Herbals and teas

Posted by JK @contentandwell, Apr 20, 2018

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

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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.

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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!

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@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

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@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!

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@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

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@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

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@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.

REPLY
@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

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@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

REPLY
@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

REPLY
@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.

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