The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    If you found the information here helpful, please consider supporting this site.If you found the information here helpful, please consider supporting this site.

  • Recent Posts

  • Recent Comments

    Safety review of popular herbal products

    Dr. Darrell Hulisz from Case Western Reserve University School of Medicine in Cleveland, Ohio reviews popular herbals.

    Let’s focus on safety issues.


    • Common side effects include unpleasant taste and allergic reactions.
    • Because the flower is related to ragweed, cross allergenicity may occur in people allergic to ragweed.
    • Not recommended in patients with progressive or autoimmune disorders.


    • Might lower blood pressure in people with hypertension.
    • Use cautiously in people with bleeding disorders or in those taking antiplatelet therapy.
    • Monitor for deceased blood levels of warfarin (Coumadin).
    • Malodorous breath and garlic-like body odor.

    Ginkgo biloba

    • Mild gastrointestinal side effects and headache.
    • Avoid in patients using anticoagulants (eg, warfarin; Coumadin) or antiplatelet therapy (eg, aspirin or clopidogrel [Plavix]), or in those with active bleeding such as peptic ulcer disease.
    • Not recommended in patients with seizure disorders.

    St. John’s wort

    • Should not be taken with serotonin uptake inhibitors (SSRIs), as symptoms of serotonin syndrome might occur (headache, sweating, dizziness, and agitation)
    • Avoid during pregnancy.
    • Associated with photosensitivity.
    • Can reduce blood levels of digoxin (Lanoxin) and indinavir (Crixivan).
    • Cases of heart transplant rejection were associated with a reduction in cyclosporine (Sandimmune) blood levels.
    • Breakthrough bleeding and unwanted pregnancies reported in women who also took oral contraceptives.


    • Restlessness and palpitations.
    • Additive effect with other central nervous system depressants.
    • Caution if operating machinery when starting treatment.
    • Headaches, excitability, and uneasiness.


    • Allergic reaction.
    • Sedative effects — use with caution when taking drugs with sedative side effects, or with alcohol.


    • Prolonged bleeding
    • Caution in people taking anticoagulants.
    • Mild gastrointestinal upset, including heartburn, diarrhea, and mouth irritation.


    • Avoid in people with heart disease who take other stimulants.
    • Rarely associated with reversible breast pain and tenderness, and postmenopausal bleeding.
    • Overuse associated with diarrhea, hypertension, nervousness, dermatologic eruptions, and insomnia.
    • Don’t use in people with active bleeding.
    • Use cautiously with anticoagulants and/or antiplatelet medications.

    Saw Palmetto

    • Headache and intestinal upset.

    Black cohosh

    • Rash or intestinal upset.
    • Don’t use in lactating or pregnant women.
    • Avoid in women with a history of estrogen-dependent tumors or endometrial cancer.

    The bottom line?
    Many of the side effects listed here are supported by limited data. Check with the article for more details and guidelines.

    11/25/08 22:22 JR

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