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RASPBERRY LEAF

















Other Common Name: Red raspberry leaf
Botanical Name: Rubus idaeus
Family: Rosaceae
Plant Part Used: Leaf


PRESCRIBING INFORMATION


































Actions Astringent, partus preparator, parturifacient, antidiarrheal
Potential Indications
Based on appropriate evaluation of the patient, practitioners should consider prescribing raspberry leaf in formulations in the context of:

• Ensuring healthy uterine function at childbirth (when taken during pregnancy) (4,5)

• Abnormal bleeding from the uterus, stomach, or bowels (5)

• Mouth ulcers, diarrhea (5)

• Dysmenorrhea (6)

• Topical treatment for tonsillitis, conjunctivitis, sore throat (5,6)
Contraindications None known.
Warnings and Precautions None required.
Interactions None known.
Use in Pregnancy and Lactation No adverse effects expected in pregnancy or lactation, but confining use to the second and third trimesters is more appropriate.
Side Effects None expected if taken within the recommended dosage.
Dosage Dose per day* Dose per week*
  4.5-14 ml of 1:2 liquid extract 30-100 ml of 1:2 liquid extract

* This dose range is extrapolated from the British Herbal Pharmacopoeia 1983 and the author’s education and experience.



SUPPORTING INFORMATION














Traditional Prescribing
Traditional Western herbal medicine uses include:

• Diarrhea, dysentery, cholera1,2

• During pregnancy and to facilitate delivery,1,2 dysmenorrhea3

• Stomatitis;1 hemorrhage from the stomach, bowel, or uterus; prolapsed uterus2

• Topically for tonsillitis and conjunctivitis,1 as a gargle for sore throats4

• Stomach complaints of children, topically for wounds and ulcers4
Pharmacologic Research
The leaves of raspberry contain flavonoids, gallotannins, and ellagitannins.5

• Aqueous extract of raspberry leaf (1 g/15 ml) had little or no effect on isolated uteri from nonpregnant rats but inhibited contractions of those from pregnant rats. A variable response was obtained from uteri in induced estrus. Inhibition lasted 3 to 4 minutes, and intrinsic contractions were resumed. Epinephrine (adrenaline)-like resistance did not develop and the inhibitory effect was not prevented by propranolol. The extract contracted strips of human uterus at 10 to 16 weeks of pregnancy. For pregnant human and rat uteri, the intrinsic rhythm (over a 20-minute period while the extract remained in contact with the tissue) appeared to become more regular in most cases, and contractions were less frequent.6

• Aqueous extract of raspberry leaf stimulated isolated smooth muscle, particularly the uterus. When the tannins were removed from this extract, spasmolytic activity was exhibited. Both stimulant and relaxant components were present in the extract, with a weak anticholinesterase component demonstrating stimulation.7

• Raspberry leaf extracts relaxed isolated intestinal smooth muscle.8

• A concentrate of raspberry leaf infusion relaxed the uterus and intestine in situ (by intravenous injection), provided the tone of the organs was normal. For the uterus, the relaxation was occasionally followed by contraction and further relaxation. The degree of relaxation increased with successive doses. Secondary contractions were eliminated, and those that occurred were evenly spaced. The experimental model included mainly nonpregnant uteri and one animal in late pregnancy. Relaxation was also promoted in tonically contracted isolated (presumably nonpregnant) uteri, but if allowed to relax, raspberry leaf caused the organ to contract. When little tone was present in isolated uterus, raspberry leaf caused stimulation, but when the uterus was toned, raspberry leaf induced relaxation.9 This finding implies a regulatory action on uterine tone.
Clinical Studies
• A retrospective, observational, controlled study involving 108 women found that women can consume raspberry leaf during their pregnancy to shorten labor, with no side effects identified for the women or their babies. Ingesting raspberry leaf may also decrease the likelihood of preterm and postterm labor, evidenced by a smaller spread of the gestation period among the raspberry leaf group. An unexpected finding of the study was that women who ingest raspberry leaf might be less likely to require artificial rupture of their membranes, cesarean section, forceps, or vacuum birth. Treatment began as early as 8 weeks’ gestation, with the majority commencing at 30 to 34 weeks. The daily dose ranged from 1 to 6 cups of tea or 1 to 8 tablets, with 6 cups or tablets per day being the most popular intake. The weight of the tablets was not defined. 10

• A follow-up trial of randomized, double-blind, placebo-controlled design was conducted by the same authors and involved 192 women who were followed from 32 weeks of pregnancy to labor. The women in the treatment group received 1.2 g of raspberry leaf twice a day.

No adverse effects were observed, but also, no effect on shortening the first stage of labor was indicated. A shortening of the second stage of labor occurred (a difference of 9.6 minutes) and a lower rate of forceps deliveries was noted for the raspberry leaf group compared with the control group (19.3% and 30.4%, respectively). The authors suggested that earlier intervention and a higher dose should be studied.11

• A pharmacologic study conducted in the 1940s observed that uterine contractions decreased in frequency and strength in three pregnant women administered a raspberry leaf extract. Secondary contractions were also eliminated. A very slight fall in the systolic blood pressure was noticeable. The authors noted that raspberry leaf may be useful for treating irregular uterine action during labor and menstruation. The dose was recorded as 20 to 40 grains (approximately 1.3 to 2.6 g) of crude extract of dried raspberry leaves, containing fragarine. “Fragarine” is the term the authors proposed for the active principle of this crude extract of raspberry leaves.3 This term has been used in popular and scientific literature ever since, but no evidence has been found to verify the existence of fragarine, let alone its chemical structure.


REFERENCES



1 British Herbal Medicine Association’s Scientific Committee. British herbal pharmacopoeia. Bournemouth: BHMA, 1983.


2 Felter HW, Lloyd JU. King’s American dispensatory, ed 18. Portland: Eclectic Medical Publications, 1905. rev 3, reprinted 1983


3 Whitehouse B. Br Med J. 1941;2:370-371.


4 Grieve M. A modern herbal. New York: Dover Publications, 1971.


5 Wagner H, Bladt S. Plant drug analysis: a thin layer chromatography atlas, ed 2. Berlin: Springer-Verlag, 1996.


6 Bamford DS, Percival RC, Tothill AU. Br J Pharmacol. 1970;40(1):161P-162P.


7 Beckett AH, et al. J Pharm Pharmacol. 1954;6:785-796.


8 Patel AV, et al. J Pharm Pharmacol. 1990;47(12B):1129.


9 Burn JH, Withell ER. Lancet. 1941;2(6149):1-3.


10 Parsons M, Simpson M, Ponton T. J Aust Coll Midwives. 1999;12(3):20-25.


11 Simpson M, et al. J Midwifery Womens Health. 2001;46(2):51-59.





RED CLOVER














Botanical Name: Trifolium pratense
Family: Leguminosae
Plant Part Used: Flower


PRESCRIBING INFORMATION


































Actions Depurative, antitumor (traditional use)
Potential Indications
Based on appropriate evaluation of the patient, practitioners should consider prescribing red clover in formulations in the context of:

• Skin disorders, including eczema, psoriasis, and ulcers (5)

• Respiratory conditions, especially with spasmodic cough, including bronchitis (5)
Contraindications None known.
Warnings and Precautions None required.
Interactions None known.
Use in Pregnancy and Lactation No adverse effects expected.
Side Effects None expected if taken within the recommended dose range.
Dosage Dose per day* Dose per week*
  1.5-6.0 ml of 1:2 liquid extract 10-40 ml of 1:2 liquid extract

* This dose range is extrapolated from the British Herbal Pharmacopoeia 1983, the British Herbal Compendium 1992, and the experience.



SUPPORTING INFORMATION














Traditional Prescribing
Traditional Western herbal medicine uses include:

• Chronic skin disease, including eczema, psoriasis, leg ulcers, and burns1,2

• Bronchitis, whooping cough, laryngitis1,2

• Cancer2
Pharmacologic Research Red clover flowers contain isoflavones, including biochanin A, formononetin, and genistein.3 Isoflavones have demonstrated weak estrogenic activity and under certain circumstances exert an antiestrogenic competitive activity.4 However, in 25% aqueous ethanolic extracts of red clover flowers, these constituents are present in low quantities. 3
Clinical Studies Trials using concentrated extracts of red clover leaf and flower, standardized for isoflavone content have been conducted. However, given that traditional liquid extracts are low in isoflavones, this information has not been reviewed here.

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Dec 4, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on R

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