Cornsilk Combination by Pure Herbs

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Angina. A meta-analysis of four generally lower-quality clinical trials in patients with angina shows that taking corn silk decoction in combination with hypolipidemic drugs reduces levels of low-density lipoprotein (LDL) cholesterol and triglycerides and increases levels of high-density lipoprotein (HDL) cholesterol by a small to moderate amount when compared with hypolipidemic drugs alone. Doses of corn silk used in the studies were corn silk decoction 60 grams daily or modified corn silk decoction containing corn silk 60 grams, corydalis 30 grams, Chinese cucumber 15 grams, and Allium macrostemon 15 grams daily for approximately one month (103364).
• Glaucoma. Increased intraocular pressure is a risk factor for glaucoma. Preliminary clinical research in adults with hypertension shows that taking a single dose of corn silk extract 130-260 mg/kg in 600 mL of water reduces intraocular pressure by around 4-10 mmHg over an 8-hour period. Reductions in intraocular pressure were dose-dependent (93869). It is unclear if this improvement would be sustained with extended use.
• Hypertension. A meta-analysis of five generally lower-quality clinical trials shows that taking corn silk in combination with antihypertensive drugs reduces blood pressure by a small amount when compared with antihypertensive drugs alone. Doses of corn silk used in the studies were 10-60 grams daily for 1-12 weeks (103362). In addition, preliminary clinical research in adults with hypertension shows that taking a single dose of corn silk extract 130-260 mg/kg in 600 mL of water reduces systolic and diastolic blood pressure by around 5-13 mmHg over an 8-hour period when compared with placebo. Reductions in blood pressure were dose-dependent (93869). More evidence is needed to rate corn silk for these uses.

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There is insufficient reliable information available about the effectiveness of stone root.

(Read more about STONE ROOT)

POSSIBLY INEFFECTIVE

• Urinary tract infections (UTIs). Clinical research does not support the use of oral uva ursi for treatment of UTIs. For prevention of UTIs, oral uva ursi has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A large clinical study in females with uncomplicated UTI shows that taking uva ursi tablets providing 210 mg arbutin orally three times daily for 5 days is less effective than a single dose of fosfomycin 3 grams for reducing UTI symptom burden and the number of rescue antibiotic courses. Rescue antibiotics were needed in 44% of patients receiving uva ursi, compared with 23% of those receiving fosfomycin. On day 4, the percentage of patients with symptom resolution was 49% with uva ursi, compared to 65% with fosfomycin. Pyelonephritis occurred in 8 patients on uva ursi and 2 patients on fosfomycin (109535). Also, a large clinical study in females experiencing symptoms of a UTI shows that taking uva ursi extract 1200 mg three times daily for 3-5 days does not improve symptoms or reduce the need for antibiotics when compared with placebo (101815). Uva ursi has also been evaluated for the prevention of UTIs. One small clinical study in females with recurrent UTI shows that taking a specific combination product containing uva ursi and dandelion (UVA-E, Medic Herb AB) 3 tablets three times daily for one month reduces the recurrence rate of UTIs when compared with placebo (1932). It is not clear if this effect is due to uva ursi, dandelion, or the combination.

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Benign prostatic hyperplasia (BPH). Although there is interest in using oral uva ursi for BPH, there is insufficient reliable information about the clinical effects of uva ursi for this condition.
• Bronchitis. Although there is interest in using oral uva ursi for bronchitis, there is insufficient reliable information about the clinical effects of uva ursi for this condition. More evidence is needed to rate uva ursi for these uses.

(Read more about UVA URSI)

LIKELY SAFE ...when used orally in amounts commonly found in foods. Corn silk, corn silk extract, and corn silk oil has Generally Recognized as Safe (GRAS) status in the US (4912). There is insufficient reliable information available about the safety of corn silk when used orally as medicine.

PREGNANCY: POSSIBLY SAFE
when consumed in food.

PREGNANCY: LIKELY UNSAFE
when used orally in larger amounts because it might have uterine stimulant effects (4); avoid using.

LACTATION: POSSIBLY SAFE
when consumed in food amounts. Insufficient reliable information available when used as medicine; avoid using.

(Read more about CORN SILK)

There is insufficient reliable information available about the safety of stone root.

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

(Read more about STONE ROOT)

POSSIBLY SAFE ...when used orally and appropriately, short-term. Uva ursi has been used with apparent safety in doses of up to 3600 mg daily for 3-5 days (101815).

POSSIBLY UNSAFE ...when used orally long-term or in high doses. There is concern about the safety of long-term or high-dose use because of the hydroquinone content of uva ursi. Hydroquinone is thought to have mutagenic and carcinogenic effects (7). At high doses (around 20 grams of dried herb) it can cause convulsions, cyanosis, delirium, shortness of breath, and collapse. At very high doses (30 grams of dried herb or more) it can be fatal (4).

CHILDREN: POSSIBLY UNSAFE
when used orally by children. Uva ursi contains hydroquinone and high tannin levels, which can cause severe liver problems in children (4,18); avoid using.

PREGNANCY: LIKELY UNSAFE
when used orally. Uva ursi can have oxytocic effects, increasing the speed of labor (4,7,19); avoid using.

LACTATION:
Insufficient reliable information available; avoid using.

(Read more about UVA URSI)

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D In an animal diabetic model, corn silk extract reduced levels of fasting blood glucose (103365). Theoretically, corn silk might have an additive effect with antidiabetes drugs and cause hypoglycemia.  Details Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.

(Read more about CORN SILK)

(Read more about STONE ROOT)

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, uva ursi may decrease the metabolism of CYP2C19 substrates.  Details In vitro, uva ursi appears to inhibit cytochrome CYP2C19 (98550). This effect 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, uva ursi may decrease the metabolism of CYP3A4 substrates.  Details In vitro, uva ursi appears to inhibit CYP3A4 (98550). This effect has not been reported in humans.

GLUCURONIDATED DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, uva ursi may increase levels of drugs metabolized by glucuronidation.  Details In vitro, uva ursi extract appears to strongly inhibit UDP-glucuronosyltransferase (UGT) 1A1 (UGT1A1). However, uva ursi extract does not appear to inhibit UGT1A1 in animal models (98549). This effect has not been reported in humans.

LITHIUM Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = D Theoretically, uva ursi may increase lithium levels, necessitating a decrease in dose.  Details Uva ursi may have diuretic properties (81637). Diuretics may increase lithium reabsorption with sodium in the proximal tubule of the kidney. Theoretically, uva ursi might reduce excretion and increase levels of lithium.

P-GLYCOPROTEIN SUBSTRATES Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, uva ursi may alter the levels of drugs transported by P-glycoprotein.  Details In vitro, uva ursi appears to inhibit the multi-drug transporter protein, P-glycoprotein (98550). This effect has not been reported in humans.

URINARY ACIDIFYING AGENTS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Effects of uva ursi in the urinary tract may be reduced by urinary acidifying agents.  Details Uva ursi seems to work best in alkaline urine. Theoretically, taking uva ursi with medications known to acidify the urine may decrease any effects of uva ursi on the urinary tract (19).

(Read more about UVA URSI)

General ...Orally, corn silk seems to be well tolerated. However, a thorough evaluation of safety outcomes associated with medicinal use has not been conducted (103362). Corn silk has been reported to cause hypokalemia with prolonged use (4). Topically, corn silk can cause contact dermatitis and urticaria (4).

Dermatologic ...Topically, corn silk can cause dermatitis and urticaria (4).

Endocrine ...Orally, corn silk has been reported to cause hypokalemia with prolonged use (4).

Renal ...Orally, corn silk extract can increase urinary volume and increase the excretion of sodium and potassium (93869).

(Read more about CORN SILK)

General ...There is limited reliable information available about the adverse effects of stone root.

Gastrointestinal ...Orally, large amounts of stone root can cause intestinal tract irritation and colic-like pain dizziness, and nausea (18).

Genitourinary ...Orally, large amounts of stone root can cause painful urination (18).

(Read more about STONE ROOT)

General ...Uva ursi is generally well tolerated in low doses, short-term.
Most Common Adverse Effects:
Orally: Diarrhea, nausea, stomach upset, and vomiting.
Serious Adverse Effects (Rare):
Orally: At high doses (20 grams of dried herb), uva ursi has been reported to cause collapse, convulsions, cyanosis, delirium, shortness of breath, and tinnitus. Very high doses of 30 grams or more may be fatal.

Gastrointestinal ...Orally, uva ursi may cause nausea, vomiting, diarrhea, and stomach upset (92148). It can also irritate the gastrointestinal tract (19).

Genitourinary ...Orally, uva ursi may cause the urine to be greenish-brown. It may also cause irritation and inflammation of the urinary tract mucous membranes (18).

Hepatic ...Uva ursi may be hepatotoxic. Theoretically, chronic use, especially in children, can cause liver impairment due its hydroquinone and high tannin content (4,18).

Neurologic/CNS ...Orally, around 20 grams of uva ursi is reported to supply up to one gram of hydroquinone, which can theoretically cause convulsions and delirium (4).

Ocular/Otic ...Orally, uva ursi may potentially cause retinal toxicity due to its hydroquinone content, which reduces melanin synthesis. A 56-year-old female developed bilateral bull's-eye maculopathy, paracentral scotomas, and retinal thinning after 3 years of uva ursi tea ingestion (16900).
Taking around 20 grams of uva ursi orally is reported to supply up to one gram of hydroquinone, which can theoretically cause tinnitus (4).

Pulmonary/Respiratory ...Orally, around 20 grams of uva ursi is reported to supply up to one gram of hydroquinone, which can theoretically cause shortness of breath and cyanosis (4).

(Read more about UVA URSI)