Overview

Ginger, the underground stem, or rhizome, of the plant Zingiber officinale has been used as a medicine in Asian, Indian, and Arabic herbal traditions since ancient times. In China, for example, ginger has been used to aid digestion and treat stomach upset, diarrhea, and nausea for more than 2,000 years. Since ancient times, ginger has also been used to help treat arthritis, colic, diarrhea, and heart conditions. In addition to these medicinal uses, ginger continues to be valued around the world as an important cooking spice and is believed to help the common cold, flu-like symptoms, headaches, and even painful menstrual periods. Native to Asia where its use as a culinary spice spans at least 4,400 years, ginger grows in fertile, moist, tropical soil.

Plant Description

Ginger is a knotted, thick, beige underground stem (rhizome). The stem extends roughly 12 inches above ground with long, narrow, ribbed, green leaves, and white or yellowish-green flowers.

What's It Made Of?

The important active components of the ginger root are thought to be volatile oils and pungent phenol compounds (such as gingerols and shogaols).

Medicinal Uses and Indications

Today, ginger root is widely used as a digestive aid for mild stomach upset and is commonly recommended by health care professionals to help prevent or treat nausea and vomiting associated with motion sickness, pregnancy, and cancer chemotherapy. Ginger is used as support in inflammatory conditions such as arthritis, and may even be used in heart disease or cancer.

Motion Sickness

Several studies suggest that ginger may be more effective than placebo in reducing symptoms associated with motion sickness. In one trial of 80 novice sailors (prone to motion sickness), those who took powdered ginger experienced a significant reduction in vomiting and cold sweating compared to those who took placebo. Similar results were found in a study with healthy volunteers. While these results are promising, other studies suggest that ginger is not as effective as medications in reducing symptoms associated with motion sickness. In a small study of volunteers who were given ginger (fresh root and powder form), scopolamine (a medication commonly prescribed for motion sickness), or placebo, those receiving the medication experienced significantly fewer symptoms compared to those who received ginger.

Conventional prescription and non-prescription medicines that decrease nausea may also cause unwanted side effects, such as dry mouth and drowsiness. Given the safety of ginger, many people find it a welcome alternative to these medications to relieve their motion sickness.

Pregnancy Related Nausea and Vomiting

A limited number of human studies suggests that 1 gram daily of ginger may be safe and effective for pregnancy-associated nausea and vomiting when used for short periods (no longer than 4 days). Several studies have found that ginger is more effective than placebo in relieving nausea and vomiting associated with pregnancy. In a small study including 30 pregnant women with severe vomiting, those who ingested 1 gram of ginger every day for four days reported more relief from vomiting than those who received placebo. In a larger study including 70 pregnant women with nausea and vomiting, those who received a similar dosage of ginger felt less nauseous and experienced fewer vomiting episodes than those who received placebo.

Chemotherapy nausea

There is evidence from a few studies that suggests ginger reduces the severity and duration of nausea (but not vomiting) during chemotherapy. Long-term studies should be performed to confirm these results and to establish safety.

Nausea and vomiting following surgery

Research has produced mixed results regarding the use of ginger in the treatment of nausea and vomiting following surgery. In two studies, 1 gram of ginger root before surgery reduced nausea as effectively as a leading medication. In one of these two studies, women who received ginger also required fewer nausea-relieving medications following surgery. Other studies, however, have failed to find the same positive effects. In fact, one study found that ginger may actually increase vomiting following surgery. For this reason, further studies are needed to determine whether ginger is safe and effective for the prevention and treatment of nausea and vomiting following surgery.

Inflammation

In addition to providing relief from nausea and vomiting, ginger extract has long been used in traditional medical practices to decrease inflammation. In fact, many health care professionals today use ginger to help treat health problems associated with inflammation, such as arthritis and ulcerative colitis. In a study of 261 people with osteoarthritis (OA) of the knee, those who received a ginger extract twice daily experienced less pain and required fewer pain-killing medications compared to those who received placebo. Although there have also been a few other studies of the benefit of ginger for arthritis, one trial found that the herb was no more effective than ibuprofen (a medication frequently used to treat OA) or placebo in reducing symptoms of OA.

Other uses

• Although it is much too early to tell if this will benefit those with heart disease, a few preliminary studies suggest that ginger may lower cholesterol and prevent the blood from clotting. Each of these effects may protect the blood vessels from blockage and the damaging effects of blockage such as atherosclerosis, which can lead to a heart attack or stroke.
• Laboratory studies have also found that components in ginger may have anticancer activity. More research needs to be performed to determine the effects of ginger on various cancers in humans.

Available Forms

Ginger products are made from fresh or dried ginger root, or from steam distillation of the oil in the root. The herb is available in extracts, tinctures, capsules, and oils. Fresh ginger root can also be purchased and prepared as a tea. Ginger is also a common cooking spice and can be found in a variety of foods and drinks, including ginger bread, ginger snaps, ginger sticks, and ginger ale.

How to Take It

Pediatric

Ginger should not be used by children under 2 years of age.

Ginger may be used by children over 2 years of age to treat nausea, digestive cramping, and headaches. Adjust the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. Therefore, if the child weighs 50 lb (20 - 25 kg), the appropriate dose of ginger for this child would be 1/3 of the adult dosage.

Adult

In general, ginger intake should not exceed 4 grams in one day (this includes the ginger obtained through diet such as from ginger ale, ginger snaps, and ginger bread). Usually, food sources contain no more than 0.5% ginger.

Standardized dose: Take 75 - 2,000 mg in divided doses with food, standardized to contain 4% volatile oils or 5% total pungent compounds including 6-gingerol or 6-shogaol.

For nausea, gas, or indigestion: 2 - 4 grams of fresh root daily (0.25 - 1.0 g of powdered root) or 1.5 - 3.0 mL (30 - 90 drops) liquid extract daily. To prevent vomiting, take 1 gram of powdered ginger (1/2 tsp) or its equivalent, every 4 hours as needed (not to exceed 4 doses daily), or 2 ginger capsules (1 gram), 3 times daily. You may also chew a 1/4 oz piece of fresh ginger when needed.

To relieve arthritis pain: Take fresh ginger juice, extract, or tea, 2 - 4 grams daily. Topical ginger oil may also be rubbed into a painful joint. Fresh ginger root may also be placed in a warm poultice or compress and apply to painful areas.

For cold and flu symptoms, sore throat, headache and menstrual cramps: Steep 2 tbsp of freshly shredded ginger in hot water, 2 - 3 times daily. A drop of ginger oil or a few slices of fresh rhizome may also be placed in steaming water and inhaled.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.

Side effects associated with ginger are rare, but if taken in excessive doses the herb may cause mild heartburn. Some of the mild gastrointestinal side effects, such as belching, heartburn, or stomach upset, may be relieved by taking ginger supplements in capsules.

People with gallstones should consult a doctor before taking ginger. Make sure to tell your doctor if you are taking ginger and will be going to surgery or placed under anesthesia for any reason.

Do not take ginger if you have a bleeding disorder or if you are taking blood thinning medications, including aspirin.

Possible Interactions

Ginger may alter the effects of some prescription and non-prescription medications. If you are currently being treated with any of the following medications, you should not use ginger without first talking to your health care provider.

Blood-thinning medications -- Although ginger may interfere with blood clotting, there have been no scientific or case reports of interactions between ginger and blood-thinning medications, such as aspirin and warfarin. However, people taking medications that thin the blood should use ginger only under the supervision of a health care provider.

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SOY

Definition

The soybean has been a part of the human diet for almost 5,000 years. Unlike most plant foods, the soybean is high in protein and is considered equivalent to animal foods in terms of the quality of the protein it contains.

Function

Soy in your diet can lower cholesterol. There are many scientific studies that support this conclusion. In fact, the U.S. Food and Drug Administration (FDA) agreed that 25 grams per day of soy protein, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.
Soy may also reduce symptoms of menopause and the risk of osteoporosis. Soy products may possibly prevent certain hormone-dependent cancers,including breast cancer, endometrial cancer, and prostate cancer.

Food Sources

Not all soy protein products contain the same amount of protein. The following list ranks some popular products from greatest amount of soy protein to lowest:

• Soy protein isolate (added to many soy food products, including soy sausage patties and soybean burgers)
• Soy flour
• Whole soybeans
• Tofu

The best way to find out about protein content is to look on the product's Nutrition Facts label to see the percentage of soy protein. Also look at the list of ingredients. If a product contains isolated soy protein (or soy protein isolate), the protein content should be fairly high.

Some products also list how many grams of soy protein are in one serving of the product.

Note: There's a difference between soy supplements (commonly sold in tablets or capsules) and soy protein products. Soy supplements are generally made of concentrated soy isoflavones. These substances may help relieve symptoms of menopause but there is not enough evidence to support using soy isoflavones for any of the other health benefits, such as lowering cholesterol.

Side Effects

For individuals who are not allergic to soy, no serious short-term or long-term side effects have been reported from eating soy foods.

Common mild side effects include stomach aches, constipation, and diarrhea.

Soybeans also contain moderate amounts of a natural substance called purine. Purines can make gout worse. Persons with gout should not eat alot of soy products.

Recommendations

In adults, 25 grams per day of soy protein may reduce the risk of heart disease.

Soy foods and soy-based infant formula are widely used in children, but no studies have shown whether isolated soy protein or isoflavone supplements are useful or safe in this population. Therefore, isolated soy products are not recommended for children at this time.

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Main Preparation Method: decoction

Main Actions (in order):
antidysenteric, antiseptic, antibacterial, antispasmodic, cardiotonic (tones, balances, strengthens the heart)

Main Uses:

1. for dysentery (bacterial and amebic), diarrhea, colic, and infantile rotavirus enteritis
2. as a broad-spectrum antimicrobial for internal and external bacterial, fungal, candidal, and amebic infections
3. to tone, balance, protect and strengthen the heart (and for arrhythmia and some heart diseases)
4. as a cough suppressant, analgesic (pain-reliever), and febrifuge (reduces fever) for colds, flu, sore throat, etc
5. as a topical remedy for ear and eye infections

Properties/Actions Documented by Research:
amebicide, analgesic (pain-reliever), antibacterial, anticandidal, antidysenteric, antifungal, antimalarial, antioxidant, antispasmodic, antiulcerous, cardiodepressant, cardiotonic (tones, balances, strengthens the heart), central nervous system depressant, cough suppressant, gastrototonic (tones, balances, strengthens the gastric tract), hypotensive (lowers blood pressure), sedative, vasoconstrictor

Other Properties/Actions Documented by Traditional Use:
anti-anxiety, anticonvulsant, antiseptic, astringent, blood cleanser, digestive stimulant, menstrual stimulant, nervine (balances/calms nerves), vermifuge (expels worms)

Cautions: It has a cardiac depressant effect and is contraindicated in some heart conditions.

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Background
The rhizome (root) of turmeric ( Curcuma longa Linn.) has long been used in traditional Asian medicine to treat gastrointestinal upset, arthritic pain, and "low energy." Laboratory and animal research has demonstrated anti-inflammatory, antioxidant, and anti-cancer properties of turmeric and its constituent curcumin. Preliminary human evidence, albeit poor quality, suggests possible efficacy in the management of dyspepsia (heartburn), hyperlipidemia (high cholesterol), and scabies (when used on the skin).


Evidence

Blood clot prevention Early research suggests that turmeric may prevent the formation of blood clots. However, more research is needed before turmeric can be recommended for these conditions.	C
Cancer Several early animal and laboratory studies report anti-cancer (colon, skin, breast) properties of curcumin. Many mechanisms have been considered, including antioxidant activity, anti-angiogenesis (prevention of new blood vessel growth), and direct effects on cancer cells. Currently it remains unclear if turmeric or curcumin has a role in preventing or treating human cancers. There are several ongoing studies in this area.	C
Cognitive function Curcumin has been shown to have antioxidant and anti-inflammatory properties and to reduce beta-amyloid and plaque burden in lab studies. However, there is currently not enough evidence to suggest the use of curcumin for cognitive performance.	C
Dyspepsia (heartburn) Turmeric has been traditionally used to treat stomach problems (such as indigestion from a fatty meal). There is preliminary evidence that turmeric may offer some relief from these stomach problems. However, at high doses or with prolonged use, turmeric may actually irritate or upset the stomach. Reliable human research is necessary before a recommendation can be made.	C
Gallstone prevention/bile flow stimulant It has been said that there are fewer people with gallstones in India, which is sometimes credited to turmeric in the diet. Early studies report that curcumin, a chemical in turmeric, may decrease the occurrence of gallstones. However, reliable human studies are lacking in this area. The use of turmeric may be inadvisable in patients with active gallstones.	C
High cholesterol Early studies suggest that turmeric may lower levels of low-density lipoprotein ("bad cholesterol") and total cholesterol in the blood. Better human studies are needed before a recommendation can be made.	C
HIV/AIDS Several laboratory studies suggest that curcumin, a component of turmeric, may have activity against HIV. However, reliable human studies are lacking in this area.	C
Inflammation Laboratory and animal studies show anti-inflammatory activity of turmeric and its constituent curcumin. Reliable human research is lacking.	C
Irritable bowel syndrome (IBS) Irritable bowel syndrome (IBS) is a common functional disorder for which there are limited reliable medical treatments. One study investigated the effects of Curcuma xanthorriza on IBS and found that treatment did not show any therapeutic benefit over placebo. More studies are needed to verify these findings.	C
Liver protection In traditional Indian Ayurvedic medicine, turmeric has been used to tone the liver. Early research suggests that turmeric may have a protective effect on the liver, but more research is needed before any recommendations can be made.	C
Oral leukoplakia Results from lab and animal studies suggest turmeric may have anticancer effects. Large, well-designed human studies are needed before a recommendation can be made.	C
Osteoarthritis Turmeric has been used historically to treat rheumatic conditions. Laboratory and animal studies show anti-inflammatory activity of turmeric and its constituent curcumin, which may be beneficial in people with osteoarthritis. Reliable human research is lacking.	C
Peptic ulcer disease (stomach ulcer) Turmeric has been used historically to treat stomach and duodenal ulcers. However, at high doses or with prolonged use, turmeric may actually further irritate or upset the stomach. Currently, there is not enough human evidence to make a firm recommendation.	C
Rheumatoid arthritis Turmeric has been used historically to treat rheumatic conditions and based on animal research may reduce inflammation. Reliable human studies are necessary before a recommendation can be made in this area.	C
Scabies Historically, turmeric has been used on the skin to treat chronic skin ulcers and scabies. It has also been used in combination with the leaves of the herb Azadirachta indica ADR or "neem." More research is necessary before a firm recommendation can be made.	C
Uveitis (eye inflammation) Laboratory and animal studies show anti-inflammatory activity of turmeric and its constituent curcumin. A poorly designed human study suggests a possible benefit of curcumin in the treatment of uveitis. Reliable human research is necessary before a firm conclusion can be drawn.	C
Viral infection Evidence suggests that turmeric may help treat viral infections. However, there is not enough human evidence in this area. Well-designed trials are needed to determine if these claims are true.	C

Uses based on tradition or theory Abdominal bloating, Alzheimer's disease, antibacterial, antifungal, antimicrobial, antispasmodic, anti-venom, appetite stimulant, asthma, boils, breast milk stimulant, bruises, cataracts, chemoprotective, contraception, cough, cystic fibrosis, diabetes, diarrhea, dizziness, epilepsy, flavoring agent, gas, gonorrhea, heart damage from doxorubicin (Adriamycin®, Doxil®), Helicobacter pylori infection, hepatitis, high blood pressure, histological dye, human papillomavirus (HPV), hypoglycemic agent (blood sugar lowering), infections (methicillin-resistant Staphylococcus aureus), insect bites, insect repellent, jaundice, kidney disease, kidney stones, leprosy, liver damage from toxins/drugs, male fertility, menstrual pain, menstrual period problems/lack of menstrual period, multidrug resistance, neurodegenerative disorders, pain, parasites, ringworm, scarring, scleroderma, weight reduction.


Dosing A. Adults (over 18 years old)
Doses used range from 450 milligrams of curcumin capsules to 3 grams of turmeric root daily, divided into several doses, taken by mouth. As a tea, 1 to 1.5 grams of dried root may be steeped in 150 milliliters of water for 15 minutes and taken twice daily. Average dietary intake of turmeric in the Indian population may range between 2 to 2.5 grams, corresponding to 60 to 200 milligrams of curcumin daily. A dose of 0.6 milliliters of turmeric oil has been taken three times daily for one month and a dose of 1 milliliter in three divided doses has been taken for two months.

One reported method for treating scabies is to cover affected areas once daily with a paste consisting of a 4:1 mixture of Azadirachta indica ADR ("neem") to turmeric, for up to 15 days. Scabies should be treated under the supervision of a qualified healthcare professional.

B. Children (under 18 years old)
There is no proven or safe medicinal dose of turmeric in children.

Allergies Allergic reactions to turmeric may occur, including contact dermatitis (an itchy rash) after skin or scalp exposure. People with allergies to plants in the Curcuma genus are more likely to have an allergic reaction to turmeric. Use cautiously in patients allergic to turmeric or any of its constituents (including curcumin), to yellow food colorings, or to plants in the Zingiberaceae (ginger) family.

Side Effects and Warnings Turmeric may cause an upset stomach, especially in high doses or if given over a long period of time. Heartburn has been reported in patients being treated for stomach ulcers. Since turmeric is sometimes used for the treatment of heartburn or ulcers, caution may be necessary in some patients. Nausea and diarrhea have also been reported.

Based on laboratory and animal studies, turmeric may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. Turmeric should be stopped prior to scheduled surgery.

Limited animal studies show that a component of turmeric, curcumin, may increase liver function tests. However, one human study reports that turmeric has no effect on these tests. Turmeric or curcumin may cause gallbladder squeezing (contraction) and may not be advised in patients with gallstones. In animal studies, hair loss (alopecia) and lowering of blood pressure have been reported. In theory, turmeric may weaken the immune system and should be used cautiously in patients with immune system deficiencies.

Turmeric should be used with caution in people with diabetes or hypoglycemia or people taking drugs or supplements that lower blood sugar.

Pregnancy and Breastfeeding Historically, turmeric has been considered safe when used as a spice in foods during pregnancy and breastfeeding. However, turmeric has been found to cause uterine stimulation and to stimulate menstrual flow and caution is therefore warranted during pregnancy. Animal studies have not found turmeric taken by mouth to cause abnormal fetal development.

Interactions Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Based on laboratory and animal studies, turmeric may inhibit platelets in the blood and increase the risk of bleeding caused by other drugs. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve® ).

Based on animal data, turmeric may lower blood sugar and therefore may have additive effects with diabetes medications.

In animals, turmeric protects against stomach ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin (Indocin®) and against heart damage caused by the chemotherapy drug doxorubicin (Adriamycin®).

Turmeric may lower blood pressure levels and may have an additive effect if taken with drugs that also lower blood pressure.

Turmeric may lower blood levels of low-density lipoprotein (LDL or "bad" cholesterol) and increase high-density lipoprotein (HDL or "good" cholesterol). Thus, turmeric may increase the effects of cholesterol-lowering drugs such as lovastatin (Mevacor®) or atorvastatin (Lipitor®).

Based on animal studies, turmeric may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a healthcare professional or pharmacist about possible interactions.

When taken with indomethacin or reserpine, turmeric may help reduce the number of stomach and intestinal ulcers normally caused by these drugs. However, when taken in larger doses or when used for long periods of time, turmeric itself can cause ulcers.

Interactions with Herbs and Dietary Supplements Based on animal studies, turmeric may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , some cases with garlic, and fewer cases with saw palmetto.

Based on animal data, turmeric may lower blood sugar. Individuals taking other herbs or supplements or diabetes medications should speak with a healthcare professional before starting turmeric.

Turmeric may lower blood levels of low-density lipoprotein (LDL or "bad" cholesterol) and increase high-density lipoprotein (HDL or "good" cholesterol). Thus, turmeric may increase the effects of cholesterol-lowering herbs or supplements such as fish oil, garlic, guggul, or niacin.

Based on animal studies, turmeric may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

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ALOE VERA
BACKGROUND
Though they look more like cactus plants, aloe vera plants are actually members of the lily family classified as succulents. The aloe vera plant was originally native to Egypt, and the ancient Egyptians were among the first people to use aloe vera for its ability to heal the body.
Transparent gel from the pulp of the meaty leaves of Aloe vera has been used topically for thousands of years to treat wounds, skin infections, burns, and numerous other dermatologic conditions. Dried latex from the inner lining of the leaf has traditionally been used as an oral laxative.
There is strong scientific evidence in support of the laxative properties of aloe latex, based on the well-established cathartic properties of anthroquinone glycosides (found in aloe latex). However, aloe's therapeutic value compared with other approaches to constipation remains unclear.
There is promising preliminary support from laboratory, animal, and human studies that topical aloe gel has immunomodulatory properties that may improve wound healing and skin inflammation


ROLE
a. Constipation (laxative)
Dried latex from the inner lining of aloe leaves has been used traditionally as a laxative taken by mouth. Although few studies have been conducted to assess this effect of aloe in humans, the laxative properties of aloe components such as aloin are well supported by scientific evidence. A combination herbal remedy containing aloe was found to be an effective laxative, although it is not clear if this effect was due to aloe or to other ingredients in the product. Further study is needed to establish dosing and to compare the effectiveness and safety of aloe with other commonly used laxatives.
b. Genital herpes
Limited evidence from human studies suggests that extract from Aloe vera in a hydrophilic cream may be an effective treatment of genital herpes in men (better than aloe gel or placebo). Additional research is needed in this area before a strong recommendation can be made.
c. Psoriasis Vulgaris dan Seborrheic Dermatitis
Early evidence suggests that an extract from aloe in a hydrophilic cream may be an effective treatment of psoriasis vulgaris. Additional research is needed in this area before a strong recommendation can be made.
d. Cancer Prevention
e. Stomatitis Aphtosa
f. Diabetes (type 2)
g. Dry Skin
h. HIV Infection
i. Lichen planus
j. Colitis Ulcerative (termasuk inflammatory bowel disease)
k. Wound Healing
l. Mucositis
m. Dermatitis Radiation
The remains are still need update research.


CONTAINS
The aloe plant, being a cactus plant, is between 99 and 99.5 per cent water, with an average pH of 4.5. The remaining solid material contains over 75 different ingredients including vitamins, minerals, enzymes, sugars, anthraquinones or phenolic compounds, lignin, saponins, sterols, amino acids and salicylic acid. These are described in more detail below.
Vitamins
The plant contains many vitamins, excluding vitamin D but including the important antioxidant vitamins A, C and F. Vitamins B (thiamine), niacin, vitamin B2 (riboflavin), choline and folic acid are also present. Some authorities suggest that there is also a trace of vitamin B12 (Coats1979).
Enzymes
When taken orally, several of these biochemical catalysts, such as amylase and lipase, can aid digestion by breaking down fats and sugars. One important enzyme, a carboxy-peptidase, inactivates bradykinins and produces an anti-inflammatory effect. During the inflamma-tory process, bradykinin produces pain associated with vasodilation and, therefore, its hydrolysis reduces these two components and produces an analgesic effect (Obata et al 1993, Shelton 1991).
Minerals
Sodium, potassium, calcium, magnesium, manganese, copper, zinc, chromium and iron are all found in the aloe plant. Magnesium lactate inhibits histidine decarboxylase and prevents the formation of histamine from the amino acid, histadine (Shelton 1991). Histamine is released in many allergic reactions and causes intense itching and pain. The prevention of its formation may explain the antipuritic effect of aloe vera.
Sugars
Sugars are derived from the mucilage layer of the plant under the rind, surrounding the inner parenchyma or gel. They form 25 per cent of the solid fraction and comprise both mono- and polysaccharides. By far the most important are the long chain polysaccharides, comprising glucose and mannose, known as the gluco-mannans (Beta - (1, 4) - linked acetylated mannan). When taken orally, some of these bind to receptor sites that line the gut and form a barrier, possibly helping to prevent ‘leaky gut syndrome’. Others are ingested whole by a method of cellular absorption known as pinocytosis. Unlike other sugars which are broken down prior to absorption, the polysaccharides are absorbed complete and appear in the blood stream unchanged. Here, they act as immuno-modulators — capable of enhancing and retarding the immune response (Green 1996, Kahlon etal 1991, Sheets etall9gi).
Anthraquinones
These phenolic compounds are found in the sap. The bitter aloes consist of free anthraquinones and their derivatives:
• Barbaloin-lO- (1151 — anhydroglucosyl) — aloe-emodin-9-anthrone)
• lsobarbaloin
• Anthrone-C-glycosides and chromones.
In large amounts these compounds exert a powerful purgative effect, but when smaller they appear to aid absorption from the gut, are potent antimicrobial agents (Lorenzetti et all 964, Sims eta/i 971 a), and possess powerful analgesic effects. Topically, they can absorb ultra violet light, inhibit tyronase activity, reduce the formation of melanin and any tendency to hyper-pigmentation (McKeown 1987, Strickland eta/i 993). Lignin This woody substance, inert in itself, endows topical aloe preparations with their singular penetrative ability to carry other active ingredients deep into the skin to nourish the dermis (Coats 1979).
Saponins
These soapy substances form 3 per cent of the gel and are general cleansers, having antiseptic properties (Hirat and Suga 1983).
Plant
Sterols These include Campesterol, f3 Sitosterol and Lupeol (Coats 1979).
Sallcylic Acid
This is an aspirin-like compound possessing anti-inflammatory and antibacterial properties. Topically, it has a kerolytic effect which helps to debride a wound of necrotic tissue.
Amino acids
These are the building blocks of proteins. Aloe vera gel provides 20 of the 22 necessary amino acids required by the human body and seven of the eight essential amino acids which the body cannot synthesize. These must be ingested in food.

DOUSAGE
The dose often recommended for constipation is the minimum amount to maintain a soft stool, typically 0.04-0.17 gram of dried juice (corresponds to 10-30 milligrams hydroxyanthraquinones) by mouth. As an alternative, in combination with celandine (300 milligrams) and psyllium (50 milligrams), 150 milligrams of the dried juice per day of aloe has been found effective as a laxative in research.
Other uses of aloe from scientific studies include the treatment of genital herpes (cream applied to lesions for five consecutive days per week for up to two weeks) and psoriasis (cream applied to skin three times per day for five consecutive days per week for up to four weeks).

SIDE EFFECT
Side Effects and Warnings
The use of aloe on surgical wounds has been reported to slow healing; redness and burning has been reported after aloe juice was applied to the face after a skin-peeling procedure (dermabrasion). Application of aloe prior to sun exposure may lead to rash in sun-exposed areas.
The use of aloe or aloe latex by mouth for laxative effects can cause cramping or diarrhea. Use for over seven days may cause dependency or worsening of constipation after the aloe is stopped. Ingestion of aloe for over one year has been reported to increase the risk of colorectal cancer. Individuals with severe abdominal pain, appendicitis, ileus (temporary paralysis of the bowel), or a prolonged period without bowel movements should not take aloe. There is a report of hepatitis (liver inflammation) with the use of oral aloe.
Electrolyte imbalances in the blood, including low potassium levels, may be caused by the laxative effect of aloe. This effect may be greater in people with diabetes or kidney disease. Low potassium levels can lead to abnormal heart rhythms or muscle weakness. People with heart disease, kidney disease, or electrolyte abnormalities should not take aloe by mouth. Healthcare professionals should watch for changes in potassium and other electrolytes in individuals who take aloe by mouth for more than a few days.
Aloe taken by mouth may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare professional, and medication adjustments may be necessary. People with thyroid disorders, kidney disease, heart disease, or electrolyte abnormalities should also use oral aloe only under medical supervision.
Avoid Aloe vera injections, which have been associated with cases of death under unclear circumstances.

INTERACTIONS WITH DRUGS
Aloe taken by mouth may lower blood sugar levels. Caution is advised when taken with medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or injection should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary. In addition, insulin may add to the decrease in blood potassium levels that can occur with aloe.
Due to the lowering of potassium levels that may occur when aloe is taken by mouth, the effectiveness of heart medications such as digoxin and digitoxin, and of other medications used for heart rhythm disturbances, may be reduced. The risk of adverse effects may be increased with these medications due to low potassium levels.
Caution should be used in patients taking loop diuretics, such as Lasix® (furosemide), or thiazide diuretics, such as hydrochlorothiazide (HCTZ), that increase the elimination of both fluid and potassium in the urine. Combined use may increase the risk of potassium depletion and of dehydration.
Use of aloe with laxative drugs may increase the risk of dehydration, potassium depletion, electrolyte imbalance, and changes in blood pH. Due to its laxative effect, aloe may also reduce the absorption of some drugs.
Application of aloe to skin may increase the absorption of steroid creams such as hydrocortisone. In addition, oral use of aloe and steroids such as prednisone may increase the risk of potassium depletion.
There is one report of excess bleeding in a patient undergoing surgery receiving the anesthetic drug sevoflurane, who was also taking aloe by mouth. It is not clear that aloe or this specific interaction was the cause of bleeding.
Preliminary reports suggest that levels of AZT, a drug prescribed in HIV infection, may be increased by intake of aloe.
Drugs used for cancer and for hormone activity (hormone replacement therapy, birth control pills) may also interact with aloe.

Interactions with Herbs and Dietary Supplements
Based on the laxative properties of oral aloe, prolonged use may result in potassium depletion. Aloe may increase the potassium-lowering effects of other herbs such as licorice ( Glycyrrhiza glabra ). Theoretically, use of oral aloe and other laxative herbs such as senna may increase the risk of dehydration, potassium depletion, electrolyte imbalance, and changes in blood pH.
Oral aloe can reduce blood sugar. Caution is advised when using herbs or supplements such as bitter melon that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Herbs and supplements used for cancer or the heart may interact with aloe. Phytoestrogens such as soy, as well as antivirals may also interact with aloe. Aloe may increase the absorption of vitamin C and vitamin E.

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