APPENDIX IV CONTRAINDICATIONS TABLE

There is not always consistency across phytotherapy texts as to which herbs are contraindicated or best avoided for particular health conditions. The BHP, Potters’ and Martindale for example record fewer contraindications than either German Commission E or the BHC. The same source may have been used by several authors for contraindication information often without an apparent reason.

Warnings may be based on the theoretical action(s) of a herb, or on the activity of its constituent(s) e.g. some contraindications for Ephedra are the same as those for ephedrine which only constitutes a small percentage of the whole herb (Martindale). Some are based on the view that no herb should be used in children, pregnancy or lactation until they are proved to be safe. Tradition is based on empirical use over many decades but may have failed to note contraindications for lack of stringent monitoring. The contraindications of a herb is therefore likely to change as new information emerges requiring additional caution or removing a previously held one.

I have included contraindications with their source (if available) and/or possible reasons for inclusion, although some appear to be unnecessary or over-stated. It is nonetheless the object of the medical herbalist to practice safely and it is therefore prudent to err on the side of caution until further evidence emerges to clarify these inconsistencies.

Pregnancy

Botanical Name	Common Name	Sources—Reason if Given
Anemone pulsatilla	pasque flower	BHC—protoanemonin causes abortion/teratogenic effects in livestock
Aloe barbadensis	aloe latex	BHC
Apium graveolens	celery seed	BHC
Arctostaphylos uva-ursi	bearberry	BHC, GCE
Barosma betulina	buchu	BHC
Berberis vulgaris	barberry	BHP (in early pregnancy), PNC, BHC
Cassia spp.	senna	BHC—recommends used only under medical supervision
Caulophyllum thalictroides	blue cohosh	recent anecdotal reports, even though PNC and BHP recommend for threatened miscarriage—see monograph
Cinchona spp.	cinchona	BHP, PNC—oxytocic (quinine) in large doses
Cytisus scoparius	broom	BHP, Mart, PNC—oxytocic (sparteine)
Fucus vesiculosus	bladderwrack	BHC
Fumaria officinalis	fumitory	BHC
Glycyrrhiza glabra	liquorice	BHC—no reason, avoid if prone to premature delivery (see monograph)
Hydrastis canadensis	golden seal	BHP, BHC
Inula helenium	elecampane	BHC
Juniperus communis	juniper	BHP, PNC, Mart—uterine stimulant
Leonurus cardiaca	motherwort	BHC—note BHP recommends for false labour pains!
Panax ginseng	Korean ginseng	BHC
Piscidia erythrina	Jamaica dogwood	BHC
Rhamnus purshiana	cascara	BHC
Rheum spp.	rhubarb	BHC
Ruta graveolens	rue	PNC—uterine stimulant
Salvia officinalis	sage	GCE
Tanacetum parthenium	feverfew	BHC
Tanacetum vulgare	tansy	BHP, PNC—an emmenagogue, thujone causes uterine contractions
Thuja occidentalis	thuja	BHP, PNC—an emmenagogue, thujone causes uterine contractions
Zanthoxylum spp.	prickly ash	BHC

Lactation

Stimulating laxative* use has been contraindicated in the past for lactating women and this may account for their appearance in this list but research has shown the levels of this type of herb that is secreted in breast milk is too low to affect the baby—see under relevant monograph.

Botanical Name	Common Name	Sources—Reason if Given
Aloe barbadensis*	aloe latex	BHC
Anemone pulsatilla	pasque flower	BHC
Arctostaphylos uva-ursi	bearberry	GCE
Cassia spp.*	senna	BHC—recommends used only under medical supervision
Fucus vesiculosus	bladderwrack	BHC
Inula helenium	elecampane	BHC
Rhamnus purshiana*	cascara	BHC
Rheum spp.*	rhubarb	BHC
Salvia officinalis	sage	No source—however BHP recommends for galactorrhoea

General conditions