Blackberry • Bleeding Heart • Borage • Filaree • Fuchsia • Honeysuckle • Pine • Star of Bethlehem • Walnut • Wild Rose flowers. Other Ingredients: Distilled Water, Vegetable Glycerin.
Brand name products often contain multiple ingredients. To read detailed information about each ingredient, click on the link for the individual ingredient shown above.
This is a homeopathic preparation. Homeopathy is a system of medicine established in the 19th century by a German physician named Samuel Hahnemann. Its basic principles are that "like treats like" and "potentiation through dilution." For example, in homeopathy, diarrhea would be treated with an extreme dilution of a substance that normally causes diarrhea when taken in high doses.
Practitioners of homeopathy believe that more dilute preparations are more potent. Many homeopathic preparations are so diluted that they contain little or no active ingredient. Therefore, most homeopathic products are not expected to have any pharmacological effects, drug interactions, or other harmful effects. Any beneficial effects are controversial and cannot be explained by current scientific methods.
Dilutions of 1 to 10 are designated by an "X." So a 1X dilution = 1:10, 3X=1:1000; 6X=1:1,000,000. Dilutions of 1 to 100 are designated by a "C." So a 1C dilution = 1:100; 3C = 1:1,000,000. Dilutions of 24X or 12C or more contain zero molecules of the original active ingredient.
Homeopathic products are permitted for sale in the US due to legislation passed in 1938 sponsored by a homeopathic physician who was also a Senator. The law still requires that the FDA allow the sale of products listed in the Homeopathic Pharmacopeia of the United States. However, homeopathic preparations are not held to the same safety and effectiveness standards as conventional medicines. For more information, see the Homeopathy monograph.
Below is general information about the effectiveness of the known ingredients contained in the product Grief Relief EFR. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of blackberry.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of nerve root.
There is insufficient reliable information available about the effectiveness of star of Bethlehem.
There is insufficient reliable information available about the effectiveness of turkey corn.
There is insufficient reliable information available about the effectiveness of wahoo.
Below is general information about the safety of the known ingredients contained in the product Grief Relief EFR. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when the fruit (nut) is consumed in amounts normally found in food.
POSSIBLY UNSAFE ...when the bark is used orally or topically, due to its juglone content (2). When applied topically, juglone-containing bark can cause skin irritation. When used orally on a daily basis, the juglone-containing bark of a related species (English walnut) is associated with increased risk of tongue cancer and lip leukoplakia (2,12). There is insufficient reliable information available about the safety of the leaf or hull when used orally as a medicine or when applied topically.
PREGNANCY AND LACTATION: LIKELY SAFE
when the fruit (nut) is consumed in amounts normally found in foods.
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when the bark is used orally or topically (12); avoid using.
There is insufficient reliable information available about the safety of black walnut leaf or hull when used orally in medicinal amounts during pregnancy or lactation; avoid using.
LIKELY SAFE ...when the fruit is used orally in amounts commonly found in foods (4912). There is insufficient reliable information available about the safety of blackberry fruit or leaf when used in medicinal amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in amounts greater than those found in foods.
POSSIBLY SAFE ...when borage seed oil is used orally or topically and appropriately. Borage seed oil has been used with apparent safety in clinical trials at a dose of up to 4 grams daily for up to 12 weeks (7632,8458,11341,13305,36804,88185,5244).
LIKELY UNSAFE ...when products containing hepatotoxic pyrrolizidine alkaloids (PA) are used orally. Borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Repeated exposure to low concentrations of hepatotoxic PAs can cause severe veno-occlusive disease. Hepatotoxic PAs might also be carcinogenic and mutagenic (12841,12842). Tell patients not to use borage preparations that are not certified and labeled as hepatotoxic PA-free.
CHILDREN: POSSIBLY SAFE
when borage seed oil is used orally and appropriately.
Borage seed oil has been used with apparent safety at a dose of 2 grams daily for 12 weeks (11341).
CHILDREN: LIKELY UNSAFE
when products containing hepatotoxic PAs are used orally.
Borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Repeated exposure to low concentrations of hepatotoxic PAs can cause severe veno-occlusive disease. Hepatotoxic PAs might also be carcinogenic and mutagenic (12841,12842). Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.
PREGNANCY AND LACTATION: LIKELY UNSAFE
when products containing hepatotoxic pyrrolizidine alkaloids (PA) are used orally.
Borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Repeated exposure to low concentrations of hepatotoxic PAs can cause severe veno-occlusive disease. Hepatotoxic PAs might also be carcinogenic, mutagenic, and teratogenic. These constituents are also excreted in breast milk (12841,12842). Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.
There is insufficient reliable information available about the safety of borage seed oil when used orally or topically during pregnancy or lactation.
LIKELY SAFE ...when the fruit (nut), leaf, or hull is consumed in amounts normally found in foods (4912,6431,8476,8477).
POSSIBLY SAFE ...when the leaf extract is used orally at doses of up to 200 mg for up to 3 months (97749,97750).
POSSIBLY UNSAFE ...when the bark is used orally or topically, due to its juglone content (12). When applied topically, juglone-containing bark can cause skin irritation. When used orally on a daily basis, juglone-containing bark is associated with increased risk of tongue cancer and lip leukoplakia (2,12). There is insufficient reliable information available about the safety of the fruit, leaf, or hull when used orally in medicinal amounts or when applied topically.
PREGNANCY AND LACTATION: LIKELY SAFE
when the fruit (nut), leaf, or hull is consumed in amounts normally found in foods (4912).
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when the bark is used orally or topically (12); avoid using.
There is insufficient reliable information available about the safety of the fruit, leaf, or hull when used orally in medicinal amounts during pregnancy and lactation; avoid using.
POSSIBLY SAFE ...when used orally and appropriately, short-term. A specific product containing Monterey pine bark extract (Enzogenol, ENZO Nutraceuticals) has been used with apparent safety at a dose of 1000 mg daily for up to 12 weeks (63614,63618,63620,105777) or 480 mg daily for up to 6 months (105778). There is insufficient reliable information available about the safety of Monterey pine when used topically.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY UNSAFE ...when the root or rhizome is used orally. Nerve root may cause hallucinations (4). There is insufficient reliable information available about the safety of nerve root when used topically.
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally (4); avoid using.
LIKELY UNSAFE ...when used orally. Star of Bethlehem contains toxic cardiac glycosides (15330,15331,15332,15333). Ingestion of star of Bethlehem could result in serious adverse effects including cardiac arrhythmia and death.
PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally.
Star of Bethlehem contains toxic cardiac glycosides (15330,15331,15332,15333). Ingestion of star of Bethlehem could result in serious adverse effects.
POSSIBLY UNSAFE ...when used orally. Theoretically, the constituent bicuculline, an antagonist of gamma-aminobutyric acid (GABA), could cause poisoning (18).
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally (18); avoid using.
LIKELY UNSAFE ...when the bark, seeds or berries are used orally. Ingesting 36 berries can be fatal (18). The poisonous principle has not been identified (17).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally (18).
Below is general information about the interactions of the known ingredients contained in the product Grief Relief EFR. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
 Details
In healthy individuals, borage seed oil supplementation does not seem to affect platelet aggregation (36823). However, gamma-linolenic acid, a constituent of borage seed oil, seems to decrease platelet aggregation by 45% and increase the risk of bleeding by 40% in animal and clinical research (1979).
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Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.
Details
Although borage seed oil contains little to no PAs, some borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Hepatotoxic PAs are substrates of CYP3A4, which converts these chemicals into toxic metabolites (12841,12860). Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.
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Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Details
Borage seed oil contains gamma-linolenic acid (GLA). There is concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. This is based on limited data from two reports published in the 1980s. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with evening primrose, another source of GLA. However, none experienced an actual seizure (21013). In the other report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily was added. One of these patients had a prior history of seizures (21010). It is unclear whether evening primrose had any additive epileptogenic effects with the phenothiazines, but there is no evidence that taking GLA-containing supplements alone can cause seizures (88187).
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Theoretically, honeysuckle might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Details
In vitro research shows that polyphenols extracted from honeysuckle can inhibit platelet aggregation (12610).
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Theoretically, taking star of Bethlehem with prolonged corticosteroid therapy might increase the risk of toxicity.
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Theoretically, taking star of Bethlehem in combination with digoxin might have additive effects and increase the risk of toxicity.
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Theoretically, taking diuretics with star of Bethlehem might increase the risk of toxicity.
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Theoretically, taking macrolide antibiotics with star of Bethlehem might increase the risk of cardiac glycoside toxicity.
Details
Star of Bethlehem contains cardiac glycosides (15330,15331). Macrolide antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of macrolide antibiotics might increase the absorption of the cardiac glycosides found in star of Bethlehem and increase the risk of adverse effects (17).
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Theoretically, taking quinine with star of Bethlehem might increase the risk of cardiac glycoside toxicity.
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Theoretically, excessive use of stimulant laxatives with star of Bethlehem might increase the risk of toxicity.
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Theoretically, taking tetracycline antibiotics with star of Bethlehem might increase the risk of cardiac glycoside toxicity.
Details
Star of Bethlehem contains cardiac glycosides similar to digitalis (15330,15331). Tetracycline antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of tetracycline antibiotics might increase the absorption of the cardiac glycosides found in star of Bethlehem and increase the risk of adverse effects (17).
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Theoretically, turkey corn might reduce excretion and increase levels of lithium due to potential diuretic effects.
Details
Turkey corn is thought to have diuretic properties (18). However, this has not been reported in humans.
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Contraindicated; using wahoo with digoxin increases risk of cardiac glycoside toxicity due to therapeutic duplication (2).
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Theoretically, concomitant use of potassium-depleting diuretics with wahoo can increase the risk of cardiac glycoside toxicity due to potassium depletion (506). Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
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Theoretically, concomitant use may increase risk of cardiac glycoside toxicity (17).
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Theoretically, concomitant use of quinine and wahoo might increase risk of cardiac toxicity (506).
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Theoretically, use of stimulant laxatives with wahoo might have additive laxative effects, and can increase the risk of cardiac glycoside toxicity due to potassium depletion (2).
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Theoretically, concomitant use may increase risk of cardiac glycoside toxicity (17).
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Below is general information about the adverse effects of the known ingredients contained in the product Grief Relief EFR. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, black walnut fruit (nut) is well tolerated.
However, the leaf, bark, and hull of black walnut contain high quantities of tannins, which may cause adverse effects when used orally or topically.
Most Common Adverse Effects:
Orally: The leaf, bark, and hull can cause gastrointestinal upset.
Topically: Hull preparations may cause a temporary yellow or brown discoloration at the site of application. The leaf, bark, and hull can cause skin irritation.
Serious Adverse Effects (Rare):
Orally: The bark may increase the risk for tongue cancer or lip leukoplakia when used long-term.
All routes of administration: Allergic reactions, including anaphylaxis.
Dermatologic ...Topically, black walnut leaf, bark, or hull may have an irritating effect on the skin due to tannin content. Black walnut hull preparations might cause a temporary yellow or brown discoloration of the skin at the site of application (12).
Gastrointestinal ...Orally, black walnut leaf, bark, or hull may cause gastrointestinal upset due to tannin content (12). Also, daily use of the juglone-containing bark of a related species (English walnut) is associated with increased risk of tongue cancer and lip leukoplakia (2,12).
Hepatic ...Orally, black walnut leaf, bark, or hull may cause liver damage if taken for extended periods of time due to tannin content (12).
Immunologic ...Tree nuts, which include black walnuts, can cause allergic reactions in sensitive individuals. Due to the prevalence of this allergy in the general population, tree nuts are classified as a major food allergen in the United States (105410).
Renal ...Orally, black walnut leaf, bark, or hull may cause kidney damage if taken for extended periods of time due to tannin content (12).
General ...Blackberry fruit is commonly consumed as a food without reports of adverse effects. However, a thorough evaluation of safety outcomes for blackberry when used as a medicine has not been conducted.
General
...Orally, borage seed oil seems to be well tolerated.
However, borage plant parts, such as the leaf, flower, and seed, that contain hepatotoxic pyrrolizidine alkaloid (PA) constituents should be avoided.
Most Common Adverse Effects:
Orally: Belching, bloating, diarrhea, and soft stools.
Serious Adverse Effects (Rare):
Orally: Borage plant parts that contain PA constituents can be hepatotoxic.
Gastrointestinal ...Orally, borage seed oil can cause soft stools, diarrhea, belching, and bloating (8013,11341).
Hepatic ...The pyrrolizidine alkaloid (PA) constituents of borage can cause significant hepatotoxicity (12841,12842). PAs can occur in borage leaf, flower, and seed; borage seed oil contains little to no PAs. Chronic exposure to other plants containing hepatotoxic PA constituents has been associated with veno-occlusive disease (VOD). Subacute VOD causes vague symptoms with persistent liver enlargement (4021). Symptoms of acute VOD include colicky pains in epigastrium, vomiting and diarrhea, and ascites within several days. Enlargement and induration of the liver occurs within a few weeks (12842).
Oncologic ...The pyrrolizidine alkaloid (PA) constituents of borage are potentially carcinogenic and mutagenic (12841,12842).
Pulmonary/Respiratory ...The pyrrolizidine alkaloid (PA) constituents of borage are potentially pneumotoxic (12841,12842).
General
...Orally, the fruit (nut) of English walnut is well tolerated (8476,8477); however, it can cause softening of stools and mild bloating (6431).
Oral allergy syndrome may occur in people who are allergic to English walnuts. This is characterized by itching of the oral cavity immediately after consumption. Rarely this syndrome may cause swelling of the lips and tongue (angioedema) (8479). English walnut leaf extract has been reported to cause gastrointestinal adverse events, especially mild diarrhea (97750). Daily use of English walnut bark is associated with increased risk of tongue cancer and lip leukoplakia due to its juglone content (2,12).
Topically, English walnut hull preparations can lead to yellow or brown discoloration of skin and mucous membranes due to its juglone content. It can also cause contact dermatitis (12,12980).
Dermatologic ...Topically, English walnut hull preparations, which contain juglone, can cause a temporary yellow or brown discoloration of skin and mucous membranes. It can also cause contact dermatitis (12,12980).
Gastrointestinal ...Orally, the fruit (nut) of English walnut might cause softening of stools and mild bloating (6431). Oral allergy syndrome may occur in people who are allergic to English walnuts. This is characterized by itching of the oral cavity immediately after consumption. Rarely this syndrome may cause swelling of the lips and tongue (angioedema) (8479). Walnut leaf extract has been reported to cause gastrointestinal adverse events, especially mild diarrhea, in 39% of adults in one study (97750). Daily use of walnut bark is associated with increased risk of tongue cancer and lip leukoplakia due to its juglone content (2,12).
Immunologic
...Tree nuts, which include English walnuts, can cause allergic reactions in sensitive individuals.
Due to the prevalence of this allergy in the general population, tree nuts are classified as a major food allergen in the United States (105410).
Oral allergy syndrome may occur in people who are allergic to English walnuts. This is characterized by itching of the oral cavity immediately after consumption. Rarely this syndrome may cause swelling of the lips and tongue (angioedema) (8479).
General ...Orally, honeysuckle seems to be well tolerated. No adverse effects have been reported. There is insufficient reliable information available about the safety of honeysuckle when used topically. However, a thorough evaluation of safety outcomes has not been conducted.
Immunologic ...Topically, applying honeysuckle to the skin has been associated with contact dermatitis in a case report (12611). Orally, a case of biopsy-confirmed allergic drug eruption is reported in a young adult male after taking honeysuckle granules 30 grams over a 24-hour period. Symptoms resolved with discontinuation of honeysuckle and 2-weeks of antihistamine and glucocorticoid therapy (112866).
General ...Orally, Monterey pine seems to be well tolerated. Topically, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.
Dermatologic ...Contact dermatitis from Monterey pine sawdust has been reported (63615).
Immunologic ...Monterey pine pollen may cause seasonal rhinoconjunctivitis (63612).
General ...There is currently a limited amount of information on the adverse effects of nerve root. Orally, nerve root may cause hallucinations, giddiness, restlessness, headache, and mental excitement, particularly when taken in large doses. Topically, nerve root may cause contact dermatitis (4).
Dermatologic ...Topically, nerve root may cause contact dermatitis (4).
Neurologic/CNS ...Orally, nerve root may cause giddiness, restlessness, headache, and mental excitement, particularly when taken in large doses (4).
Psychiatric ...Orally, nerve root may cause hallucinations when taken in large doses (4).
General
...Star of Bethlehem contains cardiac glycosides, which can cause serious adverse effects.
Serious Adverse Effects (Rare):
Orally: Star of Bethlehem contains toxic cardiac glycosides that can cause cardiac arrhythmia and death.
Cardiovascular ...Orally, the cardiac glycosides in star of Bethlehem can cause cardiac arrhythmias (2).
Gastrointestinal ...Orally, the cardiac glycosides in star of Bethlehem can cause nausea and vomiting (2).
Neurologic/CNS ...Orally, the cardiac glycosides in star of Bethlehem can cause headache and stupor (18). Visual color disturbances can also occur (18).
General ...No adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.
General ...Wahoo is considered poisonous (17). Several hours after ingesting wahoo seeds, people experience severe upset stomach, sometimes with bloody diarrhea, fever, shortness of breath, circulatory problems, signs of collapse, stupor increasing to unconsciousness, alternating with motor restlessness, severe tonic-clonic spasms with locked jaw muscles and coma.
