Herbs & Botanicals

Hello, RDs and RDs to be. Welcome to the RD Exam Ready Podcast. I'm Zak Kaesberg , your tutor, host, and coach to help guide you along the path of passing the RD exam. My biggest passion is helping RDs and RDs to be just like you understand this exam. And trust me, if you wanna know more, you are in the right place.

As an RD, your responsibility is to accurately assess your patient. It's the first step of ADIME. Me , you could assess me and I would tell you that going through a little bit of a cold today. So maybe that would be something you would note in the chart. Promise I haven't taken up smoking again. I am just having a little issues with working off this cold. So pardon my kind of raspy voice today a little bit. A proper assessment of your patient requires that you fully know their dietary needs, their intake, their cultural influence, and the alternative forms of nutrition that they are taking in. This could be things like herbs, botanicals, and supplements. And that piece of herbs and botanicals is what I would like to spend time on with you today.

I know it makes it sound like every student struggles with every topic, but herbs and botanicals especially can be difficult. But why? Much of the information that you could be learning for the first time in your life could be things like herbs and botanicals. It's not every day that we're learning about herbs, using botanicals, talking about ginkgo, biloba, or goldenseal, or any of these things. You don't use them in your everyday life.

So as we go through each of these different herbs and botanicals, you need to walk away with a few points. One, know the name of this herb and botanical. Two, know what it claims to do or provide to those that consume it. And three, know the risks. Whether it's a physical change or a food drug interaction, you may need to know this for exam day to know each of these different botanicals.

As I go through these, I'm gonna really focus on the big players here. Sure. I can teach you about aloe vera and chamomile and how it helps a sunburn or helps me get sleepy. But if there isn't any nutrition, food, or drug interactions, I'm not too concerned about these things. Really focusing on the major players that we know can really impact what we eat and the medications that we take.

Black cohosh. Black cohosh comes from a root, and it makes me think of the black dahlia. Black cohosh is taken to relieve and ease symptoms of menopause. So when I think black dahlia, I think of a woman, and I think of a woman taking black cohosh in order to prevent those menopause symptoms. Black cohosh itself can have risks, and you need to know about them.

Those risks is they may have headaches, liver damage, and stomach pain that may result after taking them. That's an easy one. Right? How about this next one? Chaparral.

Chaparral is a plant known to grow in California. Might be the first time you're hearing of it. Chaparral c and c California. Well, what's California known for? It's known for LA, for Hollywood, growing great produce, good weather, and probably some good looking people too.

And let's remember this. Chaparral, which grows in California, is used by people to prevent aging, cleanse your blood, and cure diseases. Sounds pretty Hollywood if you ask me. The issue is that Chaparral can cause acute and toxic hepatitis and liver damage. Remember, your liver is processing much of these agents, so it makes sense as how the liver is being put at risk when we take excess amounts of them, like Chaparral, which is seen in California.

Comfrey is third one here. Comfrey makes you feel comfy. Comfrey is known to soothe your nerves, and much like the others, it can cause liver disease. You can think of comfrey and coronas, and think of alcohol liver disease, which you can get after drinking too many coronas. But the action that it does is comfrey helps make you feel nice and comfy, and soothe up those nerves.

Sounds pretty nice to me if you ask me. Echinacea, which I believe that's how you say it. Echinacea is used for immunity. Echinacea, I want you to think of ecky or icky. Because I want you to think of being sick like I am right now, and take it to improve your immunity.

Your immunity is things like colds, flus, infections, etcetera. It's generally pretty safe, but echinacea can cause things like headaches, dizziness, and nausea. It's also known to decrease the effectiveness of some medications, specifically immunosuppressants like corticosteroids, which are used to kind of suppress the immune system or control it. It can interact with these drugs and decrease their effectiveness. Not good.

Ephedra. Ephedra is an urban botanical that helps to promote weight loss. You can't get ephedra anymore. It's been banned from sale from the FDA. Since you know it promotes weight loss, what you can imagine is it does have a stimulating effect on the body.

It contributes to these risks based on the stimulating effect. The risk that you're gonna see with this is that you're gonna see a rapid heart rate and increased energy. Now when your heart rate is too rapid, you can have things like tremors, seizures, insomnia, headaches, and hypertension, or just hyperactivity. And this is all things that would fit with any type of high stimulant of any kind like ephedra is known for. Fever few.

Fever few leaves are known to prevent migraine headaches. Think fever, think headaches, and think of fever few as less headaches. Feverfew. They're generally considered safe, but things that feverfew may cause could be mouth irritation, ulcers, and some GI distress. But other than that, it's generally considered safe, and I don't see any noted medications here.

We're gonna start and get into the four g's of clotting for herbs and botanicals. Hopefully, you've heard these four g's before, but let's introduce them so you know them each by each. Garlic. You know garlic, its bulbs, but you may not know what garlic claims to do. Garlic can actually lower your blood lipids and your blood pressure.

There's some evidence that it can do so. We add it to food all the time, right? So yes, garlic is generally considered safe, but there are gonna be some moments that you might have caution with excess use. Garlic can cause excessive odor. We know it can have some bad body odor.

You can have some gas as a result. You may have some garlic breath as a result of eating it. And we know it as being one of the four g's as they interact with blood clotting medications. Specifically these four Gs, what they do is they thin your blood out. Okay?

They thin you out. If you're taking an anti clotting medication known as warfarin or Coumadin, what happens is we're kind of doubling up on this blood thinning ability. The warfarin in Coumadin is trying to thin your blood out, and then the garlic you're eating is also thinning your blood. So this can lead to hemorrhage and excessive bleeding by taking garlic. That's gonna be your major nutritive concern with it.

One of our other four g's is ginger or ginger root. And gosh, it is a very tasty root. Ginger is used for nausea and motion sickness. It's supposed to just help settle your stomach a bit in my eyes. It is safe generally, but I will have interactions with drug warfarin or drug coumadin as a result.

So what it will do is it's gonna just like garlic, it's gonna thin out your blood, and then what it's gonna do is it's gonna counteract or double up on those effects, I should say. So we need to have caution with taking ginger. It's one of the four g's, and it may cause some further bleeding throughout the body. Ginkgo biloba is so fun to say. Just ginkgo.

I wanna say it all today. Ginkgo is known to improve memory, possibly relieving vertigo. It is generally safe, but it does cause some issues like headaches, GI distress, and some dizziness. A big point you need to know for exam day is, of course, it's the third of the four g's here, is it's going to have a blood thinning effect. Meaning, it's not gonna work well with Coumadin and Warfarin, those anticoagulant medications.

Since it can thin your blood, it can cause some prolonged bleeding, as well as it's just going to of counteract those effects a little bit. You can tell I'm working off the cold here based on how my brain is working here. Our last of the four g's is ginseng. Ginseng is known for its ability to boost boost immunity and increase your endurance. As a four g of clotting, we know it's gonna fit in much with the other three there, and we have to have caution when we're taking Coumadin or warfarin.

To add to this, if you're taking estrogens, corticosteroids, this drug or this herb or botanical can enhance the hormonal response of those drugs. So estrogen, corticosteroids, they get really increased as a result of taking ginseng in that case. This can be bad. We don't want medications to do too much in that case, so we want to have that concern. So to summarize, we need to make sure we use caution with ginseng, with cardiac medications, metformin, some of our kind of different, like, estrogens, corticosteroids, as well as Coumadin and warfarin for ginseng here.

Not one of the four g's next, but it does start with g. This is goldenseal. And goldenseal is known for relieving indigestion in treating UTIs. It has been known to interact with other medications and decrease its effectiveness. Per the National Institute of Health, pregnant and breastfeeding women should not use goldenseal as it has this byproduct of berberine, and this compound can be harmful to newborns.

So let's show lots of concerns when we're using goldenseal with pregnancy and breastfeeding. The next one is kava kava. Kava kava is a root to relieve anxiety and promote relaxation. People do take it for anxiety, and that's why it makes you kava. Very relaxing.

Right? It's well known for its interactions which can cause liver failure. Okay? So kava kava, very ah, very relaxing. But it may screw up your liver pretty bad.

So that is a caution you have to have with it. My other way of remembering this piece about the liver is just I remember that l, liver, and k, kava, are very are next to each other in the alphabet. So I always think of kava kava with the liver, just because they're right next to each other on the alphabet there. Okay. Saw palmetto.

We should think of palmetto, pee, and prostate. Saw palmetto relieves symptoms of an enlarged prostate, it acts as a diuretic, and it also helps with sex drive. I want you to think of these effects and relate it to any food drug interactions that may take place. For example, if palmetto helps with anxiety, we can expect it to interact with anxiety medications. So it may increase or decrease their effect.

Same with diuretics. If palmetto itself is a diuretic, well, then you should have caution if you're taking diuretics because you may now be taking too much. Another point I would make about palmetto is it does contain tannins. You remember those tannins a little bit? That phytochemical that can be found in different fruits, vegetables, wine, different things, teas.

Well, tannins are great, but one thing that they actually do is is they block absorption of a lot of things, specifically iron. So if you're taking saw palmetto and taking iron supplements, you are gonna see some inhibited absorption of iron because of that. Okay? So show caution when we're taking saw palmetto and also taking iron or iron supplements. Our next one is probably the biggest, most well known one, is Saint John's wart.

It's meant to relieve depression and anxiety. It can cause sensitivity to sunlight, GI distress, and fatigue. What it's really known for though, St. John's wart, is man, it really screws up all of your medications and their effectiveness. Firstly, it's a blood thinning effect.

So automatically, it can interact with anticoagulant medications exactly like the four g's. Secondly, it weakens the effects of many other medications and actually speeds their clearance out of the body. It may interact with antidepressants, contraception medication, cyclosporine, anticoagulants, anticonvulsants, heart meds, HIV meds, cancer meds, statins. You get the picture. St.

John's wart should not be used if we're taking a lot of medications because it's just gonna clear those out way too fast and reduce their effectiveness. Turmeric is a lovely one. I love to put it in foods, curries. I give it to my dogs a lot of the time. Because turmeric is known as a great anti inflammatory agent.

It's pretty safe to take. Of note, it does have a little bit of a blood thinning effect, so we need to just use a little bit of caution when we're taking warfarin or Coumadin because we don't want to lead to excessive bleeding just like Saint John's warts and the other four g's. It can cause some GI distress, especially on an empty stomach. And I know this personally. I used to go to the gym in the morning, and I'd take my multivitamins and turmeric as soon as I woke up.

By the time I was going to the gym, I was throwing up every time, and it was just orange and terrible. I know it's a bad picture, but you get the gist that turmeric does not do well on a very empty stomach. It can cause you to purge or have some GI distress there. So let's use caution. Valerian root.

Valerian is known to calm your nerves and help you sleep. V, valerian, should make you think of valuable sleep. Long term, if you take valerian root, you may experience some liver damage. So think valerian, think vodka, and think liver damage as all those things will fit together. Yohimbe.

Here's a tip. Yo him be. Him. Him. This is gonna clue you in as to what Yohimbe is used for.

It's used for erectile dysfunction. What it can cause is some increased blood pressure as well as kidney failure, seizures, and heart issues as related to Yohimbe. So, typically, it's used for erectile dysfunction. Think yo him. Him as in men in that case.

And then think of these effects like kidney failure, seizures, heart issues, and blood pressure issues. My last one I'll talk about is licorice. Licorice has long been used in candy, tobacco, and foods. It's promoted as a great dietary supplement for everything from digestion to respiration to energy support. With licorice, you can see some you can see it help out with things like stomach and mouth ulcers.

It can help out with those things. But one thing to note is is that licorice is a diuretic. It's gonna be kind of you know, cause that issue of helping you to urinate. So if you're taking diuretics, it's gonna be a little double up on that. It can interact with heart medications as well as it's known to to interact with corticosteroids too.

So with licorice, there is a couple food and drug interactions that I want you to make note of. Okay, r d to b. You've gotten all through all those herbs and botanicals. Now how do you apply it to a practice question? Let's see how we do.

As we approach each of these, we're gonna read through the question carefully, read through each answer before making our decision. We're gonna use our POE, our process of elimination, each time we apply to each question because what we're trying to do is put ourselves in the best position to get this question right. So use this effective strategy that I've used and many other students have used to pass the exam, and put yourself in the best position to get through this thing. Number one, a patient taking Coumadin and warfarin should avoid consuming too much of the following except. Okay.

So a patient taking Coumadin and warfarin should avoid taking too much of all of the following except. Okay. So based on this question, I'm looking for the one that does not interact with Coumadin and warfarin. Let's see our answers. A, garlic.

B. St. John's wort. C. Ginkgo.

Or D. Saw palmetto. A patient taking Coumadin and warfarin should avoid consuming too much of all of the following except. Alright. So which one of these is the one that does not interact with blood thinners?

That's what I need to answer here. So for a, garlic. I know that garlic is one of the four g's. It has a blood thinning effect, and it interacts with Coumadin and warfarin. So we're looking for the one that does not do this.

So I'm gonna get rid of a, garlic. It's one of my four g's of clotting, I need to get rid of that one. B, St. John's wort. This was also one that I learned about can cause this blood thinning effect and definitely can interact with all types of medications.

So based on that, St. John's wart is also eliminated for me. C, ginkgo or ginkgo biloba. Well, I feel like ginkgo is one of the four g's, so I wanna maybe kind of rule that out or put a question mark by it. Or D, saw palmetto.

Saw palmetto, P, prostate. Saw palmetto, I can't really remember much about it off the top. But what I have realized is that A, B, and C are all blood thinners. They all interact with Coumadin and warfarin. So that being said, if I only have D saw palmetto left as my best answer, then I'm going to choose that as my best answer, because I know the other three definitely cause interactions with coumadin and warfarin.

Number two. A patient may take excessive amounts of the herb ephedra in order to A, improve sex drive, B, lose weight, C, prevent headaches, or D, lower blood pressure. A patient may take excessive amounts of ephedra in order to I'm gonna write a, b, c, and d on my sheet here. For a, improve sex drive. I seem to remember Yohimbe being the one that really was focused on male sex drive.

I don't think this will be my best fit in this case. It just doesn't feel good to me. So I'm gonna rule out a in that case. B, lose weight. I think this is actually a good answer because ephedra was banned because it was so stimulating, it was causing people to lose weight, but have lots of other issues.

So I think lose weight is a great answer for this. C, prevent headaches. Well, if it's a stimulant, I think it would actually cause more headaches instead of prevent headaches. So I'm gonna rule out c, and d, lower blood pressure. I think ephedra would actually do the opposite as it has a stimulating effect.

I think it would increase my blood pressure instead of decreasing it. So I'm gonna rule that one out. I would say b, a patient may take excessive amounts of the herb ephedra in order to lose weight would be my best answer for number two. Alright, everyone. Number three.

The herb and botanical is known to: A. Promote weight loss. B. Improve digestion. C.

Soothe nerves. Or D. Control an enlarged prostate. The herb and botanical comfrey is known too. Let's go through each answer.

For promote weight loss. We just talked through ephedra and how it really promotes weight loss for that. I don't think comfrey is gonna be known for this. When I think comfrey, I think comfy. Right?

I think relaxing. I don't think it'll be A in this case because those don't fit too well together. B. Improved digestion. I don't know about that one.

I'm gonna put a question mark by B. I'm not a 100% sure. Maybe you are, but I just don't wanna rule it out yet if I don't really know what the best answer is quite yet. C, soothe nerves. Now I like answer C, because I know that comfrey makes me comfy, nice and relaxed, and so I think that would be a good answer to hold onto for C.

And D. Control an enlarged prostate. I would rule this one out. I don't remember prostate being talked about at all when it came to comfrey, so that one's out for me. If I was between B, improved digestion is questionable, and C, which I really liked as the answer, I'm gonna choose C as my best fit for the herb and botanical comfrey in this case.

Alright, RDs and RDs to be. That wraps up today's podcast today. Thank you for your patience. Thanks for sticking with me. Hopefully, the voice wasn't too hard to listen to along the way.

I hope you enjoyed today's lesson a lot. Remember, passing the exam is a journey. We all need assistance along the way. Do yourself, do me a favor, hit that subscribe button if you haven't, tell your other studying students if they want to learn more and get better at passing the exam, rate review, just help spread the word if you can. And remember, as always, happy studying RDTOB.