Home' Australian Pharmacist : Australian Pharmacist February 2012 Contents 134 Australian Pharmacist February 2012 I ©Pharmaceutical Society of Australia Ltd.
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The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
Black walnuts differ from their close
relative the English walnut (Juglans regia)25
and can contain high levels of serotonin
which may affect the results of urinary
5-hydroxyindoleacetic acid analysis (black
walnuts [304 μg/g +/- 46] vs. English
walnuts [87 μg/g +/- 20]).26 Although the
black walnut extract (BWE) model is used
to induce laminitis in horses it is only the
heartwood of the tree that exerts this
effect.27 Given the prevalence of treenut
allergies those at risk should also avoid
In a randomised placebo-controlled trial in
Nigeria, 20 mL of a liquid preparation made
from the seeds of the tropical fruit Carica
papaya (papaya, pawpaw) was given to
children with stool microscopic evidence
of intestinal parasites. Stool clearance rates
after seven days were significantly higher in
the papaya group (76.7% vs. 16.7%, p<.001).
No harmful effects were reported.28
Mirazid is a patented preparation of
Commiphora molmol (myrrh) that appears to
be effective against the intestinal fluke (a flat
worm) known as Heterophyes heterophyes.29
It is also registered in Egypt for the
treatment of other fluke related conditions,
schistosomiasis and fascioliasis.30
Berberine containing herbs
Berberine is a plant alkaloid present in
medicinal herbs such as Hydrastis canadensis
(goldenseal), Berberis aquifolium (Oregon
grape), and Berberis vulgaris (barberry).
Berberine extracts have demonstrated
significant activity against a variety
of organisms including protozoa and
helminths.31 It is known to inhibit the
growth of the intestinal protozoan parasites
Entamoeba histolytica, and Giardia lamblia
and is also effective against other protozoa
including Trichomonas vaginalis 32,33 and
Plasmodium falciparum, one of the species
of Plasmodium that causes malaria.34
Berberine has also demonstrated strong
nematocidal activities against Toxocara canis
While studies have been conducted
on the use of herbal medicines in the
treatment of parasites that affect other
animal species, as well as parasites that
affect sites other than the intestines in
humans, clinical studies demonstrating
direct effects against parasites that reside
in the human gastrointestinal tract are
extremely limited. Currently garlic and
Chinese wormwood show some potential
for use and, along with other herbs (such
as black walnut, papaya seed, myrrh and
berberine containing herbs), deserve
further research into their efficacy
Key learning points
• There is preliminary evidence
suggesting that garlic and Chinese
wormwood may warrant a therapeutic
trial in patients unable (or reluctant) to
take, or who are resistant to standard
• Effective doses have yet to be
established and safety data for herbs
such as Chinese wormwood is limited.
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medicines for gastrointestinal disorders among the main tribes
of Sonora, Mexico. Fitoterapia 2008;79(2):132--41.
2. Mwale M, Masika PJ. Ethno-veterinary control of parasites,
management and role of village chickens in rural households
of Centane district in the Eastern Cape, South Africa. Trop Anim
Health Prod 2009;41(8):1685--93.
3. Huffman MA. Animal self-medication and ethno-medicine:
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4. Waterman C, Smith RA, Pontiggia L. Anthelmintic screening
of Sub-Saharan African plants used in traditional medicine. J
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aqueous garlic (Allium sativum) extract in hymenolepiasis nana
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the morphological changes to male worms of Schistosoma
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13. Krishna S, Bustamante L, Haynes RK, Staines HM. Artemisinins:
their growing importance in medicine. Trends Pharmacol Sci
14. Li Y, Wu YL. How Chinese scientists discovered qinghaosu
(artemisinin) and developed its derivatives? What are the future
perspectives? Med Trop (Mars) 1998;58(3 Suppl):9--12.
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its derivatives as antimalarial and antitumor agents. Curr Med
16. Ferreira JF, Luthria DL, Sasaki T, Heyerick A. Flavonoids from
Artemisia annua L. as antioxidants and their potential synergism
with artemisinin against malaria and cancer. Molecules
17. de Oliveira TC, Silva DA, Rostkowska C, Bela SR, Ferro EA, Magalhaes
PM, et al. Toxoplasma gondii: effects of Artemisia annua L. on
susceptibility to infection in experimental models in vitro and in
vivo. Exp Parasitol 2009;122(3):233--41.
18. Ferreira JF, Peaden P, Keiser J. In vitro trematocidal effects of crude
alcoholic extracts of Artemisia annua, A. absinthium, Asimina
triloba, and Fumaria officinalis. Parasitol Res 2011;109(6):1585--92.
19. Yildiz K, Basalan M, Duru O, Gokpinar S. Antiparasitic efficiency of
Artemisia absinthium on Toxocara cati in naturally infected cats.
Turkiye Parazitol Derg 2011;35(1):10--4.
20. Sweet annie (Artemisia annua). Natural Standard: the authority on
integrative medicine [database on the Internet]. Available from:
www.naturalstandard.com. Cambridge, MA: Natural Standard,
21. CDC. Hepatitis Temporally Associated with an Herbal Supplement
Containing Artemisinin: Washington, 2008. Morbidity and
Mortality Weekly Report 2009 58(31):854--56.
22. Lans C, Turner N, Khan T, Brauer G. Ethnoveterinary medicines used
to treat endoparasites and stomach problems in pigs and pets in
British Columbia, Canada. Vet Parasitol 2007;148(3-4):325--40.
23. Clark HR. The Cure for all Diseases. San Diego, CA: New Century
24. Inbaraj JJ, Chignell CF. Cytotoxic action of juglone and plumbagin:
a mechanistic study using HaCaT keratinocytes. Chem Res Toxicol
25. Fitschen PJ, Rolfhus KR, Winfrey MR, Allen BK, Manzy M, Maher MA.
Cardiovascular effects of consumption of black versus english
walnuts. J Med Food 2011;14(9):890--8.
26. Feldman JM, Lee EM. Serotonin content of foods: effect on
urinary excretion of 5-hydroxyindoleacetic acid. Am J Clin Nutr
27. Belknap JK. Black walnut extract: an inflammatory model. Vet Clin
North Am Equine Pract 2010;26(1):95--101.
28. Okeniyi JA, Ogunlesi TA, Oyelami OA, Adeyemi LA. Effectiveness of
dried Carica papaya seeds against human intestinal parasitosis: a
pilot study. J Med Food 2007;10(1):194--6.
29. Massoud AM, El-Shazly AM, Morsy TA. Mirazid (Commiphora
molmol) in treatment of human heterophyiasis. J Egypt Soc
30. Yakoot M. A short review of the anthelmintic role of Mirazid. Arq
31. Berberine. Altern Med Rev 2000;5(2):175--7.
32. Kaneda Y, Torii M, Tanaka T, Aikawa M. In vitro effects of berberine
sulphate on the growth and structure of Entamoeba histolytica,
Giardia lamblia and Trichomonas vaginalis. Ann Trop Med Parasitol
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the growth of anaerobic protozoa in axenic culture. Tokai J Exp
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34. Sriwilaijareon N, Petmitr S, Mutirangura A, Ponglikitmongkol M,
Wilairat P. Stage specificity of Plasmodium falciparum telomerase
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35. Satou T, Akao N, Matsuhashi R, Koike K, Fujita K, Nikaido T.
Inhibitory effect of isoquinoline alkaloids on movement
of second-stage larvae of Toxocara canis. Biol Pharm Bull
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