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Date Posted: 13:32:45 01/26/02 Sat
Author: No name
Subject: DRUGS;ETC.

WHAT IS ESSIAC?
Essiac is a tea made from four herbs. A Canadian nurse named Rene Caisse developed it in 1922. She said the formula originally came from an Ojibwa Indian medicine man. She named it after the backward spelling of her own last name, Caisse. The 4 main herbs in Essiac are burdock root (Arctium lappa), Indian or Chinese rhubarb (Rheum palmatum), sheep sorrel (Rumex acetosella) and the inner bark of slippery elm (Ulmus fulva or Ulmus rubra).

Burdock root is used in folk medicine to improve digestion, to clean the blood, to increase urination or as a laxative. Laboratory studies have shown some anti-tumor effects. Rhubarb can be a strong laxative. Sheep sorrel is claimed to be effective against cancer. Slippery elm has a long, safe history in alleviating sore throats. It is used in many herbal cough drops or teas for sore throats.

Caisse used the herbal tea to treat patients with cancer. Some of them claimed to be cured; others said the herbal tea eased their pain. In 1938 in Canada a bill was introduced to authorize Caisse to treat cancer. Instead, the legislature passed a bill that required her to disclose the formula for Essiac. She refused to do so. In 1977 she sold the formula to a Canadian corporation, Resperin.

Essiac is widely available as an herbal health food, without any specific health claims. There are several different versions of the product. There are also many claims and counterclaims about authenticity. In 2000, the US Federal Trade Commission filed a complaint against a distributor of Essiac for misleading health claims on several web sites.


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WHAT ARE THE BENEFITS OF ESSIAC?
Proponents of Essiac claim that it strengthens the immune system, improves appetite, relieves pain and improves overall quality of life. They also claim that it shrinks tumors and prolongs the lives of people with cancer.


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WHY DO PEOPLE WITH HIV USE ESSIAC?
All of the claims that Essiac can help people with HIV seem to have come from Dr. Gary Glum, a chiropractor. In 1988 he wrote "Calling of an Angel," a biography of Rene Caisse. Glum claims to have treated several AIDS patients with Essiac with good results. No report of this study was published.


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HOW IS ESSIAC USED?
Many providers of Essiac claim that the only correct way to use the product is to drink a freshly brewed tea, one to three times a day on an empty stomach. Essiac is available in liquid form but is also sometimes sold as a mixture of herbs to be boiled and steeped by the user or in capsule form.

Caisse reportedly had several variations of the recipe to treat different forms of cancer. Some versions of Essiac have more than the original four ingredients. The added ingredients are supposed to enhance the product's effectiveness and improve its taste. Two common additions are watercress and Pau d'arco. Yellow dock or curly dock are sometimes used instead of sheep's sorrel.


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WHAT ARE THE SIDE EFFECTS?
There are no recorded side effects from the use of Essiac. In 1982, the Canadian Department of National Health and Welfare authorized the availability of Essiac on a "compassionate use" basis. Their decision was based in part on the lack of reports of problems in 78 patients who used Essiac between 1978 and 1982.


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HOW DOES IT INTERACT WITH OTHER THERAPIES?
There are no known interactions between Essiac and medications or other herbs. However, most interactions between herbs and medications have not been studied. Tell your doctor if you are using herbal supplements.


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HOW DO WE KNOW IT WORKS?
Essiac is supported by many personal testimonials from cancer patients, but there are no careful scientific studies. Resperin Corporation received approval in 1978 from the Canadian government to study Essiac in humans. This permission was withdrawn four years later when the studies were not proceeding as expected. The Canadian Government does not consider Essiac to be an effective cancer treatment.

There are no reports of research studies in people with HIV infection. On the other hand, laboratory studies of the herbs used in Essiac document some anti-tumor effects. Carefully designed research studies are needed.


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THE BOTTOM LINE
Essiac is a tea originally made from four herbs. A Canadian nurse developed it in 1922 and used it to treat many cancer patients. Essiac is claimed to strengthen the immune system, relieve pain, and shrink cancerous tumors. Despite many personal reports of health benefits from Essiac, there are no scientific studies to support its use.

Essiac appears to be safe to use. It is available in several forms, based on different recipes, from competing providers. Prices vary widely. Be sure to obtain a complete list of ingredients.



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Revised July 30, 2001



WHAT IS ST. JOHN'S WORT?
St. John's Wort is a flowering plant. ("Wort" is an old English word for an herb or plant.) It grows in many parts of the world. Its scientific name is Hypericum perforatum. All of the aboveground parts of the plant are used. They are collected while the plant is flowering.

St. John's Wort has traditionally been used to treat bruises, burns, and mild depression or anxiety. St. John's Wort contains many different substances that work together. A major compound is hypericin.


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WHAT ARE THE BENEFITS OF ST. JOHN'S WORT?
Currently, the major use of St. John's Wort is to treat mild depression or anxiety. In 1996, the British Medical Journal published a review of scientific studies on St. John's Wort and depression. This review supports the herb's use to treat mild or moderate depression. Exactly how St. John's Wort treats depression is unclear, although it may be similar to the action of some pharmaceutical products.

Hypericin is active against several viruses, including cytomegalovirus, human papillomavirus, hepatitis B, and herpes. This antiviral activity has been shown in the laboratory and animal studies, but not in human studies. The herb seems to work against viruses by oxidation. The herb's antiviral effect is stronger when exposed to light.

St. John's Wort was studied in 1991 in people with HIV disease. The doses were much higher than for treating depression. Patients were given intravenous doses of purified hypericin. The study was stopped when every white-skinned patient in the trial became very sensitive to light. They developed skin rashes and some could not go outside until after they stopped taking hypericin. The one black-skinned patient did not have this reaction.


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WHY DO PEOPLE WITH HIV USE ST. JOHN'S WORT?
Although St. John's Wort has some antiviral activity at high doses, there are no scientific studies to show that it can reduce people's HIV viral load. However, it is effective against mild to moderate depression and anxiety. Many people with HIV have used St. John's Wort for this purpose. Early in 2000, a study showed that St. John's Wort causes a large drop in blood levels in indinavir. See "How Does It Interact With Other Therapies."


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HOW IS ST. JOHN'S WORT USED?
St. John's Wort is used in several forms. The most common form is in capsules containing a powder of the dried plant. It is also used in oil-based preparations, especially for use on the skin. As mentioned earlier, a highly purified form of hypericin was used in research studies but caused serious sensitivity to light.

The British review of the use of St. John's Wort to treat depression found that many different doses were used. The best dosage is not known.


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WHAT ARE THE SIDE EFFECTS?
The only known side effect of St. John's Wort is skin rash and sensitivity to light. This side effect is only seen with a purified extract or at extremely high dosages. St. John's Wort has sometimes been used to increase women's menstrual flow. Pregnant women should not use it.


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HOW DOES IT INTERACT WITH OTHER THERAPIES?
There are very few studies of interactions between St. John's Wort and medications or other herbs. Some bad reactions have been reported in people who combine St. John's Wort with anti-depression medications. Do not use St. John's wort with other antidepressants.

A study published in February 2000 showed that St. John's Wort affects the liver and reduces the levels of indinavir (CrixivanŽ) in the blood. Even low doses of St. John's Wort made the blood levels of indinavir go down by more than 50%. This could make indinavir ineffective against HIV and allow resistance to develop rapidly. St. John's Wort probably also changes the blood levels of other drugs that are broken down by the liver, including non-nucleoside reverse transcriptase inhibitors and protease inhibitors. DO NOT USE ST. JOHN'S WORT IF YOU ARE TAKING ANTIVIRAL DRUGS. Be sure your doctor knows if you are using St. John's Wort.

However, most antidepressant drugs also change the blood levels of some HIV drugs. You and your doctor should discuss the costs, risks and benefits of different treatments for depression.


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THE BOTTOM LINE
St. John's Wort is a flowering plant used for several health problems. It is mainly used to treat mild or moderate depression. It is active against viruses in the laboratory and in some animal studies. However, high doses of a purified extract used in human studies of its antiviral effect caused serious sensitivity to light.

St. John's Wort interacts with the liver and speeds up the processing of some drugs, including protease inhibitors. Do not use St. John's Wort if you are taking antiviral drugs.

People with HIV may want to take St. John's Wort to deal with mild or moderate depression, if they are not taking anti-HIV drugs. Be sure your doctor knows if you are taking St. John's Wort while taking ANY medications.



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Reviewed July 30, 2001



WHAT IS MARIJUANA?
Marijuana is an herb that grows in many places around the world. It is also called hemp, reefer, or cannabis. Its scientific name is Cannabis sativa. Historically, it has had many uses in different cultures. These including reducing pain and increasing appetite. Marijuana contains chemicals called cannabinoids. The most active one is tetrahydrocannabinol or THC.

Marijuana was legal for medical use in the United States until the late 1930s. Then there were claims of "reefer madness." These led lawmakers to believe that marijuana caused crime, violence, insanity, and death. In 1970, US drug law classified marijuana as having a high potential for abuse and no medical use.

Marijuana was later found to have other health benefits. It can lower pressure within the eye. This can help treat the eye disease called glaucoma, which can cause blindness. However, this would require long-term use of marijuana, which would increase the risk of negative side effects. Marijuana can also prevent vomiting in patients taking chemotherapy treatment for cancer. It can reduce muscle spasms in people with nerve problems like multiple sclerosis. These uses led to the development of the drug dronabinol (MarinolŽ), a synthetic version of THC.

NOTE: Federal and state laws generally forbid the sale or possession of marijuana. A few states have passed "medical marijuana" laws that permit limited use for health reasons. However, in May 2001 the US Supreme Court ruled that medical use of marijuana is illegal under federal law.


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WHAT ARE THE BENEFITS?
Marijuana reduces pain and anxiety and stimulates the appetite. It also reduces vomiting for people taking strong medications. Higher doses reduce anxiety and make users feel good.


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WHY DO PEOPLE WITH HIV USE MARIJUANA?
People with HIV use marijuana to stimulate appetite and to reduce nausea.

Many people with HIV have low appetite. This can be due to fatigue or drug side effects. Low appetite can lead to AIDS wasting. Marijuana stimulates the appetite, preventing these problems.

Some people with HIV get nauseated when they take antiviral medications. This makes it difficult to take all scheduled doses. Marijuana can help control the nausea.


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HOW IS MARIJUANA USED?
Normally, dried marijuana leaves and flowers are smoked or baked into food. Doctors can legally prescribe MarinolŽ. Some people get the same effects from Marinol as from smoked marijuana. Others prefer to smoke marijuana. They can use the amount they need without bad effects from higher doses.


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WHAT ARE THE SIDE EFFECTS?
Smoking marijuana causes most of the same health problems as smoking tobacco. Smoked or eaten marijuana can disrupt balance, physical coordination and visual perception. This can make it dangerous to drive a car or operate machinery. Some people feel stoned (very disoriented or dizzy) when using marijuana. This effect can be stronger when marijuana is eaten than when it is smoked.

Some users develop a tolerance to marijuana. This means they need higher and higher doses to get the same effect. Users can also become dependent on marijuana. They may have mild withdrawal symptoms when they stop using it.


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HOW DOES IT INTERACT WITH OTHER THERAPIES?
There are no known interactions between marijuana and medications or other herbs. However, very few interactions between herbs and medications have been studied. Tell your doctor if you are using any herbs or supplements.

A research study found that smoking marijuana does not increase HIV viral load.


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HOW DO WE KNOW IT WORKS?
There are many scientific studies that document marijuana's ability to reduce nausea, to increase appetite, and to decrease pressure in the eye.


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THE BOTTOM LINE
Marijuana is an herb that is smoked or baked into food. It has been used for health purposes for thousands of years. It was legal in the United States until the 1930s. It stimulates the appetite, reduces nausea, and reduces pressure inside the eye.


US drug policy made marijuana illegal in 1970. However, doctors can prescribe Marinol. It is a synthetic version of THC, the most active substance in marijuana. Not everyone gets the same results from Marinol as from marijuana.

Some people with AIDS use marijuana to stimulate their appetites or to avoid nausea when taking their antiviral medications. A few states have passed medical marijuana laws that permit limited use for health purposes.

For more information, read the Institute of Medicine (IOM) 1999 report, Marijuana and Medicine: Assessing the Science Base; Joy, Janet E., editor. Call (800) 624-6242, or read it or order it on-line at http://www.nap.edu.



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Revised May 14, 2001



WHAT IS SILYMARIN?
Silymarin refers to the extract from the seeds of the plant Silybum marianum, also called "milk thistle". It has been used for over 2,000 years. During the Middle Ages the seed of the milk thistle was commonly used to treat liver diseases.

The active ingredients of milk thistle are chemicals called flavonoids. The flavonoids in milk thistle are silybin, silydianin, and silychristin. Together, they are called silymarin.


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WHAT ARE THE BENEFITS OF SILYMARIN?
Silymarin protects the liver by acting as an antioxidant and by promoting the growth of new liver cells. Silymarin also helps with the digestion of fats. It appears to help keep harmful substances out of liver cells.

Milk thistle can help prevent or reverse liver damage caused by alcohol, recreational drugs, pesticides, some poisons, or hepatitis.

Silymarin has been used (especially in Europe) to treat hepatitis, liver damage due to alcoholism, and poisoning by certain types of mushrooms.

There is no evidence that silymarin acts directly against HIV.


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WHY DO PEOPLE WITH HIV USE SILYMARIN?
Some medicines used to fight HIV can damage the liver. People who have had hepatitis are more likely to have liver problems when they take anti-HIV drugs. Milk thistle might help prevent liver damage.

Several anti-HIV drugs can cause stomach problems, and silymarin can help treat indigestion.


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HOW IS SILYMARIN USED?
Silymarin is an extract of the seeds of the milk thistle plant. A standardized extract should be 80% silymarin (the active ingredient).

The usual dosage of milk thistle extract is between 300 milligrams (mg) and 600 mg daily.


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WHAT ARE THE SIDE EFFECTS?
There are no documented side effects of milk thistle. Even very high doses do not seem to have any negative effects. However, some people get an upset stomach or have more gas when they start using silymarin. If this happens, cut back on your dosage and then increase it slowly.


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HOW DOES IT INTERACT WITH OTHER THERAPIES?
There are no documented interactions of milk thistle with other therapies.


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HOW DO WE KNOW IT WORKS?
Milk thistle has been used for over 2,000 years, so a lot has been written about its health effects. There have been over 300 scientific studies of silymarin that document:

Antioxidant effects
Treatment of cirrhosis of the liver caused by alcoholism
Treatment of chronic hepatitis
Treatment of poisoning due to eating wild mushrooms
Helping the liver repair itself
Most of the scientific studies of silymarin were published in Europe.


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THE BOTTOM LINE
Silymarin is an extract of the seeds of the milk thistle plant. It has been used for over 2,000 years to treat liver problems. No side effects or dangerous interactions have been noted.

For people with HIV, especially if they have had hepatitis, silymarin might help protect the liver from damage caused by antiviral medications. It might also reduce stomach upset caused by medications.


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Note: This Fact Sheet is based on the work of Direct AIDS Alternative Information Resources (DAAIR). For more details, contact DAAIR at 1-888-951-5433 or http://www.daair.org.



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Reviewed March 29, 2001

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