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    • Boswellia
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    • Essiac
      • What is Essiac?
      • How well does Essiac work?
      • Is Essiac safe?
      • Essiac conclusions
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    • Laetrile
    • Shark cartilage
    • Ukrain
    • Black cohosh
  • Diet & nutrition
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• Prevalence of CAM use

Is Essiac safe?

There is no literature regarding the safety of Essiac. However, it cannot be assumed that Essiac is safe. It is a product with an unknown safety profile and thus it should be avoided strictly during pregnancy and in concomitant use with other drugs. Adverse effects associated with its use have not been reported. The constituent herbs may cause allergic dermatitis and have a laxative effect (refs 16, 17)

Contraindications

None currently known.

Precautions/warnings

None currently known.

Adverse effects and interactions

The following information regarding safety, adverse effects and interactions is available from Natural Medicines Comprehensive Database (ref 18) for the individual plants Essiac contains:

• Burdock root (Arctium lappa L.) Orally, burdock can cause an allergic reaction. Rarely, it has caused anaphylaxis (ref 19). Theoretically, taking burdock with anticoagulant or antiplatelet drugs might increase the risk of bleeding due to decreased platelet aggregation.
• Indian rhubarb root (Rheum palmatum) Orally, rhubarb can cause cramp-like or spasmodic gastrointestinal discomfort, watery diarrhoea, and uterine contractions; there is also one report of anaphylaxis with short-term use (ref 20) Chronic use or abuse of rhubarb can cause electrolyte loss (especially potassium), hyperaldosteronism, accelerated bone deterioration, albuminuria, hematuria, dehydration, inhibition of gastric motility, pseudomelanosis coli (pigment spots in intestinal mucosa), arrhythmias, muscular weakness, nephropathies, and edema (ref 21).
• Sheepshead sorrel (Rumex acetosa L.) Orally, excessive amounts of sorrel can cause diarrhoea, nausea, polyuria, dermatitis and gastrointestinal symptoms. Theoretically, concomitant oral administration may cause precipitation of some drugs due to the high tannin content of sorrel (ref 22).
• Slippery elm bark (Ulmus rubra Muhl.) Orally, the whole bark is an abortifacient (ref 23). Topically, slippery elm extracts can cause contract dermatitis and the pollen is an allergen. In theory, the consumption of slippery elm bark when taken with other drugs may slow the absorption and reduce serum levels of orally administered drugs due to mucilage content (ref 22).
• Watercress (Nasturtium officinale) Orally, large amounts of watercress can cause gastrointestinal irritation (ref 20). Theoretically, excessive or prolonged use might cause kidney damage (ref 22). Consuming large amounts of watercress with high vitamin K content might theoretically antagonize the anticoagulant effects of warfarin (ref 24).
• Blessed thistle (Cnicus benedictus) When administered orally and used in doses greater than 5g/cup of tea, it can cause stomach irritation and vomiting (ref 21).
• Red clover (Trifolium pratense) The oral administration can cause rash-like reactions, myalgia, headache, nausea, and vaginal spotting (ref 25). Concomitant use of herbs that have constituents that might affect platelet aggregation could theoretically increase the risk of bleeding in some people. Concomitant use with large amounts of red clover can theoretically increase the anticoagulant effects and bleeding risk of these drugs due to its coumarin content (ref 26). There is some concern that red clover might interfere with tamoxifen because of its potential estrogenic effects (ref 27).
• Kelp (Fucus vesiculosus). Orally, kelp can induce or exacerbate hyperthyroidism (refs 28,29). The iodine in kelp can cause idiosyncratic reactions. Prolonged, high intake of dietary iodine is associated with goitre and increased risk of thyroid cancer (ref 30). Kelp seems to have anticoagulant effects and therefore, theoretically, taking kelp with antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding (ref 31).

Quality issues

The quality of the mixture depends on the quality of each individual ingredient used in preparing the mixture.

References

16. Rodriguez P, Blanco J, Juste S, et al. Allergic contact dermatitis due to burdock (Arctium lappa). Contact Dermatitis 1995;33:134-5.

17. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.

18. Natural Medicines Comprehensive Database http://www.naturaldatabase.com/ (accessed 15.07.05).

19. Sasaki Y, Kimura Y, Tsunoda T, Tagami H. Anaphylaxis due to burdock. Int J Dermatol 2003;42:472-3.

20. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

21. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

22. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

23. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.

24. Bolton-Smith C, Price RJ, Fenton ST, et al. Compilation of a provisional UK database for the phylloquinone (vitamin K1) content of foods. Br J Nutr 2000;83:389-99.

25. Tice J, Cummings SR, Ettinger B, et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther Health Med 2001;7:S33.

26. Nelsen J, Barrette E, Tsouronix C, et al. Red clover (Trifolium pratense) monograph: A clinical decision support tool. J Herbal Pharmacotherapy 2002;2:49-72.

27. This P, De La Rochefordiere A, Clough K, et al. Phytoestrogens after breast cancer. Endocr Relat Cancer 2001;8:129-34.

28. Baker DH. Iodine toxicity and its amelioration. Exp Biol Med (Maywood) 2004;229:473-8.

29. Phaneuf D, Cote I, Dumas P, et al. Evaluation of the contamination of marine algae (Seaweed) from the St. Lawrence River and likely to be consumed by humans. Environ Res 1999;80:S175-S182.

30. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.

31. Durig J, Bruhn T, Zurborn KH, et al. Anticoagulant fucoidan fractions from Fucus vesiculosus induce platelet activation in vitro. Thromb Res 1997;85:479-91.