Argentum metallicum 12 X • Boldo 4 X • Dulcamara 4 X • Jateorhiza palmata 4 X • Rhamnus Fragula 4 X • Rumex Crispus 4 X • Scabiosa succisa 4 X • Valeriana officinalis 4 X. Other Ingredients: Ethanol, Purified Water.
Brand name products often contain multiple ingredients. To read detailed information about each ingredient, click on the link for the individual ingredient shown above.
In 2004, Canada began regulating natural medicines as a category of products separate from foods or drugs. These products are officially recognized as "Natural Health Products." These products include vitamins, minerals, herbal preparations, homeopathic products, probiotics, fatty acids, amino acids, and other naturally derived supplements.
In order to be marketed in Canada, natural health products must be licensed. In order to be licensed in Canada, manufacturers must submit applications to Health Canada including information about uses, formulation, dosing, safety, and efficacy.
Products can be licensed based on several criteria. Some products are licensed based on historical or traditional uses. For example, if an herbal product has a history of traditional use, then that product may be acceptable for licensure. In this case, no reliable scientific evidence is required for approval.
For products with non-traditional uses, some level of scientific evidence may be required to support claimed uses. However, a high level of evidence is not necessarily required. Acceptable sources of evidence include at least one well-designed, randomized, controlled trial; well-designed, non-randomized trials; cohort and case control studies; or expert opinion reports.
Finished products licensed by Health Canada must be manufactured according to Good Manufacturing Practices (GMPs) as outlined by Health Canada.
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 Unda 17. 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
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of calumba.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of premorse.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of yellow dock.
Below is general information about the safety of the known ingredients contained in the product Unda 17. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
POSSIBLY SAFE ...when the stem is used orally or topically and appropriately (2,18).
LIKELY UNSAFE ...when the leaves or berries are used orally. The plant contains the toxic compounds solanine, solanidine, and dulcamarin (6).
CHILDREN: LIKELY UNSAFE
when used orally; unripe berries have caused poisonings.
A lethal dose is estimated to be 200 berries (18). There is insufficient reliable information available about the safety of bittersweet nightshade when used topically in children; avoid using.
PREGNANCY: LIKELY UNSAFE
when used orally.
The alkaloids of the plant, solasodine, soladulcine, and related compounds have been linked to birth defects in animals (6); avoid using. There is insufficient reliable information available about the safety of bittersweet nightshade when used topically during pregnancy; avoid using.
LACTATION: LIKELY UNSAFE
when orally; avoid using.
There is insufficient reliable information available about the safety of bittersweet nightshade when used topically; avoid using.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Boldo has Generally Recognized As Safe (GRAS) status for use in foods in the US (4912).
POSSIBLY UNSAFE ...when used orally in medicinal amounts. The volatile oil (2.5% in the leaf) contains the liver toxin ascaridole (4). Boldo has also been linked to a documented case of liver damage (13178). If boldo preparations are taken for medicinal purposes, only ascaridole-free preparations should be used. There is insufficient reliable information available about the safety of boldo when used topically.
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally in medicinal amounts.
In animals, boldo and the constituent boldine have abortive and teratogenic effects (100302). Also, the ascaridole constituent of boldo is a liver toxin (4).
There is insufficient reliable information available about the safety of calumba.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY UNSAFE ...when used orally, topically, or intravenously. Total daily silver intake should not exceed 14 mcg/kg daily, or 980 mcg daily for a 70 kg person. Combining colloidal silver supplements with regular dietary intake of silver would likely result in exceeding this amount of silver. Silver accumulates in the body and can lead to an irreversible bluish skin discoloration known as argyria. Additionally, diffuse silver deposition in visceral organs has been reported, and toxic effects on the neurological, hematopoietic, hepatic, and cardiovascular systems can occur. (5525,8148,8149,10647,10648,12092,92137,92138,92139,102575)(115303). In 1999, the US Food and Drug Administration (FDA) ruled that there is no evidence for the safety or effectiveness of colloidal silver products (14255,92137).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally, topically, or intravenously.
Silver appears to cross the placenta (92140). Epidemiological evidence links increased silver levels to developmental anomalies of the ear, face, and neck (5525). Colloidal silver supplements can also lead to silver accumulation and an irreversible bluish skin discoloration known as argyria. Neurological deficits and diffuse silver deposition in visceral organs can also occur (5525,5526,8148,8149,10647,10648,12092,92137,92138,92139).
There is insufficient reliable information available about the safety of premorse.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally and appropriately, short-term. Valerian 300-600 mg daily has been safely used in clinical studies in over 12,000 patients for up to 6 weeks (2074,3484,3485,4032,15018,17577,17578,19409,96242,103221)(104010,105718). There is insufficient reliable information available about the safety of valerian when used orally for longer than 6 weeks.
CHILDREN: POSSIBLY SAFE
when used orally and appropriately, short-term.
Valerian 160-320 mg has been used with apparent safety in children under 12 years of age for 4-8 weeks (14416).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when properly prepared and consumed in amounts commonly found in foods. Young leaves must be boiled to remove the oxalate content; death has occurred after consuming uncooked leaves (6,18).
POSSIBLY UNSAFE ...when the uncooked leaves are consumed. Young leaves must be boiled to remove the oxalate content; death has occurred after consuming uncooked leaves (6,18). There is insufficient reliable information available about the safety of properly prepared yellow dock when used orally in medicinal amounts.
PREGNANCY: POSSIBLY UNSAFE
when used orally; avoid using.
Yellow dock contains anthraquinone glycosides; unstandardized laxatives are not desirable during pregnancy (4).
LACTATION: POSSIBLY UNSAFE
when used orally; avoid using.
Anthraquinones are secreted into breast milk (4,5).
Below is general information about the interactions of the known ingredients contained in the product Unda 17. 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, taking boldo with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
 Details
Animal and in vitro research shows that boldine, a constituent of boldo, has antiplatelet activity (5191,36789). In one case report, an adult taking a combination of boldo and fenugreek with warfarin experienced an increase in international normalized ratio (INR); however, it is unclear if this effect was due to boldo, fenugreek, the combination, or another factor (5191).
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Theoretically, taking boldo with hepatotoxic drugs might increase the risk of hepatic injury and disease.
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Theoretically, taking boldo with lithium might increase the levels and clinical effects of lithium.
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Boldo is believed to have diuretic effects (4). Theoretically, these diuretic effects might reduce the excretion of lithium. The dose of lithium might need to be decreased.
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Taking boldo with tacrolimus may decrease the levels and clinical effects of tacrolimus, potentially increasing the risk of transplant rejection.
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In one case report, a patient with a long-term history of stable tacrolimus levels developed subtherapeutic levels after taking boldo 300 mg twice daily orally for several weeks. Tacrolimus levels returned to normal after discontinuing boldo. However, the mechanism of this interaction is unclear (92601).
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Theoretically, calumba might decrease the effectiveness of antacids.
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There are reports that calumba increases stomach acid (19).
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Theoretically, calumba might decrease the effectiveness of H2-blockers.
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There are reports that calumba increases stomach acid (19).
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Theoretically, calumba might decrease the effectiveness of H2-blockers.
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There are reports that calumba increases stomach acid (19).
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Valerian can have additive sedative effects when used concomitantly with alcohol.
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Valerian has sedative effects (9894). Theoretically, valerian might have an additive sedative effect when combined with alcohol. Excessive sedation has been reported in an alcohol-abusing individual who took valerian and Gingko biloba (19426). However, the potential interaction between valerian and alcohol has been disputed in other research. Limited evidence suggests that a combination of valerian 160 mg and lemon balm 80 mg (Euvegal) does not cause further deterioration in reaction ability and reaction rate when taken with alcohol as compared to the effects of alcohol alone (19427).
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Valerian can have additive sedative effects when used with alprazolam. Also, valerian in high doses might modestly increase alprazolam levels, though this is not likely to be clinically significant.
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Valerian has sedative effects (9894). Theoretically, valerian might cause additive sedation when combined with alprazolam. Also, a small pharmacokinetic study shows that taking valerian extract 1000 mg daily (providing 11 mg valerenic acid) might increase alprazolam levels by about 19%. This might be due to valerian's mild inhibition of cytochrome P450 3A4 (CYP3A4) (13014). Despite being statistically significant, this increase is not likely to be clinically significant.
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Valerian can have additive sedative effects when used concomitantly with CNS depressant drugs.
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Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP2D6.
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Although some in vitro evidence suggests that valerian affects CYP2D6, clinical pharmacokinetic (PK) studies show that valerian is unlikely to affect the CYP2D6 enzyme (13014,13536,19430,19431). In one PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days did not affect the metabolism of dextromethorphan, a CYP2D6 substrate. In another PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of debrisoquine, an accepted CYP2D6 probe-substrate (13014,13536).
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Valerian does not seem to have a clinically relevant effect on levels of drugs metabolized by CYP3A4.
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Although some in vitro evidence suggests that valerian extract might inhibit or induce CYP3A4, clinical pharmacokinetic (PK) studies show that valerian does not have a clinically significant effect on the CYP3A4 enzyme (6450,12214,13014,13536,19431). In one PK study, taking valerian 125 mg three times daily for 28 days did not affect metabolism of midazolam, an accepted CYP3A4 probe-substrate. In another PK study, taking valerian 1000 mg (providing about 11 mg valerenic acid) nightly for 14 days modestly increases levels of alprazolam, a CYP3A4 substrate, suggesting mild inhibition of CYP3A4 (13014,13536). However, this mild inhibition is unlikely to be clinically relevant.
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Valerian might weakly inhibit glucuronidation and increase concentrations of drugs metabolized by UGT1A1 and UGT2B7.
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In vitro research shows that methanolic valerian extract and valerenic acid might competitively inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1) and UGT2B7 (81685).
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Theoretically, yellow dock might increase the risk of digoxin toxicity when used long-term or in large amount.
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Theoretically, yellow dock might increase the risk of hypokalemia when taken with diuretics.
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Theoretically, the laxative effects of yellow dock might increase the effects of warfarin, including the risk of bleeding.
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Below is general information about the adverse effects of the known ingredients contained in the product Unda 17. 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
...When used orally, the leaves and berries of bittersweet nightshade may be unsafe.
There is limited information available about the adverse effects of the stem of bittersweet nightshade when used in medicinal amounts.
Serious Adverse Effects (Rare):
Orally: The leaves and berries can cause toxicity, including circulatory and respiratory depression, convulsions, cyanosis, diarrhea, dilated pupils, gastrointestinal bleeding, headache, scratchy throat, speech difficulties, subnormal temperature, vertigo, vomiting, and even death.
Cardiovascular ...Orally, bittersweet nightshade leaf and berry can cause circulatory depression (6).
Gastrointestinal ...Orally, bittersweet nightshade leaf and berry can cause diarrhea, gastrointestinal bleeding, scratchy throat, vomiting and (6).
Neurologic/CNS ...Orally, bittersweet nightshade leaf and berry can cause convulsions, headache, speech difficulties, subnormal temperature, and vertigo (6).
Ocular/Otic ...Orally, bittersweet nightshade leaf and berry can cause dilated pupils (6).
Pulmonary/Respiratory ...Orally, bittersweet nightshade leaf and berry can cause cyanosis and respiratory depression (6).
General
...Orally, boldo is generally well tolerated when used in amounts commonly found in foods.
However, when used in medicinal amounts, boldo can cause significant adverse effects such as hepatotoxicity. There is currently a limited amount of information on the adverse effects of topical boldo; however, a thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Abdominal pain, nausea, vomiting.
Topically: Dermatitis.
Severe Adverse Effects (Rare):
Orally: Hepatotoxicity, jaundice.
Cardiovascular ...In one report, a 39-year-old obese female developed palpitations and syncope after taking a weight loss supplement containing a combination of boldo, dandelion, and bladderwrack for 3 weeks. The patient was found to have prolonged QT-interval on ECG and frequent episodes of sustained polymorphic ventricular tachycardia (14321). It is not clear whether boldo, another ingredient, or the combination of ingredients is responsible for this adverse effect. The product was not analyzed to determine the presence of any potential toxic contaminants.
Dermatologic ...Topically, boldo can be irritating when applied to the skin (4). In one case report, a healthy 64-year-old patient experienced allergic contact dermatitis in an airborne pattern on the face, arms, and dorsum of both hands following airborne exposure to boldo. After exposure to boldo was avoided, the dermatitis resolved (106433).
Gastrointestinal ...In one case report, a manufacturer of an herbal laxative reformulated their product to contain boldo. Within 5 months of switching to this reformulated product, an 82-year-old male developed abdominal discomfort with gastrointestinal upset including heartburn (13178). In another case, a 72-year-old female reported nausea, vomiting, and anorexia, which were thought to be associated with hepatotoxic effects of a boldo infusion (100304).
Hepatic ...Orally, boldo is thought to potentially cause hepatotoxicity. The volatile oil from the boldo leaf contains the liver toxin, ascaridole. In one case report, a manufacturer of an herbal laxative reformulated their product to contain boldo. Within 5 months of switching to this reformulated product, an 82-year-old male with mild hepatic steatosis and very small gallbladder stones developed elevated liver transaminase levels. Levels normalized following discontinuation of the herbal product (13178). Several other cases of hepatotoxicity have been reported in elderly patients who received infusions of boldo leaves. These patients presented with elevated liver transaminase and bilirubin levels, sometimes up to 200 times the upper limit of normal, as well as nausea, vomiting, anorexia, asthenia, and jaundice. Lab tests and symptoms normalized a few days after stopping boldo (100304,106431).
Immunologic ...Boldo intake has been linked to one case of IgE-mediated anaphylactic allergic reaction (13185).
General ...There is limited information available about the adverse effects of calumba when used in medicinal amounts.
Gastrointestinal ...Orally, large doses of calumba may cause vomiting and epigastric pain (18).
General
...Orally, topically, or via inhalation, colloidal silver can cause serious adverse effects.
Most Common Adverse Effects:
All routes of administration: An irreversible deposition of silver in the skin and mucous membranes with chronic use or high doses can cause a grey-blue discoloration known as argyria. Colloidal silver has also been associated with vision loss and organ damage.
Dermatologic ...Orally, topically, or via inhalation, long-term use of colloidal silver can lead to an irreversible deposition of silver compounds in the mucous membranes, skin, and nails. This condition, which is known as argyria, has been described in numerous case reports (5525,8148,8149,10647,10648,12092,44474,44493,44498,44501)(44514,44523,44528,44538,44540,44547,44593,44638,44649,44726)(44788,44825,44815,92137,92138,92139,96760,102571,102572,102573)(102575,112289). Argyria is characterized by a blueish-gray discoloration which occurs when the silver compounds from colloidal silver are reduced to elemental silver (44474,92139). Since sunlight catalyzes the reduction of silver compounds to elemental silver, sun exposed regions are usually most affected (92138,92139). The blueish-gray discoloration also occurs because colloidal silver can stimulate melanin production in skin (92139). Argyria typically first appears in the gingiva with a slate-blue silver line (5525). It can also occur in the fingernails, where it may be an early sign of silver ingestion and is also known as azure lunula (8149,10648,112289). Argyria usually occurs after ingestion of 4-5 grams of colloidal silver (92138). Although the blueish-gray discoloration associated with argyria is permanent, laser treatment may be used to lighten the skin (92139).
Hematologic ...Orally and intravenously, hematologic effects have been reported. .In one case, a 30‐year‐old female experienced severe anemia and leukopenia with elevated serum ferritin after receiving 48 infusions with a specific colloidal silver marketed for oral use (Argentyn 23). The infusions provided silver 883 mg and were administered over 3 months. The patient was treated for anemia with oral copper, as well as four apheresis treatments. Similar symptoms occurred in other females who were treated with oral copper and repeated blood transfusions (102570). In another case, severe anemia and thrombocytopenia were reported in an older, healthy female following oral ingestion of 150 mcg of colloidal silver daily for 14-21 days. Treatment required hospitalization, blood transfusions, fluids, and intramuscular vitamin B12 (115303). The anemia associated with colloidal silver is related to a decline in serum levels of copper, which is needed for the production of hemoglobin (102570).
Hepatic ...Orally and intravenously, hepatotoxicity has been reported. A 64-year-old male experienced cholelithiasis with acute encephalopathy after repeated oral dosing with colloidal silver providing 2838 ppm of silver over 4 hours (102572). In another case, an older, healthy female had abnormal liver tests, including elevated total bilirubin, aspartate aminotransferase (AST), and lactate dehydrogenase after ingesting 150 mcg of colloidal silver daily for 2 to 3 weeks (115303). Intravenously, elevated liver enzymes, up to 150 times normal, have been reported in a 30‐year‐old female who received 48 infusions with a specific colloidal silver marketed for oral use (Argentyn 23) providing silver 883 mg over 3 months (102570).
Neurologic/CNS ...At least two cases of myoclonic seizures have been reported after the use of homemade colloidal silver preparations (44485,44649). In one case, myoclonic status epilepticus and coma occurred secondary to consumption of a homemade colloidal silver drink (Schaffer's Health Center Ltd., Unity). The patient had consumed at least one ounce daily for 4 months. The seizures did not respond to benzodiazepines, valproate, phenytoin, phenobarbital, or propofol. The patient required mechanical ventilation and remained in a coma in the intensive care unit for 50 days (44485). In another case, myoclonic seizures and aspiration pneumonia occurred in a 75-year-old male who ingested "several spoons" of homemade colloidal silver up to 4 times daily whenever he "felt a cold coming on" for 4 years. The seizures were treated with clonazepam, and after being hospitalized for 2 months, he was discharged to a nursing home (44649). A more recent case report describes a 70-year-old male hospitalized after exhibiting expressive aphasia, focal seizure followed by generalized seizure, hypertension, encephalopathy, and an abnormal electroencephalogram. The patient had been self-medicating with colloidal silver 1 ounce daily, and blood tests revealed silver levels nearly 16 times that of normal. Extensive tests could not identify any other probable cause other than the silver use. The patient recovered and was discharged on levetiracetam, which was well tolerated at 2 months follow-up. The colloidal silver was a home-made electrolysis preparation using direct current, silver anodes, and steam distilled water (112290).
Ocular/Otic ...Chronic ingestion or inhalation of colloidal silver may cause silver deposition in the eye. This condition is known as ocular argyrosis, which is characterized by a blueish-gray discoloration of the eye (44514,102571). In one case report, chronic use of oral colloidal silver over 9 years resulted in a 2-week history of loss of vision in one eye (102571). Topically, use of eye drops containing colloidal silver can also cause this condition (44821). In one report, a case of ocular argyrosis reportedly occurred in a patient with long-standing herpetic keratitis after only one treatment with eye drops consisting of a 1% solution of colloidal silver (44822).
Oncologic ...Orally, chronic intake of colloidal silver over a 10-year period may have caused bone marrow damage, possibly contributing to the diagnosis of acute myeloid leukemia in a 72-year-old male. The patient died of respiratory failure related to recurrent pneumonia (102574).
Renal ...Orally, glomerulonephritis has been reported in a 47-year-old female who took colloidal silver to treat her T-cell lymphoma. She was treated with hemodialysis, intravenous methylprednisolone, and intravenous cyclophosphamide (102575).
...None reported.
General
...Orally, valerian is generally well-tolerated.
Most Common Adverse Effects:
Orally: Dizziness, drowsiness, and mental slowness. Other reported side effects include headache, gastrointestinal upset, excitability, and vivid dreams. When used chronically and abruptly stopped, symptoms of withdrawal such as tachycardia, anxiety, irritability, and insomnia might occur. Advise patients to taper doses slowly after extended use.
Serious Adverse Effects (Rare):
Orally: Several case reports raise concerns about hepatotoxicity after the use of valerian and valerian-containing multi-ingredient dietary supplements. Withdrawal from chronic valerian use has been associated with cases of cardiac failure and hallucinations.
Cardiovascular ...When used orally in high doses for an extended period of time, valerian withdrawal has been associated with tachycardia and high output cardiac failure in one patient with a history of coronary artery disease (3487). Chest tightness has been reported for an 18-year-old female who took 40-50 capsules containing valerian 470 mg/capsule (659). A case of severe hypotension, suspected to be due to vasodilation, hypocalcemia, and hypokalemia, has been reported for a patient who injected an unknown quantity of a crude tap water extract of raw valerian root (81734).
Dermatologic ...Orally, valerian might rarely cause a rash. A case of valerian-related rash that resolved after valerian root discontinuation was reported in clinical research (19422).
Gastrointestinal ...Orally, valerian has been associated with increased incidence of gastrointestinal problems including diarrhea, nausea, vomiting, and stomach pain (15046,19406,19407,19422,110712). In one individual, taking 20 times the normal dose caused abdominal cramping (659).
Hepatic
...There have been several case reports of hepatotoxicity associated with the use of multi-ingredient oral preparations containing valerian (8243,96241).
In one case report, a 57-year-old man presented with acute hepatitis after consuming a cold and flu remedy containing valerian 2 grams for 3 days; the remedy also contained white willow, elderberry, and horseradish. Although the use of the cold and flu remedy was discontinued one month prior to symptom presentation, the acute hepatitis was attributed to valerian root and treated with steroids (96241). It is possible, however, that some of these preparations may have been adulterated with hepatotoxic agents (8243).
Hepatotoxicity involving long-term use of single-ingredient valerian preparations has also been reported (3484,17578). Also, a case of a 38-year-old female with liver insufficiency and cirrhosis of a vascular parenchymal nature who developed hepatotoxic symptoms following valerian and ethyl-alcohol abuse has been reported (81697). Symptoms resolved and laboratory values normalized following intense plasmapheresis treatment. Another case of acute hepatitis characterized by elevated aminotransferases, mild fibrosis, and liver inflammation has been reported for a 50-year-old female who consumed valerian root extract 5 mL three times weekly along with 10 tablets of viamine, a product containing dry valerian extract 125 mg/tablet, for 2 months (81696). Because a variety of doses were used in these cases, and many people have used higher doses safely, these hepatotoxic reactions might have been idiosyncratic. Tell patients the long-term effect of valerian on liver function is unknown.
Musculoskeletal ...In a case report, combined intake of valerian and passionflower caused throbbing and muscular fatigue when taken concomitantly with lorazepam (19429).
Neurologic/CNS ...Orally, valerian might cause dizziness, headaches, fatigue, sleepiness, and mental dullness (3484,17578,19411,19422,81723,89407). The severity of adverse effects appears to increase with higher doses (19411). However, taking valerian extracts in doses up to 1800 mg does not appear to significantly affect mood or psychomotor performance (10424,15044). Valerian does not usually have a negative impact on reaction time, alertness, and concentration the morning after intake (2074,8296). Clinical research shows that a single dose of valerian root 1600 mg is not associated with any changes in sleepiness, reaction time, or driving performance within 1-4 hours after intake (96240). More serious side effects may occur when valerian is taken at higher doses. In one individual, 20 times the normal dose caused tremor of the hand and foot and lightheadedness (659). In a case report, combined intake of valerian and passionflower caused shaking of the hands and dizziness when taken concomitantly with lorazepam (19429).
Psychiatric ...Orally, valerian has been associate with reports of restlessness, excitability, uneasiness, agitation, and vivid dreams (3484,17578,19411,19422). Chronic use and rapid cessation can lead to withdrawal syndrome with symptoms of agitation, insomnia, and hallucinations (104003). There appears to be a trend towards increased severity of adverse effects with higher doses (19411). A case of acute hypomania has been reported for a 21-year-old female patient who took a valerian decoction in water each night for one month to treat subclinical anxiety. Symptoms included euphoric mood, rapid speech, and increased sociability and sexual interest. Following cessation of valerian use and treatment with quetiapine 100 mg daily for two weeks, the patient recovered (89405). In another case report, an 85-year-old male with mild cognitive impairment, major depression, anxiety, and chronic kidney disease presented to the emergency department with hallucinations, confusion, and agitation thought to be due to abrupt cessation after taking valerian 600 mg daily for about 6 months. The symptoms resolved in about 5 days (104003).
General
...Orally, yellow dock seems to be well tolerated when properly prepared and consumed in food amounts.
Consuming raw yellow dock leaves or rhizomes may be unsafe.
Serious Adverse Effects (Rare):
Orally: Raw leaves or rhizomes can cause hypocalcemia, kidney stones, and vomiting.
Cardiovascular ...Orally, yellow dock has been linked to ventricular fibrillation and death after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the blood vessels and heart (12). Older or uncooked leaves should be avoided (6).
Dermatologic ...Orally, yellow dock can cause dermatitis when consumed in large amounts (4). Topically, contact with the plant may cause dermatitis in people sensitive to yellow dock (6).
Gastrointestinal ...Orally, vomiting may occur after ingestion of fresh rhizome (18). Consuming excessive amounts can cause diarrhea and nausea (6). Excessive use can also cause abdominal cramps and intestinal atrophy (4). There is one report of a death, preceded by vomiting and diarrhea, after ingestion of 500 grams of yellow dock (17). Older or uncooked leaves should be avoided (6).
Genitourinary ...Orally, yellow dock can cause polyuria when consumed in large amounts (6).
Hematologic ...Orally, in one case report, a 38-year-old female developed immune-mediated thrombocytopenia after consuming a "cleansing" tea containing unknown amounts of yellow dock and burdock. The patient presented with bruising, mild weakness, and fatigue, which started 2-3 days after consuming the tea, and was found to have a platelet count of 5,000 per mcL. Symptoms resolved after platelet transfusion and treatment with oral dexamethasone (108971). It is unclear if these effects were caused by yellow dock, burdock, the combination, or other contributing factors.
Hepatic ...Orally, yellow dock has been linked to liver failure and death after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the liver (12). Older or uncooked leaves should be avoided (6).
Neurologic/CNS ...Orally, yellow dock has been linked to coma and death after ingestion of 500 grams (17). Older or uncooked leaves should be avoided (6).
Pulmonary/Respiratory ...Orally, yellow dock has been linked to respiratory depression and death after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the lungs (12). Older or uncooked leaves should be avoided (6).
Renal ...Orally, yellow dock can cause polyuria when consumed in large amounts (6). There is one report of a death, preceded by kidney failure, after ingestion of 500 grams (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the kidneys. Individuals with a history of kidney stones should use yellow dock cautiously (12). Older or uncooked leaves should be avoided (6).
Other ...Orally, yellow dock can cause hypokalemia when taken in large amounts (4). There is one report of a death, preceded by severe metabolic acidosis, after ingestion of 500 grams of yellow dock (17). Oxalic acid, a constituent of yellow dock, reacts with calcium in plasma, forming insoluble calcium oxalate, which can cause hypocalcemia; the crystals may precipitate in the kidneys, blood vessels, heart, lungs, and liver (12). Older or uncooked leaves should be avoided (6).
