DHEA-F by Nature's Sunshine US

LIKELY EFFECTIVE

• Vaginal atrophy. Intravaginal DHEA can reduce pain during intercourse and improve vaginal health in patients with this condition. Details: Clinical research shows that ovules or suppositories containing DHEA 0.25% to 1%, inserted vaginally once daily for 12 weeks, can reverse vaginal thinning, restore vaginal pH, and reduce pain during sexual intercourse by up to 15% when compared with placebo in patients with vaginal atrophy (21320,21429,21430,94576). A specific vaginal insert containing DHEA 0.5% (Intrarosa, Endoceutics Inc.) is an FDA approved drug used for reducing pain during sexual intercourse in patients with vaginal atrophy (94573,94576). Other clinical research shows that applying DHEA 10% cream (Diosynth) to the inner thighs daily for 12 months might improve vaginal atrophy by stimulating maturation of the vaginal epithelium in postmenopausal patients. It might also increase bone mineral density in these patients (4242).

POSSIBLY EFFECTIVE

• Aging skin. Oral and topical DHEA have been evaluated for treating aging skin, with promising results. Details: Some clinical research shows that taking DHEA 50 mg daily for 12 months increases epidermal thickness, sebum production, and skin hydration, and decreases facial skin pigmentation in elderly patients (6446). Other preliminary clinical research shows that applying 1% DHEA daily for 4 months improves the appearance of paper-like skin when compared with placebo in postmenopausal patients. It also improves sebum production, skin wrinkling, and skin appearance when compared with baseline (21428).
• Depression. Oral DHEA 30-500 mg daily for up to 8 weeks seems to improve symptoms of depression and dysthymia in patients with depression. Details: Canadian clinical practice guidelines recommend DHEA as a third-line treatment for depression (95691). Most clinical research shows that taking DHEA 30-500 mg daily for around 6-8 weeks improves symptoms of depression and dysthymia when compared with placebo (3270,3864,3892,4233,21404,21405). Additionally, a pooled analysis of these and 9 other clinical studies shows that DHEA can improve depressive symptoms when compared with placebo, although most of the trials evaluated in the analysis included patients without clinically diagnosed depression (104161). Other preliminary clinical research using lower doses of 5-20 mg daily over 3 weeks shows no improvement in depressive symptoms in psychotic patients (21406).
• Infertility. Oral DHEA appears to improve fertility outcomes, including pregnancy and live birth rates, in females undergoing assisted reproduction. However, it is unclear if oral DHEA can reduce the risk for miscarriage after in vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI). Details: Meta-analyses of clinical research show that taking DHEA, typically at a dose of 75 mg daily, improves fertility outcomes for females undergoing assisted reproduction (96819,96820,96821,111227). One meta-analysis limited to randomized controlled trials in patients considered poor responders to standard IVF found that taking DHEA prior to IVF or ICSI treatments increases the clinical pregnancy rate by 34% and the rate of live births or ongoing pregnancy by 88% when compared with placebo or no treatment (96820). Another meta-analysis consisting of 16 studies, including both randomized controlled trials and observational research, in patients with diminished ovarian reserve (DOR) or poor ovarian response (POR) undergoing IVF or ICSI shows that taking DHEA 50-90 mg daily is associated with increases in oocyte yields, fertilized oocytes, top-quality embryos, clinical pregnancy rates, and ongoing pregnancy rates when compared with control groups. However, DHEA supplementation was not linked to improvements in live birth rates (111227). In females with various conditions of compromised fertility, some preliminary clinical research shows that taking DHEA 50-75 mg daily for at least 4 months may aid with natural conception, insemination-induced conception, and IVF pregnancy outcomes (21362). Some observational research in older females with DOR has also found that taking DHEA 30 mg three times daily for 12 weeks before IVF cycles is associated with a greater number of retrieved oocytes, improved oocyte quality, and increased cumulative pregnancy rates (103185). Inclusion of lower quality research also supports these findings (21413,21414,88493,96819,96821,99923). However, other research conflicts with findings that show a benefit of DHEA for infertility. (21415,88726,90304,111226). A large clinical study shows that pretreatment with DHEA in infertile females with POR prior to IVF and embryo transfer does not improve the number of retrieved oocytes and the rates of clinical pregnancy, pregnancy loss, and cumulative live births when compared with placebo (111226). Observational research in older patients with DOR suggests that DHEA supplementation is not linked to improved clinical pregnancy or live birth rates when compared with a control group (103185). Other clinical research in females with primary ovarian insufficiency shows that taking DHEA 75 mg daily for 16 weeks might not improve follicle size when compared with placebo (21364). The effect of DHEA pretreatment on miscarriage rates after IVF or ICSI is not clear. A meta-analysis of randomized clinical research does not support the use of DHEA pretreatment for preventing miscarriage (96820). However, when lower quality research is considered, use of DHEA seems to reduce the risk of miscarriage by up to 50% (21418,96819).

POSSIBLY INEFFECTIVE

• Aging. Oral DHEA, taken for up to 2 years, does not appear to improve bone health, quality of life, or sexual function in older adults. Details: Clinical research shows that DHEA, taken as 75 mg daily in males or 50 mg daily in females, for 2 years does not seem to improve body composition, bone mineral density (BMD), insulin sensitivity, or quality of life in people aged 60 years or older who have low DHEA-S levels (15027). Additionally, a pooled analysis of clinical trials shows that taking DHEA 50-1600 mg daily for up to 2 years does not improve body composition, bone health, sexual function, lipid and glycemic parameters, or quality of life in elderly males (88434).
• Muscle strength. Oral DHEA does not seem to improve muscle strength in adults. Details: While some clinical research shows that adults who take DHEA have increased muscle strength when measured by grip strength, leg press, chest press, and other measures, most clinical evidence shows that DHEA provides no benefit to muscle strength in younger and older adults (1365,10406,17617,21392,21419,21420,21421,47198).
• Physical performance. Oral DHEA does not seem to improve physical performance in elderly patients. Details: Most clinical research and a meta-analysis show that older adults who take DHEA do not have increased physical function or performance as measured by oxygen uptake, duration of exercise, balance, and ability to rise from a chair (17617,21420,21421). However, one clinical study shows that taking DHEA 50 mg daily for 6 months improves lower body strength and function by a small amount when compared with placebo in elderly frail females (21392). More research is needed to determine if DHEA is beneficial in specific populations.

LIKELY INEFFECTIVE

• Cognitive function. Oral DHEA does not improve cognitive function or prevent cognitive decline in most populations. Details: In the majority of clinical research, taking DHEA orally does not seem to improve cognitive function or decrease cognitive decline in healthy people over the age of 50 (3893,11334,14862,21333,21445), in peri- or post-menopausal women (6011,21397,21445), in patients with HIV (47435), or in young healthy adults when given as an acute dose (21399). However, preliminary clinical research shows that taking DHEA 50 mg daily for 4 weeks may improve certain measures of visual spatial performance and memory when compared with placebo in middle aged and elderly females (21396,21398).
• Sjogren syndrome. Oral DHEA does not appear to improve symptoms with this condition. Details: Clinical research shows that taking DHEA 50-200 mg daily for 4-12 months does not benefit symptoms of primary Sjogren syndrome when compared with placebo (21354,21358,21363,21365).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Addison disease. It is unclear if oral DHEA is beneficial in patients with this condition. Details: Some preliminary clinical research shows that taking DHEA up to 50 mg daily for up to 12 months improves symptoms of Addison disease, including reversing the loss of bone mineral density (BMD) and lean mass, but without improving cognitive function (8595,21387). However, taking DHEA 50 mg daily for 12 weeks does not appear to improve cognitive or sexual function, body composition, or BMD, although it may improve mood and fatigue (7614,21330,21356).
• Adrenal insufficiency. It is unclear if oral DHEA is beneficial in patients with primary or secondary adrenal insufficiency. Details: Some clinical research shows that taking low-dose DHEA, 20-50 mg daily, improves feelings of well-being, skin and hair, pubic hair growth, and sexuality in females with adrenal insufficiency or androgen deficiency due to hypopituitarism (3231,8593,17218,21317,21370,21385). However, other clinical research shows that taking low-dose DHEA for 3-12 months has little to no effect on quality of life, body composition, physical performance, cardiac function, depression, anxiety, and sexual arousal in patients with primary or secondary adrenal insufficiency (17218,21351,21357,21360,21386,21388,21389). Also, there is contradictory evidence about the effects of DHEA on plasma lipid levels in patients with adrenal insufficiency (21348,21351).
• Athletic performance. It is unclear if oral DHEA can improve sprint performance. Details: Preliminary clinical research in female recreationally trained athletes shows that taking DHEA 100 mg daily for 4 weeks does not improve sprint performance when compared with placebo (99925).
• Cardiovascular disease (CVD). Observational research has found that low DHEA levels are linked to a greater risk for CVD, but it is unclear if supplementation with oral DHEA is beneficial. Details: A meta-analysis of population research shows that patients with CVD and lower blood levels of DHEA-S have a worse overall prognosis when compared with patients with higher levels. Patients with the lowest levels have a 47% increased risk of future mortality events, including a 58% increased risk of fatal cardiovascular events. There was also a 42% increased risk of nonfatal cardiovascular events (96817). In elderly males, population research also shows that low serum levels of DHEA and DHEA-S are associated with an increased risk of coronary heart disease (CHD) but not cerebrovascular disease (90303).
• Cervical dysplasia. It is unclear if intravaginal DHEA is beneficial in patients with cervical dysplasia. Details: Preliminary clinical research shows that DHEA 150 mg intravaginally for up to 6 months reverses dysplasia in 83% of treated females with low-grade cervical dysplasia when compared to baseline (21426). The validity of these findings is limited by the lack of a comparator group.
• Chronic fatigue syndrome (CFS). It is unclear if oral DHEA is beneficial in patients with CFS. Details: Preliminary clinical research shows that oral DHEA 25-100 mg daily for 6 months improves symptoms of CFS by 8.5% to 26% when compared to baseline (7559). The validity of these findings is limited by the lack of a comparator group.
• Chronic obstructive pulmonary disease (COPD). It is unclear if oral DHEA is beneficial in patients with COPD. Details: A small clinical study shows that taking DHEA 200 mg daily for 3 months increases walking distance and improves lung function in patients with COPD when compared to baseline (21395). The validity of these findings is limited by the lack of a comparator group.
• Cocaine dependence. It is unclear if oral DHEA is beneficial for reducing cocaine cravings. Details: A small clinical study shows that taking DHEA 100 mg daily for 12 weeks, in addition to cognitive-behavioral group counseling, does not reduce cocaine craving when compared with counseling alone in cocaine-dependent participants (21411).
• Crohn disease. It is unclear if oral DHEA is beneficial for inducing Crohn disease remission. Details: A small clinical study shows that taking DHEA 200 mg daily for 8 weeks reduces symptoms in some patients with Crohn disease when compared to baseline. Remission occurred in 6 of 7 Crohn patients (21416). The validity of these findings is limited by the small study size and lack of a comparator group.
• Diabetes. Although there has been interest in using oral DHEA for diabetes, there is insufficient reliable information available about the clinical effects of DHEA for this purpose.
• Erectile dysfunction (ED). It is unclear if oral DHEA is beneficial in patients with ED. Details: Preliminary clinical research shows that taking DHEA orally for 24 weeks improves erectile function, orgasmic function, sexual desire, and overall sexual satisfaction in patients with ED. DHEA seems to be beneficial for idiopathic ED or ED secondary to hypertension, but doesn't seem to provide benefit for ED related to diabetes or neurological disorders (793,8596).
• Exercise-induced muscle damage. It is unclear if oral DHEA is beneficial for reducing muscle damage from exercise. Details: Preliminary clinical research shows that taking DHEA 50 mg twice daily for 5 days improves delayed-onset muscle soreness and reduces post-training blood creatinine kinase levels when compared with placebo in young males completing a 5-day exercise training program (88375).
• Fibromyalgia. It is unclear if oral DHEA is beneficial for improving fibromyalgia symptoms. Details: Preliminary clinical research shows that taking DHEA 50 mg daily for 3 months does not reduce fibromyalgia symptoms when compared with placebo in postmenopausal patients with fibromyalgia (21355).
• HIV/AIDS. Small clinical studies suggest that oral DHEA may improve mental health and quality of life in patients with HIV/AIDS, but DHEA does not seem to improve CD4 counts or body composition. Details: Population research shows that levels of DHEA seem to be lower in patients with more severe HIV/AIDS, suggesting that DHEA could be a marker for disease severity. Some evidence suggests that lower DHEA levels are associated with an increased risk of disease progression and AIDS (8598,14278,14279). Some clinical research shows that taking DHEA 50-500 mg daily for 2-4 months might improve mental health and quality of life when compared with placebo (3864,8598,14277,21390). However, taking DHEA in doses up to 2.25 grams daily does not appear to improve CD4 counts, muscle mass, or bone mass when compared with placebo (3865,14277,21390).
• Menopausal symptoms. Oral DHEA might reduce hot flashes and intravaginal DHEA might improve vaginal atrophy and sexual activity; however, oral DHEA does not seem to improve psychological symptoms associated with menopause. Details: Some research shows that taking DHEA 10-25 mg daily for 12 months improves subjective vasomotor symptoms such as hot flashes, as well as psychological symptoms and sexuality (11464,21417). Also, administering a daily ovule containing DHEA (Vaginorm, Recipharm) 3.5-13 mg intravaginally for 12 weeks appears to reverse vaginal atrophy and improve sexual activity in postmenopausal patients with vaginal atrophy (21442). However, other clinical research shows that taking DHEA 50 mg daily for up to 26 weeks does not improve mood, fatigue, cognition, sexual function, or sense of well-being in post- or peri-menopausal patients when compared with placebo (6011,21361). Additionally, a pooled analysis of clinical research shows that DHEA taken orally does not improve psychological symptoms related to menopause (88492).
• Metabolic syndrome. It is unclear if oral DHEA is beneficial for reducing risk for metabolic syndrome. Details: Preliminary clinical research shows that taking DHEA 50 mg daily for 6 months or 100 mg daily for 3 months decreases weight, abdominal fat, and blood pressure and reduces cholesterol, glucose, and insulin levels when compared with placebo in overweight elderly patients (12215,21350).
• Muscular dystrophy. It is unclear if oral DHEA is beneficial in patients with myotonic dystrophy type I. Details: Taking DHEA 100 or 400 mg daily for 12 weeks might not affect muscle strength in patients with myotonic dystrophy type I when compared with placebo (21334). However, intravenous DHEA-S 200 mg daily for 8 weeks appears to improve daily function, muscle strength, and heart function compared with baseline (21434). The validity of this finding is limited by the lack of a control group.
• Obesity. It is unclear if oral DHEA is beneficial for reducing body weight in patients who are obese or overweight. Details: Preliminary clinical research shows that taking DHEA 40 mg sublingually twice daily for 8 weeks, or 1600 mg by mouth for 28 days, does not affect body weight or body composition when compared with placebo in obese adults (21410,21427). Also, preliminary clinical research shows that taking DHEA 50-100 mg daily for 3-12 months does not affect central adiposity in older individuals when compared with placebo (21349).
• Opioid withdrawal. It is unclear if oral DHEA is beneficial in patients with heroin withdrawal. Details: Preliminary clinical research shows that taking DHEA 100 mg daily as adjunct to standard therapy for 12 months does not improve drug withdrawal symptoms in heroin addicts when compared with standard therapy alone (21412).
• Osteoporosis. It is unclear if oral DHEA is beneficial in patients with osteoporosis; any benefit may depend on individual patient characteristics. Details: There is contradictory evidence about the effectiveness of DHEA 50-100 mg daily for improved bone mineral density (BMD) in older adults with osteoporosis or osteopenia (12563,12564,21392), as well as the effectiveness of DHEA for improved BMD in females with anorexia nervosa (12562,21393). One pooled analysis shows that DHEA does not improve BMD in postmenopausal patients (88492), while another shows that DHEA can increase hip BMD in healthy older females, but not males (103186). The reason for these discrepant findings is unclear, but may relate to different patient populations, durations of therapy, and DHEA doses assessed in the included studies. Additionally, most of the studies included in these analyses were of low quality and inadequate statistical power.
• Parkinson disease. Although there has been interest in using oral DHEA for Parkinson disease, there is insufficient reliable information available about the clinical effects of DHEA for this purpose.
• Partial androgen deficiency. It is unclear if oral DHEA is beneficial for symptom improvement in patients with this condition. Details: Preliminary clinical research shows that taking DHEA 25 mg daily for one year might clinically improve mood, fatigue, and joint pain in older males with partial androgen deficiency when compared to baseline (21331). Other preliminary clinical research shows that taking DHEA 50 mg twice daily for 4 months does not improve erectile or sexual function when compared with placebo in hypoandrogenic males (21424).
• Parturition. Intravenous DHEA before the onset of labor may shorten the time to labor onset and shorten labor duration. Details: Clinical research shows that intravenous DHEA-S 100 mg daily for 3 days, or given twice weekly until the onset of labor starting after 38 weeks of gestation, increases cervical ripening and shortens the time to onset of labor and the duration of labor when compared with a control in nulliparous women (21384,21431). Also, intravenous DHEA 50-200 mg given multiple times until the onset of labor starting after 37 weeks of gestation appears to shorten the time to delivery in primiparous and multiparous women (21432,21433). It is unclear if oral DHEA is beneficial for this purpose.
• Rheumatoid arthritis (RA). It is unclear if oral DHEA is beneficial in patients with RA. Details: Preliminary clinical research shows that taking oral DHEA 200 mg for 16 weeks does not reduce symptoms of RA in elderly patients (21422). However, other clinical research in a small number of premenopausal females with RA shows that taking DHEA 50 mg daily for 12 weeks improves quality of life, but not disease activity, when compared with placebo (104159).
• Schizophrenia. It is unclear if oral DHEA is beneficial in patients with schizophrenia. Details: Some research shows that taking DHEA orally improves both negative and positive symptoms in patients with schizophrenia. It may be more effective in females (9692). However, other clinical research shows no benefit (21423).
• Sexual dysfunction. It is unclear if oral or intravaginal DHEA is beneficial for improving sexual dysfunction in males or females. Details: DHEA may be modestly beneficial in some postmenopausal patients with decreased libido or dyspareunia. Preliminary clinical research shows that taking DHEA 50-100 mg daily, or a single dose of DHEA 300 mg, improves sexual desire when compared to baseline (9906,21443). Additional clinical research shows that use of intravaginal DHEA (Vaginorm, Recipharm) at concentrations of 0.25% to 1% daily for 12 weeks might improve sexual function when compared with placebo (47361). However, a pooled analysis shows that DHEA is not associated with improvements in libido or sexual function (88414,88492). DHEA has also been evaluated in other patient populations. Small clinical studies show that taking DHEA doesn't seem to influence response to sexual stimuli in sexually functional premenopausal women (8594) or improve libido in individuals age 40-70 years (21449). Preliminary clinical research in males with hypoactive sexual desire disorder (HSDD) shows that taking DHEA 50 mg twice daily for 6 weeks does not improve erectile or sexual function when compared with placebo (88414). In adults with midlife-onset or HIV-associated depression, preliminary clinical research shows that taking DHEA 90-500 mg daily for 3-8 weeks may improve sexual function and libido when compared with placebo (3864,21405).
• Systemic lupus erythematosus (SLE). Most small clinical studies suggest that oral DHEA may modestly improve symptoms in patients with SLE, but some conflicting research exists. Details: Some clinical research shows that taking DHEA has little to no effect on disease activity in patients with mild to moderate SLE (21425,21447). However, small clinical studies and a meta-analysis of these studies show that taking DHEA in conjunction with conventional treatment may help improve frequency of flare-ups, muscle ache, oral ulcers, and quality of life, reduce corticosteroid doses needed (2113,2114,2136,6068,6447,12561,12574,21346,21447), and improve bone mineral density (6068,6097,6447,21394).
• Ulcerative colitis. It is unclear if oral DHEA is beneficial for inducing ulcerative colitis remission. Details: A small clinical study shows that taking DHEA 200 mg daily for 8 weeks reduces symptoms of ulcerative colitis when compared to baseline in some patients with ulcerative colitis. Remission occurred in 6 of 13 ulcerative colitis patients (21416). The validity of these findings is limited by the small study size and the lack of a comparator group. More evidence is needed to rate DHEA for these uses.

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There is insufficient reliable information available about the effectiveness of false unicorn.

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POSSIBLY EFFECTIVE

• Mastalgia. Meta-analyses of small clinical studies show that vitex agnus-castus moderately reduces breast pain due to cyclic mastalgia. Details: Two small meta-analyses of low-to-moderate quality clinical studies in patients with cyclic mastalgia show that taking vitex agnus-castus moderately reduces breast pain when compared with placebo (101981,111753). The validity of these findings is limited by the heterogeneity of the included studies. Doses of vitex agnus-castus dried fruit extract range from 3.2-40 mg daily, for 2-6 months (90617,96250,101981,111753). Vitex agnus-castus is commonly used in proprietary products, alone or in combination with other herbs (Agnucaston/Cyclodynon, Bionorica AG, Femicur, Mastodynon, Bionorica AG, Monoselect Agnus, ZE 440) (13395).
• Premenstrual syndrome (PMS). Clinical research shows that vitex agnus-castus produces modest improvements in PMS symptoms. Details: Clinical research shows that taking vitex agnus-castus fruit extract orally for 2-6 menstrual cycles seems to reduce symptoms of PMS, especially breast pain or tenderness (mastalgia), edema, constipation, irritability, depressed mood, anxiety, anger, and headache (7055,7076,7078,7079,13394,15065,41483,41489,41490,41494,90619,101981). Doses of fruit extracts have varied from 3.5-40 mg daily, usually for 2-3 menstrual cycles (7055,7076,7078,7079,15065,41483,41489,41490,90619,96435). A meta-analysis of the available clinical research, including 17 studies involving 2,401 patients, shows that taking vitex agnus-castus is comparable to fluoxetine or oral contraceptives, and modestly more effective than placebo, for reducing the symptoms of PMS. A sub-group analysis indicates that efficacy is not impacted by the dose or form used, although the dried powdered berries appear to be ineffective. The low quality of the included studies and the high level of bias and heterogeneity limit the validity of these findings (96435). Another meta-analysis limited to three randomized controlled trials shows that taking vitex agnus-castus increases the likelihood of PMS symptom remission by 2.6-fold over placebo (101979). Some clinical studies have used a specific dried extract of vitex agnus-castus fruit (Agnolyt, Madaus AG) (7076). Other studies used a specific fruit extract known as Ze 440 (Prefemin, Zeller AG), which is standardized to casticin content (7078,90619). Additional studies have used the fruit extract BNO 1095 (Agnucaston/Cyclodynon, Bionorica AG) (15065,41483,41489,41490).

POSSIBLY INEFFECTIVE

• Fractures. Limited evidence suggests that vitex agnus-castus does not improve fracture healing rates. Details: Clinical research shows that taking a specific vitex agnus-castus dried fruit extract (Agnugol, Goldaru Pharmacy Company) 4 mg, alone or in combination with magnesium oxide (Nature Made Company) 250 mg, daily for 8 weeks does not improve long bone fracture healing when compared with placebo (90618).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acne. Although there is interest in using oral vitex agnus-castus for acne, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Aging skin. Vitex agnus-castus has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A clinical trial in postmenopausal adults with wrinkles shows that taking one capsule orally daily of a combination of vitex agnus-castus 400 mg, evening primrose oil 500 mg, soy isoflavones 100 mg, and black cohosh 520 mg (Estosalus, Max Biocare Pty Ltd) for 12 weeks improves skin elasticity, skin smoothness, and wrinkle density scores when compared with placebo (109440).
• Amenorrhea. Although there is interest in using oral vitex agnus-castus for amenorrhea, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Anxiety. Although there is interest in using oral vitex agnus-castus for anxiety, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Benign prostatic hyperplasia (BPH). Although there is interest in using oral vitex agnus-castus for BPH, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Dementia. Although there is interest in using oral vitex agnus-castus for dementia, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Dysmenorrhea. It is unclear if oral vitex agnus-castus is beneficial in patients with dysmenorrhea. Details: Preliminary clinical research in patients with primary dysmenorrhea shows that taking a specific vitex agnus-castus extract (Agnucaston, Bionorica AG) daily for 3 months reduces pain, as measured on a visual analog scale, similarly to ethinyl estradiol 0.03 mg / drospirenone 3 mg (Yasmin) taken daily (104975).
• Fibrocystic breast disease. Although there is interest in using oral vitex agnus-castus for fibrocystic breast disease, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Hyperprolactinemia. Although there is interest in using oral vitex agnus-castus for hyperprolactinemia, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Infertility. It is unclear if oral vitex agnus-castus is beneficial for female infertility. Details: Preliminary clinical research in infertile females with oligomenorrhea or amenorrhea shows that taking homeopathic vitex agnus-castus (Phyto Hypophyson L, Steierl-Pharma GmbH) 50 drops orally three times daily for 3 months does not increase the chance of getting pregnant (41470). Also, one small clinical study in those with infertility due to secondary amenorrhea or luteal insufficiency shows that taking a vitex agnus-castus preparation (Mastodynon, Bionorica GmbH, Neumarkt/Opf.) 30 drops twice daily for at least 3 months does not increase the chance of pregnancy when compared with placebo, although the study was likely inadequately powered to detect a difference (7077).
• Insect repellent. Limited research suggests that topical vitex agnus-castus has insect repellent activity. Details: Preliminary clinical research shows that applying a carbon dioxide extract of vitex agnus-castus seeds seems to repel ticks and fleas for 6 hours, mosquitoes for 3-8 hours, and biting flies for 3 hours (13396). It is unclear how this compares with commonly used insect repellants.
• Insomnia. Although there is interest in using oral vitex agnus-castus for insomnia, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Lactation. Although there is interest in using oral vitex agnus-castus for stimulating lactation, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Menopausal symptoms. Clinical research suggests that vitex agnus-castus can relieve some menopausal symptoms; however, most research uses vitex agnus-castus in combination with other treatments. Details: Clinical research shows that taking vitex agnus-castus extract 15 mg twice daily for 8 weeks improves some menopausal symptoms, including anxiety and vasomotor dysfunction, by 76% and 88%, respectively, when compared with baseline. However, there was no effect on depression or sexual dysfunction (101980). Vitex agnus-castus has also been studied as a component of combination products. Preliminary clinical research shows that taking a combination of vitex agnus-castus, equivalent to 1000 mg dried fruit, black seed powder 500 mg, and citalopram 20 mg daily for 8 weeks reduces vasomotor, psychosocial, and physical symptoms of menopause when compared with citalopram alone (100325). Other preliminary clinical research shows that taking one capsule orally daily of a combination of vitex agnus-castus 400 mg, evening primrose oil 500 mg, soy isoflavones 100 mg, and black cohosh 520 mg (Estosalus, Max Biocare Pty Ltd) for 12 weeks moderately reduces the severity of hot flashes, sweating, sleep problems, depressed mood, and irritability when compared with placebo. There was no effect on plasma lipids, joint discomfort, anxiety, exhaustion, or sexual problems (105102). It is unclear if these effects are due to vitex agnus-castus, other ingredients, or the combination.
• Menorrhagia. It is unclear if oral vitex agnus-castus is beneficial in patients with menorrhagia. Details: A meta-analysis of two moderate quality clinical trials in patients who had heavy menstrual periods shows that taking vitex agnus-castus does not reduce menstrual bleeding over the next 1-2 menstrual cycles when compared with placebo (101982). However, preliminary clinical research in patients using an intrauterine device (IUD) shows that taking vitex agnus-castus three times daily for 8 days, starting on the first day of menstruation, and repeated for four consecutive menstrual cycles, reduces the amount of bleeding by approximately 48% when compared with baseline. This reduction was similar to the effects of mefenamic acid 250 mg daily after 4 months, although treatment with mefenamic acid was superior during the first three months (90620).
• Migraine headache. Although there is interest in using oral vitex agnus-castus for migraine headache, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Polycystic ovary syndrome (PCOS). Vitex agnus-castus has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in patients with oligomenorrhea due to PCOS shows that taking a traditional combination product (Aslagh) containing equivalent amounts of essential oils of vitex agnus-castus fruit, fennel, and wild carrot seeds orally daily for 3 months, either alone or in combination with metformin, improves rates of menstrual bleeding and menstrual cyclicity similarly to metformin alone. All three groups experienced a significant improvement from baseline. Aslagh was taken as two, 500-mg capsules twice daily, except during menses; metformin was titrated over one week to a dose of 500 mg three times daily (108974).
• Premenstrual dysphoric disorder (PMDD). Limited evidence suggests that vitex agnus-castus might improve symptoms of PMDD. Details: In a clinical trial, vitex agnus-castus 20-40 mg daily for 8 weeks was similar to fluoxetine 20-40 mg daily for relieving symptoms of PMDD. About 58% of patients responded to vitex agnus-castus, compared to about 68% of patients taking fluoxetine. Vitex agnus-castus was more effective for physical symptoms such as breast tenderness, swelling, cramps, and food cravings (12207,41493).
• Rheumatoid arthritis (RA). Although there is interest in using oral vitex agnus-castus for RA, there is insufficient reliable information available about the clinical effects of vitex agnus-castus for this condition.
• Sexual dysfunction. It is unclear if oral vitex agnus-castus is beneficial in patients with sexual dysfunction. Details: Preliminary clinical research in healthy females under 44 years of age with sexual dissatisfaction shows that taking a specific vitex agnus-castus product (Agnugol, Goldaru Herbal Pharmaceutical Company) 3.2-4.8 mg orally once daily for 16 weeks modestly improves scores of sexual satisfaction, function, arousal, and desire when compared with placebo (109437). Additionally, a moderate-sized clinical study in females 50-69 years old with sexual dysfunction conducted in Iran shows that taking vitex agnus-castus 40 drops daily for 8 weeks improves sexual dysfunction scores from mild dysfunction to no dysfunction at 6 and 8 weeks when compared with placebo but does not improve scores at 4 weeks (112361). More evidence is needed to rate the effectiveness of vitex agnus-castus for these uses.

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POSSIBLY INEFFECTIVE

• Menopausal symptoms. Topical wild yam does not seem to improve menopausal symptoms. Details: Wild yam applied topically as a cream in menopausal patients for 3 months appears to be no better than placebo for relieving vasomotor symptoms, such as hot flashes and night sweats. It also does not appear to change serum follicle stimulating hormone (FSH), estradiol, or progesterone levels (10989).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Cognitive function. It is unclear if oral wild yam is beneficial for improving cognitive function in healthy adults. Details: Preliminary clinical research in healthy adults shows that taking a specific wild yam extract (Diopower 15, Anti-Aging Pro Corporation) orally, 50 mg (containing diosgenin 8 mg) daily for 12 weeks, modestly improves overall measures of cognitive function and semantic fluency when compared with placebo (96724).
• Dysmenorrhea. Although there is interest in using oral or topical wild yam for dysmenorrhea, there is insufficient reliable information about the clinical effects of wild yam for this condition.
• Gallbladder disease. Although there is interest in using oral wild yam for gallbladder disease, there is insufficient reliable information about the clinical effects of wild yam for this condition.
• Infertility. Although there is interest in using oral or topical wild yam for infertility, there is insufficient reliable information about the clinical effects of wild yam for this condition.
• Osteoporosis. Although there is interest in using oral wild yam for osteoporosis, there is insufficient reliable information about the clinical effects of wild yam for this condition.
• Postmenopausal conditions. Although there is interest in using oral wild yam for postmenopausal conditions, there is insufficient reliable information about the clinical effects of wild yam for these conditions.
• Premenstrual syndrome (PMS). Although there is interest in using oral wild yam for PMS, there is insufficient reliable information about the clinical effects of wild yam for this condition.
• Rheumatoid arthritis (RA). Although there is interest in using oral wild yam for RA, there is insufficient reliable information about the clinical effects of wild yam for this condition.
• Sexual dysfunction. Although there is interest in using oral wild yam for sexual dysfunction, there is insufficient reliable information about the clinical effects of wild yam for this condition. More evidence is needed to rate wild yam for these uses.

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POSSIBLY SAFE ...when used orally and appropriately, short-term. Most studies have been small and lasted from a few weeks to 6 months, with usual doses of 50 mg daily (793,1635,2133,3231,4249,4251,4252,4253,4254,4255,9691)(9692,10986,12215,12564,14277,21416,88726,90304,99925). Some studies have also used oral DHEA with apparent safety for 12-24 months (2113,6446,10406,11464,12561,15027,88492). ...when used intravaginally and appropriately. Intravaginal ovules of DHEA 3.25 mg to 13 mg have been safely used for up to 12 weeks (21320,21429,21430). ...when used topically and appropriately. A DHEA cream 1% to 10% has been safely used for up to 12 months (4242,21428).

POSSIBLY UNSAFE ...when used orally in high doses or long-term. There is concern that long-term use or use of amounts that cause higher than normal physiological DHEA levels might increase the risk of prostate cancer (2111,12565), breast cancer (10370,10401,10403), or other hormone-sensitive cancers (6445). In some cases, 50-100 mg daily can produce slightly higher than normal physiological DHEA levels (4249,4251). There is insufficient reliable information available about the safety of using DHEA intravenously or intramuscularly.

PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally. DHEA can cause higher than normal androgen levels (2133,4249,4251,4253), which might adversely affect pregnancy or a nursing infant.

(Read more about DHEA)

There is insufficient reliable information available about the safety of false unicorn when used orally.

PREGNANCY: LIKELY UNSAFE
when used orally because it is a potential uterine stimulant (12,18).

LACTATION:
Insufficient reliable information available; avoid using.

(Read more about FALSE UNICORN)

LIKELY SAFE ...when the fruit extract is used orally and appropriately, short-term. Vitex agnus-castus fruit extract has been used safely in studies at doses up to 40 mg daily, for up to 3 months (7055,7076,7077,7078,7079,12207,13393,15065,90617,90618,96435). There is insufficient reliable information available about the safety of vitex agnus-castus seeds when used orally or topically.

PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally. Theoretically, the hormonal effects of vitex agnus-castus might adversely affect pregnancy or lactation (10979,11456,13393,109439). Animal research shows that taking vitex agnus-castus fruit extract when planning to become pregnant or during pregnancy may increase the risk of infertility, low fetal body weight, abortion, and stillbirth (109439); avoid using.

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POSSIBLY SAFE ...when used orally. A dose of 50 mg (containing 8 mg diosgenin) has been used with apparent safety for 12 weeks (12,96724). ...when used topically. A wild yam cream has been used with apparent safety for 3 months (10989).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about WILD YAM)

ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.  Details Human and laboratory research show that DHEA and DHEA-S can inhibit platelet aggregation (19109,19127).

ANTIDEPRESSANT DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might increase the risk of psychiatric adverse events when used with antidepressants.  Details In a human case report, the use of a selective serotonin reuptake inhibitor (SSRI) with DHEA caused a manic episode (7023). Concern for this interaction may be greater in younger individuals with higher baseline DHEA levels.

AROMATASE INHIBITORS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might interfere with the clinical effects of aromatase inhibitors.  Details DHEA is a potent estrogen agonist, which may antagonize the anti-estrogen activity of aromatase inhibitors (10401).

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might increase the levels of drugs metabolized by CYP3A4.  Details Some preliminary evidence shows that DHEA may inhibit CYP3A4 (1389); however, the clinical significance of this potential interaction is not known.

ESTROGENS Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might increase the effects and adverse effects of estrogen therapy.  Details DHEA is a precursor to estrogen and androgen and is metabolized into those substances. In clinical research, DHEA supplements increase the levels of these hormones (6012,7614,8593,10986,12651,12564,15027,21321,21323,21324)(21325,21326,21327,21328,21330,21331,21356,21364,21389,21393)(21397,21398,21417,21419,21427,47273,47348,88375,90304). Also, in clinical research, estrogen-progestin oral contraceptives and conjugated estrogens reduce blood levels of DHEA and DHEA-S (21372,21373,21374,21437,21438). The clinical significance of these findings is unclear.

FULVESTRANT (Faslodex) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might interfere with the anti-estrogen effects of fulvestrant.  Details DHEA is a potent estrogen agonist (10401). Some research shows that it can overcome the estrogen receptor antagonist action of fulvestrant in estrogen-receptor positive cancer cells (10370).

TAMOXIFEN (Nolvadex) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might interfere with the anti-estrogen effects of tamoxifen.  Details DHEA is a potent estrogen agonist. Some research shows that it can overcome the estrogen receptor antagonist activity of tamoxifen in estrogen-receptor positive cancer cells (10370,10403).

TESTOSTERONE Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, DHEA might increase the effects and side effects of testosterone therapy.  Details DHEA is a precursor to estrogen and androgen and is metabolized into those substances. In clinical research, DHEA supplements increase the levels of these hormones (6012,7614,8593,10986,12651,12564,15027,21321,21323,21324)(21325,21326,21327,21328,21330,21331,21356,21364,21389,21393)(21397,21398,21417,21419,21427,47273,47348,88375,90304,99924,99925,104162). The clinical significance of these findings is unclear.

TRIAZOLAM (Halcion) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = D DHEA can increase blood levels of triazolam.  Details Administration of DHEA 200 mg daily for two weeks was shown to inhibit the cytochrome P450 3A4 (CYP3A4) metabolism of triazolam. This inhibition appears to be due to DHEA-S, rather than DHEA (1389).

TUBERCULOSIS VACCINE Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D DHEA might reduce the effectiveness of the tuberculosis vaccine.  Details Animal research shows that high doses of DHEA can reduce the efficacy of the Bacillus Calmette-Guérin (BCG) tuberculosis vaccine (21316).

(Read more about DHEA)

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ANTIPSYCHOTIC DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, vitex agnus-castus could interfere with the activity of antipsychotic drugs.  Details Vitex agnus-castus might interfere with the action of dopamine antagonists such as antipsychotic drugs due to its dopamine agonist effects (7014,7015).

CONTRACEPTIVE DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = B Theoretically, vitex agnus-castus could interfere with oral contraceptives.  Details Vitex agnus-castus might interfere with the efficacy of oral contraceptives due to possible hormone modulating activity (10979,11456).

DOPAMINE AGONISTS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, vitex agnus-castus could interfere with dopamine agonists.  Details Vitex agnus-castus might potentiate the actions of dopaminergic agonists due to possible dopaminergic effects (10122).

ESTROGENS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = D Theoretically, vitex agnus-castus could interfere with the activity of estrogens.  Details Vitex agnus-castus has hormone modulating activity that can interfere with the efficacy of hormone replacement therapy (10979,11456).

METOCLOPRAMIDE (Reglan) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, dopaminergic effects of vitex agnus-castus could interfere with metoclopramide.  Details Vitex agnus-castus might interfere with the action of dopamine antagonists such as metoclopramide due to its possible dopaminergic effects (7014,7015).

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ESTROGENS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, wild yam might increase or decrease the effects of estrogen.  Details Wild yam root shows estrogenic and anti-estrogenic effects in vitro (6180,70411,96723,96725). Theoretically, wild yam might interfere with hormone therapy.

(Read more about WILD YAM)

General ...Orally and topically, DHEA seems to be well tolerated when used in typical doses, short-term. However, there is some concern that long-term oral use of DHEA may be linked to a greater risk for cancer.
Most Common Adverse Effects:
Orally: Acne, headache, insomnia, mood changes, and nausea. In females, masculinization symptoms including deepening of the voice, increased size of genitals, irregular menses, oily skin, reduced breast size, and unnatural hair growth. In males, aggression, breast tenderness or enlargement (gynecomastia), urinary urgency, and testicular wasting.
Serious Adverse Effects (Rare):
Orally: Possible increased risk for cardiovascular events and various types of cancer.

Cardiovascular ...Incidences of arrhythmia (21334,47540), chest pain (21332,21333), palpitations (21332,21333,88492), hypertension, and transient ischemic attacks (21353,21354,47300) have been reported. DHEA has also been found to decrease high-density lipoprotein (HDL) levels (21344,21345,21346,21347,21348,21349) and increase triglycerides (21334).

Dermatologic ...Acne has been the most commonly reported adverse effect in human research, particularly in females (2113,2114,4242,7614,7559,12561,12574,21346,21351,21354)(21355,21356,21357,21358,21360,21361,21362,21363,21364,47300)(47355,47409,90304,103185). However, it is generally mild and may be treated by reducing the dose (7559). Incidences of contact dermatitis (47402), acneiform dermatitis (2113), greasy hair and skin (17218,21351,21355,21363,21387,21389,47355), keratosis (47402), skin rash (12574,21361,21363), erythema (21334), scalp itching (17218,21357), and skin spots (21387) have also been reported. Increased hair growth and hirsutism have been noted in several clinical trials, including the development of mild mustache in females (2114,4242,12561,12574,17218,21346,21351,21354,21355,21358) (21361,21362,21363,21370,21387,21389,21415,47300). Increased perspiration and odor have also been reported in human research (17218,21354,21356,21357).

Endocrine ...In postmenopausal patients, high doses of DHEA (1600 mg daily) induced insulin resistance, reportedly due to increased androgen levels that occurred during supplementation (21324).

Gastrointestinal ...Gastrointestinal disturbances such as nausea, diarrhea, and abdominal discomfort have been noted in human research (2111,6098,7559,12574,21348,21358,21386).

Genitourinary ...In older adults, elevated and severe urinary symptoms (as evidenced by scores of more than 20, using the American Urological Association Symptom Index for Benign Prostatic Hyperplasia [International Prostate Symptom Score]) and urinary tract infection were reported (21353). Rare incidences of abnormal menses (2114) and increased discharge (21415) have been reported. DHEA has been associated with hematuria (47300).

Hepatic ...Elevated liver enzymes have been reported following DHEA supplementation (21364,47300). However, an analysis of multiple studies in varied patient populations taking DHEA supplements found no elevations in liver enzymes (107791).

Musculoskeletal ...Incidences of asthenia, arthralgia, and myalgia, including calf cramps, have been reported (12574,21354,21358,21365,47355).

Neurologic/CNS ...In humans, dizziness, fatigue, malaise, sleep disturbances, increased dreaming, night sweats, restlessness, "painful spots," and a crawling scalp sensation have been reported (3865,21354,21363,21389). There is a case of seizure associated with DHEA use in a 30 year-old female with fragile X syndrome and no history of convulsive disorder who used DHEA to try to improve ovarian production (47344).

Ocular/Otic ...In patients with Sjögren syndrome, maculae lesions, ocular pain and dryness, and painful eye exams have been reported (21358,21363,21365).

Oncologic ...Preclinical research suggests that DHEA may increase the risk of cancer, particularly prostate, liver, breast, and pancreatic cancers (2111,10370,10401,10403,12565,21332,21333,21334,47251,47256)(47366,47388,47539). High concentrations of DHEA in postmenopausal patients have been associated with an increased risk of breast cancer (2115,6445).

Psychiatric ...DHEA-induced mania has been reported (5870,6102,7023,21383). Clinical studies have also reported anxiety, nervousness, irritability, emotional change, and depression in patients receiving DHEA (2114,21358,21360,21370).

Pulmonary/Respiratory ...Increased cough and nasal congestion have been noted in human research (3865,11334). A report of acute respiratory failure was made in clinical study evaluating the use of DHEA in patients with myotonic dystrophy (type 1) (21334).

Other ...Perceived increases in weight gain have been reported with use of DHEA (2114,21361).

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General ...Orally, false unicorn root seems to be generally well tolerated (12). Large doses have been reported to cause nausea and vomiting (4).

Gastrointestinal ...Orally, large doses of false unicorn have been reported to cause nausea and vomiting (4).

(Read more about FALSE UNICORN)

General ...Orally, vitex agnus-castus is generally well tolerated.
Most Common Adverse Effects:
Orally: Diarrhea, fatigue, headache, insomnia, irregular menstruation, nausea, skin irritation, stomach pain, vomiting.

Dermatologic ...Orally, skin conditions such as itching, irritation, urticaria, rash, acne, eczema, and hair loss have been reported (7055,7076,7078,7079,12207,13393,15065,90617,90619,101981).

Gastrointestinal ...Orally, gastrointestinal upset or pain, diarrhea, and nausea and vomiting, have been reported (7079,12207,13393,15065,90620,101981,101982). In one clinical trial, a single patient reported persistent gastroenteritis while taking vitex agnus-castus (7076). Orally, development of a bezoar resulting in colonic obstruction is described in a 63-year-old male who consumed an unknown amount of vitex agnus-castus seeds (111752).

Genitourinary ...Orally, irregular or prolonged menstrual bleeding has been reported (7055,7079,12207,13393,15065,41489,41490,95326).

Hematologic ...Orally, nosebleed has been reported in a single patient in a clinical trial (7079).

Immunologic ...Orally, multiple abscesses have been reported in a single patient (7055).

Neurologic/CNS ...Orally, headache, fatigue, and insomnia (7076,7078,12207,13393,13395,15065), confusion (90617), and vertigo (7079) have been reported.

Other ...Orally, weight gain has been reported (12207,13393,15065).

(Read more about VITEX AGNUS-CASTUS)

General ...Orally, wild yam is generally well tolerated.
Most Common Adverse Effects:
Orally: Fever, headache, upset stomach, and vomiting.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis.

Gastrointestinal ...Orally, wild yam can cause upset stomach and vomiting, especially at higher doses (12,86450).

Hematologic ...In one case report, a 55-year-old female with protein S deficiency and systemic lupus erythematosus (SLE) had temporary vision loss in the left eye from hemiretinal vein thrombosis 3 days after taking a combination phytoestrogen product containing wild yam 276 mg, dong quai 100 mg, red clover 250 mg, and black cohosh 250 mg (13155). It is unclear if wild yam contributed to this event.

Immunologic ...There are three case reports of anaphylaxis after ingestion of cooked wild yam (96722).

Neurologic/CNS ...Orally, wild yam can cause headache and fever, especially at higher doses (86450).

(Read more about WILD YAM)