supplementation practices that are best suited to your circumstances, according to currently available scientific studies
The Meschino Health Assessment is a Free Service
Why take it?
We all know that we should eat better, exercise more and change some of our less then desirable lifestyle habits. Did
you know that 7 out of 10 North Americans are taking some form of nutritional supplements to augment their diet?
While that might sound like good news, the downside is that many people are guessing at what supplements to take!
So which one should you take? Better yet, what does eating better look like?
You need a plan.
But where would you even begin to find a health assessment that takes into account your personal health status, diet,
lifestyle activities and family health history-before recommending a plan of action?
Where? Right here.
www.meschinohealth.com
6
Meschino Health Comprehensive Guide to Herbs
Aloe Vera
General Features
Aloe Vera is a perennial plant with yellow flowers. The leaves contain active ingredients, including the polysaccharide
acemannan and anthraquinones.1 Aloe Vera gel and juice has been used therapeutically for the treatment of peptic
ulcers and other intestinal disturbances, including its use as a natural laxative. Aloe Vera gel can also be applied
topically to aid in the healing of burns, wounds, and other skin conditions.4
Principle Active Constituents
Acemannan and Other Polysaccharides – Acemannan, in particular, has shown impressive immune-stimulating and
anti-viral effects.
Anthraquinones – these agents have been shown to account for the natural laxative effect induced by Aloe Vera
ingestion.1
Clinical Application and Mechanism of Action
1. Peptic Ulcer and Gastritis
Aloe Vera gel inactivates pepsin release when the stomach is empty. The gel also inhibits the release of
hydrochloric acid by interfering with the binding of histamine to parietal cells. Clinical studies on humans have
shown that Aloe Vera gel can be effective in healing peptic ulcers in a percentage of patients.2 (Author’s Note:
More substantial evidence exists for the use of DGL-licorice chewable tablets in regards to the natural treatment of
peptic ulcers, although both interventions can be used concurrently (see Licorice in this document).
2. Improved Protein Digestion
Aloe Vera Juice (50% Aloe gel plus 50% other fluids) has been shown to improve protein absorption and reduces
the degree to which intestinal bacteria are engaged in putrefactive processes. This may be of benefit in cases of
poor protein digestion.1 (also consider the use of Digestive Enzymes and/or Betaine Hydrochloride
supplementation).
3. Laxative Effect
The latex form of Aloe Vera is reported to have a natural laxative effect.4
Oral Dosage Range
1. General Intestinal Tract Support (e.g., improved digestion, laxation)
Up to 1 quart per day of Aloe Vera juice can be consumed. No formal dosages are established.
2. Peptic Ulcers
For Aloe gel, a tablespoon of the gel in mineral oil was taken once daily for the treatment of peptic ulcers.2
www.meschinohealth.com
7
Meschino Health Comprehensive Guide to Herbs
Topical Application of Aloe Gel
1. Burns: Aloe Vera Gel has been used successfully to treat sunburn, radiation burn, and chemical burns. In 1935 a
group of physicians first documented improvement in the treatment of facial burns due to X-rays, using topically
applied fresh Aloe Vera juice.3,4,5 Scientists think Aloe enhances the body’s natural-healing systems while
stimulating the activity of collagen and elastin synthesis, which are responsible for regenerating and maintaining
connective tissue structure and integrity.6 As such, Aloe Vera is a common ingredient in many topical creams and
lotions intended to heal the skin from sunburn, as well as other burns and wounds.4
2. Diabetic and Chronic Pressure Ulcers (leg ulcers and deeper wounds) - in more severe cases including, leg ulcers,
diabetic and pressure ulcers, Aloe gel is applied to ulcers on gauze bandages.3,4
3. Genital Herpes – several double-blind, placebo-controlled trials have shown that Aloe cream applied topically
reduced the time necessary for lesions to heal (4.9 days versus 12 days) compared to the placebo group.8
4. Psoriasis and Seborrhea – double-blind, placebo-controlled studies have also shown that topical Aloe Vera extract
(0.5%) has been effective in minimizing the severity of psoriasis and seborrhea. The usual application is three time
daily.9,10
Topical Dosage
Aloe Vera Gel can be applied liberally for topical applications.3 The usual application for the skin lesions noted above is
three times per day, using a 0.5% Aloe Vera cream.8,9,10
Adverse Side Effects, Toxicity, and Contraindications
Although rare, allergic reactions by the skin have been reported with use of Aloe Vera creams and lotions. Aloe Vera
gel may also delay wound healing in cases of surgical wounds such as those produced during laparotomy or cesarean
delivery, thus it is contraindicated for deep, vertical (surgical) wounds.3
Drug-Nutrient Interactions
Laxative Effect – as Aloe Vera is known to act as a laxative it may reduce the absorption of medications, if taken at the
same time. Thus, other medications and supplements should not be taken at the same time as Aloe Vera ingestion.7
www.meschinohealth.com
8
Meschino Health Comprehensive Guide to Herbs
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 insufficient 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 attending 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. Sheltom RW, Aloe Vera, Its Chemical and Therapeutic Properties, Int J Dermatol 1991;30:679-83.
2. Blitz JJ, Smith JW, and Gerard JR, Aloe Vera Gel in Peptic Ulcer Therapy: Preliminary Report, J Am Osteopathol Soc 1963;62:731-5.
3. Davis RH, Kabbani JM, and Maro NP, Aloe and Wound Healing, J Am Pod Med Assoc 1987;77:165-9.
4. Dietary Supplement Information Bureau. www.content.intramedicine.com: Aloe Vera.
5. Collins CE, et al. Roentgen dermatitis treated with fresh whole leaf Aloe vera. Am J Roentgenol.1935; 33: 396-97.
6. Chithra P et al. Influence of Aloe Vera on collagen characteristics in healing wounds in rats. Mol Cell Biochem. 1998; 181 (I-2): 71-6.
7. Ishii Y, et al. Studies of Aloe .III. Mechanism of cathartic effect. (2). Chem Pharm Bull.Tokyo.1990; 38 (1): 197-200.
8. Syed TA, Cheeman KM, Ashfaq A, et al. Aloe Vera extract 0.5% in a hydrophilic cream versus Aloe Vera gel for the management of
genital herpes in males. A placebo-controlled, double-blind, comparative study. J Eur Acad Detmatol Venereol. 1996;7: 294-95.
9. 9 Syed TA, Ahmed SA, Holt AH, et al. Management of psoriasis with Aloe Vera extract in a hydrophilic cream: a placebo-controlled,
double blind study. Trop Med Int Health. 1996; 1: 505-509.
10. 10 Vardy DA, Cohen AD, Tchetov T, et al. A double-blind, placebo-controlled trial of Aloe Vera emulsion in the treatment of seborrheic
dermatitis. J Dermatol Treat. 1999; 10: 7-11.
www.meschinohealth.com
9
Meschino Health Comprehensive Guide to Herbs
Angelica Species (Angelica sinesis, e.g. Dong Quai)
General Features
The Angelica Species is native to China. The plant’s active ingredients are found in the roots and rhizomes. Dong
Quai has traditionally been used to treat menstrual cramps or dysmenorrhea and PMS, as well as hot flashes and
other menopausal symptoms. The scientific evidence to support these applications is not strong compared to the use
of other herbal agents such as Black Cohosh, Gamma Oryzanol and Chasteberry, which have been shown to provide
consistently reliable outcomes in the management of these cases.1,3
Principle Active Constituents
The primary active constituents for menopausal and menstrual symptoms are coumarin and phytoestrogens. Angelica
phytoestrogens exhibit 1:400 the biological activity of animal-based estrogens (i.e., Premarin). 1,4,5
Clinical Application and Mechanism of Action
Menopausal Symptoms and Menstrual Irregularities:
Phytoestrogens are known to provide hormonal support in the regulation of reproductive tissues and organs, although
more research is required to evaluate the effects of Dong Quai in this regard. At present there are no well-controlled
studies illustrating that Dong Quai is highly effective in the management of PMS, menopausal symptoms and related
female conditions. Its use is based primarily upon historical applications and some animal studies.3
As a general statement, phytoestrogens (plant-based estrogens) compete with the body’s own estrogens for binding
sites on estrogen receptors on reproductive and other tissues, helping to guard against estrogen over-stimulation,
which can exacerbate or cause PMS and related symptoms. During menopause, when the body’s estrogen secretion
drops off, phytoestrogens can provide estrogenic support to help reduce hot flashes and other menopausal
symptoms.1,2,4,5 (see Black Cohosh, Soy Isoflavones and Red Clover in this document for a more detailed explanation
of phytoestrogens)
Angelica may reduce smooth muscle spasm, easing cramping and related menstrual symptoms.1,2
Dosage and Standardized Grade
Management of PMS and Menopausal Symptoms:
Powdered root or as a tea: 1-2 gms, 3 times per day
Tincture (1:5): 4 ml (1 teaspoon), 3 times per day
Fluid extract: 1 ml (1/4 teaspoon), 3 times per day
Solid Extract (capsule) – 200 mg, two times daily, standardized to 0.8-1.1% ligustilide content.
www.meschinohealth.com
10
Meschino Health Comprehensive Guide to Herbs
Adverse Side Effects, Toxicity and Contraindications
Angelica contains coumarins that can react with sunlight to cause photo-sensitivity induced skin rash or severe
sunburn upon exposure to sunlight. Therefore, women using this supplement should avoid prolonged exposure to
direct sunlight.1 Animal studies reveal Dong Quai is very non toxic. Side effects in humans are rare and consist of mild
gastrointestinal distress and occasional allergic reactions (such as rash). 3 However, the use of Dong quai has resulted
in several cases of bleeding disorders (in the brain), most likely due to the anti-coagulant effect of Dong Quai’s
coumarin content.6
Drug-Nutrient Interactions
Anticoagulants (warfarin, coumadin, aspirin etc) – animal studies demonstrate that Angelica Species potentiates the
anti-clotting effects of warfarin and thereby, may increase the chance of a serious bleeding disorder. Several reports
of this consequence in humans have been reported, even in women not taking concurrent anticoagulant therapy.
Therefore, women should not take Dong Quai concurrently with any anticoagulant drug.6,7,8,9 (note that Black Cohosh,
Soy Isoflavones, Gamma Oryzanol and Chasteberry are not associated with this risk).
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 insufficient 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 attending 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. Duke JA, Handbook of Medicinal Herbs. Boca Raton, FL. CRC Press. 1985:43-4.
2. Murray MT, The Healing Power of Herbs (2nd edition), Prima Publishing, 1995.
3. Natural Health Products Encyclopedia. www.consumerlab.com: Dong Quai
4. Hikino H: Recent research on Oriental medicinal plants. Econ Med Plant Res. 1985; 1: 53-85
5. Zhu DPQ: Dong Quai. Am J Chin Med. 1985;15: 117-125.
6. Heck A, et al. Potential interactions between alternative therapies and warfarin. Am J Health-Syst Pharm.2000;57 (13): 1221-1227
7. Lo AC, et al. Danggui (Angelica sinensis). Affects the Pharmacodynamics But Not the Pharmacokinetics of Warfarin in Rabbits. Eur J
Drug Metab and Pharmacokinet. 1995;20(1): 55-60
8. Ellis GR, Stephens MR. Untitled (brief case report). BMJ 1999;319:650
9. Page RL II, Lawrence JD. Potentiation of Warfarin by Dong Quai.Pharmacotherapy 1999;19(7):870-76
www.meschinohealth.com
11
Meschino Health Comprehensive Guide to Herbs
Astragalus
General Features
Astragalus has been used for at least 2000 years in China and continues to be widely used as a herb that is known to
enhance function of the immune system and facilitates an increase in energy production within the heart muscle, in
cases where certain forms of heart disease exist.1,2,3,4,5 It is one of the most widely used herbs in Fu-zheng therapy −
the use of herbs to augment the host defense mechanisms.1,2,3,6 Astragalus is a herbaceous perennial with the root of
the plant used for medicinal purposes.7
Active Constituents
These primarily include:
1. Triterpene glycosides (saponins): astragalosides, etc.
2. Polysaccharides: astragalans
3. Flavonoids7,8,9,10,11
Clinical Application and Mechanism of Action
Immune Function (The common cold and minimizing the effects of chemotherapy and radiation treatment)
Astragalus is used as an immune stimulant to treat and help prevent the common cold.4,8 It has also been used to
reduce the side effects of chemotherapy and radiation treatment in human studies. A large clinical study of 572
cancer patients demonstrated that Astragalus supplementation was able to protect adrenal cortical function during
radiation and chemotherapy treatment. It also helped to greatly minimize bone marrow depression and
gastrointestinal side effects, such as nausea, vomiting and intestinal tract ulcerations in these patients.6
In patients with very low white blood cell counts, as a side effect of drugs, radiation or chemotherapy, Astragalus
supplementation has been shown to help significantly increase the number of circulating white blood cells, helping
to restore normal function of the immune system in these severely immune-compromised patients.12
The biological activity that can account for these outcomes is related the active constituents in Astragalus, primarily
its triperpene glycosides and polysaccharide content, which have been shown to significantly increase the
proliferation of lymphocytes,3,12 enhance interferon and interleukin-2 production and activity- two powerful
signalling agents that enhance the effectiveness of immune cells,13,14,15,16 activate T cell blastogenesis,17 increase T
cell cytotoxicity,2,17 enhance the secretion of the immune modifying chemical known as tumor necrosis factor
(TNF),9 enhance phagocytosis by immune cells,18 increase natural killer cell cytotoxicity – the ability of these white
blood cells to destroy developing cancer cells, viruses and other pathogens,17,19 increase the activity of peritoneal
macrophages,18 and provide direct anti-viral effects.20,21,22,23
2. Congestive Heart Failure and Angina Pectoris
The active constituents of Astragalus appear to provide an inotropic effect on the heart muscle, in a similar manner
to hawthorn. An inotropic effect implies that these active ingredients in some way enhance the ability of the heart
muscle to synthesize ATP energy, which is required for heart muscle contraction. In congestive heart failure the
heart muscle becomes weak, partly due to insufficient ATP production, and preliminary evidence suggests that
Astragalus may help to improve these cases. Thus far, two small clinical trials have shown that patients with
www.meschinohealth.com
12
Meschino Health Comprehensive Guide to Herbs
congestive heart failure demonstrate improvement in chest distress, dyspnea (shortness of breath), exercise
tolerance and other parameters of cardiac function, when given Astragalus intravenously.10,24
Astragalus has also been used effectively in patients suffering from ischemic heart disease 25 and it has been shown to
increase cardiac output in 20 patients with angina pectoris.26
3. Anti-Cancer Effects
The immune- enhancing effects of Astragalus make this herb an interesting compound in terms of its potential in
cancer treatment. A clinical study of 54 patients with small cell lung cancer were treated with regular medical
interventions plus Traditional Chinese Medicine (including Astragalus). Increased survival was noted in comparison
to the average survival statistics of conventional medicine alone.27
Animal studies demonstrate quite strongly that Astragalus has the potential to prevent some cancers and has
curative potential in others (e.g., renal cell carcinome model in mice).28,29 Intensive research continues in an
attempt to establish the true anti-tumor potential of Astragalus.
4. Male Fertility
Astragalus has been shown to significantly increase the motility of human sperm in vitro.30 This may be of value in
the treatment of male infertility where poor sperm motility is a suspected factor. Note that L-carnitine and zinc
supplementation have demonstrated similar capabilities (see details in this document under their individual
headings.)
Dosage and Standardized Grade (2:1 powdered extract)
1. Common Cold – For general prevention consider 100-200 mg per day.
During the preliminary stages of a cold consider up to 500 mg, three times daily if used as single agent.31
2. Radiation Treatment, Chemotherapy – Consider up to 500 mg, three times per day if taken as a single agent.
(Consider combining Astragalus with reishi mushroom extract to minimize side effects of these treatments.)
(Requires attending physician’s approval)
3. Congestive Heart Failure, Angina Pectoris and Ischemic Heart Disease – No oral dose values have been
established.
4. Decreased Sperm Motility Causing Infertilty – Dosage not established, however taking up to 500 mg, three times
daily is considered to be safe.
Toxicity and Adverse Side Effects
There are no reported side effects or toxicity associated with the use of Astragalus at recommended doses.31
Drug-Nutrient Interactions
Immunosuppressive Medications – As Astragalus has been shown to enhance immune function, it may counter the
efficacy of immnosuppressive drugs.32,33
www.meschinohealth.com
13
Meschino Health Comprehensive Guide to Herbs
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 insufficient 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 attending 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. Foster S, ChongxlY. Herbal Emissaries. Bringing Chinese Herbs to the West. Rochester, VT; Healing Arts Press, 1992