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JK, Volunteer Mentor
@contentandwell

Posts: 1943
Joined: Feb 18, 2017

Herbals and teas

Posted by @contentandwell, Fri, Apr 20 9:49pm

I have had some difficulty finding a good reference on what herbals and teas us post-transplant patients should not use. I have found a few that are definitely taboo like echinacea and perhaps licorice root but there are others that I have seen in passing that I have not seen in other lists, like ginger, turmeric, cardamon. I have even seen green tea mentioned.

Does anyone have a fairly comprehensive list of these? If so I would really like to know what they are. I found something from MGH that was FOUR BOOKS of reference on this, about 800 pages in all, and only the first book was available online. This has been my one disappointment at Mass General, that they have not provided a list like this, but maybe other transplant centers have not either.
JK

REPLY

Hello @contentandwell, this is a great post. I have done a brief search myself, and the results are overwhelming. Have you tried searching on PubMeb? A lot of Mayo Clinic doctors publish research and most of them end up on PubMeb. Here is a link to the search results I found using "Herbal teas and transplant patients," https://www.ncbi.nlm.nih.gov/pubmed/?term=herbal+teas+and+transplant+patients. It may give you a few articles to look over, but I will continue to see if I can find more Mayo Clinic sources.

Hi @contentandwell@colleenyoung flagged your post for us wondering if we had access to any additional information within Mayo’s transplant center. Unfortunately, we couldn’t find a comprehensive list, but we did consult Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester. Here’s what she said: “Your question is a great one – and one that we do not have a quick or easy answer for. As you have found there is NOT a comprehensive list of herbals and teas to avoid post-transplant. This is partially because there is limited information regarding some of the herbals, partially because so many of these products contain multiple ingredients and partially because this market is ever changing – it literally could be a full-time job to keep a list like this up!

Here in our transplant center we advise patients to avoid herbal supplements and teas as an overall statement – however, if there are a few in particular that someone is interested in consuming, we will review the ingredients on a case-by-case or one-by-one basis. You are correct in your findings that Echinacea and licorice root teas would not be recommended. For the others you mentioned, I referenced the Natural Medicines Comprehensive Database (naturalmedicines.therapeuticresearch.com) that our institution subscribes to. Ginger is fine for transplant recipients– especially in the amounts we would normally consume in foods. Turmeric is also likely safe, however does list a side effect of possible constipation and there is a case report of very elevated tacrolimus levels in a post-transplant patient who had started taking 15 spoonfuls of turmeric powder on a daily basis – which we would describe as an excessive amount. We do not see this issue with patients who use turmeric in cooking. Cardamom has no known concerns so should be safe to consume, also. Green tea is a bit more complicated as there are several medications that may interact with green tea such as anticoagulants (Warfarin, Plavix etc.), some types of chemotherapy and Corgard. If you take any of these types of medications it is advisable to not take green tea. Otherwise, again, in normal amounts (not more than 3 caffeinated beverages per day) green tea should be fine to consume.”

Reminder, this is general information that could relate to any patient. For your particular case, we strongly suggest you consult your physician team before you consume any herbal or teas to be sure they are safe with your particular medications and illnesses.

I hope that helps!

@kequick @contentandwell @colleenyoung I'm so impressed – when I y'all do not have an answer you go the extra distance to find it. I just want to add another thought to why a list would be difficult. That is one size really does not fit all. I may have an intolerance or am downright allergic to an ingredient that you may need for overall health & of course vice versa

@kequick

Hi @contentandwell@colleenyoung flagged your post for us wondering if we had access to any additional information within Mayo’s transplant center. Unfortunately, we couldn’t find a comprehensive list, but we did consult Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester. Here’s what she said: “Your question is a great one – and one that we do not have a quick or easy answer for. As you have found there is NOT a comprehensive list of herbals and teas to avoid post-transplant. This is partially because there is limited information regarding some of the herbals, partially because so many of these products contain multiple ingredients and partially because this market is ever changing – it literally could be a full-time job to keep a list like this up!

Here in our transplant center we advise patients to avoid herbal supplements and teas as an overall statement – however, if there are a few in particular that someone is interested in consuming, we will review the ingredients on a case-by-case or one-by-one basis. You are correct in your findings that Echinacea and licorice root teas would not be recommended. For the others you mentioned, I referenced the Natural Medicines Comprehensive Database (naturalmedicines.therapeuticresearch.com) that our institution subscribes to. Ginger is fine for transplant recipients– especially in the amounts we would normally consume in foods. Turmeric is also likely safe, however does list a side effect of possible constipation and there is a case report of very elevated tacrolimus levels in a post-transplant patient who had started taking 15 spoonfuls of turmeric powder on a daily basis – which we would describe as an excessive amount. We do not see this issue with patients who use turmeric in cooking. Cardamom has no known concerns so should be safe to consume, also. Green tea is a bit more complicated as there are several medications that may interact with green tea such as anticoagulants (Warfarin, Plavix etc.), some types of chemotherapy and Corgard. If you take any of these types of medications it is advisable to not take green tea. Otherwise, again, in normal amounts (not more than 3 caffeinated beverages per day) green tea should be fine to consume.”

Reminder, this is general information that could relate to any patient. For your particular case, we strongly suggest you consult your physician team before you consume any herbal or teas to be sure they are safe with your particular medications and illnesses.

I hope that helps!

Jump to this post

@kequick I am really just interested in things that conflict with my immunosuppressant. I did ask the nurse coordinator who is the first line of communication but she really did not know much. She did connect me with a nutritionist/dietician type of person and I am pretty sure she said that green tea would be fine. I will try to find her communication and if I am wrong I will update this.
Thank you for your response.
JK

@beckyjohnson

@kequick @contentandwell @colleenyoung I'm so impressed – when I y'all do not have an answer you go the extra distance to find it. I just want to add another thought to why a list would be difficult. That is one size really does not fit all. I may have an intolerance or am downright allergic to an ingredient that you may need for overall health & of course vice versa

Jump to this post

@beckyjohnson what you say is true, but beyond individual allergies, I am just trying to make sure that I do not use anything that would be contraindicated with my immunosuppressants. That of course would apply to any of us on those pharmaceuticals.
JK

@kequick

Hi @contentandwell@colleenyoung flagged your post for us wondering if we had access to any additional information within Mayo’s transplant center. Unfortunately, we couldn’t find a comprehensive list, but we did consult Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester. Here’s what she said: “Your question is a great one – and one that we do not have a quick or easy answer for. As you have found there is NOT a comprehensive list of herbals and teas to avoid post-transplant. This is partially because there is limited information regarding some of the herbals, partially because so many of these products contain multiple ingredients and partially because this market is ever changing – it literally could be a full-time job to keep a list like this up!

Here in our transplant center we advise patients to avoid herbal supplements and teas as an overall statement – however, if there are a few in particular that someone is interested in consuming, we will review the ingredients on a case-by-case or one-by-one basis. You are correct in your findings that Echinacea and licorice root teas would not be recommended. For the others you mentioned, I referenced the Natural Medicines Comprehensive Database (naturalmedicines.therapeuticresearch.com) that our institution subscribes to. Ginger is fine for transplant recipients– especially in the amounts we would normally consume in foods. Turmeric is also likely safe, however does list a side effect of possible constipation and there is a case report of very elevated tacrolimus levels in a post-transplant patient who had started taking 15 spoonfuls of turmeric powder on a daily basis – which we would describe as an excessive amount. We do not see this issue with patients who use turmeric in cooking. Cardamom has no known concerns so should be safe to consume, also. Green tea is a bit more complicated as there are several medications that may interact with green tea such as anticoagulants (Warfarin, Plavix etc.), some types of chemotherapy and Corgard. If you take any of these types of medications it is advisable to not take green tea. Otherwise, again, in normal amounts (not more than 3 caffeinated beverages per day) green tea should be fine to consume.”

Reminder, this is general information that could relate to any patient. For your particular case, we strongly suggest you consult your physician team before you consume any herbal or teas to be sure they are safe with your particular medications and illnesses.

I hope that helps!

Jump to this post

I’m post transplant for almost 2 years. Tea was never on any of my don’t lists. I drink tea, green & black, on a daily basis.

@kequick

Hi @contentandwell@colleenyoung flagged your post for us wondering if we had access to any additional information within Mayo’s transplant center. Unfortunately, we couldn’t find a comprehensive list, but we did consult Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester. Here’s what she said: “Your question is a great one – and one that we do not have a quick or easy answer for. As you have found there is NOT a comprehensive list of herbals and teas to avoid post-transplant. This is partially because there is limited information regarding some of the herbals, partially because so many of these products contain multiple ingredients and partially because this market is ever changing – it literally could be a full-time job to keep a list like this up!

Here in our transplant center we advise patients to avoid herbal supplements and teas as an overall statement – however, if there are a few in particular that someone is interested in consuming, we will review the ingredients on a case-by-case or one-by-one basis. You are correct in your findings that Echinacea and licorice root teas would not be recommended. For the others you mentioned, I referenced the Natural Medicines Comprehensive Database (naturalmedicines.therapeuticresearch.com) that our institution subscribes to. Ginger is fine for transplant recipients– especially in the amounts we would normally consume in foods. Turmeric is also likely safe, however does list a side effect of possible constipation and there is a case report of very elevated tacrolimus levels in a post-transplant patient who had started taking 15 spoonfuls of turmeric powder on a daily basis – which we would describe as an excessive amount. We do not see this issue with patients who use turmeric in cooking. Cardamom has no known concerns so should be safe to consume, also. Green tea is a bit more complicated as there are several medications that may interact with green tea such as anticoagulants (Warfarin, Plavix etc.), some types of chemotherapy and Corgard. If you take any of these types of medications it is advisable to not take green tea. Otherwise, again, in normal amounts (not more than 3 caffeinated beverages per day) green tea should be fine to consume.”

Reminder, this is general information that could relate to any patient. For your particular case, we strongly suggest you consult your physician team before you consume any herbal or teas to be sure they are safe with your particular medications and illnesses.

I hope that helps!

Jump to this post

Did you receive your list of what foods to avoid? If no, please request one

Liked by beckyjohnson

@beckyjohnson

@kequick @contentandwell @colleenyoung I'm so impressed – when I y'all do not have an answer you go the extra distance to find it. I just want to add another thought to why a list would be difficult. That is one size really does not fit all. I may have an intolerance or am downright allergic to an ingredient that you may need for overall health & of course vice versa

Jump to this post

@contentandwell, I am a lot like you! I want to be sure that what I eat/drink is okay to use with my immunosuppressant meds. As a general rule, I may be over cautious,. Seldom do I feel like I'm deprived because I like to concentrate on taking care of me. I don't want to do anything to compromise my transplanted organs if I can avoid it.

I sometimes have asked different pharmacists about certain side or cautions, and even they disagree. That is my cue to 'don't' or to contact my coordinator.
There is a belief in our society that 'natural equates with 'safe'. That does make it difficult, doesn't it?
Nice to chat with you:-)
Rosemary

@kequick

Hi @contentandwell@colleenyoung flagged your post for us wondering if we had access to any additional information within Mayo’s transplant center. Unfortunately, we couldn’t find a comprehensive list, but we did consult Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester. Here’s what she said: “Your question is a great one – and one that we do not have a quick or easy answer for. As you have found there is NOT a comprehensive list of herbals and teas to avoid post-transplant. This is partially because there is limited information regarding some of the herbals, partially because so many of these products contain multiple ingredients and partially because this market is ever changing – it literally could be a full-time job to keep a list like this up!

Here in our transplant center we advise patients to avoid herbal supplements and teas as an overall statement – however, if there are a few in particular that someone is interested in consuming, we will review the ingredients on a case-by-case or one-by-one basis. You are correct in your findings that Echinacea and licorice root teas would not be recommended. For the others you mentioned, I referenced the Natural Medicines Comprehensive Database (naturalmedicines.therapeuticresearch.com) that our institution subscribes to. Ginger is fine for transplant recipients– especially in the amounts we would normally consume in foods. Turmeric is also likely safe, however does list a side effect of possible constipation and there is a case report of very elevated tacrolimus levels in a post-transplant patient who had started taking 15 spoonfuls of turmeric powder on a daily basis – which we would describe as an excessive amount. We do not see this issue with patients who use turmeric in cooking. Cardamom has no known concerns so should be safe to consume, also. Green tea is a bit more complicated as there are several medications that may interact with green tea such as anticoagulants (Warfarin, Plavix etc.), some types of chemotherapy and Corgard. If you take any of these types of medications it is advisable to not take green tea. Otherwise, again, in normal amounts (not more than 3 caffeinated beverages per day) green tea should be fine to consume.”

Reminder, this is general information that could relate to any patient. For your particular case, we strongly suggest you consult your physician team before you consume any herbal or teas to be sure they are safe with your particular medications and illnesses.

I hope that helps!

Jump to this post

@donnan, I also drink tea – hot in winter, and iced in summer.
I think the 'green tea' concern is about the green tea supplements that are available. I know people who believe all of the advertisements for natural remedies that 'cure' all sorts of conditions. Before my transplant, there was a good number of friends and family members who knew just what would cure me! And they couldn't even say the name of my condition.

I am on a daily multi vitamin, but it is supposed to be 'plain' one. And it is getting difficult to find these days with all of the specialty ones. My local pharmacy always has them, though.
Rosemary

Liked by beckyjohnson

@kequick

Hi @contentandwell@colleenyoung flagged your post for us wondering if we had access to any additional information within Mayo’s transplant center. Unfortunately, we couldn’t find a comprehensive list, but we did consult Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester. Here’s what she said: “Your question is a great one – and one that we do not have a quick or easy answer for. As you have found there is NOT a comprehensive list of herbals and teas to avoid post-transplant. This is partially because there is limited information regarding some of the herbals, partially because so many of these products contain multiple ingredients and partially because this market is ever changing – it literally could be a full-time job to keep a list like this up!

Here in our transplant center we advise patients to avoid herbal supplements and teas as an overall statement – however, if there are a few in particular that someone is interested in consuming, we will review the ingredients on a case-by-case or one-by-one basis. You are correct in your findings that Echinacea and licorice root teas would not be recommended. For the others you mentioned, I referenced the Natural Medicines Comprehensive Database (naturalmedicines.therapeuticresearch.com) that our institution subscribes to. Ginger is fine for transplant recipients– especially in the amounts we would normally consume in foods. Turmeric is also likely safe, however does list a side effect of possible constipation and there is a case report of very elevated tacrolimus levels in a post-transplant patient who had started taking 15 spoonfuls of turmeric powder on a daily basis – which we would describe as an excessive amount. We do not see this issue with patients who use turmeric in cooking. Cardamom has no known concerns so should be safe to consume, also. Green tea is a bit more complicated as there are several medications that may interact with green tea such as anticoagulants (Warfarin, Plavix etc.), some types of chemotherapy and Corgard. If you take any of these types of medications it is advisable to not take green tea. Otherwise, again, in normal amounts (not more than 3 caffeinated beverages per day) green tea should be fine to consume.”

Reminder, this is general information that could relate to any patient. For your particular case, we strongly suggest you consult your physician team before you consume any herbal or teas to be sure they are safe with your particular medications and illnesses.

I hope that helps!

Jump to this post

@contentandwell @kequick There is no doubt that self Advocacy is a must especially in a world where we usually do not have time or energy to go the extra 5 miles for others. Should you need help with post 36 month immunosuppressants there are 2 links in The Journey From the Donors side. I will move them here if you're interested or need of such information.

@kequick

Hi @contentandwell@colleenyoung flagged your post for us wondering if we had access to any additional information within Mayo’s transplant center. Unfortunately, we couldn’t find a comprehensive list, but we did consult Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester. Here’s what she said: “Your question is a great one – and one that we do not have a quick or easy answer for. As you have found there is NOT a comprehensive list of herbals and teas to avoid post-transplant. This is partially because there is limited information regarding some of the herbals, partially because so many of these products contain multiple ingredients and partially because this market is ever changing – it literally could be a full-time job to keep a list like this up!

Here in our transplant center we advise patients to avoid herbal supplements and teas as an overall statement – however, if there are a few in particular that someone is interested in consuming, we will review the ingredients on a case-by-case or one-by-one basis. You are correct in your findings that Echinacea and licorice root teas would not be recommended. For the others you mentioned, I referenced the Natural Medicines Comprehensive Database (naturalmedicines.therapeuticresearch.com) that our institution subscribes to. Ginger is fine for transplant recipients– especially in the amounts we would normally consume in foods. Turmeric is also likely safe, however does list a side effect of possible constipation and there is a case report of very elevated tacrolimus levels in a post-transplant patient who had started taking 15 spoonfuls of turmeric powder on a daily basis – which we would describe as an excessive amount. We do not see this issue with patients who use turmeric in cooking. Cardamom has no known concerns so should be safe to consume, also. Green tea is a bit more complicated as there are several medications that may interact with green tea such as anticoagulants (Warfarin, Plavix etc.), some types of chemotherapy and Corgard. If you take any of these types of medications it is advisable to not take green tea. Otherwise, again, in normal amounts (not more than 3 caffeinated beverages per day) green tea should be fine to consume.”

Reminder, this is general information that could relate to any patient. For your particular case, we strongly suggest you consult your physician team before you consume any herbal or teas to be sure they are safe with your particular medications and illnesses.

I hope that helps!

Jump to this post

@donnan @rosemarya I've always been fairly conscious about eating healthy and avoiding tobacco & alcohol (not to say I don't have a drink or 2 with dinner on the town or holiday party) and I use herbal remedies like Jasmine tea to sleep. I now know that what I put in my body may effect renal testing so I can only imagine how much more so for recipients. I'm looking forward to meeting the nutrionist for these guidelines. But there is very little to compare to literal experience which is also a wealth of knowledge.

@beckyjohnson

@kequick @contentandwell @colleenyoung I'm so impressed – when I y'all do not have an answer you go the extra distance to find it. I just want to add another thought to why a list would be difficult. That is one size really does not fit all. I may have an intolerance or am downright allergic to an ingredient that you may need for overall health & of course vice versa

Jump to this post

@rosemarya @contentandwell It is absolutely thrilling to know you do not want to compromise your donated organs (that means someone didn't donate in vain or die for nothing) by contradicting your immunosuppressants. What if your immunosuppressants were no longer part of your diet (if I dare call it diet) for whatever reason? Would you still have to avoid the same foods or just eat a healthy diet based on your individual condition?

@beckyjohnson

@kequick @contentandwell @colleenyoung I'm so impressed – when I y'all do not have an answer you go the extra distance to find it. I just want to add another thought to why a list would be difficult. That is one size really does not fit all. I may have an intolerance or am downright allergic to an ingredient that you may need for overall health & of course vice versa

Jump to this post

@beckyjohnson, Great question. Immunosuppressants suppress the body’s immune system so that our ‘natural defense/our immune system response does not fight the transplanted organ. Think about how your body has its own defense system to fight off germ (foreign body)of flu, colds, scrape or cut. Well that same response will occur toward the (foreign) transplanted organ. The immunosuppressant drugs slow down the body’s natural response. This protects our transplanted organ from this defense system. If the meds are stopped-the organ fails (rejection). It also makes recipients vulnerable to infections and germs. that is why we take so many precautions and try to be careful.
Does this make sense?
Now it’s my bedtime. See you tomorrow.
Rosemary

Liked by beckyjohnson

@beckyjohnson

@kequick @contentandwell @colleenyoung I'm so impressed – when I y'all do not have an answer you go the extra distance to find it. I just want to add another thought to why a list would be difficult. That is one size really does not fit all. I may have an intolerance or am downright allergic to an ingredient that you may need for overall health & of course vice versa

Jump to this post

@rosemarya I think more people are beginning to realize that natural can also mean unregulated and that can be dangerous. If you are going with "natural" foods and supplements you really need to make sure that the company is extremely reputable.
There really are so many different opinions though. I did read an article that a nutritionist at MGH sent to me and a lot of what it comes down to is to not overdo it. There are many things that are not problematic if used judiciously, like green tea, but if you drank an inordinate amount of it, it could be harmful.
Pretty much everyone knows that grapefruit juice interferes with a lot of drugs but when I got this list I discovered that pomegranate does also, and so does tangerine juice! These days pomegranates and pomegranate juice are so popular that they really need to be included in all of the information.
JK

Liked by beckyjohnson

@beckyjohnson

@kequick @contentandwell @colleenyoung I'm so impressed – when I y'all do not have an answer you go the extra distance to find it. I just want to add another thought to why a list would be difficult. That is one size really does not fit all. I may have an intolerance or am downright allergic to an ingredient that you may need for overall health & of course vice versa

Jump to this post

@rosemarya It makes sense but it also makes me sad for both the giver & receivers who are not able to get their meds. I sure hope those links in the discussion thread Journey From the Donors Side helps at least one person (which is really 2, recipient/ donor) to keep whatever organ/s is improving their life to keep functioning well. A fine example of why I appreciate you doing your best to take of your life saving donations.

Liked by beckyjohnson

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