

C. Information is provided for herbs containing standard levels of active constituents. See elsewhere for information on extracts containing very high levels of active constituents such as berberine and curcumin.

B. Analysis of Baical skullcap root samples from Japan found the baicalin content varied from 3.5 to 12%. For a dose of 150 mg/day of baicalin, 1.2–4.3 g/day of dried root would be required.409

A. Research paper describes administration of Scutellaria radix. Trial authors confirm this was root of Baical skullcap (Scutellaria baicalensis).408

* This chart contains information the authors believe to be reliable or which has received considerable attention as potential issues. However, many theoretical concerns expressed by other authors have not been included. Due to the focus on safety, positive interactions between herbs and drugs, and the effect of drugs on the bioavailability of herbs are generally not included.

NOTES

Z. Haem iron is derived from haemoglobin and myoglobin mainly in meat products. Nonhaem iron is derived mainly from cereals, vegetables and fruits.

Y. The word tannin has a long established and extensive usage although it is considered in more recent years to lack precision. Polyphenol is the preferred term when considering the properties at a molecular level. Plant polyphenols are broadly divisible into proanthocyanidins (condensed tannins) and polymers of esters based on gallic and/or hexahydroxydiphenic acid and their derivatives (hydrolyzable tannins).425 The terms ‘tannin’ and ‘polyphenol’ are sometimes used interchangeably. For example, the results of a clinical study are described: “polyphenols present in tea and coffee inhibited iron absorption in a dose-dependent manner”. The ‘polyphenol’ content was measured using a spectrophotometric method for the determination of “tannins and other polyphenolics”.395 Depending on the analytical method used, it is possible that the polyphenol content may actually be the content of tannins or tannins + polyphenols.426 It is recommended that both sections of this chart be considered: Polyphenol-containing or Flavonoid-containing herbs, and Tannin-containing or OPCcontaining herbs.

X. A higher prednisolone/prednisone ratio indicates decreased conversion of prednisolone (active) to prednisone (inactive).

W. Maximum plasma cortisol (exogenous) was not increased in one volunteer;219 in the other, plasma (exogenous) cortisone/cortisol ratio decreased,218 suggesting increased (exogenous) cortisol while (endogenous) cortisol decreased (although statistical and clinical significance is unknown, and may have been within the normal range). In these studies isotope-labelled cortisol was administered, which allowed exogenous and endogenous cortisol to be measured.

V. ACE-inhibitors cause mild natriuresis (an increase in sodium excretion in the urine) and occasionally hyperkalaemia. The mechanism of the interaction is not known, although it may involve opposing effects on 11beta-hydroxysteroid dehydrogenase type 2 (glycyrrhizin inhibiting, ACE-inhibitor promoting), thus affecting mineralocorticoid receptor activity. Reduction of drug dosage revealed the existing hypokalaemia caused by this dosage of glycyrrhizin.

U. This is a guide, based on a recommendation from the German Commission E for longterm consumption of licorice as a flavouring. Glycyrrhizin is also known as glycyrrhizinic acid and glycyrrhizic acid.

T. No effect on blood pressure in healthy volunteers in two studies (130 mg/day of glycyrrhetinic acid = 227 mg/day of glycyrrhizin, for 14 days;200 licorice tablets (266 mg/day of glycyrrhizin) for 56 days);212 including where plasma renin levels were high (3.1 ng/mL/h),212 but in another study, blood pressure increased in healthy volunteers taking 546 mg/day of glycyrrhizin for 4 weeks, only for those with plasma renin activity greater than 1.5 ng/mL/h.424

S. Glycyrrhetinic acid, is the aglycone of glycyrrhizin. Glycyrrhizin, is the glycoside and contains the aglycone (glycyrrhetinic acid) and a sugar unit.

R. A better design would have volunteers take warfarin alone for a period long enough to allow the drug to reach its maximum effect (about 3–5 days) before adding the herb.

149

Q. Better gastric tolerance to metformin was noted in the psyllium group of one trial.

P The in vitro study found a pronounced reduction in the cytotoxic effect of the drug for a concentration of 2.5–5 microM of EGCG, and when applied as green tea polyphenols a very substantial effect occurred at a EGCG concentration of 1 microM (the other polyphenols may contribute to the activity).124 A pharmacokinetic study with healthy volunteers found a EGCG plasma concentration of 0.7 microM after a dose of 580 mg of EGCG, and a EGCG plasma concentration of 0.5 microM after a dose of 1 g of green tea polyphenols.423

N. The in vitro reduction by EGCG was overcome when the concentration of the drug was increased (to a level expected clinically ie in plasma from the standard drug dose).422 A further in vivo study found no reduction in the activity of the drug (when EGCG administered by injection to achieve plasma levels of 11–16 microM).125

medication.419 In a trial involving 3069 healthy volunteers treated for an average of 6.1 years, there were no statistically significant differences between placebo and Ginkgo in the rate of major bleeding or the incidence of bleeding in individuals taking aspirin. (Compliance during the trial was however low (at the end of the trial, about 60% were taking Ginkgo/placebo).420) In Korea, Ginkgo extract is administered with ticlopidine for the prevention of ischaemic stroke or acute coronary syndrome.421

QQ. Sorghum also contains phytate. Both phytate and polyphenol inhibit nutrients such as iron.436,437

PP. Several variants of CYP2C9 have been identified in humans: the most important mutations are CYP2C9*2 and CYP2C9*3. The CYP2C9*3 variant shows decreased metabolic activity for many drugs metabolised by CYP2C9. CYP2C9 is the main enzyme responsible for transforming losartan to its active metabolite.

NN. Of the 14 volunteers, in three, a small increase in AUC was observed after administration of St John’s wort.

MM. Two of the 10 patients with the highest hyperforin levels prior to drug administration showed the greatest decrease in the AUC∞ of docetaxel, for the other patients, no apparent correlation between hyperforin levels and the docetaxel AUC∞ was observed.

LL. Genetic polymorphisms are important in determining differences in the response to drugs, and may influence interactions. There are many genetic variants of the CYP genes, including the CYP2C19 gene. Phenotypes of CYP2C19 have been classified functionally as extensive metabolizers and poor metabolizers, the latter having a deficiency of CYP2C19 activity.238,435

KK. As noted for several drugs, the hyperforin content of the St John’s wort preparation, as well as the dosage of herb, affects the extent of the interaction. All types of preparations can contain hyperforin, including dry extracts used in tablets and capsules. Hyperforin is however, unstable – particularly when in solution.433 Tinctures and liquid extracts made using a standard ethanol content (45%) contain negligible amounts of hyperforin. Liquid extracts using a higher ethanol content (such as 60%) will contain a higher initial amount of hyperforin than standard liquid extracts. Over time the hyperforin content is substantially reduced and after a few months tinctures and liquid extracts contain no hyperforin.434

JJ Eleutherosides (from Siberian ginseng) and ginsenosides (from Korean ginseng) have some structural similarity with digoxin. Because of this similarity interference with serum digoxin measurements is possible, as confirmed when mice fed these herbs demonstrated digoxin activity in their serum. More specific assays are able to negate the interference.432

HH. Fructus Schisandra is defined as the fruit of Schisandra chinensis or Schisandra sphenanthera in traditional Chinese medicine. The major constituents are dibenzocyclooctene lignans. Several factors including harvest season, origin of herb and extraction solvent affect the levels of the individual lignans. Aqueous or ethanolic extracts of S. chinensis are not likely to contain more than 2.5 mg/g of deoxyschisandrin.430,431A maximum dose of S. chinensis extract equivalent to 4 g/day, would provide 10 mg/day of deoxyschisandrin.

GG. This procedure has been adopted in clinical trials where hypocholesterolaemic drugs (statins) were coadministered.428,429

FF. Orlistat inhibits gastric and pancreatic lipases in the lumen of the stomach and small intestine which leads to decreased absorption of dietary fat, and the subsequent excretion of the unabsorbed fats in faeces. No systemic absorption is required to exert its therapeutic effect.

EE. Plant part defined in other publication.427

DD. The different results for cayenne and turmeric under the same experimental conditions, suggest it is not only the quantity of polyphenol present that determines the inhibition, but also for example, the structure of the polyphenol (and hence mechanism of iron binding).247

CC. Administered in freeze-dried form (4.2 g), which would be expected to have a lower inhibitory effect than with the use of fresh chilli, as freeze drying probably decreased the ascorbic acid content (ascorbic acid enhances iron absorption).247

BB. Another clinical study also found a dose-dependent effect, and the reduced absorption was most marked when coffee was taken with the meal or one hour later. No decrease in iron absorption occurred when coffee was consumed one hour before the meal.394

AA. At an identical concentration of total polyphenols, black tea was more inhibitory than all the herb teas excluding peppermint: black tea was of equal inhibition to peppermint tea.243 The type of polyphenols present, as well as the concentration, may affect iron absorption.

128

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379 Huseini HF, Larijani B, Heshmat R et al. Phytother Res 2006; 20(12): 1036-1039 380 Taher MA, Atia YA, Amin MK. Iraqi J Pharm Sci 2010; 19(2): 11-18 381 Hashemi SJ, Hajiani E, Sardabi EH. Hep Mon 2009; 9(4): 265-270 382 Deng YQ, Fan XF, Li JP. Chin J Integr Med 2005; 11(2): 117-122 383 Han Y, Guo D, Chen Y et al. Eur J Clin Pharmacol 2009; 65(6): 585-591 384 Rajnarayana K, Reddy MS, Vidyasagar J et al. Arzneim Forsch 2004; 54(2): 109-113 385 Fuhr U, Beckmann-Knopp S, Jetter A et al. Planta Med 2007; 73(14): 1429-1435 386 Repalle SS, Yamsani SK, Gannu R et al. Acta Pharm Sci 2009; 51(1): 15-20 387 Han Y, Guo D, Chen Y et al. Xenobiotica 2009; 39(9): 694-699 388 Rossander L, Hallberg L, Bjorn-Rasmussen E. Am J Clin Nutr 1979; 32(12): 2484-2489 389 Disler PB, Lynch SR, Charlton RW et al. Gut 1975; 16(3): 193-200 390 Brune M, Rossander L, Hallberg L. Eur J Clin Nutr 1989; 43(8): 547-557 391 Derman D, Sayers M, Lynch SR et al. Br J Nutr 1977; 38(2): 261-269 392 Hallberg L, Rossander L. Hum Nutr Appl Nutr 1982; 36(2): 116-123 393 Chung KT, Wong TY, Wei CI et al. Crit Rev Food Sci Nutr 1998; 38(6): 421-464 394 Morck TA, Lynch SR, Cook JD. Am J Clin Nutr 1983; 37(3): 416-420 395 Layrisse M, García-Casal MN, Solano L et al. J Nutr 2000; 130(9): 2195-2159. Erratum in: J Nutr 2000; 130(12): 3106 396 Thankachan P, Walczyk T, Muthayya S et al. Am J Clin Nutr 2008; 87(4): 881-886 397 Nelson M, Poulter J. J Hum Nutr Diet 2004; 17(1): 43-54 398 Gabrielli GB, De Sandre G. Haematologica 1995; 80(6): 518-520 399 Mahlknecht U, Weidmann E, Seipelt G. Haematologica 2001; 86(5): 559 400 Kaltwasser JP, Werner E, Schalk K et al. Gut 1998; 43(5): 699-704 401 Ganji V, Kies CV. Plant Foods Hum Nutr 1994; 46(3): 267-276 402 Juan H, Terhaag B, Cong Z et al. Eur J Clin Pharmacol 2007; 63(7): 663-668 403 USP Drug Information, US Pharmacopeia Patient Leaflet, Valerian (Oral). Rockville: The United States Pharmacopeial Convention, 1998. 404 Herberg KW. Therapiewoche 1994; 44(12): 704-713 405 Carrasco MC, Vallejo JR, Pardo-de-Santayana M et al. Phytother Res 2009; 23(12): 1795-1796 406 Donovan JL, DeVane CL, Chavin KD et al. Drug Metab Dispos 2004; 32(12): 13331336 407 Krivoy N, Pavlotzky E, Chrubasik S et al. Planta Med 2001; 67(3): 209-212 408 Personal communication from trial author Yu KS, 2 February 2010. 409 Makino T, Hishida A, Goda Y et al. Nat Med 2008; 62(3): 294-299 410 Product information for Cranberry Classic juice drink. Available from www. oceanspray.com.au. Accessed November 2009. 411 Warshafsky S, Kamer RS, Sivak SL. Ann Intern Med 1993; 119(7 Pt 1): 599-605 412 Lawson LD, Wang ZJ, Papadimitriou D. Planta Med 2001; 67(1): 13-18 413 De Smet PA, Floor-Schreudering A, Bouvy ML et al. Curr Drug Metab 2008; 9(10): 1055-1062 414 Leistner E, Drewke C. J Nat Prod 2010; 73(1): 86-92 415 Kajiyama Y, Fujii K, Takeuchi H et al. Pediatrics 2002; 109(2): 325-327 416 Hasegawa S, Oda Y, Ichiyama T et al. Pediatr Neurol 2006; 35(4): 275-276 417 Arenz A, Klein M, Fiehe K et al. Planta Med 1996; 62(6): 548-551 418 Kuenick C. Dtsch Apoth Ztg 2010; 150(5): 60-61 419 Gaus W, Westendorf J, Diebow R. et al. Methods Inf Med 2005; 44(5): 697-703 420 DeKosky ST, Williamson JD, Fitzpatrick AL et al. JAMA 2008; 300(19): 2253-2262 421 Kim TE, Kim BH, Kim J et al. Clin Ther 2009; 31(10): 2249-2257 422 Shah JJ, Kuhn DJ, Orlowski RZ. Blood 2009; 113(23): 5695-5696 423 Henning SM, Niu Y, Liu Y et al. J Nutr Biochem 2005; 16(10): 610-616 424 Kageyama Y, Suzuki H, Saruta T. Endocrinol Jpn 1991; 38(1): 103-108 425 Haslam E, Lilley TH. Crit Rev Food Sci Nutr 1988; 27(1): 1-40 426 Price ML, Butler LG. J Agric Food Chem 1977; 25(6): 1268-1273 427 Ewerth S, Ahlberg J, Holmstrom B et al. Acta Chir Scand Suppl 1980; 500: 49-50 428 Moreyra AE, Wilson AC, Koraym A. Arch Intern Med 2005; 165(10): 1161-1166 429 Agrawal AR, Tandon M, Sharma PL. Int J Clin Pract 2007; 61(11): 1812-1818 430 Halstead CW, Lee S, Khoo CS et al. J Pharm Biomed Anal 2007; 45(1): 30-37 431 Zhu M, Chen XS, Wang KX. Chromatographia 2007; 66(1-2): 125-128 432 Dasgupta A, Wu S, Actor J et al. Am J Clin Pathol 2003; 119(2): 298-303 433 Ang CYW, Hu L, Heinze TM et al. J Agric Food Chem 2004; 52(20): 6156-6164 434 MediHerb Research Laboratories, 2004. 435 Tomlinson B, Hu M, Lee VW. Mol Nutr Food Res 2008; 52(7): 799-809 436 Lynch SR. Nutr Rev 1997; 55(4): 102-110 437 Gillooly M, Bothwell TH, Charlton RW et al. Br J Nutr 1984; 51(1): 37-46

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