Cat's Claw

Keywords: cat's claw, uña de gato, osteoarthritis, rheumatoid arthritis

Introduction
This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. cat's claw—common names, uses, potential side effects, and resources for more information. Cat's claw grows wild in many countries of Central and South America, especially in the Amazon rainforest. The use of this woody vine dates back to the Inca civilization.

Common Names—cat's claw, uña de gato
Latin Names—Uncaria tomentosa, Uncaria guianensis

What It Is Used For

1. Cat's claw has been used for centuries in South America to prevent and treat disease.
   
2. It has been used for a variety of health conditions, including viral infections (such as herpes and HIV), Alzheimer's disease, cancer, and arthritis.
3. Cat's claw has been used to support the immune system and promote kidney health, as well as to prevent and abort pregnancy.
   

How It Is Used
The inner bark of cat's claw is used to make liquid extracts, capsules, and teas. Preparations of cat's claw can also be applied to the skin.

What the Science Says

• There is not enough scientific evidence to determine whether cat's claw works for any health problem, including arthritis, HIV, or cancer.
• Small studies in humans have shown a possible benefit of cat's claw in osteoarthritis and rheumatoid arthritis, but no large trials have been done. In laboratory studies, cat's claw stimulates part of the immune system, but it has not been proven to reduce inflammation or boost the immune system in humans.
• The National Institute on Aging is studying how cat's claw may affect the brain. Findings may point to new avenues for research in Alzheimer's disease treatment.
  

Side Effects and Cautions

• Few side effects have been reported for cat's claw when it is taken at recommended dosages. Though rare, side effects may include headaches, dizziness, and vomiting.
• Women who are pregnant or trying to become pregnant should avoid using cat's claw because of its past use for preventing and aborting pregnancy.
• Because cat's claw may stimulate the immune system, it is unclear whether the herb is safe for people with conditions affecting the immune system.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
  

Sources
* Cat's claw. Natural Medicines Comprehensive Database Web site. Accessed on July 5, 2007.
* Cat's claw (Uncaria tomentosa, Uncaria guianensis). Natural Standard Database Web site. Accessed on July 3, 2007.

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Black Cohosh

Introduction
This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. black cohosh—common names, uses, potential side effects, and resources for more information. Black cohosh is a plant native to North America.

Common Names—black cohosh, black snakeroot, macrotys, bugbane, bugwort, rattleroot, rattleweed
Latin Names—Actaea racemosa, Cimicifuga racemosa

What It Is Used For

• Black cohosh has a history of use for rheumatism (arthritis and muscle pain), but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.
• Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor.
  

How It Is Used
The underground stems and roots of black cohosh are commonly used fresh or dried to make strong teas (infusions), capsules, solid extracts used in pills, or liquid extracts (tinctures).

What the Science Says

• Study results are mixed on whether black cohosh effectively relieves menopausal symptoms.
• Studies to date have been less than 6 months long, so long-term safety data are not currently available.
• NCCAM is funding studies to determine whether black cohosh reduces the frequency and intensity of hot flashes and other menopausal symptoms.
• There are not enough reliable data to determine whether black cohosh is effective for rheumatism or other uses.
  

Side Effects and Cautions

• Black cohosh can cause headaches and stomach discomfort. In clinical trials comparing the effects of the herb and those of estrogens, a low number of side effects were reported, such as headaches, gastric complaints, heaviness in the legs, and weight problems.
• No interactions have been reported between black cohosh and prescription medicines.
• Black cohosh has recently been linked to a few cases of hepatitis (inflammation of the liver), but it is not clear whether black cohosh caused the problem.
• It is not clear if black cohosh is safe for women who have had breast cancer or for pregnant women.
• Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides), which has different properties, treatment uses, and side effects than black cohosh. Black cohosh is sometimes used with blue cohosh to stimulate labor, but this therapy has caused adverse effects in newborns, which appear to be due to blue cohosh.
• It is important to inform your health care providers about any herb or dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. you are using, including black cohosh. This helps to ensure safe and coordinated care.
  

Sources

• 1 Office of Dietary Supplements and National Center for Complementary and Alternative Medicine. Questions and Answers About Black Cohosh and the Symptoms of Menopause. Office of Dietary Supplements Web site. Accessed June 30, 2005.
• National Center for Complementary and Alternative Medicine and Office of Dietary Supplements. Workshop on the Safety of Black Cohosh in Clinical Studies. National Center for Complementary and Alternative Medicine Web site. Accessed June 30, 2005.
• Natural Medicines Comprehensive Database. Black cohosh. Natural Medicines Comprehensive Database Web site. Accessed June 30, 2005.
• Natural Standard Database. Black cohosh (Cimicifuga racemosa [L.] Nutt.). Natural Standard Database Web site. Accessed June 30, 2005.
• Black cohosh root. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:22–26.
  

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Bitter Orange

Introduction
This fact sheet provides basic information about bitter orange—common names, uses, potential side effects, and resources for more information. The bitter orange tree is native to eastern Africa and tropical Asia. Today, it is grown throughout the Mediterranean region and elsewhere, including California and Florida. Bitter orange oil is used in foods, cosmetics, and aromatherapyA therapy in which the scent of essential oils from flowers, herbs, and trees is inhaled to promote health and well-being. products. Bitter orange oil from the tree's leaves is called petitgrain, and oil from the flowers is called neroli.

Common Names—bitter orange, Seville orange, sour orange, Zhi shi
Latin Names—Citrus aurantium

What It Is Used For

• Bitter orange has been used in traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi. and by indigenous people of the Amazon rainforest for nausea, indigestion, and constipation.
• Current uses of bitter orange are for heartburn, loss of appetite, nasal congestion, and weight loss. It is also applied to the skin for fungal infections such as ringworm and athlete's foot.

How it is used
The dried fruit and peel (and sometimes flowers and leaves) are taken by mouth in extracts, tablets, and capsules. Bitter orange oil can be applied to the skin.

What the Science Says

• There is not enough scientific evidence to support the use of bitter orange for health purposes.
• Many herbal weight-loss products now use bitter orange peel in place of ephedra. However, bitter orange contains the chemical synephrine, which is similar to the main chemical in ephedra. The U.S. Food and Drug Administration banned ephedra because it raises blood pressure and is linked to heart attacks and strokes; it is unclear whether bitter orange has similar effects. There is currently little evidence that bitter orange is safer to use than ephedra.

Side Effects and Cautions

• Because bitter orange contains chemicals that may speed up the heart rate and raise blood pressure, it may not be safe to use as a dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs.. There have been reports of fainting, heart attack, and stroke in healthy people after taking bitter orange supplements alone or combined with caffeine. People should avoid taking bitter orange if they have a heart condition or high blood pressure, or if they are taking medications (such as MAO inhibitors), caffeine, or other herbs/supplements that speed up the heart rate.
• Due to lack of safety evidence, pregnant women should avoid products that contain bitter orange.
• Bitter orange oil used on the skin may increase the risk of sunburn, particularly in light-skinned people.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources

• Bent S, Padula A, Neuhaus J. Safety and efficacy of citrus aurantium for weight loss. American Journal of Cardiology. 2004;94(10):1359–1361.
• Bitter orange. Natural Medicines Comprehensive Database Web site. Accessed on May 16, 2007.
• Bitter orange (Citrus aurantium). Natural Standard Database Web site. Accessed on May 16, 2007.
• Orange peel, bitter. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:287–289.
• U.S. Food and Drug Administration. FDA Requests Seizure of More Dietary Supplements Containing Ephedrine Alkaloids. U.S. Food and Drug Administration Web site. Accessed at www.fda.gov/bbs/topics/news/2006/new01325.html on May 23, 2007.

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Bilberry

Introduction

This fact sheet provides basic information about bilberry—common names, uses, potential side effects, and resources for more information. Bilberry is a relative of the blueberry, and its fruit is commonly used to make pies and jams. It has been used for nearly 1,000 years in traditional European medicine. Bilberry grows in North America, Europe, and northern Asia.

Common Names—bilberry, European blueberry, whortleberry, huckleberry
Latin Names—Vaccinium myrtillus

What It Is Used For

• Historically, bilberry fruit was used to treat diarrhea, scurvy, and other conditions.
• Today, the fruit is used to treat diarrhea, menstrual cramps, eye problems, varicose veins, venous insufficiency (a condition in which the veins do not efficiently return blood from the legs to the heart), and other circulatory problems.
• Bilberry leaf is used for entirely different conditions, including diabetes.

How It Is Used

The fruit of the bilberry plant can be eaten or made into extracts. Similarly, the leaves of the bilberry plant can be made into extracts or used to make teas.

Side Effects and Cautions

• Bilberry fruit is considered safe. However, high doses of bilberry leaf or leaf extract are considered unsafe due to possible toxic side effects.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources

* Bilberry. Natural Medicines Comprehensive Database Web site. Accessed July 2, 2007.
* Bilberry (Vaccinium myrtillus). Natural Standard Database Web site. Accessed June 28, 2007.
* Bilberry fruit. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:16–21.

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ASTRAGALUS

Introduction

This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. astragalus—common names, uses, potential side effects, and resources for more information. Native to China, astragalus has been used for centuries in traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi.. In the United States, the herb gained popularity in the 1980s. There are actually over 2,000 species of astragalus; however, the two related species Astragalus membranaceus and Astragalus mongholicus are the ones primarily used for health purposes.

Common Name—astragalus, bei qi, huang qi, ogi, hwanggi, milk vetch

Latin Name—Astragalus membranaceus, Astragalus mongholicus

What It Is Used For

• Historically, astragalus has been used in traditional Chinese medicine, usually in combination with other herbs, to support and enhance the immune system. It is still widely used in China for chronic hepatitis and as an adjunctive therapy in cancer.
• It is also used to prevent and treat common colds and upper respiratory infections.
• Astragalus has also been used for heart disease.

How It Is Used

The root of the astragalus plant is typically used in soups, teas, extracts, or capsules. Astragalus is generally used with other herbs, such as ginseng, angelica, and licorice.

What the Science Says

• The evidence for using astragalus for any health condition is limited. Results from small or preliminary studies suggest that astragalus may benefit heart function and help the immune system fight infections.
• A few studies have shown potential benefits for using astragalus—in combination with another herb, glossy privet (Ligustrum lucidum)—as an adjunctive therapy for cancer. In general, however, these studies were not well designed.
• NCCAM-funded investigators are studying the effects of astragalus on the body, particularly on the immune system.

Side Effects and Cautions

• Astragalus is considered safe for most adults. Its possible side effects are not well known because astragalus is generally used in combination with other herbs.
• Astragalus may interact with medications that suppress the immune system, such as the drug cyclophosphamide taken by cancer patients and similar drugs taken by organ transplant recipients.
• People should avoid using astragalus species such as "locoweed" that grow in the United States, as these other species may have different effects and side effects.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources
* Astragalus. Natural Medicines Comprehensive Database Web site. Accessed May 10, 2007.
* Astragalus (Astragalus membranaceus). Natural Standard Database Web site. Accessed May 9, 2007.
* Upton R. Astragalus. In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005:25–30

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ASIAN GINSENG

Introduction
This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Asian ginseng—common names, uses, potential side effects, and resources for more information. Asian ginseng is native to China and Korea and has been used in various systems of medicine for many centuries. Asian ginseng is one of several types of true ginseng (another is American ginseng, Panax quinquefolius). An herb called Siberian ginseng or eleuthero (Eleutherococcus senticosus) is not a true ginseng.

Common Names—Asian ginseng, ginseng, Chinese ginseng, Korean ginseng, Asiatic ginseng
Latin Name—Panax ginseng

What It Is Used For
Treatment claims for Asian ginseng are numerous and include the use of the herb to support overall health and boost the immune system. Traditional and modern uses of ginseng include:
Improving the health of people recovering from illness

• Increasing a sense of well-being and stamina, and improving both mental and physical performance
• Treating erectile dysfunction, hepatitis C, and symptoms related to menopause
• Lowering blood glucose and controlling blood pressure

How It Is Used
The root of Asian ginseng contains active chemical components called ginsenosides (or panaxosides) that are thought to be responsible for the herb's medicinal properties. The root is dried and used to make tablets or capsules, extracts, and teas, as well as creams or other preparations for external use.

What the Science Says
Some studies have shown that Asian ginseng may lower blood glucose. Other studies indicate possible beneficial effects on immune function.
To date, research results on Asian ginseng are not conclusive enough to prove health claims associated with the herb. Only a handful of large clinical trials on Asian ginseng have been conducted. Most studies have been small or have had flaws in design and reporting. Some claims for health benefits have been based only on studies conducted in animals.
NCCAM supports studies to better understand the use of Asian ginseng. Areas of recent NCCAM-funded research include Asian ginseng's interactions with other herbs and drugs and the herb's potential to treat chronic lung infection, impaired glucose tolerance, and Alzheimer's disease.

Side Effects and Cautions
When taken by mouth, ginseng is usually well tolerated. Some sources suggest that its use be limited to 3 months because of concerns about the development of side effects.
The most common side effects are headaches and sleep and gastrointestinal problems.
Asian ginseng can cause allergic reactions.
There have been reports of breast tenderness, menstrual irregularities, and high blood pressure associated with Asian ginseng products, but these products' components were not analyzed, so effects may have been due to another herb or drug in the product.
Asian ginseng may lower levels of blood sugar; this effect may be seen more in people with diabetes. Therefore, people with diabetes should use extra caution with Asian ginseng, especially if they are using medicines to lower blood sugar or taking other herbs, such as bitter melon and fenugreek, that are also thought to lower blood sugar.
Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources
Ginseng, Asian (Panax ginseng). In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005:265-277.

Ginseng, Panax. Natural Medicines Comprehensive Database Web site. Accessed on July 2, 2007.

Ginseng. Natural Standard Database Web site. Accessed on June 28, 2007.

Ginseng root. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:170-177.

National Center for Complementary and Alternative Medicine. Hepatitis C and Complementary and Alternative Medicine: 2003 Update. National Center for Complementary and Alternative Medicine Web site. Accessed on July 9, 2007.

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ALOE VERA

Introduction
This fact sheet provides basic information about aloe vera—common names, uses, potential side effects, and resources for more information. Aloe vera's use can be traced back 6,000 years to early Egypt, where the plant was depicted on stone carvings. Known as the "plant of immortality," aloe was presented as a burial gift to deceased pharaohs.

Common Names—aloe vera, aloe, burn plant, lily of the desert, elephant's gall, lidah buaya
Latin Names—Aloe vera, Aloe barbadensis

What It Is Used For
Traditionally, aloe was used topically to heal wounds and for various skin conditions, and orally as a laxative. Today, in addition to traditional uses, people take aloe orally to treat a variety
of conditions, including diabetes, asthma, epilepsy, and osteoarthritis. People use aloe topically for osteoarthritis, burns, and sunburns. Aloe vera gel can be found in hundreds of skin products, including lotions and sunblocks. The Food and Drug Administration (FDA) has approved aloe vera as a natural food flavoring.

How It Is Used
Aloe leaves contain a clear gel that is often used as a topical ointment.
The green part of the leaf that surrounds the gel can be used to produce a juice or a dried substance (called latex) that is taken by mouth.

What the Science Says
Aloe latex contains strong laxative compounds. Products made with various components of aloe (aloin, aloe-emodin, and barbaloin) were at one time regulated by the FDA as oral over-the-counter (OTC) laxatives. In 2002, the FDA required that all OTC aloe laxative products be removed from the U.S. market or reformulated because the companies that manufactured them did not provide the necessary safety data. Early studies show that topical aloe gel may help heal burns and abrasions. One study, however, showed that aloe gel inhibits healing of deep surgical wounds. Aloe gel does not prevent burns from radiation therapy. There is not enough scientific evidence to support aloe vera for any of its other uses.

Side Effects and Cautions
Use of topical aloe vera is not associated with significant side effects. Abdominal cramps and diarrhea have been reported with oral use of aloe vera. Diarrhea, caused by the laxative effect of oral aloe vera, can decrease the absorption of many drugs.

People with diabetes who use glucose-lowering medication should be cautious if also taking aloe by mouth because preliminary studies suggest aloe may lower blood glucose levels.
Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Sources
Aloe. Natural Medicines Comprehensive Database Web site. June 5, 2007.
Aloe (Aloe vera). Natural Standard Database Web site. Accessed on June 3, 2007.

For More Information
"What's in the Bottle? An Introduction to Dietary Supplements"
"Herbal Supplements: Consider Safety, Too"
NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

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