If you want to take borage oil, find a qualified herbalist, naturopath, or physician to supervise you. It’s not a good do-it-yourself herb.
Borage oil may cause loose stools and/or stomach upset.167 If you experience stomach upset, discontinue taking borage oil immediately. Stomach upset is an early symptom of pyrrolizidine alkaloids poisoning. The disease, however, can be doing damage before any symptoms manifest themselves.168
People with liver problems should not take borage oil.169 Even healthy people should not take it in conjunction with any other herb or drug known to affect liver function. (See Chapter 5 for a list.)
Pregnant women and nursing mothers should avoid using borage oil supplements.170
Those with seizure disorders should avoid using borage oil.171 Those taking phenothiazine drugs are at increased seizure risk if they take borage concurrently.172
Furthermore, high doses (24 g per day) of borage oil can increase spontaneous clotting of the blood.173 If you plan to have surgery, tell your surgeon you have been taking borage oil and discontinue use.
Bromelain
Scientific name: Sulphydryl proteolytic enzyme, cysteine-proteinase
Commercially prepared bromelain tablets
Bromelain is an enzyme obtained from pineapple. Though bromelain can be derived from both the fruit and the stem, most commercial preparations come from the stem.
Bromelain, discovered in 1957, is not strictly an herb, but rather is an enzyme. A treatment for bruises and inflammation, it works by breaking down fibrin, a blood clotting protein. Once the protein is broken down, circulation increases and tissues drain better. Bromelain is also an anti-inflammatory agent.174
What is it good for?
Bruises to skin and muscle (the attendant pain and inflammation). The most carefully controlled study was one conducted on rabbits. When bromelain was applied to a skeletal muscle and then the muscle was injured, the bromelain helped protect the muscle (as compared to similarly injured rabbits not treated with bromelain).175 The human studies so far also show promise. In a small human study that used bromelain to treat blunt injuries to muscles, subjects receiving bromelain in addition to standard care by an orthopedist had a significant reduction in swelling, tenderness, and pain at rest and during movement as compared with those who just received standard care.176 In another study of boxers, bruises healed significantly quicker in those who took bromelain.177 Test-tube studies have found that bromelain contains anti-inflammatory properties, which may explain these results.178
Reducing joint pain, especially knee pain. Bromelain has shown some anti-inflammatory and analgesic properties in a small study. Researchers put otherwise healthy subjects, who were experiencing mild yet acute knee pain (less than three months’ duration) on 200–400 mg of bromelain per day. At the higher dose, subjects experienced a reduction in overall symptoms, including stiffness, and had improved function.179
Arthritis. Studies investigating bromelain as a treatment for the symptoms of osteoarthritis have been promising. A least ten preliminary studies have been conducted investigating its use for treating pain and stiffness of arthritis. Though not unequivocal, evidence is strong that it can be useful.180
Repairing ligament and tendon damage. A German study, conducted in 1995 gave bromelain to people with torn ligaments. After one to three weeks of taking the supplements, swelling, tenderness and pain were comparable to people taking NSAIDs such as aspirin.181
Asthma and allergies. Preliminary studies show that bromelain may help reduce the symptoms of asthma and allergic airway disorders.182
Delayed onset muscle soreness. Bromelain’s benefits seem to be limited to pain and swelling due to injury (either accidental or surgical). Studies into delayed onset muscle soreness (in other words, muscle soreness not resulting from injury but from strenuous exercise) show mixed results. One found no help from either bromelain or ibuprofen.183 Another found some help from protease tablets containing bromelain and other ingredients, but it is not clear that the benefit came from bromelain and not from another one of the ingredients.184
How do you use it?
Bromelain comes in commercially prepared tablets or capsules. Bromelain can be used after trauma to aid healing. If, however, you anticipate a particularly grueling tournament or other event, you can also begin to take bromelain 72 hours before the event and it will help mitigate trauma. Take bromelain on an empty stomach.185
Dosage: How much do you use?
It is difficult to tell how much of the active ingredient you are getting as compared to the bromelain used in studies. Standardized bromelain can be measured in any one of several methods. The most common are GDUs (gelatin dissolving units) or MCUs (milk clotting units). One GDU equals approximately 1.5 MCU.186 Bromelain can, however, also be standardized to FIP units, Bromelain Tyrosine Units, or Rorer units.
A dose of 3,000 MCU, three times per day for several days, followed by 2,000 MCU three times per day is about the highest dose found in the literature.187 Most of the studies used smaller amounts, roughly 500 MCU taken four times per day.188 Doses above 460 mg can begin to cause troubling side effects (increased heart rate, heart palpitations, and raised blood pressure) in some people.189
What should you be aware of before using it?
Bromelain is thought to have fairly low toxicity. Studies where high doses were given daily to dogs showed no ill effects after six months.190
Bromelain is a natural blood thinner in that it prevents platelets from sticking together.191 Don’t take bromelain if you are taking anticoagulants. In other words, choose between bromelain and aspirin or ibuprofen; don’t take them both together. If you plan to have surgery, tell your surgeon you have been taking bromelain and discontinue use. Be cautious when using it in conjunction with other herbs known or suspected of increasing the risk of bleeding. (See Chapter 5 for a list.)
Bromelain may interfere with the absorption of some antibiotics.192
Bromelain may compound the effects of some sedatives.193
Don’t take more than 460 mg per day if you have a history of heart palpitation.194
Be very conservative using it if you are prone to menorrhagia.
Occasionally gastric disturbances or diarrhea occur, especially with higher dose. If you have an ulcer or gastritis, check with your doctor before taking bromelain.195
Allergic reactions are possible,196 but they are more common when the bromelain powder is inhaled than they are when it is taken orally. Be especially cautious if you are allergic to pineapple, horseradish, or olive tree pollen.197
Calendula
Scientific name: Calendula officinalis
Also