Use of Herbal Supplements in

Chronic Kidney Disease

As a chronic kidney disease (CKD) patient, you may have considered the use of herbal products to assist you with various health concerns. This fact sheet will give you some information to enable you to make decisions regarding your use of herbs.

Use of herbal supplements may be unsafe for CKD patients, since your body is not able to clear waste products like a healthy person. There are some facts about herbs that every CKD patient should know:

Very few herbs have been studied in CKD patients. What may be safe for healthy persons may not be safe for someone with CKD, and in fact, could be dangerous. Therefore, you need to be very cautious about your use of these products.
The government does not regulate herbal supplements, so the exact content of these products is unknown.
Without regulation, there are no requirements for testing, so the purity, safety and effectiveness of the products are unknown.
Herbal preparations are subject to contamination (may contain toxic heavy metals such as lead or mercury).
Products may contain minerals harmful to CKD patients, for example: potassium.

Some herbs that may serve as diuretics may also cause “kidney irritation” or damage. These include bucha leaves and juniper berries. Uva Ursi and parsley capsules may have negative side effects as well.

Many herbs can interact with prescription drugs. A few examples are St. Johns Wort, echinacea, ginkgo, garlic, ginseng, ginger, and blue cohosh. Transplant patients are especially at risk, as any interaction between herbs and medications could potentially put them at risk for rejection or losing the kidney. It is important to ask your doctor and/or pharmacist about any herbs or medicines you want to take to avoid potential problems.

Herbs that may be toxic to the kidneys
Artemisia absinthium (wormwood plant)	Periwinkle
Autumn crocus	Sassafras
Chuifong tuokuwan (Black Pearl)	Tung shueh
Horse chestnut	Vandelia cordifolia

Herbs that may be harmful in chronic kidney disease
Alfalfa	Buckthorn	Ginger	Nettle	Vervain
Aloe	Capsicum	Ginseng	Noni juice
Bayberry	Cascara	Horsetail	Panax
Blue Cohosh	Coltsfoot	Licorice	Rhubarb
Broom	Dandelion	Mate	Senna

Herbs known to be unsafe for all people
Chapparal	Pennyroyal
Comfrey	Pokeroot
Ephedra (Ma Huang)	Sassafras
Lobelia	Senna
Mandrake	Yohimbe

These lists are not necessarily complete. More information regarding the use of herbs will become available over time. You are encouraged to proceed with caution with all herbal preparations and use them only under the direction of your medical team.
With all of these cautions, perhaps you are wondering if use of any herbs is a good idea. The use of common herbs, in normal amounts, when cooking is just fine and typically recommended to enhance the flavor of foods on a low-sodium diet.
So, before you take any herbal supplement, we recommend:

Checking with your doctor, dietitian, pharmacist and/or product manufacturer regarding safety, dosage, duration of use, interactions with prescription drugs, etc.
Use only standardized herbal extracts made by reputable companies.
Never take more than the recommended dosage, or longer than recommended.
Do not use herbal remedies for serious illness.
Do not use herbs if considering pregnancy.

Remember … natural does not mean safe, especially for CKD patients. Be smart and ask questions before using any herbal products.
The following references can provide additional information regarding the use of herbal supplements:

American Botanical Council
www.herbalgram.org

National Center for Complementary and Alternative Medicine
nccam.nih.gov

National Library of Medicine, Medline Plus
www.nlm.nih.gov/medlineplus/alternativemedicine.html
www.nlm.nih.gov/medlineplus/herbalmedicine.html

United States Pharmacopoeial
www.usp.org

PDR for Herbal Medicines . Gruenwald J, Bendler T, Jaenicke C, eds. Montvale NJ: Medical Economics Company, Inc., 2000
The Honest Herbal . Tyler V. Pharmaceutical Products Press, New York, 1999

More than 20 million Americans—one in nine adults—have chronic kidney disease, and most don't even know it. More than 20 million others are at increased risk. The National Kidney Foundation, a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. Through its 50 affiliates nationwide, the foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of the National Kidney Foundation is funded by public donations.

The National Kidney Foundation would like to thank the
Council on Renal Nutrition for the development of this fact sheet.

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About Chronic Kidney Disease

Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over time. To read more about kidney function, see How Your Kidneys Work. CKD is also known as chronic renal disease.

What is chronic kidney disease (CKD)?

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

The Facts About Chronic Kidney Disease (CKD)

26 million American adults have CKD and millions of others are at increased risk.
Early detection can help prevent the progression of kidney disease to kidney failure.
Heart disease is the major cause of death for all people with CKD.
Glomerular filtration rate (GFR) is the best estimate of kidney function.
Hypertension causes CKD and CKD causes hypertension.
Persistent proteinuria (protein in the urine) means CKD is present.
High risk groups include those with diabetes, hypertension and family history of kidney disease.
African Americans, Hispanics, Pacific Islanders, Native Americans and Seniors are at increased risk.
Three simple tests can detect CKD: blood pressure, urine albumin and serum creatinine.

What causes CKD?

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes. High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.
Other conditions that affect the kidneys are:

Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney's filtering units. These disorders are the third most common type of kidney disease.
Inherited diseases, such as polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue.
Malformations that occur as a baby develops in its mother's womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
Lupus and other diseases that affect the body's immune system.
Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men.
Repeated urinary infections.

What are the symptoms of CKD?

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:

feel more tired and have less energy
have trouble concentrating
have a poor appetite
have trouble sleeping
have muscle cramping at night
have swollen feet and ankles
have puffiness around your eyes, especially in the morning
have dry, itchy skin
need to urinate more often, especially at night.

Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:

have diabetes
have high blood pressure
have a family history of chronic kidney disease
are older
belong to a population group that has a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians.

Learn more About Glomerular Filtration Rate (GFR)

GFR—glomerular filtration rate is the best test to measure your level of kidney function and determine your stage of kidney disease. Your doctor can calculate it from the results of your blood creatinine test, your age, race, gender and other factors.
The earlier kidney disease is detected, the better the chance of slowing or stopping its progression.

What happens if my test results show I may have chronic kidney disease?

Your doctor will want to pinpoint your diagnosis and check your kidney function to help plan your treatment. The doctor may do the following:

Calculate your Glomerular Filtration Rate (GFR), which is the best way to tell how much kidney function you have. You do not need to have another test to know your GFR. Your doctor can calculate it from your blood creatinine, your age, race, gender and other factors. Your GFR tells your doctor your stage of kidney disease and helps the doctor plan your treatment.
Perform an ultrasound or CT scan to get a picture of your kidneys and urinary tract. This tells your doctor whether your kidneys are too large or too small, whether you have a problem like a kidney stone or tumor and whether there are any problems in the structure of your kidneys and urinary tract.
Perform a kidney biopsy, which is done in some cases to check for a specific type of kidney disease, see how much kidney damage has occurred and help plan treatment. To do a biopsy, the doctor removes small pieces of kidney tissue and looks at them under a microscope.

Your doctor may also ask you to see a kidney specialist who will consult on your case and help manage your care.
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HERBS SIDE EFFECT

Valerian Root

Posted on November 9, 2010 by admin

Valerian Root

Valerian Root is the root of a perennial plant which produces beautiful sweet smelling white or purple flowers and the name “Valere” in Latin means to be in peak health. Valerian is indigenous to parts of Asia, South Africa and Europe and since has been introduced to most countries around the globe. It is an exceptionally pungent smelling plant when dried due to the isovaleric acid the root produces.
Dating back to the ancient Romans and Greeks this valuable medicinal plant was used as a folk medicine for various illnesses such as urinary tract infections, nausea and vomiting, severe headaches, heart conditions, insomnia and liver disorders. Valerian is known to have a sedative effect and is used widely to treat patients suffering from insomnia as well as a muscle relaxant as the effects of valerian reduce tension and irritability.
In Germany mothers used Valerian as a coffee substitute and as a condiment during medieval times and a tea made for children thought to be misbehaved at that time but in today’s times we would term this behaviour as ADHD. This medicinal herb is also used for conditions such as nervousness, epilepsy and hysteria. The herb also contains diuretic properties.
Researchers have found no consensus as to what the active valerian constituents in valerian root are. The result of valerian activity may be due to a combination of compounds. Researchers have established that valerian increases the GABA by increasing its production in the body or may even decrease the GABA absorption and/ar break down the GABA. There is inconclusive evidence of the effectiveness of valerian.
Valerian root can be purchased in most pharmacies as well as health outlets around the globe and can be bought directly over the counter as well as online. Valerian can now be obtained in capsule or tablet form as a dietary supplement. The preparation method is easy all you do is add 1 teaspoon of valerian root to a cup of boiling water. Allow the tea to cool off and then strain and drink.

Valerian Root – Side Effects.. THIS IS USE IN HERBALIFE

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Herbal medicine like any other medication needs to be taken with caution as all medications have side effects. If valerian is being used for insomnia it should not be combined with other medications such as sedatives or benzodiazepines like Temazepam, Zopiclone, Lorazepam or Phenargan. Valerian should not be taken by children nor expectant ( pregnant) and nursing mothers. The side effects may include itchiness, drowsiness, dizziness, headaches, dry mouth or an upset stomach.
There have been reported cases where valerian root has been associated with liver damage but has not been proven. Should you experience any pain or discomfort on the right side of the abdomen accompanied by nausea, vomiting, diarrhoea and intense itching, you are advised to stop the medication and contact your doctor immediately. Always consult a professional before using valerian root and should you be suffering from any liver disease avoid taking this herb.
Contra Indications of Valerian Root
Valerian root should under no circumstances be taken with other medications such as antifungal agents, allergy medications, cholesterol medications or chemotherapy medications as valerian is broken down by enzymes in the liver and could interfere with these other types of medications.
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Is Ephedra Legal or Banned?

Ephedra-based diet supplements are completely and fully banned, despite many years of mixed messages.

Here is where things stand:

February 2004 – FDA prohibited sales of diet supplements containing ephedrine alkaloids.
In April 2005 a judge in Utah struck down the FDA ban.
Later in 2005 supplement makers began making pills with a 10mg dose of the ephedra alkaloid. This made things very confusing and left many wondering whether ephedra was legal or not.
Aug 17 2006, the FDA upheld their original ban (effectively reversing the Utah court decision).

The FDA Ban

From the FDA:

No dosage of dietary supplements containing ephedrine alkaloids is safe and the sale of these products in the United States is illegal and subject to FDA enforcement action.

Ephedra will always remain a controversial supplement. Along with many critics, there are also many who support the use of ephedra as an effective fat burner.
The supporters claim an overall ban is unfair and that pharmaceutical drugs consistently bring far more deaths and adverse side effects than ephedra ever did. As to it’s effectiveness, a report available on the FDA site concludes that:

The short-term use of ephedrine, ephedrine plus caffeine, or the assessed dietary supplements containing ephedra and herbs with caffeine is associated with a statistically significant increase in short-term weight loss (compared to placebo).

I suspect this debate will carry on for many years to come.

Ephedra is Still Available

A ban always drives a product underground. Unfortunately, consumers can still get ephedra online.
This is dangerous because consumers aren’t protected if they buy it and get sick. There’s no way to tell if it’s real ephedra or something else and scams abound.
Why not work on changing your lifestyle and spend that money on healthy food. The weight loss results would last longer and your heath would improve instead of being compromised by drugs like ephedra. Posted in Drugs, Insomnia

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The C.A.M. Report

Consumer alert: 12 dietary herbal supplements

Caught in the act by the FDA, Herbal Science International, Inc. (aka Jen-On Herbal Science International, Inc.) is recalling 12 dietary supplements that contain ephedra, aristolochic acid, or human placenta.
Human placenta!
These products contain ephedra.

Wu Yao Shun Qi San
Qing Bi Tang (Nasal Cleanser)
Zhong Fong Huo Luo Wan (Stroke Revito Formula)
Xiao Qing Long Tang (Little Green Dragon)
Ding Chuan Tang
Xiao Xu Ming Tang
Feng Shi Zhi Tong Wan (Joint Relief)
Guo Min Bi Yan Wan
Fang Feng Tong Sheng San

No dose of ephedra is considered safe.
These products contain aristolochic acid, a cancer causing chemical and kidney toxin.

Tou Tong San (Headache Formula)
Du Huo Ji Sheng Tang (Du Huo Joint Relief)

This product contains human placenta that may transmit disease.

Seng Jong Tzu Tong Tan

The bottom line?
The FDA is moving to gain tighter control the quality of manufactured supplements. It can’t come soon enough.
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The C.A.M. Report

What not to take before surgery

OK, you’re scheduled for surgery, and you take herbals.
Does your surgeon know what you take?
Be smart. If you use any of the herbals on this list, tell your surgeon.

Danshen: May cause bleeding
Dong quai: May cause bleeding
Echinacea: May interfere with immune functioning, may alter effectiveness of immunosuppressant drugs given after transplant surgery
Ephedra: May cause abnormal heartbeat, may cause extreme high blood pressure and coma if combined with certain antidepressants and anesthesia
Feverfew: May cause bleeding
Garlic: May cause bleeding, may interfere with normal blood clotting
Ginger: May cause bleeding
Ginkgo: May cause bleeding
Ginseng: May cause bleeding, may cause rapid heartbeat, may cause high blood pressure
Goldenseal: May cause or worsen high blood pressure
Kava: May enhance sedative effects of anesthesia
Licorice (not including licorice candy): May increase blood pressure
Senna: May cause electrolyte imbalance
St. John’s wort: May increase or decrease the effects of some drugs used during and after surgery
Valerian: May interfere with the effects of anesthesia