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An Evidence-Based Guide

Lesley Braun & Marc Cohen

Herbs — Therapeutic use — Textbooks
Dietary supplements — Textbooks
Alternative medicine — Textbooks
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Book Details
 1236 p
 File Size 
 16,393 KB
 File Type
 PDF format
 978 0 7295 3910 4 (pbk.) 
 2010 Elsevier Australia

About the Authors
Dr Lesley Braun PhD, BPharm, DipAppSci
Naturopathy, GradDip Phytotherapy
Dr Lesley Braun is a registered pharmacist and
naturopath. She holds a PhD from RMIT
University, Melbourne, Australia, in which she
investigated the integration of complementary
medicine into hospitals in Victoria. She is currently
Research Fellow in the Cardiothoracic
Surgical Research Unit at the Alfred Hospital
(Department of Surgery, Monash University),
where she conducts clinical trials using integrative
medicine in the hospital setting, supervises
research students and is involved in the
National Institute of Complementary Medicine
Collaborative Centre for Natural Medicines
and Neurocognition. Her other role at
the Alfred hospital is as Research Pharmacist
in the Pharmacy Department, where her work
focuses on complementary medicine products
and the practice of integrative medicine within
pharmacy settings.
Dr Braun is also Vice President of the
National Herbalists Association of Australia,
a member of the Therapeutic Goods Administration’s
(TGA) Complementary Medicine
Evaluation Committee (CMEC), an advisory
board member to the Australasian Integrative
Medicine Association (AIMA), on the editorial
board of the Journal of Complementary
Medicine (JCM), a member of several advisory
committees for the National Institute of
Complementary Medicine (NICM), on the
academic board of the Endeavour College
of Natural Health and a member of several
complementary medicine working groups for
the Clinical Oncology Society of Australia (COSA).
Since 1996 she has authored numerous
chapters for books and more than 100 articles,
and since 2000 has written regular columns
for the Australian Journal of Pharmacy and the
Journal of Complementary Medicine. She lectures
to medical students at Monash University and
to chiropractic students at RMIT University,
and is regularly invited to present at national
and international conferences about evidencebased
complementary medicine, drug interactions
and complementary medicine safety.
Her role as the main author of Herbs and
Natural Supplements — An Evidence-based Guide
represents a continuation of a life-long goal
to integrate evidence-based complementary
medicine into standard practice and improve
patient outcomes safely and effectively.

Professor Marc Cohen MBBS(Hons),
PhD(TCM), PhD(Elec Eng), BMedSc
Marc Cohen is currently Professor of Complementary
Medicine at RMIT University, where
he leads the world’s first online postgraduate
Master of Wellness program, supervises postgraduate
research students and conducts research
funded by the National Health and Medical
Research Council and other agencies into various
aspects of wellness and complementary medicine.
He is also Senior Research Fellow at the
Centre for Medical and Health Sciences Education,
Monash University, Expert Advisor to
the Therapeutic Goods Administration’s (TGA)
Complementary Medicine Evaluation Committee
(CMEC), a member of the Scientific
Advisory Committee for the National Institute
of Complementary Medicine (NICM), a current
Board Member and Past-President (President
2000–2007) of the Australasian Integrative
Medicine Association (AIMA) and a member
of the Royal Australian College of General
Practitioners (RACGP)/AIMA Joint Working
Party, which has guided the development of the
RACGP curriculum on integrative medicine.
Professor Cohen is a registered medical
practitioner with degrees in Western medicine,
physiology and psychological medicine,
as well as PhDs in both Chinese medicine and biomedical
engineering. He sits on the
editorial boards of a number of international
journals and has published widely, including
writing more than 50 peer-reviewed journal
articles as well as co-editing the text ‘Understanding
the Global Spa Industry’. Professor
Cohen has organised eight International Holistic
Health Conferences and is on the board of
the Global Spa Summit. He is a sought-after
presenter and in the past five years has been an
invited speaker at more than 100 conferences
including more than 50 international and 50
national conferences. As one of Australia’s
foremost pioneers of complementary medicine,
he has made significant impacts on education,
research, clinical practice and policy,
and his achievements have been recognised
with three consecutive RMIT Media Star
Awards and the inaugural award for leadership
and collaboration from the National Institute
of Complementary Medicine.

– an evidence-based guide is organised into
four sections. The first section provides a basic
introduction to complementary medicine in
general and then, more specifically, to herbal
medicine, clinical nutrition, aromatherapy,
and food as medicine. It is hoped that many of
your general questions will be answered here.
The second section focuses on issues relating
to clinical practice and explores the relatively
new fields of integrative medicine and wellness,
as it relates to health. These areas are gaining
popularity around the globe and complementary
medicine philosophy and treatments are
often an integral part of the approach. This
section also contains chapters with a focus on
safety because the wise clinical use of all interventions
must be based on a benefit versus risk
assessment. There are general chapters discussing
the safety of herbs and natural supplements
and drug interactions, and then specific chapters
focusing on safety in pregnancy, before
surgery and for people undertaking treatment
for cancer. These topics are discussed in both
a theoretical and a practical way to clarify the
key concerns and produce some general guidelines
that can be used to inform practice.
The third and largest section comprises 130
evidence-based reviews of some of the most
popular herbs and natural supplements available
over the counter. Exhaustive reviews of
the peer-reviewed literature have been undertaken
by the author team to update, modify and
expand information from the previous edition,
and 10 new monographs are included. Common
names, chemical components, main actions,
clinical uses, dosage range and safety issues are
included for each herbal medicine. For nutritional
supplements, background information
and pharmacokinetics, food sources, deficiency
signs and symptoms and the new Australian
and New Zealand recommended daily intakes
(RDIs) are also included where appropriate.
Although technical language is frequently used,
there is also a summary in non-technical language
(Practice Points and Patient Counselling)
and answers to key questions patients may have
about the product (Patients’ FAQs). A ‘Historical
note’ is included where appropriate and
occasionally there are also ‘Clinical note’ boxes
that provide further information.
The fourth section consists of ready-reference
appendices, the largest of which is a table that
outlines the interactions possible between the
130 complementary medicines reviewed and
pharmaceutical drugs (Appendix 2). Although
investigation into this area is still in its infancy,
we have provided a brief explanation for each
possible interaction and a general recommendation
based on what is currently known or suspected.
It is intended as a guide only, to be used
to inform practice when clinicians take a medical
and medication history: obviously it should
be interpreted within the individual patient’s
context. It is anticipated that this section will
continue to change in future editions as more
clinical studies are published and theoretical
predictions are tested. Appendix 5 is a guide
to the safe use of complementary medicines in
the preoperative period. Appendix 7 is a table
organised by pharmacological action giving the
herbs and nutrients that produce that action and
the type of evidence available to support this.
For example, to find which herbs and nutrients
exert an anti-inflammatory action, check under
‘Anti-inflammatory’. We have also included a
glossary of medical, research, integrative and
complementary medicine terms and abbreviations
(Appendix 1), a list of Australian and New
Zealand poisons information centres and their
phone numbers (Appendix 3), and the contact
details for teaching institutions, complementary
and integrative medicine associations and product
manufacturers in Australia and New Zealand
(Appendix 4). These lists are not exhaustive but
aim to provide a general guide for the reader.

Table of Contents
Organisation of this book vii
Acknowledgments viii
About the authors ix
Contributors xi
Reviewers xiv
Herbal and natural supplements
1 Introduction to complementary medicine 1
2 Introduction to herbal medicine 14
3 Introduction to clinical nutrition 23
4 Introduction to aromatherapy 36
5 Introduction to food as medicine 47
Clinical practice
6 Introduction to the practice of integrative medicine 67
7 Safety and complementary medicines 80
8 Interactions with herbal and natural medicines 94
9 Preoperative care: considerations 113
10 Cancer and safety of complementary medicines 126
11 Herbs and natural supplements in pregnancy 149
12 Introduction to wellness 173
Adhatoda 187
Albizia 190
Aloe vera 192
Andrographis 200
l-Arginine 207
Astragalus 213
Baical skullcap 218
Beta-carotene 229
Bilberry 247
Bitter melon 251
Black cohosh 255
Brahmi 263
Calcium 267
Calendula 281
Carnitine 285
Celery 296
Chamomile 299
Chaste tree 305
Chickweed 310
Chitosan 312
Chondroitin 315
Chromium 320
Cinnamon 328
Cloves 332
Cocoa 336
Coenzyme Q10 346
Colostrum 358
Cranberry 363
Creatine 367
Damiana 374
Dandelion 376
Devil’s claw 379
Dong quai 383
Dunaliella salina 388
Echinacea 391
Elder 400
Eucalyptus 403
Evening primrose oil 408
Fenugreek 416
Feverfew 420
Fish oils 426
Flaxseed oil 444
Folate 452
Garlic 466
Gentian 479
Ginger 480
Ginkgo biloba 493
Ginseng — Korean 509
Ginseng — Siberian 524
Globe artichoke 532
Glucosamine 535
l-Glutamine 543
Goji 552
Goldenrod 555
Goldenseal 557
Grapeseed extract 565
Green tea 572
Guarana 582
Gymnema sylvestre 587
Hawthorn 591
Honey 598
Hops 604
Horse chestnut 608
Horseradish 613
Iodine 614
Iron 622
Kava kava 633
Lavender 638
Lemon balm 645
Licorice 650
Lutein and zeaxanthin 661
Lycopene 669
l-Lysine 677
Magnesium 680
Meadowsweet 691
Mullein 693
Myrrh 695
New Zealand green-lipped mussel 700
Noni 701
Oats 704
Olive 710
Orange 718
Passionflower 722
Pelargonium 725
Peppermint 728
Perilla 737
Policosanol 743
Prebiotics 748
Probiotics 754
Psyllium 767
Pygeum 771
Quercetin 774
Raspberry leaf 782
Red clover 785
Red yeast rice 791
Rhodiola 794
Rosemary 801
S-Adenosyl-L-methionine (SAMe) 805
Sage 810
St John’s wort 813
St Mary’s thistle 824
Saw palmetto 836
Schisandra 840
Selenium 844
Shark cartilage 856
Shatavari 859
Slippery elm 864
Soy 866
Stinging nettle 877
Taurine 881
Tea tree oil 885
Thyme 890
Tribulus 893
Turmeric 897
Tyrosine 907
Valerian 912
Vitamin A 917
Vitamin B1 926
Vitamin B2 — riboflavin 932
Vitamin B3 — niacin 936
Vitamin B5 — pantothenic acid 946
Vitamin B6 949
Vitamin B12 957
Vitamin C 966
Vitamin D 985
Vitamin E 1002
Wild Yam 1024
Willowbark 1026
Withania 1029
Zinc 1037
1 Glossary and abbreviations 1055
2 Herb/nutrient–drug interactions 1060
3 Poisons information centres 1113
4 Resources: training, manufacturers and information 1114
5 Guide to the safe use of complementary medicines during the preoperative period 1118
6 Clinical use and safety of vitamins and minerals 1123
7 Evidence base for physiological activities of herbs and supplements 1134
Index 1173

Churchill Livingstone
is an imprint of Elsevier
Elsevier Australia. ACN 001 002 357
(a division of Reed International Books Australia Pty Ltd)
Tower 1, 475 Victoria Avenue, Chatswood, NSW 2067

This edition © 2010 Elsevier Australia
2nd edition © 2007 Elsevier Australia
1st edition © 2005 Elsevier Australia
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