Recent Trends in Use of Herbal and Other Natural Products

Slone Epidemiology Center, Boston University School of Public Health, Boston, MA 02215, USA.
Archives of Internal Medicine (Impact Factor: 17.33). 03/2005; 165(3):281-6. DOI: 10.1001/archinte.165.3.281
Source: PubMed


The benefits of herbal and other natural products (dietary supplements) are increasingly cited in the media. Dramatic increases in use reported during the last decade have led to growing concerns about efficacy and safety.
To determine which dietary supplements American adults use, whether the prevalence has continued to increase in recent years, and whether popularity of individual supplements has changed, demographic information and details of use of all medicines and dietary supplements in the preceding week were obtained by telephone interview from February 1998 through December 2002 from households in 48 contiguous states and the District of Columbia. Participants included randomly selected residents of households with telephones; compared with 2000 US Census data, participants were representative of the US population. The main outcome measure was the weekly prevalence of dietary supplement use, alone or in a multicomponent product.
There were 8470 subjects 18 years or older. The annual prevalence of dietary supplement use increased from 14.2% in 1998-1999 to 18.8% in 2002. Although use did not change among younger subjects, it doubled for men and women 65 years or older. Use of Ginkgo biloba and Panax ginseng declined during the study, while lutein use increased dramatically, because of its addition to multivitamin products. The overall 2002 prevalence excluding lutein use was 13.9%.
The popularity of specific supplements has varied over time and differs according to age and sex. The sharp increase in supplement use in the 1990s appears to have slowed. However, the addition of supplements, such as lutein and lycopene, to mainstream multivitamins has become an important source of exposure.

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    • "The cys form is preferentially captured by benign and malignant prostate tissues and it is produced during cooking [77]. As lycopene has been correlated with a low frequency of adenocarcinoma [78], from 2003 it was added to most multivitamin products as an agent for the prevention of cancer and has become the most commonly used carotenoid , among men of 45–65 years old [79]. In addition to lycopene, tomato contains lycopene cyclase (the enzyme that catalyzes the conversion of lycopene to β-carotene). "
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    ABSTRACT: Benign prostatic hyperplasia (BPH) is one of the most common urological diseases in aging men. Because of its long latency, BPH is a good target for prevention. The aim of the study has been to review the various options of treatment, currently available, in the field of phytotherapy. Watchful waiting, pharmacological therapy, and surgery are also helpful, depending on the severity of the disease. Although drug therapy (alpha1-blockers, 5alpha-reductase inhibitors) and surgery (prostatectomy, transurethral resection, etc.) seem to be the most effective for patients with moderate-severe BPH, herbal medicines (i.e., Serenoa repens, Pygeum africanum, Urtica dioica) are also commonly used in patients with mild-moderate symptoms. On the basis of preclinical studies several mechanisms of action have been postulated, including 5alpha-reductase inhibition, alpha-adrenergic antagonism, dihydrotestoterone and estrogen receptors inhibition. Randomized clinical trials indicate significant efficacy in improving urinary symptoms and mild adverse effects for some of phytotherapeutic agents, while further clinical evidence is needed for others (e.g., Epilobium Spp., Secale cereale, Roystonea regia). Healthcare professionals should be constantly informed about BPH phytotherapy, taking into account the risks/benefits profile of the use of medicinal plants in the management of BPH. Copyright © 2015. Published by Elsevier Inc.
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    • "A 2007 survey demonstrated that 15% of patients receiving conventional pharmacotherapy were also taking herbal medicines and potential adverse HDIs were observed in 40% of these patients (Bush et al., 2007). Some patients take the decision to medicate with several different herbs and herbal preparations themselves, without consulting their doctor (Kelly et al., 2005). Many studies have produced evidence for the induction or inhibition of drug-metabolizing enzymes by herbs (Zhou et al., 2003; Gorski et al., 2004; Gao et al., 2013). "
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    ABSTRACT: Ethnopharmacological relevance: Polygonum capitatum is a well-known Miao medicinal plant that has been used for many years for its unique therapeutic effects on various urological disorders, including urinary calculus and urinary tract infections. To investigate the effect of Polygonum capitatum on cytochrome P450 (CYP) isoforms (CYP1A2, CYP2C9, CYP2C19, CYP2E1, and CYP3A4) in vivo using a "cocktail" approach by administering five probe drugs to rats. This study assessed the potential of Polygonum capitatum to interact with co-administered drugs. Materials and methods: An aqueous extract of dried whole Polygonum capitatum was prepared and administered orally to rats at a dose of 0.58g/kg or 1.74g/kg twice daily for 7 or 14 consecutive days. A cocktail of caffeine (1.0mg/kg), tolbutamide (1.0mg/kg), omeprazole (2.0mg/kg), chlorzoxazone (4.0mg/kg) and midazolam (4.0mg/kg) was then administered on the eighth or fifteenth day to evaluate the effects of Polygonum capitatum on CYP1A2, 2C9, 2C19, 2E1, and 3A4, respectively. Blood samples were collected at a range of time-points and the plasma concentrations of the probe drugs were simultaneously quantified using ultra high-performance liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were calculated to evaluate the effects of Polygonum capitatum on the activities of these CYP enzymes in rats. Results: Polygonum capitatum pre-treatment had no significant effect on the pharmacokinetic parameters of caffeine, omeprazole or chlorzoxazone. However, the pharmacokinetics of tolbutamide and midazolam were affected significantly (P<0.05) by Polygonum capitatum, which induced more rapid metabolism of these probe compounds. Conclusions: These results suggested that Polygonum capitatum could induce CYP2C9 and CYP3A4, and did not influence CYP1A2, CYP2C19 or CYP2E1. Therefore, the clinical dose of drugs metabolized by human CYP2C9 or CYP3A4 may need to be adjusted in patients taking Polygonum capitatum, as this herbal medication may result in reduced effective concentrations of these drugs.
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    • "The use of herbs as the complementary and alternative medicine (CAM) is on the rise and gaining increased popularity (Kelly et al., 2005). Meanwhile, it has been reported more and more herb–drug interactions related to the use of herbs or natural products, such as St. John's wort (Hypericum perforatum) (Zhou et al., 2004), Garlic (Allium sativum) (Gallicano et al., 2003), Ginkgo (Ginkgo biloba), Ginseng (Panax ginseng), Milk thistle (Silybum marianum) and so on (Pal and Mitra, 2006). "
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