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Herb of the Month

JUNE - Ginger (Zingiber officinale) 生薑 (Sheng Jiang)

Garlic belongs to the family Zingiberaceae which includes turmeric, cardamon, and galangal. Traditionally, it is used to for malaria, snake bites, toothache, pain, cough, bowel gas, heartburn, and as a diuretic. It can be consumed raw, in juice or tea forms, in cooking in dishes and soups, or as supplement preparations.

Garlic is high in vitamin B6, magnesium, and manganese. It is a good source of potassium. It also has some amounts of B vitamins, vitamin C, vitamin E, iron, calcium, and zinc.

Some evidence suggests ginger may help with nausea and vomiting due to pregnancy and antiretroviral medications used to treat HIV, painful menses (dysmenorrhea), and osteoarthritis. Evidence does not support using ginger for motion sickness. There is insufficient evidence for using ginger to prevent nausea and vomiting due to chemotherapy, rheumatoid arthritis, migraine headache, irritable bowel syndrome, diabetes, or hay fever.

Garlic is on the FDA generally recognized as safe list. It is well tolerated although increased risk of side effects and decrease in tolerability occurs at doses higher than 5 grams per day. Notable side effects include abdominal discomfort, burping, diarrhea, heartburn, and irritating feeling in the mouth. It is generally safe during pregnancy and breastfeeding when consumed in amounts found in foods.

Although research is conflicting, ginger may increase the risk of bleeding if used with antiplatelet or anticoagulant medications (e.g. aspirin, clopidogrel, warfarin). Theoretically, ginger may decrease the effect of the immunosuppressant cyclosporine or potentiate the blood pressure lowering effect of losartan and calcium channel blockers, or potentiate the blood sugar lowering effect of antidiabetes medications, but the level of evidence for this is low.

References

  1. Mohammadbeigi R, Shahgeibi S, Soufizadeh N, et al. Comparing the effects of ginger and metoclopramide on the treatment of pregnancy nausea. Pak J Biol Sci. 2011;14:817-20.
  2. Pongrojpaw D, Somprasit C, Chanthasenanont A. A randomized comparison of ginger and dimenhydrinate in the treatment of nausea and vomiting in pregnancy. J Med Assoc Thai 2007;90:1703-9.
  3. Hu Y, Amoah AN, Zhang H, et al. Effect of ginger in the treatment of nausea and vomiting compared with vitamin B6 and placebo during pregnancy:a meta-analysis. J Matern Fetal Neonatal Med. 2020:1-10.
  4. Dabaghzadeh F, Khalili H, Dashti-Khavidaki S, Abbasian L, Moeinifard A. Ginger for prevention of antiretroviral-induced nausea and vomiting: a randomized clinical trial. Expert Opin Drug Saf 2014;13(7):859-66.
  5. Jenabi E. The effect of ginger for relieving of primary dysmenorrhoea. J Pak Med Assoc 2013;63(1):8-10.
  6. Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 2009;15:129-32.
  7. Bartels EM, Folmer VN, Bliddal H, et al. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015;23(1):13-21.
  8. Araya-Quintanilla F,Gutierrez-Espinoza H, Munoz-Yanez MJ, Sanchez-Montoya U, Lopez-Jeldes J. Effectiveness of ginger on pain and function in knee osteoarthritis: A PRISMA systematic review and meta-analysis. Pain Physician. 2020;23(2):E151-E161.
  9. Paramdeep G. Efficacy and tolerability of ginger (Zingiber officinale) in patients of osteoarthritis of knee. Indian J Physiol Pharmacol 2013;57(2):177-83.
  10. "Code of Federal Regulations, Title 21, Part 182, Sec. 182.20: Essential oils, oleoresins (solvent-free), and natural extractives(including distillates): Substances Generally Recognized As Safe". US FDA. 1 September 2014. Retrieved 28 June 2021.

 


July - Peppermint (Mentha haplocalyx) 薄荷 (Bo He)

Peppermint is a naturally occurring hybrid of spearmint and water mint. Peppermint is high in menthol, which activates cold-sensitive TRPM8 receptors in the skin and mucosal tissues resulting in the characteristic cooling sensation. It can be used as an oil, extract, tea, or flavoring.

Oral enteric-coated peppermint oil appears to be effective for irritable bowel syndrome and is conditionally recommended by the American College of Gastroenterology. Peppermint may be effective for nausea and vomiting due to chemotherapy, colonic spasms due to barium enema, dyspepsia (in combination with caraway), and colonoscopy-associated spasticity (if administered at least 4 hours prior to procedure). Topical peppermint may be effective for nipple fissures, pressure ulcers, and tension headaches.

There is insufficient evidence for using peppermint for nausea and vomiting postoperatively or due to pregnancy, diffuse esophageal spasm, painful menses, menopausal symptoms, breast-cancer-related hot flashes, migraine headache, and stress.

Peppermint is generally well tolerated. Notable side effects include abdominal pain, anal burning, belching, diarrhea, dry mouth, heartburn, nausea, and vomiting. It is generally safe during pregnancy and breastfeeding when consumed in amounts found in foods.

Caution is advised in people with heartburn as high doses of peppermint can relax the lower esophageal sphincter which keeps acid in the stomach from rising into the esophagus. Theoretically, peppermint may affect the metabolism of various medications resulting in their increased levels, but the level of evidence for this is low and has not been reported in humans or suggested only at very high concentrations of peppermint.

References

  1. Eccles R. Menthol and related cooling compounds. J Pharm Pharmacol. 1994 Aug;46(8):618-30.
  2. Lacy BE, Pimentel M, Brenner DM, et al. ACG clinical guideline: Management of irritable bowel syndrome. Am J Gastroenterol. 2021;116(1):17-44.
  3. Alammar N, Wang L, Saberi B, et al. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019;19(1):21.
  4. Asao T, Kuwano H, IDE M, et al. Spasmolytic effect of peppermint oil in barium during double-contrast barium enema compared with Buscopan. Clin Radiol 2003;58:301-5.
  5. Jafarimanesh H, Akbari M, Hoseinian R, Zarei M, Harorani M. The effect of peppermint (Mentha piperita) extract on the severity of nausea, vomiting and anorexia in patients with breast cancer undergoing chemotherapy: A randomized controlled trial. Integr Cancer Ther. 2020;19:1534735420967084.
  6. Efe Ertürk N, Tasci S. The effects of peppermint oil on nausea, vomiting and retching in cancer patients undergoing chemotherapy: An open label quasi-randomized controlled pilot study. Complement Ther Med. 2021;56:102587.
  7. Mapp CP, Hostetler D, Sable JF, et al. Peppermint oil: Evaluating efficacy on nausea in patients receiving chemotherapy in the ambulatory setting. Clin J Oncol Nurs. 2020;24(2):160-164.
  8. Li J, Lv L, Zhang J, et al. A combination of peppermint oil and caraway oil for the treatment of functional dyspepsia: A systematic review and meta-analysis. Evid Based Complement Alternat Med. 2019;2019:7654947.
  9. Han JY, Moosvi Z, Duh E, Park S, Albers GC, Samarasena JB, Karnes W. Oral IBGard Before Colonoscopy: A Single-Center Double-Blinded, Randomized, Placebo-Controlled Trial. Dig Dis Sci. 2020.
  10. Shanazi M, Farshbaf Khalili A, Kamalifard M, Asghari Jafarabadi M, Masoudin K, Esmaeli F. Comparison of the Effects of Lanolin, Peppermint, and Dexpanthenol Creams on Treatment of Traumatic Nipples in Breastfeeding Mothers. J Caring Sci 2015;4(4):297-307
  11. Babamohamadi H, Ansari Z, Nobahar M, Mirmohammadkhani M. The effects of peppermint gel on prevention of pressure injury in hospitalized patients with head trauma in neurosurgical ICU: A double-blind randomized controlled trial. Complement Ther Med. 2019;47:102223.
  12. Gobel H, Schmidt G, Soyka D. Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters. Cephalalgia 1994;14:228-34;discussion 182.
  13. Gobel H, Fresenius J, Heinze A, et al. [Effectiveness of Oleum menthae piperitaeand paracetamol in therapy of headache of the tension type]. Nervenarzt 1996;67:672-81.
  14. Begas E, Tsioutsiouliti A, Kouvaras E, et al. Effects of peppermint tea consumption on the activities of CYP1A2, CYP2A6, Xanthine Oxidase, N-acetyltranferase-2 and UDP-glucuronosyltransferases-1A1/1A6 in healthy volunteers. Food Chem Toxicol 2017;100:80-9.
  15. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;18:2273-81.
  16. Wacher VJ, Wong S, Wong HT. Peppermint oil enhances cyclosporine oral bioavailability in rats: comparison with D-alpha-tocopheryl poly(ethylene glycol 1000)succinate (TPGS) and ketoconazole. J Pharm Sci 2002;91:77-90.

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