Abnormal Development - Herbal Drugs

From Embryology

Introduction

St. John's Wort

This page introduces the possible effects of maternal use of herbal drugs (therapeutic chemicals/agents) on development. In some cases these drugs are "prescribed" to treat pre-existing or pregnancy related maternal medical conditions. In all cases, a discussion with a medical practioner should be had prior to any reproductive decision.

The following herbal drugs have been used for a number of different maternal conditions: Ginkgo Biloba, Kava (Piper methysticum), St. John's wort (Hypericum perforatum), Tian Ma (Gastrodia elata), Valerian (Valeriana officinalis). In some cases very little is known about the potential teratogenic effects of these drugs. Furthermore, care should be made when comparing evaluation of drugs in different species.[1]

The National Center Complementary and Alternative Medicine (USA) provides excellent summary information sheets on many of the commonly used herbal treatments, though many of these information sheets do not include information about herbal drug use during pregnancy. This current page gives some examples of herbs which may impact on development, for further information see NIH - Herbs at a Glance PDF.

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Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.

Some Recent Findings

  • Prenatal exposure of a girl with autism spectrum disorder to 'horsetail' (Equisetum arvense) herbal remedy and alcohol: a case report [2]"We describe the pediatric environmental history of a three-year-old Caucasian girl with an autism spectrum disorder. We utilized her pediatric environmental history to evaluate constitutional, genetic, and environmental factors pertinent to manifestation of neurodevelopment disorders. Both parents reported prenatal exposure to several risk factors of interest. A year prior to conception the mother began a weight loss diet and ingested 1200mg/day of 'horsetail' (Equisetum arvense) herbal remedies containing thiaminase, an enzyme that with long-term use can lead to vitamin deficiency. The mother reported a significant weight loss during the pregnancy and a deficiency of B-complex vitamins. Thiamine (vitamin B1) deficiency could have been potentiated by the horsetail's thiaminase activity and ethanol exposure during pregnancy. No other risk factors were identified."
  • Effects of Ginkgo biloba extract on the embryo-fetal development in Wistar rats[3] "Ginkgo biloba extract (GBE) is an herbal medicine used for treating neurodegenerative diseases, cerebrovascular insufficiency, peripheral arterial occlusive disease, and also vestibular disturbance. ...The GBE treatment in pregnant Wistar rats, during the tubal transit and implantation period, caused no toxic effect on the maternal organism and did not induce embryonic death, growth retardation, and/or fetal malformations."

Black Cohosh

Cimicifuga racemosa.jpg Black cohosh (Actaea racemosa, Cimicifuga racemosa, black snakeroot, macrotys, bugbane, bugwort, rattleroot, rattleweed) is a member of the buttercup family and is native to North America. It is not clear if black cohosh is safe for women with a liver disorder, hormone-sensitive conditions, or for pregnant women or nursing mothers.

Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides).


Links: USA Office of Dietary Supplements - Black Cohosh

Cat’s Claw

Cats-claw.jpg Cat’s Claw (Uncaria tomentosa, Uncaria guianensis) should be avoided because of its past use for preventing and aborting pregnancy.

Chasteberry

Chasteberry (Vitex agnus-castus, chaste-tree berry, vitex, monk’s pepper) is the fruit of the chaste tree. This herb may affect certain hormone levels, women who are pregnant or taking birth control pills or who have a hormone-sensitive condition (such as breast cancer) should not use chasteberry.

Ephedra

Ephedra-Sinica.jpg Ephedra (Ephedra sinica) is an evergreen shrub-like plant, the principal active ingredient ephedrine can powerfully stimulate the nervous system and heart. In 2004, the FDA banned the U.S. sale of dietary supplements containing ephedra.

Fenugreek

Fenugreek (Trigonella foenum-graecum) is a legume plant who's seeds are commonly as a food spice. It was used historically for inducing childbirth.

Feverfew

Feverfew 02.jpg Feverfew (Tanacetum parthenium, Chrysanthemum parthenium) is a short bush with daisy-like flowers. This herb may cause the uterus to contract, increasing the risk of miscarriage or premature delivery.

Ginkgo Biloba

Ginkgo Biloba Ginkgo leaf extract has been used to treat a variety of ailments and conditions, including asthma, bronchitis, fatigue, and tinnitus (ringing or roaring sounds in the ears).

Extracts are usually taken from the ginkgo leaf and are used to make tablets, capsules, or teas. Occasionally, ginkgo extracts are used in skin products.

Goldenseal

Goldenseal.jpg Goldenseal (Hydrastis canadensis, orange-root, yellow-root) is a perennial herb in the buttercup family, it contains the chemical berberine that can cause or worsen jaundice in newborns and may lead to a life-threatening problem called kernicterus.


Kernicterus is a form of brain damage caused by excessive jaundice.

Horsetail

Horsetail.jpg Field Horsetail or Common Horsetail (Equisetum arvense, rhizomatous stem formation) is a bushy perennial herb native to the northern hemisphere.

The herb contains containing thiaminase, an enzyme that with long-term use can lead to vitamin deficiency.

Has been used in weight loss diets, and a case report has identified that combined with alcohol linked to autism spectrum disorder[2].

Licorice Root

Licorice (Glycyrrhiza glabra, Glycyrrhiza uralensis, gan zao (Chinese licorice)) contains a compound called glycyrrhizin (or glycyrrhizic acid) and consuming large amounts of licorice as food may alter cortisol and related steroid drug levels, as well as increase the risk of preterm labor.

Red Clover

Red clover.jpg Red clover (Trifolium pratense) is a legume and contains phytoestrogens, compounds that are similar to the female hormone estrogen.

St. John's Wort

St. John's Wort St. John's Wort (Hypericum perforatum, hypericum, Klamath weed, goatweed) a plant with yellow flowers used to prepare teas, this herb interacts with many medications in ways that can interfere with their intended effects.


HSTAT St. John's Wort | Appendix II: Side Effects, Adverse Effects, Precautions, and Warnings "The safety of using hypericum during pregnancy or lactation has not been proven so it should be avoided." "St. John's wort induces the CYP 450 3A4 metabolic pathway which is also used by many prescription drugs used to prevent conditions (transplant rejection or pregnancy oral contraceptives), health care providers should alert patients about these potential drug interactions."

Yohimbe

Yohimbine structure.jpg Yohimbe (Pausinystalia yohimbe ) is derived from the bark of a tall evergreen tree native to western Africa. Women who are pregnant or breastfeeding should not take yohimbe.


Links: MedlinePlus - Yohimbe

References

  1. H Nau Species differences in pharmacokinetics and drug teratogenesis. Environ. Health Perspect.: 1986, 70;113-29 PubMed 3104022 | PMC1474298
  2. 2.0 2.1 Juan A Ortega García, Mario G Angulo, Elías J Sobrino-Najul, Offie P Soldin, Alberto Puche Mira, Eduardo Martínez-Salcedo, Luz Claudio Prenatal exposure of a girl with autism spectrum disorder to 'horsetail' (Equisetum arvense) herbal remedy and alcohol: a case report. J Med Case Rep: 2011, 5;129 PubMed 21453474
  3. Eduardo Siqueira Fernandes, Rafael Moraes Pinto, João Evangelista de Paula Reis, Martha de Oliveira Guerra, Vera Maria Peters Effects of Ginkgo biloba extract on the embryo-fetal development in Wistar rats. Birth Defects Res. B Dev. Reprod. Toxicol.: 2010, 89(2);133-8 PubMed 20437472

Books

  • Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Benzie IFF, Wachtel-Galor S, editors. Boca Raton (FL): CRC Press; 2011. Bookshelf

Reviews

  • Saunders EJ, Saunders JA. Drug therapy in pregnancy: the lessons of diethylstilbestrol, thalidomide, and bendectin. Health Care Women Int. 1990;11(4):423-32.

Articles

  • McBride WG. Prescription drugs in the first trimester and congenital malformations. Aust N Z J Obstet Gynaecol. 1992 Nov;32(4):386.

Search Pubmed

June 2010 "herbal drugs in pregnancy" All (395) Review (50) Free Full Text (30)

Search Pubmed: herbal drugs in pregnancy | herbal drug teratogen

External Links

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Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.

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Cite this page: Hill, M.A. 2017 Embryology Abnormal Development - Herbal Drugs. Retrieved May 24, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Herbal_Drugs

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