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ACEROLA Category: Functional Foods Related Term: Malpighia Glabra Definition: Natural Plant Product Promoted As a Dietary Supplement for Specific Health Benefits

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ACEROLA Category: Functional Foods Related Term: Malpighia Glabra Definition: Natural Plant Product Promoted As a Dietary Supplement for Specific Health Benefits A ACEROLA Category: Functional foods Related term: Malpighia glabra Definition: Natural plant product promoted as a dietary supplement for specific health benefits. Principal proposed use: Source of vitamin C Other proposed use: Antioxidant Overview Acerola is a small tree (Malpighia glabra) that grows in dry areas of the Caribbean and Central America and South America. Traditionally, its fruit has been used to treat diarrhea, arthritis, and fevers, and kidney, heart, and liver problems. Acerola contains ten to fifty times more vitamin C by weight than oranges. Other impor- The blossom and fruit of a Brazilian acerola (Malpighia glabra). (Eric Gaba) tant substances found in acerola include bioflavonoids, magnesium, pantothenic acid, and vitamin A. Safety Issues Uses and Applications As a widely used food, acerola is believed to have a rela- tively high safety factor. However, it has been discov- Acerola is primarily marketed as a source of vitamin C ered that people who are allergic to latex may be allergic and bioflavonoids. Because of these constituents, it has to acerola too. Maximum safe doses in young children, substantial antioxidant properties. One study found that pregnant or nursing women, and people with severe acerola significantly increased the antioxidant activity liver or kidney disease have not been established. of soy and alfalfa. It is not clear, however, that this rather theoretical finding indicates anything of significance to —EBSCO CAM Review Board human health. Other powerful antioxidants such as vita- See also: Antioxidants; Vitamin C min E and beta-carotene have proved disappointing when they were subjected to studies that could discern Further Reading whether their actions as antioxidants translated into Moura, Carlos F. H., et al. “Acerola—Malpighia Emarginata.” actual health benefits. Exotic Fruits, 2018, pp. 7-14. Prakash, Anand, and Revathy Baskaran. “Acerola, an Untapped Like many plants, acerola has antibacterial and Functional Superfruit: a Review on Latest Frontiers.” Journal antifungal properties, at least in the test tube. However, of Food Science and Technology, vol. 55, no. 9, 2018, pp. no studies in humans have been reported. 3373-3384. Roller, Marc. “What Applications and Properties of Acerola for Dosage Nutraceutical Products?” Natural Origins, 11 Dec. 2018, A typical supplemental dosage of acerola is 40 to 100 www.mynaturalorigins.com/en/blog/what-applications-and- properties-of-acerola-for-nutraceutical-products. milligrams daily. 2 • Integrative, Alternative & Complementary Medicine White, Adrian. “Acerola Cherry: Vitamin C, Fruit, Powder, and acetaminophen. These anticholinergic properties are Benefits.” Healthline, 12 Jan. 2018, what make this plant very dangerous and widely www.healthline.com/health/food-nutrition/acerola-cherry. Wong, Cathy. “The Health Benefits of Acerola Berry.” Verywell regarded as unsafe without monitored use. Fit, 3 Feb. 2020, www.verywellfit.com/acerola-berry-89397. Black Cohosh Effect: Possible Harmful Interaction ACETAMINOPHEN Black cohosh (Cimicifuga racemosa rhizome) has be- Category: Drug interactions come a popular herb for female health issues including Definition: A common drug used to reduce pain and menopause, painful menstruation, and osteoporosis. fever. The active compounds of black cohosh can be toxic to Interactions: Belladonna, black cohosh, cannabidiol, the liver. There have been documented cases of liver chaparral, citrate, coenzyme Q10, coltsfoot, com- toxicity linked to this herb that required hospitalization, frey, echinacea, methionine, milk thistle, vitamin C fortunately most improved or resolved after discontinu- Over-the-counter trade names containing ation of the product. The combined use with acetaminophen: Actifed, Acephen, Aceta, acetaminophen could increase risk of liver toxicity. Alka-Seltzer Plus Liquid Gels, Amaphen, Anacin, Cannabidiol Anoquan, Apacet, Arthritis Foundation Aspirin Effect: Possible Harmful Interaction Free, Arthritis Foundation Nighttime, Aspirin Free Cannabidiol (CBD) is a phytochemical extracted from Anacin, Aspirin Free Excedrin, Bayer Select, the cannabis plant but does not have the psychoactive Cepacol, Contac, Coricidin, Dapacin, Dayquil, properties of tetrahydrocannabinol (THC) that also de- Dimetapp, Dristan, Dynafed, Endolor, Esgic, rives from the same plant. The medicinal effects of Excedrin P.M., Fem-Etts, Femcet, Feverall, For- CBD are not very well understood, but it has been ap- mula 44, Genapap, Genebs, Goody’s, Halenol, proved by the FDAin 2018 for treatment-resistant epi- Isocet, Liquiprin, Mapap, Maranox, Meda, lepsy. CBD is known to cause elevations in liver en- Medigesic, Midol, Multi-Symptom Pamprin, zymes which can be a sign of liver stress or damage. Neopap, Nighttime Pamprin, Nyquil, Oraphen-PD, The added use with acetaminophen can potentiate Panadol, Phrenilin, Repan, Ridenol, Robitussin, harm to the liver. Saint Joseph, Sedapap, Silapap, Sominex Pain Re- lief, Tapanol, Tempra, Tylenol, Uni-Ace, Unisom Chaparral, Comfrey, and Coltsfoot with Pain Relief Effect: Possible Harmful Interaction Common prescription medicines containing The herbs chaparral (Larrea tridentata or L. mexicana), acetaminophen:Endocet, Fioricet, Hycotab, comfrey (Symphytum officinale), and coltsfoot Hydrocet, Hydrocodone bitartrate, Lortab, (Tussilago farfara) have had documented cases linked Percocet, Phenaphen, Sedapap, Tapanol, Tylenol to liver toxicity either due to their active compounds, with Codeine, Tylox, Ultracet, Vicodin, Zydone. contaminants, or method of extraction and preparation. For a comprehensive list of all medications that The combined use with acetaminophen could accentu- contain acetaminophen, visit the National Library ate liver toxicity. of Medicine’s web site: www.medlineplus.gov. Citrate Belladonna Effect: Possible Harmful Interaction Effect: Possible Harmful Interaction Potassium citrate, sodium citrate, and potassium-mag- Belladonna (Atropa belladonna) has long been used for nesium citrate are sometimes used to prevent kidney various medicinal purposes including pain relief, mo- stones. These supplements reduce urinary acidity which tion-sickness, muscle relaxant, and anti-inflammatory increases urine levels of acetaminophen. This leads to properties. However, this herb has anticholinergic prop- decreased blood levels and effectiveness of erties that can delay or decrease gastrointestinal absorp- acetaminophen. tion. This can reduce the blood levels and efficacy of Acne • 3 Echinacea Nimmo J, Heading RC, Tothill P, Prescott LF “Pharmacological Effect: Possible Harmful Interaction modification of gastric emptying: effects of propantheline and metoclopramide on paracetamol absorption.” Br Med J 1 (1973): Echinacea is a widely popular supplement from flower- 587-9. ing plants that has been historically used as an immune Neuvonen, P. J., et al. “Methionine in Paracetamol Tablets: A Tool system booster. The complex mix of active compounds to Reduce Paracetamol Toxicity.” International Journal of Clini- may provide antioxidant effects but can also inhibit cal Pharmacology, Therapy, and Toxicology 23 (1985): hepatic enzymes that break down acetaminophen. This 497-500. can increase the blood levels and toxic effects of acetaminophen to the liver. ACNE Milk Thistle, Coenzyme Q10 (CoQ10), Methionine Category: Condition Related terms: Effect: Possible Helpful Interaction Acne vulgaris, blackheads, pimples, The herb milk thistle (silymarin) and the supplements whiteheads Definition: CoQ10 and methionine have antioxidant properties that Treatment of a skin condition caused by may help protect toxin damage to the liver from clogged, inflamed, or infected pores. Principal proposed natural treatments: acetaminophen. However, it is still extremely danger- Niacinamide ous to take excessive amounts of acetaminophen greater gel, tea tree oil, zinc than three to four grams daily. Other proposed natural treatments: Ayurvedic medi- cine, burdock, chromium, gugulipid, low-glycemic- Vitamin C (ascorbic acid) load diet, red clover, selenium, vitamin E Effect: Possible Harmful Interaction High doses (>2 grams daily) of Vitamin C (ascorbic Introduction acid) may decrease urine levels of acetaminophen, The blackheads and sometimes painful pimples known which can reflexively increase blood levels of as acne occur most commonly during adolescence, but acetaminophen. This could potentially put a person at they also may persist into adulthood. Much remains to higher risk for acetaminophen toxicity. be learned about what causes acne. During adolescence —Daniel Azof, MD and other times of hormonal imbalance, such as meno- pause, glands in the skin increase their levels of oil se- See also: Food and Drug Administration (FDA); Herbal cretions. A combination of naturally occurring yeast medicine; Pain management; Supplements; Vitamin C and bacteria then breaks down these secretions, causing the skin to become inflamed and the pimples to eventu- Further Reading ally rupture. In severe cases, acne can cause permanent Gorski JC, Huang SM, Pinto A, et al. “The effect of echinacea scarring. (Echinacea purpurea root) on cytochrome P450 activity in vivo.” Clin Pharmacol Ther 75 (2004): 89-100 Conventional treatment of acne, which usually is LiverTox: Clinical and Research Information on Drug-Induced quite successful, consists primarily of oral or topical an- Liver Injury. Bethesda (MD): National Institute of Diabetes and tibiotics, cleansing agents, and chemically modified Digestive and Kidney Diseases; 2012-. Chaparral.
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