3. Cholesterol-lowering drugs. 23,24
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Pregnancy and Lactation
During pregnancy and lactation, the only supplements that are considered safe include standard prenatal
vitamin and mineral supplements. All other supplements or dose alterations may pose a threat to the
developing fetus and there is generally insuf icient evidence at this time to determine an absolute level of
safety for most dietary supplements other than a prenatal supplement. Any supplementation practices
beyond a prenatal supplement should involve the cooperation of the at ending physician (e.g., magnesium
and the treatment of preeclampsia.)
References: Pregnancy and Lactation
1. Encyclopedia of Nutritional Supplements. Murray M. Prima Publishing 1998.
2. Reavley NM. The New Encyclopedia of Vitamins, Minerals, Supplements, and Herbs. Evans and
Company Inc. 1998.
3. The Healing Power of Herbs (2nd edition). Murray M. Prima Publishing 1995.
4. Boon H and Smith M. Health Care Professional Training Program in Complementary Medicine.
Institute of Applied Complementary Medicine Inc. 1997.
1. Healthnotes, Inc. 2001. www.healthnotes.com: Psyllium
2. Dietary Supplement Information Bureau. www.content.intramedicine.com: Psyllium Seed
3. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York:John Wiley &
sons 1996:427-9
4. Jenkins, DJ, Kendall CW, Vuksan V, Vidgen E, Parker T, Faulkner D, et al. Soluble fiber intake at a dose approved by the US Food and
Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled
crossover trial. Am J Clin Nutr May 2002;75(5):834-9
5. Frati Muari AC, et al. Lowering glycemic index of food by acarbose and Plantago psyllium mucilage. Arc Med Res Jun1998;29(2):137-41
6. McRorie JW et al. Psyllium is superior to docusate sodium for treatment of chronic constipation. Aliment Pharmacol Ther
May1998;12(5):491-7
7. Voderholzer WA, Schatke W, Mühldorfer BE, et al. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol
1997;92:95-8
8. Washington N et al. Moderation of lactulose-induced diarrhea by psyllium: effects on motility and fermentation. Am J Clin Nutr
Feb1998:;67(2):317-21
9. Leib MS. Treatment of chronic idiopathic large-bowel diarrhea in dogs with a highly digestible diet and soluble fiber: a retrospective review
of 37 cases. J Vet Intern Med Jan2000;14(1):27-32
10. Sherman DS, Fish DN. Management of Protease Inhibitor-associated Diarrhea. Clin Infect Dis Jun2000;30(6):908-14
11. Davidson MH, et al. Long-term effects of consuming foods containing psyllium seed husk on serum lipids in subjects with
hypercholesterolemia. Am j Clin Nutr Mar1998;67(3):367-76
12. Anderson JW, Aligood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid response in men with type 2 diabetes and
hypercholesterolemia. Am J Clin Nutr 1999;70:466-73
13. Schwesinger WH, et al. Soluble dietary fiber protects against cholesterol gallstone formation. Am J Surg Apr1999;177(4):307-10
14. Oson BH, Anderson SM, Becker MP et al. Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL
cholesterol, in hypercholesterolemic adults:Results of a meta-analysis. J nutr 1997 1997;127:1973-80
15. Davidson MH, Dugan LD, Burns JH, et al. A psyllium-enriched cereal for the treatment of hypercholesterolemia in children: A controlled,
double-blind, crossover study. Am J Clin Nutr 1996;63:96-102
16. Florholmen J, Arvidsson-Lenner R, Jorde R, Burhol PG. The effect of Metamucil on postprandial blood glucose and plasma gastric
inhibitory peptide in insulin-dependent diabetics. Acta Med Scand 1982;212:237-9
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17. Rodriguez-Moran M, Guerrero-Romero F, Lazcano-Burciaga G. Lipid- and glucose-lowering efficacy of plantago psyllium in type II
diabetes. J Diabetes Complicaitons 1998;12:273-8
18. Anderson JW, Allgood LD, Turner J et al. Effects of psyllium on glucose and serum lipid response in men with type 2 diabetes and
hypercholesterolemia. Am J Clin Nutr 1999;70:466-73
19. Fernandez-Banares F, Hinojosa J, Sanchez-Lombrana JL, et al., Randomized clinical trial of Plantago ovata seeds (dietary fiber as
compared with mesalamine in maintaining remission in ulcerative colitis. Am J Gastroenterol 1999;94:427-33
20. Hotz J et al. Effectiveness of plantago seed husks in comparison with wheat brain on stool frequency and manifestations of irritable colon
syndrome with constipation. Med Klin Dec1994;89(12):645-51
21. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to herbal medicines,
Boston, MA: Integrative Medicine Communication 1998:190-2
22. Obata K et al. Dietary fiber, psyllium, attenuates salt-accelerted hypertension in stroke-prone spontaneously hypertensive rats. J
Hypertens Dec1998;16(12 Pt 2):1959-64
23. Brown L et al. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr Jan1999;69(1):30-42
24. Anderson JW et al. Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of
hypercholesterolemia. Am J Clin Nutr Jun2000;71(6):1433-8
25. Gaw A. A new reality: achieving cholesterol-lowering goals in clinical practice. Atheroscler Suppl 2002Apr;2(4):5-11
26. Anderson JW, Allgood LD, Lawrence A, Altringer LA, Jerdack GR, Hengehold DA et al. Cholesterol-lowering effects of psyllium intake
adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials.
27. Larsen HR. Psyllium decreases cholesterol. Alive: Canadian journal of Health & Nutrition 0228586X Feb2000;208
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Quercetin
General Features
Quercetin is a flavonoid that serves as the backbone for many other flavonoids in nature, including the citrus flavonoids
rutin, quercitin, and hesperidin. These derivates differ from Quercetin in that they have sugar molecules at ached to
their Quercetin backbone. Experimental studies reveal that many medicinal plants owe much of their biological activity
to their high Quercetin content.1
This water-soluble pigment has been shown to inhibit histamine release at therapeutic doses, making it an attractive
agent in the management of some allergic conditions, such as hay fever. It also demonstrates impressive anti-
inflammatory and antioxidant properties, and like some other flavonoids (e.g. genistein, diadzein), appears to possess
phytoestrogen ef ects. Under experimental conditions, its phytoestrogen ef ects have been shown to inhibit the
proliferation of human breast cancer cells in test tube experiments. In one human trial, Quercetin supplementation
demonstrated improvement in prostatitis, with 67% of patients experiencing significant improvement in the Quercetin
group compared to only 20% of patients reporting improvement in the placebo group. This benefit may be due to its
phytoestrogen activity and/or its anti-inflammatory properties.
Experimental studies also reveal that Quercetin may help to prevent cataracts in diabetics, by inhibiting the enzyme
that forms sorbitol (aldose reductase) in the lens of the eye.2,3
Clinical Applications and Mechanism of Action