Slim Trim U by Floyd Nutrition

POSSIBLY INEFFECTIVE

• Athletic performance. Small clinical studies suggest that oral bee pollen may not improve athletic performance. Details: Clinical research in athletes shows that taking bee pollen supplements orally does not seem to improve athletic performance or stamina (7062,7063,33973).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. Although there has been interest in using oral bee pollen for aging, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Allergic rhinitis (hay fever). Although there has been interest in using oral bee pollen for allergic rhinitis (hay fever), there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Amenorrhea. Although there has been interest in using oral bee pollen for amenorrhea, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Atopic dermatitis (eczema). Although there has been interest in using topical bee pollen for atopic dermatitis (eczema), there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Benign prostatic hyperplasia (BPH). Although there has been interest in using oral bee pollen for BPH, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Bleeding. Although there has been interest in using oral bee pollen for bleeding, including intracranial hemorrhage, there is insufficient reliable information about the clinical effects of bee pollen for these conditions.
• Breast cancer-related hot flashes. It is unclear if oral bee pollen is beneficial for the treatment of menopause-like symptoms in breast cancer patients. Details: Preliminary clinical research in breast cancer patients suggests that taking a combination of bee pollen and honey does not reduce hot flashes or other menopause-like symptoms when compared with honey alone (91983).
• Constipation. Although there has been interest in using oral bee pollen for constipation, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Diarrhea. Although there has been interest in using oral bee pollen for diarrhea, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Diaper rash. Although there has been interest in using topical bee pollen for diaper rash, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Dysmenorrhea. Although there has been interest in using oral bee pollen for dysmenorrhea, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Obesity. Although there has been interest in using oral bee pollen for obesity, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Oral mucositis. Although there has been interest in using oral bee pollen for oral mucositis, there is insufficient reliable information about the clinical effects of bee pollen for this purpose.
• Premenstrual syndrome (PMS). Oral bee pollen has only been studied in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research shows that taking two tablets twice daily of a specific combination product (Female, Natumin Pharma) containing royal jelly 6 mg, bee pollen extract 36 mg, and bee pollen with pistil extract 120 mg per tablet over a period of 2 menstrual cycles seems to decrease some symptoms of PMS, including irritability, weight gain, and edema, when compared with placebo (12008). More evidence is needed to rate bee pollen for these uses.

(Read more about BEE POLLEN)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Age-related macular degeneration (AMD). It is unclear if oral goji berry reduces the risk of developing AMD. Details: A small, unblinded clinical study in healthy adults aged 45 to 65 years shows that consuming goji berries 28 grams five times a week for 90 days improves macular pigment optical density, which is a marker for AMD, when compared to baseline (110767). The validity of this finding is limited by the lack of statistical comparison to the other study group that received a supplement containing lutein and zeaxanthin.
• Cancer. Although there is interest in using oral goji for cancer, there is insufficient reliable information about the clinical effects of goji for this condition.
• Cardiovascular disease (CVD). It is unclear if oral goji improves risk factors for CVD. Details: A meta-analysis of 6 mostly small clinical studies of adults in China shows that consuming goji as polysaccharide extract or juice for 1-3 months modestly improves triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and fasting blood glucose but does not impact total cholesterol when compared with no treatment or placebo (110765). Another meta-analysis of 4 small clinical studies in adults also shows that consuming goji polysaccharide extract or goji berries for 1-4 months modestly improves triglycerides and HDL but does not impact total or LDL cholesterol when compared with placebo or healthy eating. Goji also had no impact on systolic or diastolic blood pressure, or markers of oxidative stress (110768). However, the interpretation of the findings from these meta-analyses is limited by the use of variable goji forms and doses, as well as inclusion of studies in heterogeneous patients, including healthy people, patients with diabetes, and patients with metabolic syndrome. Furthermore, most studies were conducted in China; it is unclear if these benefits can be extrapolated to other geographic locations.
• Cognitive function. It is unclear if oral goji berry improves cognition in healthy young individuals. Details: A small clinical crossover study in healthy participants 14-24 years of age shows that taking goji berry fruit water extract (BIOMIX Company) 3600 mg in 3 divided doses daily for 4 weeks might improve certain cognitive measures such as verbal learning, short-term memory, and attention when compared with baseline (105488). The validity of these findings are limited due to incomplete outcome reporting and a lack of statistical comparisons between the treatment and placebo groups.
• Cough. Although there is interest in using oral goji for cough, there is insufficient reliable information about the clinical effects of goji for this purpose.
• Depression. It is unclear if oral goji berry polysaccharide is beneficial for adolescents with subthreshold depression. Details: A small clinical study in adolescents aged approximately 15 years with subthreshold depression in China shows that taking goji berry polysaccharide extract 300 mg daily for 6 weeks modestly improves clinician-assessed depression scores (i.e. Hamilton Depression Scale, HAMD-24) but does not improve self-reported depression scores (i.e. Beck Depression Inventory) or scores assessing sleep quality, psychological distress, or anxiety when compared with placebo (110769). However, these results are from an interim analysis, which limits the interpretation of these findings. Furthermore, it is unclear if results can be extrapolated to patients in other geographic locations.
• Diabetes. It is unclear if oral goji berry polysaccharides improve glycemic control in patients with diabetes. Details: One small clinical study in patients with type 2 diabetes shows that taking goji fruit polysaccharide powder 150 mg twice daily for 3 months results in a slightly lower postprandial glucose area under the curve (AUC), but does not seem to affect insulin levels or insulin resistance, when compared with placebo. A subgroup of patients who were not taking antidiabetes medications had a greater reduction in postprandial blood glucose (92117).
• Dry eye. Although there is interest in using oral goji for dry eye, there is insufficient reliable information about the clinical effects of goji for this purpose.
• Erectile dysfunction (ED). Although there is interest in using oral goji for ED, there is insufficient reliable information about the clinical effects of goji for this condition.
• Hypertension. Although there is interest in using oral goji root bark for hypertension, there is insufficient reliable information about the clinical effects of goji for this condition.
• Obesity. It is unclear if oral goji berry juice improves weight loss. Details: Preliminary clinical research in healthy, overweight adults shows that drinking a specific goji fruit juice (GoChi, FreeLife International LLC) 120 mL daily for 14 days while following a weight loss diet and participating in an exercise program decreases waist circumference by about 4.7 cm more than exercise and diet alone. However, drinking goji berry juice along with diet and exercise does not improve body weight, body mass index, or body fat when compared with diet and exercise alone (52536).
• Quality of life. Small clinical studies suggest that oral goji berry juice may modestly improve quality of life in healthy adults. Details: Small clinical studies in healthy adults suggest that taking a specific standardized goji fruit juice (GoChi, FreeLife International LLC) 120 mL daily for 14-30 days improves subjective measures of energy levels, athletic performance, sleep quality, mental acuity, calmness, feelings of well-being, and gastrointestinal regularity when compared with placebo (17082,52532,52542). These studies were funded by the juice manufacturer.
• Sunburn. It is unclear if oral goji extract can prevent sunburn. Details: A small clinical study in healthy Japanese adults shows that taking goji extract 900 mg daily for 8 weeks reduces and accelerates resolution of erythema after exposure to a standard dose of UVB irradiation when compared with placebo (110770). All study participants were highly UV-sensitive; it is unclear whether these results can be extrapolated to individuals less sensitive to UV irradiation.
• Tinnitus. Although there is interest in using oral goji for tinnitus, there is insufficient reliable information about the clinical effects of goji for this purpose. More evidence is needed to rate goji for these uses.

(Read more about GOJI)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Anxiety. Although there has been interest in using oral lotus stem for anxiety, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Bleeding. Although there has been interest in using oral lotus flowers and leaves for bleeding, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Cholera. Although there has been interest in using oral lotus flowers and leaves for cholera, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Cough. Although there has been interest in using oral lotus seeds for cough, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Diarrhea. Although there has been interest in using oral lotus flowers, leaves, rhizome, and seeds for diarrhea, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Halitosis. Although there has been interest in using oral lotus seeds for halitosis, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Hemorrhoids. Although there has been interest in using topical lotus seeds for hemorrhoids, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Insomnia. Although there has been interest in using oral lotus seeds for insomnia, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Leprosy. Although there has been interest in using oral lotus stem for leprosy, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Menorrhagia. Although there has been interest in using oral lotus seeds for menorrhagia, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Nausea and vomiting. Although there has been interest in using oral lotus stem for nausea and vomiting, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Obesity. It is unclear if oral lotus is beneficial in patients who are overweight. Details: Preliminary clinical research in overweight adults (BMI 24-28 kg/m2) shows that taking a lotus leaf extract, 1-2 grams orally daily for 12 weeks, modestly reduces total body fat when compared with no treatment. Preliminary subgroup analyses also suggests that it reduces visceral fat and waist circumference in males (110686).
• Pharyngitis. Although there has been interest in using oral lotus rhizome for pharyngitis, there is insufficient reliable information about the clinical effects of lotus for this purpose.
• Urinary retention. Although there has been interest in using oral lotus stem for urinary retention, there is insufficient reliable information about the clinical effects of lotus for this purpose. More evidence is needed to rate Lotus for these uses.

(Read more about LOTUS)

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.

(Read more about WILD YAM)

POSSIBLY SAFE ...when used orally and appropriately, short-term. Bee pollen has been safely used in clinical trials lasting up to 30 days (7062,7063,12008,33973). There is also preliminary evidence that taking 2 tablets twice daily of a specific combination product containing royal jelly 6 mg, bee pollen extract 36 mg, and bee pollen plus pistil extract 120 mg (Femal, Natumin Pharma) per tablet for up to 2 months seems to be safe (12008).

PREGNANCY: POSSIBLY UNSAFE
when used orally. There is some concern that bee pollen might have uterine stimulant effects (5,6,11); avoid using.

LACTATION:
Insufficient reliable information available; avoid using.

(Read more about BEE POLLEN)

POSSIBLY SAFE ...when goji fruit preparations are used orally and appropriately, short-term. Goji berry whole fruit, boiled or steamed, has been used with apparent safety at a dose of 15 grams daily for 16 weeks (105489). Other goji berry products have also been used with apparent safety in clinical research, including a specific goji fruit juice (GoChi, FreeLife International) 120 mL daily for 30 days (52532), a goji fruit polysaccharide 300 mg daily for 3 months (92117), and a specific milk-based formulation of goji berry (Lacto-Wolfberry, Nestlé Research Center) for 3 months (52539). There has been some concern about the atropine content of goji; however, most analyses show that levels of atropine in goji berries from China and Thailand are far below potentially toxic levels (52524,94667). There is insufficient reliable information available about the safety of oral use of other parts of the goji plant.

PREGNANCY AND LACTATION:
Insufficient reliable information available. Some animal research shows that goji fruit may stimulate the uterus (12). However, this has not been reported in humans. Until more is known, avoid using during pregnancy or lactation.

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LIKELY SAFE. ..when used orally in food amounts. The flowers, seeds, leaves, and rhizomes of lotus are all edible (95261). There is insufficient reliable information available about the safety of medicinal lotus.

PREGNANCY AND LACTATION:
Insufficient reliable information available on the medicinal use of lotus; avoid using.

(Read more about LOTUS)

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)

WARFARIN (Coumadin) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D There is some concern that bee pollen might interact with warfarin and increase the risk of bleeding.  Details In one case report, a patient on warfarin had a stable international normalized ratio (INR) of 1.9-3.3 for 9 months. The patient's INR was found to be 7.1 after starting bee pollen granules one teaspoon twice daily for approximately one month. The patient's warfarin dose was decreased by approximately 11% in order to return the INR to the therapeutic range while continuing the bee pollen supplement (18063).

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ANTIDIABETES DRUGS Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = B Theoretically, concomitant use of goji fruit polysaccharides or goji root bark with antidiabetes drugs might have additive effects.  Details Animal and in vitro research show that goji root bark and fruit polysaccharides might have hypoglycemic effects (7126,92118,94667). However, clinical research has only shown that taking goji fruit polysaccharides with or without antidiabetes drugs modestly reduces postprandial glucose when compared with control, with no reports of hypoglycemia (92117).

ANTIHYPERTENSIVE DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, concomitant use of goji root bark, but not goji fruit, with antihypertensive drugs might have additive effects.  Details Animal and in vitro research suggest that goji root bark has hypotensive effects (7126,94667). However, goji fruit juice does not appear to reduce systolic or diastolic blood pressure in humans (17082).

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, goji berry might inhibit CYP2C19 and reduce metabolism of CYP2C19 substrates.  Details In vitro research shows that goji berry tincture and juice inhibit CYP2C19 enzymes (105486). Concomitant use with goji may decrease metabolism and increase levels of CYP2C19 substrates. However, this has not been reported in humans.

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, goji berry might inhibit CYP2C9 and reduce metabolism of CYP2C9 substrates.  Details In vitro research shows that goji berry tincture and juice inhibit CYP2C9 enzymes (105486). Additionally, multiple case reports suggest that goji berry concentrated tea and juice inhibit the metabolism of warfarin, a CYP2C9 substrate (7158,105462). Concomitant use with goji may decrease metabolism and increase levels of CYP2C9 substrates.

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, goji berry might inhibit CYP2D6 and reduce metabolism of CYP2D6 substrates.  Details In vitro research shows that goji berry juice inhibits CYP2D6 enzymes (105486). Concomitant use with goji may decrease metabolism and increase levels of CYP2D6 substrates. However, this has not been reported in humans.

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, goji berry might inhibit CYP3A4 and reduce metabolism of CYP3A4 substrates.  Details In vitro research shows that goji berry juice inhibits CYP3A4 enzymes (105486). Concomitant use with goji may decrease metabolism and increase levels of CYP3A4 substrates. However, this has not been reported in humans.

FLECAINIDE (Tambocor) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, goji berry might increase the levels and clinical effects of flecainide.  Details In one case report, a 75-year-old patient stable on flecainide and warfarin presented to the emergency room with fainting and pleomorphic arrhythmia caused by flecainide toxicity. Flecainide toxicity was attributed to drinking 1-2 glasses of concentrated goji tea daily for 2 weeks. Theoretically, goji may have inhibited the cytochrome P450 2D6 (CYP2D6) metabolism of flecainide (105462).

WARFARIN (Coumadin) Interaction Rating = Major Do not take this combination. Severity = High •  Occurrence = Probable •  Level of Evidence = D Goji can increase the effects of warfarin and possibly increase the risk of bleeding.  Details There are at least 5 case reports of increased international normalized ratio (INR) in patients stabilized on warfarin who began drinking goji juice, concentrated goji tea, or goji wine (7158,16529,23896,105462,105487). Goji may inhibit the metabolism of warfarin by cytochrome P450 2C9 (CYP2C9) (7158).

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, concurrent use of lotus with other antiplatelet drugs might reduce platelet aggregation and increase the risk of bleeding.  Details Neferine and isoliensinine, constituents of lotus, have been shown to inhibit platelet aggregation, in vitro. These constituents can inhibit the production of pro-aggregating factors like prostaglandins (59994,60005).

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, lotus might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.  Details Animal research shows that the ethanolic extract of lotus reduces blood glucose levels and potentiates the effects of injected insulin (60053). Monitor blood glucose levels closely. Dose adjustments might be necessary.

PENTOBARBITAL (Nembutal) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, taking lotus concomitantly with pentobarbital might increase sedation.  Details Animal research shows that lotus extract increases pentobarbitone-induced sleeping time (60051). It is not known if this occurs in humans or if this effect occurs with other barbiturates or sedatives.

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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.

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General ...Orally, bee pollen seems to be well tolerated in most patients.
Serious Adverse Effects (Rare):
Orally: Acute hepatitis, allergic reactions, interstitial nephritis, kidney failure.

Dermatologic ...Orally, a case of photosensitivity has been reported for a 32-year-old patient who took a dietary supplement containing ginseng, goldenseal, bee pollen, and other ingredients. Symptoms included a pruritic, erythematous rash that was localized to the sun-exposed surfaces of the neck and extremities. Following treatment with topical and subcutaneous corticosteroids and discontinuation of the supplement, the skin rash slowly resolved. It is not known if this effect was due to the bee pollen, one of the other ingredients, or their combination (33954).

Hepatic ...Orally, there have been two cases of acute hepatitis associated with bee pollen use. One case involved ingestion of two tablespoons of pure bee pollen daily for several months. Another case involved ingestion of 14 tablets per day of a combination herbal product containing bee pollen, chaparral, and 19 other herbs for 6 weeks (1351). In this case, it is not known if bee pollen or another herb might have caused the adverse event.

Immunologic ...Patients with a history of seasonal pollen allergies, particularly allergies to plants in the Asteraceae/Compositae family, including ragweed, chrysanthemums, marigolds, daisies, and many other herbs, are at risk for serious allergic reactions to oral bee pollen. Allergic reactions can include itching, swelling, shortness of breath, lightheadedness, and anaphylaxis (5,6,11,13480,33952,33965,91981,91984,109991). In one case, exercise may have contributed to the reaction. A 15-year-old male developed generalized urticaria, facial angioedema, and dyspnea 30 minutes into a vigorous exercise session and an hour after ingesting bee pollen granules. The patient experienced abdominal cramps within minutes of consuming bee pollen on 3 previous occasions and had a positive skin prick test for bee pollen after the anaphylactic reaction (109991). Allergy symptoms due to chronic intake of bee pollen include gastrointestinal and neurologic symptoms and eosinophilia (2627,33964).
A case of allergic eosinophilic gastropathy has been reported for a 5 year-old child who was given bee pollen daily to strengthen the immune system. Symptoms included abdominal pain, vomiting, and swelling of the eyelids and legs (91981).

Neurologic/CNS ...Orally, there is one report of dizziness in a patient who took a combination product containing royal jelly, bee pollen extract, and a bee pollen plus pistil extract (12008). It is not known if this effect was due to the bee pollen, another ingredient, or the combination.

Renal ...Orally, there is one report of a patient taking a bee pollen-containing supplement for greater than 5 months who developed breathing difficulties, edema with weight gain, and loss of appetite. The patient was diagnosed with interstitial nephritis and drug-induced acute kidney failure. The supplement was discontinued and the patient was started on hemodialysis. The patient improved after several sessions of hemodialysis (18068).

Other ...Although some research has shown a lack of mycotoxins in twenty samples of bee pollen, analysis of other ready-to-eat bee pollen products have revealed contamination with potential mycotoxin producing species, including Penicillium verrucosum, Aspergillus niger aggregate, Aspergillus carbonarius, Aspergillus ochraceus, Aspergillus flavus, Aspergillus parasiticus, and Alternaria spp. (33959,33961).

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General ...Orally, goji fruit seems to be well tolerated.
Serious Adverse Effects (Rare):
Orally: Allergic reactions including anaphylaxis.

Dermatologic ...A case of photosensitivity secondary to consumption of goji berries has been reported. The patient presented with a pruriginous eruption that had lasted for 2 weeks. The patient had been taking goji berries for 5 months and cat's claw for 3 months. Upon testing, it was revealed that the patient tested positive to goji berries in a photoprovocation test, but not to cat's claw (40263).

Hepatic ...Orally, consumption of goji berries has been associated with a single case report of autoimmune hepatitis (52541). A case of acute hepatitis has also been reported in a female who consumed 2 ounces of a specific combination product (Euforia, Nuverus International) containing goji berry, pomegranate, curcumin, green tea, noni, acai berry, aloe vera, blueberry, resveratrol, mangosteen, and black seed, daily for one month. It is unclear whether the liver injury was caused by goji berry, other ingredients, or the combination (90125).

Immunologic ...Several cases of allergic reactions secondary to consumption of goji berries have been reported. Symptoms included facial angioedema with dyspnea, pharyngeal itching, itching in the mouth, ears, and axilla, labial angioedema, and perioral skin rash (92116). Anaphylaxis has also been reported (52538).

(Read more about GOJI)

General ...Orally, adverse effects to lotus seem to be rare when taken in medicinal amounts; however, a thorough safety evaluation has not been conducted.

Immunologic ...Orally and topically, lotus root can cause allergic reactions such as urticaria and contact dermatitis. In a case report, a 6-year-old female developed urticaria after ingesting lotus root. She had also developed contact dermatitis on body areas that had been in contact with the lotus root (99738).

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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)