Introduction to Nutraceuticals

Nutraceuticals, a term that combines "nutrition" and "pharmaceutical," refers to food products
that provide health benefits, including the prevention and treatment of diseases. The concept of
nutraceuticals has gained significant traction over the years, as consumers increasingly seek natural
alternatives to pharmaceuticals for health management. This growing interest is driven by a
combination of factors, including rising health awareness, the increasing prevalence of chronic
diseases, and a shift towards preventive healthcare.

The term "nutraceutical" was first coined by Dr. Stephen L. DeFelice in 1989, who defined it as
"food or part of food that provides medical or health benefits, including the prevention and/or
treatment of a disease." Despite its widespread use, there remains no universally accepted definition
of nutraceuticals, leading to varying interpretations across different regions and among different
stakeholders. This ambiguity can create confusion for consumers, healthcare professionals, and
regulatory bodies alike.

Nutraceuticals are nonspecific biological therapies used to promote wellness, prevent malignant
processes and control symptoms. Nutraceutical foods are not subject to the same testing and regulations
as pharmaceutical drugs.

As per the Food Safety Standard Act, 2006 it has been recommended that Food should be classified as
follows:

• Novel foods
• Genetically modified food
• Irradiated food
• Organic foods
• Foods for special dietary use
• Functional foods
• Nutraceuticals
• Health Supplements

This makes it very clear that Nutraceuticals are a part of the food segment and it should not be
considered as a form of pharmaceutical or drug formulation.
Scope of Nutraceuticals

• Awareness that prevention is better than cure

• People especially of younger generation are becoming progressively more health conscious
• Gradual shift toward natural ingredients
• Increased work stress, busy schedule and Agricultural pollution unable to provide proper
nutrition
• High cost of health care with the expensive disease-treatment approach
• Chronic diseases without effective medicines

So there is great demand of alternative beneficial products like dietary supplement, functional food and
nutraceuticals by people as well as researchers to explore therapeutic values.

Nutraceuticals have numerous health and nutritional benefits which helps in immunity enhancement,
reduction of disease risk and also have anti-ageing effect.

But, unrealistic claims, poor packaging and labeling, poor stability and poor taste masking are few of
challenges in the field of nutraceuticals.

Historical Context

The use of food for medicinal purposes is not a new concept; it dates back thousands of years. Ancient
civilizations, including the Egyptians, Chinese, and Indians, recognized the health benefits of various
foods. For instance, Ayurveda, a traditional Indian system of medicine, has long emphasized the
therapeutic properties of food. The modern nutraceutical industry began to take shape in the 1980s,
driven by advancements in food science and a growing interest in preventive healthcare.

In recent years, the nutraceutical market has expanded significantly, with a global market value
estimated at approximately $117 billion in 2008, projected to reach around $336 billion by 2023. This
growth is fuelled by increasing consumer awareness of health and wellness, as well as a desire for
natural alternatives to pharmaceuticals.

Classification of Nutraceuticals

Depending on various characteristics, nutraceuticals are classified into the following major classes:

1) Nutraceuticals according to their food source,

2) Nutraceuticals according to their mechanism of action,

3) Nutraceuticals according to their chemical nature, and

4) Nutraceuticals according to their higher content in specific food items.

1. Classification Based on Source

Food Examples
Source
Plants β-Glucan, Ascorbic acid, γ-Tocotrienol, Quercetin, Luteolin, Cellulose, Lutein,
Gallic acid, Perillyl alcohol, Indole-3-carbonol, Pectin, Daidzein, Glutathione,
Potassium, 1 Allicin, δ-Limonene, Genestein, Lycopene, Hemicellulose, Lignin,
Capsaicin, Geraniol, β-Lonone, α-Tocopherol, β-Carotene,
Nordihydrocapsaicin, Selenium, Zeaxanthin, and Minerals.
Animals Conjugated Linoleic Acid (CLA), Eicosapentaenoic Acid (EPA),
Docosahexaenoic Acid (DHA), Sphingolipids, Choline, Lecithin, Calcium,
Coenzyme Q10, Selenium, Zinc, Creatine, and Minerals.
Microbes Saccharomyces boulardii (yeast), Bifidobacterium bifidum, B. longum, B.
infantis, Lactobacillus acidophilus (LCI), L. acidophilus (NCFB 1748), and
Streptococcus salvarius (subs. Thermophilus)
 2. Classification Based on mechanism of action

Positive Influence
on Blood Lipid Antioxidant Anti- Osteogenetics or Bone
Anticancers Profile Activity Inflammatories Protectives
Conjugated
Linoleic Acid
Capsaicin β-Glucan (CLA) Linolenic acid CLA
Eicosapentaenoic
Genestein γ-Tocotrienol Ascorbic acid Acid (EPA) Soy protein
Docosahexaenoic
Daidzein δ-Tocotrienol β-Carotene Acid (DHA) Daidzein
Monounsaturated Gamma-Linolenic
α-Tacotrienol Fatty Acids (MUFA) Polyphenolics Acid (GLA) Calcium
γ-Tocotrienol Quercetin Tocopherols Capsaicin Casein phosphopeptides
Omega-3
Conjugated Polyunsaturated
Linoleic Acid Fatty Acids (ω-3 FOS
(CLA) PUFAs) Tocotrienols Quercetin (Fructooligoaccharides)
Lactobacillus Indole-3-
acidophilus Resveratrol carbonol Curcumin Inulin
Sphingolipids Tannins α-Tocopherol
Limonene β-Sitosterol Ellagic acid
Diallyl sulphide Saponins Lycopene
Ajoene Guar Lutein
α-Tocopherol Pectin Glutathione
Enterolactone Hydroxytyrosol
Glycyrrhizin Luteolin
Equol Oleuropein
Curcumin Catechins
Ellagic acid Gingerol
Chlorogenic
Lutein acid
Carnosol Tannins
 3. Classification Based on Chemical nature

Classes/Components Sources Potential Benefits

Carotenoids
i) α-Carotene CarrotsVarious fruits and Neutralizes free radicals which may
ii) β-Carotene vegetablesGreen cause damage to cells.Neutralizes
iii) Lutein vegetablesTomatoes and tomato free radicals.Maintenance of healthy
iv) Lycopene products (ketchup, sauces, vision.Reduce the risk of prostate
v) Zeaxanthin etc.)Eggs, citrus, and corn cancer.Maintenance of healthy vision.
Improve some symptoms associated
Collagen Hydrolysate Gelatin with osteoarthritis.
Reduce risk of breast and/or colon
cancer.Reduce the risk of
Dietary Fibrei) Insoluble Cardiovascular Diseases
fibreii) β-Glucaniii) Soluble Wheat branOatsPsylliumCereal (CVDs).Reduce the risk of
fibreiv) Whole grains grains CVDs.Reduce the risk of CVDs.
Fatty Acidsi) Omega-3-fatty Reduce the risk of CVDs; and improve
acids (DHA/EPA)ii) mental, visual functions.Improve body
Conjugated Linoleic Acid Tuna fish and marine oilsCheese composition; and decrease the risk of
(CLA) and meat products certain cancers.
Neutralize free radicals; and reduce
the risk of cancer.Neutralize free
radicals; and reduce the risk of
Flavonoidsi) cancer.Neutralize free radicals; and
Anthocyanidinsii) reduce the risk of cancer.Neutralize
Catechinsiii) Flavanonesiv) FruitsTeaCitrusFruits and free radicals; and reduce the risk of
Flavones vegetables cancer.
Glucosinolates, indoles,
isothiocyanates, and Cruciferous vegetables (broccoli Induce detoxification enzymes; and
sulforaphane and kale) and horseradish reduce the risk of cancer.
Antioxidant-link activities; and reduce
Phenolsi) Caffeic acidii) the risk of degenerative diseases,
Ferulic acid Fruits, vegetables, and citrus heart diseases, and eye diseases.
Plant sterols and stanol Lower blood cholesterol levels by
ester Corn, soy, wheat, and wood oils inhibiting cholesterol absorption.
4. Nutraceuticals According to their Higher Content in Specific Food Items Market
Growth of Nutraceuticals
Types of Nutraceutical products available in the market

1) Traditional Nutraceuticals:
i) Chemical constituents:
a) Nutrients,
b) Herbals, and
c) Phytochemicals.
ii) Probiotic microorganisms, and
iii) Nutraceutical enzymes.
2) Non-Traditional Nutraceuticals:
i) Fortified nutraceuticals, and
ii) Recombinant nutraceuticals.

Traditional Nutraceuticals
Traditional nutraceuticals are natural substances with no changes to the food. They contain
several natural components that deliver benefits beyond basic nutrition, e.g., lycopene in
tomatoes, omega -3 fatty acids in salmon, or saponins in soy.
1) Chemical Constituents: These are of the following types:
i) Nutrients: These substances, e.g., vitamins, minerals, amino acids , and fatty acids, have
established nutritional functions. Most vegetables, wholegrain cereals, dairy products, fruits,
and animal products (such as, meat and poultry) contain vitamins and cure heart diseases,
stroke, cataracts, osteoporosis, diabetes, and cancer. Plant, animal and dairy products contain
minerals that are useful in osteoporosis, anaemia, building strong bones, teeth and muscles, and
improving nerve impulses and heart rhythm. Flax seeds and salmon contain fatty acids and
omega-3 PUFAs, and control the inflammatory processes, maintain brain functions, and reduce
cholesterol deposition.
ii) Herbals: Nutraceuticals are very useful in improving health and preventing chronic diseases with the
help of herbals. Some examples of which are:
a) Willow bark (Salix nigra) contains salicin, which is an anti -inflammatory, analgesic, antipyretic,
astringent, and anti-arthritic.
b) Parsley (Petroselinum crispum) contains flavonoids (apiol and psoralen) and is a diuretic, carminative,
and antipyretic.
c) Peppermint (Mentha piperita) contains menthol and cures cold and flu.
d) Lavender (Lavandula angustifolia) contains tannin, which cures depression, hypertension, stress, cold,
cough, and asthma.
e) Cranberries (Vaccinium erythrocarpum) contain proanthocyanidin and are useful in cancer, ulcers, and
urinary tract infections.

iii) Phytochemicals: These nutraceuticals are classified on the basis of the chemical name given to them
as per their phytochemical properties.

Some examples are:

a) Carotenoids (isoprenoids) found in various fruits, vegetables and egg yolk, are anti -carcinogenic, boost
natural killer immune cells , and protect cornea against UV light.

b) Legumes (chickpeas and soybeans), grains, and palm oil contain non-carotenoids, which remove
cholesterol and are anticarcinogenic.

c) Flavonoid polyphenolics, present in berries, fruits, vegetables, and legumes, are antioxidants,
phytoestrogens, prevent breast cancer, prostate cancer, and control diabetes.

d) Non-flavonoid polyphenolics, present in dark grapes, raisins, berries, peanuts, and turmeric roots ar e
strong anti -inflammatory, anti-oxidants, and anti -clotting agents, and reduce cholesterol.

e) Phenolic acids, present in blueberries, tomatoes, and bell peppers, are antioxidants, and reduce
mutagenicity of polycyclic aromatic hydrocarbons.

f) Seeds of Barbarea verna and broccoli contain isothiocyanates (glucosinolates) having anti-
tumorigenesis activity.

2) Probiotic Microorganisms: The scientific interest in probiotics was encouraged from the work of
Metchnikoff. To transform the toxic flora of large intestine into a host-friendly colony of Bacillus
bulgaricus was found by Hord. Probiotics mean for life and are live microorganisms, which on consuming
in adequate amounts confer a healthy effect on the host.

Probiotics are friendly bacteria that promote healthy digestion and absorption of some nutrients. They
crowd out pathogens, such as yeasts, bacteria, and viruses that may cause disease and develop a mutually
advantageous symbiosis with human GIT. Probiotics exert an antimicrobial effect by modifying the
microflora, preventing adhesion of pathogens to intestinal epithelium, competing for nutrients essential
for pathogen survival, producing an antitoxin e ffect, and reversing some consequences of infection on
intestinal epithelium, such as secretory changes and neutrophil migration. They can cure lactose
intolerance by producing β-galactosidase enzyme that hydrolyses the offending lactose into its component
sugars

Sources of Probiotic Micro-organisms

3) Nutraceutical Enzymes: Enzymes are an essential part of life, without which our bodies
would stop functioning. Individuals suffering from hypoglycaemia, blood sugar disorders,
digestive problems, and obesity, are relieved from the symptoms by adding enzyme
supplements to their diet. These enzymes are derived from microbial, plant and animal sources
Non-Traditional Nutraceuticals

Non-traditional nutraceuticals are artificial foods prepared with the help of biotechnology.
Food samples contain bioactive components engineered to produce products for human
wellness. These nutraceuticals are classified into:

1) Fortified Nutraceuticals: These nutraceuticals include fortified food from agricultural

breeding or added nutrients and/or ingredients. Some examples are:

i) Orange juice fortified with calcium,

ii) Cereals with added vitamins or minerals,

iii) Flour with added folic acid,

iv) Milk fortified with cholecalciferol is used in vitamin D deficiency,

v) Prebiotic and probiotic milk fortified with Bifidobacterium lactis HN019 is used in
diarrhoea, respiratory infections, and severe illnesses in children, and

vi) Banana fortified with soybean ferritin gene is used in iron deficiency.

2. Recombinant Nutraceuticals: These nutraceuticals include energy providing foods, such

as bread, alcohol, fermented starch, yogurt, cheese, vinegar, etc. These are produced with the
help of biotechnology. Production of probiotics and extraction of bioactive components by
enzyme/fermentation technologies and genetic engineering techno logy are achieved through
biotechnology.
Recombinant plants

Regulatory aspects related to nutraceuticals.

United States

In the United States, the regulation of nutraceuticals is primarily governed by the Dietary
Supplement Health and Education Act (DSHEA) of 1994. Under this legislation,
manufacturers are responsible for ensuring the safety of their products before they are
marketed. The Food and Drug Administration (FDA) oversees the enforcement of these
regulations and can take action against unsafe products after they reach the market.
Additionally, the federal Good Manufacturing Practice (GMP) regulations require companies
to maintain high standards for the identity, purity, quality, strength, and composition of dietary
supplements. Companies must also report any serious adverse events to the FDA.

European Union

In the European Union, the European Food Safety Authority (EFSA) regulates food legislation,
particularly focusing on food supplements. The EU defines food supplements as concentrated
sources of nutrients and other substances that provide beneficial nutritional effects. The
legislation related to food supplements is outlined in Directive 2002/46/EC, which includes a
list of permitted vitamin and mineral substances that can be added to food supplements. The
EU enforces strict rules regarding health claims, and there is variability in product claims and
recommended daily allowances (RDAs) across different member states. To address these
challenges, nutraceutical companies in Europe have formed a coalition known as Food
Supplements Europe (FSE) to collaborate with regulators.

Japan

Japan categorizes its nutraceutical industries into two segments: foods with nutrient function
claims (FNFC) and foods for specified health uses (FoSHU). The FNFC sets standards for the
minimum and maximum daily levels of certain vitamins and minerals, while FoSHU includes
dietary ingredients with reported health benefits. Unlike other countries, Japan does not allow
disease risk reduction claims, and products in the FoSHU category require premarketing
approval from the Consumer Affairs Agency (CAA), which operates under the Ministry of
Health, Labor, and Welfare (MHLW). This agency ensures compliance with nutritional
labeling and health claims.

China

In China, the nutraceutical industry is overseen by the China Health Care Association (CHCA)
and several government entities, including the State Food and Drug Administration (SFDA),
which is responsible for dietary supplements and the issuance of "blue hat" registrations. The
Ministry of Health (MOH) oversees the approval of new novel food ingredients, while the
Administration of Quality Supervision Inspection and Quarantine (AQSIQ) manages imports
and exports. This regulatory framework ensures that nutraceuticals meet safety and efficacy
standards before they can be marketed.

India

In India, nutraceuticals are categorized as functional foods and dietary supplements, which
include fortified food items, vitamins, minerals, and herbal products. Unlike pharmaceuticals,
nutraceuticals are not regulated under the Drugs and Cosmetics Act of 1940. Instead, various
acts, such as the Prevention of Food Adulteration Act and the Food Safety and Standards Act
(FSSA) of 2006, govern their regulation. The FSSA aims to unify food safety laws and establish
the Food Safety and Standards Authority of India (FSSAI) as the regulatory body responsible
for overseeing the nutraceutical market. The FSSAI defines nutraceuticals as foods processed
to meet specific dietary requirements for physiological conditions.

Country Regulatory Body Key Points

Manufacturers ensure safety before marketing; FDA
United Food and Drug
can act against unsafe products. Good
States Administration (FDA)
Manufacturing Practice (GMP) regulations apply.

Strict rules for health claims; variability in product

European European Food Safety
claims across member states. Coalition formed
Union Authority (EFSA)
(Food Supplements Europe) to ensure quality.
Consumer Affairs Requires premarketing approval for FoSHU; disease
Japan
Agency (CAA) risk reduction claims are not allowed.
Overseen by SFDA for dietary supplements; MOH
China Health Care
China oversees new food ingredient approvals; AQSIQ
Association (CHCA)
controls imports/exports.
Food Safety and Regulated under the Food Safety and Standards Act
India Standards Authority (FSSA); no separate regulations for nutraceuticals;
of India (FSSAI) aims to unify food safety laws.
Market Growth of Nutraceuticals

The global nutraceutical market has been experiencing significant growth. In 2008, the market
was estimated to be around $117 billion, projected to reach approximately $336 billion by
2023, growing at a compound annual growth rate (CAGR) of about 8%. The major markets for
nutraceuticals are currently dominated by the USA, Japan, and Europe, which together account
for about 90% of the total global market.

• United States: The U.S. nutraceutical market is one of the largest, valued at
approximately $40 billion in 2015, with significant growth expected due to increasing
health awareness.
• European Union: The European dietary supplements market was valued at around €14
billion in 2015, with expectations for a 14% expansion by 2020.
• India: The Indian nutraceutical market has shown remarkable growth, with a CAGR
of 18% over the last few years, valued at approximately $5 billion in 2015 and expected
to reach around $18 billion by 2025.

Health benefits and role of Nutraceuticals in ailments like Diabetes, CVS diseases,
Cancer, Irritable bowel syndrome and various Gastro intestinal diseases.

Diabetes

Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders

characterized by a high blood sugar level over a prolonged period of time. Serious long-term
complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers,
damage to the nerves, damage to the eyes and cognitive impairment. There are three main types
of diabetes mellitus:

➢ Type 1 diabetes results from failure of the pancreas to produce enough insulin due to loss
of beta cells. This form was previously referred to as "insulin-dependent diabetes mellitus"
(IDDM) or "juvenile diabetes". The loss of beta cells is caused by an autoimmune response.
The cause of this autoimmune response is unknown.

➢ Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond to
insulin properly. As the disease progresses, a lack of insulin may also develop. This form was
previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adultonset
diabetes". The most common cause is a combination of excessive body weight and

insufficient exercise.

➢ Gestational diabetes is the third main form, and occurs when pregnant women without a
previous history of diabetes develop high blood sugar levels.

In recent years a wide range of herbal dietary supplements and herbal medicines have
scientifically proven to benefit type 2 diabetes mellitus in preclinical studies, however, few
have been proven to do so in properly designed randomized clinical trials.

1. Phytochemicals

Soy contains the largest concentration of isoflavones, a class of phytoestrogens.

Phytoestrogens are structurally similar to estradiol and mimic its effects. Soy and
phytoestrogens have received increasing attention due to the health benefits associated with
their consumption. In animal studies, soy and phytoestrogens are effective at reducing
adipose tissue and improving glucose uptake. Isoflavones, are phytoestrogens which have
structural/functional similarities to human estrogen. Soy isoflavones have been studied
most and their consumption have been associated with lower incidence and mortality rate
of type II diabetes, heart disease, osteoporosis and certain cancers.

2. Vitamin C:
Vitamin C acts as a powerful antioxidant, helping to prevent oxidative stress, which
can make insulin resistance worse. Research suggests that taking Vitamin C
supplements (around 800 mg per day) can help restore Vitamin C levels in people with
Type II diabetes. This can improve their overall metabolic health and help manage the
condition better.

3. Calcium and Vitamin D:

High calcium intake has been linked to a lower risk of developing diabetes because it
helps maintain insulin sensitivity. Insulin sensitivity means that the body responds well
to insulin, which is important for regulating blood sugar levels. When insulin sensitivity
 is good, the body can use insulin more effectively, reducing the risk of developing Type
II diabetes.
Calcium also helps reduce the secretion of parathyroid hormone (PTH). PTH is a
hormone that can raise blood sugar levels and affect insulin function. By lowering PTH
levels, calcium can help keep blood sugar levels in check and support overall better
metabolic health. So, getting enough calcium, either through diet or supplements, may
play an important role in preventing diabetes.
4. Minerals
Chromium is a trace element that is often found in lower amounts in people with
diabetes. Some studies suggest that chromium supplements might help improve insulin
sensitivity, which means the body can use insulin more effectively. This could be
particularly helpful for people with Type 2 diabetes, as better insulin sensitivity helps
manage blood sugar levels more effectively.
Magnesium is another important nutrient. Diets rich in magnesium have been linked to
a lower risk of developing diabetes. Research shows an inverse relationship between
magnesium intake and fasting insulin levels. This means that as magnesium intake
increases, fasting insulin levels tend to decrease, suggesting that magnesium helps
improve insulin sensitivity. In other words, getting enough magnesium may help the
body better respond to insulin, potentially lowering the risk of Type 2 diabetes.
5. Dietary fibers
Dietary fibers from psyllium have been used widely in supplements and as ingredients
in processed foods. These fibers are known to help with weight loss, control blood sugar
levels in people with diabetes, and reduce cholesterol in those with high lipid levels
(hyperlipidemia). Soluble dietary fiber, like that found in psyllium, is particularly
beneficial for managing blood sugar.
Soluble fiber helps lower blood sugar levels after meals (postprandial glucose) and can
increase insulin sensitivity, making the body respond better to insulin. This is true for
both people with diabetes and healthy individuals. These benefits are mainly due to the
viscous or gel-like properties of soluble fiber, which slow down the absorption of
glucose and help regulate blood sugar levels.
6. Alpha Lipoic Acid:
Alpha-lipoic acid (ALA) is a naturally occurring antioxidant that plays a key role in
protecting the body from damage caused by free radicals. One of its important functions
is helping to regenerate other antioxidants, which enhances the body's ability to fight
 oxidative stress. This is especially beneficial for people with diabetes, as oxidative
stress can lead to complications such as diabetic retinopathy, a condition that affects
the eyes.
By protecting against oxidative damage and supporting antioxidant defense systems,
alpha-lipoic acid helps reduce the risk of diabetic complications, including issues with
the eyes, nerves, and blood vessels. It is considered a helpful supplement for managing
diabetes-related damage and improving overall health.
7. Dietary Fiber:

High-fiber foods, such as fruits, vegetables, and whole grains, are beneficial for improving
glycemic control (the management of blood sugar levels) and lipid metabolism (the way
the body processes fats). Fiber helps slow down the absorption of sugars, leading to more
stable blood sugar levels. It can also help lower cholesterol and improve fat metabolism,
which is important for heart health.

The recommended daily intake of fiber is 26 grams for women and 38 grams for men.
Eating enough fiber from these foods can support better overall health, particularly in
managing conditions like diabetes and improving cardiovascular health.

8. Omega-3 Fatty Acids:

Omega-3 fatty acids, found in fish oil, are known for their anti-inflammatory properties. They
help reduce inflammation in the body, which is important because chronic inflammation is
linked to insulin resistance and higher blood sugar levels. By reducing inflammation, omega-
3s can improve insulin sensitivity, meaning the body uses insulin more effectively.

Improved insulin sensitivity leads to better blood sugar control, which is especially beneficial
for people with diabetes or those at risk of developing it. Including fish oil or omega-3-rich
foods, such as fatty fish (like salmon or mackerel), in the diet can support better blood sugar
management and overall health.

Mechanisms of Action

Nutraceuticals, which are foods or supplements that provide health benefits beyond basic
nutrition, can play an important role in managing diabetes. They can help regulate various
metabolic pathways, improve gut health, and reduce inflammation—key factors in controlling
blood sugar levels and preventing complications.

For example, antioxidants like Vitamin C and E help fight oxidative stress, which can damage
cells and worsen insulin resistance. By neutralizing harmful free radicals, these antioxidants
protect the body and support better blood sugar control.

Dietary fibers also contribute to managing diabetes by improving gut health. Fiber helps
nourish the gut microbiota (the community of microbes living in the digestive system). A
healthy gut microbiota is now recognized as an important factor in metabolic health and insulin
sensitivity, helping to regulate blood sugar levels more effectively. By including fiber-rich
foods and antioxidants in the diet, people with diabetes can improve their overall health and
manage their condition more effectively.

Conclusion

Incorporating nutraceuticals into the diet can be a beneficial strategy for managing diabetes,
potentially reducing the need for pharmaceutical interventions and improving overall health
outcomes.

Cardiovascular diseases

Worldwide, the prevalence of CVD and the researches in this area is increasing. CVD is a term
which is used for disorders of the heart and blood vessels and includes coronary heart disease
(heart attack), peripheral vascular diseases, cerebrovascular disease (stroke), hypertension,
deep vein thrombosis, pulmonary embolism, rheumatic heart disease, heart failure, and so on.

CVDs are the major cause of death globally: more people die annually from CVDs than from
any other cause. Most cardiovascular diseases can be prevented by addressing behavioural risk
factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of
alcohol using population-wide strategies.
Heart attacks and strokes are usually acute events and are mainly caused by a blockage that
prevents blood from flowing to the heart or brain. The most common reason for this is a buildup
of fatty deposits on the inner walls of the blood vessels that supply the heart or brain.

Nutraceuticals in the form of vitamins, minerals, antioxidants, dietary fibers and omega-3
polyunsaturated fatty acids (omega-3 PUFAs) together with physical exercise are
recommended for prevention and treatment of CVD. The molecules such as polyphenols alter
cellular metabolism and signaling, which is believed to reduce arterial disease.

1. Phytosterols: Phytosterols are natural compounds found in plants that can help
improve heart health. They work by competing with dietary cholesterol in our bodies,
which means they can block the absorption of cholesterol from the food we eat. This
helps lower cholesterol levels in the blood, which is important for reducing the risk of
cardiovascular diseases (CVD).
• When you consume phytosterols, they act like cholesterol but are not absorbed
by the body in the same way. Instead, they block the uptake of cholesterol from
the intestines and help the body excrete it. This process can lead to lower levels
of low-density lipoprotein (LDL) cholesterol, often referred to as "bad"
cholesterol. By reducing LDL cholesterol, phytosterols can help lower the risk
of heart disease and improve overall cardiovascular health.

Phytosterols in your diet can lead to significant health benefits, including:

• Lower Cholesterol Levels: Regular intake of phytosterols can reduce LDL

cholesterol levels by about 8-10%.
• Reduced Risk of Heart Disease: By lowering cholesterol, phytosterols can
help decrease the chances of developing heart-related issues.
2. Flavonoids:
Flavonoids are natural compounds found in many fruits and vegetables that are
important for our health. They are responsible for the vibrant colors of many plants and
have been shown to provide various health benefits, especially in preventing heart
diseases (CVD).
Flavonoids are present in a variety of foods, including:
• Vegetables: Onions, endives, and cruciferous vegetables (like broccoli and
cabbage).
 • Fruits: Grapefruits, apples, cherries, pomegranates, and berries.
• Beverages: Black grapes and red wine.
Flavonoids come in different types, such as flavones (apigenin found in chamomile),
flavanones (hesperidins found in citrus fruits; silybin in milk thistle), and flavonols
(quercetin found in tea; kaempferol and rutin in grapefruit). Each type has unique
properties and benefits.
Flavonoids play a major role in keeping your heart healthy by:
• Blocking Enzymes: They can block certain enzymes in the body, like
angiotensin-converting enzyme (ACE) and cyclooxygenase, which helps reduce
inflammation and lower blood pressure.
• Preventing Clots: Flavonoids help prevent platelets in the blood from sticking
together, which reduces the risk of blood clots.
• Protecting Blood Vessels: They protect the blood vessels that carry oxygen and
nutrients to your cells, ensuring that your body functions properly.
3. Buckwheat: Buckwheat contains phytosterols, flavonoids, and fiber, which help lower
blood cholesterol and blood pressure, reducing the risk of heart disease and diabetes.
• Phytosterols: These are plant compounds that help lower cholesterol levels in
the body. They work by blocking the absorption of cholesterol from the food
we eat, which can help reduce the risk of heart disease.
• Flavonoids and Flavones: These are antioxidants found in buckwheat that help
protect your body from damage caused by harmful molecules called free
radicals. They also have anti-inflammatory properties, which can help reduce
the risk of chronic diseases.
• Proteins: Buckwheat contains high-quality proteins that are beneficial for your
body. These proteins can help lower blood cholesterol levels and manage blood
pressure, contributing to overall heart health.
• Thiamin-Binding Proteins: These proteins help improve the stability and
absorption of thiamin (vitamin B1), which is important for energy metabolism
and overall health.
• Dietary Fiber: Buckwheat is rich in dietary fiber, which is important for
digestive health. Fiber can help lower cholesterol levels and is beneficial in
preventing and managing conditions like cardiovascular disease (CVD) and
diabetes.
 4. Ginger (Zingiber officinalis): Ginger has antioxidant and anti-inflammatory
properties, which help protect the heart and blood vessels. It can also help lower high
blood pressure and heart palpitations (irregular heartbeats).
5. Omega-3 Fatty Acids: Omega-3 fatty acids are healthy fats found in fish. They help
lower bad fats (lipids) in the blood and reduce the risk of heart problems like irregular
heartbeats (arrhythmias).
6. Octacosanol: Octacosanol is a natural compound found in various foods, particularly
in whole grains and fruits. It is a type of long-chain fatty alcohol that has gained
attention for its potential health benefits, especially for heart health.
Octacosanol is present in:
• Whole Grains: Foods like oats, wheat, and barley are good sources.
• Fruits: Some fruits also contain octacosanol, contributing to its health benefits.

Functions

• Lowers Blood Fats: One of the main benefits of octacosanol is its ability to
help lower blood fats, also known as lipids. This can be important for
maintaining a healthy heart and reducing the risk of cardiovascular diseases.
• Safe to Use: Octacosanol is considered safe for consumption and does not
have significant side effects. This makes it a good option for people looking
to improve their heart health without worrying about adverse reactions.

Cancer:

Cancer is a growing health problem around the world particularly with the changes in
environmental conditions and lifestyle and steady rise in life expectancy.

Normal cell become cancerous due to phenotype requires stages of initiation, progression, and
promotion by altering specific genes.

Current cancer treatments, such as chemotherapy, radiotherapy and surgery, induce unintended
side effects compromising also health and well-being of patients. Emerging studies suggest
that some plant-based agents may impact cellular and molecular processes underlying tumour
progression.
Phytochemicals are plant based chemicals that mediate their positive health benefits directly,
by affecting specific molecular targets or indirectly as stabilized conjugates affecting metabolic
pathways

Chemical
Plant Source Mechanism of Action Uses
Constituent

Inhibits microtubule formation, Used in the treatment of

Vinca rosea Vincristine,
disrupting mitosis and leukemia, lymphoma, and
(Periwinkle) Vinblastine
preventing cancer cell division. testicular cancer.

Taxus Stabilizes microtubules,

Paclitaxel Used for breast, ovarian,
brevifolia preventing their disassembly,
(Taxol) and lung cancers.
(Pacific Yew) which inhibits cell division.

Camptotheca Inhibits topoisomerase I, leading

Used for ovarian and lung
acuminata Camptothecin to DNA damage and apoptosis
cancers.
(Happy Tree) in cancer cells.

Podophyllum Inhibits topoisomerase II,

Etoposide, Used for testicular cancer
peltatum preventing DNA replication and
Teniposide and certain leukemias.
(Mayapple) leading to cell death.

Exhibits anti-inflammatory and Investigated for its

Curcuma
antioxidant properties; potential in various
longa Curcumin
modulates multiple signaling cancers, including breast
(Turmeric)
pathways. and colorectal cancer.
 Ginger Exhibits anti-inflammatory and
Studied for its effects on
(Zingiber Gingerol antioxidant effects; may inhibit
gastrointestinal cancers.
officinale) cancer cell growth.

Allium Induces apoptosis and inhibits Associated with reduced

sativum Allicin cancer cell proliferation; risk of stomach and
(Garlic) enhances immune function. colorectal cancers.

Activates detoxifying enzymes

Brassica Investigated for its
and inhibits histone
oleracea Sulforaphane protective effects against
deacetylases, leading to cancer
(Broccoli) prostate and breast cancers.
cell death.

Exhibits antioxidant properties

Grapes (Vitis and modulates cell signaling Studied for its potential in
Resveratrol
vinifera) pathways involved in cancer breast and colon cancers.
progression.

Associated with reduced

Green Tea Inhibits tumor growth and
Epigallocatechin risk of various cancers,
(Camellia angiogenesis; induces apoptosis
gallate (EGCG) including breast and
sinensis) in cancer cells.
prostate cancer.

Nutraceuticals in Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a common problem in children. There are mainly two
common forms of IBS such as Ulcerative Colitis (UC) and Crohn’s Disease (CD), which are
generally associated with diarrhoea, nausea, abdominal pain, fatigue, rectal bleeding, weight
loss, anxiety, etc.
There are no safe and effective treatments available. The conventional treatment of IBS is
aimed at controlling symptoms with spasmolytic agents, antidepressants, laxatives, anti-
diarrheal agents, and fibre supplements. Recently, it is seen that the supplementation of fruits
and vegetables, probiotic bacteria, dietary fibres, and fat-soluble vitamins are helpful in
reduction of the symptoms of IBS through their anti-inflammatory functions.

Herbals (curcumin, Chinese herbals, peppermint oil) and dietary supplements (melatonin,
prebiotics, probiotics) are most important in IBS. They alleviate gastrointestinal inflammation
by modulating inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin 1
(IL-1), IL-6, IL-1β, and IL-10.

Thereafter, functional foods ameliorate IBS by down regulating the pro-inflammatory

signaling pathways, such as nuclear factor κB, STAT1, STAT6, and pro-inflammatory
cytokines, including IL-1β, IL-4, IL-6, COX-2, TNF-α, and interferon g. Hence, they have the
potential to alleviate IBS by modulating the underlying pathogenic mechanisms.

Probiotics are live microorganisms that benefit humans by promoting gut health and the
immune system upon ingestion in an acceptable amount. Probiotics reduce harmful
microorganisms and maintain the microbial balance inside the gut by blocking the site of
adhesion, competing for nutrients, and killing pathogenic microorganisms.

They also produce Short-Chain Fatty Acids (SCFA) and butyrate by probiotic bacteria which
lowers the pH level in the colon and limits the growth of pathogens. Furthermore they act as
anti-inflammatory agents by modulating the NF-κB signaling pathway, inflammatory
cytokines, and the regulatory T cell response. Such important probiotics that is effective in
alleviating gastrointestinal inflammation, Lactobacillus and Bifidobacteria. Lactobacillus
suntoryeus suppressed toll-like receptor (TLR)-4 linked NF-κB and IL-6 expression in TNBS-
induced colitis.

.
Nutrient Source Benefits Mechanism of Action
Fatty fish Reduces
Competes with omega-6 fatty
Omega-3 Fatty (salmon, inflammation, may
acids, lowering pro-
Acids mackerel), improve symptoms
inflammatory cytokines
flaxseeds of IBD
Promotes gut
Fermented in the colon to
health, regulates
Whole grains, produce short-chain fatty
Dietary Fiber bowel movements,
fruits, vegetables acids (SCFAs) that have anti-
may reduce
inflammatory effects.
symptoms of IBD
Restores gut
microbiota Competes with pathogens,
Yogurt, kefir, balance, reduces produces antimicrobial
Probiotics
sauerkraut inflammation, agents, and modulates
improves gut immune response.
health
Antioxidant
properties, Vitamin D deficiency linked
Fruits,
Vitamins (C, D, supports immune to increased disease activity;
vegetables,
E) function, may vitamins C and E scavenge
fortified foods
reduce free radicals.
inflammation

Anti-inflammatory
Inhibits pro-inflammatory
properties, may
Curcumin Turmeric cytokines and oxidative
help in managing
stress.
IBD symptoms

Antioxidant and
Fruits,
anti-inflammatory Scavenges free radicals and
Polyphenols vegetables, tea,
effects, modulates reduces inflammation.
red wine
gut microbiota
 Promotes growth Fermented in the colon,
Chicory root, of beneficial gut producing SCFAs that
Prebiotics
garlic, onions bacteria, improves nourish mucosal cells and
gut health enhance gut barrier function

Antibacterial, anti-
Stimulates tissue growth and
Natural inflammatory, may
Honey inhibits harmful bacteria like
sweetener help with gastric
H. pylori
ulcers

Improves gut
Competes with pathogens for
health, reduces
Lactobacillus Yogurt, binding sites, produces
symptoms of IBD,
spp. fermented foods antimicrobial substances, and
aids in lactose
modulates immune response
digestion

Enhances gut
microbiota Produces short-chain fatty
Bifidobacterium Yogurt, dietary balance, may acids (SCFAs) that nourish
spp. supplements alleviate diarrhea, mucosal cells and enhance
supports immune gut barrier function
function

Effective against
Competes with pathogens,
Probiotic antibiotic-
Saccharomyces produces antimicrobial
supplements, associated
boulardii agents, and enhances
fermented foods diarrhea, improves
mucosal immunity
gut health
 Aids in lactose Produces lactic acid, which
Streptococcus Yogurt, dairy
digestion, may lowers pH and inhibits
thermophilus products
improve gut health pathogenic bacteria

Supports gut
Probiotic Competes with harmful
Enterococcus health, may help in
supplements, bacteria and enhances gut
faecium managing IBD
fermented foods barrier function
symptoms
Bitter Gourd

Bitter gourd, scientifically known as Momordica charantia (Cucurbitaceae), is a tropical and subtropical
fruit that has gained recognition for its remarkable health benefits and culinary versatility. Often referred
to as bitter melon, this unique vegetable is not only valued for its distinct bitter flavor but also for its
extensive medicinal properties, which have been utilized in traditional medicine systems like Ayurveda
and Chinese medicine. Bitter gourd is particularly noted for its anti-diabetic effects, making it a popular
choice among those managing blood sugar levels. Additionally, it is rich in essential vitamins, minerals,
and antioxidants, contributing to overall health and wellness. Despite its bitter taste, bitter gourd can be
incorporated into various dishes and processed into value-added products, enhancing its appeal and
accessibility. As awareness of its health benefits grows, bitter gourd is increasingly recognized as a
superfood that can play a significant role in a balanced diet.

Chemical Constituents

The fruits and leaves contain charantin, a steroidal saponin which shows blood sugar lowering activity.
Karela fruits even contain a cathartic principle called momordicin. The drug also contains carbohydrates
(10 per cent), mineral matter (1.5 per cent) and ascorbic acid (88 – 188 mg/100 gm). Additionally,
alkaloids, glucoside, saponins, and mucilage are the other contents of Karela.

Mineral Matter: including calcium, magnesium, potassium, phosphorous and iron.

Health benefits

1. Anti-Diabetic Properties

Bitter gourd is widely recognized for its ability to help manage diabetes. It contains several bioactive
compounds, including charantin, vicine, and polypeptide-p, which have hypoglycemic effects. These
compounds improve blood sugar levels by enhancing glucose uptake and glycogen synthesis in the liver,
muscles, and fat cells.

2. Antioxidant Activity

The fruit is rich in antioxidants, which help protect the body from oxidative stress and reduce the risk of
chronic diseases. Antioxidants in bitter gourd, such as carotenoids, combat free radicals and may lower
the risk of heart disease and certain cancers.

3. Antimicrobial and Antiviral Effects

Bitter gourd exhibits antimicrobial properties against various pathogens, including E.

coli, Staphylococcus, and Helicobacter pylori. Additionally, it has shown antiviral activity, particularly
against the HIV virus, due to compounds that inhibit viral replication.
4. Anti-Cancer Properties

Research indicates that bitter gourd may have anticancer effects. Certain phytochemicals in the fruit can
inhibit enzymes linked to cancer progression, potentially reducing the risk of certain types of cancer.

5. Digestive Health

Bitter gourd is a good source of dietary fiber, which aids in digestion and helps prevent constipation. Its
consumption can promote a healthy digestive system.

6. Blood Purification

Bitter gourd is traditionally used as a blood purifier. Its tonic properties can help cleanse the blood and
may alleviate skin conditions related to blood impurities.

7. Weight Management

The fruit is low in calories and high in fiber, making it a suitable food for weight management. Its bitter
taste can also help suppress appetite, contributing to weight loss efforts.

8. Respiratory Health

Bitter gourd is used in traditional remedies for respiratory issues. A paste made from its leaves can be
taken to alleviate symptoms of asthma, bronchitis, and other respiratory conditions.

9. Nutritional Value

Bitter gourd is rich in vitamins and minerals, including vitamin C, calcium, magnesium, and B vitamins. It
contains significant amounts of vitamin C, which supports the immune system and overall health.

10. Potential Risks

While bitter gourd has many health benefits, it should be consumed with caution. Individuals with allergies
to bitter melon or related plants should avoid it. Additionally, pregnant women are advised against its
consumption due to potential risks.

Spirulina
Spirulina, a blue-green algae (cyanobacteria) from the genus Arthrospira (Oscillateriaceae), is
renowned for its rich nutritional profile and health benefits. Below are the key chemical constituents and
mineral content found in spirulina:
1. Phytoconstituents

• Proteins: Spirulina contains a high protein content, ranging from 60% to 70% of its dry weight. It
is a complete protein source, providing all essential amino acids.

• C-Phycocyanin: This is a major pigment-protein complex in spirulina, accounting for about 20%
of its dry weight. It has antioxidant properties and contributes to the blue-green color of the algae.

• Lipids: Spirulina has a lipid content of approximately 5-10%, primarily consisting of essential fatty
acids, including gamma-linolenic acid (GLA), linoleic acid, and oleic acid.

• Carbohydrates: Spirulina contains polysaccharides, including rhamnose and glycogen, which

are easily absorbed and provide energy.

• Nucleic Acids: Spirulina contains about 4-6% nucleic acids (DNA and RNA), which are
important for cellular functions.

• Vitamins: Spirulina is a rich source of vitamins, particularly vitamin B12, which is crucial for
vegans, as it is typically found in animal products. It also contains beta-carotene, which is
converted to vitamin A in the body.

• Minerals: Spirulina is rich in essential minerals, including:

o Iron: Contains about 580-1800 mg/kg, significantly higher than many plant sources.

o Calcium: Comparable to that found in milk, important for bone health.

o Phosphorus: Supports bone health and energy metabolism.

o Magnesium: Important for muscle and nerve function.

Health benefits

1. Nutrient-Rich Superfood: Spirulina is packed with essential nutrients, including proteins (60-
70% of its dry weight), vitamins (especially B12 and beta-carotene), and minerals (such as iron,
calcium, and magnesium), making it an excellent dietary supplement.

2. Antioxidant Properties: Spirulina contains powerful antioxidants, including C-phycocyanin,

which help combat oxidative stress and reduce inflammation in the body. This can lower the risk
of chronic diseases.

3. Cholesterol-Lowering Effects: Studies have shown that spirulina can help lower LDL (bad)
cholesterol and triglyceride levels while increasing HDL (good) cholesterol, contributing to
improved heart health.
 4. Blood Sugar Control: Spirulina has been found to help regulate blood sugar levels, making it
beneficial for individuals with diabetes. It may enhance insulin sensitivity and reduce fasting blood
sugar levels.

5. Anti-Inflammatory Effects: The anti-inflammatory properties of spirulina can help alleviate

symptoms of inflammatory conditions, such as arthritis and allergies.

6. Immune System Support: Spirulina is known to enhance immune function, making it beneficial
for individuals with weakened immune systems, such as those living with HIV.

7. Weight Management: Due to its high protein content and low calorie count, spirulina can
promote satiety and help with weight management.

8. Improved Muscle Strength and Endurance: Spirulina supplementation has been associated
with increased muscle strength and endurance, making it popular among athletes.

9. Digestive Health: Spirulina can support gut health by promoting the growth of beneficial gut
bacteria, which can improve digestion and overall gut function.

10. Potential Anti-Cancer Properties: The combination of antioxidants and immune-modulating

effects may contribute to cancer prevention, particularly against certain types of cancer.

11. Detoxification: Spirulina may help detoxify the body by binding to heavy metals and toxins,
facilitating their excretion.

12. Anti-Viral Properties: Some studies suggest that spirulina may have antiviral effects, inhibiting
the replication of certain viruses, including HIV and influenza.

13. Energy Boosting: Spirulina is often promoted as a natural energy booster due to its high nutrient
content, which can enhance overall vitality and reduce fatigue.

14. Skin Health: The antioxidants in spirulina can help improve skin health by reducing oxidative
stress and promoting a healthy complexion.

15. Anti-Aging Effects: The rich antioxidant content of spirulina may help combat signs of aging by
reducing oxidative damage to cells.

16. Support for Anemia: Spirulina is a good source of iron, which can help improve hemoglobin
levels and combat anemia.

Ginger
Biological Source: Ginger consists of whole or cut, dried scrapped or unscrapped rhizomes of Zingiber
officinale Roscoe, family Zingiberaceae. It contains not less than 0.8 per cent of total gingerols on dried
basis.

Chemical Constituents

Ginger consists of several key components, including volatile oil (1-4%), starch (40-60%), fat (10%), fiber
(5%), inorganic material (6%), residual moisture (10%), and acrid resinous matter (5-8%). The volatile oil
in ginger is made up of monoterpene and sesquiterpene hydrocarbons, oxygenated mono- and
sesquiterpenes, and phenylpropanoids. The sesquiterpene hydrocarbons found in ginger oil are
consistent across different types and include compounds like a-zingiberene, b-bisabolene, a-farnesene,
b-sesquiphellandrene, and a-curcumene. The aroma of ginger is primarily due to the fragrant volatile oil,
while its flavor, pungency, and pharmacological effects are attributed to phenolic ketones in the oleo-resin.
These phenolic ketones include gingerols like shogaols, zingerone, paradols, gingediols,
hexahydrocurcumin, and their methylated derivatives. Some components of the volatile oil, such as
isometric terpenic aldehydes like geranial and citral, contribute a delicate lemony aroma, while
sesquiterpene hydrocarbons add a spicy note to the overall flavor profile.

Health benefits

1. Anti-inflammatory Properties: Gingerol is the main bioactive compound in ginger, responsible

for its unique flavor and many of its health benefits. It has potent anti-inflammatory and antioxidant
effects, which can help reduce oxidative stress and inflammation in the body.

2. Nausea Relief: Ginger is well-known for its ability to alleviate nausea, particularly morning
sickness during pregnancy. Studies have shown that doses of 1.1 to 1.5 grams of ginger can
significantly reduce nausea symptoms. It is also effective against nausea related to
chemotherapy and post-surgery.

3. Weight Management: Research indicates that ginger may play a role in weight management. A
literature review concluded that ginger supplementation can significantly reduce body weight and
waist-hip ratio in individuals with obesity. It may also help reduce body mass index (BMI) and
blood insulin levels.

4. Anti-Osteoarthritis: Ginger has been shown to reduce pain and disability in individuals with
osteoarthritis. Studies indicate that daily ginger supplementation can lead to significant
improvements in joint pain and function.

5. Blood Sugar Control: Ginger has demonstrated anti-diabetic properties. In a study involving
individuals with type 2 diabetes, ginger supplementation significantly lowered fasting blood sugar
levels and improved hemoglobin A1c, a marker for long-term blood sugar control.
 6. Digestive Aid: Ginger can help speed up the emptying of the stomach, which is beneficial for
individuals suffering from chronic indigestion. It has been shown to reduce discomfort and pain
associated with digestive issues.

7. Anti-Cancer Properties: Gingerol and other compounds in ginger have been studied for their
potential anti-cancer effects. Research suggests that ginger may inhibit the growth of certain
cancer cells, particularly in gastrointestinal cancers, and may help reduce inflammation linked to
cancer progression.

8. Brain Health: The antioxidants in ginger can help protect against age-related cognitive decline.
Some studies suggest that ginger may enhance brain function and improve memory and reaction
time in healthy individuals.

9. Immune System Support: Ginger has antimicrobial properties that can help fight infections. It
may inhibit the growth of various bacteria and viruses, including those responsible for respiratory
infections.

10. Menstrual Pain Relief: Ginger has been found to be effective in reducing menstrual pain.
Studies indicate that it can alleviate discomfort associated with dysmenorrhea, making it a natural
alternative to over-the-counter pain relievers.

11. Reduces Muscle Pain and Soreness: Ginger has been shown to reduce muscle pain and
soreness after exercise. Its anti-inflammatory properties can help alleviate post-workout
discomfort.

12. Immune System Support: Gingerol can lower the risk of infections by inhibiting the growth of
various types of bacteria. It has been found effective against oral bacteria linked to gum diseases
and may also combat respiratory syncytial virus (RSV).

13. Cardiovascular Health: Ginger may help lower cholesterol levels and improve overall heart
health. It has been shown to reduce LDL cholesterol and triglycerides while increasing HDL
cholesterol.

14. Respiratory Health: Ginger can help relieve respiratory problems, such as asthma and
bronchitis, due to its anti-inflammatory properties. It may also help clear mucus from the airways.

15. Anti-Aging Effects: The antioxidant properties of ginger can help combat oxidative stress, which
is linked to aging and age-related diseases.

ASHWAGANDHA
The name Ashwagandha has been derived from the Sanskrit language and is a
combination of the word ashva meaning horse and gandha meaning smell. Thus, the
roots have a strong horse-like odour.

Biological Source: It consists of dried roots and stem bases of Withania somnifera
(Linn.) Dunal, belonging to family Solanaceae and should contain not less than 0.02
per cent of total withanolide A and withaferin A on dried basis.

Chemical Constituents: The main constituents of ashwagandha are alkaloids and

steroidal lactones. Among the various alkaloids, withanine is the main constituent. The
other alkaloids are somniferine, somnine, somniferinine, withananine, pseudo-
withanine, tropine, pseudo tropine, 3-a-gloyloxytropane, choline, cuscohygrine,
isopelletierine, anaferine and anahydrine. Two acyl steryl glucosides viz. Sitoindoside
VII and sitoindoside VIII have been isolated from roots. The leaves contain steroidal
lactones, which are commonly called as "withanolides". The withanolides have C28
steroidal nucleus with C9 side chain, having six membered lactone rings.

Health benefits

1. Reduces Stress and Anxiety: Ashwagandha is renowned for its ability to reduce
stress and anxiety levels. It has been shown to lower cortisol, the stress hormone,
which can help alleviate symptoms of anxiety.

2. Improves Sleep Quality: The calming effects of ashwagandha can enhance sleep
quality and help with insomnia. Its adaptogenic properties may promote relaxation
and improve overall sleep patterns.

3. Enhances Cognitive Function: Some studies suggest that ashwagandha may

improve memory, attention, and cognitive function. It may protect against
neurodegenerative diseases like Alzheimer’s by reducing oxidative stress and
inflammation in the brain.

4. Anti-Inflammatory Effects: The herb has potent anti-inflammatory properties,

which can help reduce inflammation in the body. This is beneficial for conditions like
arthritis, where inflammation plays a significant role.

5. Supports Immune Function: Ashwagandha may enhance immune system

function, helping the body to fight off infections and diseases. Its antioxidant
properties contribute to overall immune health.
 6. Hormonal Balance: Ashwagandha can help balance hormones, particularly in
men, by increasing testosterone levels and improving fertility. This can be beneficial
for those experiencing hormonal imbalances.

7. Weight Management: Some research indicates that ashwagandha may assist in

weight management by reducing stress-related eating and improving metabolic
health.

8. Blood Sugar Control: Ashwagandha has been shown to lower blood sugar levels
and improve insulin sensitivity, making it beneficial for individuals with type 2
diabetes.

9. Potential Anti-Cancer Properties: Preliminary studies suggest that ashwagandha

may inhibit the growth of cancer cells and enhance the effectiveness of certain
cancer treatments. It has shown promise in reducing tumor growth in animal studies.

10. Heart Health: Ashwagandha may help lower cholesterol and triglyceride levels,
contributing to overall heart health. Some studies suggest it can enhance
cardiorespiratory endurance, which is beneficial for cardiovascular health.

11. Muscle Strength and Recovery: Research indicates that ashwagandha can
enhance muscle strength and recovery, making it popular among athletes and
fitness enthusiasts. It may help improve physical performance and increase muscle
mass.

12. Improved Sexual Function: Traditionally, ashwagandha has been used to

enhance libido and sexual function in both men and women. It may help improve
sexual health by balancing hormones and reducing stress.

13. Neuroprotective Effects: Ashwagandha may protect against neurodegenerative

diseases by reducing oxidative stress and inflammation in the brain. This can help
maintain cognitive function as one ages.

14. Anti-depressant: Some studies suggest that ashwagandha may have

antidepressant effects, helping to alleviate symptoms of depression and improve
overall mood.

15. Brain Health: Ashwagandha has been shown to enhance brain function and
memory, potentially protecting against age-related cognitive decline.
AMLA
Biological Source: This consists of dried, as well as fresh fruits of the plant Emblica
officinalis, Phyllanthus emblica Linn. belonging to family Euphorbiaceae. It contains not
less than 1.0 per cent w/w of gallic acid calculated on dry basis.

Chemical Constituents: Amla fruit is a rich natural source of vitamin C (Ascorbic acid) and
contains 600 - 750 mg per 100 g of the fresh pulp. Furthermore, fruits also contain about
0.5 per cent fat, phyllemblin and 5 per cent tannin. Amla fruits are also rich in mineral matters
like phosphorus, iron and calcium. It contains appreciable amount of pectin. The fresh fruits
contain about 75 per cent moisture. The fruits are dehydrated and stored. It is found that
vitamin content of dried fruits is not lost considerably. It may be due to the presence of
tannins, which retards oxidation of vitamin C.

Health Benefits

Amla is associated with a wide range of health benefits, including:

1. Immunity Booster: Amla is known for its high vitamin C content, which enhances
the immune system and helps the body fight infections.

2. Antioxidant Properties: The antioxidants in amla help combat oxidative stress,

reducing the risk of chronic diseases and promoting overall health.

3. Supports Digestive Health: Amla is beneficial for digestive health, helping to

alleviate issues such as constipation and indigestion. It can also promote a healthy
gut microbiome.

4. Anti-Inflammatory Effects: Amla has anti-inflammatory properties that can help

reduce inflammation in the body, which is linked to various chronic conditions.

5. Blood Sugar Management: Some studies suggest that amla may help regulate
blood sugar levels, making it beneficial for individuals with diabetes.

6. Heart Health: Amla may help lower cholesterol levels and improve heart health by
reducing the risk of cardiovascular diseases. Its antioxidant properties also protect
against oxidative damage to the heart.

7. Skin Health: The high vitamin C content and antioxidant properties of amla can
promote healthy skin, reduce signs of aging, and improve skin texture.

8. Hair Health: Amla is commonly used in hair care products due to its ability to
strengthen hair, promote hair growth, and prevent premature graying.
 9. Eye Health: Amla may help improve vision and protect against age-related eye
disorders due to its antioxidant properties.

10. Anti-Cancer Properties: Preliminary studies suggest that amla may have anti-
cancer effects, potentially inhibiting the growth of certain cancer cells and preventing
tumor formation.

11. Weight Management: Amla may aid in weight management by promoting healthy
metabolism and reducing fat accumulation.

12. Enhances Food Absorption: Amla can improve the absorption of nutrients from
food, contributing to overall health and vitality.
HONEY

Biological Source: Honey is a sugar secretion deposited in honey comb by the bees, Apis
mellifera, Apis dorsata, and other species of Apis, belonging to family Apidae, order
Hymenoptera.

Chemical Constituents

Honey is composed of various bioactive compounds that contribute to its health benefits:

1. Carbohydrates: Honey is primarily made up of sugars, including fructose (about

38%) and glucose (about 31%), which provide quick energy.

2. Vitamins: Honey contains small amounts of vitamins, including B vitamins (such as

niacin, riboflavin, and pantothenic acid) and vitamin C.

3. Minerals: It includes essential minerals such as calcium, potassium, magnesium,

and iron.

4. Enzymes: Honey contains enzymes like diastase (amylase) and invertase, which
aid in the breakdown of sugars.

Health Benefits

Honey is associated with numerous health benefits, including:

1. Wound Healing: Honey has antibacterial, antiviral, and anti-inflammatory

properties, making it effective for wound healing. It promotes tissue regeneration
and helps prevent infection.
 2. Antioxidant Effects: The antioxidants in honey help protect the body from oxidative
stress, reducing the risk of chronic diseases and supporting overall health.

3. Soothing Sore Throats: Honey is a natural remedy for sore throats and coughs. It
can help soothe irritation and reduce coughing, making it a popular ingredient in
herbal teas.

4. Digestive Health: Honey can aid digestion by promoting the growth of beneficial
gut bacteria. It may also help alleviate symptoms of gastrointestinal disorders.

5. Anti-Diabetic Properties: Some studies suggest that honey may help regulate
blood sugar levels and improve insulin sensitivity, making it a better alternative to
refined sugars for individuals with diabetes.

6. Heart Health: Honey may improve cardiovascular health by reducing cholesterol

levels, lowering blood pressure, and improving blood circulation.

7. Skin Health: Honey is often used in skincare products due to its moisturizing and
antibacterial properties. It can help treat acne, hydrate the skin, and promote a
healthy complexion.

8. Cough Suppressant: Honey is an effective natural cough suppressant, particularly

in children. It can help reduce the frequency and severity of coughing.

9. Energy Booster: The natural sugars in honey provide a quick source of energy,
making it an excellent choice for athletes and those needing an energy boost.

10. Immune System Support: Honey has immune-boosting properties that can help
the body fight off infections and diseases.

11. Anti-Cancer Properties: Preliminary studies suggest that honey may have anti-
cancer effects due to its antioxidant content, which can help prevent cell mutations
and inhibit tumor growth.

12. Promotes Sleep: Honey may help improve sleep quality by promoting the release
of melatonin, a hormone that regulates sleep.

Garlic

Garlic, scientifically known as Allium sativum, is a widely used herb that has been
recognized for its numerous health benefits. It belongs to the Liliaceae family and is
primarily known for its culinary uses as well as its medicinal properties. Below, we will
explore the nutritional content, health benefits, potential side effects, and interactions of
garlic.

Nutritional Content

Garlic is rich in various nutrients and bioactive compounds, including:

1. Vitamins: Garlic is a good source of vitamin C and vitamin B6.

2. Minerals: It contains essential minerals such as manganese, copper, and selenium.
3. Bioactive Compounds: The primary active compound in garlic is allicin, which is
responsible for many of its health benefits. Other compounds include diallyl disulfide,
ajoene, and various sulfur-containing compounds
Health benefits

1. Cardiovascular Health:
o Garlic is known to lower blood pressure and cholesterol levels, which
can significantly reduce the risk of heart disease. It helps improve blood
circulation and prevents the formation of blood clots.
2. Antimicrobial Properties:
o Garlic exhibits strong antibacterial, antiviral, and antifungal properties. It
has been shown to combat various pathogens, including Escherichia coli
and Staphylococcus aureus, making it effective in preventing infections.
3. Cancer Prevention:
o The bioactive compounds in garlic have been linked to anticancer
effects, particularly against prostate and stomach cancers. Garlic may
inhibit tumor growth and enhance the body’s detoxification processes.

4. Anti-inflammatory Effects:
o Garlic has potent anti-inflammatory properties that can help reduce
inflammation in the body, benefiting conditions such as arthritis and other
inflammatory diseases.
5. Blood Sugar Regulation:
o Garlic may help lower blood sugar levels, making it beneficial for
individuals with diabetes. It enhances insulin sensitivity and promotes
better glucose metabolism.
 6. Immune System Support:
o Regular consumption of garlic can boost the immune system, helping
the body to fend off infections and illnesses. Its antioxidant properties
also help reduce oxidative stress.
7. Digestive Health:
o Garlic can promote healthy digestion by enhancing the growth of
beneficial gut bacteria. It may also help alleviate digestive issues such
as bloating and gas.
8. Weight Management:
o Some studies suggest that garlic may aid in weight loss by enhancing
metabolism and reducing appetite, making it a useful addition to a weight
management plan.
9. Detoxification:
o Garlic has been shown to support the body’s detoxification processes,
helping to eliminate harmful substances and heavy metals.
10. Skin Health:
o The antimicrobial and anti-inflammatory properties of garlic can benefit
skin health, helping to treat conditions like acne and other skin infections.
11. Bone Health:
o Some research indicates that garlic may improve bone health by
increasing estrogen levels in females, which can be beneficial for bone
density.

12. Cognitive Function:

o The antioxidants in garlic may help protect against age-related cognitive
decline and neurodegenerative diseases, such as Alzheimer’s.

HERB-DRUG AND HERB-FOOD INTERACTIONS

Herb-drug interactions occur between herbal medicines and conventional drugs. These
interactions are more common than drug-drug interactions because herbal medicines
contain multiple pharmacologically active ingredients, while conventional drugs contain a
single ingredient. Some of these interactions are significant, although most herbal remedies
are not associated with drug interactions and cause serious consequences.

Types of Interactions

Interactions can be classified into three main categories:

1. Herb-Herb Interaction (Drug-Drug Interaction):

This type of interaction occurs when multiple herbal medicines are taken together.
The combined effects can enhance or inhibit the activity of one another, potentially
leading to side effects. For example, taking a sedative herb with another sedative can
amplify drowsiness.

2. Herb-Food Interaction (Food-Drug Interaction):

This interaction happens when herbal products interact with food or beverages in the
stomach. Certain foods can affect the absorption or metabolism of drugs, leading to adverse
effects. For instance, grapefruit juice is known to inhibit enzymes that metabolize various
medications, increasing their effects and potential toxicity.

3. Herb-Disease Interaction (Drug-Disease Interaction):

This occurs when existing medical conditions alter the effectiveness or safety of herbal
products. For example, a patient with high blood pressure may experience adverse effects
from certain decongestants.

Mechanisms of Interaction

Interactions can occur through two primary mechanisms: pharmacokinetic and

pharmacodynamic.

Pharmacokinetic Interactions:

These involve changes in the absorption, distribution, metabolism, or excretion of drugs

due to the presence of herbal products. For example, some herbs can inhibit the absorption
of medications by binding to them in the gastrointestinal tract.

Pharmacodynamic Interactions:
 These occur when the effects of a drug are altered by an herbal product without changing
the drug's concentration in the body. For instance, combining anticoagulants like warfarin
with herbs that have blood-thinning properties can increase the risk of bleeding.

5.1.3.1. Hypercium

Biological Source: This consists of dried aerial parts of the plant known as Hypericum
perforatum Linn. Fam. Hypericaceae collected during flowering season or shortly before
flowering.

St. John’s wort (hypercium) is a 50 -100cm tall plant with yellow, star -shaped flowers and
five petals. It grows in Euro pe, North and South America, Australia, New Zealand, and
Eastern Asia in sunny, well -drained areas. It is most commonly used for depression and
symptoms related to mood like nervousness, tiredness, poor appetite, and trouble sleeping.
It has been scientifically proved to be effective for mild to moderate depression. It is also
used for relieving menopause symptoms like hot flashes and mood swings.

Possible Side Effects

Hypercium is safe when taken orally for 12 weeks. As per some evidences, it can be safel
y used for a year. It can cause some side effects such as trouble in sleeping, vivid dreams,
difficulty in sitting still, nervousness, irritability, stomach upset, tiredness, dry mouth,
dizziness, headache, skin rash, diarrhoea, and skin tingling.

Hypercium is however regarded unsafe when taken orally in large doses as it might cause
severe skin reactions to sun exposure. Women are at risk of severe skin reactions even at
usual doses.

Possible Interactions

Interaction Drug/Condition Effect of Outcome

Hypericum
1 Alprazolam Increases Reduces effectiveness of
excretion alprazolam, potentially
leading to anxiety resurgence.
2 Aminolevulinic Acid Increases skin Heightens risk of sunburn,
sensitivity to blistering, or rashes on sun-
sunlight exposed skin.
3 Amitriptyline Increases Reduces effectiveness of
breakdown amitriptyline, potentially
worsening depression.
4 Birth Control Pills Increases Reduces effectiveness of
breakdown contraceptive drugs,
increasing the risk of
unintended pregnancy.
5 Cyclosporine Increases Reduces effectiveness of
breakdown cyclosporine, which may
compromise organ transplant
success.
6 Digoxin Decreases Reduces effectiveness of
absorption digoxin, which is critical for
heart function.
7 Fenfluramine Increases Risk of serotonin syndrome,
serotonin levels leading to serious side effects
like heart problems and
anxiety.
8 Imatinib Increases Reduces effectiveness of
breakdown imatinib, potentially affecting
cancer treatment.
9 Irinotecan Increases Reduces effectiveness of
breakdown irinotecan, which is used in
cancer therapy.
10 CYP3A4 Substrates Increases Reduces effectiveness of
(e.g., lovastatin, breakdown various drugs metabolized by
ketoconazole) the liver.
11 Antidepressants Increases Risk of serotonin syndrome,
(SSRIs) serotonin levels leading to serious side effects
like heart problems and
anxiety.
 12 HIV Medications Increases Reduces effectiveness of
(NNRTIs) breakdown medications like nevirapine
and efavirenz.
13 Narcotic Pain Decreases Increases effects and side
Medications breakdown effects of narcotics, leading to
potential overdose.
14 P-Glycoprotein Increases Reduces absorption of various
Substrates activity medications, decreasing their
effectiveness.
15 Photosensitizing Drugs Increases Heightens risk of sunburn and
sensitivity to skin reactions.
sunlight
16 Meperidine Increases Risk of serotonin syndrome,
serotonin levels leading to serious side effects.
17 Nefazodone Increases Risk of serotonin syndrome,
serotonin levels leading to serious side effects.
18 Nortriptyline Increases Reduces effectiveness of
breakdown nortriptyline, potentially
worsening depression.
19 Paroxetine Increases Risk of serotonin syndrome,
serotonin levels leading to serious side effects.
20 Warfarin Increases Reduces effectiveness of
breakdown warfarin, increasing the risk
of clotting.

Summary of Effects of Hypericum

• Increased Excretion: Hypericum can enhance the excretion of several medications,

leading to reduced effectiveness. This is particularly significant for drugs like
alprazolam, amitriptyline, and birth control pills.
• Increased Sensitivity: It can heighten sensitivity to sunlight, especially when taken
with other photosensitizing drugs, increasing the risk of skin reactions.
• Serotonin Levels: Hypericum can increase serotonin levels when combined with
other serotonergic medications, leading to a risk of serotonin syndrome, which can be
life-threatening.
• Decreased Absorption: It can decrease the absorption of certain medications, such as
digoxin, which is critical for heart function.

Kava-Kava

Kava-kava is prepared from the rhizome and roots of Piper methysticum (of Piperaceae
family). It is used for treating anxiety. Some people take kava -kava orally to calm anxiety,
stress, restlessness, and insomnia. It is also used in Attention Deficit -Hyperactivity Dis
order (ADHD), epilepsy, psychosis, depression, migraines, other headaches, Chronic
Fatigue Syndrome (CFS), common cold, respiratory tract infections, tuberculosis, muscle
pain, to relieve withdrawal symptoms of benzodiazepines, and for cancer prevention.
Possible Side Effects

Kava-kava is safe when taken orally for a short -term. Its extracts have been safely used
under medical supervision for up to 6 months. However, after taking kava one cannot drive
or operate machinery safely. It can cause liver damage. Using kava for 1 -3 months may
urge the need for liver transplants and even cause death. Early symptoms of liver damage
include jaundice, fatigue, and dark urine.

However, these cases are rare as most patients using kava do not experience liver toxicity.
Some experts believe that liver toxicity in such cases cannot be directly linked to kava, and
other factors may have contributed to these toxic effects.

Interaction Drug/Condition Effect of Kava Outcome

1 Sedative Medications Potentiates Increases drowsiness and risk
(e.g., Benzodiazepines) sedative effects of respiratory depression, which
can be dangerous.
2 Alcohol Potentiates Enhances the sedative effects of
effects alcohol, leading to excessive
drowsiness and potential
respiratory issues.
3 Antidepressants Increases May enhance the sedative
sedation effects, increasing the risk of
side effects like dizziness and
fatigue.
4 Antipsychotics (e.g., Alters Kava may slow down the
Haloperidol) metabolism breakdown of these
medications, increasing their
effects and side effects.
5 Medications Alters Kava can inhibit liver enzymes,
Metabolized by the metabolism affecting how quickly the liver
Liver (CYP450 processes these drugs, which
Enzymes) may lead to increased side
effects.
6 Hepatotoxic Drugs Increases liver Taking Kava with liver-
(e.g., Acetaminophen) damage risk damaging medications can
heighten the risk of liver
toxicity.
7 Anticonvulsants (e.g., Decreases Kava may reduce the
Phenytoin) effectiveness effectiveness of
anticonvulsants, increasing the
risk of seizures.
8 Muscle Relaxants Potentiates Increases the sedative effects,
effects leading to excessive drowsiness
and impaired motor function.
 9 Caffeine Potentially May lead to increased
increases side jitteriness or anxiety when
effects taken with caffeine.
10 Warfarin Alters Kava may affect the
effectiveness anticoagulant effects of
warfarin, potentially increasing
the risk of bleeding.

Summary of Kava Interactions

• CNS Depression: Kava enhances the effects of other central nervous system
depressants, such as alcohol and sedatives, which can lead to dangerous levels of
sedation and respiratory issues.
• Liver Metabolism: Kava can inhibit liver enzymes that metabolize many
medications, leading to increased concentrations and potential side effects of those
drugs.
• Liver Toxicity: There is a risk of liver damage when Kava is taken with other
medications that can harm the liver, necessitating caution.
• Seizure Risk: Kava may decrease the effectiveness of anticonvulsants, which can
increase the risk of seizures in individuals with seizure disorders.

Ginseng

Biological Source: Ginseng is the dried root of various species of Panax, like P. ginseng
(Korean ginseng), P. japonica (Japanese ginseng), P. notoginseng (Chinese ginseng) and
P. quinquefolium (American ginseng), belonging to family Araliaceae. It contains not less
than 0.4% of Ginesenosides calculated on dried baris.

Panax ginseng is taken orally to improve thinking, concentration, memory, Alzheimer’s

disease, work efficiency, physical stamina, and to prevent muscle damage from exercise
and athletic endurance. It is also used for depression, anxiety, general fatigue, Chronic
Fatigue Syndrome (CFS), multiple sclerosis, for boosting immune system, and for fighting
particular infections in cystic fibrosis (a lung disease caused by Pseudomonas). Panax
ginseng is safe when applied to the skin as part of a multi-ingredient product in the short-
term.

Possible Side Effects

Panax ginseng is unsafe when taken orally for a long-term (more than 6 months). The most
common side effect of ginseng is insomnia. The less common side effects include
menstrual problems, breast pain, increased heart rate, high or low blood pressure,
headache, loss of appetite, diarrhoea, itching, rash, dizziness, mood changes, and vaginal
bleeding. The uncommon side effects include severe rash called Stevens-Johnson
syndrome, liver damage, and severe allergic reactions.

Interaction Drug/Condition Effect of Outcome

Ginseng
1 Warfarin (Coumadin) Decreases Ginseng may reduce the
effectiveness anticoagulant effect of
warfarin, increasing the risk of
blood clotting. Regular
monitoring of INR is
necessary.
2 Antidiabetic Medications Lowers blood Ginseng can enhance the
sugar effects of diabetes
medications, potentially
leading to hypoglycemia (low
blood sugar).
3 Antihypertensive Drugs Decreases Ginseng may reduce the
effectiveness effectiveness of blood
pressure medications,
potentially leading to
increased blood pressure.
4 Caffeine Increases Ginseng may enhance the
stimulant effects of caffeine, leading to
effects increased nervousness,
sweating, insomnia, or
irregular heartbeat.
5 Angiotensin-Converting Alters Ginseng may interact with
Enzyme (ACE) effectiveness ACE inhibitors (e.g.,
Inhibitors captopril, enalapril),
potentially affecting their
efficacy.
6 Immunosuppressants Alters Ginseng may interact with
effectiveness medications that suppress the
immune system, affecting
their effectiveness.
7 Stimulant Medications Increases Ginseng may enhance the
(e.g., ADHD drugs) stimulant effects of stimulant
effects medications, leading to
increased heart rate and blood
pressure.
8 Midazolam (Versed) Alters Ginseng may increase the
metabolism breakdown of midazolam,
potentially decreasing its
sedative effects.
9 Imatinib (Gleevec) Alters Ginseng may decrease how
metabolism quickly the liver breaks down
imatinib, increasing its effects
and side effects.
 10 MAOIs (Monoamine Increases side Ginseng may increase the risk
Oxidase Inhibitors) effects of side effects (e.g., anxiety,
headache) when taken with
MAOIs like phenelzine.

Summary of Ginseng Interactions

• Warfarin Interaction: Ginseng can reduce the effectiveness of warfarin, a blood

thinner, which may lead to an increased risk of clotting. Patients on warfarin should
be cautious and have their INR monitored regularly.
• Blood Sugar Effects: Ginseng may lower blood sugar levels, which can enhance the
effects of antidiabetic medications, leading to hypoglycemia. Monitoring blood sugar
levels is essential for diabetic patients.
• Blood Pressure: Ginseng may interfere with antihypertensive medications,
potentially causing an increase in blood pressure.
• Stimulant Effects: Ginseng can amplify the effects of caffeine and other stimulants,
which may lead to increased heart rate and anxiety.
• Metabolism of Other Drugs: Ginseng can affect the metabolism of various
medications, including midazolam and imatinib, which may alter their effectiveness
and side effects.

Ginkgo biloba

Ginkgo (Ginkgo biloba of Ginkgoaceae family) is a large tree with fan -shaped leaves.
Extracts from the leaves of ginkgo tree are used for the treatment of cognitive impairments,
dementia, intermittent claudication, and tinnitus. Ginkgo leaf is taken orally for treating
memory disorders like Alzheimer’s disease. It is also used for conditions that occur due to
reduced blood flow in brain (especially in older people), such as memory loss, dizziness,
difficulty in concentrating, and mood disturbances. Ginkgo is also used for relieving leg pain
when walking related to poor blood flow (claudication).

Possible Side Effects

Ginkgo leaf extract is mostly safe when taken orally in appropriate doses. It can cause some
minor side effects like stomach upset, headache, dizziness, constipation, forceful heartbeat,
and allergic skin reactions. Ginkgo leaf extract can increase the risk of l iver and thyroid
cancers. However, this has only occurred in animals given high doses of ginkgo. No
information has been provided to know if it could happen in humans. Ginkgo leaf extract
can increase the risk of bruising and bleeding as it reduces the blo od viscosity and
decreases its ability to form clots. In some people, ginkgo has caused bleeding in eyes,
brain, and lungs and excessive bleeding after a surgery. Ginkgo leaf extract is considered
safe when taken intravenously for a short -term (up to 10 days).
Ginkgo fruit and pulp can cause severe allergic skin reactions and irritation of mucous
membranes in individuals who are allergic to poison ivy, poison oak, poison sumac, mango
rind, or cashew shell oil.

The fresh seeds are unsafe when taken orally as they are poisonous and considered
dangerous. They can cause seizures and death. Roasted seeds or crude ginkgo plant is
unsafe when taken orally. Eating more than 10 roasted seeds in a single day can cause
difficulty in breathing, weak pulse, seizures , loss of consciousness, and shock.

Interaction Drug/Condition Effect of Outcome

Ginkgo
Biloba
1 Warfarin Potentiates Ginkgo may increase the risk of
(Coumadin) effects bleeding by enhancing the
anticoagulant effect of warfarin,
leading to potential hemorrhage.
Regular monitoring of INR is
necessary.
2 Aspirin Potentiates Ginkgo can increase the risk of
effects bleeding when taken with aspirin, as
both have antiplatelet effects.
Caution is advised.
3 Ibuprofen (Advil) Potentiates Ginkgo may enhance the blood-
effects thinning effects of ibuprofen,
increasing the risk of bruising and
bleeding.
4 Antidepressants Alters effects Ginkgo may interact with selective
(SSRIs) serotonin reuptake inhibitors
(SSRIs), potentially increasing the
risk of serotonin syndrome, which
can be life-threatening.
5 Anticonvulsants Alters Ginkgo may reduce the effectiveness
(e.g., Phenytoin) effectiveness of anticonvulsants, increasing the
risk of seizures.
6 Caffeine No significant Ginkgo does not appear to affect the
interaction metabolism of caffeine, so it is
unlikely to increase its adverse
effects.
7 Talinolol Alters effects Taking ginkgo may increase the
levels of talinolol, potentially
enhancing its effects and side effects.
8 Midazolam Alters Ginkgo may increase the breakdown
metabolism of midazolam, potentially decreasing
its sedative effects.
9 Nifedipine Alters effects Ginkgo may increase the plasma
levels of nifedipine, a calcium
 channel blocker, which could
enhance its effects.
10 Ginkgo with Other Potentiates Concurrent use with other
Antiplatelet Drugs effects antiplatelet drugs (e.g., clopidogrel)
may increase the risk of bleeding due
to additive effects.

Summary of Ginkgo Biloba Interactions

• Increased Bleeding Risk: Ginkgo biloba is known to enhance the effects of

anticoagulants like warfarin and antiplatelet medications like aspirin, increasing the
risk of bleeding. Patients on these medications should be monitored closely.
• Serotonin Syndrome Risk: When taken with SSRIs, ginkgo may increase the risk of
serotonin syndrome, a potentially life-threatening condition characterized by
confusion, rapid heart rate, and high blood pressure.
• Effect on Anticonvulsants: Ginkgo may reduce the effectiveness of anticonvulsants,
which can lead to an increased risk of seizures in individuals with seizure disorders.
• Metabolism Alterations: Ginkgo can affect the metabolism of certain medications,
such as midazolam and nifedipine, potentially altering their effectiveness and side
effects.

Garlic

Garlic is being used medicinally in Egypt since ancient times. Earlier, it was used in the
treatment of leprosy , but later it was started to be used in the treatment of scurvy, ear aches,
flatulence , etc. Garlic is the fresh compound bulb of Allium sativum Linn. (and belongs to
family Liliaceae). It is cultivated in India, Russia, USA, Italy, and Southern Europe. Plentiful
of minerals, vitamins, carbohydrates, amino acids, volatile oils, and other trace elements
are found in garlic bulbs. Garlic has the maximum sulphur content amongst all the members
of Allium species. The sulphur compounds found in garlic include diallyldisulphide,
diallyltrisulphide, methylallyltrisulphide, allyl propyl disulphide, alliin, ajoene, etc.

Concentration of volatile oils in garlic is about 0.1 -0.5%. On crushing the garlic clove, the
enzyme alliinase catalyses the conversion of alliin (S-allyl-l-cysteine sulfoxide) into 2-
propene-2-sulfenic acid, which further undergoes dimerization and forms allicin
(diallylthiosulfinate). This compound imparts the pungent odour and also some of the
pharmacological activities to garlic.

Other sulphur compounds of g arlic, such as alliin, allicin, diallyldisulphide , etc., are also
responsible for its pharmacological activities. Minerals like phosphorus, calcium,
magnesium, potassium, iron, selenium, germanium, etc. are also present in garlic, along
with some vitamins like B1, A, C, etc.
 Medication Class Interaction with Garlic Effect

Increased risk of bruising and

Anticoagulants/Antiplatelet Garlic may enhance the effects of
bleeding. Regular blood
Drugs anticoagulants like warfarin.
monitoring is advised.

Risk of hypoglycemia when

taken with diabetes medications.
Antidiabetic Medications Garlic can lower blood sugar levels.
Blood sugar should be
monitored closely.

Risk of hypotension when

combined with antihypertensive
Antihypertensive Drugs Garlic may lower blood pressure.
medications. Blood pressure
should be monitored.

Garlic can decrease the absorption Reduced effectiveness of these

HIV/AIDS Medications
of HIV medications like saquinavir medications, potentially leading
(Protease Inhibitors)
and atazanavir. to therapeutic failure.

Decreased effectiveness of
Garlic may increase the breakdown
Cyclosporine cyclosporine, which is critical for
of cyclosporine.
transplant patients.

Garlic can increase the metabolism Reduced effectiveness of birth

Birth Control Pills of estrogen-containing control pills, leading to potential
contraceptives. unintended pregnancies.

Garlic can affect the metabolism of May either increase or decrease

Medications Metabolized
drugs processed by cytochrome the effectiveness of these
by the Liver (CYP450
P450 enzymes, such as medications, depending on the
Substrates)
acetaminophen and lovastatin. specific drug.

Reduced effectiveness of
Garlic decreases the absorption of
Isoniazid isoniazid, which is used for
isoniazid.
tuberculosis treatment.
Decreased effectiveness of
Garlic reduces the bioavailability of
Saquinavir saquinavir, which is critical for
saquinavir.
HIV treatment.

Garlic may interact with various

Potentially alters the
other medications, including
Other Medications effectiveness and side effects of
NSAIDs and theophylline, affecting
these medications.
their metabolism.
Ephedra

Ephedra obtained from Ephedra sinica of family Ephedraceae, is an alkaloid that provides
relief in breathlessness, chest tightness, and wheezing due to bronchial asthma. It falls into
the category of over-the-counter formulations for the temporary relief of bronchial asthma.

Possible Side Effects

Consumption of ephedra or its active ingredients should be avoided as it is unsafe for

children as well as adults. It is a very harmful drug or can put individual in disabling
conditions. Ephedra can cause high blood pressure, heart attacks, muscle disorders,
seizures, strokes, irregular heartbeat, loss of consciousness, and even death. These side
effects worsen if ephedra is taken in high doses or for long-term. Doses greater than
32mg/day may increase the risk of haemorrhagic stroke up to three times. The serious side
effects are of greater concern than any potential benefit.

Some minor serious side effects of ephedra are dizziness, restlessness, anxiety, irritability,
heart pounding, headache, loss of appetite, nausea, and vomiting.

Medication/Substance Interaction with Ephedra Effect

Ephedra may reduce the effect of

Antihypertensive Drugs Potential rise in blood pressure.
antihypertensive medications.

CNS Stimulants (e.g., Ephedra should not be mixed May enhance hyperactivity and
Amphetamines) with other CNS stimulants. produce serious problems.

Blood Thinning Drugs Ephedra should be avoided with

Increased risk of bleeding.
(e.g., Aspirin, Warfarin) blood thinning drugs.

By increasing blood sugar, it might

Ephedra may interact with
Diabetic Medications decrease the effect of these
antidiabetic drugs.
medications.

Increased risk of cardiovascular and

Ephedra can potentiate the
Caffeine central nervous system adverse
effects of caffeine.
effects.
 Concurrent use with alcohol may Increased risk of cardiovascular
Alcohol
exacerbate adverse effects. events and psychosis.

Ephedra contains ephedrine and Potential for hypertensive crises and

Ephedrine
may interact similarly. increased cardiovascular risks.

Ephedra should be avoided with

Herbal Products Increased risk of adverse
other herbal products containing
Containing Stimulants cardiovascular events.
stimulants.

No significant interactions found Generally considered safe when

Food
with food. consumed with food.

No significant interactions found Generally considered safe when

Other Herbal Medicines
with other herbal medicines. consumed with other herbal products.

Pepper

Pepper (Piper nigrum of family Piperaceae) is found in India and other tropical Asian
countries. It is the most commonly used spice around the world. Black pepper and white
pepper belong to same plant species, but their preparation method is different. Black
pepper is obtained by cooking the dried unripe fruit, while the white pepper is obtained by
cooking and drying the ripe seeds.

Black pepper contains piperine which is pharmacologically active. It kills bacteria, fungi,
and parasites. Piperine also aids in absorption of some medications and is effective
against cancer

Possible Side Effects

Black pepper is considered safe if orally ingested in amounts found in foods. There is no
evidence to prove that oral consumption of black pepper as a medicine is safe. Black
pepper oil is applied to skin and inhaled through nose or mouth and is said to be safe.

Black pepper gives a burning aftertaste and causes stomach disturbance. Its exposure to
eyes must be avoided or else it causes a burning sensation. Cough may occur if black
pepper oil is inhaled through nose or mouth. Some individuals may get allergic to black
pepper. On oral consumption of black pepper in large amounts, it can accidentally reach
the lungs and cause death; this incident mostly occurs in children.
 Medication/Substance Interaction with Pepper Effect

Black and white pepper may Increased lithium levels in the body,
Lithium decrease the metabolism and potentially leading to serious side
excretion of lithium. effects.

Increased risk of bruising and

Anticoagulants/Antiplatelet Black pepper may slow blood
bleeding when taken with blood-
Drugs clotting.
thinning medications.

Risk of hypoglycemia when taken

Black pepper may lower blood
Antidiabetic Medications with diabetes medications; blood
sugar levels.
sugar should be monitored closely.

CNS Stimulants (e.g., Should not be mixed with other May enhance hyperactivity and
Amphetamines) CNS stimulants. produce serious problems.

Increased risk of cardiovascular and

Black pepper can potentiate the
Caffeine central nervous system adverse
effects of caffeine.
effects.

Black pepper may inhibit Altered effects and side effects of

Cytochrome P450
cytochrome P450 enzymes, medications metabolized by these
Substrates
affecting drug metabolism. enzymes.

Black pepper may change how Potentially alters the effectiveness

P-Glycoprotein Substrates medications are moved in and and side effects of these
out of cells. medications.

Black pepper may increase the Increased effects and side effects of
Phenytoin (Dilantin)
absorption of phenytoin. phenytoin.

Black pepper may increase the Increased effects and side effects of
Propranolol (Inderal)
absorption of propranolol. propranolol.

Black pepper may increase Increased effects and side effects of

Cyclosporine levels of cyclosporine in the cyclosporine, though the clinical
body. significance is unclear.

Black pepper may increase Increased effects and side effects of

Nevirapine (Viramune)
levels of nevirapine in the body. nevirapine; caution is advised.
 Black pepper may increase
Increased sedative side effects of
Pentobarbital (Nembutal) sleepiness caused by
pentobarbital.
pentobarbital.

Black pepper may increase

Increased effects and side effects of
Atorvastatin (Lipitor) levels of atorvastatin in the
atorvastatin.
blood.

Black pepper should be avoided

Increased risk of adverse
Other Herbal Medicines with other herbal products
cardiovascular events.
containing stimulants.