Ingredients | Amount Per Serving |
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Botanical Extract Blend
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1.2 mL |
(Hydrangea arborescens )
(root)
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(Eupatorium purpureum )
(root)
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(Lycopodium clavatum )
(aerial parts)
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(Borago officinalis )
(aerial parts)
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Jerusalem Artichoke extract
(Helianthus tuberosus )
(tuber)
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(Iris versicolor )
(root)
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(Rumex crispus )
(root)
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(Cnicus benedictus )
(aerial parts)
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(Raphanus sativus )
(seed)
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purified Water, Ethyl Alcohol Note: 22-28%
Below is general information about the effectiveness of the known ingredients contained in the product Core Hydrangea Blend. 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 blue flag.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of clubmoss.
There is insufficient reliable information available about the effectiveness of gravel root.
There is insufficient reliable information available about the effectiveness of hydrangea.
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 Core Hydrangea Blend. 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 used orally in amounts commonly found in foods. Blessed thistle has Generally Recognized As Safe (GRAS) status in the US (4912). There is insufficient reliable information available about the safety of blessed thistle when used in medicinal amounts.
PREGNANCY: LIKELY UNSAFE
when used orally (4,12); avoid using.
LACTATION:
Insufficient reliable information available; avoid using.
LIKELY UNSAFE ...when used orally; contraindicated in all but small doses (4). The fresh root can cause nausea, vomiting, and mucosal irritation (4,12). The blue flag oil is a mucous membrane irritant (4).
PREGNANCY AND LACTATION: LIKELY UNSAFE
when used orally (4,12); avoid using.
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.
POSSIBLY UNSAFE ...when used orally. Clubmoss contains toxic alkaloids, but no poisonings have been reported (18).
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally; avoid using.
LIKELY UNSAFE ...when products containing hepatotoxic pyrrolizidine alkaloid (PA) constituents are used orally. 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 gravel root preparations that are not certified and labeled as hepatotoxic PA-free. ...when products containing hepatotoxic PAs are used topically on abraded or broken skin. Absorption of hepatotoxic PAs through broken skin can lead to systemic toxicities (12841). Tell patients not to use topical gravel root preparations that are not certified and labeled as hepatotoxic PA-free. There is insufficient reliable information available about the safety of using PA-free gravel root orally or topically.
PREGNANCY: LIKELY UNSAFE
when used orally.
Gravel root preparations containing hepatotoxic pyrrolizidine alkaloid (PA) constituents might be teratogenic and hepatotoxic (12841,12842). There is insufficient reliable information available about the safety of using gravel root products that do not contain hepatotoxic PAs during pregnancy.
LACTATION: LIKELY UNSAFE
when used orally.
Hepatotoxic pyrrolizidine alkaloid (PA) constituents in gravel root are excreted in milk (12841,12842). There is insufficient reliable information available about the safety of using gravel root products that do not contain hepatotoxic PAs during lactation.
POSSIBLY UNSAFE ...when used orally in excessive amounts. Doses of dried hydrangea rhizome/root greater than 2 grams have been associated with reports of dizziness and a feeling of tightness in the chest (4,12). There is insufficient reliable information available about the safety of hydrangea when used in lower amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally in moderate amounts (18). Large amounts may lead to gastrointestinal irritation (18).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid very large doses.
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 Core Hydrangea Blend. 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, blessed thistle might decrease the effectiveness of antacids.
Details
There are reports that blessed thistle increases stomach acid (19).
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Theoretically, blessed thistle might decrease the effectiveness of H2-blockers.
Details
There are reports that blessed thistle increases stomach acid (19).
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Theoretically, blessed thistle might decrease the effectiveness of PPIs.
Details
There are reports that blessed thistle increases stomach acid (19).
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Theoretically, overuse or abuse of this product increases the risk of adverse effects from cardiac glycoside drugs.
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Overuse of blue flag might compound diuretic-induced potassium loss (19). There is some concern that people taking blue flag along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
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Blue flag has stimulant laxative effects. In some people blue flag can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of blue flag.
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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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Evidence from in vitro research suggests that clubmoss extract can inhibit acetylcholinesterase activity (43717). Theoretically, concurrent use of clubmoss with other acetylcholinesterase (AChE) inhibitors might have additive effects and increase the risk of cholinergic side effects. AChE inhibitors and cholinergic drugs include bethanechol (Urecholine), donepezil (Aricept), echothiophate (Phospholine Iodide), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmin), physostigmine (Antilirium), pyridostigmine (Mestinon, Regonol), succinylcholine (Anectine, Quelicin), and tacrine (Cognex).
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Evidence from in vitro research suggests that clubmoss extract can inhibit acetylcholinesterase activity (43717). Theoretically, concurrent use of anticholinergic drugs and clubmoss might decrease the effectiveness of club moss or the anticholinergic agent. Some anticholinergic drugs include atropine, benztropine (Cogentin), biperiden (Akineton), procyclidine (Kemadrin), and trihexyphenidyl (Artane).
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Evidence from in vitro research suggests that clubmoss extract can inhibit acetylcholinesterase activity (43717). Theoretically, concurrent use of clubmoss with other cholinergic drugs might have additive effects and increase the risk of cholinergic side effects. AChE inhibitors and cholinergic drugs include bethanechol (Urecholine), donepezil (Aricept), echothiophate (Phospholine Iodide), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmin), physostigmine (Antilirium), pyridostigmine (Mestinon, Regonol), succinylcholine (Anectine, Quelicin), and tacrine (Cognex).
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Hepatotoxic pyrrolizidine alkaloids (PA) are substrates of cytochrome P450 3A4 (CYP3A4) (12841,12860). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.
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Gravel root is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, gravel root might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Hydrangea is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, hydrangea might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Theoretically, radish might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
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Theoretically, yellow dock might increase the risk of digoxin toxicity when used long-term or in large amount.
Details
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Theoretically, yellow dock might increase the risk of hypokalemia when taken with diuretics.
Details
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Theoretically, the laxative effects of yellow dock might increase the effects of warfarin, including the risk of bleeding.
Details
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Below is general information about the adverse effects of the known ingredients contained in the product Core Hydrangea Blend. 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, there is limited information available about the adverse effects of blessed thistle when used in medicinal amounts.
Dermatologic ...Topically, blessed thistle can cause an allergic reaction, such as dermatitis, in individuals sensitive to the Asteraceae/Compositae family. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs (12).
Gastrointestinal ...Orally, when blessed thistle is used in doses higher than 5 grams per cup of tea, it can cause stomach irritation and vomiting (12).
Immunologic ...Blessed thistle can cause allergic reaction in individuals with sensitivity to the Asteraceae/Compositae family, which includes ragweed, chrysanthemums, marigolds, daisies, and many other herbs (12).
General ...Orally, blue flag can cause nausea and vomiting, and the fresh root can irritate mucosa (4,19). Orally and topically, the volatile oil constituent of blue flag irritates mucous membranes and can cause lacrimation, eye inflammation, irritation of the throat, and headache (4).
Dermatologic ...Orally, the fresh blue flag root can irritate mucosa (4,19). Topically, the volatile oil constituent of blue flag irritates mucous membranes (4).
Gastrointestinal ...Orally, blue flag can cause nausea and vomiting and the fresh blue flag root can irritate mucosa (4,19). The volatile oil constituent of blue flag irritates mucous membranes and can cause irritation of the throat (4).
Neurologic/CNS ...Orally, the volatile oil constituent of blue flag can cause headache (4).
Ocular/Otic ...Orally and topically, the volatile oil constituent of blue flag can cause lacrimation and eye inflammation (4).
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, no adverse effects have been reported; however, a thorough evaluation of safety outcomes has not been conducted.
Additionally, clubmoss contains toxic alkaloids, which could cause serious adverse effects (43721). When fir club moss (Lycopodium selago) is mistaken for clubmoss, cholinergic toxicity has been reported. This toxicity is due to huperzine A, which is not present in clubmoss (13193).
Airborne exposure to clubmoss spores might cause symptoms of asthma (43721).
Pulmonary/Respiratory ...Occupational exposure to clubmoss spores, including cases associated with facilities that use the spores to coat condoms, has been reported to cause asthma (43721).
Other ...Clubmoss (Lycopodium clavatum) might be mistaken for fir club moss (Lycopodium selago), which contains huperzine A, a constituent with strong inhibitory activity against acetylcholinesterase. In two case reports, fir club moss was mistaken for clubmoss and ingested as tea. This caused cholinergic toxicity with symptoms of sweating, nausea, dizziness, cramping, and slurred speech (13193).
General
...Orally, the major concern with gravel root use is its pyrrolizidine alkaloid (PA) content.
These constituents can cause liver and lung injury (12841,12842). Chronic exposure to other plants containing hepatotoxic PA constituents has been associated with veno-occlusive disease (4021). Sub-acute veno-occlusive disease can cause vague symptoms, including colicky pains, vomiting, diarrhea, and ascites within several days; persistent liver enlargement occurs within a few weeks (4021,12842).
Topically, PA can be absorbed through the skin in quantities sufficient to cause systemic toxicity when applied to broken skin or in large quantities (11990).
Gravel root products containing PAs should be avoided. There is currently a limited amount of information available about the adverse effects of PA-free gravel root.
Hepatic ...Orally, gravel root might cause liver damage. The major concern with gravel root use is its hepatotoxic pyrrolizidine alkaloid (PA) content (12841,12842). Chronic exposure to other plants containing hepatotoxic PA constituents is associated with veno-occlusive disease (4021). Sub-acute veno-occlusive disease can cause vague symptoms, including colicky pains, vomiting, diarrhea, and ascites within several days; persistent liver enlargement occurs within a few weeks (4021,12842).
Pulmonary/Respiratory ...Orally, gravel root might cause lung damage. The major concern with gravel root use is its pyrrolizidine alkaloid (PA) content. These constituents can cause lung damage with pulmonary-arterial hypertension (12841,12842).
General ...Orally, hydrangea may cause gastroenteritis, dizziness, and a feeling of tightness in the chest (4).
Cardiovascular ...Orally, hydrangea may cause a feeling of tightness in the chest (4).
Gastrointestinal ...Orally, hydrangea may cause gastroenteritis (4).
Neurologic/CNS ...Orally, hydrangea may cause dizziness (4).
General ...Orally, radish seems to be well tolerated when used in moderate amounts.
Gastrointestinal ...Large amounts of radish may cause irritation of the gastrointestinal mucus membrane (18). Mild indigestion has also been associated with use of a specific product containing radish, camu camu, acerola, honey, and tapioca in clinical research. However, it is unclear if this adverse event is due to radish, other ingredients in the product, or the combination (94290).
Immunologic ...A case of allergy to oral intake of radish has been reported. Symptoms included throat tightness and generalized urticaria (94289).
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).