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Herbs and Essential Oils That May Assist
Pomegranate
Punica granatum
Myrrh
Commiphora myrrha
Nigella
Nigella sativa
Sweet wormwood
Artemisia annua
Black walnut
Juglans nigra
Peppermint oil
Mentha X piperita
Actions
- Antimicrobial – antiparasitic, antifungal and antibacterial
- Stimulate microbial self-destruction
- Stimulate an antimicrobial immune response
Clinical Applications
-
Dysbiosis
- Parasites
- Fungal overgrowth
- Bacteria and viruses
- Part of a clinical detoxification program
Clinical Overview
During times of dysbiosis, the displacement of key commensal groups makes the gastrointestinal environment more susceptible to colonisation by potential pathogens, such as parasites (protozoa and worms), fungi and bacteria. For centuries, pomegranate, myrrh, nigella, sweet wormwood, peppermint oil and black walnut have traditionally been used to destroy a wide range of such pathogens. In an effort to reduce the risk of drug resistance, drug-drug interactions, and minimise the side effects that accompany pharmaceuticals, the evidence for assessing the antimicrobial potential of such herbs is growing. Although still in its infancy, such research is revealing new insights into how herbs help to destroy a variety of different pathogens. (Figure 1) Following in the antiparasitic footsteps of sweet wormwood in the treatment of malaria, a range of herbs are showing equally favourable antimicrobial results to a number of commonly used pharmaceutical antimicrobials, with more human studies emerging. The combination of empirical knowledge with current evidence provides applied and researched resolutions for the age old problem of supporting the body in the presence of infections; notably, this can be done without causing further microbial disruption (Figure 1).
Figure 1: Herbs to support the elimination of gut pathogens. [1],[2],[3],[4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14]
Background Information
Keeping the Microbial Balance in Balance
A complex community of microbes, collectively referred to as the microbiome, inhabits the human body. This community is predominantly comprised of anaerobic bacteria, both commensal and pathogenic, which cohabit alongside a diverse range of protozoa (including parasites), fungi and viruses. [15] The digestive tract houses the greatest quantity of microbes, [16] and changes to the gut terrain, as a result of the host’s diet, lifestyle, medications and the like, [17],[18] can result in an environment that supports the proliferation of one or more pathogens.
Nature to the Rescue
The World Health Organization (WHO) has recognised that approximately 80% of pharmaceutical medications are inspired by or originated from plants or their derivatives. WHO has also noted that medicinal plants are used as the primary source of healthcare in over 80% of those living in areas where parasitic infections are commonplace within a population or location. [19]
Based on this, it should not be surprising that in vitro, animal and human studies have shown that key antimicrobial herbs and their constituents have been shown to be as effective as their pharmaceutical counterparts. This includes Punica granatum (pomegranate), [20] Nigella sativa (nigella), [21] Commiphora myrrha (myrrh), [22],[23] Artemisia annua (sweet wormwood), [24] and Mentha X piperita (peppermint) oil. [25] When assessing the use of such herbs, traditional evidence on the therapeutic impact of the whole plant, not simply individual constituents, is an essential consideration.
Moreover, as resistance to orthodox antimicrobials increases, [26] it is now more pertinent than ever to consider herbal medicines to address pathogenic overgrowth in an effort to avoid drug multi-resistance and ensure the pharmaceuticals are left standing as a viable treatment option for more severe infections. Interestingly, poly-herbal combinations have been shown to be as beneficial as the antibiotic rifaximin, in the treatment of small intestine bacterial overgrowth (SIBO). [27]
Table 1: Summary of actions of key antimicrobial herbs
(+++ = stronger evidence, ++ = moderate evidence, + less evidence)
|
Antimicrobial |
Anti-parasitic /helmintic |
Antifungal |
Antibacterial |
Carminative |
Myrrh [28],[29],[30],[31] |
+++ |
+++ |
++ |
++ |
+ |
Pomegranate [32],[33],[34],[35],[36],[37],[38] |
+++ |
++ |
++ |
++ |
|
Nigella [39],[40],[41] |
+++ |
++ |
++ |
++ |
++ |
Sweet wormwood [42],[43],[44][45] |
+++ |
+++ |
++ |
+ |
|
Black walnut [46] |
++ |
+ |
+ |
+ |
|
Peppermint oil [47],[48],[49],[50],[51] |
+++ |
+ |
++ |
++ |
++ |
Actions
Antimicrobial, Antiparasitic, Antifungal and Antibacterial
Regardless of the herbal tradition, Western, Chinese or Ayurvedic, there is a long history of medicinal herbs, including their resins and oils, being prescribed to expel pathogens. [52] Through a range of antiparasitic, anthelmintic, antifungal,
antibacterial and antibiofilm activities, herbal medicines address dysbiosis and help return the gut microbiota to a symbiotic status.
Scientific evidence supports the traditional use of herbal medicines such as myrrh, pomegranate, nigella, sweet wormwood, black walnut and peppermint oil for pathogenic elimination via a range of mechanisms that alter the biochemical pathways within the microbes and mediate their eradication. Table 1 provides a summary of the actions of these powerful herbs.
Stimulate Microbial Self-Destruction
As plants are as susceptible to pathogenic attack as humans, it is not surprising they produce antimicrobial substances as defence mechanisms to help them withstand the invasion. Herbs are composed of a variety of constituents that have been shown together, or in isolation, to destroy pathogens in particularly interesting ways. For example:
- Myrrh. Antibacterial effects are due primarily to its levels of the sesquiterpene lactone (STL), T-cadinol, which drives bacterolysis via the penetration of cell envelopes leading to cell wall destruction. [53]
- Nigella. The oils in nigella displayed membrane-disrupting properties of fungi in multiple membranes, most importantly at the level of the mitochondria and nucleus. [54]
- Pomegranate. Shown to stimulate cell death in the gram-positive bacteria by decreasing the integrity of the cytoplasmic membranes. [55] Punicalagin, a constituent of pomegranate, has shown to inhibit Staphylococcus aureus biofilm formation by more than 90%. [56] Pomegranate has also demonstrated reduction and elimination of parasitic cyst shedding, possibly through the presence of metabolic toxins. [57]
- Peppermint oil. Peppermint oil has been shown to inhibit an enzyme responsible for maintaining the cell membrane electrochemical proton gradient in pathogens. This gradient is vital for the growth and the survival of cells. An in vitro study highlighted peppermint oil’s ability to inhibit PM-H + ATPase in the Candida spp. leading to cell membrane damage, leakage of the cells constituents and cell death. [58] A range of in vitro studies has also highlighted peppermint oil’s ability to inhibit biofilm formation in the Candidaalbicans, Candida dubliniensis, and Pseudomonas aeruginosa. [59]
It is thought that the unusual endoperoxide bridge in the STL artemisinin, the key constituent in sweet wormwood, provides the ability to stimulate microbial self-destruction. [60],[61] Via cleavage of the peroxide bridge four mechanisms are activated resulting in:
- Increased intracellular oxidative stress as a result of interference with process of haeme detoxification of toxic free haeme to the innocuous biocrystal haemozoin. [62]
- Alkylation, and reduction of the translation, of the ‘housekeeping’ translationally controlled tumour protein, PfTCTP, thought to be responsible for cell cycle regulation and immunological function. [63]
- Inhibition of the sarco−endoplasmic reticulum Ca 2+ -ATPase (SERCA) thereby disrupting calcium homeostasis and, in turn, the motility and invasion ability into host cells. [64]
- Disruption of the mitochondrial membrane via an increase in the levels of reactive oxygen species. [65] This mechanism has also been shown in yeasts. [66]
Stimulate an Antimicrobial Immune Response
Research on the potential of herbal medicines to influence the body’s immune response to pathogens is limited, however there is some suggestion herbs may be having an effect and this novel mechanism may be worth further study. For example one of the ways nigella may exert its antiparasitic activity is through its immunomodulatory effects. [67]
Myrrh’s immunomodulatory effects have been investigated, highlighting the following mechanisms:
- Stimulation of phagocytosis (in vitro);
- Stimulation of phagocytic activity as noted by an increase in the phagocytic index, a marker of phagocytic activity, along with lymphocyte transformation (animal);
- Increased levels of both interferon-c (IFN-c) and interleukin-2 (IL-2) in mice infested with parasitic flatworm, schistosoma (animal); and
- Raised levels of IL-4 in a patient suffering from fascioliasis (human). [68]
Additionally, pomegranate may facilitate the expression of antiparasitic genes. [69] Interestingly, pomegranate peel has demonstrated a prebiotic effect, modulating gut microbiota towards bifidobacterium, which supports natural antiphlogistic (anti-inflammatory) activity in the intestinal tract. [70] A direct interaction between punicalagin and cytokines was also demonstrated, thus suggesting interaction with the proinflammatory cytokines in the gut lumen, decreasing the intercellular communication and limiting the local and systemic inflammation, contributing to an anti-inflammatory effect. [71]
Clinical Applications
Dysbiosis
The result of pathogenic overgrowth is a swing from a balanced, mutualistic relationship, to one of dysbiosis. Dybiosis is linked to a range of negative health conditions [72] and addressing gut pathogen overgrowth is, therefore, important not only for those with acute digestive conditions, but for health and wellbeing as a whole.
Parasites
A clinical trial with 204 patients infected with schistosoma, a parasitic flatworm that infects 1 in 30 people globally, has highlighted myrrh’s antiparasitic activity. The participants received myrrh at a dose of 10 mg/kg of body weight/day for 3 days. At the end of the three days, 185 of the 204 participants (90.7%) showed complete improvement of symptoms, 13 (6.4%) showed partial improvement, and six (2.9%) reported no improvement. A subgroup of 12 participants not previously treated with the antiparasitic pharmaceutical, praziquantel, showed a 100% improvement rate (Figure 2). [73]
Interestingly, retreatment of the small number of non-responsive cases was carried out at the same dose for six days which increased the overall improvement rate to 98%. This demonstrates a significant efficacy in eradiation, with almost all participants being completely improved after one or two treatments. Twenty people provided biopsy specimens six months after the trial and all were clear of living ova. [74]
Figure 2: Rates of symptom improvement in those infected with schistosoma after three days of treatment with myrrh. [75]
In another human trial (open label), participants testing positive for schistosoma received 600 mg of myrrh extract for six consecutive days. The cure rate for Schistosoma haematobium was 97.4% and Schistosoma mansoni was 96.2% with no major side effects noted. In those not receiving full cure from the treatment, a marked reduction in the egg levels was noted. [76] This suggests a significant therapeutic effect was still achieved in the few participants where it wasn’t fully eradicated.
Myrrh has also been shown to be effective against Cryptosporidium spp., a parasite responsible for a range of digestive and respiratory symptoms. In a study of 60 children, either myrrh extract alone (10 mg/kg body weight), the antibiotic, paromomycin, or a combination of the two was given for two weeks. Assessment at weeks one, two, three and four showed a reduction in cryptosporidium oocyst [*] numbers, along with the reduction in a range of digestive symptoms, after four weeks. Notably, the combination of myrrh and paromomycin resulted in the greatest reduction in symptoms. [77]
Furthermore, the impact of a short duration of treatment or low trial dosage has been shown in further human studies, [78],[79] highlighting the importance of the appropriate dosing of myrrh to achieve the desired results.
Animal studies have also demonstrated significant antimicrobial actions of myrrh. A pharmaceutical medication containing 300 mg of purified myrrh resin, Mirazid, has shown positive effects against the parasite, Giardia lamblia, in animal models. A 100% reduction in intestinal and faecal parasitic load was noted after treatment. [80]
Myrrh’s anthelmintic capabilities have been further elucidated in an animal study assessing its abilities to modulate the degree of Trichinella spiralis infection. In this study myrrh was compared with the effect of ivermectin, an antiparasitic pharmaceutical which is showing increasing rates of drug resistance. The positive impact of myrrh was nearly comparable to the effects of ivermectin. [81]
The pathogenic nature of Blastocystis hominis may be controversial, yet those living with persistent symptoms are frequently treated with metronidazole (MTZ), with varying degrees of benefit due to drug resistance and/or reinfection. [82] An alternative to MTZ is nitazoxanide (NTZ), which is considered to treat as effectively as MTZ. In an animal study, the effect of pomegranate peel, NTZ and placebo was assessed via the degree of blastocystis cyst shedding over a 10-day period. Both the pomegranate and NTZ significantly decreased the degree of cyst shedding, compared to placebo (Figure 3). By day 10 of the study, the pomegranate group showed complete resolution of cyst shedding. [83]
Additionally, pomegranate fruit peel has proven to be valuable in prevention and treatment of G. lamblia in animal models. For example, stool cyst counts have been shown to reduce by 75.6% after 20 days of treatment (assessed by a reduction in cyst shedding), with an overall cure rate of 97.4% by day 28. [84] The antiparasitic activity of pomegranate peel has also been displayed against B. hominis, [85]Entamoeba histolytica and Entamoeba invadens. [86]
Day 4 |
Day 6 |
Day 8 |
Day 10 |
|
|
Parasite load in the stool of rates of different studies groups (Mean ± SD) | ||||
Healthy group |
0 |
0 |
0 |
0 |
Infected untreated |
11.4±0.9 |
**15.25± 0.9 |
*** 18.25± 0.9 |
***23.6±1.4 |
|
Infected (+P. granatum) |
11.6±0.5 |
7.2±0.8 |
3.4±0.5 |
1.4±0.5 |
Infected (+NTZ) |
10.5±0.5 |
6.2±0.8 |
2.4±0.5 |
0.9±0.4 |
* P value <0.05, ** P value <0.001, ***P value <0.0001. | ||||
Figure 3: Effect of pomegranate peel on the blastocystis cyst's shedding intensity. [87]
P. granatum – pomegranate. NTZ – nitazoxanide.
Hymenolipes nana, dwarf tapeworm, is an intestinal worm that impacts humans, especially children, living in cosmopolitan regions of countries with temperate climates. Furthermore, an animal model has displayed pomegranate peel extract’s anthelmintic properties as noted with a reduction in the H. nana egg count per gram in the faeces over a 21-day period. [88]
The sesquiterpene lactone from sweet wormwood, artemisinin, is used throughout the world and well accepted by the scientific community at large for its ability to eradicate Plasmodium falciparum, the parasite responsible for malaria. Artemisinins also possess a wide range of constituents and mechanisms resulting in its antibacterial, antifungal, antiviral and antischistosomiatic properties, as elucidated in human clinical, in vivo and in vitro studies. Some of the infections impacted by the artemisinins are:
- Anti-parasitic – Trypanosoma, Toxoplama gondii; Giardia spp., [89] and trematodes (flukes); [90]
- Antischistosomiasis – S. japonicum, S. mansoni, S haematobium, S. mekongi and S. intercalatum. [91]
In addition, nigella has been shown to have an inhibitory effect on B. hominis in both in vitro and in vivo models. [92] Juglans nigra, commonly known as Black Walnut has been used for hundreds of years in traditional western herbal medicine as an anthelmintic, to expel intestinal worms. [93]
Fungal Overgrowth
Punicalagin, an ellagitannin found in pomegranate, has been shown to negatively influence the two stages of fungal growth, the conidial and hyphal stages. Though the exact mechanism remains unclear, in vitro studies highlight its ability to reduce the replication of a range of fungi, including C. albicans and the dermatophytes, Trichophyton mentagrophytes, Trichophyton rubrum, Microsporum canis and Microsporum gypseum. [94]
Further research has supported pomegranate’s anti-candida properties, this time comparing the effectiveness of pomegranate, clotrimazole, a commonly prescribed antifungal medication, and ethanol in 60 saliva samples from individuals presenting with oral candidiasis. The authors concluded that not only was pomegranate’s minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) [†] similar to clotrimazole, thereby proving to be equally beneficial (Figure 4), but that pomegranate should be considered a substitute to avoid clotrimazole’s unfavourable side effects. [95]
Peppermint oil has also shown strong biofilm reducing effects, as seen in a study comparing the anti-biofilm effects of 30 essential oils and a commonly prescribed azole antifungal medication against the biofilm forming Candida spp, CA 1. Peppermint oil showed results comparable to the pharmaceutical, highlighting the fungistatic, fungicidal and anti-biofilm potential.[96]
Figure 4: Comparable inhibitory efficacy of pomegranate, clotrimazole against Candida spp. [97]
In addition, nigella has displayed activity against a range of pathogenic yeasts, dermatophytes, nondermatophytic filamentous fungi and aflatoxin-producing fungi in both in vitro and in vivo studies. This includes Candida spp., Trichophyton spp. and Aspergillus spp. [98]
Sweet wormwood also shows antifungal properties with in vivo and in vitro studies highlighting the benefits in the eradication of Cryptococcus neoformans, Aspergillus funigatus and Candida spp. [99]
Bacteria and Viruses
It is thought that myrrh resins may have been used in embalming practices due to its fungicidal and bactericidal activity. Sesquiterpene subfractions of myrrh resin have shown antibacterial and antifungal activity against a number of common pathogens including E. coli, S. aureus, C. albicans and Pseudomonas aeruginosa in in vitro studies.
The antibacterial potential of myrrh, alongside neem, licorice and chlorhexidine (CTX), an antimicrobial solution used for oral health, was studied looking specifically at the ability to reduce the levels of the bacteria Enterococcus faecalis. Using real-time polymerase chain reaction (PCR) analysis, myrrh and CTX showed comparable antibacterial effects, with no statistically significant difference in the results. Notably, both showed superiority to neem and licorice (Figure 5). [100]
Groups |
% Reduction in bacterial load compared to saline |
Myrrh |
73.8% |
2% CTX |
73.7% |
Neem |
33.9% |
Liquorice |
20.1% |
Figure 5: Comparison of antibacterial effects of myrrh, neem, liquorice and chlorhexidine in the eradication of Enterococcus faecalis. [101]
CTX – chlorhexidine
Helicobacter pylori, the spiral-shaped bacteria that is linked with a range of digestive issues, is increasing its resistance to antibiotics, [102] instigating the need to assess alternatives for its eradication. Nigella has been shown to possess anti-helicobacter activity in vitro, as well as in a comparative trial of 88 participants with non-ulcer dyspepsia. Four trial groups were formed to assess the effects of one, two or three grams of nigella combined with 40 mg of the proton pump inhibitor (PPI), omeprazole, and the standard antibiotic triple therapy (clarithromycin, amoxicillin, and omeprazole) for a four-week period. H. pylori stool antigen levels were used to detect the rate of eradication. Two grams of nigella and omeprazole created statistically comparative results to the triple therapy regime – 66.7% compared to 82.6% respectively (Figure 6). Moreover, participants in all groups reported a reduction in both epigastric pain and reflux symptoms at the end of the trial (p<0.001). [103]
In vitro studies have shown the independent impact of nigella on Staphylococcus spp, P. aeruginosa, and E. coli, as well as highlighting its ability to offer synergistic support to antibacterials such as streptomycin and gentamicine, and additive antibacterial actions with agents such as doxycycline and erythromycin. It is further suggested that antibiotics could potentiate the activity of thymoquinone (TQ), a key constituent in nigella, in the treatment of S. aureus. A range of in vivo studies further support the antibacterial and antiviral activities of nigella, particularly against S. aureus, E. coli, S. mansoni, and Streptococcus spp. [104]
Additionally, peppermint oil has proven effective in the eradication of Clostridum difficile, a gram-positive bacteria linked with episodes of diarrhoea originating from hospitals, nursing homes and also antibiotic-associated diarrhoea. In an Australian based in vitro study, 20 natural products, including raw and processed preparations, were assessed for their impact on C. difficile. Peppermint oil and menthol proved to be both inhibitory and bactericidal and superior to the majority of products. [105] It is thought this is due to the essential oils being able to penetrate microbial membranes due to their hydrophobic disposition. [106]
Additionally, peppermint oil’s antibacterial effects have been shown against a range of bacteria including H. pylori, S. aureus, E. coli, Salmonella enteritidis and Listeria monocytogenes. [107] When compared to chlorhexidine, an anti-infective antiseptic used to sterilise medical instruments and hands presurgery, peppermint oil has been shown to possess stronger antimicrobial and antibiofilm properties against the gram-positive bacteria Streptococcus mutans and Streptococcus pyrogens. [108]
Sweet wormwood has displayed antiviral effects against cytomegalovirus, herpes simplex 1, human herpes 6, Epstein Barr virus and hepatitis B and C in both in vitro and in vivo studies. [109]
Part of a Clinical Detoxification Program
A detoxification program will often involve gut pathogen elimination and the restoration of intestinal health. A combination of antimicrobial herbs designed to rid the body of a broad range of detrimental organisms in the gut including bacteria, yeasts, fungi, intestinal worms and parasites will address dysbiosis, a key focus of many clinical detoxification programs.
Figure 6: Comparison of H. pylori stool antigen test results after 4 weeks treatment with varying amounts of nigella and omeprazole or triple therapy.
Table 2: Summary of presented evidence highlighting the impact of a range of antimicrobial herbs
Microbe |
Study Design |
Outcome |
ANTIPARASITIC | ||
|
Schistosoma (worm) (Sheir 2001, Abo-Madyan 2004) |
Clinical trial; 10 g/kg/BW of Myrrh daily |
90.7% of 204 participants showed complete improvement of symptoms. Retreatment of non-responsive same dose for 6 days led 98% improvement rate. Six-month post-trial biopsy of 20 people noted all were clear of living ova. |
Open label human trial; 600 mg/d of Myrrh |
Cure rate for S. haematobium was 97.4% and S. mansoni was 96.2%. |
|
Fascioloa (worm) (Abo-Madyan 2004) |
Summary of human evidence; 10 mg/kg/BW of Myrrh or 600 mg /d |
One neutral trial and 6 positive. Cure rates range from 88.2% - 100%. Majority of evidence suggests the complete eradication or marked decrease in egg count. |
Cryptosporidium spp. (Braun and Cohen 2013) |
60 Children;10 g/kg of Myrrh daily |
Assessment at weeks one, two, three and four showed a reduction in cryptosporidium oocyst[‡] numbers, along with the reduction in a range of digestive symptoms, after four weeks. |
Giardia lambila (Fathy 2011, Al-Megrin 2017) |
Animal; 300 mg purified Myrrh resin daily |
100% reduction in giardia load, both intestinally and within the faeces. |
Animal; 300 mg/kg/BW Pomegranate peel extract daily |
Prevention rate of 50% by day 10 post infection. 75.6% cyst shedding by day 20. Cure rate of 97.4% by day 28. |
|
Blastocystis hominis (Abdel-Haffez 2016_ |
Animal; 3 g/kg/Pomegranate |
Complete resolution of B. hominis cyst shedding at the end of 10-day trial. |
ANTIFUNGAL | ||
|
Candida spp (Madugula 2017, Shokri 2016, Agaral 2008) |
In vitro; Pomegranate |
Pomegranate’s minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) similar to the antifungal, clotrimazole. |
In vitro and in vivo; Nigella |
Activity against a range of yeasts, dermatophytes, nondermatophytic filamentous fungi and aflatoxin-producing fungi. |
|
In vitro; Peppermint oil |
Peppermint oil showed results comparable to the pharmaceutical highlighting the fungistatic, fungicidal and anti-biofilm potential. |
|
ANTIBACTERIAL / ANTIVIRAL | ||
Enterococcus faecalis (Anand 2016) |
In vitro; Myrrh |
Myrrh showed comparable effects to chlorhexidine, an antimicrobial solution used for oral health. |
Staphylococcus aureus (Xu 2017) |
In vitro; Pomegranate |
Significant increase in cell death and more than 90% inhibition of biofilm formation. |
Helicobacter pylori (Salem 2010) |
Comparative trial; 88 participants; Nigella |
2g nigella, alongside omeprazole, yielded results comparable to triple therapy. |
Staphylococcus spp, Pseudomonas aeruginosa, and Escherichia coli (Forousanfar 2014) |
In vitro; Nigella |
Independent impact and synergistic and/or additive support of a number of antibacterials. |
Clostridum difficile (Nazzaro 2013) |
In vitro; Peppermint oil |
Inhibitory and bactericidal. |
Streptococcus mutans and Streptococcus pyrogens. (Braun and Cohen 2013) |
In vitro; Peppermint oil |
Strong antimicrobial and antibiofilm properties, when compared to chlorhexidine, an anti-infective antiseptic. |
Cytomegalovirus, herpes simplex 1, human herpes 6 and Epstein Barr virus and hepatitis B and C. (Pandey 2016) |
In vivo; Sweet wormwood |
Antiviral impact against a range of virus. |
Safety Information
Disclaimer: In the interest of supporting health Practitioners, all safety information provided at the time of publishing (Oct 2025) has been checked against authoritative sources. Please note that not all interactions have been listed.
For further information on specific interactions with health conditions and medications, refer to clinical support on 1800 777 648(AU), 0508 227 744(NZ) or via email, anz_clinicalsupport@metagenics.com, or via Live Chat www.metagenics.com.au, www.metagenics.co.nz
Prescribing Tips and Notes
-
Long term use: Duration of use should be guided by a health care practitioner due to the uncertain impact of antiparasitic/antimicrobial herbs on the gut microbiome. Be guided by patients' development or resolution of symptoms.
- Consider breaks every 6-8 weeks for 2 weeks of appropriate strain-specific probiotic therapy
Pregnancy:
- Do not use if pregnant or if likely to become pregnant as Myrrh and Black Walnut are likely unsafe during pregnancy.
Breastfeeding
- Not recommended as Black Walnut is possibly unsafe in breastfeeding.
Contraindicated
- Allergies and Sensitivities: Avoid in individuals with known allergy or hypersensitivity to nigella (Ranunculaceae family), myrrh, pomegranate, sweet wormwood and/or members of the Asteraceae/Compositae family.
- Gallbladder obstruction, gallstones and cholecystitis: Peppermint oil is contraindicated in patients with gallbladder obstruction, and it is recommended to only use after consultation with a physician if patients have gallstones.
- Liver disease and hepatic disorders: Peppermint oil is contraindicated in patients with severe liver disease. This is likely due to the content of pulegone in peppermint oil, and is less likely to be a concern where pulegone content is reduced. The amount of pulegone present in this combination is low, therefore use with caution and monitor patient.
Cautions
- Antidiabetic drugs: Theoretically, Myrrh might increase the risk of hypoglycaemia when taken with antidiabetic drugs.
- Antihypertensive medications: Theoretically, taking Pomegranate with antihypertensive drugs, including ACE inhibitors, might increase the risk of hypotension and drug side effects.
- Cyclosporine (Immunosuppressant): Theoretically, Peppermint oil might increase the levels and adverse effects of cyclosporine.
- Cytochrome P450 (CYP) CYP2B6, CYP2C9, CYP2D6 and/or CYP3A4 substrates: Theoretically, Peppermint, Pomegranate and/or Sweet Wormwood might increase the levels of drugs metabolised by these enzymes.
- Hepatotoxic drugs: Theoretically, Sweet Wormwood may adversely affect the liver and may lead to additive adverse hepatotoxic effects.
- Warfarin: Theoretically, Myrrh and Pomegranate might decrease the effectiveness of warfarin
References
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