Name | Suggested Attributes | Suggested Mechanisms of Action | Reported Adverse Effects | Notes, Drug-Herb Interactions |
---|---|---|---|---|
Boswellia (Boswellia serrata) | Analgesic Anti-inflammatory Anticancer | Inhibits 5-lipoxygenase and cyclo-oxygenase-1 Inhibits nuclear transcription factor kappa B (NF-kappa B) signaling, thereby decreasing production of tumor necrosis factor alpha (TNF-alpha) Cytotoxic Radioenhancing Improves cognitive function Lowers insulin resistance | Typically well tolerated; occasional GI upset | Unknown clinical significance regarding anion transporter OATP1B3, multidrug resistant protein MRP2, and P-glycoprotein May inhibit platelet aggregation and thereby increase risk of bleeding |
Turmeric (Curcuma longa) | Analgesic Anti-inflammatory Anticancer Antiemetic | Decreases TNF-alpha concentration Antiproliferative Inhibits matrix metalloproteinase Radioenhancing, chemosensitizing | Diarrhea, flatulence, and/or bloating with high doses May lead to headache and nausea | May increase risk of bleeding when combined with NSAIDs Unknown clinical significance of interactions with chemotherapeutic drugs |
Ginger (Zingiber officinale) | Analgesic Anti-inflammatory Anticancer Hypoglycemic Antiemetic Regulates GI motility Anti-infective for GI tract | Stimulates flow of saliva, bile, and gastric secretions Competitive antagonist of serotonin 5-HT3 receptors Inhibits thromboxane formation and platelet aggregation Stimulates mucosal cells to secrete interferon-beta to combat viral infection Reduces tumor growth by damaging microtubules and inducing mitotic arrest Inhibits angiogenic cytokines, vascular endothelial growth factor, and interleukin-beta in cell cultures Increases levels of circulating antioxidant and phase II enzymes Reduces lipid peroxidation levels | Abdominal discomfort, diarrhea, gastric irritation, and mucosal irritation of the oropharynx are possible. | May increase risk of bleeding when combined with NSAIDs Can cause additive reductions in blood glucose when co-administered with other glucose-lowering substances. May lead to decreased blood concentrations of cyclosporine |
Devil's claw (Harpagophytum procumbens) | Analgesic Anti-inflammatory Antiosteoporotic Antioxidant Appetite suppressing | Decreases inflammatory cytokine production such as TNF-alpha Inhibits pro-inflammatory gene expression | GI bleeding, acute pancreatitis, gastric discomfort or ulcers | May affect blood levels of substances metabolized by cytochrome P450 enzymes due to its inhibition of several families of these enzymes. May impact drug transport mediated by P-glycoprotein. |
Cayenne or capsaicin (Capsicum frutescens) | Analgesic Circulatory support | Depletes substance P from C-fiber polymodal nociceptors. Activates transient receptor potential vanilloid subfamily member 1 (TRPV1). Releases calcitonin gene-related peptide (CGRP) to cause coronary vasodilation. | GI irritation with oral administration | Interacts with cytochrome P450 (CYP) 3A and P-glycoprotein (P-gp) substrates, leading to altered absorption and metabolism of co-administered medications. Drugs affected by capsaicin include ACE inhibitors, antihypertensive agents, antiplatelet drugs, immunosuppressants such as cyclosporine, and theophylline. |
Peppermint (Mentha piperita L.) | Analgesic for aches Alleviates digestive discomfort / antispasmodic Anti-inflammatory Anticancer Hypoglycemic/antidiabetic Antifungal Antibacterial Antifibrotic Antioxidant Anti-infective for GI tract | Diminishes calcium influx, thereby regulating calcium channel–dependent activities in GI tract smooth muscle Menthol reduces lipid peroxidation, oxidative stress, and inflammation in colitis animal model | Mild GI upset, nausea, vomiting with oral administration Dermatitis with topical administration | May increase risk of bleeding Unknown clinical significance of interactions with chemotherapeutic drugs |
Lavender (Lavandula angustifolia) | Anxiolytic Analgesic Anti-inflammatory Antioxidant Antimicrobial Anticonvulsant Neuroprotective Anti-infective for GI tract | Anti-inflammatory and analgesic effects are attributed to the terpene 1,8-cineole; linalool and linalyl acetate relax vasculature and counter anxiety | Nausea, confusion, eructation from oral administration Possible dermatitis and photosensitivity with topical administration | Additive effects with sedating medications are possible |
Kava (Piper methysticum) | Anticonvulsant Local anesthetic Skeletal muscle relaxant | Kavapyrones act on CNS to induce skeletal muscle relaxation | Hepatotoxicity Headache Urticaria Skin irritation Ataxia Altered mental status | Additive effects when co-administered with CNS depressants |
St John's wort (Hypericum perforatum) | Antidepressant Neuroprotective Analgesic for neuropathic pain | Hyperforin and hypericin may alleviate neuropathic pain and offer neuroprotective effects Inhibit neuronal uptake of serotonin, norepinephrine, and dopamine | Photosensitivity Increased prothrombin time GI upset Dry mouth Headache Nausea Neuropathy | Commonly causes herb-drug interactions Can lead to serotonin syndrome when combined with selective serotonin reuptake inhibitor(s) |
Reishi mushroom (Ganoderma lucidum) | Immunomodulatory Renoprotective Anti-inflammatory Hepatoprotective Anticancer | Beta glucans, polysaccharides provide antitumor and immunostimulatory activities Triterpene compounds may inhibit invasiveness of tumors by reducing expression of matrix metalloproteinases Additional anticancer possible | Nausea Insomnia | May increase risk of bleeding when given with anticoagulants and antiplatelet substances Can counter immunosuppressant drug activity by enhancing immune responses May counteract chemotherapeutic agents that rely on free radical formation by increasing plasma antioxidant activity. Inhibits cytochrome P450 enzyme activity so may affect intracellular concentrations of drugs metabolized by same CYP enzyme families. |
Milk thistle (Silybum marianum) | Treat various liver diseases Antioxidant Anticancer Reduce chemotherapy-induced hepatotoxicity and other adverse effects, including the severity of radiodermatitis (silymarin gel) | Silymarin may confer hepatoprotection by downregulating extracellular matrix proteins such as collagen May reduce liver carcinogenesis by inhibiting mast cells and matrix metalloprotein production Silibinin (a milk thistle flavonoid) demonstrates antioxidant and anti-inflammatory activity by inhibiting release of hydrogen peroxide and production of TNF-alpha Various anticancer effects such as arresting G1 and S phases of the cell cycle. | High doses of silibinin may increase bilirubin levels and liver enzymes | Effects on CYP 450 enzymes have unclear clinical significance |
Yunnan Baiyao (or Yunnan Paiyao) | Hemostatic Anti-inflammatory Antimicrobial Notoginseng, a major component, demonstrates the following activities when administered as a solo agent: Anticoagulant Antiplatelet Fibrinolytic | Although preparations vary across manufacturers and the ingredients are unknown (proprietary), it appears that some of the nanofiber components in Yunnan Baiyao may help activate blood clotting Notoginseng also reduces fibrinogen levels in the blood and protects endothelial function, among many other effects on platelets and immune cells | Estrogenic activity in notoginseng and ginsenosides may stimulate the growth of hormone-sensitive mammary cancer | May increase risk of bleeding when given with anticoagulant or antiplatelet medications May inhibit or induce cytochrome P450 enzymes and thereby alter the metabolism of substrate drugs of those enzymes |
Cannabidiol (Cannabis sativa) | Anti-inflammatory Anticonvulsant Analgesic Neuroprotective Antioxidant | Endocannabinoid modulator Inhibits pro-inflammatory pathways Interacts with multiple receptors and neurotransmitter pathways | Nausea Oversedation Inappetence Liver enzyme changes Possible reproductive system changes | Changes have been reported in co-administered anti-epileptic medications. Concern is growing about additional potential herb-drug interactions. |