KidneXX by Viatrexx Bio Incorporated

POSSIBLY EFFECTIVE

• Diarrhea. Low-quality evidence shows that oral cooked green bananas might be helpful for the management of acute and persistent diarrhea due to various causes in children. Details: Many clinical studies in children aged 5 months to 5 years with acute diarrhea of various etiologies shows that consuming cooked green bananas with or without rice for up to 14 days increases recovery rates by 30% to 266% when compared with control (93451,93462,93463,106469). Consuming cooked green bananas also reduced the need for rehydration therapy and the incidence of dehydration (93462,93463,106469). Clinical trials used cooked green bananas 50-100 grams per day in children aged 6-12 months, 100-200 grams per day in children aged 12-24 months, and 300 grams per day aged 24 months to 5 years (93451,93462,93463,106469). A moderate size, open label clinical study among children aged 6-35 months hospitalized with persistent diarrhea in Bangladesh shows that consuming a diet of green banana mixed with rice suji increases the number of children who recover within 5 days when compared with a full-strength rice suji diet but is equivalent to the standard treatment (control) of 75% strength rice suji diet (112150). Duration of hospital stay is also similar with green banana and 75% strength rice suji and shorter than with full strength rice suji. There is also less relapse at home among children who had been given the green banana rice suji diet in hospital compared with the 75%-strength rice suji. The validity of the study is limited by the lack of blinding. Clinical research also shows that bananas might be beneficial for diarrhea associated with enteral feeding in adults with critical illness. Adding banana flakes (Kanana Banana, Corpak Co) 1-3 tablespoons every 8 hours to the feeding tube seems to be as effective as routine medical treatment involving feeding rate adjustments and use of antidiarrheal agents for reducing symptoms and duration of diarrhea. After 7 days of treatment, 57% of patients in the banana group were free of diarrhea compared with only 24% of patients in the group receiving routine treatment (93453).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Allergic rhinitis (hay fever). Although there has been interest in using oral banana flower for allergic rhinitis, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Athletic performance. It is unclear if oral banana is beneficial for athletic performance. Details: Preliminary clinical research in trained male cyclists shows that consuming 0.4 grams/kg carbohydrate orally from ripe bananas with water 10-20 minutes prior to a 75 km cycling time trial, and 0.15-0.2 grams/kg carbohydrate from bananas with water every 15 minutes during the trial, modestly improves cycling time and oxygen consumption when compared with water alone. This regimen is equally effective to the same dose of carbohydrate from a 6% carbohydrate beverage (Gatorade) (93459,93465). However, another study from the same group of researchers found conflicting results with the use of carbohydrates from banana for this purpose (100995). It is possible that the consumption of carbohydrates in general, not the use of bananas specifically, is beneficial for athletic performance. However, other preliminary clinical research in trained male runners shows that consuming a banana and drinking plain water does not improve the time to run 10 km on a treadmill when compared with plain water alone. No benefit was seen with the consumption of other carbohydrate drinks when compared with plain water; it is possible that the duration of exercise was too short to identify an improvement in performance (93457). Further research is needed to clarify the benefits of banana, if any, for athletic performance.
• Burns. It is unclear if topical banana leaf is beneficial in patients with burns. Details: Preliminary clinical research in adults and children with partial thickness burns shows that daily changes of a banana leaf dressing with povidone iodine reduces pain during dressing changes. Furthermore, wound healing is as effective as a boiled potato peel bandage with povidone iodine, with no increased need for skin grafting (93454). When compared with Vaseline gauze dressing for 8 days following skin graft treatment for burns in adults, banana leaf dressing increases speed of epithelization from 11.7 days to 8.7 days, and improves average pain, pain during dressing removal, and ease of dressing removal. By the 8th day, complete epithelization was present in 57% of the wounds dressed with banana leaves when compared with 0% of the wounds dressed with Vaseline gauze (93455).
• Cancer. Although there has been interest in using topical banana green fruit for cancer, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Constipation. It is unclear if oral green banana is beneficial in patients with constipation. Details: Preliminary clinical research in children with functional constipation shows that consuming cooked green bananas, 30 grams daily for 8 weeks, improves stool consistency and abdominal pain and reduces straining and pain during defecation when compared with baseline. Consuming cooked green bananas with a conventional laxative such as polyethylene glycol plus electrolytes or sodium picosulfate also appears to decrease the dose of laxative needed in these children when compared with baseline (100996). The validity of these findings is limited by the lack of a comparator group.
• Contraception. Although there has been interest in using oral banana root for contraception, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Cough. Although there has been interest in using oral banana flower for cough, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Depression. It is unclear if oral banana is beneficial in patients with depression. Details: A large cross-sectional study in the general Chinese adult population has found that moderate, but not high, banana consumption is associated with a lower likelihood of depressive symptoms in males. However, high banana consumption is associated with a higher likelihood of depressive symptoms in females (106471).
• Diabetes. It is unclear if oral banana starch is beneficial in patients with diabetes. Details: Two small clinical studies in adults with type 2 diabetes shows that taking banana starch 24-57.2 grams orally daily for 4-28 days does not improve serum glucose levels, glucose variability, glucose control scores, or insulin levels when compared with control starches (110619,93448).Other preliminary clinical research in obese patients with type 2 diabetes shows that taking banana starch 24 grams in 240 mL of water each day for 4 weeks reduces body weight when compared with a taking soymilk powder in water. However, banana starch did not improve lipid levels or body fat (93448). Other preliminary clinical research in patients with type 2 diabetes shows that taking desiccated banana 250 grams daily for 12 weeks does not improve lipid levels or glycemic response when compared to baseline (93452).
• Exercise-induced muscle soreness. It is unclear if oral banana is beneficial for exercise-induced muscle soreness. Details: Preliminary clinical research in trained cyclists shows that consuming 0.4 grams/kg of carbohydrates orally from mini-yellow bananas with water 20 minutes prior to a 75 km cycling time trial, and 0.2 grams/kg of carbohydrates from banana every 15 minutes during the trial, decreases muscle soreness ratings 1.5 hours after the time trial when compared with water alone. Consuming carbohydrates from Cavendish bananas in the same manner did not decrease delayed onset muscle soreness, although cyclists reported less muscle cramping with both types of bananas when compared with water (100995). It is unclear whether carbohydrates from banana are any more effective than other carbohydrate sources or whether these results are generalizable to other types of exercise.
• Gastroesophageal reflux disease (GERD). Although there has been interest in using oral banana fruit for GERD, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Hangover. Although there has been interest in using oral banana fruit for hangover, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Headache. Although there has been interest in using topical banana leaves for headache, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Hypercholesterolemia. It is unclear if oral banana is beneficial in patients with hypercholesterolemia. Details: Preliminary clinical research shows that taking desiccated banana 500 grams orally daily for 12 weeks reduces levels of total cholesterol by 7.5% when compared with baseline in patients with hypercholesterolemia. Taking 250 grams daily does not seem to reduce total cholesterol levels; however, high-density lipoprotein (HDL) cholesterol levels increase by 14.5% (93452). The validity of these findings is limited by the lack of a comparator group.
• Hypertension. Although there has been interest in using oral banana fruit for hypertension, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Hypokalemia. Although there has been interest in using oral banana fruit for hypokalemia, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Inflammatory bowel disease (IBD). Although there has been interest in using oral banana fruit for IBD, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Joint pain. Although there has been interest in using oral banana flower for joint pain, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Kidney stones (nephrolithiasis). Oral banana stem has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in patients with calculi of at least 5 mm shows that taking a specific Ayurvedic product (Herbmed) containing banana stem 250 mg and Crateva nurvala 250 mg orally daily for 3 months moderately improves symptoms associated with urinary calculi and reduces the size of the calculi by 11% to 33% when compared with baseline (93460). It is not clear if this is due to banana stem, Crateva nurvala, or the combination. Also, the validity of this finding is limited by the lack of a comparator group.
• Menorrhagia. Although there has been interest in using oral banana fruit for menorrhagia, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Obesity. It is unclear if oral banana is beneficial in patients with obesity. Details: Preliminary clinical research in obese patients with type 2 diabetes shows that taking banana starch 24 grams in 240 mL of water orally each day for 4 weeks reduces body weight by 1 kg more when compared to a control group consuming soymilk powder in water (93448).
• Peptic ulcers. Although there has been interest in using oral banana fruit for peptic ulcers, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Shigellosis. It is unclear if oral green banana is beneficial in patients with shigellosis. Details: Clinical research in children 6-60 months of age who are being treated with antibiotics for shigellosis shows that eating cooked green banana 250 grams per liter of a rice-based diet for 5 days improves symptoms of diarrhea, including the presence of fecal mucus and blood, when compared with a rice-based diet alone. Adding banana to the diet decreased the number of daily stools by 70% in those consuming banana compared to 50% in children consuming the rice diet alone (93461).
• Skin grafts. Although there has been interest in using topical banana leaves for skin grafts, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Smoking cessation. Although there has been interest in using oral banana fruit for smoking cessation, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Stroke. Although there has been interest in using oral banana fruit for stroke, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Tuberculosis. Although there has been interest in using oral banana flower for tuberculosis, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Vaginitis. Although there has been interest in using oral banana root for vaginitis, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Vitamin A deficiency. Although there has been interest in using oral banana fruit for vitamin A deficiency, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Warts. Although there has been interest in using topical banana leaves or peels for warts, there is insufficient reliable information about the clinical effects of banana for this purpose.
• Wound healing. Although there has been interest in using topical banana leaves, peels, or green fruit for wound healing, there is insufficient reliable information about the clinical effects of banana for this purpose. More evidence is needed to rate banana for these uses.

(Read more about BANANA)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Benign prostatic hyperplasia (BPH). Oral goldenrod has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in adults with BPH, some of whom were already receiving treatment for their symptoms, shows that taking 1200 mg of a specific product containing water-soluble extracts of goldenrod, boldo, chanca piedra, fireweed, and spiny restharrow (Fluxonorm, Omega Pharma) for 30 days improves lower urinary tract symptom scores by about 50% when compared to baseline. Maximum urinary flow rate and quality of life were also improved when compared with baseline (106432). The validity of these findings is limited by the lack of a comparator group.
• Dental plaque. Topical goldenrod has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in healthy adults shows that using a specific toothpaste (Bucovia, Givaudan) containing goldenrod extract 0.3% and sodium fluoride 0.15% twice daily for 4 weeks improves plaque index scores when compared to baseline. These effects were not different from use of a toothpaste containing only sodium fluoride 0.15%, although the study may have been inadequately powered to detect a difference between groups. Also, it is unclear if these effects are due to goldenrod, sodium fluoride, or the combination (105115).
• Kidney stones (nephrolithiasis). Although there has been interest in using oral goldenrod for kidney stones, there is insufficient reliable information about the clinical effects of goldenrod for this purpose.
• Urinary tract infections (UTIs). Oral goldenrod has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A secondary analysis of clinical research in females with a UTI who were not taking antibiotics shows that taking a specific combination supplement (Aqualibra, Medice Arzneimittel Pütter GmbH & Co. KG) containing extracts of goldenrod 360 mg, Java tea 180 mg, and spiny restharrow root 160 mg three times daily for 7 days modestly improves clinical symptom scores when compared with placebo. Individuals taking the combination supplement also had a 63% reduction in microbial count, compared with 25% in those taking placebo. Additionally, antibiotics were prescribed in only 15% of those taking the combination product, compared with 49% of those taking placebo (102763). It is unclear if these findings are due to goldenrod, other ingredients, or the combination. More evidence is needed to rate goldenrod for these uses.

(Read more about GOLDENROD)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Androgenic alopecia. Although there is interest in using oral horsetail for alopecia, there is insufficient reliable information about the clinical effects of horsetail for this condition.
• Hypertension. Oral horsetail seems to reduce blood pressure in patients with hypertension. Details: A clinical trial in patients with stage 1 systemic arterial hypertension shows that taking horsetail extract 900 mg daily for 3 months decreases systolic and diastolic blood pressure by 13 mmHg and 8 mmHg, respectively, and is similarly effective to hydrochlorothiazide 25 mg daily (108849). The validity of this finding is limited due to high withdrawal rates and low adherence to treatment protocols.
• Kidney stones (nephrolithiasis). Although there is interest in using oral horsetail for kidney stones, there is insufficient reliable information about the clinical effects of horsetail for this condition.
• Obesity. Although there is interest in using oral horsetail for weight loss, there is insufficient reliable information about the clinical effects of horsetail for this purpose.
• Osteoporosis. It is unclear if oral horsetail is beneficial for osteoporosis. Details: Preliminary clinical research shows that taking two tablets of either dried horsetail extract or a specific combination of horsetail extract with calcium (Osteosil Calcium) daily for 2-month intervals separated by 2 weeks of no treatment for up to one year can increase bone density when compared with no treatment in postmenopausal patients with osteoporosis. The effect of horsetail extract plus calcium (Osteosil Calcium) seems to be greater than the effect of dried horsetail extract alone (55578).
• Tonsillitis. Oral horsetail has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in children with acute non-bacterial tonsillitis shows that taking a specific combination product (Imupret) for 10 days in addition to standard symptomatic therapy accelerates recovery by a small amount when compared with symptomatic therapy alone. Overall treatment response after 10 days occurred in 82% of patients taking the combination product compared with 65% of patients receiving symptomatic therapy alone. Withdrawal from antipyretic drugs occurred approximately one day earlier in children using the horsetail product. Per 100 grams, Imupret provides 29 grams of an alcoholic extract produced from horsetail 0.5 grams, marshmallow root 0.4 grams, chamomile flowers 0.3 grams, walnut leaves 0.4 grams, English walnut leaves 0.4 grams, yarrow 0.4 grams, oak bark 0.2 grams, and dandelion 0.4 grams. In children aged 6-11 years, 15 drops 6 times daily for 5 days and then 15 drops 3 times daily for 5 days was used. In children aged 12-18 years, 25 drops 6 times daily for 10 days was used. (100347). Due to the small difference between the two groups and the open-label design, the clinical relevance of this study is unclear. Also, it is unclear if these benefits are due to horsetail, the other ingredients, or the combination.
• Urinary incontinence. Oral horsetail has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research shows that taking a specific supplement (Urox, Seipel Group) 840 mg, containing a combination of horsetail stem, three-leaf caper, and lindera root daily with food for 8 weeks modestly decreases urinary frequency, stress incontinence, and urgency incontinence when compared with placebo in patients with urinary incontinence and/or overactive bladder (97575). It is unclear if these effects are due to horsetail, the other ingredients, or the combination.
• Urinary tract infections (UTIs). Although there is interest in using oral horsetail for UTIs, there is insufficient reliable information about the clinical effects of horsetail for this condition. More evidence is needed to rate horsetail for these uses.

(Read more about HORSETAIL)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Hypertension. Some preliminary clinical research in adults with hypertension that is not adequately controlled with antihypertensive medication shows that taking a specific combination supplement (OrthoSiphon, Rottapharm-Madaus SpA) containing Java tea 100 mg (standardized leaf alcoholic dry extract, with sinensetin 0.1%), berberine 500 mg, monakolin 3 mg, and policosanols 10 mg, daily for 8 weeks, reduces systolic and diastolic blood pressure by 5 mmHg and 2 mmHg, respectively, when compared to baseline. However, this supplement is less effective when compared with hydrochlorothiazide 12.5 mg daily (94851). It is unclear if these effects are due to Java tea, other ingredients, or the combination.
• Urinary tract infections (UTIs). A secondary analysis of clinical research in females with a UTI who are not taking antibiotics shows that taking a specific combination supplement (Aqualibra, Medice Arzneimittel Pütter GmbH & Co. KG), containing extracts of Java tea 180 mg, spiny restharrow root 160 mg, and goldenrod 360 mg, three times daily for 7 days modestly improves symptom scores when compared with placebo. Reductions in urinary microbial count were 63% with the supplement, compared with 25% in those taking placebo. Antibiotics were added to treatment in 15% and 49% of patients taking the supplement or placebo, respectively (102763). It is unclear if the effects are due to Java tea, other ingredients, or the combination. More evidence is needed to rate Java tea for these uses.

(Read more about JAVA TEA)

POSSIBLY EFFECTIVE

• Psoriasis. Clinical research shows that applying a specific 10% Oregon grape extract cream (Relieva, Apollo Pharmaceutical) modestly decreases the severity of psoriasis and improves quality of life in patients with psoriasis when compared with placebo (854,857,14000,14333). One small clinical study shows that this specific cream might be as effective as calcipotriene (Dovonex) cream for some patients (14000).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Atopic dermatitis (eczema). Preliminary clinical research shows that applying a specific Oregon grape extract cream (Relieva) for 12 weeks improves the severity and area of eczema when compared to baseline in adult patients with atopic dermatitis (67370). The validity of this finding is limited by the lack of a comparator group. In contrast, applying a combination of Oregon grape, heart's ease, and gotu kola extracts for 4 weeks does not improve eczema when compared with a base cream, although there appears to be improvement in eczema for skin exposed to cold weather (67372). More evidence is needed to rate Oregon grape for this use.

(Read more about OREGON GRAPE)

EFFECTIVE

• Hypokalemia. Oral or intravenous potassium can treat and prevent hypokalemia. Details: Administering potassium orally or intravenously is effective for treating and preventing hypokalemia (15,107970). Oral potassium 20 mEq (780 mg of elemental potassium) is typically taken once daily to prevent hypokalemia (15,95010). Oral potassium 40-100 mEq (1560-3900 mg of elemental potassium) is typically taken in 2-5 divided doses daily to treat hypokalemia (95010). Doses should be limited to 40 mEq (1560 mg of elemental potassium), and the total dose should not exceed 200 mEq (7800 mg of elemental potassium) in 24 hours (95010). Potassium supplementation and route of administration should be individualized based on serum potassium level and patient status (15,107970).

LIKELY EFFECTIVE

• Hypertension. Oral potassium, via dietary intake or supplementation, reduces blood pressure. Details: Population research has found that higher dietary potassium consumption is associated with a lower risk of developing hypertension (1310,8817,69512). Additionally, most clinical research shows that potassium, taken orally as part of the diet or as a supplement, reduces systolic blood pressure by about 3-9.5 mmHg and diastolic blood pressure by about 2-6.4 mmHg in patients with or without hypertension (3385,92104,92106,95624,107974). In most of these studies, daily intake of potassium typically ranged from about 1500-7800 mg, with the most common intake being about 2340-2540 mg daily (92104,95624). However, some research shows that taking potassium does not lower systolic or diastolic blood pressure (69541,69550,107966). Differences in the patient populations, potassium intake, and salt intake could have contributed to the conflicting results. Potassium seems to be more effective for people with hypertension, low potassium levels, high daily sodium intake, and for Black adults (3384,3385,3386,92104,92106). Some research also shows that the greatest blood pressure-lowering effects of potassium occur at doses of about 3900-7800 mg daily (95624). A meta-analysis of clinical trials using a novel computational technique to assess both potassium intake and excretion suggests that the optimal blood pressure reduction occurs when taking about 1500 mg supplemental potassium daily or an overall intake of 4500-6500 mg potassium daily (105448). This analysis is limited by the heterogeneity and short duration of the included trials. There is also interest in utilizing low-sodium, high-potassium food substitutes to treat hypertension. Research shows that using salt substitutes containing 25% to 30% potassium chloride reduces systolic and diastolic blood pressure by 3-4.6 mmHg and 1 mmHg, respectively, when compared with regular table salt (107971,107976). In 2017, the American College of Cardiology and the American Heart Association (ACC/AHA) published guidelines recommending that patients with hypertension consume 3500-5000 mg of potassium daily (95680). This intake of potassium is expected to lower systolic blood pressure by about 4-5 mmHg in patients with hypertension and by about 2 mmHg in normotensive patients (3385). Although potassium supplements and dietary potassium both seem to be beneficial, the guidelines recommend getting potassium from dietary sources, since potassium-rich diets are usually heart-healthy (95680). Additionally, the US Food and Drug Administration (FDA) has determined that foods containing at least 350 mg potassium and that are low in sodium, saturated fat, and cholesterol can state that "diets containing foods that are good sources of potassium and low in sodium may reduce the risk of high blood pressure and stroke" (1310,8817).
• Kidney stones (nephrolithiasis). Oral prescription potassium citrate reduces the risk of kidney stone recurrence. It is unclear if non-prescription potassium citrate would be beneficial. Details: The American Urological Association (AUA) recommends potassium citrate therapy for patients with recurrent calcium stones and low urinary citrate, those with recurrent calcium or calcium oxalate stones without current metabolic abnormalities, and those with uric acid or cystine stones. The citrate component reduces urine calcium excretion and increases urine citrate and urine pH, which in turn alleviates crystal growth, formation, and aggregation. Sodium citrate may also be used to prevent stone recurrence; however, due to sodium's propensity to increase urine calcium excretion, potassium citrate remains the preferred salt formulation (107972). It is important to note that potassium citrate supplements are not equivalent to prescription potassium citrate products. Dose and duration of treatment is determined by a healthcare professional and individualized based on a patient's urinary citrate levels (107975,107989). Serum potassium levels should be monitored prior to starting potassium citrate, within 2 weeks of treatment initiation, and every 12 months (107975).

POSSIBLY EFFECTIVE

• Cardiovascular disease (CVD). Eating foods high in potassium and low in sodium might reduce the risk of cardiovascular disease. It is unclear if taking potassium supplements has the same benefit. Details: Large population studies in adults without prior CVD have found that higher dietary potassium intake is associated with a lower risk of cardiovascular events (109395,109399). One study found that daily potassium intake of about 3300 mg is associated with a 13% reduction in CVD risk when compared with intake of about 1920 mg (109399). The other study found that each additional 1000 mg of daily urinary potassium excretion, which is a marker of dietary intake, is associated with an 18% reduction in CVD risk (109395). Another observational study in over 15,000 adults with history of stroke or hypertension shows that replacing regular table salt with a substitute product containing 75% sodium chloride and 25% potassium chloride for an average of 5 years decreases the rate of stroke, major cardiovascular events, or death (107976). High quality clinical trials are needed to confirm this association. The US Food and Drug Administration (FDA) has determined that foods containing at least 350 mg potassium and that are low in sodium, saturated fat, and cholesterol can state that "diets containing foods that are good sources of potassium and low in sodium may reduce the risk of high blood pressure and stroke" (1310,8817).
• Stroke. Eating foods high in potassium and low in sodium might reduce the risk of stroke. It is unclear if taking potassium supplements has the same benefit. Details: Higher dietary intake of potassium seems to be associated with a lower risk of stroke. Population research has found that increasing dietary potassium intake by 1-1.5 grams daily is associated with up to a 20% reduced risk of stroke (92105,92107). Some population research has found that higher supplemental intake of potassium is associated with a 29% reduced risk of ischemic stroke. However, supplemental potassium intake is not found to be associated with a lower risk of hemorrhagic or total stroke (92107). An observational study in over 15,000 adults with history of stroke or hypertension shows that replacing regular table salt with a substitute product containing 75% sodium chloride and 25% potassium chloride for an average of 5 years decreases the rate of stroke, major cardiovascular events, or death (107976). High quality clinical trials are needed to confirm this association. The US Food and Drug Administration (FDA) has determined that foods containing at least 350 mg potassium and that are low in sodium, saturated fat, and cholesterol can state that "diets containing foods that are good sources of potassium and low in sodium may reduce the risk of high blood pressure and stroke" (1310,8817).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Dental hypersensitivity. It is unclear if topical potassium improves dental hypersensitivity. Details: One meta-analysis of clinical research shows that using a dentifrice containing 5% potassium nitrite reduces dentin sensitivity when compared with a dentifrice that does not contain potassium nitrite (69549). Other clinical research published in a systematic review shows that potassium-containing toothpastes might reduce dentin sensitivity more than controls that do not contain potassium. However, these toothpastes might be less effective than other active toothpastes, such as those containing sodium monofluorophosphate, and the effect may result from a placebo effect, since the mechanism of action of potassium is unclear (69456).
• Diabetes. It is unclear if increasing dietary potassium reduces the risk of diabetes. Details: A meta-analysis of 7 large population studies has found that consuming dietary potassium 3300-3500 mg daily is associated with a 20% reduction in the risk of diabetes when compared with consumption below 1000 mg daily. Results were similar when studies that measured potassium intake with a dietary questionnaire were analyzed separately from those that measured intake based on urinary potassium excretion (110776). However, the validity of this finding is limited by the heterogeneity of the included studies. Furthermore, despite use of data from various databases, most studies included in the analysis were conducted by the same author.
• Impaired glucose tolerance (prediabetes). It is unclear if oral potassium improves glycemic control in prediabetes. Details: A small clinical study in Black patients with prediabetes shows that taking extended-release potassium (Klor-Con M10, Cardinal Health) 40 mEq daily as potassium chloride for 3 months does not improve glucose tolerance when compared with placebo. Although fasting glucose levels were slightly reduced in the potassium group when compared with placebo, both groups experienced a worsening of glucose intolerance, with no change in insulin levels or glycated hemoglobin (98533).
• Osteoporosis. Although there is interest in using oral potassium for osteoporosis, there is insufficient reliable information about the clinical effects of potassium for this condition.
• Physical performance. It is unclear if oral potassium improves physical performance in older adults. Details: Observational research in older adults has found that decreased dietary potassium intake and increased dietary sodium intake over 5 years is associated with worsened physical performance (105450).
• Systemic lupus erythematosus (SLE). It is unclear if oral potassium is beneficial in patients with SLE. Details: Observational research in patients with SLE has found that increased dietary potassium intake is not associated with improvements in disease activity scores or markers of cardiovascular disease, including lipid levels and blood pressure, when compared with low dietary potassium intake. However, higher potassium intake does seem to reduce the odds of having elevated levels of C-reactive protein, a marker of inflammation, in these patients (109397). More evidence is needed to rate potassium for these uses.

(Read more about POTASSIUM)

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Cancer. Although there has been interest in using oral sarsaparilla for cancer, there is insufficient reliable information about the clinical effects of sarsaparilla for this purpose.
• Psoriasis. Although there has been interest in using oral sarsaparilla for psoriasis, there is insufficient reliable information about the clinical effects of sarsaparilla for this purpose.
• Rheumatoid arthritis (RA). Although there has been interest in using oral sarsaparilla for RA, there is insufficient reliable information about the clinical effects of sarsaparilla for this purpose. More evidence is needed to rate sarsaparilla for these uses.

(Read more about SARSAPARILLA)

LIKELY SAFE ...when used in the amounts commonly found in food.

POSSIBLY SAFE ...when the leaves are applied topically and appropriately (93456). There is insufficient reliable information available about the safety of the other parts of the banana plant when used orally or topically as a medicine.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using amounts greater than those found in food.

(Read more about BANANA)

POSSIBLY SAFE ...when used topically as a toothpaste, short-term. A specific toothpaste (Bucovia, Givaudan) containing goldenrod extract 0.3% and sodium fluoride 0.15% has been used safely twice daily for up to 4 weeks (105115). There is insufficient reliable information available about the safety of goldenrod when used orally or when applied topically to the skin.

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

(Read more about GOLDENROD)

POSSIBLY UNSAFE ...when horsetail products containing thiaminase are used orally, long-term. Thiaminase is an enzyme that destroys thiamine, which could theoretically lead to thiamine deficiency. In Canada, horsetail products are required to be thiaminase-free (105301).

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

(Read more about HORSETAIL)

POSSIBLY SAFE ...when used orally and appropriately, short-term. Java tea 100 mg daily has been safely used in a clinical trial for 8 weeks (94851).

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

(Read more about JAVA TEA)

LIKELY SAFE ...when used orally in amounts commonly found in food.

POSSIBLY SAFE ...when used topically and appropriately (854,856,857,14000,14333). A specific 10% Oregon grape cream (Relieva, Apollo Pharmaceutical) has been used with apparent safety in studies lasting up to 12 weeks (14000,14333). There is insufficient reliable information available about the safety of Oregon grape when used orally in medicinal amounts.

CHILDREN: LIKELY UNSAFE
when used orally in newborns. The berberine constituent of Oregon grape can cause kernicterus in newborns, particularly preterm neonates with hyperbilirubinemia (2589).

PREGNANCY: LIKELY UNSAFE
when used orally. Berberine is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine (2589).

LACTATION: LIKELY UNSAFE
when used orally. Berberine and other harmful constituents can be transferred to the infant through breast milk (2589).

(Read more about OREGON GRAPE)

LIKELY SAFE ...when used orally in doses up to 100 mEq total potassium daily, not to exceed 200 mEq in a 24-hour period (95010,107989). Oral potassium chloride and potassium citrate are FDA-approved prescription products (95010,107989). Larger doses increase the risk of hyperkalemia (15). ...when administered intravenously (IV) at appropriate infusion rates (95011). Parenteral potassium is an FDA-approved prescription product (15,95011). A tolerable upper intake level (UL) for potassium has not been established; however, potassium levels should be monitored in individuals at increased risk for hyperkalemia, such as those with kidney disease, heart failure, and adrenal insufficiency (100310,107966).

CHILDREN: LIKELY SAFE
when used orally and appropriately in dietary amounts. A tolerable upper intake level (UL) has not been established for healthy individuals (6243,100310).

PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in dietary amounts of 40-80 mEq daily (15). A tolerable upper intake level (UL) has not been established for healthy individuals (100310).

(Read more about POTASSIUM)

LIKELY SAFE ...when used orally in amounts commonly found in foods. Sarsaparilla has Generally Recognized As Safe (GRAS) status for use in foods in the US (4912). There is insufficient reliable information available about the safety of sarsaparilla when taken orally in medicinal amounts.

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

(Read more about SARSAPARILLA)

LEVODOPA Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Taking banana may reduce the effectiveness of levodopa.  Details A case report describes apparent wearing off in a patient with Parkinson disease after eating a banana every day. The wearing off subsided after removing dietary bananas (110618).

(Read more about BANANA)

DIURETIC DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, goldenrod might increase the effects and adverse effects of diuretic drugs.  Details In vitro and animal research suggests that goldenrod has diuretic effects (512,52565,52570,52571,52572).

(Read more about GOLDENROD)

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, taking horsetail with antidiabetes drugs might increase the risk of hypoglycemia.  Details Equisetum myriochaetum has demonstrated hypoglycemic activity in clinical research (13576). In an animal diabetic model, Equisetum giganteum had hypoglycemic effects (105300). It is unclear whether other horsetail species have hypoglycemic effects.

DIURETIC DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, taking horsetail with diuretic drugs might increase potassium loss and the risk of hypokalemia.  Details Laboratory research shows that various species of horsetail have diuretic properties (13574,13575). Due to its diuretic effects, there has been concern that taking horsetail along with potassium-depleting diuretics might increase the risk for hypokalemia. However, pharmacokinetic research in humans shows that taking horsetail 900 mg daily for 4 days does not affect urinary excretion of electrolytes, including potassium and sodium, despite having a diuretic effect similar to taking hydrochlorothiazide 25 mg daily (92288). It is unclear if taking horsetail for a longer duration would affect electrolyte levels. Until more is known, use with caution.

EFAVIRENZ (SUSTIVA) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, horsetail might decrease the levels and clinical effects of efavirenz.  Details In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral regimen that included efavirenz. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing horsetail, the viral loads became undetectable in both cases. The exact mechanism of this interaction is unknown (97573). It is also unclear if this interaction is specific to efavirenz or if it is related to various components of antiretroviral therapy.

LITHIUM Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, horsetail might increase the levels and adverse effects of lithium.  Details Animal research suggests that horsetail has diuretic properties (13574). Theoretically, due to these potential diuretic effects, horsetail might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, horsetail might decrease the levels and clinical effects of NRTIs.  Details In two case reports, patients were found to have detectable viral loads when taking horsetail-containing supplements along with an antiretroviral therapy. In one case, the antiretroviral regimen included zidovudine, lamivudine, and efavirenz; in the other case, the regimen consisted of emtricitabine, tenofovir disoproxil fumarate, and efavirenz. One month after discontinuing the supplement, the viral loads became undetectable in both cases. The exact mechanism of these interactions is unknown (97573). It is also unclear if these interactions are specific to NRTIs or if they are related to various components of antiretroviral therapy.

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D In vitro and in vivo research suggests that berberine, a constituent of Oregon grape, can inhibit platelet aggregation (33660,33694). Theoretically, Oregon grape might have additive effects when used with anticoagulant and antiplatelet drugs and increase the risk of bleeding.  Details Some anticoagulant and antiplatelet drugs include aspirin, cilostazol (Pletal), clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), and others.

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = A Clinical research suggests that berberine, a constituent of Oregon grape, can lower blood glucose levels (20579,34247,34265,34282). Theoretically, Oregon grape might have additive effects when used with antidiabetes drugs and increase the risk of hypoglycemia.  Details Some antidiabetes drugs include glimepiride (Amaryl), glyburide (Diabeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.

ANTIHYPERTENSIVE DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Animal research suggests that berberine, a constituent of Oregon grape, can have hypotensive effects (33692,34308). Also, an analysis of clinical evidence suggests that taking berberine in combination with amlodipine (Norvasc) can lower systolic and diastolic blood pressure when compared with taking amlodipine alone (91956). Theoretically, taking Oregon grape along with antihypertensive drugs might have additive effects when used with antihypertensive drugs and increase the risk of hypotension.  Details Some antihypertensive drugs include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.

CNS DEPRESSANTS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Animal research suggests that berberine, a constituent of Oregon grape, can have sedative effects (13519,33650,33664,33692). Theoretically, use of Oregon grape along with CNS depressants might increase the risk of additive therapeutic and adverse effects.  Details Some CNS depressants are benzodiazepines, pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), thiopental (Pentothal), fentanyl (Duragesic, Sublimaze), morphine, propofol (Diprivan), and others.

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Preliminary clinical evidence suggests that berberine, a constituent of Oregon grape, can inhibit cytochrome P450 2C9 (CYP2C9) (34279). Theoretically, taking Oregon grape with drugs metabolized by CYP2C9 might increase drug levels and potentially increase the risk of adverse effects.  Details Some drugs metabolized by CYP2C9 include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), and S-warfarin (Coumadin).

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B In vitro research and preliminary clinical evidence suggest that berberine, a constituent of Oregon grape, can inhibit cytochrome P450 2D6 (CYP2D6) (21117,34279,34297). Theoretically, taking Oregon grape with drugs metabolized by CYP2D6 might increase drug levels and potentially increase the risk of adverse effects.  Details Some drugs metabolized by CYP2D6 include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), haloperidol (Haldol), imipramine (Tofranil), metoprolol (Lopressor, Toprol XL), ondansetron (Zofran), paroxetine (Paxil), risperidone (Risperdal), tramadol (Ultram), venlafaxine (Effexor), and others.

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D In vitro research and preliminary clinical evidence suggest that berberine, a constituent of Oregon grape, moderately inhibits cytochrome P450 3A4 (CYP3A4) (13524,21114,34279,34297). Theoretically, taking Oregon grape with drugs metabolized by CYP3A4 might increase drug levels and potentially increase the risk of adverse effects.  Details Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), clarithromycin (Biaxin), indinavir (Crixivan), sildenafil (Viagra), triazolam (Halcion), and numerous others. Use European barberry cautiously or avoid in patients taking these drugs.

(Read more about OREGON GRAPE)

ACE INHIBITORS (ACEIs) Interaction Rating = Moderate Be cautious with this combination. Severity = Mild •  Occurrence = Likely •  Level of Evidence = C Using ACEIs with high doses of potassium increases the risk of hyperkalemia.  Details ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion (95628). Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia (15,23207). However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels (95628).

ANGIOTENSIN RECEPTOR BLOCKERS (ARBs) Interaction Rating = Moderate Be cautious with this combination. Severity = Mild •  Occurrence = Likely •  Level of Evidence = C Using ARBs with high doses of potassium increases the risk of hyperkalemia.  Details ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion (95628). Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia (15,23207). However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels (95628).

POTASSIUM-SPARING DIURETICS Interaction Rating = Moderate Be cautious with this combination. Severity = Mild •  Occurrence = Likely •  Level of Evidence = C Concomitant use increases the risk of hyperkalemia.  Details Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia (15).

(Read more about POTASSIUM)

DIGOXIN (Lanoxin) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, concomitant use of sarsaparilla with digoxin might increase the risk of cardiac toxicity.  Details Sarsaparilla is thought to have diuretic properties, which could potentially cause potassium loss. Overuse or misuse of sarsaparilla with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss (2,11).

LITHIUM Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = D Theoretically, sarsaparilla might increase the effects and adverse effects of lithium.  Details Sarsaparilla is thought to have diuretic properties (11). Due to these effects, sarsaparilla might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.

(Read more about SARSAPARILLA)

General ...Orally, bananas are well tolerated when consumed as food.
Most Common Adverse Effects:
Orally: Bloating, cramping, gas.
Topically: Urticaria.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis, intestinal obstruction.

Endocrine ...In one case report, an adolescent girl who consumed nothing other than 20 bananas daily developed hyperkalemia and hyperdopaminemia. These changes in the blood resulted in pseudoaldosteronism and dysthymia (93780).

Gastrointestinal ...Orally, banana starch isolated from green bananas has resulted in bloating, gas, cramping, and softer feces (93448,93449,110619). When consumed prior to exercise, fullness and bloating during exercise have been reported (93459). In children, nausea, vomiting, and abdominal distension have been reported when banana is used in the treatment of diarrhea (93461). Cases of intestinal obstruction due to banana seeds have been reported (93777).
In one case report, food protein-induced enterocolitis syndrome (FPIES) has been associated with banana consumption (93778).

Immunologic ...Orally, banana has been reported to cause allergic reaction, including urticaria and redness, abdominal pain and nausea, dyspnea (93779,93781,93782,93797,93798,93803), and anaphylaxis (93783,93793,93802,93803). Topically, contact urticara has also been reported (93784). Skin testing is not always accurate, even for patients with severe banana allergy (93793).

Psychiatric ...Orally, high banana consumption has been associated with a higher likelihood of depressive symptoms in females, but not males, in a cross-sectional study of the general Chinese adult population (106471).

(Read more about BANANA)

General ...There is a limited amount of information available about the adverse effects of goldenrod.
Most Common Adverse Effects:
Topically: Allergic contact dermatitis in sensitive individuals.

Dermatologic ...Topically, goldenrod has been reported to cause allergic contact dermatitis (52558,52581).

Immunologic ...Topically, goldenrod has been reported to cause allergic contact dermatitis (52558,52581). Environmental exposure to goldenrod has been reported to cause an allergic reaction involving rhinoconjunctivitis and bronchial asthma in one case report (52558).

Pulmonary/Respiratory ...Environmental exposure to goldenrod has been reported to cause a delayed allergic reaction involving rhinoconjunctivitis and bronchial asthma in one case report of a 42 year-old woman who worked at a flower shop and was exposed to members of the Asteraceae/Compositae family, including goldenrod (52558).

(Read more about GOLDENROD)

General ...There is limited clinical research evaluating the safety of horsetail.
Most Common Adverse Effects:
Orally: Abdominal distension, increased bowel movements, and nausea.

Dermatologic ...In one case report, a patient developed seborrheic dermatitis after topical application of horsetail, requiring treatment with local epinephrine and oral antihistamines. The nicotine component of horsetail was determined to be the likely cause of this reaction (13563).

Gastrointestinal ...Orally, horsetail has been associated with mild gastrointestinal side effects including abdominal distension, increased frequency of bowel movements, and nausea (55576). Orally, chronic consumption of horsetail infusion has been associated with acute pancreatitis. In a case report, a 56-year-old female presenting with recurrent mild acute pancreatitis every 6-7 months, previously thought to be drug-induced, discontinued ingesting horsetail infusions. The patient had a history of bilateral adrenal gland removal and was being treated for hypertension, dyslipidemia, and hormone replacement, and then self-medicated with horsetail infusions. After discontinuing horsetail infusions, there were no further recurrences of pancreatitis during a 14-month follow-up (97574).

Hepatic ...In one case report, a patient with asymptomatic hepatitis B developed symptomatic liver failure following consumption of boiled horsetail juice 500 mL daily for 2 weeks. Liver enzymes returned to normal following discontinuation of the juice (92291). It is not known if the horsetail juice was contaminated or mixed with other ingredients.

Immunologic ...Horsetail has been associated with cross-allergenicity with carrots (13577).

Renal ...There are at least 4 case reports of hyponatremia thought to be at least partially associated with horsetail consumption. In one case report, an elderly patient who had taken oral horsetail 15 mg daily for 10 years presented with hyponatremia and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) secondary to reduced oral intake and nausea for the previous 2 days. Horsetail was thought to be a contributing factor. The patient's symptoms resolved after 5 days of treatment with oral sodium chloride and fluid restriction (108851).

Other ...Crude horsetail contains thiaminase, which can cause thiamine deficiency with prolonged consumption. Canadian Equisetum arvense products are required to be certified as free from thiaminase-like activity (55579,105301). In one case report, the development of autism in a child exposed to both horsetail and alcohol during pregnancy was thought to be caused by thiamine deficiency attributed to this combination (92292). However, it is not known if other genetic or environmental factors were involved in the development of this condition in utero.

(Read more about HORSETAIL)

General ...Orally, Java tea seems to be well tolerated. However, a thorough evaluation of safety outcomes has not been conducted.

(Read more about JAVA TEA)

General ...Orally, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted. Topically, Oregon grape can cause itching, burning, skin irritation, and allergic reactions (854,14000).

Dermatologic ...Topically, Oregon grape can cause itching, burning, and skin irritation (854,14000).

Immunologic ...Topically, Oregon grape can cause allergic reactions (854,14000).

(Read more about OREGON GRAPE)

General ...Orally or intravenously, potassium is generally well-tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, belching, diarrhea, flatulence, nausea, and vomiting.
Serious Adverse Effects (Rare):
All ROAs: High potassium levels can cause arrhythmia, heart block, hypotension, and mental confusion.

Cardiovascular ...Orally or intravenously, high potassium levels can cause hypotension, cardiac arrhythmias, heart block, or cardiac arrest (15,16,3385,95011,95626,95630).

Gastrointestinal ...Orally or intravenously, high doses of potassium can cause, nausea, vomiting, abdominal pain, diarrhea, and flatulence (95010,95011). Bleeding duodenal ulcers have also been associated with ingestion of slow-release potassium tablets (69625,69672).

Neurologic/CNS ...Orally or intravenously, high potassium levels can cause paresthesia, generalized weakness, flaccid paralysis, listlessness, vertigo, or mental confusion (15,16,3385,95011).

(Read more about POTASSIUM)

General ...Orally, sarsaparilla seems to be well tolerated.

Gastrointestinal ...Orally, there is some concern that sarsaparilla may cause GI irritation when used in large amounts (11,18). However, these claims cannot be substantiated.

Pulmonary/Respiratory ...Occupational exposure to sarsaparilla root dust can cause rhinitis and asthma symptoms (4111).

Renal ...Orally, there is some concern that sarsaparilla may cause temporary kidney impairment and diuresis, possibly leading to shock, when used in large amounts (11,18). However, these claims cannot be substantiated.

(Read more about SARSAPARILLA)