Essiac?

Related Terms

Burdock root (Arctium lappa)synonyms/related terms: Akujitsu, anthraxivore, arctii, Arctium minus, Arctium tomentosa, bardana, Bardanae Radix, bardane, bardane grande (French), beggar's buttons, burr, burr seed, chin, clot-burr, clotbur, cocklebur, cockle button, cocklebuttons, cuckold, daiki kishi, edible burdock, fox's clote, grass burdock, great bur, great burdock, great burdocks, gobo (Japan), Grosse klette (German), happy major, hardock, hare burr, hurrburr, Kletterwurzel (German), lampazo (Spanish), lappola, love leaves, niu bang zi, oil of lappa, personata, Philanthropium, thorny burr, turkey burrseed, woo-bang-ja, wild gobo.
Sheep sorrel (Rumex acetosella)synonyms/related terms: Acedera, acid sorrel, azeda-brava, buckler leaf, cigreto, common sorrel, cuckoo sorrow, cuckoo's meate, dock, dog-eared sorrel, field sorrel, French sorrel, garden sorrel, gowke-meat, greensauce, green sorrel, herba acetosa, kemekulagi, Polygonaceae (family), red sorrel, red top sorrel, round leaf sorrel, Rumex scutatus, Rumex acetosa L., sheephead sorrel, sheep's sorrel, sorrel, sorrel dock, sour dock, sour grass, sour sabs, sour suds, sour sauce, Wiesensauerampfer, wild sorrel.
Slippery elm inner bark (Ulmus fulva)synonyms/related terms: Indian elm, moose elm, red elm, rock elm, slippery elm, sweet elm, Ulmaceae, Ulmi rubrae cortex, Ulmus fulva Michaux, Ulmus rubra, winged elm.
Turkish rhubarb (Rheum palmatum)synonyms/related terms: Baoshen pill, Canton rhubarb, Chinesischer Rhabarber (German), Chinese rhubarb, chong-gi-huang, common rhubarb, da-huang, Da Huang, daio, Da huang Liujingao, English rhubarb, Extractum Rhei Liquidum, Himalayan Rhubarb, Indian rhubarb, Japanese rhubarb, Jiang- Zhi Jian-Fel Yao (JZJFY), Jinghuang tablet, medicinal rhubarb, pie rhubarb, Polygonaceae (family), Pyralvex, Pyralvex Berna, racine de rhubarbee (French), RET (Rhubarb extract tablet), rhabarber, rhei radix, rhei rhizoma, rheum, Rheum australe, Rheum emodi Wall, Rheum officinale Baill, Rheum rhabarbarum, Rheum rhaponticum L., Rheum tanguticum Maxim, Rheum tanguticum Maxim. ex. Balf., Rheum tanguticum Maxim L., Rheum undulatum, Rheum x cultorum, Rheum webbianum (Indian or Himalayan rhubarb), rhizoma, rheirhubarbe de chine (French), rhubarb, rubarbo, ruibarbo (Spanish), shenshi rhubarb, tai huang, Turkey rhubarb.

Background

Essiac? contains a combination of herbs, including burdock root (Arctium lappa), sheep sorrel (Rumex acetosella), slippery elm inner bark (Ulmus fulva), and Turkish rhubarb (Rheum palmatum). The original formula was developed by the Canadian nurse Rene Caisse (1888-1978) in the 1920s ("Essiac" is Caisse spelled backwards). The recipe is said to be based on a traditional Ojibwa (Native American) remedy, and Caisse administered the formula by mouth and injection to numerous cancer patients during the 1920s and 1930s. The exact ingredients and amounts in the original formulation remain a secret.
During investigations by the Canadian government and public hearings in the late 1930s, it remained unclear if Essiac? was an effective cancer treatment. Amidst controversy, Caisse closed her clinic in 1942. In the 1950s, Caisse provided samples of Essiac? to Dr. Charles Brusch, founder of the Brusch Medical Center in Cambridge, Massachusetts, who administered Essiac? to patients (it is unclear if Brusch was given access to the secret formula). According to some accounts, additional herbs were added to these later formulations, including blessed thistle (Cnicus benedictus), red clover (Trifolium pratense), kelp (Laminaria digitata), and watercress (Nasturtium officinale).
A laboratory at Memorial Sloan-Kettering Cancer Center tested Essiac? samples (provided by Caisse) on mice during the 1970s. This research was never formally published, and there is controversy regarding the results, with some accounts noting no benefits, and others reporting significant effects (including an account by Dr. Brusch). Questions were later raised of improper preparation of the formula. Caisse subsequently refused requests by researchers at Memorial Sloan-Kettering and the U.S. National Cancer Institute for access to the recipe.
In the 1970s, Caisse provided the formula to Resperin Corporation Ltd., with the understanding that Resperin would coordinate a scientific trial in humans. Although a study was initiated, it was stopped early amidst questions of improper preparation of the formula and inadequate study design. This research was never completed. Resperin Corporation Ltd., which owned the Essiac? name, formally went out of business after transferring rights to the Essiac? name and selling the secret formula to Essiac Products Ltd., which currently distributes products through Essiac? International.
Despite the lack of available scientific evidence, Essiac? and Essiac-like products (with similar ingredients) remain popular among patients, particularly in those with cancer. Essiac? is most commonly taken as a tea. A survey conducted in the year 2000 found almost 15% of Canadian women with breast cancer to be using Essiac?. It has also become popular in patients with HIV and diabetes, and in healthy individuals for its purported immune-enhancing properties, although there is a lack of reliable scientific research in these areas.
There are more than 40 Essiac-like products available in North America, Europe, and Australia. Flor-Essence? includes the original four herbs (burdock root, sheep sorrel, slippery elm bark, Turkish rhubarb) as well as herbs that were later added as "potentiators" (blessed thistle, red clover, kelp, watercress). Virginias Herbal E-TonicT contains the four original herbs along with echinacea and black walnut. Other commercial formulations may include additional ingredients, such as cat's claw (Uncaria tomentosa).

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


There is a lack of properly conducted published human studies using Essiac? for cancer. Currently, there is not enough evidence to recommend for or against the use of this herbal mixture as a therapy for any type of cancer.

C


There is a lack of properly conducted published human studies using Essiac? for cancer. Currently, there is not enough evidence to recommend for or against the use of this herbal mixture as a therapy for any type of cancer.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (over 18 years old)
Historically, Essiac?was administered by mouth or injection. The most common current use is as a tea. There is a lack of reliable published human studies of Essiac? or Essiac-like products, and safety or effectiveness has not been established scientifically for any dose. Instructions for tea preparation and dosing vary from product to product. Patients are advised to read product labels and speak with their cancer healthcare professional before starting any new therapy, such as Essiac? or Essiac-like products.
Women with breast cancer have taken low doses (total daily dose 43.6 ? 30.8 milliliters) of Essiac? that matched the label instructions on most Essiac? products.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Essiac? interactions are not well studied scientifically. Most potential interactions are based on theoretical and known reactions associated with herbal components of Essiac?: burdock root (Arctium lappa), sheep sorrel (Rumex acetosella), slippery elm bark (Ulmus fulva), and Turkish rhubarb (Rheum palmatum). However, the interactions of these individual herbs are also not well studied. Various Essiac-like products may contain different or additional ingredients, and patients are advised to carefully review product labels.
Essiac? may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a healthcare professional or pharmacist about possible interactions. This is based on a report of one patient in a research study taking the experimental drug DX-8951f (metabolized by CYP3A4 and CYP1A2), who experienced toxic side effects and drug clearance that was 4 to 5 times slower than in other patients. This patient was also taking "Essiac tea," although further details are not available and it is not clear if the patient was taking Essiac? or an Essiac-like product.
Anthraquinones in rhubarb root or sheep sorrel may lead to diarrhea, dehydration, or loss of electrolytes (such as potassium), and may increase the effects of other laxative agents. Burdock has been associated with diuretic effects (increased urine flow) in one human report, and in theory may cause excess fluid loss (dehydration) or electrolyte imbalances (such as changes in blood potassium or sodium levels). These effects may be increased when burdock is taken at the same time as diuretic drugs such as chlorothiazide (Diuril?), furosemide (Lasix?), hydrochlorothiazide (HCTZ), or spironolactone (Aldactone?). The laxative and diuretic properties of herbs in Essiac? may lead to low potassium blood levels that are potentially dangerous in people taking digoxin or digitoxin.
Based on animal research and limited human study, burdock may either lower or raise blood sugar levels. Caution is advised when using medications that may also affect blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary.
Based on limited human evidence that is not entirely clear, burdock may have estrogen-like properties, and may act to increase the effects of estrogenic agents including hormone replacement therapies such as Premarin? or birth control pills.
Essiac? may also interact with antibiotics, angiotensin converting enzyme (ACE) inhibitors, antacids, corticosteroids, heart-regulating agents, or agents used for cancer including radiotherapy or chemotherapy. Essiac? may increase the risk of kidney or liver damage when taken with other agents that also affect the kidney or liver.
There is early evidence suggesting that Essiac? may have a positive interaction when used with nifedipine, an agent used for high blood pressure during pregnancy, although more studies are needed to confirm this finding. Based on human evidence, the combination of rhubarb with anti-psychotic agents used in the management of schizophrenia may show promise.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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