T-W by Pure Herbs

POSSIBLY INEFFECTIVE

• Human papillomavirus (HPV). Topical carrageenan gel does not seem to reduce the risk of anal HPV in males who have sex with males. Details: A clinical study in adult males who have sex with males shows that applying 15 mL of carrageenan 1.4% gel to the anus, condom, or partners' penis prior to receptive anal intercourse does not decrease the rate of anal HPV when compared with placebo, regardless of HPV strain, HPV vaccination status, or HIV status. Although patients were enrolled for an intended duration of 1 year, the study was terminated early due to a lack of observed benefit and potential safety concerns, resulting in a median follow-up of 8 months. A total of 60% of patients in the treatment group reported adverse effects, compared with 40% of patients in the placebo group (107851). Additionally, the prevalence of HPV at baseline was 61%, which may have reduced the study's ability to identify an effect.

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Common cold. Evidence on the use of intranasal iota-carrageenan for improving symptoms of the common cold is conflicting. Details: A small clinical study in patients with early symptoms of the common cold shows that spraying a saline solution containing iota-carrageenan 0.12% into the nose three times daily for 4 days seems to reduce total symptoms during days 2-4 when compared with using a plain saline spray. However, in a larger clinical trial using the same methods, there were no differences between placebo and treatment groups. Furthermore, neither study noted an improvement in total cold symptoms over 7-10 days (99449,99450). In children with the common cold, spraying a saline solution containing iota-carrageenan 0.12% seemed to be no better for improving cold symptoms than using plain saline spray (99451). Some research suggests that carrageenan might benefit patients with a confirmed viral infection. In a clinical study in patients with symptoms of a common cold and a laboratory-confirmed viral infection, using a specific nasal spray (Coldamaris) containing carrageenan 0.12% three times daily for 7 days reduced symptom duration by about 2 days when compared with using a saline nasal spray. However, there was no difference in disease duration when all patients were considered, regardless of viral infection status (99452). Furthermore, the validity of this study is limited by the changing definitions for disease duration and primary outcome over the course of the study.
• Coronavirus disease 2019 (COVID-19). There is limited evidence on the intranasal use of iota-carrageenan for the prevention of COVID-19. Details: A clinical study in healthcare professionals working with patients hospitalized for COVID-19 shows that using a nasal spray containing iota-carrageenan 0.17% as 1 puff in each nostril 4 times daily (providing 1 mg daily) for 21 days decreases the absolute rate of confirmed, symptomatic COVID-19 to 1%, compared with 5% of patients in the placebo group. This suggests that 25 people would need to use this nasal spray to prevent one infection (107852). The validity of this study is limited due to the lack of baseline viral testing and short duration; additionally, asymptomatic COVID-19 infections may be underreported due to study design.
• Cough. Although there is interest in using oral carrageenan for cough, there is insufficient reliable information about the clinical effects of carrageenan for this condition. More evidence is needed to rate the effectiveness of carrageenan for these uses.

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INSUFFICIENT RELIABLE EVIDENCE to RATE

• Hypercholesterolemia. In patients with hypercholesterolemia, clinical research shows that taking dulse powder 2 grams daily for 8 weeks does not improve low-density lipoprotein (LDL) cholesterol levels or glycemic control when compared with placebo. However, there was a small beneficial effect on triglyceride levels in women (103323). More evidence is needed to rate dulse for this use.

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INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging skin. Although there has been interest in using topical Fucus vesiculosus for aging skin, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose.
• Cardiovascular disease (CVD). Although there has been interest in using oral Fucus vesiculosus for CVD, including atherosclerosis and hypertension, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose.
• Constipation. Although there has been interest in using oral Fucus vesiculosus for constipation, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose.
• Diarrhea. Although there has been interest in using oral Fucus vesiculosus for diarrhea, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose.
• Dyspepsia. Although there has been interest in using oral Fucus vesiculosus for dyspepsia, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose.
• Hypercholesterolemia. It is unclear if oral Fucus vesiculosus is beneficial in hypercholesterolemia. Details: A small clinical study in patients with obesity or overweight and low-density lipoprotein (LDL) cholesterol levels exceeding 77 mg/dL shows that taking a polyphenol-rich extract of Fucus vesiculosus (Maritech Synergy, Marinova) 2000 mg, providing 560 mg of polyphenols, daily for 12 weeks increases levels of high-density lipoprotein (HDL) cholesterol by 10%, compared with 2% in those receiving placebo. No differences were observed for total cholesterol, LDL cholesterol, or triglycerides (106723).
• Hypothyroidism. Although there has been interest in using oral Fucus vesiculosus for hypothyroidism, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose.
• Impaired glucose tolerance (prediabetes). Oral Fucus vesiculosus has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in patients with prediabetes and dysglycemia shows that taking a specific product (Gdue, Aesculapius), containing extracts of Fucus vesiculosus and Ascophyllum nodosum in a 5:95 ratio along with chromium picolinate three times daily for 6 months reduces fasting and postprandial blood glucose, glycated hemoglobin (HbA1c), insulin, and insulin resistance when compared with placebo (100847). It is unclear if these effects are due to Fucus vesiculosus, other ingredients, or the combination. Another small clinical study in adults with prediabetes and also overweight or obese shows that taking a specific product (InSea2, InnoVactiv Inc.) containing 500 mg of Fucus vesiculosus and Ascophyllum nodosum extracts daily for 12 weeks reduces postprandial blood glucose but does not improve fasting blood glucose, HbA1c, body weight, lipids, or blood pressure when compared with placebo (110560).
• Iodine deficiency. Although there has been interest in using oral Fucus vesiculosus for iodine deficiency and goiter, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose.
• Metabolic syndrome. Oral Fucus vesiculosus has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Observational research in adults with one or more components of metabolic syndrome has found that taking a specific combination product (Gdue, Aesculapius) containing extracts of Fucus vesiculosus and Ascophyllum nodosum in a 5:95 ratio along with chromium picolinate two to three times daily with meals for around 6 months is associated with reductions in body weight by 7.3 kg, waist circumference by 7.5 cm, fasting blood glucose by 16 mg/dL, glycated hemoglobin (HbA1c) by 0.55%, systolic blood pressure by 7 mmHg, diastolic blood pressure by 4 mmHg, low-density lipoprotein (LDL) cholesterol by 18 mg/dL, and 10-year cardiovascular risk scores by 1.8% when compared to baseline (110559). It is unclear if these effects are due to Fucus vesiculosus, other ingredients, or the combination. Further, the validity of these findings is limited by a lack of control group.
• Obesity. Oral Fucus vesiculosus has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in moderately overweight females shows that seaweeds such as Fucus vesiculosus, taken in combination with lecithin and vitamins for up to 2 years, do not result in sustained weight loss when compared to baseline (13663). Another small clinical study in adults with prediabetes and also overweight or obese shows that taking a specific product (InSea2, InnoVactiv Inc.) containing 500 mg of Fucus vesiculosus and Ascophyllum nodosum extracts daily for 12 weeks does not reduce body weight, body mass index (BMI), body fat, lipids, blood pressure, or measures of glycemic control when compared with placebo (110560).
• Wound healing. Although there has been interest in using topical Fucus vesiculosus for wound healing, there is insufficient reliable information about the clinical effects of Fucus vesiculosus for this purpose. More evidence is needed to rate Fucus vesiculosus for these uses.

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There is insufficient reliable information available about the effectiveness of wild lettuce.

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LIKELY SAFE ...when undegraded carrageenan is used orally in the amounts found in foods (11). Carrageenan has Generally Recognized as Safe (GRAS) status in the US (4912,102538).

POSSIBLY SAFE ...when used intranasally, short-term. Saline solution containing iota-carrageenan 0.12% has been sprayed into the nose with apparent safety three times daily for up to 7 days (99449,99450,99451,99452,99466). Also, saline solution containing iota-carrageenan 0.17% has been sprayed into both nostrils with apparent safety four times daily (providing 1 mg daily) for up to 21 days (107852).

POSSIBLY UNSAFE ...when the degraded form, called poligeenan, is used orally. Poligeenan contains a lower molecular weight product that is partially absorbed. There is concern about the safety of this form because it has been linked to colonic lesions, neoplasms, and bleeding in animals (40065,40047). Due to public concern that commercial carrageenan contains poligeenan or can be degraded to poligeenan in the stomach, the United States Food and Drug Administration (FDA) reevaluated the safety of carrageenan and reaffirmed its status as GRAS in 2012 (99466). Carrageenan that is not degraded has an average molecular weight of 453-652 kDA, while degraded carrageenan is usually 20-30 kDA. In order to limit potential safety concerns, the European Commission Scientific Committee on Food advises that the total weight of any carrageenan food additives contain no more than 5% of a molecular weight below 50 kDa (99901). There is insufficient reliable information available about the safety of carrageenan when used topically.

PREGNANCY AND LACTATION: LIKELY SAFE
when used in food amounts (11). There is insufficient reliable information available about the safety of using larger amounts; avoid using.

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LIKELY SAFE ...when used orally in food amounts. Dulse has a long history of use as a food ingredient in various parts of the world (103315,103317,103321).

POSSIBLY SAFE ...when used topically and appropriately (103322). There is insufficient reliable information available about the safety of dulse when used in amounts greater than those found in foods.

PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of dulse when used in medicinal amounts during pregnancy or lactation; avoid amounts greater than those found in foods.

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POSSIBLY SAFE ...when applied topically to the skin. A gel containing 1% Fucus vesiculosus extract, applied to the skin twice daily, has been used in clinical research with apparent safety for up to 5 weeks (12799).

POSSIBLY UNSAFE ...when used orally due to its iodine content and possible heavy metal content. Fucus vesiculosus contains up to 0.05% iodine or 226 mcg/gram dry weight (12789,74217). Ingesting more than 150 mcg of iodine daily can cause hyperthyroidism or exacerbate existing hyperthyroidism (12788). Fucus vesiculosus can also contain heavy metals, including cadmium, arsenic, and lead, and can cause heavy metal nephropathy (12789,12800,74213).

PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally because it may contain iodine and heavy metals (12789,74213,74217); avoid using.

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POSSIBLY SAFE ...when mature, properly harvested wild lettuce is used orally and appropriately (12,4).

LIKELY UNSAFE ...when used orally in large doses or when harvested prematurely. Large doses of wild lettuce, or prematurely harvested wild lettuce, have been reported to cause anticholinergic side effects, stupor, depressed respiration, and death (4,93563).

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

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, carrageenan may increase the risk of bleeding in patients taking anticoagulant or antiplatelet drugs.  Details Laboratory research suggests that carrageenan has anticoagulant effects (6002). However, this has not been reported in humans.

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ACE INHIBITORS (ACEIs) Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Dulse is rich in potassium (103317). ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion (95628). Concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels (95628). However, using these drugs while consuming dulse in quantities that provide larger amounts of potassium daily might increase the risk of hyperkalemia. Additionally, in vitro research suggests that dulse protein hydrolysates inhibit the activity of ACE (103319). Theoretically, concomitant use of these drugs with dulse might increase their effects and side effects. However, these effects have not been demonstrated in humans.  Details The ACE inhibitors include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik).

ANGIOTENSIN RECEPTOR BLOCKERS (ARBs) Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Dulse is rich in potassium (103317). ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion (95628). Concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels (95628). However, using these drugs while consuming dulse in quantities that provide higher amounts of potassium daily might increase the risk of hyperkalemia. Additionally, in vitro research suggests that dulse protein hydrolysates inhibit the activity of angiotensin converting enzyme (ACE) (103319). Theoretically, concomitant use of ARBs with dulse might increase their effects and side effects. However, these effects have not been demonstrated in humans.  Details Some ARBs include losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), candesartan (Atacand), telmisartan (Micardis), eprosartan (Teveten), and others.

POTASSIUM-SPARING DIURETICS Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Dulse is rich in potassium (103317). Therefore, concomitant use of potassium-sparing diuretics with dulse may increase the risk of hyperkalemia. This has not been shown in humans.  Details Some potassium-sparing diuretics include amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium), and others.

THYROID HORMONE Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Dulse is rich in iodine (103315,103323). Although dulse has been associated with a statistically significant increase in thyroid stimulating hormone (TSH) levels in clinical research, clinically significant increases have not been documented (103315,103323). Theoretically, dulse might interfere with drugs used to treat thyroid dysfunction.  Details Some thyroid hormones include levothyroxine (Synthroid, Levoxyl, Levothroid), liothyronine sodium (Cytomel), desiccated thyroid (Armor Thyroid), and others.

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AMIODARONE (Cordarone) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = D Theoretically, combining Fucus vesiculosus with amiodarone might cause excessively high iodine levels.  Details Fucus vesiculosus contains high concentrations of iodine (7135). Amiodarone contains 37.3% iodine and can increase iodine levels. Concomitant use might increase the risk of having excessive iodine levels and adversely affecting thyroid function (7135,17574). Monitor thyroid function.

ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Minor Be watchful with this combination. Severity = Moderate •  Occurrence = Unlikely •  Level of Evidence = D Theoretically, taking Fucus vesiculosus with antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.  Details In vitro evidence suggests that a constituent of Fucus vesiculosus, known as fucoidan, has anticoagulant effects (12797,74149,74183,74240). However, in clinical research, fucoidan does not seem to have significant anticoagulant activity when taken orally, possibly due to poor absorption (74183).

ANTITHYROID DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Due to its iodine content, Fucus vesiculosus might alter the effects of antithyroid drugs.  Details Fucus vesiculosus contains high concentrations of iodine (7135). Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using antithyroid drugs could alter the effects of the antithyroid drugs (2138,17574).

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, concomitant use of Fucus vesiculosus with CYP2C8 substrates might increase the risk for adverse effects.  Details In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C8 (97791). This interaction has not been reported in humans.

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, concomitant use of Fucus vesiculosus with CYP2C9 substrates might increase the risk for adverse effects.  Details In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP2C9 (97791). This interaction has not been reported in humans.

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, concomitant use of Fucus vesiculosus with CYP2D6 substrates might alter the effects of these substrates.  Details In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, both inhibits and induces CYP2D6 (97791). This interaction has not been reported in humans.

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, concomitant use of Fucus vesiculosus with CYP3A4 substrates might increase the risk for adverse effects.  Details In vitro research shows that fucoidan, a constituent of Fucus vesiculosus, inhibits CYP3A4 (97791). This interaction has not been reported in humans.

LITHIUM Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Concomitant use of Fucus vesiculosus and lithium has resulted in hyperthyroidism.  Details There is a case of hyperthyroidism occurring in a patient taking Fucus vesiculosus and lithium (74217). Monitor thyroid hormones closely in patients taking lithium and Fucus vesiculosus concomitantly.

THYROID HORMONE Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Due to its iodine content, Fucus vesiculosus might alter the effects of thyroid hormone.  Details Fucus vesiculosus contains high concentrations of iodine (7135). Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking Fucus vesiculosus while using thyroid hormone could alter the effects of thyroid hormone.

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General ...Orally, carrageenan is well tolerated in amounts found in foods. Intranasally, carrageenan seems to be well tolerated.
Most Common Adverse Effects: None known.

Dermatologic ...Topically, when carrageenan gel was applied to the penis or anus prior to anal intercourse in one clinical study, it was reported to cause discomfort or adverse reactions in 59% of males, compared with 44% of those using placebo (107851).

Genitourinary ...Intravaginally, carrageenan gel has been associated with mild vaginal itching and burning, a vaginal abrasion, bladder fullness, and urinary hesitancy. However, it is unclear if carrageenan was the causal factor of these symptoms (40044,40068).

Hematologic ...In one clinical study in males, carrageenan gel applied topically to the penis and anus prior to anal intercourse was reported to cause rectal bleeding that was not directly related to anal intercourse in 8% of patients, compared with 0% of patients using placebo (107851).

Oncologic ...Observational research has found that increased consumption of carrageenan is associated with an increase in breast cancer incidence (40046).

(Read more about CARRAGEENAN)

General ...Orally, dulse seems to be well tolerated. No adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.

(Read more about DULSE)

General ...When used orally, Fucus vesiculosus may be unsafe due to its iodine content. Topically, Fucus vesiculosus appears to be well tolerated.
Most Common Adverse Effects:
Orally: Goiter, hyperthyroidism, hypothyroidism.
Serious Adverse Effects (Rare):
Orally: Thyroid cancer.

Cardiovascular ...In one report, a young adult with obesity developed palpitations and syncope after taking an oral weight loss supplement containing a combination of Fucus vesiculosus, dandelion, and boldo for 3 weeks. The patient was found to have a prolonged QT interval on ECG and frequent episodes of sustained polymorphic ventricular tachycardia (14321). It is not clear whether Fucus vesiculosus, 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.

Endocrine ...Orally, Fucus vesiculosus can cause or exacerbate hyperthyroidism due to its high iodine content (12789,13061,74217). One case of hyperthyroidism has been reported for a 60-year-old patient taking lithium for bipolar disorder and a combination product containing Fucus vesiculosus 0.125 grams, cascara 0.170 grams, and Frangula 0.222 grams per tablet for laxative purposes. The patient had been taking one tablet of the combination laxative product daily for several years. Following discontinuation of the supplement, thyroid levels normalized (74217). Similar cases of hyperthyroidism have been reported for patients taking other seaweed-containing herbal supplements (Dream Shape; Ever Youth). Analyses of these supplements shows that these products contain triiodothyronine 1 mcg and thyroxine 3-4 mcg. In addition to seaweed, Dream Shape also contains hydrangea vine, maltose, chrysanthemum, Chinese matrimony vine, and sucrose, while Ever Youth contains radish, lotus leaf, chrysanthemum, hawthorn, senna tea, and Chinese matrimony vine (13061).
Orally, prolonged use of Fucus vesiculosus has been associated with hypothyroidism (13664). The iodine in Fucus vesiculosus can cause idiosyncratic reactions.
According to the Institute of Medicine Food and Nutrition Board, prolonged, high dietary intake of iodine is associated with goiter and an increased risk of thyroid cancer (7135).

Genitourinary ...A case of hemorrhagic cystitis characterized by dysuria and polyuria has been reported in a young adult who took a specific product (Slim-Kombu, Balestra and Mech) containing Fucus vesiculosus and 19 other herbal extracts orally for weight loss. Upon discontinuation, symptoms improved (46959). It is unclear if this effect was due to Fucus vesiculosus or other ingredients in the supplement.

Renal ...A case of hemorrhagic cystitis characterized by dysuria and polyuria has been reported in a young adult who took a specific product (Slim-Kombu, Balestra and Mech) containing Fucus vesiculosus and 19 other herbal extracts orally for weight loss. Upon discontinuation, symptoms improved (46959). It is unclear if this effect was due to Fucus vesiculosus or other ingredients in the supplement. Nephrotoxicity has been associated with oral intake of Fucus vesiculosus that was contaminated with arsenic (12800).

(Read more about FUCUS VESICULOSUS)

General ...There is currently a limited amount of information on the adverse effects of wild lettuce. Orally, large amounts of wild lettuce, as well as eating prematurely harvested wild lettuce, can cause sweating, increased respiration, tachycardia, pupil dilation, dizziness, ringing in the ears, vision disorders, pressure in the head, somnolence, excitatory states (18,93563), respiratory depression, coma, and death (4).
Topically, wild lettuce can cause contact dermatitis (4).
Intravenously, boiled wild lettuce has been reported to cause fever, severe headache, tachycardia, nausea, and abdominal pain in three intravenous drug users (93566).

Cardiovascular ...Orally, large amounts of wild lettuce or prematurely harvested wild lettuce has been reported to cause sweating, flushing, and tachycardia (18,93563).

Dermatologic ...Topically, wild lettuce can cause contact dermatitis (4). It can cause an allergic reaction in individuals sensitive to the Asteraceae/Compositae family. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many other herbs.

Gastrointestinal ...Orally, wild lettuce has been reported to cause nausea, vomiting, and abdominal cramps (93563).
Intravenously, boiled wild lettuce, prepared by hand in combination with valerian root, has been reported to cause nausea and abdominal pain in three intravenous drug users (93566).

Genitourinary ...Orally, wild lettuce can cause urinary retention (93563).

Immunologic ...Intravenously, boiled wild lettuce, prepared by hand in combination with valerian root, has been reported to cause fever, severe headache, and tachycardia in three intravenous drug users. This reaction was hypothesized to be due to an immunologic response (93566).

Neurologic/CNS ...Orally, large amounts of wild lettuce or prematurely harvested wild lettuce has been reported to cause dizziness, pressure in the head, somnolence, anxiety, headache, excitatory states (18,93563), and coma (4).

Ocular/Otic ...Orally, large amounts of wild lettuce or prematurely harvested wild lettuce has been reported to cause mydriasis, pupil dilation, dizziness, ringing in the ears, and vision disorders (18,93563).

Pulmonary/Respiratory ...Orally, large amounts of wild lettuce or prematurely harvested wild lettuce has been reported to cause increased respiration (18) or respiratory depression (4).

(Read more about WILD LETTUCE)