About Herbs Database

Memorial Sloan Kettering Cancer Center’s About Herbs database, a tool for the public as well as healthcare professionals, can help you figure out the value of using common herbs and other dietary supplements. A pharmacist and botanicals expert manages and continually updates the database with assistance from other MSK Integrative Medicine Service experts, providing you with objective and evidence-based information that can be helpful in judging a product’s: traditional and proven uses; potential benefits; possible adverse effects; interactions with other herbs or medicines.

Effectiveness of food supplement on treatment outcomes and quality of life in pulmonary tuberculosis: Phased implementation approach.

BACKGROUND: By encouraging treatment adherence and lowering mortality, dietary supplements can serve as adjuvant therapy for the success of medical interventions. We determined the effect of locally accessible food supplements on treatment outcomes, and health-related quality of life in patients with pulmonary tuberculosis initiating anti-tuberculosis treatment (ATT) in Odisha, India. METHOD: Between September 2017 and December 2018, implementation research in patients with newly diagnosed sputum smear-positive pulmonary tuberculosis initiating ATT in five districts of the tribal belt of Odisha, offered food supplements along with ATT in a phased manner. Clinical symptoms, anthropometry, sputum for M. tuberculosis (M. tb), health-related quality of life and return to normal function were assessed periodically, and favourable treatment outcome (cure or treatment completed) was measured at the end of treatment. The effect of the food supplement on unfavorable outcomes (treatment failure, death, or lost-to-follow-up) was modelled using mixed-effects Poisson regression to determine the risk factors. RESULTS: Among the 761 participants enrolled, 614 participants received the food supplement and 147 did not receive the food supplement. Among the 614 participants in the supplement group, 537 (87%) had a favorable outcome and among the 147 participants in the no-supplement group, 113 (77%) had a favorable outcome (p = 0.0017). Higher age (>55 years) [aRR = 2.1(95% CI: 1.1-3.8)], male gender [aRR = 1.7(95% CI: 1.2-2.9)], and smear grading ≥2+ [aRR = 1.5 (95% CI: 1.1-2.2)] were associated with unfavorable treatment outcomes. Nutritional status, quality of life and lung health showed significant improvement from baseline in the supplement group. CONCLUSION: Improvement in the nutritional status of the patient can be considered a predictor of treatment success rates. Early food supplementation has a positive impact on the nutritional status.

Growth performance, antioxidant status, intestinal morphology, and body composition of Nile tilapia (Oreochromis niloticus) supplemented with essential oils: A meta-analysis.

This study aimed to evaluate the effects of dietary supplementation with essential oils (EOS) on growth performance, antioxidant status in blood serum, intestinal morphology, and whole-body composition of Nile tilapia (Oreochromis niloticus) through a meta-analytic approach. The search and collection of scientific articles were conducted using the PRISMA methodology, and 45 full-text scientific articles were obtained. The data used in the meta-analysis were extracted from these 45 documents. The effect size was assessed through weighted mean differences (WMD) using Der-Simonian and Laird random effects models. Dietary supplementation with EOS increased (P < 0.001) final weight, body weight gain, specific growth rate, feed intake, protein efficiency ratio, and survival but decreased (P < 0.001) feed conversion ratio. In blood serum, EOS supplementation decreased (P < 0.001) the concentration of malondialdehyde and increased (P < 0.001) the concentration of catalase, superoxide dismutase, and glutathione peroxidase. In the foregut, midgut, and hindgut, greater (P < 0.01) villus height, villus width, and number of goblet cells were observed in response to EOS supplementation. EOS supplementation increased (P < 0.01) crude protein content and decreased (P < 0.05) crude lipid content in the whole-body. In conclusion, essential oils can be used as a dietary additive to improve growth performance, antioxidant status in blood serum, and intestinal morphology in Nile tilapia. Likewise, supplementation with essential oils increases the protein content and decreases the fat content in the whole-body of Nile tilapia.

Excess Folic Acid and Vitamin B12 Deficiency: Clinical Implications?

BACKGROUND: In the 1940s to 1950s, high-dose folic acid supplements (>5 mg/d) were used clinically to reverse the megaloblastic anemia of vitamin B12 deficiency caused by pernicious anemia. However, this treatment strategy masked the underlying B12 deficiency and possibly exacerbated its neuropathological progression. The issue of masking and exacerbating B12 deficiency has recently been rekindled with the institution of folic acid fortification and the wide-spread use of folic acid supplements. OBJECTIVES: The objectives of this review are to describe clinical and epidemiological evidence that excess folic acid exacerbates B12 deficiency, to summarize a hypothesis to explain this phenomenon, and to provide guidance for clinicians. RESULTS: Cognitive function test scores are lower and blood homocysteine and methylmalonic acid concentrations are higher in people with low B12 and elevated folate than in those with low B12 and nonelevated folate. High-dose folic acid supplementation in patients with pernicious anemia or epilepsy cause significant reductions in serum B12. It is hypothesized that high-dose folic acid supplements cause depletion of serum holotranscobalamin and thus exacerbate B12 deficiency. CONCLUSION: The evidence for excess folic acid exacerbating B12 deficiency is primarily correlative or from uncontrolled clinical observations, and the hypothesis to explain the phenomenon has not yet been tested. Nonetheless, the evidence is sufficiently compelling to warrant increased vigilance for identifying B12 deficiency in at risk individuals, including older adults and others with low B12 intake or conditions that are associated with B12 malabsorption, who also ingest excessive folic acid or are prescribed folic acid in high doses.

Plain language titleExcess Folic Acid and Vitamin B12 Deficiency: Clinical Implications?Plain language summaryIt has been known for many decades that high doses of the B vitamin supplement, folic acid, can alleviate the anemia of vitamin B12 deficiency, at least temporarily. However, by alleviating the anemia, such folic acid supplements were said to "mask" the underlying vitamin B12 deficiency, thus allowing neurological damage to continue or possibly be exacerbated. Consequently, treating vitamin B12 deficiency with high dose folic acid was discontinued in the 1970s. The issue of whether folic acid supplements can exacerbate vitamin B12 deficiency reemerged in the 1990s with folic acid fortification of cereals and grains in the United States and Canada (and now in over 80 countries around the world) to prevent spina bifida and other birth defects. This narrative review summarizes the results of studies that have assessed the relationships between folic acid and folate and vitamin B12 status in patients and in populations. A recent hypothesis on how folic acid might exacerbate vitamin B12 deficiency is summarized, and recommendations to clinicians are made for increased vigilance in assessing vitamin B12 status in certain groups at risk of vitamin B12 deficiency, including older adults, people with gastrointestinal issues and other factors that cause vitamin B12 malabsorption, people with unexplained neurological problems, and people who follow vegan or vegetarian diets which are naturally low in vitamin B12.

Vitamin B12 Deficiency in Clinical Practice-Proceedings of the International B12 Conference, June 2023, Rotterdam.

This supplement of the Food and Nutrition Bulletin is dedicated to the proceedings of "the International B12 Conference in Clinical Practice," held in Rotterdam in June 2023. The conference brought together physicians, scientists, patient groups, and health care professionals with substantial expertise in diagnosing and treating vitamin B12 deficiency from many universities around the world. With a collective commitment to advancing clinical practice and improving patient outcomes, this event was instrumental in addressing the many complex and challenging aspects of vitamin B12 deficiency. The subjects explored at the conference ranged from the latest research findings to real-world case studies, spanning diverse medical disciplines, including pediatrics, obstetrics, neurology, internal medicine, gastroenterology, psychiatry, clinical chemistry, nutrition, public health, biomedical science, and nursing. The broad spectrum of disciplines reflects the multifaceted nature of vitamin B12 deficiency and underscores the necessity of a comprehensive and multidisciplinary approach to its diagnosis and treatment. This supplement aims to distill into a concise and accessible format the knowledge shared by stimulating and provocative presentations at the B12 Conference and to make the information available for the broader scientific and health care community. The compendium bridges the insights generated at the conference and the wider audience of health care practitioners, researchers, and policymakers who recognize the urgency of addressing the critical public health concerns surrounding vitamin B12 deficiency.

Plain language title Vitamin B12 Deficiency in Clinical Practice: Proceedings of an International B12 Conference Plain language summary This supplement focuses on vitamin B12, a crucial micronutrient essential for overall human health. It summarizes the proceedings of the "International B12 Conference in Clinical Practice," held in June 2023 in Rotterdam. The conference gathered experts from various fields, including physicians, scientists, patient groups, and health care professionals, to address the complexities of diagnosing and treating vitamin B12 deficiency. The content covers various topics, from the latest research findings to real-world case studies spanning diverse medical disciplines. The aim is to distill the conference's knowledge into an accessible format for the broader scientific and health care community. The supplement emphasizes the need for a comprehensive and multidisciplinary approach to address Vitamin B12 deficiency by bringing together insights from different disciplines. The manuscripts within the supplement delve into the intricacies of vitamin B12 deficiency offering a synthesis of research findings, clinical insights, and innovative approaches to diagnosis and treatment. The goal is to inspire further research, inform clinical practice, and ultimately improve patient care in the critical areas of nutrition and health care. The supplement expresses gratitude to conference contributors, attendees, and supporters who made the event and publication possible. It aims to contribute to preventing or treating B12 deficiency and improving patients' health and well-being. Whether at the beginning or end of life and all ages in between, addressing B12 deficiency can significantly enhance global health and quality of life.

Meta-analysis of the effect of curcumin supplementation on skeletal muscle damage status.

OBJECTIVES: Meta-analysis was conducted to examine the effect of supplemental curcumin intake on skeletal muscle injury status and to propose an optimal intervention program. METHODS: In accordance with the procedures specified in the PRISMA statement for systematic reviews and meta-analyses of randomized controlled trials, the Review Manager 5.3 was used to analyze the results of creatine kinase (CK), muscle soreness, interleukin-6 (IL-6), and range of motion (ROM) as outcome indicators in the 349 subjects included in the 14 articles. RESULTS: The effect size of curcumin supplementation on muscle soreness, mean difference (MD) = -0.61; the relationship between curcumin supplementation and muscle soreness for time of measurement (I2 = 83.6%)、the relationship between curcumin supplementation and muscle soreness for period of intervention (I2 = 26.2%)、the relationship between whether one had been trained (I2 = 0%) and supplementation dose (I2 = 0%) were not heterogeneous for the relationship between curcumin supplementation and muscle soreness; The effect size on CK, MD = -137.32; the relationship between curcumin supplementation and CK (I2 = 79.7%)、intervention period (I2 = 91.9%)、whether or not trained (I2 = 90.7%)、and no heterogeneity in the relationship between curcumin supplementation and CK for the time of measurement (I2 = 0%); The effect size MD = 4.10 for the effect on ROM; The effect size for IL-6 was MD = -0.33. CONCLUSIONS: This meta-analysis highlights that curcumin supplementation significantly mitigates skeletal muscle damage, with notable improvements in CK levels, muscle soreness, IL-6 levels, and ROM. The results highlight the importance of curcumin dosage and timing, revealing that prolonged supplementation yields the best results, especially for untrained individuals or those less exposed to muscle-damaging exercise. For muscle soreness and ROM enhancement, a pre-emptive, low-dose regimen is beneficial, while immediate post-exercise supplementation is most effective at reducing CK and IL-6 levels.

The influence of vitamin and mineral consumption on the course of coronavirus disease (COVID-19).

OBJECTIVE: Aim: The study of the role of micronutrients in the prevention of the severe course of the coronavirus disease. PATIENTS AND METHODS: Materials and Methods: In order to fulfill the task, there was conducted an analytical review of medical and biological publications in English in the electronic databases PubMed Medline of the US National Library of Medicine (NLM), Embase, Cochrane Database of Systematic Reviews for the period from 2015 to November 2023, where included 50 published articles, 28 preprints and 109 trials. In the course of the study, the bibliographic-semantic research method was used according to the "Preferred Reporting Elements for Systematic Reviews and Meta-Analyses" (PRISMA) protocol. According to this protocol, identified literary sources were sequentially analyzed by title, keywords, abstract and full text of articles. Based on the results of 16 searches, 2650 articles from PubMed, Cochrane Database of Systematic Reviews and Embase, 3162 articles from preprint servers and 237 trials were rejected. In the final article synthesis, we included 50 published articles, 28 preprints, and 109 trials. CONCLUSION: Conclusions: The most effective in preventing complications of the coronavirus disease are vitamins A, D, E, K, C, B3, B6, B9, B12 and such mineral substances as Mg, Se and Zn. The consumption of appropriate bioactive complexes and source products can be considered a clinically and economically effective strategy for the prevention of a severe course of the coronavirus disease.

Efficacy of iron supplementation on physical capacity in non-anaemic iron-deficient individuals: protocol for an individual patient data meta-analysis.

BACKGROUND: A deficiency in iron stores is associated with various adverse health complications, which, if left untreated, can progress to states of anaemia, whereby there is significant detriment to an individual's work capacity and quality of life due to compromised erythropoiesis. The most common methods employed to treat an iron deficiency include oral iron supplementation and, in persistent and/or unresponsive cases, intravenous iron therapy. The efficacy of these treatments, particularly in states of iron deficiency without anaemia, is equivocal. Indeed, both randomised control trials and aggregate data meta-analyses have produced conflicting evidence. Therefore, this study aims to assess the efficacy of both oral and intravenous iron supplementation on physical capacity, quality of life, and fatigue scores in iron-deficient non-anaemic individuals using individual patient data (IPD) meta-analysis techniques. METHODS: All potential studies, irrespective of design, will be sourced through systematic searches on the following databases: Cochrane Central Register of Controlled Trials, MEDLINE Ovid, Embase Ovid, Web of Science: Science Citation Index Expanded, Web of Science: Conference Proceedings Citation Index-Science, ClinicalTrials.gov, and World Health Organization (WHO) International Clinical Trials Registry Platform. Individual patient data from all available trials will be included and subsequently analysed in a two-stage approach. Predetermined subgroup and sensitivity analyses will be employed to further explain results. DISCUSSION: The significance of this IPD meta-analysis is one of consolidating a clear consensus to better inform iron-deficient individuals of the physiological response associated with iron supplementation. The IPD approach, to the best of our knowledge, is novel for this research topic. As such, the findings will significantly contribute to the current body of evidence. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020191739.

The Effect of Omega-3 Fatty Acid Supplementation and Exercise on Locomotor Activity, Exploratory Activity, and Anxiety-Like Behavior in Adult and Aged Rats.

Aging is an inevitable and complex biological process that is associated with a gradual decline in physiological functions and a higher disease susceptibility. Omega-3 fatty acids, particularly docosahexaenoic acid, play a crucial role in maintaining brain health and their deficiency is linked to age-related cognitive decline. Combining omega-3-rich diets with exercise may enhance cognitive function more effectively, as both share overlapping neurobiological and physiological effects. This study aimed to evaluate the effect of exercise and omega-3 fatty acid (FA) supplementation in two different doses (160 mg/kg and 320 mg/kg) on anxiety-like behavior and cognitive abilities in both adult and aged rats. Male Wistar rats (4-5- and 23-24-month-old) were randomly divided into seven groups: 3-week control supplemented with placebo without exercise, low-dose omega-3 FAs, high-dose omega-3 FAs, 7-week control supplemented with placebo without exercise, exercise-only, low-dose omega-3 FAs with exercise, and high-dose omega-3 FAs with exercise. The administered oil contained omega-3 FAs with DHA:EPA in a ratio of 1.5:1. Our results indicate that aging negatively impacts the locomotor and exploratory activity of rats. In adult rats, a low dose of omega-3 FAs reduces locomotor activity when combined with exercise while high dose of omega-3 FAs reduces anxiety-like behavior and improves recognition memory when combined with exercise. The combination of omega-3 FAs and exercise had varying impacts on behavior, suggesting a need for further research in this area to fully understand their therapeutic efficacy in the context of cognitive changes associated with aging.

Rhabdomyolysis Risk: The Dangers of Tribulus Terrestris, an Over-the-Counter Supplement.

BACKGROUND Over-the-counter (OTC) supplement use is a very common practice within the United States. Supplements are not tightly regulated by the Food and Drug Administration. There are many case reports involving OTC supplement adverse effects and medication interactions, but there remains minimal clinical research regarding these subjects. Rhabdomyolysis is one interaction and adverse effect frequently documented in case reports among a variety of OTC supplements, although, to date, there is no documentation of rhabdomyolysis occurring from an interaction between the supplement Tribulus terrestris and atorvastatin. CASE REPORT A 71-year-old man presented to the Emergency Department in rhabdomyolysis with a mild transaminitis after taking the over-the-counter supplement Tribulus terrestris while on long-term atorvastatin. His rhabdomyolysis peaked at day 4 after cessation of the Tribulus and atorvastatin and aggressive fluid resuscitation with a normal saline bolus at admission followed by a D5 sodium bicarbonate drip later transitioned to a normal saline drip with subsequent down-trending of the creatinine phosphokinase levels. CONCLUSIONS Tribulus terrestris is an herbal supplement used for erectile dysfunction and energy. Recent research suggests it to be a moderate CYP 3A4 inhibitor that plays a significant role in metabolism of statin and many other commonly prescribed medications. This may put patients at increased risk of developing serious adverse effects, including rhabdomyolysis and drug-induced liver injury. Screening patients for over-the-counter supplement use and educating them on the potential risks of their use is extremely important for inpatient and outpatient healthcare professionals to avoid dangerous medication interactions.

The Aggregated and Micellar Forms of ß-Casein Purified from Donkey and Bovine Milk Present Potential as Carriers for Bioactive Nutritional Compounds.

In recent years, there has been a growing interest in the pure casein fraction of milk protein, particularly ß-casein due to its physicochemical properties as well as its bio- and techno-functional properties. The utilization of self-assembled ß-caseins from bovine origin as nanocarriers for the delivery of nutraceutical compounds or drugs has increased dramatically. Concerning ß-caseins from other milk sources, the use of hypoallergenic donkey ß-caseins as a potential delivery vehicle for nutraceutical hydrophobic compounds is beginning to generate interest. The present review deals with casein micelles models, bovine and donkey ß-casein molecular structures, as well as their physical-chemical properties that account for their exploitation in nutraceutics and pharmaceutics. This review work suggests the possibility of developing delivery systems for hydrophobic bioactive compounds using ß-casein purified from hypoallergenic donkey milk, highlighting the potential of this protein as an innovative and promising vehicle for enhancing the enrichment and bioavailability of various bioactive substances in food products.

Dietary magnesium supplementation in cats with chronic kidney disease: A prospective double-blind randomized controlled trial.

BACKGROUND: Plasma total magnesium concentration (tMg) is a prognostic indicator in cats with chronic kidney disease (CKD), shorter survival time being associated with hypomagnesemia. Whether this risk factor is modifiable with dietary magnesium supplementation remains unexplored. OBJECTIVES: Evaluate effects of a magnesium-enriched phosphate-restricted diet (PRD) on CKD-mineral bone disorder (CKD-MBD) variables. ANIMALS: Sixty euthyroid client-owned cats with azotemic CKD, with 27 and 33 allocated to magnesium-enriched PRD or control PRD, respectively. METHODS: Prospective double-blind, parallel-group randomized trial. Cats with CKD, stabilized on a PRD, without hypermagnesemia (tMg >2.43 mg/dL) or hypercalcemia (plasma ionized calcium concentration, (iCa) >6 mg/dL), were recruited. Both intention-to-treat and per-protocol (eating ≥50% of study diet) analyses were performed; effects of dietary magnesium supplementation on clinicopathological variables were evaluated using linear mixed effects models. RESULTS: In the per-protocol analysis, tMg increased in cats consuming a magnesium-enriched PRD (ß, 0.25 ± .07 mg/dL/month; P < .001). Five magnesium supplemented cats had tMg >2.92 mg/dL, but none experienced adverse effects. Rate of change in iCa differed between groups (P = .01), with decreasing and increasing trends observed in cats fed magnesium-enriched PRD and control PRD, respectively. Four control cats developed ionized hypercalcemia versus none in the magnesium supplemented group. Log-transformed plasma fibroblast growth factor-23 concentration (FGF23) increased significantly in controls (ß, 0.14 ± .05 pg/mL/month; P = .01), but remained stable in the magnesium supplemented group (ß, 0.05±.06 pg/mL/month; P =.37). CONCLUSIONS AND CLINICAL IMPORTANCE: Magnesium-enriched PRD is a novel therapeutic strategy for managing feline CKD-MBD in cats, further stabilizing plasma FGF23 and preventing hypercalcemia.

[Cushing syndrome because of herbal supplement]. / Syndroom van Cushing door kruidenpreparaat.

The use of exogenous glucocorticoids is a common cause of Cushing syndrome. We present a case of exogenous Cushing syndrome caused by Binahong: an over-the-counter 'herbal' supplement. A 54-year-old woman presented with weight gain, joint pain, hypertension and poorly regulated type 2 diabetes mellitus despite the start of semaglutide one year before presentation. Physical examination revealed signs of steroid excess with a moon face and abdominal obesity. Her serum cortisol level and ACTH level were suppressed. Synthetic glucocorticoid screening revealed a positive dexamethason level in the herbal supplement. After stopping the supplement her serum cortisol and dexamethason increased to normal levels. This case emphasizes the importance of awareness for the use of supplements containing hidden glucocorticoids causing Cushing syndrome.

Dietary supplementing South African indigenous rams with flaxseed oil and ascorbic acid improves cryopreserved semen quality and in vitro fertility.

The purpose of this study was to evaluate how ascorbic acid with dietary flaxseed oil affects the quality and fertility of cryopreserved ram sperm in South African indigenous rams. Treatment diets were supplemented 60 days before semen collection to afford proper spermatogenesis, adaptation to the feed formulated and fed throughout the study. Semen was collected with the use of artificial vagina following dietary supplementation with five treatment diets (neg. cont. - negative control, pos. cont. - positive control, FLO - 5% Flaxseed oil, ASA - 4% Ascorbic acid, and FLO + ASA). Semen was then extended using tris-based extender and cryopreserved using the programmable freezer (CBS Freezer 2100 series, Laboratory consumables & chemical suppliers, America). Ovaries were collected from a neighbouring slaughter house and conveyed to the lab in 0.9% saline at 37 °C. Data (sperm parameters and in vitro fertility) was then exposed to the GLM (General Linear Model) in Minitab 17. Pearson's correlation coefficient was utilized to investigate the relationship between cryopreserved sperm quality and in vitro fertility. The student Least Significant Difference Test was used to separate the treatment means, and differences were accepted when the p-value was less than 0.05. The FLO + ASA group had higher (p < 0.05) progressive (36.33 ± 1.87), total (88.24 ± 2.24), rapid motility (27.52 ± 1.74), intact plasma membrane (75.67 ± 2.08), total fertilization (65.98 ± 7.39), and total cleavage (66.19 ± 6.50) when compared to other treatment groups. Total fertilization rate had a medium significant (p < 0.001) medium correlation with the progressive motility (r2 = 0.435), total motility (r2 = 0.447) and rapid motility (r2 = 0.409). In conclusion, dietary flaxseed and ascorbic acid (FLO + ASA) improves cryopreserved semen quality, in vitro fertilization rate, and the total cleavage rate. Noteworthy, the progressive, total and rapid motility play a crucial in the in vitro fertilization rate.

[THE ON-LINE TURNOVER OF BIOLOGICALLY ACTIVE ADDITIVES. PART 2. CUSTOMS CONTROL FOR THE TURNOVER OF IMPORTED DIETARY SUPPLEMENTS ON MARKETPLACES AS A MEASURE TO PROTECT THE LIFE AND HEALTH OF CITIZENS].

Various dietary supplements are used as prevention, and in some cases treatment, of a large number of pathological processes in the human body. The purchase of such dietary supplements on various online platforms, including marketplaces, as evidenced by the results of monitoring the Russian online market for 2021-2022, turned out to be the riskiest for human life and health: the components actually contained do not correspond to the declared ones, the presence of Dietary supplement of prohibited substances, lack of a state registration certificate, the presence of which confirms the safety of such dietary supplement for use. The listed violations in the conditions of complete lack of control during the sale of dietary supplements on marketplaces confirm the danger to health, and in some cases, to human life. Uncontrolled use of such products can lead to serious side effects and complications: allergic reactions, kidney failure, liver failure, complications from the gastrointestinal tract, nervous system and genitourinary tract. In this regard, issues related to ensuring the safety of human health and life in the event of their purchasing dietary supplements on marketplaces are relevant. The analysis carried out in the study confirmed the existence of a problem of unreliable declaration of imported dietary supplements on marketplaces by participants in foreign economic activity. In this regard, this article examines the requirements of technical regulations that must be observed when importing dietary supplements into the territory of the EAEU, studies in detail the issue of the possibility of selling imported dietary supplements on marketplaces, and formulates appropriate conclusions and recommendations for eliminating identified problems, which will eliminate possible sales of low-quality products on the marketplace. and prohibited products and identify sellers selling dietary supplements with violations.

Analyzing Potential Interactions Between Complementary and Alternative Therapies, Over-the-Counter, and Prescription Medications in the Older Population.

BACKGROUND: The escalating use of complementary and alternative medicine (CAM) raises concerns, particularly among geriatric patients taking multiple medications. Notably, the doubled chance of major drug interactions between prescription and over-the-counter (OTC) drugs in older adults underscores the need for further research. This study aimed to evaluate clinically significant CAM and prescription medication interactions in a geriatric clinic, emphasizing the growing importance of understanding CAM implications in health care. METHODS: A 2-year cross-sectional study, approved by the Institutional Review Board, enrolled 420 participants aged 65 and older from a geriatric primary care clinic. Participants completed a survey, and pharmacy students conducted chart reviews to evaluate potential CAM products and prescription medication interactions. RESULTS: Among the 420 participants-who were predominantly White females and who were taking supplements, OTC medications, or both-15.6% experienced potential drug interactions. Ginkgo biloba, garlic, and calcium were common contributors to major, moderate, and minor interactions, respectively, among supplements. Meanwhile, ibuprofen was among the contributors to major and moderate interactions among OTC medications. Most supplements and OTC medications were disclosed to health care professionals. However, there was a lack of investigation by health care professionals regarding CAM use, emphasizing a discrepancy between patient-reported and physician-inquired CAM usage. CONCLUSION: This study highlighted the significant use of CAM and/or OTC medications, particularly among vulnerable older adults, revealing a concerning 15.6% rate of potential drug interactions. The findings emphasized the need for awareness among health care practitioners and standardized CAM surveys to enhance accuracy and patient safety.

Ginseng supplementation and cardiovascular disease risk factors: a protocol for GRADE-assessed systematic review and dose-response meta-analysis.

INTRODUCTION: Heart diseases constitute a significant global public health concern. Cardiovascular diseases (CVDs) are characterised by disruptions in blood circulation and are notably prevalent among adults exposed to Westernised diets. Ginseng, a medicinal plant, has been recognised for its healing properties and has a history of use spanning thousands of years. This systematic review aims to evaluate the efficacy of ginseng in modifying risk factors for CVD, including lipid profiles, glycaemic control, anthropometric indices, inflammation indicators, blood pressure, oxidative stress, liver function tests, adipokines and heart rate among individuals aged 18 and above, encompassing both genders. METHODS AND ANALYSIS: We will conduct an electronic search for articles published from inception to September 2023 using a predefined search strategy in PubMed, Scopus, Web of Science, CENTRAL and EMBASE. Our search will focus exclusively on randomised controlled clinical trials involving both healthy and unhealthy participants. The process of reviewing articles, extracting pertinent information and assessing the quality of studies using the Cochrane risk of bias tool will be carried out independently by two reviewers. Any discrepancies will be resolved through discussion with a third party. If a sufficient number of eligible studies are identified, a meta-analysis will be conducted using these outcomes. ETHICS AND DISSEMINATION: This study serves as the procedural framework for a comprehensive examination and does not require ethical approval. Additionally, the study adhered to the guidelines outlined in the Declaration of Helsinki. Ethical approval for the study was obtained from the Ethics Committee of Golestan University of Medical Sciences (IR.GOUMS.REC.1402.298). PROSPERO REGISTRATION NUMBER: CRD42023465688.

Role of omega-3 fatty acids in reducing proteinuria: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: Proteinuria, a hallmark of renal and systemic disorders, is associated with adverse outcomes, especially in chronic kidney disease and cardiovascular disease. Omega-3 fatty acids have garnered attention for their cardiovascular benefits and potential therapeutic effects on proteinuria. This systematic review and meta-analysis aimed to evaluate the impact of omega-3 fatty acid supplementation on proteinuria levels across various kidney-related conditions. METHODS AND STUDY DESIGN: Studies published from 1989 to 2023 were systematically identified, including randomized controlled trials, cohort, case-control, and cross-sectional studies. Nine studies involving a total of 347 participants were included in the analysis. RESULTS: The meta-analysis revealed a neutral overall effect size of omega-3 fatty acid supplementation on proteinuria levels, assessed under both common and random effect models. Despite the lack of statistically significant evidence supporting the efficacy of omega-3 fatty acids in reducing proteinuria, the variability in interventions and patient populations suggests potential individual responses. CONCLUSIONS: The find-ings highlight the heterogeneity in responses to omega-3 fatty acid supplementation and emphasize the need for cautious interpretation. While no definitive conclusion can be drawn, the results underscore the importance of targeted research focusing on specific subgroups or conditions that may benefit from omega-3 supplementation. These findings contribute to the evolving understanding of personalized kidney health strategies and pave the way for further exploration and optimization of omega-3 fatty acids' therapeutic applications.