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Derived from the bulb or clove of the plant. Garlic is used as a spice and to treat hyperlipidemia, hypertension, atherosclerosis, cancer, and infections. Processing can have a substantial effect on the chemical content in garlic; the volatile oil components are sensitive to heat and certain enzymes are acid-labile. Several oral garlic formulations are available, and clinical studies have addressed a variety of the proposed claims. Placebo-controlled trials on the cholesterol lowering effect of garlic yielded mixed results (16) (17) (18) (21) (22) (26). Studies evaluating the antithrombotic effects repeatedly have shown modest reduction in platelet aggregation, but varying levels of fibrinolytic activity. Research shows mixed effects with regard to reductions in blood glucose, blood pressure, or risk of cardiovascular disease (23). Frequently reported adverse events include bad breath, headache, fatigue, GI upset, diarrhea, sweating, and possible hypoglycemia (9). Because garlic is known to decrease platelet aggregation and potentially elevate the INR, it should not be used with anticoagulants or in patients with platelet dysfunction (15). Garlic appears to induce cytochrome p450 3A4 and may enhance metabolism of many medications (e.g. cyclosporin and saquinavir) (12). An analysis of several case-control studies in Europe suggests an inverse association between garlic consumption and risk of common cancers (25).

A proprietary extract prepared from co-cultured mycelia of several species of Basidiomycete mushrooms, including shiitake (Lentinus edodes), active hexose correlated compound (AHCC) is extracted from mushrooms using hot water following an enzyme pretreatment, but specific mushroom source and preparation details have not been fully disclosed. Patients use this to prevent and treat cancer. Animal studies suggest that AHCC has antioxidant effects and may protect against disorders induced by oxidative stress (1) and may also enhance resistance against bacterial (2) (7)and viral infections (3). In healthy humans, AHCC increased dendritic cell number and function (4) In vitro and animal studies show that AHCC exhibits some anticancer activities, but the results of these studies are vague

Derived from the cap and stem of the mushroom, Reishi mushroom is used as an immune stimulant by patients with HIV or cancer. The active constituents are thought to include both beta-glucan polysaccharides and triterpenes (1). Extracts of Reishi can stimulate macrophages and alter the levels of TNF and interleukins (2) (3) (4) (5). Reishi also inhibited platelet aggregation (11) (12) and improved lower urinary tract symptoms (LUTS) in men (9) (10). Studies done in rats have shown that Reishi extract may alleviate chemotherapy-induced nausea (13). In clinical studies, Reishi increased plasma antioxidant capacity (6) (7)and enhanced immune responses in advance-stage cancer patients (8).

Derived from the cap and stem of the mushroom. The active constituent is thought to be a beta-glucan polysaccharide. The whole mushroom is used primarily as a dietary element, but extracts and supplements are sold as immune stimulants for patients with HIV or cancer. While no adverse effects have been reported, some studies reveal a hypoglycemic effect following administration of maitake extract (9) (12). Maitake was shown to enhance bone marrow colony formation, reduce doxorubicin toxicity in vitro (11), and to inhibit tumor metastasis

Shiitake mushroom, native to East Asia, is cultivated worldwide for its purported health benefits. The fresh and dried forms of the mushroom are commonly used in East Asian cooking. It is also valued as an anticancer agent. Lentinan (1,3 Beta-D-glucan), a polysaccharide isolated from Shiitake, has been well studied and is thought responsible for its beneficial effects. It was shown to have anticancer effects in colon cancer cells (1), which may be due to its ability to suppress cytochrome P450 1A enzymes that are known to metabolize pro-carcinogens to active forms

The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center was established in 1999 to complement mainstream medical care and address the emotional, social, and spiritual needs of patients and families. The Service includes: patient and outpatient clinical care research, and education and training. In addition, the Service provides unique access to otherwise unavailable information about over-the-counter products and unproven cancer treatments and their impact in the context of cancer care via our About Herbs database

"Derived from the root of the plant. This supplement is used in traditional Chinese medicine primarily for gastrointestinal complaints, diarrhea, hypertension, bacterial and viral infections. Berberine and berberine-like alkaloids are thought responsible for its activity (1). Laboratory studies indicate that berberine induces morphological changes and internucleosomal DNA fragmentation in hepatoma cancer cells (3). Preliminary data support the hypothesis that huanglian suppresses cyclin B1 protein and causes cell cycle arrest at G2 (5). Huanglian has potent antiangiogenesis activity (6). It also interacts with acetylcholine and muscarinic receptors and inhibits cholinesterase. Possible adverse effects include nausea and vomiting (1). Theoretically huanglian may have additive hypotensive effects with antihypertensive agents. A phase I dose escalation study of huanglian in solid tumors is currently underway at Memorial Sloan-Kettering Cancer Center based on"

ABOUT HERBS, BOTANICALS & OTHER PRODUCTS\n\nThis information resource, presented by our Integrative Medicine Service, provides evidence-based information about herbs, botanicals, supplements, and more.