Class #: / 2
Common symptoms of taking toxic herbs
Acute effects are obvious and fairly quick in onset. Patient is uncomfortable and can identify the side effects.
Most common/milder effects
HA, dizziness, heaviness in head, n/v/d, ab pain
Old school TCM docs thought that a mild HA/dizziness after taking herbs was a good things – herbs are taking effect.
Severe effects
Irritability, cold extrems, BP drop, pale face, cold sweating, loss of consc, coma, convulsions
Specific effects
Cardiac glycoside type effects
Herbs with these effects often come from the fu zi family. Herbs with cardiac glycoside type effects include chuan wu (the stronest), cao wu, fu zi, chan su (from a toad), etc. These herbs must be used cooked 30 min to one hour prior to other herbs, never raw.
These herbs should not be tinctured from raw herbs. Additionally, patient must not drink alcohol with these herbs!
Symptoms include:
Arrhythmia
Tachyarrhythmia
Bradycardia
Shock and respiratory failure with high overdose
Atropin like effects
Herbs include xi xin, da ma ren (huo ma ren), and shang lu. Ma zi ren wan used to always have huo ma ren, but often changed to sesame seeds to avoid symptoms.
Flushed face
Pupil dilation
Irritability
Mania
Excessive thirst
Nuxvomica like effects
Cang er zi (also called cang er miao, cang er ya), ma qian zi, da hui xiang. Cang er zi must be dry fried until the barbs break off which makes the side fx far less likely. Ma qian zi is used in China, but not here. Very good for rheumatic arthritis, but is toxic so must be burnt/fried. Da hui xiang is a type of fennel and is larger.
Stiffness of muscles
Convulsions
Respiratory depression
Gelsemiumelegans-like effects
Gou Wen is a legendary toxic herb leading to limited movement/sensation and paralysis. This is the herb that killed the Divine Farmer, Shen Dong, who was the legendary guy that tried all the herbs and wrote the Divine Farmer’s Materia Medica. Other herbs in this category include chong wei zi (yi mu cao seeds), ku lian gen pi (which treats parasites), ku lian zi, lei gong teng (for arthritis), lei gong teng, kun ming shan hai tang, zao jia.
Limited movement/paralysis
Reduced sensations and numbness
Amygdala poisoning
Herbs include: bai guo, pi pa ren, tao ren, xing ren. Bai guo stew is popular with chicken China. Bai guo is good for lung Qi and asthma with wheezing. The toxicity is in the peel of the bai guo. If you remove that it helps – there’s also a woody center that you may or may not find in this fruit that must be avoided also. Pi pa ren is the seed of the loquat. Tao ren/xing ren used for cough.
Symptoms include:
Cyanosis
Dyspnia
Irritation to the mucous membranes
Some herbs, such as ba dou, bi ma zi, bing lang, gua di, qian niu zi (morning glory flower seed – also a hallucinogen), ya dan zi (toxicity in this herb used to treat cancer – injected), and shan ci gu (in preliminary stages of testing - treats breast cancer). Ba dou has very harsh oils in it. Symptoms include:
Severe vomiting
Diarrhea
Ban mao (beautiful insect and very toxic – used to treat liver cancer) and rou gui (cinamon bark) are seldom used in more than 3 gram increments. Can cause:
Painful urination
Scanty urine even bloody urine
Liver/Kidney toxicity
There are many chemicals inside of each herb.
Hepatitis from herbs: ku lian zi, huang yao zi
Liver/Kidney dysfunction (including failure): cang er zi
Blood related toxicity
Dan fan can cause anemia. Ban lan gen and she xiang can cause bleeding symptoms. Be aware of this since ban lan gen is popularly prescribed for flu, cold, etc. Normally very safe, but be aware in the event your patient has bleeding problems or is on platelet type medications.
She xiang is totally forbidden (even the aroma) for pregnant women as it is an abortifactant. Often used for trauma, bone/tendon problems.
Heavy metal toxicity
Herbs planted in soil that is contaminated (especially leaves) there is a danger of this. Lead, mercury, and arsenic can be present in mineral herbs. These were also once prescribed as medications.
Miscellaneous
Too much gan cao can cause electrolyte disturbance, edema, sodium retention and/or elevated BP in large doses.
Chronic effects are often ignored by patients and practitioners. Long term use examples:
Yunan bai yao is very popular for stop bleeding and is used for many situations – trauma, cut on the finger, internal bleeding, post surgery, etc. The main herb is San Qi, which has a double direction to both control bleeding and move blood. The long term toxicity is bruising and bleeding (gum and nasal). Use it for short term until the symptoms stop.
Xiao chai hu tang – alternating chills/fever, bitter taste in the mouth…treats a lot of things. Afterwards, however, can develop liver damage and/or hepatitis. This takes a LONG time however.
Kidney Intoxication
Herbal Kidney intoxication is a danger from herbs that contain aristolochic acid. This causes kidney damage (nephrotoxicity) that doesn’t reverse when the herbs are stopped. The gotcha list is below:
This is a list of patents to watch out for:
Acute toxicity experiments use high dosages. It’s then tested on rats to see if it causes death or extreme suffering. So much for our medicine being peaceful. Wouldn’t you think they’d know this after an uber-thousand of years? Long term studies are done for 6+ months. Most herbs have no side-effects when used in small short term doses, but over the long haul can damage internal organs.
Long term herb toxicity of mu tong includes edema, scanty urination, anemia, abnormal urine and blood tests. The normal dose of mu tong is 3 – 9 grams. Most studies show that toxicity starts at 10g doses. Scanty urination seems to be the key symptom indicating that the kidneys have been damaged.
General symptoms to watch for:
Fatigue
Poor appetite
N/V
Skin itching
Anemia
Palpitations
Shortness of Breath
Urinary system problems include acute nephritis and kidney failure which can be acute or chronic.
Acute KI failure / Chronic KI failureDigestive problems
Azotemia
Scanty urination
Stop taking the herbs, treat the nephritis. Results mostly good / Renal tubules interstitial fibrosis
Very poor prognosis.
The following herbs actually protect Kidney function:
Da huang
Treats both acute and chronic KI failure.
Dong chong xia cao
Improves the health of damaged renal tubules. Must be the cordyceps that nature created – the kind collected in Tibet that includes the grub it grows out of. The lab grown kind does not work
Chuan xiong
Acute or chronic KI failure.
Huang qi
Often used in food therapy. Heals KI damage.
Liver Toxicity
Liver toxicity usually takes about 10 days. Symptoms include fever, fatigue, poor appetite, nausea, and abdominal distention. Sounds a lot like hepatitis.
Cang zhu is commonly asked on the board exams. Dou Kou mentioned in #6 could be bai dou kou or cao dou kou…unspecific information given.
Often if an herb causes a toxicity it will also target that organ. For instance, some above clear liver fire, but also cause liver damage. Side effects are related to the channels they go to.
Bo he oil extract will treat cholecystitis, but when overdosed will kill you!
Nervous system intoxication
Central excitation = CNS over-excitement, like activating the sympathetic nervous system. Central inhibition = supression of the CNS. Central paralysis = CNS supression to the point of paralysis like ACH crisis.
Shan dou gen is extremely toxic – short term, small doses. Patents like Watermelon Frost Spray has this herb in it. Note that chuan xiong makes the blood pressure drop also.
Pupil dilation happens for the same reason it does for people that take drugs – as a matter of fact huo ma ren which is marijuana seed will do this.
Quan xie – scorpions – can cause irritability.
Zhang nao isn’t used here, but the others in #7 are.
Single Herbs to be aware of
Most lead to Liver failure and KI damage. They usually have obvious toxicity.
Mu Tong.
No more than 6 g raw used. One report said 10 mg will damage ki.
Wu tou and Fu zi
Aconite (fu zi) is way toxic. Watch out for herb/drug or herb/herb interactions.
Fu zi has an interaction with anti-arrhythmics (antagonistic effect).
Cang Er Zi
Often used herb. Can cause KI and LV damage as well as bleeding and respiratory depression.
Wu Gong
Centipede. Allergies to any animal proteins (egg, seafood, etc) will often react to these too.
Xiao feng san above is used for skin reactions.
Xi Xin
Always remember: Raw at less than 3 grams!
Needs a longer cook time to reduce toxicity.
Chuan Lian Zi or Jin Ling Zi
NEVER use a large dosage!
Wei Ling Xian
Homework:
3 or 4 students form a group, do project/paper. Can e-mail paper to Violet. Make powerpoint presentation. The 4th class we will have a final which is open book – 1 hour for that. The first 2 hours we will present. Oh boy. Like we’re going to be paying attention and not studying. Sounding like APA styling.
Due 4th class at beginning of class.
Intro:
Title
name of the authors (us)
keywords relating to topic (i.e., Kidney failure, name of chemicals that are the problem, etc.)
abstract.
Content:
General introduction to the herb – what the properties, actions, common usage and dosage.
Toxicity
Way to avoid and treat toxicity
Find out what patents contain this herb/s.
Conclusion
References and citations
Presentation:
Powerpoint – less than 10 minutes.
Tim, Donna T, Louise L, Cat.
Friday 12/12/09 12:30
Herbal Safety – Fall 2009
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