This table provides a practical approach and guideline on the classes or families of plant nutrients:

Question

How do phytonutrients improve health and why do they work in the human body?

Answer

Plants use their phytonutrients for their own survival. Some phytonutrients act as hormones, some as enzymes, or pigments to attract birds and insects for pollination and for growth regulation. Plant nutrients provide the distinguishing colour, odour and taste of plants. Without them plants won't be able to protect themselves from free radicals, environmental toxins, pollution, parasite invasion, viruses, bacteria, insects and injuries.

Question

Can the use of plant nutrients and vitamins in the form of food supplements be dangerous?

Answer

Remember, if a little bit of something is good for you, more isn't necessarily better!

The toxicity of vitamins is often a topic for hot debate. People are so concerned about vitamin poisoning, yet they don't bother to read the package inserts of their ordinary prescription medicines or even insist that they be included with the medicine. The package inserts contain a long list of the specific medicine's side effects. Read these and then decide on the actual benefit of the medication. Discuss the side effects with your doctor. Remember that medicine is often prescribed to treat symptoms which are actually the side effects of other medicines.

Vitamins are divided into fat-soluble and water-soluble vitamins. Fat-soluble vitamins include vitamins A, E, D and K. The water-soluble vitamins are the B-complex vitamins, carotenes and vitamin C. The fat-soluble vitamins are stored in the body, while the water-soluble ones are easily excreted. The water-soluble vitamins seldom cause toxicity, especially if you follow the recommended guidelines.

The recent vitamin C scare

A British study, published in the magazine Nature (9 April 1998) and in the New York Times, alleged that, although vitamin C is an effective antioxidant, it should only be taken in dosages of less than 60 mg a day. Dosages of above 500 mg apparently caused cell damage in research subjects. The study was done with thirty volunteers who took 500 mg of vitamin C daily over a period of six weeks. Before and after the intake of the vitamin, researchers monitored two indicators for oxidative damage in the DNA molecule. The one indicator showed a reduction in oxidation during the vitamin intake, while the other indicator showed more oxidation after than before taking the vitamin. This contradictory and confusing article caused an outcry.

Professor Balz Frei, director of the Linus Pauling Institute, said the findings contradicted other research. The investigation also focused on a single biological indicator which had not been irrefutably proven to be a good indicator of oxidative stress and cell damage. The well-researched and proven value of vitamin C in risk reduction in cancer, cardiovascular disorders and other serious health problems should be weighed against a single, flawed study that focused on one aspect of a biological effect.

According to Alex G. Schauss, PhD, director of the Life Science Department of Research on Natural and Medicinal Products, the study did not report that vitamin C caused clinical damage. The researchers found that vitamin C worked as an antioxidant by neutralising the oxygen atoms of certain free radicals, thereby suppressing the growth of cancer. Vitamin C supplementation is therefore quite justified.

Fat-soluble vitamins

Fat-soluble vitamins may cause toxicity, because they are stored in the body, but this is very rare.

Vitamin A may cause chronic toxicity only with a daily intake in excess of 50 000 IU (15 000 micrograms or 15 mg of retinol equivalent or RE per day). This far exceeds the amounts found in supplements. Symptoms of toxicity include increased pressure in the cerebrospinal fluid (in the brain and spinal cord), dermatitis and liver damage. The symptoms can usually be reversed if the high dosages are stopped. If the water-soluble precursor beta carotene (and other mixed carotenes) is taken as a main source of vitamin A, toxicity will never occur. The body converts the carotene into vitamin A as and when needed. Children under the age of four should not take more than 5 000 IU of pure vitamin A a day (1 500 micrograms or 1,5 mg of RE). Children older than four and adults do not need more than 10 000 IU (3 000 micrograms or 3 mg of RE) a day. Pregnant women and women who are breastfeeding should not take more than 8 000 IU (2 400 micrograms or 2,4 mg of RE) a day.

Vitamin D can be very potent and therefore toxic, but only with an intake in excess of 25 000 IU a day for adults. Most supplements contain the recommended daily allowance (RDA) of 400-800 IU. Toxicity is therefore extremely rare.

Vitamin E seldom causes toxicity, even when massive daily doses are taken.

Vitamin K, essential for blood clotting, is seldom included in supplements. The natural bacteria in our intestines manufacture enough Vitamin K for our requirements. It is only prescribed for people after large sections of their intestine have been removed.

Question

It seems as though micronutrients and plant nutrients are miracle cures – is that assumption correct?

Answer

Micronutrients restore the functions of the body. They are not miracle cures. They simply help the body-mind unit to perform all its functions effectively so that you can thrive in a condition of optimal health and wellbeing. Use your supplements regularly and in the correct quantities and combinations. Eat healthy, wholesome food. Use alcohol sparingly or not at all. Do not smoke. Practise stress management techniques for physical, emotional, spiritual and mental health. Adopt a positive attitude to life. Laugh a lot. Do regular, moderate exercise. You will have an excellent chance of living to a ripe, healthy, wise and fit age of 120 years!

Question

Why do people suddenly want to know more about plant nutrients?

Answer

The health benefits of phytochemicals (phyto = plant), phytonutrients or nutriceuticals are becoming better known as more and more research is published, proclaiming and proving their benefits. The public has thereby become more aware of and interested in phytonutrients. Scientists worldwide have been reporting on the health benefits of plant chemicals for many years. They have identified the many ingredients in plants (over and above the vitamins, minerals, amino acids and fatty acids) that prevent major diseases and improve our quality of life. Many cultures and ancient peoples have known and used this intuitive knowledge all along. Modern science and research technology have now been able to reassure the analytical and sceptical Western mindset.

There is a global renaissance and renewed interest in natural medicine. Natural medicine is “an idea whose time has come” and the world’s acceptance of the importance and validity of natural medicine (both as an alternative to conventional medication as well as a synergistic part of conventional treatments) could also be seen as a sign of our time! This is happening despite the extensive growth and development in the technological advances taking place in physics, biogenetic engineering, physiology, genetics, pharmacology and the scientific advances in understanding disease processes. Smallpox has been eradicated. The risk of developing many previously serious childhood diseases has been diminished. Surgical procedures have been revolutionised with intricate and life saving procedures becoming run of the mill, daily occurrences. Lives are saved every day by the progresses made in modern medicine.

Yet there is a growing dissatisfaction with mainstream health care, or rather, disease management, that only treats the symptoms with potent drugs that severely affect the metabolism and cause side effects. People have a growing need to know why they are ill, how it happened and how they can help themselves to get better.

Question

Why doesn’t my doctor know about, or want to prescribe herbs or food supplements?

Answer

Despite the availability of a wealth of research papers using the proper and accepted research protocols, the majority of allopathic doctors, by their own admission, in the UK, USA, Australia and SA, know very little about the nutritional approach to health maintenance and disease prevention. This is no excuse, however, as there are many readily available reputable sources of research information available, as easy as clicking on a reputable natural medicine website.

Question

Herbs are natural, so I suppose I can use it however and whenever I want to?

Answer

No, not at all! This is a wrong perception. Everything natural isn’t always health enhancing or even good for you.

Thousands of plants are used as medicines. It is always important to keep in mind that a dis-ease process in a system of the body, is a physical manifestation of a deeper process and that healing should also occur on a mental, emotional and spiritual level.

Plants can also be harmful. Don't just use herbs or supplements from any source. If you have the knowledge, either make your own infusions from recognised herbs in your garden or buy properly researched and well-known products from a reliable, established source. Consult one of the many registered and qualified health care practitioners, who are knowledgeable regarding the use of medicinal herbs and supplements. Pregnant women and children should only take herbs recommended by trained experts. Most herbal plants are in fact quite safe - unlike many of the over-the-counter medicines and prescription drugs that we take in our ignorance without thinking any more about it. Always read the package inserts provided with conventional medication and find out about the possible side effects. Then make an informed decision on whether you want to use ordinary prescription medicines, or opt for the kinder healing effect of herbs.

Question

How do I know which herbs to use?

Answer

A good rule of thumb when using herbal products would be the following:

Herbs are plants with either or all of the following properties: medicinal, aromatic and culinary. Herbs that comply with all three, such as garlic, ginger, rosemary, thyme, basil and oregano can be freely used on a daily basis to improve the taste of your food and the state of your health. Herbs with mainly medicinal properties should be used as a medicine to assist you in returning to health, and not as a daily supplement! Examples include Echinacea, Kava Kava and St John’s Wort. Ginkgo Biloba is one exception to this rule and can be taken in an antioxidant combination on a regular basis.

The food supplements that you should take on a daily basis to maintain health would be a combined antioxidant and multivitamin supplements, the essential fatty acids and a calcium and magnesium combination.

If you have an infection or any disease, use herbs until you feel better. The dosage and form (drops, tincture, dried leaves for a tea, etc.) will be indicated on the container or specifically prescribed. Stop taking the herbs as soon as you are well again. Many fresh herbs that we use with our food have medicinal value and, if used regularly, will be a good preventive measure against infection. Examples are rosemary, basil, thyme and garlic - to mention a few.

Question

When I choose a herbal supplement to use as natural medicine, how do I know which preparations are best?

Answer

Standardised herb extracts are the best, followed by tinctures and then freeze-dried preparations. Herbal products are made from plants that have medicinal properties. Light, air and moisture affect dried plants and they lose their effectiveness. Plants react with oxygen and form free radicals; when plants are picked, they are no longer able to dispose of free radicals and the chemistry of the plant changes. Buy products that have been dried recently, preferably in light-resistant and airtight containers (dark-brown bottles or thick plastic containers). Before buying a herbal mixture, smell it. A strong smell indicates that the product is still fresh.

A standardised extract complies with the requirements for certain key ingredients in a product. Standardisation ensures that the product contains what it indicates and in sufficient quantities for the desired effect. It can be in liquid or solid form.

Tinctures are made by dissolving extracts of fresh or dried plants in alcohol. The alcohol content is high enough to preserve the plant matter. Remember that the quality of tincture is as good (or bad) as the herbs it contains. Shake tinctures well before using them and dissolve them in hot water. The usual dose is a dropper full in a quarter of a glass of water, taken three or four times a day with meals.

Freeze-drying is a process in which chemical solvents are used to make plant extracts. The extracts are then exposed to extremely low temperatures, thereby removing the solvents. The fixed residue is then packed in capsules. This process ensures products of a much better quality than whole air-dried plants.

It is not a good idea to use whole air-dried plants for medicinal purposes. If they are chopped fine and stored in a tin, they will probably lose all their healing powers. Leaves and flowers are especially prone to deterioration. If such herbs smell old, dusty or mouldy, they are probably of little value. Herbal teas must be very carefully packed to prevent deterioration and they should retain a strong, characteristic aroma. Try to buy organically grown herbal preparations. This ensures that poisons are eliminated and that natural compost has been used in their cultivation. Check the list of ingredients and make sure that no other pharmaceutical and potentially toxic substances have been added.

It is a wise precautionary measure for consumers to be careful about all herbal medicines. Medicinal herbs are prescribed and advised for specific ailments and should be used with caution and only for the illness they are recommended for. Even so, most herbs exert a gentle healing effect without disturbing the metabolism unduly.

Question

I’ve heard about herb-drug interactions. Is it a common occurrence?

Answer

It doesn’t happen too often, fortunately! There are, however, certain herbs that cannot be used together with prescription drugs.

It is often not the herb that is the problem, but the prescription drug that interacts with the herb. Prescription drugs often seriously interfere with the normal metabolic pathways in the body. That is why they are effective and the reason they often have many side effects. It might be a good idea to make an informed decision (in consultation with your doctor - who should also be knowledgeable on complementary medicine), to stop all prescription medication not essential for survival, then use the more natural options for a period of time. Remember also that natural medicines may take longer before you notice an effect. The improvement in your condition takes place more subtly and gently so that one day you suddenly realise that you are feeling better.

It defeats the purpose of taking control over your own health and wellbeing to just add more natural medicines to your existing grocery list of prescription medication. Medicinal herbs are medicines, after all!

Health is not simply the absence of the symptoms of disease, but a balanced wellness that includes the health of all six levels of human existence: body, mind, emotions, soul, social and occupational aspects. Looking at any disease process from a holistic perspective, rather than a simplistic, symptomatic one, is more effective in helping you return to optimal health.

Always tell your doctor if you are using herbal remedies. Herbs used as medicine, are medicine. Even though they are natural, they can still be toxic, like poisonous mushrooms, deadly nightshade or hemlock! Medicinal herbs may have powerful and pharmacologically active chemicals. Indiscriminate use of medicinal herbs may have side effects. Quite a few herbs are contra-indicated during pregnancy. Herbs may interact with other drugs – both prescription and over-the-counter drugs.

You should be very well read before self-medicating with herbs. Do not try to treat serious diseases or any symptoms you don’t know the origin of by yourself. There are doctors knowledgeable on both mainstream orthodox medicine as well as complementary options. Consult one if you are in doubt.

Question

Which herbs are known to interact with specific prescription drugs?

Answer

Herbs that are used only in their medicinal capacity, should be regarded as such. Please refer to an earlier question and answer on how to distinguish between herbs you can use freely, and those that are only used when you are sick. Herbs are readily available from health food stores, pharmacies and natural health practitioners. You should always inform your doctor when you are using food supplements or herbs, before he/she prescribes medication. More and more literature and published clinical experience are becoming available that prove and support the use of herbal and natural medicines and that show when used appropriately, they seldom cause side effects.

It is often not the herb that is the problem. Prescription drugs work because they have dramatic effects on the metabolism. Herbs tend to have a milder, more moderate effect on the body’s physiology. The herb might just potentiate the drug’s effect, making it too potent and this might lead to side effects or interactions. There are actually very few herbs that interact with drugs. Herbs might be therapeutic on its own, with possible toxicity when used with a prescription drug. The toxicity is often due to the drug becoming too potent.

This is just a summary of the most wellknown interactions:

Coumarins: These anti-clotting plant nutrients are found in herbs like angelica, horse chestnut and liquorice root. It is also found in grapefruit. There might be interactions of coumarins with the calcium channel blocker felodipine (Plendil), a drug used to treat high blood pressure. Coumarins could also interact with prescription anti-clotting drugs. Coumarins could also interact with tranquilisers such as midazolam (Dormicum) and triazolam (Halcion) due to enzyme inhibition.

Devil’s claw (Harpagophytum procumbens): This herb, often used in the treatment of arthritis, gout, muscle pains (myalgia), and as appetite suppressant, can cause purpura (bruising underneath the skin) when used with the anti-clotting agent, warfarin.

Feverfew (Tanacetum parthenium): This herb is used in the treatment of migraine headaches, arthritis, menstrual irregularities and allergies. No adverse reactions have been reported when feverfew was prescribed together with the anti migraine drug, sumatriptan (Imigran). Feverfew’s efficacy is compromised when used together with anti blood clotting agents such as warfarin, heparin, Actilyse, Streptase. Selective serotonin re-uptake inhibitors (SSRI’s) like Prozac can also prolong bleeding time and used together with feverfew, may cause patients to have a bleeding tendency. Feverfew is contraindicated in people allergic to chamomile, ragweed or yarrow.

Garlic (Allium sativum): This wellknown herb provides many health benefits such as lowering blood pressure, blood fats and anticlotting activity. Garlic is used for infections of the respiratory tract, whooping cough, bronchitis and gut disease. Garlic could inhibit the function of the blood platelets, leading to a bleeding tendency in some individuals. Risk of bleeding could also increase when garlic is used together with prescription anti clotting agents like warfarin. Non-steroidal anti-inflammatory drugs (NSAID’s), such as Voltaren, Brufen, Indocid, Feldene, used together with garlic, might also cause a bleeding tendency in some people.

Ginkgo biloba: This herb is used for the treatment of brain dysfunction (e.g. Alzheimer’s disease), vertigo, tinnitus, intermittent claudication (extreme pain on the legs due to arterial spasm), impotence and concentration problems. Ginkgo can cause a bleeding tendency in the blood vessels of the eyes and brain when used together with anti clotting drugs such as warfarin, acetylsalicylic acid (Aspirin, Disprin), or ergotamine (Migril), used for migraine headaches. It is therefore recommended not to take them together.

Ginseng (Asian – Panax ginseng, American – Panax quinguefolis, Siberian – Eleutherococcus senticosus): These herbs are known as adaptogens that increase energy and reduce the effects of stress. Herbalists also use them for loss of appetite, anxiety, impotence, sterility, neuralgia and insomnia. Ginseng may inhibit the efficacy of antidiabetic drugs, including insulin. This might lead to high blood sugar levels in diabetics. On its own, used to treat type 2 diabetes, ginseng 100mg and 200mg per day, reduced fasting blood sugar levels, improved physical activity and elevated mood.

Ginseng should be used with caution in patients on loop diuretics and anti clotting agents like warfarin. Ginseng is contraindicated in patients with kidney disease.

Guarana (Paullina cupana): This herb is used to treat fatigue. Guarana’s chemical structure is similar to that of caffeine, and has many of the same stimulant effects. Guarana is considered as a mild diuretic and can also inhibit blood platelet aggregation, preventing blood form clotting.

Kava kava (Piper methysticum): This herb is widely used to treat stress, anxiety, restlessness and insomnia. Kava kava can potentiate the effect of drugs that act on the central nervous system, such as levodopa prescribed for Parkinson’s disease, alprazolam (Xanor) a tranquiliser, and cimetidine (Tagamet), prescribed for peptic ulcers. Kava kava should not be used together with the benzodiazipines (e.g. Valium) – it is in any case totally unnecessary to do so!). Some data suggest interaction of kava with alcohol, while others show no effect.

Liquorice (Glycyrrhiza glabra): This herb is used to treat coughs, bronchitis, gastritis, respiratory infections, peptic and duodenal ulcers. It is also often used as an adaptogen. Liquorice can potentiate the effects of the corticosteroids. Liquorice used together with oral contraceptives, may cause high blood pressure, edema and low potassium levels. Liquorice together with anti-arhythmic drugs or furosemide (Lasix – a potent diuretic), may cause severe hypokalemia (low potassium levels) leading to ventricular tachycardia (fast, irregular heart beat). Women are more sensitive to the adverse effects of liquorice than men.

Ma huang (Ephedra sinica): This Chinese herb is sometimes used in weight loss formulations. Because of its adrenalin (ephedrine) and noradrenalin effect, it might lead to anxiety and high tension states in sensitive individuals. Heart rhythm might be disturbed when Ma huang is used with glycosides (e.g. Digoxin) or the general anaesthetic halothane (Fluothane).

Naringenins: These nutrients found in grapefruit juice might increase levels of tranquilisers such as Dormicum and Halcion, as well as caffeine and some calcium channel blocking anti hypertension drugs (e.g. Isoptin, Verapamil and felopdipine).

Paw paw (Carica papaya): The leaf of this wellknown fruit is used to treat gastrointestinal disorders, parasitic infections, coughs, bronchitis and to promote diuresis. Interactions with warfarin have been documented. Papain, the enzyme extract of paw paw may increase warfarin activity, promoting a bleeding tendency in some patients.

St John’s wort (Hypericum perforatum): St John’s wort (SJW) is used to treat skin problems, burns, wounds and injuries when used as a cream. When taken orally, it is best known as remedy for mild to moderate depression, anxiety and restlessness. It cannot be used together with the anti-Aids drug indinavir, or cyclosporine, used to treat some auto immune disease like systemic lupus erythematosis and to prevent organ donor rejection in transplant patients. Warfarin is less effective when used together with SJW. SJW should not be used together with any other prescription antidepressants. It should also not be used together with digoxin (Lanoxin).

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