Green Tea

GREEN TEA

SCIENTIFIC NAME: Camellia sinensis L. Kuntze. Family: Theaceae

COMMON NAMES: Tea, Green tea, AR25®, Camellia, Camellia assamica, Camellia sinensis, Camellia sinensis (L.) Kuntze, Camellia tea, Catechins, Chinese Tea, EGCG, Epigallocatechin-3-gallate, Exolise®, GTE, Green Tea Extract, Matsu-cha Tea, Thea sinensis, Thea bohea, Thea viridis, Theanine, Theifers.

 
HISTORY

     The dried, cured leaves of C. sinensishave been used to prepare beverages for more than 4000 years.3 The method of curing determines the nature of the tea to be used for infusion, and green tea is type of cured tea. Green tea is prepared from the steamed and dried leaves; by comparison, black tea leaves are withered, rolled, fermented, and then dried. Oolong tea is semifermented and considered to be intermediate in composition between green and black teas. Green tea is less popular in America and Europe than the black tea varieties. Tea has been used medicinally for centuries, and the Chinese regarded the drink as a cure for cancer, although the tannin component is believed to be carcinogenic. Tea has been known to act as a diuretic and has been used to relieve headaches.

USES

    Uses based on scientific evidence


Cancer prevention

Heart attack prevention

High cholesterol

Mental performance/alertness

Memory enhancement

Dental cavity prevention

Sun protection

Asthma

Weight loss

Arthritis

Menopausal Symptoms

Uses based on tradition, theory or limited scientific evidence

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Alcohol intoxication, antioxidant, astringent, bone density improvement, cataracts, cognitive performance enhancement, Crohn's disease, detoxification from alcohol or toxins, diabetes, diarrhea, diuretic (increasing urine), fibrosarcoma, flatulence, fungal infections, gastritis, gum swelling, headache, heart disease, Helicobacter pylori infection, HIV/AIDS, improving blood flow, improving urine flow, improving resistance to disease, inhibition of platelet aggregation, ischemia-reperfusion injury protection, joint pain, kidney stone prevention, liver cancer, longevity, lung cancer, neuroprotection, oral leukoplakia, ovarian cancer, Parkinson's disease prevention, promotion of digestion, protection against asbestos lung injury, regulation of body temperature, stimulant, stomach disorders, bleeding of gums or tooth sockets, stroke prevention, sunburn, tired eyes, vomiting.



TOXICOLOGY

     There is evidence that in animals caffeine can be teratogenic, and the FDA has advised that women who are or may become pregnant should avoid caffeine-containing products. Caffeine-containing beverages may also alter female hormone levels, including estradiol.

There is evidence that condensed catechin tannin of tea is linked to a high rate of esophageal cancer in regions of heavy tea consumption. This effect may be overcome by adding milk, which binds the tannin, possibly preventing its detrimental effects.


SUMMARY

     Green tea is a widely popular beverage, particularly in Asia. Because of its unique preparation process, green tea retains many of the chemical characteristics of the fresh leaf. Pharmacologically, a wealth of information is available concerning green tea's effects on lipid levels, dental caries prevention, antimicrobial, antimutagenic, and antioxidative actions. It appears that green tea components may exert a chemoprotective effect that may contribute to a reduced incidence of cancers and other life-threatening diseases. Because of the caffeine present in the tea, it should be avoided by pregnant women. The tea may be an asthma-inducing agent.

PATIENT INFORMATION — Green Tea

    Uses: Traditionally consumed as a beverage, green tea retains many chemicals of the fresh leaf. It is thought to reduce cancer and other fatal diseases, lower lipid levels, help prevent dental caries, and possess antimicrobial, antimutagenic, antioxidative, and other effects.

    
    Side Effects: The FDA advises those who are or may become pregnant to avoid caffeine. Heavy consumption may be associated with esophageal cancer. Tea may impair iron metabolism.

    Dosing: Green tea has been studied as a component of diet for its cancer preventative and caries preventative properties. A typical tea bag contains 2 g of leaf. Doses of 4 to 5 cups/day (corresponding to ca. 300 mg caffeine) are considered high, depending on the patient's caffeine tolerance. The content of polyphenols increases with extended brewing time. Green tea extracts are available standardized to 25%, 60%, and 80% total polyphenols, compared with a content of 8% to 12% in the leaf. Use of this extract can avoid the inconvenience of drinking large volumes of liquids.

Ginkgo Biloba

GINKGO

SCIENTIFIC NAME: Ginkgo biloba L. Family: Ginkgoaceae

COMMON NAMES: Ginkgo, maidenhair tree, kew tree, ginkyo, Arbre aux quarante ecus, adiantifolia, baiguo, bai guo ye, BN-52063, duck foot tree, Elefantenohr, EGb, EGb 761, Eun-haeng, facherblattbaum, Fossil tree, GBE, GBE 24, GBX, ginan, gin-nan, Ginkgoaceae (family), ginkgo balm, ginkgoblatter, Ginkgo folium, Ginkgo biloba blatter, ginkgogink, ginkgold, ginkgopower, ginkyo, icho, ityo, Japanbaum, Japanese silver apricot, kew tree, kung sun shu, LI 1370, maidenhair tree, noyer du Japon, oriental plum tree, pei kuo, pei-wen, Pterophyllus, Pterophyllus salisburiensis, Rokan, salisburia, Salisburia adiantifolia, Salisburia macrophylla, sophium, silver apricot, tempeltrae, tanakan, tanakene, tebofortan, tebonin, temple balm, tramisal, valverde, vasan, vital, ya chio, yin-guo, , yinhsing (Silver Apricot-Japanese).

HISTORY

     The ginkgo species was almost destroyed during the ice age. The species survived in China, where it was cultivated as a sacred tree, and is still found decorating Buddhist temples throughout Asia. Preparations have been used for medicinal purposes for more than a thousand years. Traditional Chinese physicians used ginkgo leaves to treat asthma and chillblains, which is the swelling of the hands and feet from exposure to damp cold. The ancient Chinese and Japanese ate roasted ginkgo seeds, and considered them a digestive aid and preventive for drunkenness. In the Western world, ginkgo has been used since the 1960s when technology made it possible to isolate its essential compounds. The flavonoids act as free radical scavengers, and the terpenes (ginkgolides) inhibit platelet activating factor. Currently, oral and intravenous forms are available in Europe, where it is one of the most widely prescribed medications. Neither form has been approved for medical use in the United States, although ginkgo is sold as a nutritional supplement.


USES

Uses based on scientific evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Claudication (painful legs from clogged arteries)

Dementia (multi-infarct and Alzheimer's type)

Cerebral insufficiency

Age-associated memory impairment (AAMI)

Altitude (mountain) sickness

Chemotherapy side effects reduction

Decreased libido and erectile dysfunction (impotence)

Depression and seasonal affective disorder (SAD)

Glaucoma

Macular degeneration

Memory enhancement (in healthy people)

Multiple sclerosis

Premenstrual syndrome (PMS)

Ringing in the ears (tinnitus)

Vertigo

Vitiligo

Stroke

Cocaine dependence

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acidosis, aging, alcoholism, allergies, angina, anti-bacterial, anti-fungal, antioxidant, anti-parasitic, anxiety, atherosclerosis ("clogged" arteries), asthma, attention deficit hyperactivity disorder, blood vessel disorders, blood clots, breast disease, breast tenderness, bronchitis, cancer, cardiac rhythm abnormalities, chilblains (inflammation of toes, fingers, ears, or face with exposure to cold), chronic rhinitis, congestive heart failure, cough, deafness, dermatitis, diabetes, diabetic nerve damage (neuropathy), diabetic eye disease, digestion, dizziness, dysentery (bloody diarrhea), eczema, fatigue, filariasis, freckle-removing, gastric cancer, genitourinary disorders, hearing loss, heart disease, heart attack, headache, hepatitis B, high cholesterol, high blood pressure, hypoxia (lack of oxygen), insomnia, labor induction, menstrual pain, migraine, mood disturbances, Raynaud's phenomenon, respiratory tract illnesses, scabies (ginkgo cream), schizophrenia, sepsis, skin sores (ginkgo cream), swelling, traumatic brain injury, ulcerative colitis, varicose veins.


TOXICOLOGY

     Ingestion of the extract has not been associated with severe side effects. Adverse events from clinical trials of up to 160 mg/day for 4 to 6 weeks did not differ from placebo group.  

A toxic syndrome, ("Gin-nan" food poisoning) has been recognized in the Orient in children who have ingested ginkgo seeds. Approximately 50 seeds produce tonic/clonic seizures and loss of consciousness.

Contact with the fleshy fruit pulp has been known since ancient times to be a skin irritant. Constituents alkylbenzoic acid, alkylphenol and their derivatives cause reactions of this type. Allergic dermatitis such as erythema, edema, blisters and itching have all been reported. A cross-allergenicity exists between ginkgo fruit pulp and poison ivy. Ginkgolic acid and bilobin are structurally similar to the allergens of poison ivy, mango rind and cashew nut shell oil. Contact with the fruit pulp causes erythema and edema, with the rapid formation of vesicles accompanied by severe itching. The symptoms last 7 to 10 days. Ingestion of as little as two pieces of pulp has been reported to cause perioral erythema, rectal burning and tenesmus (painful spasms of the anal sphincter).



SUMMARY

     The ginkgo is the oldest known living tree species. An extract of the leaves has been shown to have pharmacologic activity in the areas of cerebral insufficiency, dementias, circulatory disorders and bronchoconstriction. The plant also is known for its antioxidant and neuroprotective effects. Ingestion of ginkgo extract has not been associated with severe side effects, but contact with the fleshy fruit pulp causes allergic dermatitis, similar to poison ivy. In animals, ginkgo does not produce teratogenicity, but limited human data is available on this subject, suggesting avoidance of use during pregnancy and lactation.

PATIENT INFORMATION — Ginkgo

    Uses: Ginkgo has been used in treating Raynaud's disease, cerebral insufficiency, anxiety/stress, tinnitus, dementias, circulatory disorders/asthma. It has positive effects on memory and diseases associated with free radical generation.

    Side Effects: Severe side effects are rare; possible effects include headache, dizziness, heart palpitations and GI and dermatologic reactions. Ginkgo pollen can be strongly allergenic. Contact with the fleshy fruit pulp causes allergic dermatitis, similar to poison ivy.

Echinacea

ECHINACEA



SCIENTIFIC NAMES: Echinacea angustifolia DC. The related species E. purpurea (L.) Moench and E. pallida (Nutt.) Britton have also been used in traditional medicine. Family: Compositae

COMMON NAMES: American coneflower, black susans, comb flower, echinacea, hedgehog, Indian head, Kansas snakeroot, narrow-leaved purple coneflower, purple coneflower, Echinacin, Echinaforce®, Echinaguard®, black Sampson, black Susan, cock-up-hat, combflower, hedgehog, igelkopf, Indian head, Kansas snake root, kegelblume, narrow-leaved purple coneflower, purple coneflower, red sunflower, rudbeckia, scurvy root, snakeroot, solhat, sun hat.


HISTORY
     Echinacea is a popular herbal remedy in the central US, an area to which it is indigenous. The plant was used in traditional medicine by the American Indians and quickly adopted by the settlers. During the 1800s, claims for the curative properties of the plant ranged from a blood purifier to a treatment for dizziness and rattlesnake bites. During the early part of the 20th century, extracts of the plant were used as anti-infectives; however, the use of these products fell out of favor after the discovery of modern antibiotics.

The plant and its extracts continue to be used topically for wound-healing action and internally to stimulate the immune system. Most of the research during the past 10 years has focused on the immunostimulant properties of this plant.

USES

Uses based on scientific evidence
    
Traditional uses of echinacea as a wound-healing agent and immunostimulant.

 Immune system stimulation .Echinacea contains the most potent immunostimulating components.

Treatment and prevention of the common cold. Prevention of upper respiratory tract infections

Photodamage prevention/treatment

Treatment of upper respiratory tract infections

 Low white blood cell counts after X-ray treatment

Cancer

Genital herpes

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Abscesses, acne, attention deficit hyperactivity disorder (ADHD), bacterial infections, bee stings, boils, burn wounds, cancer, cold sores, diphtheria, dizziness, eczema, gingivitis, hemorrhoids, HIV/AIDS, malaria, menopause, migraine headache, nasal congestion/runny nose, pain, psoriasis, rheumatism, skin ulcers, snake bites, stomach upset, syphilis, tonsillitis, typhoid, urinary tract infections, whooping cough (pertussis), yeast infections.




TOXICOLOGY

 Little is known about the toxicity of echinacea despite its widespread use in many countries. It has been documented in American traditional medicine for more than a century and generally has not been associated with acute or chronic toxicity. Purified echinacea polysaccharide is relatively nontoxic.

    Side effects: Exclusion criteria from clinical trials provide information regarding patients who should not receive echinacea. Some of the exclusion criteria were the following: Childhood, chronic diseases such as diabetes, bronchial asthma, allergy, or autoimmune deficiency, tuberculosis, leukemia, collagenous disease, multiple sclerosis, polyarthritis, HIV infection, organ transplantation, pneumonia, or fungal infections, other infections not involving the respiratory tract, known inflammatory GI disease or impairment of resorption, acute influenza, chronic diseases of the respiratory tract; patients taking any immunosuppressants including corticosteroids, antibiotics, or cytostatic therapy; pregnancy or lactation; fever; hypersensitivity to plants of the Asteraceae/Compositae family; and any type of acute infection.

SUMMARY

 Echinacea is a native American plant that has been documented in traditional herbal medicine for more than a century. Its uses have included topical application to stimulate wound healing and ingestion to improve immune function. Studies have indicated that the plant does possess pharmacologic activity that supports some of these traditional uses.

Echinacea has been shown to have some beneficial effects on the symptoms of the common cold. A few studies have shown echinacea (E. purpurea and E. pallida) to be effective for the treatment, but not prevention, of the common cold. However, the variation in products used in clinicial trials (some products are not available in the US), including part of the plant used, variable dosing, treatment duration, and different extraction methods (eg, alcoholic extraction, pressed juice) makes specific dosing recommendations difficult to determine .

PATIENT INFORMATION — Echinacea

    Uses: There is some evidence that echinacea (purpurea and pallida species) is effective in shortening the duration of symptoms of URIs, including the common cold, but it has not been shown to be effective as a preventative. The variation in available products makes specific recommendations difficult to determine.

    Side Effects: Side effects are rare. Patients with allergies, specifically allergies to daisy-type plants (Asteraceae/Compositae family) might be more susceptible to reactions. Nausea and other mild GI effects have been reported in clinical trials. Because of the potential immune stimulating property of echinacea, patients who are immunocompromised should not take echinacea. Many patients were excluded from clinical trials (see Pharmacology, Clinical Trials, Toxicology).

    Dosing: Echinacea clinical trials for prevention or treatment of cold symptoms have been run primarily on the frest pressed juice of the herb, which is preserved with 22% alcohol. Typical daily doses are 5 to 10 mL of the juice. Echinacin (Madaus, EC31) and Echinagard are fresh juice prepared from the herb. Extracts of the root are available, including Echinaforce and Echinacea Plus. These have been given at doses corresponding to 1 g of the crude herb or root 3 times/day.

Lactobacillus acidophilus

ACIDOPHILUS

SCIENTIFIC NAME: Lactobacillus acidophilus

RELATED TERMS: Acidophilus, Acidophilus Extra Strength®, acidophilus milk, Actimel®, Bacid®, DDS-Acidophilus, Enpac®, Fermalac® (Canadian), Florajen®, Gynoflor®, Kala®, Kyo-Dophilus®, L. acidophilus milk, L. acidophilus yogurt, Lactinex®, Lactobacillaceae (family), lactobacillus, Lacto Bacillus, lactobacilli, Lacteol Fort®, MoreDophilus®, Narine®, Probiata®, Pro-Bionate®, probiotic, Superdophilus®, yogurt.

HISTORY

 For several decades, health and nutritional benefits have been claimed for products containing Lactobacillus cultures.

The topical or intravaginal application of yogurt products has been reported to control yeast and bacterial infections, and

the ingestion of these preparations has been recommended to reduce the symptoms of antibiotic-induced diarrhea or sore

mouth caused by Candida infections. Other reports have indicated that the ingestion of acidophilus-containing products

can reduce serum cholesterol levels, improve lactose intolerance, and slow the growth of experimental tumors. L.

acidophilus has been referred to as a probiotic, defined as microorganisms that have a beneficial effect on the host by

improving the properties of the indigenous microflora. The term "probiotic" is used to describe organisms that are used medicinally, including bacteria such as L. acidophilus and yeast such as Saccharomyces Boulardii.


PHARMACOLOGY

Replenishment of normal bacterial flora: Products containing live cultures have been investigated for their ability to

compete with pathogens in the microenvironment, thereby permitting the reestablishment of normal bacterial flora.

Lactobacilli have been shown to inhibit the growth of other vaginal microorganisms including Escherichia coli, Candida

albicans, and Gardnerella vaginalis. Several factors may contribute to the possible activity of Lactobacillus, including

the ability to generate lactic acid, hydrogen peroxide, and exogenous antibacterial compounds, to influence the

production of interferon by target cells, and to alter the adherence of bacteria. Lactacin F, an antibacterial compound

produced by L. acidophilus, has been isolated and partially characterized as a heat-stable protein with at least 56 amino

acid residues.

Lactobacillus has long been considered to be a component of the protective flora in the vagina. Recently, Lactobacillus

species that produce hydrogen peroxide have been found in normal vaginal flora. Consequently, the therapeutic benefits

of Lactobacillus products have been investigated in women with vaginal and urinary tract infections. Women who used

acetic acid jelly, an estrogen cream, a fermented lactobacillus-containing milk product, or metronidazole (eg, Flagyl)

were evaluated to determine the effects of intravaginal therapy on bacterial vaginosis.  The American Medical

Association proposed guidelines for manufacturers to state on yogurt containers the number of viable L. acidophilus

organisms contained therein.9 Vaginal tablets containing L. acidophilus and estriol were shown to cure bacterial

vaginosis. A study showed decreased candidal vaginitis after ingestion of yogurt containing L. acidophilus.

Lactobacillusspecies that are strong producers of hydrogen peroxide and are highly adherent to vaginal epithelial cells

effectively treat bacterial vaginosis. Specific isolates of Lactobacillus with these characteristics are potential probiotics

for vaginal recolonization. The weekly instillation of Lactobacillus has been shown to reduce the recurrence rate of

uncomplicated lower urinary tract infections in women, and the use of a strain that is resistant to nonoxynol-9, a

spermicide that kills protective vaginal flora, may have potential for use in women with recurrent cystitis using this

contraceptive agent.

L. acidophilus is normally found in the human alimentary tract. Because of its acid-resistance, it persists in the stomach

much longer than other bacteria do. Consequently, the oral administration of products containing L. acidophilusmay be

useful in the management of a variety of conditions associated with altered GI flora. Their beneficial effects may be

related to the ability to suppress the growth of pathogens. In vitro, L. acidophilus has been shown to suppress the growth

of Campylobacter pylori, a pathogen implicated as a causative factor in acid-peptic disease.

No consensus has been reached regarding the effectiveness of Lactobacillus-containing products in ameliorating

antibiotic-induced diarrhea. However, L. acidophilusdid not prevent traveler's diarrhea.

Effect on cholesterol levels: It has been suggested that appropriately selected strains of Lactobacillus may be useful

adjuncts for the control of hypercholesterolemia in humans, by virtue of the bacteria's ability to assimilate cholesterol

and to grow well in the presence of bile.

Consumption of yogurt containing L. acidophilusin asthmatic patients showed trends in decreased eosinophilia and

increased interferon gamma, however, without improving clinical parameters. Viability might be a prerequisite for

effects on the immune system.

Effect on lactose intolerance: Acidophilus milk containing L. acidophilushas been used in hospitals to treat patients

with lactose intolerance, although controversy remains regarding effectiveness on lactose digestion. In a randomized

trial of 18 patients, symptoms were not significantly improved after ingestion of L. acidophilus.

USES

Uses based on scientific evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Bacterial vaginosis

Vaginal candidiasis (yeast infection)

Diarrhea treatment (children)

Diarrhea prevention

Hepatic encephalopathy (confused thinking due to liver disorders)

Asthma

High cholesterol

Lactose intolerance

Necrotizing enterocolitis prevention in infants

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acne, AIDS, allergies, cancer, canker sores, colitis, colon cancer prevention, constipation, diaper rash, Crohn's disease, diverticulitis, E. coli infection in cancer patients, fever blisters, heart disease, heartburn, hives, immune enhancer, indigestion, infection, overgrowth of bacteria in the small bowel, preoperative prevention of infections or gut bacteria loss, stomach ulcer, thrush, ulcerative colitis, urinary tract infection.




TOXICOLOGY

     Endocarditis caused by Lactobacillusspecies, including L. acidophilus has been reported. This is a rare

infection seen in patients with abnormal heart valves who have recently experienced dental manipulation. Neurological

sequelae from D-lactic acidosis, caused by consumption of acidophilus tablets and yogurt containing L. acidophilus,

was observed in a child with short-bowel syndrome. Complete avoidance of L. acidophilus in children with short-bowel

syndrome may help prevent episodes of D-lactic acidosis.

SUMMARY

    Preparations containing L. acidophilusinclude yogurt, milk, tablets, capsules, and granules. They are used

most frequently to restore normal flora to the GI tract and vagina. However, the data supporting the efficacy of these

products for these uses are conflicting. Use of L. acidophilus is generally considered safe. Rare adverse events include

endocarditis in susceptible patients and lactic acidosis in children with short-bowel syndrome.

PATIENT INFORMATION — Acidophilus

    Uses: L. acidophilus has been used to restore normal oral, GI, and vaginal flora in those affected by

antibiotics or by Candida and bacterial infections. Its value in treating these infections, lower urinary tract infections,

and lactose intolerance remains unclear. In vitro, it suppresses growth of C. pylori, implicated in acid-peptic disease. In

vivo, it suppresses growth of H. pylori, also implicated in upper GI diseases.

    Side Effects: L. acidophilus is generally considered safe, as it is normally found in the human alimentary

tract. However, in patients with abnormal heart valves who have recently experienced dental manipulation, endocarditis

caused by Lactobacillus species has been reported. Complete avoidance of L. acidophilusin children with short-bowel

syndrome may help prevent episodes of D-lactic acidosis.

Aloe Vera Usage

ALOE VERA


COMMON NAMES

Aloe vera, Acemannan, Aloe africana, Aloe arborescens Miller, Aloe barbadesis, Aloe capensis, Aloe ferox, aloe latex, aloe mucilage, Aloe perfoliata, Aloe perryi baker, Aloe spicata, Aloe vulgari, Barbados aloe, bitter aloe, Burn Plant, Cape Aloe, Carrisyn, hirukattali, Curacao aloe, elephant's gall, First-Aid Plant, Ghai kunwar, Ghikumar, Hsiang-Dan, Jelly leek, kumari, lahoi, laloi, Lily of the Desert, Lu-Hui, Medicine Plant, Mediterranean aloe, Miracle Plant, mocha aloes, musabbar, natal aloes, nohwa, Plant of Immortality, Plant of Life, rokai, sabilla, Savila, Socotrine aloe, subr, True Aloe, Venezuela Aloe, Za'bila, Zanzibar Aloe.


BOTANY

Aloes, of which there are 500 species, belong to the family Liliaceae. The name, meaning "bitter and shiny substance," derives from the Arabic "alloeh." Indigenous to the Cape of Good Hope, these perennial succulents grow throughout most of Africa, southern Arabia and Madagascar, and are cultivated in Japan, North and South America, and in the Caribbean and Mediterranean regions. They do not grow in rain forests or arid deserts. Often attractive ornamental plants, their fleshy leaves are stiff and spiny along the edges and grow in a rosette. Each plant has 15 to 30 tapering leaves, each up to 0.5 meters long and 8 to 10 cm wide. Beneath the thick cuticle of the epidermis lies the chlorenchyma. Between this layer and the colorless mucilaginous pulp containing the aloe gel are numerous vascular bundles and inner bundle sheath cells, from which a bitter yellow sap exudes when the leaves are cut.

HISTORY

Drawings of aloe have been found in the wall carvings of Egyptian temples erected in the fourth millennium BC. Called the "Plant of Immortality," it was a traditional funerary gift for the pharaohs. The Egyptian Book of Remedies (ca. 1500 BC) notes the use of aloe in curing infections, treating the skin, and preparing drugs that were chiefly used as laxatives. The Bible (John 19:39-40) says that Nicodemus brought a mixture of myrrh and aloes for the preparation of Christ's body. Alexander is said to have conquered the island of Socotra to obtain control of it. The Greek physician Dioscorides, in 74 AD, recorded its use to heal wounds, stop hair loss, treat genital ulcers, and eliminate hemorrhoids. In the 6th century AD, Arab traders carried it to Asia. From the Mediterranean region, it was carried to the New World in the 16th century by the Spaniards. In the modern era, its clinical use began in the 1930s as a treatment for roentgen dermatitis.

USAGE

Uses based on scientific evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Constipation (laxative)
There is a strong scientific evidence for this use.

Dried Aloe latex from the inner lining of aloe leaves has been used traditionally as a potent laxative taken by mouth. A combination herbal remedy containing aloe was found to be an effective laxative, the aloinosides exert strong purgative effects by irritating the large intestine. Only the dried latex is approved for internal use as a cathartic. In some cases, A. vera is sold as a food supplement, allegedly with FDA approval. FDA has only approved A. perryi, A. vera, A. ferox, and certain hybrids for use as natural food flavorings.


The most common use of the gel remains in the treatment of minor burns and skin irritation.
The activity of aloe in treating burns may stem from its moisturizing effect, which prevents air from drying the wound.

Studies of the antibacterial activity of aloe have yielded conflicting results. Aloe has been found to be more effective than sulfadiazine and salicylic acid creams in promoting wound healing and as effective as silver sulfadiazine in reducing wound bacterial counts.

Aloe-emodin is antileukemic in vitro. The US Department of Agriculture has approved A. vera as an adjunctive treatment for fibrosarcomas in dogs and cats.

Other health claims are generally poorly documented.

A. vera extract 0.5% in a hydrophilic cream was shown in a placebo-controlled study to shorten time to healing in male patients with first episodes of genital herpes.

A gel containing A. vera extract 0.125%, allantoin 0.35%, and silicon dioxide was found effective in decreasing the duration of lesions associated with aphthous stomatitis.

Lyophilized A. barbadensis combined with zinc acetate has been studied in rabbits for use as a vaginal contraceptive.

A small study has found that parenteral administration of aloe extract protects the liver from chemical injury.

Seborrheic dermatitis (seborrhea, dandruff)

Psoriasis vulgaris

Genital herpes

Skin burns

Radiation dermatitis

Canker sores (aphthous stomatitis)

Diabetes (type 2)
Laboratory studies show that aloe can stimulate insulin release from the pancreas and can lower blood glucose levels in mice. Results from two poorly conducted human trials suggest that oral aloe gel may be effective in lowering blood glucose levels, although a third, smaller study found no effect. More research is needed to explore the effectiveness and safety of aloe in diabetics.

HIV infection

Acemannan, a component of aloe gel, has been shown in laboratory tests to have immune-stimulating and anti-viral activities. Results from early human studies are mixed, and due to weaknesses in the way these studies were designed, firm conclusions are not possible. Without further human trials, the evidence cannot be considered convincing either in favor or against this use of aloe.

Cancer prevention

There is preliminary evidence from a small case-control study that oral aloe may reduce the risk of developing lung cancer. Further study is needed in this area to clarify if it is aloe itself or other factors that may cause this benefit.

Pressure ulcers

Infected surgical wounds

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Alopecia (hair loss), antimicrobial, arthritis, asthma, bacterial skin infections, bowel disorders, chemoprotectant, chronic fatigue syndrome, chronic leg wounds, congestive heart failure, damaged blood vessels, elevated cholesterol or other lipids, frostbite, heart disease prevention, hepatitis, kidney or bladder stones, leukemia, lichen planus stomach ulcers, parasitic worm infections, scratches or superficial wounds of the eye, skin protection during radiation therapy, sunburn, systemic lupus erythematosus, tic douloureux, untreatable tumors, vaginal contraceptive, wound healing after cosmetic dermabrasion, yeast infections of the skin.


DOSING

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels and discuss doses with a qualified healthcare provider before starting therapy.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients.

Standardized aloe products are not widely available. Although this is likely not a concern for the use of aloe gel to the skin, it may pose dangers with oral aloe (due to potential lowering of blood sugar levels). Oral aloe preparations often contain 10-30mg hydroxyanthracene derivatives per daily dose, calculated as anhydrous aloin.

Adults (18 years and older)

Topical (on the skin):

General use: Pure Aloe vera gel is often used liberally on the skin. There are no reports that using aloe on the skin causes absorption of chemicals into the body that may cause significant side effects. Skin products are available that contain aloe alone or aloe combined with other active ingredients.

Psoriasis vulgaris: Hydrophilic cream of 0.5% (by weight) of a 50% ethanol extract of aloe, combined with mineral and castor oils, three times daily for five consecutive days per week, for up to four weeks has been studied.

Genital herpes: Hydrophilic cream of 0.5% (by weight) of a 50% ethanol extract, combined with liquid paraffin and castor oil, three times daily on lesions for five consecutive days per week, for up to two weeks has been studied.

Oral (by mouth):

Constipation: The dose often recommended is the minimum amount to maintain a soft stool, typically 0.04-0.17g of dried juice (corresponds to 10-30mg hydroxyanthraquinones). As an alternative, in combination with celandin (300mg) and psyllium (50mg), 150mg of the dried juice/day of aloe has been found effective as a laxative in research.

Diabetes (type 2): 5-15mL of aloe juice twice daily has been used but safety and efficacy of this dose has not been proven.

HIV infection: 1000mg-1600mg of acemannan orally in four equal doses. Effectiveness and safety have not been proven by studies.

Intravenous/Intramuscular:

Four cases of death have been associated with Aloe vera injections under unclear circumstances. Oral or injected use is not recommended due to lack of safety data.

Children (younger than 18 years)

Topical (skin) use of aloe gel in children is common and appears to be well tolerated.

SAFETY

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

People with known allergy to garlic, onions, tulips, or other plants of the Liliaceae family may have allergic reactions to aloe. Individuals using aloe gel for prolonged times have developed allergic reactions including hives and eczema-like rash.

Side Effects and Warnings

The use of aloe on surgical wounds has been reported to slow healing and, in one case, to cause redness and burning after aloe juice was applied to the face after a skin-peeling procedure (dermabrasion). Application of aloe prior to sun exposure may lead to rash in sun-exposed areas.

The use of aloe or aloe latex by mouth for laxative effects can cause cramping or diarrhea. Use for over seven days may cause dependency or worsening of constipation after the aloe is stopped. Ingestion of aloe for over one year has been reported to increase the risk of colorectal cancer. Individuals with severe abdominal pain, appendicitis, ileus (temporary paralysis of the bowel), or a prolonged period without bowel movements should not take aloe.

Electrolyte imbalances in the blood, including low potassium levels, may be caused by the laxative effect of aloe. This effect may be greater in people with diabetes or kidney disease. Low potassium levels can lead to abnormal heart rhythms or muscle weakness. People with heart disease, kidney disease, or electrolyte abnormalities should not take aloe by mouth. Healthcare providers should monitor for changes in potassium and other electrolytes in individuals who take aloe by mouth for more than a few days.

Based on a small number of human studies, aloe taken by mouth may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.

Avoid aloe vera injections, which have been associated with cases of death under unclear circumstances.

Pregnancy and Breastfeeding

Although topical (skin) use of aloe is unlikely to be harmful during pregnancy or breastfeeding, oral (by mouth) use is not recommended due to theoretical stimulation of uterine contractions. It is not known whether active ingredients of aloe may be present in breast milk. The dried juice of aloe leaves should not be consumed by breastfeeding mothers.



SUMMARY

Aloe products derived from the latex of the outer skin are strong cathartics to be used with caution. Compounds derived from the inner gel intended for internal administration have not been shown to exert any consistent therapeutic effect. The effective topical use of the gel in the treatment of minor burns and wounds has not been established, although several human trials indicate a potential therapeutic benefit. Use of A. veracream has been placed in the protocol for frostbite treatment.

PATIENT INFORMATION — Aloe

Uses: Aloe appears to inhibit infection and promote healing of minor burns and wounds, frostbite, and possibly of skin affected by diseases such as psoriasis and seborrheic dermatitis. Dried aloe latex is used, with caution, as a drastic cathartic.

Side Effects: There has been 1 report that using the gel as standard wound therapy delayed healing. The gel may cause burning sensations in dermabraded skin, and redness and itching can also occur. Use caution with cosmetic products containing A. vera gel.

Dosing: As a gel, A. vera may be applied externally ad lib. The resin product is cathartic at doses of 250 mg and is not recommended for internal use.