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Interaction with other interventions

Interaction with caffeine discussed extensively in the ephedra report; not discussed in other examples reviewed

Interactions discussed in the examples reviewed

Other comments and considerations for using this resource

AHRQ reviews are extensive reviews of health care practices

Thorough resource for those supplements considered; less useful due to small number of supplements included to date: garlic, milk thistle, SAMe (S-adenosyl-L-methionine), and ephedra

Only 18 monographs are available to date; starting assumption appears to be one of safety, therefore a lack of information appears to be interpreted as safe

This is a useful resource to understand use levels, stability, and analytical methods, but the literature search on safety information may not be sufficiently comprehensive for all ingredients considered




American Herbal Products Association Botanical Safety Handbook (McGuffin et al., 1997)

Institute of Medicine (IOM) Dietary Reference Intakes—Tolerable Upper Intake Levels (ULs) (IOM, 1997, 1998a, 1998b, 2000, 2001, 2002, 2004)

Type of organization responsible for resource

Nonprofit trade association representing the herbal products industry

Prepared by expert panels assembled by the IOM of the National Academies (Nonprofit organization chartered to give advice to the government)

Substances reviewed

Botanicals sold in North America

Essential vitamins, minerals, and electrolytes, as well as macronutrients and water


Book; safety classifications of botanicals

Chapter sections; component of Dietary Reference Intakes publications

Focus on safety/risk

Safety is primary focus

Safety is primary focus; specifically, determining the level at which nutrient intake may cause adverse effects

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