Eleuthero

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Eleuthero

Uses

Eleuthero
© Steven Foster
Common names:
Ci Wu Jia, Devil’s Shrub, Eleutherococcus, Siberian Ginseng, Touch-Me-Not
Botanical names:
Acanthopanax senticosus, Eleutherococcus senticosus

Parts Used & Where Grown

Eleuthero belongs to the Araliaceae family and is a distant relative of Asian ginseng (Panax ginseng). Also known commonly as touch-me-not and devil’s shrub, eleuthero has been most frequently nicknamed Siberian ginseng in this country. Eleuthero is native to the Taiga region of the Far East (southeastern part of Russia, northern China, Korea, and Japan). The root and the rhizomes (underground stem) are used medicinally.

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

This supplement has been used in connection with the following health conditions:


Used for Amount Why
Athletic Performance
 Refer to label instructions 2 stars   Eleuthero supplementation may improve athletic performance, according to preliminary research. The herb strengthens the immune system and thus might reduce the risk of post-exercise infection.

2 stars  Athletic Performance

Eleuthero (Eleutherococcus senticosus) supplementation may improve athletic performance, according to preliminary Russian research.1 Other studies have been inconclusive and two recent double-blind studies showed no beneficial effect on endurance performance in trained men.2 , 3 , 4 Eleuthero strengthens the immune system and thus might reduce the risk of post-exercise infection. Although some doctors suggest taking 1 to 4 ml (0.2 to 0.8 tsp) of fluid extract of eleuthero three times per day, evidence supporting the use of this herb to enhance athletic performance remains weak.


Used for Amount Why
Immune Function
 10 ml of tincture three times per day 2 stars   Eleuthero has historically been used to support the immune system.

2 stars  Immune Function

10 ml of tincture three times per day

Eleuthero (Siberian ginseng) has also historically been used to support the immune system. Preliminary Russian research has supported this traditional use.5 A double-blind study has shown that healthy people who take 10 ml of eleuthero tincture three times per day had an increase in certain T lymphocytes important to normal immune function. These effects have not been studied in people with lowered immune function. The amount of eleuthero used in this trial is exceptionally high, though no side effects were seen.

Used for Amount Why
Stress
 2 to 3 grams per day of powdered root for 6 to 8 weeks, then stop 1 to 2 weeks, then resume if desired 2 stars   Eleuthero appears to have antistress effects. Supplementing with an eleuthero extract led to higher quality-of-life measures in healthy elderly people, according to one study.

2 stars  Stress

2 to 3 grams per day of powdered root for 6 to 8 weeks, then stop 1 to 2 weeks, then resume if desired

The herbs discussed here are considered members of a controversial category known as adaptogens, which are thought to increase the body's resistance to stress, and to generally enhance physical and mental functioning.6 , 7 Many animal studies have shown that various herbal adaptogens have protective effects against physically stressful experiences,8 , 9 but whether these findings are relevant to human stress experiences is debatable.

Animal research has reported antistress effects of Eleutherococcus senticosus (also known as Siberian ginseng),10 and Russian research not available in the English language reportedly describes human studies showing similar effects in humans.11 , 12 A double-blind study of healthy elderly people reported that those who took 60 drops per day of a eleuthero liquid extract (concentration not specified) scored higher in some quality-of-life measures after four weeks, but not after eight weeks, compared with a group taking a placebo.13 Athletes experiencing the stress of training who took an eleuthero extract equivalent to 4 grams per day had no changes in their blood levels of an adrenal stress hormone after six weeks.14 More research is needed to clarify the value of eleuthero for treating stress.

Used for Amount Why
Breast Cancer
 Refer to label instructions 1 star   Eleuthero has been shown to enhance immune function in trials studying people with cancer, particularly breast cancer.

1 star  Breast Cancer

Also known as Siberian ginseng, eleuthero (Eleutherococcus senticosus, Acanthopanax s.) has been shown to enhance immune function in preliminary Russian trials studying people with cancer, particularly breast cancer.15 , 16 These trials typically used 1to 2 ml of a fluid extract taken three times per day for at least one month. Most of the people in these trials were also treated with chemotherapy, radiation therapy, and/or surgery.17 , 18 Several of the Russian trials showed fewer side effects from conventional therapies among those who also took eleuthero extracts. No information is available on the ability of eleuthero to prevent cancer, nor have clinical trials yet explored whether eleuthero extracts affect either recurrence of breast cancer or survival in women with breast cancer.

Used for Amount Why
Chronic Fatigue Syndrome
 Refer to label instructions 1 star   “Adaptogenic” herbs such as eleuthero have an immunomodulating effect and help support the normal function of the body’s hormonal stress system.

1 star  Chronic Fatigue Syndrome

Adaptogenic herbs such as Asian ginseng and eleuthero may also be useful for CFS patients—the herbs not only have an immunomodulating effect but also help support the normal function of the hypothalamic-pituitary-adrenal axis, the hormonal stress system of the body.19 These herbs are useful follow-ups to the six to eight weeks of taking licorice root and may be used for long-term support of adrenal function in people with CFS. However, no controlled research has investigated the effect of adaptogenic herbs on CFS.

Used for Amount Why
Common Cold and Sore Throat
 Refer to label instructions 1 star   Adaptogens such as eleuthero are thought to help keep various body systems—including the immune system—functioning optimally.

1 star  Common Cold and Sore Throat

Eleuthero contains eleutherosides that appear to have immune-enhancing effects according to preliminary studies.20 , 21 Human research, some of it double-blind,22 , 23 has shown benefits for treating the common cold using Kan Jang, a combination of andrographis extract (48 to 60 mg andrographolides per day) and an eleuthero extract containing 2.0 to 2.4 mg per day of eleutherosides.

Used for Amount Why
HIV and AIDS Support
 Refer to label instructions 1 star   Eleuthero is an immune-modulating plant that may be beneficial for people with HIV infection.

1 star  HIV and AIDS Support

Immune-modulating plants that could theoretically be beneficial for people with HIV infection include Asian ginseng, eleuthero, and the medicinal mushrooms shiitake and reishi. One preliminary study found that steamed then dried Asian ginseng (also known as red ginseng) had beneficial effects in people infected with HIV, and increased the effectiveness of the anti-HIV drug, AZT.24 This supports the idea that immuno-modulating herbs could benefit people with HIV infection, though more research is needed.

Used for Amount Why
Infection
 Refer to label instructions 1 star   Eleuthero supports the immune system and protects against microbes.

1 star  Infection

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Double-blind trials have shown that common cold symptoms improve25 , 26 and recovery is faster27 when andrographis extract containing 48 to 60 mg andrographolides is taken in three or four divided doses daily, beginning as soon as possible after symptoms appear. In addition, preliminary research in Russia suggests andrographis extract may be effective for the treatment of influenza.28 This extract was also tested for preventing colds in a double-blind study of teenagers.29 After three months, the group taking 5 mg of andrographolides twice daily had only half the number of colds experienced by the placebo group.

Other preliminary30 and double-blind31 , 32 research has shown similar benefits for treating the common cold from a combination of andrographis extract and an eleuthero extract containing 2.0 to 2.4 mg per day eleutherosides.


Used for Amount Why
Influenza
 Refer to label instructions 1 star   Eleuthero has immune-enhancing properties, which may play a role in preventing infection with the influenza virus.

1 star  Influenza

Asian ginseng and eleuthero (Siberian ginseng) have immune-enhancing properties, which may play a role in preventing infection with the influenza virus. However, they have not yet been specifically studied for this purpose. One double-blind trial found that co-administration of 100 mg of Asian ginseng extract with a flu vaccine led to a lower frequency of colds and flu compared to people who just received the flu vaccine alone.33

Traditional Use (May Not Be Supported by Scientific Studies)

Although not as popular as Asian ginseng, eleuthero use dates back 2,000 years, according to Chinese medicine records. Referred to as ci wu jia in Chinese medicine, it was used to prevent respiratory tract infections, colds and flu. It was also believed to provide energy and vitality. In Russia, eleuthero was originally used by people in the Siberian Taiga region to increase performance and quality of life and to decrease infections.

In more modern times, eleuthero has been used to increase stamina and endurance in Soviet Olympic athletes. Russian explorers, divers, sailors, and miners also used eleuthero to prevent stress-related illness. After the Chernobyl accident, many Russian and Ukrainian citizens were given eleuthero to counteract the effects of radiation.

How It Works

Common names:
Ci Wu Jia, Devil’s Shrub, Eleutherococcus, Siberian Ginseng, Touch-Me-Not
Botanical names:
Acanthopanax senticosus, Eleutherococcus senticosus

How It Works

The constituents in eleuthero that have been most studied are the eleutherosides.34 Seven primary eleutherosides have been identified, with most of the research attention focusing on eleutherosides B and E.35 Eleuthero also contains complex polysaccharides (complex sugar molecules).36 These constituents may play a critical role in eleuthero’s ability to support immune function.

Eleuthero is an “adaptogen” (an agent that helps the body adapt to stress). It is thought to help support adrenal gland function when the body is challenged by stress.37

Eleuthero has been shown to enhance mental acuity and physical endurance without the letdown that comes with caffeinated products.38 Research has shown that eleuthero improves the use of oxygen by the exercising muscle.39 This means that a person is able to maintain aerobic exercise longer and recover from workouts more quickly. Preliminary research from Russia indicates it may be effective for this purpose.40 Other trials have been inconclusive41 or have shown no beneficial effect.42

Eleuthero may also support the body by helping the liver detoxify harmful toxins. It has shown a protective action in animal studies against chemicals such as ethanol, sodium barbital, tetanus toxoid, and chemotherapeutic agents.43 According to a test tube study eleuthero also helps protect the body during radiation exposure.44 Preliminary research in Russia has suggested that eleuthero may help alleviate side effects and help the bone marrow recover more quickly in people undergoing chemotherapy and radiation therapy for cancer.45

Eleuthero has been shown to be effective as a treatment for the common cold when combined with andrographis in a formula sometimes referred to as Kan Jang.46 , 47 Preliminary evidence also suggests that eleuthero may prove valuable in the long-term management of various diseases of the immune system, including HIV infection and chronic fatigue syndrome. Healthy people taking 2 teaspoons (10 ml) of tincture three times daily have been shown to have increased numbers of the immune cells (T4 lymphocytes) that have been found to decrease during HIV-infection and AIDS.48 Further human clinical trials are needed to confirm that eleuthero may be helpful for this disease.

How to Use It

Dried, powdered root and rhizomes, 2 to 3 grams per day, are commonly used.49 Alternatively, 300 to 400 mg per day of concentrated solid extract standardized on eleutherosides B and E can be used, as can alcohol-based extracts, 8 to 10 ml in two to three divided dosages. Kan Jang is a formula combining an andrographis extract with an eleuthero extract providing 2 to 2.4 mg eleutherosides daily. Historically, eleuthero is taken continuously for six to eight weeks, followed by a one- to two-week break before resuming.

Interactions

Common names:
Ci Wu Jia, Devil’s Shrub, Eleutherococcus, Siberian Ginseng, Touch-Me-Not
Botanical names:
Acanthopanax senticosus, Eleutherococcus senticosus

Interactions with Supplements, Foods, & Other Compounds

In one case report, a person taking eleuthero with digoxin developed dangerously high serum digoxin levels.50 Although a clear cause-and-effect relationship could not be established, it is wise for someone taking digoxin to seek the advise of a doctor before taking eleuthero.

Interactions with Medicines

Certain medicines interact with this supplement.

May Be Beneficial: Some medicines may increase the need for this supplement.
Avoid: Some medicines interact with this supplement, so they should not be taken together.
Check: Some interactions between this supplement and certain medicines require more explanation. Click the link to see details.

Note: The following list only includes the generic or class name of a medicine. To find a specific brand name, use the Medicines Index.

May Be Beneficial: Bicalutamide
May Be Beneficial: Busulfan
May Be Beneficial: Capecitabine
May Be Beneficial: Cisplatin
May Be Beneficial: Cladribine
May Be Beneficial: Cyclophosphamide
May Be Beneficial: Cytarabine
May Be Beneficial: Docetaxel
May Be Beneficial: Erlotinib
May Be Beneficial: Etoposide
May Be Beneficial: Floxuridine
May Be Beneficial: Fludarabine
May Be Beneficial: Fluorouracil
May Be Beneficial: Hydroxyurea
May Be Beneficial: Influenza Virus Vaccine
May Be Beneficial: Irinotecan
May Be Beneficial: Mercaptopurine
May Be Beneficial: Methotrexate
May Be Beneficial: Paclitaxel
May Be Beneficial: Thioguanine
May Be Beneficial: Vinblastine
May Be Beneficial: Vincristine
Avoid: Digoxin
Check: Busulfan
Check: Carboplatin
Check: Carmustine
Check: Chlorambucil
Check: Ifosfamide
Check: Lomustine
Check: Mechlorethamine
Check: Melphalan
Check: Polifeprosan 20 with Carmustine
Check: Streptozocin
Check: Thiotepa
Check: Ticlopidine
Check: Uracil Mustard
Check: Warfarin

Side Effects

Common names:
Ci Wu Jia, Devil’s Shrub, Eleutherococcus, Siberian Ginseng, Touch-Me-Not
Botanical names:
Acanthopanax senticosus, Eleutherococcus senticosus

Side Effects

Reported side effects have been minimal with use of eleuthero.51 Mild, transient diarrhea has been reported in a very small number of users. Eleuthero may cause insomnia in some people if taken too close to bedtime. Eleuthero is not recommended for people with uncontrolled high blood pressure. There are no known reasons to avoid eleuthero during pregnancy and breast-feeding. However, pregnant or breast-feeding women should be aware that some products may be adulterated with herbs that should not be taken in pregnancy, such as Asian ginseng. Only eleuthero from a trusted source should be used.

References

1. Kelly GS. Sports nutrition: A review of selected nutritional supplements for endurance athletes. Alt Med Rev 1997;2:282–95 [review].

2. McNaughton L. A comparison of Chinese and Russian ginseng as ergogenic aids to improve various facets of physical fitness. Int Clin Nutr Rev 1989;9:32–5.

3. Dowling EA, Redondo DR, Branch JD, et al. Effect of Eleutherococcus senticosus on submaximal and maximal exercise performance. Med Sci Sports Exer 1996;28:482–9.

4. Eschbach LF, Webster MJ, Boyd JC, et al. The effect of siberian ginseng (Eleutherococcus senticosus) on substrate utilization and performance. Int J Sport Nutr Exerc Metab 2000;10:444–51.

5. Baranov AI. Medicinal uses of ginseng and related plants in the Soviet Union: Recent trends in the Soviet literature. J Ethnopharmacol 1982;6:339–53 [review].

6. Brekhman II, Dardymov IV. New substances of plant origin which increase nonspecific resistance. Annu Rev Pharmacol 1969;9:419–30 [review].

7. Panossian A, Wikman G, Wagner H. Plant adaptogens. III. Earlier and more recent aspects and concepts on their mode of action. Phytomedicine 1999;6:287–300 [review].

8. Rege NN, Thatte UM, Dahanukar SA. Adaptogenic properties of six rasayana herbs used in Ayurvedic medicine. Phytother Res 1999;13:275–91 [review].

9. Wagner H, Nrr H, Winterhoff H. Plant adaptogens. Phytomed 1994;1:6376 [review].

10. Deyama T, Nishibe S, Nakazawa Y. Constituents and pharmacological effects of Eucommia and Siberian ginseng. Acta Pharmacol Sin 2001;22:1057–70 [review].

11. Brekhman II, Dardymov IV. New substances of plant origin which increase nonspecific resistance. Annu Rev Pharmacol 1969;9:419–30 [review].

12. Farnsworth NR, Kinghorn AD, Soejarto D, Waller DP. Siberian ginseng (Eleutherococcus senticosus): Current status as an adaptogen. Econ Med Plant Res 1985;1:156–215.

13. Cicero AFG, Derosa G, Brillante R, et al. Effects of Siberian ginseng (eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial. Arch Gerontol Geriatr Suppl2004;9:69–73.

14. Gaffney BT, Hugel HM, Rich PA. The effects of Eleutherococcus senticosus and Panax ginseng on steroidal hormone indices of stress and lymphocyte subset numbers in endurance athletes. Life Sci 2001;70:431–42.

15. Gvamichava AR, Khatiashvili TM, Khudzhadze RG, et al. First results of the use of Eleutherococcus in the combined treatment of breast carcinoma. Lek Sredestva Dal’nego Vostoka 1966;7:231–5 [in Russian].

16. Kupin VI, Polevaia YeB, Sorokin AM. Stimulation of the immunological reactivity of cancer patients by Eleutherococcus extract. Vopr Onkol 1986;32:21–6 [in Russian].

17. Gvamichava AR, Khatiashvili TM, Khudzhadze RG, et al. First results of the use of Eleutherococcus in the combined treatment of breast carcinoma. Lek Sredestva Dal’nego Vostoka 1966;7:231–5 [in Russian].

18. Kupin VI, Polevaia YeB, Sorokin AM. Stimulation of the immunological reactivity of cancer patients by Eleutherococcus extract. Vopr Onkol 1986;32:21–6 [in Russian].

19. Brown D. Licorice root—potential early intervention for chronic fatigue syndrome. Quart Rev Natural Med 1996;Summer:95–7.

20. Li XY. Immunomodulating Chinese herbal medicines. Mem Inst Oswaldo Cruz 1991;86 Suppl 2:159–64.

21. Davydov M, Krikorian AD. Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an adaptogen: a closer look. J Ethnopharmacol 2000;72:345–93.

22. Melchior J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine 2000;7(5):341–50.

23. Gabrielian ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine 2002;9:589–97.

24. Cho YK, Kim Y, Choi M, et al. The effect of red ginseng and zidovudine on HIV patients. Int Conf AIDS 1994;10:215 [abstract no. PB0289].

25. Caceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine 1999;6:217–23.

26. Hancke J, Burgos R, Caceres D, et al. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in the recovery from common colds. Phytother Res 1995;9:559–62.

27. Melchior J, Palm S, Wikman G. Controlled clinical study of standardized Andrographis paniculata extract in common cold-a pilot trial. Phytomedicine 1996;34:315–18.

28. Kulichenko LL, Kireyeva LV, Malyshkina EN, Wikman GA. Randomized, controlled study of Kan Jang versus amantadine in the treatment of influenza in Volgograd. J Herb Pharmacother 2003;3:77–93.

29. Caceres DD, Hancke JL, Burgos RA, et al. Prevention of common colds with Andrographis paniculata dried extract: a pilot double blind trial. Phytomedicine 1997;4:101–104.

30. Spasov AA, Ostrovskij, OV, Chernikov MV, Wikman G. Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang and an Echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children. Phytother Res 2004;18:47–53.

31. Melchior J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine 2000;7(5):341–50.

32. Gabrielian ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine 2002;9:589–97.

33. Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized ginseng extract G 115 for potentiating vaccination against common cold and/or influenza syndrome. Drugs Exptl Clin Res 1996;22:65–72.

34. Collisson RJ. Siberian ginseng (Eleutherococcus senticosus). Brit J Phytother 1991;2:61–71 [review].

35. Farnsworth NR, Kinghorn AD, Soejarto DD, Waller DP. Siberian ginseng (Eleutherococcus senticosus): Current status as an adaptogen. In Economic and Medicinal Plant Research, vol 1, ed. Wagner H, Hikino HZ, Farnsworth NR. London: Academic Press, 1985, 155–215 [review].

36. Hikino H, Takahashi M, Otake K, konno C. Isolation and hypoglycemic activity of eleutherans A, B, C, D, E, F and G: glycans of Eleutherococcus senticosus roots. J Natural Prod 1986;49:293–7.

37. Wagner H, Nörr H, Winterhoff H. Plant adaptogens. Phytomed 1994;1:63–76 [review].

38. Farnsworth NR, Kinghorn AD, Soejarto DD, Waller DP. Siberian ginseng (Eleutherococcus senticosus): Current status as an adaptogen. In Economic and Medicinal Plant Research, vol 1, ed. Wagner H, Hikino HZ, Farnsworth NR. London: Academic Press, 1985, 155–215 [review].

39. Asano K, Takahashi T, Miyashita M, et al. Effect of Eleutherococcus senticosus extract on human working capacity. Planta Medica 1986;37:175–7.

40. Asano K, Takahashi T, Miyashita M, et al. Effect of Eleutherococcus senticosus extract on human working capacity. Planta Medica 1986;37:175–7.

41. Kelly GS. Sports nutrition: A review of selected nutritional supplements for endurance athletes. Alt Med Rev 1997;2:282–95 [review].

42. McNaughton L. A comparison of Chinese and Russian ginseng as ergogenic aids to improve various facets of physical fitness. Int Clin Nutr Rev 1989;9:32–5.

43. Collisson RJ. Siberian ginseng (Eleutherococcus senticosus). Brit J Phytother 1991;2:61–71 [review].

44. Ben-Hur E, Fulder S. Effect of P. ginseng saponins and Eleutherococcus S. on survival of cultured mammalian cells after ionizing radiation. Am J Chin Med 1981;9:48–56.

45. Kupin VI, Polevaia EB. Stimulation of the immunological reactivity of cancer patients by eleutherococcus extract. Vopr Onkol 1986;32:21–6 [in Russian].

46. Poolsup N, Suthisisang C, Prathanturarug S, et al. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther 2004;29:37–45.

47. Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med 2004;70:293–98.

48. Bohn B, Nebe CT, Birr C. Flow cytometric studies with Eleutherococcus senticosus extract as an immunomodulating agent. Arzneim-Forsch Drug Res 1987;37:1193–6.

49. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 69–77.

50. McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. Can Med Assoc J 1996;155:293–5.

51. McGuffin M, Hobbs C, Upton R, Goldberg A. American Herbal Products Association’s Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997, 45.

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