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Adverse Effects of Plant Food Supplements Self-Reported by Consumers in the PlantLIBRA Survey Involving Six European Countries

Identifieur interne : 000377 ( Pmc/Corpus ); précédent : 000376; suivant : 000378

Adverse Effects of Plant Food Supplements Self-Reported by Consumers in the PlantLIBRA Survey Involving Six European Countries

Auteurs : Patrizia Restani ; Chiara Di Lorenzo ; Alicia Garcia-Alvarez ; Mihaela Badea ; Alessandro Ceschi ; Bernadette Egan ; Lorena Dima ; Saskia Lüde ; Franco M. Maggi ; Angela Marculescu ; Raimon Milà-Villarroel ; Monique M. Raats ; Lourdes Ribas-Barba ; Liisa Uusitalo ; Lluís Serra-Majem

Source :

RBID : PMC:4771165

Abstract

Background

The use of food supplements containing botanicals is increasing in European markets. Although intended to maintain the health status, several cases of adverse effects to Plant Food Supplements (PFS) have been described.

Objectives

To describe the self-reported adverse effects collected during the European PlantLIBRA PFS Consumer Survey 2011–2012, with a critical evaluation of the plausibility of the symptomatology reported using data from the literature and from the PlantLIBRA Poisons Centers' survey.

Subjects/Setting

From the total sample of 2359 consumers involved in the consumers' survey, 82 subjects reported adverse effects due to a total of 87 PFS.

Results

Cases were self-reported, therefore causality was not classified on the basis of clinical evidence, but by using the frequency/strength of adverse effects described in scientific papers: 52 out of 87 cases were defined as possible (59.8%) and 4 as probable (4.6%). Considering the most frequently cited botanicals, eight cases were due to Valeriana officinalis (garden valerian); seven to Camellia sinensis (tea); six to Ginkgo biloba (Maidenhair tree) and Paullinia cupana (guarana). Most adverse events related to the gastrointestinal tract, nervous and cardiovascular systems.

Conclusions

Comparing the data from this study with those published in scientific papers and obtained by the PlantLIBRA Poisons Centers' survey, some important conclusions can be drawn: severe adverse effects to PFS are quite rare, although mild or moderate adverse symptoms can be present. Data reported in this paper can help health professionals (and in particular family doctors) to become aware of possible new problems associated with the increasing use of food supplements containing botanicals.


Url:
DOI: 10.1371/journal.pone.0150089
PubMed: 26928206
PubMed Central: 4771165

Links to Exploration step

PMC:4771165

Le document en format XML

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<addr-line>Ciber Obn Fisiopatologıa de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain</addr-line>
</nlm:aff>
</affiliation>
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<nlm:aff id="aff010">
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<sec id="sec001">
<title>Background</title>
<p>The use of food supplements containing botanicals is increasing in European markets. Although intended to maintain the health status, several cases of adverse effects to Plant Food Supplements (PFS) have been described.</p>
</sec>
<sec id="sec002">
<title>Objectives</title>
<p>To describe the self-reported adverse effects collected during the European PlantLIBRA PFS Consumer Survey 2011–2012, with a critical evaluation of the plausibility of the symptomatology reported using data from the literature and from the PlantLIBRA Poisons Centers' survey.</p>
</sec>
<sec id="sec003">
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<p>From the total sample of 2359 consumers involved in the consumers' survey, 82 subjects reported adverse effects due to a total of 87 PFS.</p>
</sec>
<sec id="sec004">
<title>Results</title>
<p>Cases were self-reported, therefore causality was not classified on the basis of clinical evidence, but by using the frequency/strength of adverse effects described in scientific papers: 52 out of 87 cases were defined as possible (59.8%) and 4 as probable (4.6%). Considering the most frequently cited botanicals, eight cases were due to
<italic>Valeriana officinalis</italic>
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<italic>Camellia sinensis</italic>
(tea); six to
<italic>Ginkgo biloba</italic>
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<italic>Paullinia cupana</italic>
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</sec>
<sec id="sec005">
<title>Conclusions</title>
<p>Comparing the data from this study with those published in scientific papers and obtained by the PlantLIBRA Poisons Centers' survey, some important conclusions can be drawn: severe adverse effects to PFS are quite rare, although mild or moderate adverse symptoms can be present. Data reported in this paper can help health professionals (and in particular family doctors) to become aware of possible new problems associated with the increasing use of food supplements containing botanicals.</p>
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<subj-group>
<subject>Sleep Disorders</subject>
<subj-group>
<subject>Dyssomnias</subject>
<subj-group>
<subject>Insomnia</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Pain Management</subject>
<subj-group>
<subject>Myalgia</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Adverse Effects of Plant Food Supplements Self-Reported by Consumers in the PlantLIBRA Survey Involving Six European Countries</article-title>
<alt-title alt-title-type="running-head">Adverse Effects Reported in the PlantLIBRA Survey</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Restani</surname>
<given-names>Patrizia</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Di Lorenzo</surname>
<given-names>Chiara</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Garcia-Alvarez</surname>
<given-names>Alicia</given-names>
</name>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Badea</surname>
<given-names>Mihaela</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ceschi</surname>
<given-names>Alessandro</given-names>
</name>
<xref ref-type="aff" rid="aff004">
<sup>4</sup>
</xref>
<xref ref-type="aff" rid="aff005">
<sup>5</sup>
</xref>
<xref ref-type="aff" rid="aff006">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Egan</surname>
<given-names>Bernadette</given-names>
</name>
<xref ref-type="aff" rid="aff007">
<sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dima</surname>
<given-names>Lorena</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lüde</surname>
<given-names>Saskia</given-names>
</name>
<xref ref-type="aff" rid="aff004">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Maggi</surname>
<given-names>Franco M.</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Marculescu</surname>
<given-names>Angela</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Milà-Villarroel</surname>
<given-names>Raimon</given-names>
</name>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Raats</surname>
<given-names>Monique M.</given-names>
</name>
<xref ref-type="aff" rid="aff007">
<sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ribas-Barba</surname>
<given-names>Lourdes</given-names>
</name>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff009">
<sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Uusitalo</surname>
<given-names>Liisa</given-names>
</name>
<xref ref-type="aff" rid="aff008">
<sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Serra-Majem</surname>
<given-names>Lluís</given-names>
</name>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff009">
<sup>9</sup>
</xref>
<xref ref-type="aff" rid="aff010">
<sup>10</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001">
<label>1</label>
<addr-line>Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy</addr-line>
</aff>
<aff id="aff002">
<label>2</label>
<addr-line>Fundación para la Investigacion Nutricional, Barcelona Science Park, University of Barcelona, Barcelona, Spain</addr-line>
</aff>
<aff id="aff003">
<label>3</label>
<addr-line>Transilvania University of Brasov, Brasov, Romania</addr-line>
</aff>
<aff id="aff004">
<label>4</label>
<addr-line>National Poisons Center, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland</addr-line>
</aff>
<aff id="aff005">
<label>5</label>
<addr-line>Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland</addr-line>
</aff>
<aff id="aff006">
<label>6</label>
<addr-line>Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland</addr-line>
</aff>
<aff id="aff007">
<label>7</label>
<addr-line>Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, United Kingdom</addr-line>
</aff>
<aff id="aff008">
<label>8</label>
<addr-line>Finnish Food Safety Authority Evira, Helsinki, Finland</addr-line>
</aff>
<aff id="aff009">
<label>9</label>
<addr-line>Ciber Obn Fisiopatologıa de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain</addr-line>
</aff>
<aff id="aff010">
<label>10</label>
<addr-line>Institute of Biomedical and Health Research of Las Palmas, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Nerurkar</surname>
<given-names>Pratibha V.</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>College of Tropical Agriculture and Human Resources, University of Hawaii, UNITED STATES</addr-line>
</aff>
<author-notes>
<fn fn-type="conflict" id="coi001">
<p>
<bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001">
<p>Conceived and designed the experiments: LSM LRB AGA BE LD FMM MMR MB. Analyzed the data: PR CDL RMV LRB AGA. Wrote the paper: PR CDL. Responsible for the survey: LSM. Coordination of the survey: AGA. Material elaboration: AGA BE LD FMM LRB MMR MB. Data reviewing/handling/cleaning: AGA BE LD FMM LRB MB FB MS AM LU. Data analysis strategy: LRB LSM AGA RMV BE MMR LD FMM MB AM LU PR CDL AC SL. Drafts reviews: AC SL AGA LRB LD FMM BE MMR MB AM LU LSM. Manuscript coordination: PR.</p>
</fn>
<corresp id="cor001">* E-mail:
<email>patrizia.restani@unimi.it</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>29</day>
<month>2</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection">
<year>2016</year>
</pub-date>
<volume>11</volume>
<issue>2</issue>
<elocation-id>e0150089</elocation-id>
<history>
<date date-type="received">
<day>14</day>
<month>10</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>9</day>
<month>2</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>© 2016 Restani et al</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>Restani et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the terms of the
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0150089.pdf"></self-uri>
<abstract>
<sec id="sec001">
<title>Background</title>
<p>The use of food supplements containing botanicals is increasing in European markets. Although intended to maintain the health status, several cases of adverse effects to Plant Food Supplements (PFS) have been described.</p>
</sec>
<sec id="sec002">
<title>Objectives</title>
<p>To describe the self-reported adverse effects collected during the European PlantLIBRA PFS Consumer Survey 2011–2012, with a critical evaluation of the plausibility of the symptomatology reported using data from the literature and from the PlantLIBRA Poisons Centers' survey.</p>
</sec>
<sec id="sec003">
<title>Subjects/Setting</title>
<p>From the total sample of 2359 consumers involved in the consumers' survey, 82 subjects reported adverse effects due to a total of 87 PFS.</p>
</sec>
<sec id="sec004">
<title>Results</title>
<p>Cases were self-reported, therefore causality was not classified on the basis of clinical evidence, but by using the frequency/strength of adverse effects described in scientific papers: 52 out of 87 cases were defined as possible (59.8%) and 4 as probable (4.6%). Considering the most frequently cited botanicals, eight cases were due to
<italic>Valeriana officinalis</italic>
(garden valerian); seven to
<italic>Camellia sinensis</italic>
(tea); six to
<italic>Ginkgo biloba</italic>
(Maidenhair tree) and
<italic>Paullinia cupana</italic>
(guarana). Most adverse events related to the gastrointestinal tract, nervous and cardiovascular systems.</p>
</sec>
<sec id="sec005">
<title>Conclusions</title>
<p>Comparing the data from this study with those published in scientific papers and obtained by the PlantLIBRA Poisons Centers' survey, some important conclusions can be drawn: severe adverse effects to PFS are quite rare, although mild or moderate adverse symptoms can be present. Data reported in this paper can help health professionals (and in particular family doctors) to become aware of possible new problems associated with the increasing use of food supplements containing botanicals.</p>
</sec>
</abstract>
<funding-group>
<funding-statement>The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007–2013) under grant agreement n. 245199. It has been carried out within the PlantLIBRA project (
<ext-link ext-link-type="uri" xlink:href="http://www.plantlibra.eu">www.plantlibra.eu</ext-link>
).</funding-statement>
</funding-group>
<counts>
<fig-count count="0"></fig-count>
<table-count count="6"></table-count>
<page-count count="20"></page-count>
</counts>
<custom-meta-group>
<custom-meta id="data-availability">
<meta-name>Data Availability</meta-name>
<meta-value>The authors confirm that data of the WHOLE SURVEY are available upon request from: Lluis Sierra Majem, Fundación para la Investigacion Nutriciònal, Barcelona Science Park, University of Barcelona, Barcelona, Spain (Email:
<email>lluis.serra@ulpgc.es</email>
). All relevant data for the present paper are included in
<xref ref-type="table" rid="pone.0150089.t003">Table 3</xref>
.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes>
<title>Data Availability</title>
<p>The authors confirm that data of the WHOLE SURVEY are available upon request from: Lluis Sierra Majem, Fundación para la Investigacion Nutriciònal, Barcelona Science Park, University of Barcelona, Barcelona, Spain (Email:
<email>lluis.serra@ulpgc.es</email>
). All relevant data for the present paper are included in
<xref ref-type="table" rid="pone.0150089.t003">Table 3</xref>
.</p>
</notes>
</front>
<body>
<sec sec-type="intro" id="sec006">
<title>Introduction</title>
<p>The European Union (EU) Directive on Food Supplements (2002/46/EC) defines food supplements (which include PFS): ‘‘…foodstuffs the purpose of which is to supplement the normal diet and which are concentrated sources of nutrients or other substances with a nutritional or physiological effect, alone or in combination, marketed in dose form, namely forms such as capsules, pastilles, tablets, pills and other similar forms, sachets of powder, ampoules of liquids, drop dispensing bottles and other similar forms of liquids and powders designed to be taken in measured small quantities”. Their market is growing significantly both in Europe and the USA [
<xref rid="pone.0150089.ref001" ref-type="bibr">1</xref>
]. Although there exists some overlap/confusion with traditional herbal medicinal products [
<xref rid="pone.0150089.ref002" ref-type="bibr">2</xref>
], plant food supplements cannot be sold as having any diagnostic, preventative or therapeutic properties; their role is only complementary to the diet.</p>
<p>The consumption of Plant Food Supplements (PFS) is usually estimated on the basis of market data, and mainly from import/export of raw ingredients, but since botanicals are used in both food and medicinal areas, the extrapolation to PFS is quite difficult [
<xref rid="pone.0150089.ref003" ref-type="bibr">3</xref>
]. Data on the use of dietary supplements reported by consumers are very limited and normally include only those products containing vitamins and minerals [
<xref rid="pone.0150089.ref004" ref-type="bibr">4</xref>
]; other available data come from studies relating to complementary/traditional medicine [
<xref rid="pone.0150089.ref005" ref-type="bibr">5</xref>
].</p>
<p>To provide new data on PFS usage patterns, a survey was performed with consumers of PFS in the framework of the European Project PlantLIBRA (n. 249159); it involved 2359 adults from Finland, Germany, Italy, Romania, Spain and UK. The main results of the PlantLIBRA PFS Consumer Survey (2011–2012) were published in 2014 [
<xref rid="pone.0150089.ref006" ref-type="bibr">6</xref>
]; the present paper deals with the adverse effects self-reported by the consumers participating in the survey.</p>
<p>Adverse effects to PFS have been reported by several authors; most of the studies were: a) case reports describing a specific acute event, or b) reviews of cases in a specific clinical area (cardiovascular, gastrointestinal, etc.) [
<xref rid="pone.0150089.ref007" ref-type="bibr">7</xref>
–
<xref rid="pone.0150089.ref008" ref-type="bibr">8</xref>
]. A critical limitation of the information reported to date in the scientific literature is a lack of assessment of causality; in other words, the strict association between the intake of a specific plant and the clinical event is rarely demonstrated by measuring biomarkers or by the de-challenge/re-challenge approach. On this basis, a systematic review of the data on adverse effects due to PFS/botanical ingredients, including misidentification and interactions of PFS/botanicals with pharmaceutical drugs or nutrients was undertaken [
<xref rid="pone.0150089.ref009" ref-type="bibr">9</xref>
]. Data were collected for 66 botanicals, which are common ingredients of PFS; all papers were classified for causality according to the WHO guidelines [
<xref rid="pone.0150089.ref010" ref-type="bibr">10</xref>
] and grouped as "certain, probable, possible and uncertain/unclassifiable events". Among the 492 papers selected, 402 (81.7%) dealt with adverse effects due to the botanical as such or in a PFS, and 89 (18.1%) described interactions with conventional drugs. Misidentification was confirmed in one case [
<xref rid="pone.0150089.ref009" ref-type="bibr">9</xref>
].</p>
<p>The aims of this paper are: 1) to identify the adverse effects reported by the European participants in the PlantLIBRA PFS Consumer Survey, and 2) to critically evaluate the plausibility of the symptomatology reported as being related to PFS.</p>
</sec>
<sec sec-type="materials|methods" id="sec007">
<title>Materials and Methods</title>
<p>The survey was conducted in 6 European countries (Finland, Germany, Italy, Romania, Spain and the United Kingdom), and recruitment of participants occurred in 4 cities in each country. In this study, "Botanical" means raw material and derived preparations made from plants, algae, fungi or lichens (
<ext-link ext-link-type="uri" xlink:href="http://www.efsa.europa.eu/en/topics/topic/botanicals">http://www.efsa.europa.eu/en/topics/topic/botanicals</ext-link>
). The botanicals to be included in the survey were clearly defined at the outset; PFS were defined as the "foodstuffs the purpose of which is to supplement the normal diet and which are concentrated sources of botanical preparations that have nutritional or physiological effect, alone or in combination with vitamins, minerals and other substances which are not plant-based". Herbal remedies, other medicinal products based on botanicals, herbal teas or juices were excluded [
<xref rid="pone.0150089.ref006" ref-type="bibr">6</xref>
].</p>
<p>In order to obtain a sample of 400 consumers/each country, approximately 2000 individuals were screened per country (total number close to 2400) [
<xref rid="pone.0150089.ref006" ref-type="bibr">6</xref>
]. Eligible consumers completed a detailed questionnaire on PFS usage, providing product/plant names, dosage forms, frequency of use, reasons for use, adverse effects, places and patterns of purchase and information sources on products. Data on a maximum of five different PFS for each consumer was recorded; when PFS were more than 5, the inclusion was based on the frequency of use. Responders' sociodemographic data, including age, gender, level of education and employment status, as well as height, weight and health-related lifestyle information, were also collected. Further details on the survey have been reported previously [
<xref rid="pone.0150089.ref006" ref-type="bibr">6</xref>
]. The composition of each PFS was obtained from the label, if at disposal, or by searching the PFS ingredients in the website of producers.</p>
<p>Regarding the collection of data on adverse effects, the following two questions were included for each product:</p>
<list list-type="order">
<list-item>
<p>Have you experienced any adverse effects while taking this product?</p>
</list-item>
<list-item>
<p>If yes, which one? (list of symptoms provided, with "other" as an option).</p>
</list-item>
</list>
<sec id="sec008">
<title>Ethical aspects</title>
<p>Approval of the survey protocols was obtained from four ethics committees: the Bioethics Commission of the University of Barcelona, Spain; the Ethics Committee of the Università degli Studi di Milano, Italy; the Ethical Committee of the Faculty of Medicine—Transilvania University of Brasov, Romania; and the Coordinating Ethics Committee, Hospital District of Helsinki and Uusimaa, Finland.</p>
<p>Approval of the survey by these four ethics Committees required submitting all survey material to their members for evaluation. No ethical approval for the survey was needed in Germany and the United Kingdom. Furthermore, the ethical aspects were considered in the European Commission Consolidated Review Report dated 30
<sup>th</sup>
September 2013 and evaluated as “ethical issues regarding the surveys have been handled appropriately”.</p>
<p>In all countries, informed consent was obtained from survey participants verbally after reading the survey information sheet. The data were collected anonymously on paper questionnaires and then transferred to an electronic database; all responders were assigned an ID number prior to data analyses.</p>
</sec>
<sec id="sec009">
<title>Statistical analysis</title>
<p>All data were entered into the statistical package SPSS for Windows v. 18 (IBM Corporation, Somers, NY, USA), which was used for analysis.</p>
</sec>
</sec>
<sec id="sec010">
<title>Results and Discussion</title>
<p>A total of 11783 consumers (5799 males and 6004 females) were screened during the PlantLIBRA survey, of which 2359 were considered eligible and included in the study. The number of consumers per country and the percentage self-reporting adverse effects are listed in
<xref ref-type="table" rid="pone.0150089.t001">Table 1</xref>
.</p>
<table-wrap id="pone.0150089.t001" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pone.0150089.t001</object-id>
<label>Table 1</label>
<caption>
<title>Consumers included in the PlantLIBRA PFS Consumer Survey and self-reporting adverse effects.</title>
</caption>
<alternatives>
<graphic id="pone.0150089.t001g" xlink:href="pone.0150089.t001"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Country</th>
<th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">Number of consumers in the survey</th>
<th align="center" rowspan="1" colspan="1">Number of consumers reporting adverse effects</th>
<th align="center" rowspan="1" colspan="1">Percentage</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Finland</td>
<td align="left" rowspan="1" colspan="1">Total number</td>
<td align="center" rowspan="1" colspan="1">401</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">5.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Males</td>
<td align="center" rowspan="1" colspan="1">193</td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">5.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Females</td>
<td align="center" rowspan="1" colspan="1">208</td>
<td align="center" rowspan="1" colspan="1">13</td>
<td align="center" rowspan="1" colspan="1">6.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Germany</td>
<td align="left" rowspan="1" colspan="1">Total number</td>
<td align="center" rowspan="1" colspan="1">398</td>
<td align="center" rowspan="1" colspan="1">22</td>
<td align="center" rowspan="1" colspan="1">5.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Males</td>
<td align="center" rowspan="1" colspan="1">197</td>
<td align="center" rowspan="1" colspan="1">13</td>
<td align="center" rowspan="1" colspan="1">6.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Females</td>
<td align="center" rowspan="1" colspan="1">201</td>
<td align="center" rowspan="1" colspan="1">9</td>
<td align="center" rowspan="1" colspan="1">4.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Italy</td>
<td align="left" rowspan="1" colspan="1">Total number</td>
<td align="center" rowspan="1" colspan="1">378</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1">1.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Males</td>
<td align="center" rowspan="1" colspan="1">187</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">1.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Females</td>
<td align="center" rowspan="1" colspan="1">191</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">1.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Romania</td>
<td align="left" rowspan="1" colspan="1">Total number</td>
<td align="center" rowspan="1" colspan="1">400</td>
<td align="center" rowspan="1" colspan="1">7</td>
<td align="center" rowspan="1" colspan="1">1.8</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Males</td>
<td align="center" rowspan="1" colspan="1">199</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">2.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Females</td>
<td align="center" rowspan="1" colspan="1">201</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">1.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Spain</td>
<td align="left" rowspan="1" colspan="1">Total number</td>
<td align="center" rowspan="1" colspan="1">402</td>
<td align="center" rowspan="1" colspan="1">24</td>
<td align="center" rowspan="1" colspan="1">6.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Males</td>
<td align="center" rowspan="1" colspan="1">174</td>
<td align="center" rowspan="1" colspan="1">9</td>
<td align="center" rowspan="1" colspan="1">5.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Females</td>
<td align="center" rowspan="1" colspan="1">228</td>
<td align="center" rowspan="1" colspan="1">15</td>
<td align="center" rowspan="1" colspan="1">6.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">United Kingdom</td>
<td align="left" rowspan="1" colspan="1">Total number</td>
<td align="center" rowspan="1" colspan="1">380</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">0.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Males</td>
<td align="center" rowspan="1" colspan="1">191</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">0.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Females</td>
<td align="center" rowspan="1" colspan="1">189</td>
<td align="center" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">-</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="left" rowspan="1" colspan="1">
<bold>Total number</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>2359</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>82</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>3.5</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">
<bold>Males</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>1141</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>39</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>3.4</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">
<bold>Females</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>1218</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>43</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>3.5</bold>
</td>
</tr>
</tbody>
</table>
</alternatives>
</table-wrap>
<p>Considering the entire survey, the percentage of consumers, who reported adverse effects was approximately 3.5%. Differences were observed between countries; the number of consumers reporting adverse effects ranged between 5 and 6% of the total interviewed in three countries (Finland, Germany and Spain), while they were less numerous in Romania (2%), Italy (1%) and the United Kingdom (0.3%).</p>
<p>There were no significant differences based on sex or age groups (
<xref ref-type="table" rid="pone.0150089.t001">Table 1</xref>
and
<xref ref-type="table" rid="pone.0150089.t002">Table 2</xref>
).</p>
<table-wrap id="pone.0150089.t002" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pone.0150089.t002</object-id>
<label>Table 2</label>
<caption>
<title>Age of consumers included in the PlantLIBRA PFS Consumer Survey and of those reporting adverse effects.</title>
</caption>
<alternatives>
<graphic id="pone.0150089.t002g" xlink:href="pone.0150089.t002"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Country</th>
<th align="center" rowspan="1" colspan="1">Consumers in the whole survey (m±SD)</th>
<th align="center" rowspan="1" colspan="1">Consumers reporting adverse effects (m±SD)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Finland</td>
<td align="center" rowspan="1" colspan="1">48.3±15.7</td>
<td align="center" rowspan="1" colspan="1">48.7±13.8</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Germany</td>
<td align="center" rowspan="1" colspan="1">47.0±15.8</td>
<td align="center" rowspan="1" colspan="1">48.3±16.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Italy</td>
<td align="center" rowspan="1" colspan="1">44.0±16.2</td>
<td align="center" rowspan="1" colspan="1">40.6±15.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Romania</td>
<td align="center" rowspan="1" colspan="1">42.9±16.7</td>
<td align="center" rowspan="1" colspan="1">43.1±17.9</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Spain</td>
<td align="center" rowspan="1" colspan="1">47.1±13.9</td>
<td align="center" rowspan="1" colspan="1">50.6±11.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">United Kingdom</td>
<td align="center" rowspan="1" colspan="1">48.9±14.2</td>
<td align="center" rowspan="1" colspan="1">35.0
<xref ref-type="table-fn" rid="t002fn002">
<sup>a</sup>
</xref>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>46.4±15.6</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>48.0±14.2</bold>
</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t002fn001">
<p>m±SD = mean±Standard Deviation</p>
</fn>
<fn id="t002fn002">
<p>
<sup>a</sup>
no SD since only one consumer reported adverse effects</p>
</fn>
</table-wrap-foot>
</table-wrap>
<p>The data collected on adverse effects are presented in
<xref ref-type="table" rid="pone.0150089.t003">Table 3</xref>
. Details of each of the 82 cases are recorded including:</p>
<list list-type="bullet">
<list-item>
<p>ID of the 82 consumers reporting adverse effects. ID 1–23 were from Finland, ID 24–45 from Germany, ID 46–69 from Spain, ID 70–74 from Italy, ID 75–81 from Romania, ID 82 from the United Kingdom. When a consumer reported adverse effects for two PFS, letters A and B follows the ID;</p>
</list-item>
<list-item>
<p>Age and gender;</p>
</list-item>
<list-item>
<p>The botanical/s contained in the PFS associated with the reported adverse effect. For a more precise identification, Latin names have been used but the corresponding common names are reported in
<xref ref-type="table" rid="pone.0150089.t004">Table 4</xref>
(see table note for scientific sources);</p>
</list-item>
<list-item>
<p>The daily dose and the period of intake;</p>
</list-item>
<list-item>
<p>The reason for use reported by the consumer, i.e. the physiological effect expected by the consumer;</p>
</list-item>
<list-item>
<p>An assessment of the suitability of the botanical ingredient(s) present in the consumed PFS for the condition used, based on what the literature says about these ingredients. The main literature sources were the list of physiological effects published by the Italian Ministry of Health [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
] and the EMA website [
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]. In specific cases, other scientific papers were cited;</p>
</list-item>
<list-item>
<p>The general health status of the consumer. These data allow a better assessment of adverse effect causality;</p>
</list-item>
<list-item>
<p>Any reported simultaneous intake of conventional medicines and other food supplements; these data allow the assessment of possible interactions;</p>
</list-item>
<list-item>
<p>The adverse effects reported by the consumers;</p>
</list-item>
<list-item>
<p>A judgement as to the likelihood of causality, according to previous scientific citations and taking into consideration all available data.</p>
</list-item>
</list>
<table-wrap id="pone.0150089.t003" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pone.0150089.t003</object-id>
<label>Table 3</label>
<caption>
<title>Adverse effects reported by PlantLIBRA PFS Consumer Survey participants.</title>
</caption>
<alternatives>
<graphic id="pone.0150089.t003g" xlink:href="pone.0150089.t003"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="center" rowspan="1" colspan="1">ID</th>
<th align="center" rowspan="1" colspan="1">Age/Gender</th>
<th align="left" rowspan="1" colspan="1">Botanical/s
<xref ref-type="table-fn" rid="t003fn001">^</xref>
</th>
<th align="left" rowspan="1" colspan="1">Dose and period</th>
<th align="left" rowspan="1" colspan="1">Reasons for use</th>
<th align="left" rowspan="1" colspan="1">"Suitability"</th>
<th align="left" rowspan="1" colspan="1">Present or past main health problems</th>
<th align="left" rowspan="1" colspan="1">Conventional drugs + FS</th>
<th align="left" rowspan="1" colspan="1">Adverse effects</th>
<th align="left" rowspan="1" colspan="1">Causality</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">01</td>
<td align="center" rowspan="1" colspan="1">55/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
,
<italic>Panax ginseng</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2w</td>
<td align="left" rowspan="1" colspan="1">Tonic</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Migraine</td>
<td align="left" rowspan="1" colspan="1">Antihistaminics, Corticosteroids, Ibuprofen, Roxithromycin + FO, PO, VM</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible worsening of gastric side effects of anti-inflammatory drugs</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">02</td>
<td align="center" rowspan="1" colspan="1">31/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea angustifolia</italic>
,
<italic>E</italic>
.
<italic>purpurea</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 2w</td>
<td align="left" rowspan="1" colspan="1">Immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + AA, VM</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref043" ref-type="bibr">43</xref>
–
<xref rid="pone.0150089.ref044" ref-type="bibr">44</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">03</td>
<td align="center" rowspan="1" colspan="1">55/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Glycine max</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 6m</td>
<td align="left" rowspan="1" colspan="1">Menopause</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Allergy</td>
<td align="left" rowspan="1" colspan="1">Antiallergic drugs + Vitamin D</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref045" ref-type="bibr">45</xref>
–
<xref rid="pone.0150089.ref046" ref-type="bibr">46</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">04</td>
<td align="center" rowspan="1" colspan="1">36/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Gossypium spp</italic>
.,
<italic>Zingiber officinale</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Neuralgia</td>
<td align="left" rowspan="1" colspan="1">No</td>
<td align="left" rowspan="1" colspan="1">Allergy/asthma, joint/bone pain</td>
<td align="left" rowspan="1" colspan="1">Budesonide, Formoterol, Salbutamol + FO, V</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref014" ref-type="bibr">14</xref>
;
<xref rid="pone.0150089.ref047" ref-type="bibr">47</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">05</td>
<td align="center" rowspan="1" colspan="1">54/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Zingiber officinale</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 24d</td>
<td align="left" rowspan="1" colspan="1">Joints/bones</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">Simvastatin + PO, VM</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref014" ref-type="bibr">14</xref>
;
<xref rid="pone.0150089.ref047" ref-type="bibr">47</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">06</td>
<td align="center" rowspan="1" colspan="1">72/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea angustifolia</italic>
,
<italic>E</italic>
.
<italic>purpurea</italic>
,</td>
<td align="left" rowspan="1" colspan="1">3/d x 4d</td>
<td align="left" rowspan="1" colspan="1">Immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">No drug + Vitamin D</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref043" ref-type="bibr">43</xref>
–
<xref rid="pone.0150089.ref044" ref-type="bibr">44</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">07</td>
<td align="center" rowspan="1" colspan="1">57/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea angustifolia</italic>
,
<italic>E</italic>
.
<italic>purpurea</italic>
,</td>
<td align="left" rowspan="1" colspan="1">3/d x 3d</td>
<td align="left" rowspan="1" colspan="1">Immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Cancer</td>
<td align="left" rowspan="1" colspan="1">No drug + FO, V</td>
<td align="left" rowspan="1" colspan="1">Tachycardia</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">08</td>
<td align="center" rowspan="1" colspan="1">44/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Achillea millefolium</italic>
,
<italic>Citrus aurantium</italic>
,
<italic>Crataegus spp</italic>
.,
<italic>Daucus carota</italic>
,
<italic>Equisetum arvense</italic>
,
<italic>Foeniculum vulgare</italic>
,
<italic>Fucus vesiculosus</italic>
[alga],
<italic>Hibiscus rosa-sinensis</italic>
,
<italic>Ribes nigrum</italic>
,
<italic>Spinacia oleracea</italic>
,
<italic>Triticum spp</italic>
.,
<italic>Urtica dioica</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/w x 1m</td>
<td align="left" rowspan="1" colspan="1">Immunity, tonic</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
<td align="left" rowspan="1" colspan="1">Migraine</td>
<td align="left" rowspan="1" colspan="1">No drug + VM</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Unassessable due to the presence of several ingredients</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">09</td>
<td align="center" rowspan="1" colspan="1">53/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Arctium lappa</italic>
,
<italic>Betula spp</italic>
.,
<italic>Cichorium intybus</italic>
,
<italic>Cynara scolymus</italic>
,
<italic>Filipendula ulmaria</italic>
,
<italic>Foeniculum vulgare</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 1m</td>
<td align="left" rowspan="1" colspan="1">Detoxification</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + AA, E, FO, PO, PE, VM</td>
<td align="left" rowspan="1" colspan="1">Increased diuresis</td>
<td align="left" rowspan="1" colspan="1">Possible due to the presence of diuretic ingredients [
<italic>Betula spp</italic>
.,
<italic>Arctium lappa</italic>
] [
<xref rid="pone.0150089.ref048" ref-type="bibr">48</xref>
–
<xref rid="pone.0150089.ref049" ref-type="bibr">49</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">61/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Equisetum arvense</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 12m</td>
<td align="left" rowspan="1" colspan="1">Hair/skin</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + FO, V</td>
<td align="left" rowspan="1" colspan="1">Hair loss/fragile nail</td>
<td align="left" rowspan="1" colspan="1">Possible due to decreased level of thiamine [
<xref rid="pone.0150089.ref050" ref-type="bibr">50</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">11</td>
<td align="center" rowspan="1" colspan="1">31/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Calendula officinalis</italic>
,
<italic>Citrus sinensis</italic>
,
<italic>Dunaliella salina</italic>
[alga],
<italic>Glycine max</italic>
,
<italic>Picea spp</italic>
.</td>
<td align="left" rowspan="1" colspan="1">1/d x 6m</td>
<td align="left" rowspan="1" colspan="1">Antioxidant</td>
<td align="left" rowspan="1" colspan="1">Limited evidence [
<xref rid="pone.0150089.ref013" ref-type="bibr">13</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + PO, VM</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Unassessable due to the presence of several ingredients</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">12</td>
<td align="center" rowspan="1" colspan="1">42/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Zingiber officinale</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 1m</td>
<td align="left" rowspan="1" colspan="1">Bodybuilding, tonic</td>
<td align="left" rowspan="1" colspan="1">Unlikely [
<xref rid="pone.0150089.ref014" ref-type="bibr">14</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + AA</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref014" ref-type="bibr">14</xref>
;
<xref rid="pone.0150089.ref047" ref-type="bibr">47</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">13</td>
<td align="center" rowspan="1" colspan="1">35/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Immunity, body weight, tonic, HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">No drug + Vitamin D, AA, FO</td>
<td align="left" rowspan="1" colspan="1">Insomnia and nausea</td>
<td align="left" rowspan="1" colspan="1">Possible for the content in caffeine [
<xref rid="pone.0150089.ref051" ref-type="bibr">51</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">14</td>
<td align="center" rowspan="1" colspan="1">39/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Olea europaea</italic>
(olive oil)</td>
<td align="left" rowspan="1" colspan="1">1/d x 9m</td>
<td align="left" rowspan="1" colspan="1">Immunity, hair/skin, tonic, mood, joints/bones, blood circulation</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Psoriasis</td>
<td align="left" rowspan="1" colspan="1">No drug + FO, PE, VM</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea and nausea</td>
<td align="left" rowspan="1" colspan="1">Possible—high intake of olive oil could produce laxative effect [
<xref rid="pone.0150089.ref022" ref-type="bibr">22</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">15</td>
<td align="center" rowspan="1" colspan="1">72/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oryza sativa + Monascus purpureus</italic>
[fungus]</td>
<td align="left" rowspan="1" colspan="1">1/d x 12m</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref015" ref-type="bibr">15</xref>
–
<xref rid="pone.0150089.ref019" ref-type="bibr">19</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Asthma, hypertension, cancer, depression, joint/bone pain</td>
<td align="left" rowspan="1" colspan="1">Acetylsalicylic acid, Amilodipine, Lisinopril, Pantoprazole + VM</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref051" ref-type="bibr">51</xref>
–
<xref rid="pone.0150089.ref052" ref-type="bibr">52</xref>
] Possible worsening of gastric side effects of anti-inflammatory drugs</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">16</td>
<td align="center" rowspan="1" colspan="1">46/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oryza sativa + Monascus purpureus</italic>
[fungus]</td>
<td align="left" rowspan="1" colspan="1">1/d x 12m</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref015" ref-type="bibr">15</xref>
–
<xref rid="pone.0150089.ref019" ref-type="bibr">19</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, hypertension</td>
<td align="left" rowspan="1" colspan="1">Drugs for hypertension + FO, PO, VM</td>
<td align="left" rowspan="1" colspan="1">Increased liver enzymes</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref052" ref-type="bibr">52</xref>
–
<xref rid="pone.0150089.ref053" ref-type="bibr">53</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">17A</td>
<td align="center" rowspan="1" colspan="1">70/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oryza sativa + Monascus purpureus</italic>
[fungus]</td>
<td align="left" rowspan="1" colspan="1">1/d x 11m</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref015" ref-type="bibr">15</xref>
–
<xref rid="pone.0150089.ref019" ref-type="bibr">19</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, diabetes, hearth disease, allergy, depression</td>
<td align="left" rowspan="1" colspan="1">Acetylsalicylic acid, Enapril, Loratadine, Metoprolol, Mometasone + E, FO, PO, VM</td>
<td align="left" rowspan="1" colspan="1">Dry skin</td>
<td align="left" rowspan="1" colspan="1">Unlikely [
<xref rid="pone.0150089.ref052" ref-type="bibr">52</xref>
–
<xref rid="pone.0150089.ref053" ref-type="bibr">53</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">17B</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">
<italic>Plantago psyllium</italic>
,
<italic>Prunus africana</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Urinary tract</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref020" ref-type="bibr">20</xref>
]</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref054" ref-type="bibr">54</xref>
] Possible worsening of gastric side effects of anti-inflammatory drugs</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">18</td>
<td align="center" rowspan="1" colspan="1">49/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Gossypium spp</italic>
.,
<italic>Zingiber officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Sleeping, joints/bones</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
<td align="left" rowspan="1" colspan="1">Muscle, joint/bone pain</td>
<td align="left" rowspan="1" colspan="1">Glucosamine + VM</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref014" ref-type="bibr">14</xref>
,
<xref rid="pone.0150089.ref047" ref-type="bibr">47</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">19</td>
<td align="center" rowspan="1" colspan="1">68/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oryza sativa + Monascus purpureus</italic>
[fungus]</td>
<td align="left" rowspan="1" colspan="1">1/d x 12m</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref015" ref-type="bibr">15</xref>
–
<xref rid="pone.0150089.ref019" ref-type="bibr">19</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, hypertension, depression</td>
<td align="left" rowspan="1" colspan="1">Bisoprolol, Olanzapine, Thyroxin, Zopiclon + VM</td>
<td align="left" rowspan="1" colspan="1">Difficulty in swallowing</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref055" ref-type="bibr">55</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">20</td>
<td align="center" rowspan="1" colspan="1">46/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oryza sativa + Monascus purpureus</italic>
[fungus]</td>
<td align="left" rowspan="1" colspan="1">1/d x 6m</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref021" ref-type="bibr">21</xref>
–
<xref rid="pone.0150089.ref022" ref-type="bibr">22</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, hypertension, diabetes</td>
<td align="left" rowspan="1" colspan="1">Metformin, Telmisartan + FO, PO, VM</td>
<td align="left" rowspan="1" colspan="1">Increased liver enzymes</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref052" ref-type="bibr">52</xref>
–
<xref rid="pone.0150089.ref053" ref-type="bibr">53</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">21</td>
<td align="center" rowspan="1" colspan="1">39/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Olea europaea</italic>
,
<italic>Melissa officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2w</td>
<td align="left" rowspan="1" colspan="1">Immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref021" ref-type="bibr">21</xref>
–
<xref rid="pone.0150089.ref022" ref-type="bibr">22</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Migraine, allergy</td>
<td align="left" rowspan="1" colspan="1">Enoxaparin+ PO, VM</td>
<td align="left" rowspan="1" colspan="1">Allergic symptoms</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref056" ref-type="bibr">56</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">22</td>
<td align="center" rowspan="1" colspan="1">24/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Immunity, body weight, tonic, antioxidant</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + E, FO, PO, VM</td>
<td align="left" rowspan="1" colspan="1">Nausea</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref057" ref-type="bibr">57</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">40/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Urtica dioica</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Body weight, immunity</td>
<td align="left" rowspan="1" colspan="1">Limited evidence [
<xref rid="pone.0150089.ref023" ref-type="bibr">23</xref>
–
<xref rid="pone.0150089.ref024" ref-type="bibr">24</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + AA, FO, PO, VM</td>
<td align="left" rowspan="1" colspan="1">"Easy" sweating</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref058" ref-type="bibr">58</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">24</td>
<td align="center" rowspan="1" colspan="1">48/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Arthrospira platensis</italic>
[alga]</td>
<td align="left" rowspan="1" colspan="1">1/d x 5m</td>
<td align="left" rowspan="1" colspan="1">Antioxidant, immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref025" ref-type="bibr">25</xref>
–
<xref rid="pone.0150089.ref026" ref-type="bibr">26</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Migraine</td>
<td align="left" rowspan="1" colspan="1">Analgesics + V</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Uncertain</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">25</td>
<td align="center" rowspan="1" colspan="1">47/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Auricularia auricula-judae</italic>
[fungus],
<italic>Coffea arabica</italic>
,
<italic>Fallopia japonica/Polygonum cuspidatum</italic>
,
<italic>Ginkgo biloba</italic>
,
<italic>Panicum miliaceum</italic>
,
<italic>Polyporus umbellatus</italic>
[fungus],
<italic>Saccharomyces cerevisiae</italic>
[yeast],
<italic>Serenoa repens</italic>
,
<italic>Trigonella foenum-graecum</italic>
,
<italic>Ziziphus jujuba</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 12m</td>
<td align="left" rowspan="1" colspan="1">Hair/skin, energy</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
,
<xref rid="pone.0150089.ref027" ref-type="bibr">27</xref>
–
<xref rid="pone.0150089.ref028" ref-type="bibr">28</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Discomfort</td>
<td align="left" rowspan="1" colspan="1">Unassessable due to the presence of several ingredients</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">26</td>
<td align="center" rowspan="1" colspan="1">57/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cucurbita maxima</italic>
,
<italic>Vaccinium macrocarpon</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Urinary tract</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, hypertension</td>
<td align="left" rowspan="1" colspan="1">Benazepril</td>
<td align="left" rowspan="1" colspan="1">Discomfort</td>
<td align="left" rowspan="1" colspan="1">Unassessable</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">27</td>
<td align="center" rowspan="1" colspan="1">45/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Saccharomyces cerevisiae</italic>
[yeast]</td>
<td align="left" rowspan="1" colspan="1">3/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Hair/skin</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref029" ref-type="bibr">29</xref>
–
<xref rid="pone.0150089.ref030" ref-type="bibr">30</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Skin problems</td>
<td align="left" rowspan="1" colspan="1">Unlikely [Allergy
<xref ref-type="table-fn" rid="t003fn002">?</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">28</td>
<td align="center" rowspan="1" colspan="1">42/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Asparagus officinalis</italic>
,
<italic>Cynara scolymus</italic>
,
<italic>Cichorium intybus (inulin)</italic>
,
<italic>Plantago psyllium</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2w</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + M</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref059" ref-type="bibr">59</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">29</td>
<td align="center" rowspan="1" colspan="1">64/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Nigella sativa</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 1m</td>
<td align="left" rowspan="1" colspan="1">Immunity, HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref031" ref-type="bibr">31</xref>
–
<xref rid="pone.0150089.ref032" ref-type="bibr">32</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + M</td>
<td align="left" rowspan="1" colspan="1">Mild flatulence</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">30</td>
<td align="center" rowspan="1" colspan="1">42/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cynara scolymus</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 6m</td>
<td align="left" rowspan="1" colspan="1">Digestion, HCHO</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">No drug + VM</td>
<td align="left" rowspan="1" colspan="1">Nausea</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref059" ref-type="bibr">59</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">31</td>
<td align="center" rowspan="1" colspan="1">62/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Glycine max</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Menopause</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Allergy</td>
<td align="left" rowspan="1" colspan="1">No drug + FO, M</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref045" ref-type="bibr">45</xref>
–
<xref rid="pone.0150089.ref046" ref-type="bibr">46</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">32</td>
<td align="center" rowspan="1" colspan="1">31/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Matricaria recutita</italic>
,
<italic>Melissa officinalis</italic>
,
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 6m</td>
<td align="left" rowspan="1" colspan="1">Sleeping and mood problems</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Migraine, peptic ulcer, sleep disorders</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Dizziness</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref060" ref-type="bibr">60</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">33</td>
<td align="center" rowspan="1" colspan="1">56/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Brassica oleracea</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Body weight</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
<td align="left" rowspan="1" colspan="1">Hypertension, sleeping disorders, chronic bronchitis</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">34</td>
<td align="center" rowspan="1" colspan="1">29/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Saccharomyces cerevisiae</italic>
[yeast]</td>
<td align="left" rowspan="1" colspan="1">2/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Hair/skin</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref029" ref-type="bibr">29</xref>
–
<xref rid="pone.0150089.ref030" ref-type="bibr">30</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Gastric problems, diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">35A</td>
<td align="center" rowspan="1" colspan="1">64/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cynara scolymus</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 5d</td>
<td align="left" rowspan="1" colspan="1">Body weight, HCHO, digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Hypertension, asthma, diabetes, joint/bone pain</td>
<td align="left" rowspan="1" colspan="1">Beclometason [spray], Formoterol [spray], Metformin, Thyroxin + VM, E (lactase)</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref022" ref-type="bibr">22</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">35B</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
,
<italic>Crataegus spp</italic>
.,
<italic>Olea europaea</italic>
(olive oil),
<italic>Viscum album</italic>
</td>
<td align="left" rowspan="1" colspan="1">Unknown</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Possible (olive oil)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">36</td>
<td align="center" rowspan="1" colspan="1">27/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Olea europaea</italic>
(olive oil)</td>
<td align="left" rowspan="1" colspan="1">1/d x 5w</td>
<td align="left" rowspan="1" colspan="1">HCHO, body weight, digestion, blood circulation</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">No drug + FO, VM</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref022" ref-type="bibr">22</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">37</td>
<td align="center" rowspan="1" colspan="1">65/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">4/w x 12m</td>
<td align="left" rowspan="1" colspan="1">Memory</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO</td>
<td align="left" rowspan="1" colspan="1">Iron supplementation, V</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref061" ref-type="bibr">61</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">38</td>
<td align="center" rowspan="1" colspan="1">66/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">5/w x 6m</td>
<td align="left" rowspan="1" colspan="1">Memory</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref062" ref-type="bibr">62</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">39</td>
<td align="center" rowspan="1" colspan="1">23/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Paullinia cupana</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Energy</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">40</td>
<td align="center" rowspan="1" colspan="1">19/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Paullinia cupana</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/w x 3w</td>
<td align="left" rowspan="1" colspan="1">Energy, urinary tract</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">41</td>
<td align="center" rowspan="1" colspan="1">71/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cynara scolymus</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/w x 4w</td>
<td align="left" rowspan="1" colspan="1">Antioxidant, immunity, digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, hypertension</td>
<td align="left" rowspan="1" colspan="1">Metopolol, Ramipril</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref059" ref-type="bibr">59</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">42A</td>
<td align="center" rowspan="1" colspan="1">31/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Peumus boldus</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/w x 1w</td>
<td align="left" rowspan="1" colspan="1">Digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">42B</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">
<italic>Linum usitatissimum</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/w x 3w</td>
<td align="left" rowspan="1" colspan="1">Digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Unlikely at the dose used</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">43</td>
<td align="center" rowspan="1" colspan="1">66/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Panax ginseng</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/w x 6w</td>
<td align="left" rowspan="1" colspan="1">HCHO, relaxing, hair/skin</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref033" ref-type="bibr">33</xref>
–
<xref rid="pone.0150089.ref034" ref-type="bibr">34</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, cataract</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref063" ref-type="bibr">63</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">44</td>
<td align="center" rowspan="1" colspan="1">66/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Olea europaea</italic>
</td>
<td align="left" rowspan="1" colspan="1">5/w x 2w</td>
<td align="left" rowspan="1" colspan="1">Hair/skin</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">45</td>
<td align="center" rowspan="1" colspan="1">41/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oenothera biennis</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d X 3m</td>
<td align="left" rowspan="1" colspan="1">Immunity, hair/skin</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Hypertension, allergy</td>
<td align="left" rowspan="1" colspan="1">Antihypertensive drugs, Thyroxin</td>
<td align="left" rowspan="1" colspan="1">Mild eructation</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref064" ref-type="bibr">64</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">46</td>
<td align="center" rowspan="1" colspan="1">57/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
,
<italic>Paullinia cupana</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Body weight, digestion, energy/tonic</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
,
<xref rid="pone.0150089.ref035" ref-type="bibr">35</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Probable due to the content in caffeine [
<xref rid="pone.0150089.ref035" ref-type="bibr">35</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">47</td>
<td align="center" rowspan="1" colspan="1">43/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cassia angustifolia</italic>
,
<italic>Illicium verum</italic>
,
<italic>Raphanus sativus var</italic>
.
<italic>niger</italic>
,
<italic>Rhamnus purshiana</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 4w</td>
<td align="left" rowspan="1" colspan="1">Body weight, digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Hypertension, migraine</td>
<td align="left" rowspan="1" colspan="1">No drug</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref065" ref-type="bibr">65</xref>
–
<xref rid="pone.0150089.ref066" ref-type="bibr">66</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">48</td>
<td align="center" rowspan="1" colspan="1">47/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Rhamnus purshiana</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 9m</td>
<td align="left" rowspan="1" colspan="1">Digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Chronic neutropenia, glaucoma, vascular problems</td>
<td align="left" rowspan="1" colspan="1">Bimatoprost, Timolol</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref066" ref-type="bibr">66</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">49</td>
<td align="center" rowspan="1" colspan="1">36M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">4/w x 5m</td>
<td align="left" rowspan="1" colspan="1">Sleeping, relaxing, mood</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Unlikely but described [
<xref rid="pone.0150089.ref067" ref-type="bibr">67</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">50</td>
<td align="center" rowspan="1" colspan="1">61/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Punica granatum</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 12m</td>
<td align="left" rowspan="1" colspan="1">Prostate</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref036" ref-type="bibr">36</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Cancer</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Possible for high intake or previous intestinal disorders [
<xref rid="pone.0150089.ref068" ref-type="bibr">68</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">51</td>
<td align="center" rowspan="1" colspan="1">46/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cassia angustifolia</italic>
,
<italic>Raphanus sativus var</italic>
.
<italic>niger</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Flatulence</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref065" ref-type="bibr">65</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">52</td>
<td align="center" rowspan="1" colspan="1">69/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Pimpinella anisum</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 12m</td>
<td align="left" rowspan="1" colspan="1">Digestion</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Hypertension, osteoporosis</td>
<td align="left" rowspan="1" colspan="1">Amlodipine</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Uncertain (associated with allergic reaction)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">53</td>
<td align="center" rowspan="1" colspan="1">61/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 12m</td>
<td align="left" rowspan="1" colspan="1">Sleeping, relaxing, mood</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, heart disease, muscles, joint/bone pain, cataract</td>
<td align="left" rowspan="1" colspan="1">Alprazolam, Simvastatin</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Possible—abdominal cramps have been described [
<xref rid="pone.0150089.ref069" ref-type="bibr">69</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">54</td>
<td align="center" rowspan="1" colspan="1">72/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 8m</td>
<td align="left" rowspan="1" colspan="1">Sleeping, memory, relaxing</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Cancer, joint/bone pain</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Migraine</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref067" ref-type="bibr">67</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">55</td>
<td align="center" rowspan="1" colspan="1">36/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Panax ginseng</italic>
,
<italic>Paullinia cupana</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Energy/tonic</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Birth-control pill</td>
<td align="left" rowspan="1" colspan="1">Tachycardia</td>
<td align="left" rowspan="1" colspan="1">Probable [
<xref rid="pone.0150089.ref070" ref-type="bibr">70</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">56</td>
<td align="center" rowspan="1" colspan="1">39/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Passiflora incarnata</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 10m</td>
<td align="left" rowspan="1" colspan="1">Sleeping, relaxing</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Fatigue; insomnia</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">57</td>
<td align="center" rowspan="1" colspan="1">63/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Malus domestica</italic>
,
<italic>Citrus limon</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 4m</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
<td align="left" rowspan="1" colspan="1">HCHO, heart disease, hypertension</td>
<td align="left" rowspan="1" colspan="1">Quinapril/Hydrochlorthiazide, Diosmin/Esperidin [flavonoids]</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">58</td>
<td align="center" rowspan="1" colspan="1">50/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Paullinia cupana</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2w</td>
<td align="left" rowspan="1" colspan="1">Energy/tonic</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Hypertension, anxiety, depression</td>
<td align="left" rowspan="1" colspan="1">Fluoxetine</td>
<td align="left" rowspan="1" colspan="1">Tachycardia</td>
<td align="left" rowspan="1" colspan="1">Probable [
<xref rid="pone.0150089.ref070" ref-type="bibr">70</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">59</td>
<td align="center" rowspan="1" colspan="1">49/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Relaxing</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO; hypertension, migraine, allergy, anxiety</td>
<td align="left" rowspan="1" colspan="1">No drug + SI, VM</td>
<td align="left" rowspan="1" colspan="1">Flatulence</td>
<td align="left" rowspan="1" colspan="1">Possible—abdominal cramps have been described [
<xref rid="pone.0150089.ref069" ref-type="bibr">69</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">60</td>
<td align="center" rowspan="1" colspan="1">64/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oenothera biennis</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 9m</td>
<td align="left" rowspan="1" colspan="1">Breast nodule</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Hypertension, allergy</td>
<td align="left" rowspan="1" colspan="1">Valsartan + AA, V, SI</td>
<td align="left" rowspan="1" colspan="1">Cystitis</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">61</td>
<td align="center" rowspan="1" colspan="1">60/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Harpagophytum procumbens</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 1m</td>
<td align="left" rowspan="1" colspan="1">Joints/bones</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Bone/joint pain, low back pain</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref071" ref-type="bibr">71</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">62</td>
<td align="center" rowspan="1" colspan="1">42/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Allium sativum</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref037" ref-type="bibr">37</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Asthma, renal problems</td>
<td align="left" rowspan="1" colspan="1">Amoxicillin/clavulinic acid</td>
<td align="left" rowspan="1" colspan="1">Allergic symptoms</td>
<td align="left" rowspan="1" colspan="1">Possible (quite rare)</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">63</td>
<td align="center" rowspan="1" colspan="1">49/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Taraxacum officinale</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 8m</td>
<td align="left" rowspan="1" colspan="1">Digestion, diuretic</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Liver disease</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">64</td>
<td align="center" rowspan="1" colspan="1">42/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 4m</td>
<td align="left" rowspan="1" colspan="1">Sleeping, relaxing</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Liver disease, gallbladder inflammation</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Unlikely but described [
<xref rid="pone.0150089.ref067" ref-type="bibr">67</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">65A</td>
<td align="center" rowspan="1" colspan="1">38/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Equisetum arvense</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 4m</td>
<td align="left" rowspan="1" colspan="1">Hair/skin, urinary tract</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Muscle and bone pain, migraine, ulcer, anxiety and depression, urinary problems</td>
<td align="left" rowspan="1" colspan="1">Trimethoprim, Sulfamethoxazol, Ibuprofen</td>
<td align="left" rowspan="1" colspan="1">Constipation</td>
<td align="left" rowspan="1" colspan="1">Possible—gastrointestinal complaints have been reported [
<xref rid="pone.0150089.ref072" ref-type="bibr">72</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">65B</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">
<italic>Taraxacum officinale</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 4m</td>
<td align="left" rowspan="1" colspan="1">Urinary tract</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">Dizziness</td>
<td align="left" rowspan="1" colspan="1">Unlikely even though described for interaction with acetylsalicylic acid</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">66</td>
<td align="center" rowspan="1" colspan="1">46/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Lepidium meyenii</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Urinary tract [kidney stones]</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref038" ref-type="bibr">38</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Allergy, kidney stones</td>
<td align="left" rowspan="1" colspan="1">Ibuprofen, Metamizole, Potassium citrate</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">67</td>
<td align="center" rowspan="1" colspan="1">54/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea angustifolia</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 1m</td>
<td align="left" rowspan="1" colspan="1">Flu cold</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, hypertension</td>
<td align="left" rowspan="1" colspan="1">Metformin, Olmesartan/Medoxomil</td>
<td align="left" rowspan="1" colspan="1">Increased glycemia</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">68</td>
<td align="center" rowspan="1" colspan="1">61/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea spp</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Sinusitis</td>
<td align="left" rowspan="1" colspan="1">Yes (cold) [
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, anxiety and depression</td>
<td align="left" rowspan="1" colspan="1">Atorvastatin, Enalapril</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref073" ref-type="bibr">73</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">69A</td>
<td align="center" rowspan="1" colspan="1">30/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Allium sativum</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 3m</td>
<td align="left" rowspan="1" colspan="1">Immunity, flu cold</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref037" ref-type="bibr">37</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Allergy</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref074" ref-type="bibr">74</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">69B</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 12m</td>
<td align="left" rowspan="1" colspan="1">Sleeping</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Allergy</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Migraine</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref067" ref-type="bibr">67</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">70</td>
<td align="center" rowspan="1" colspan="1">29/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Foeniculum vulgare</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 2m</td>
<td align="left" rowspan="1" colspan="1">Body weight, urinary tract</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Asthma, allergy</td>
<td align="left" rowspan="1" colspan="1">Beclometasone, Drospirenone/Ethinyl estradiol, Salbutamol</td>
<td align="left" rowspan="1" colspan="1">Difficult swallowing</td>
<td align="left" rowspan="1" colspan="1">Possible since reported in cases of allergy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">71</td>
<td align="center" rowspan="1" colspan="1">35/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Paullinia cupana</italic>
</td>
<td align="left" rowspan="1" colspan="1">1d x 5m</td>
<td align="left" rowspan="1" colspan="1">Energy/tonic, mood</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Heart disease</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Dizziness</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref075" ref-type="bibr">75</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">72</td>
<td align="center" rowspan="1" colspan="1">52/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Aloe barbadensis</italic>
,
<italic>Harpagophytum procumbens</italic>
</td>
<td align="left" rowspan="1" colspan="1">2d x 4w</td>
<td align="left" rowspan="1" colspan="1">Joints/bones</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Muscle, bone/joint pain</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Unspecified</td>
<td align="left" rowspan="1" colspan="1">Unassessable</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">73</td>
<td align="center" rowspan="1" colspan="1">26/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Panax ginseng</italic>
</td>
<td align="left" rowspan="1" colspan="1">1d x 2w</td>
<td align="left" rowspan="1" colspan="1">Energy/tonic</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + Inositol, folic acid</td>
<td align="left" rowspan="1" colspan="1">Tachycardia</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref076" ref-type="bibr">76</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">74</td>
<td align="center" rowspan="1" colspan="1">61/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cyamopsis tetragonoloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">20/m x
<xref ref-type="table-fn" rid="t003fn002">?</xref>
</td>
<td align="left" rowspan="1" colspan="1">Body weight, energy/tonic</td>
<td align="left" rowspan="1" colspan="1">Unlikely [
<xref rid="pone.0150089.ref039" ref-type="bibr">39</xref>
–
<xref rid="pone.0150089.ref040" ref-type="bibr">40</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Diabetes</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Nausea</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref040" ref-type="bibr">40</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">75</td>
<td align="center" rowspan="1" colspan="1">69/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x
<xref ref-type="table-fn" rid="t003fn002">?</xref>
</td>
<td align="left" rowspan="1" colspan="1">Joints/bones, blood circulation</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Diabetes, heart disease, hypertension, liver disease, stroke, gallbladder inflammation/stones</td>
<td align="left" rowspan="1" colspan="1">Acenocumarole, Captopril, Trimetazidine</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref077" ref-type="bibr">77</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">76</td>
<td align="center" rowspan="1" colspan="1">21/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x
<xref ref-type="table-fn" rid="t003fn002">?</xref>
</td>
<td align="left" rowspan="1" colspan="1">Memory</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">No drug + Polyphenols</td>
<td align="left" rowspan="1" colspan="1">Dizziness</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref078" ref-type="bibr">78</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">77</td>
<td align="center" rowspan="1" colspan="1">19/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">2/d x 14d</td>
<td align="left" rowspan="1" colspan="1">Memory</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Hypertension</td>
<td align="left" rowspan="1" colspan="1">Captopril</td>
<td align="left" rowspan="1" colspan="1">Insomnia</td>
<td align="left" rowspan="1" colspan="1">Possible [
<xref rid="pone.0150089.ref077" ref-type="bibr">77</xref>
]</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">78</td>
<td align="center" rowspan="1" colspan="1">41/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Arthrospira platensis</italic>
[alga],
<italic>Hippophae rhamnoides</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x
<xref ref-type="table-fn" rid="t003fn002">?</xref>
</td>
<td align="left" rowspan="1" colspan="1">Immunity, energy/tonic</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Anemia, arrhythmia</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Gastric problems, nausea</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">79</td>
<td align="center" rowspan="1" colspan="1">50/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2w</td>
<td align="left" rowspan="1" colspan="1">Immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref041" ref-type="bibr">41</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, diabetes, migraine</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea, gastric problems (nausea)</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">80</td>
<td align="center" rowspan="1" colspan="1">49/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="left" rowspan="1" colspan="1">1/d x 2w</td>
<td align="left" rowspan="1" colspan="1">Immunity</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref041" ref-type="bibr">41</xref>
]</td>
<td align="left" rowspan="1" colspan="1">Migraine, ulcer</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea, gastric problems (nausea)</td>
<td align="left" rowspan="1" colspan="1">Unlikely</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">81</td>
<td align="center" rowspan="1" colspan="1">53/F</td>
<td align="left" rowspan="1" colspan="1">
<italic>Betula spp</italic>
.,
<italic>Equisetum arvense</italic>
,
<italic>Juniperus communis</italic>
,
<italic>Pimpinella anisum</italic>
,
<italic>Vaccinium vitis-idaea</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/d x 20d</td>
<td align="left" rowspan="1" colspan="1">Urinary tract</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
]</td>
<td align="left" rowspan="1" colspan="1">HCHO, asthma, diabetes, heart disease, hypertension, liver disease, chronic bronchitis, cataract, osteoporosis, allergy, cancer, Basedow disease</td>
<td align="left" rowspan="1" colspan="1">Enalapril, Metformin, Nicergoline, Simvastatin</td>
<td align="left" rowspan="1" colspan="1">Gastric problems</td>
<td align="left" rowspan="1" colspan="1">Unassessable due to the presence of several ingredients</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">82</td>
<td align="center" rowspan="1" colspan="1">35/M</td>
<td align="left" rowspan="1" colspan="1">
<italic>Aloe vera</italic>
</td>
<td align="left" rowspan="1" colspan="1">3/w x 12m</td>
<td align="left" rowspan="1" colspan="1">Joints/bones</td>
<td align="left" rowspan="1" colspan="1">Yes [
<xref rid="pone.0150089.ref042" ref-type="bibr">42</xref>
]</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Diarrhoea</td>
<td align="left" rowspan="1" colspan="1">Probable [laxative effect]</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t003fn001">
<p>^ according to: for plants US Department of Agriculture (
<ext-link ext-link-type="uri" xlink:href="http://plants.usda.gov">plants.usda.gov</ext-link>
); for algae
<ext-link ext-link-type="uri" xlink:href="http://www.algaebase.org/">www.algaebase.org</ext-link>
; for fungi
<ext-link ext-link-type="uri" xlink:href="http://www.indexfungorum.org/">www.indexfungorum.org</ext-link>
</p>
</fn>
<fn id="t003fn002">
<p>? unknown</p>
</fn>
<fn id="t003fn003">
<p>AA= Supplement containing amino acids; FO= Fish Oil; E= Enzymes; HCHO= Hypercholesterolemia; M= Supplement containing minerals; PE= Prebiotics; PO= Probiotics; SI= Soy isoflavones; V= Supplement containing vitamins; VM= Supplement containing vitamins and minerals; d= day; m= month; w= week</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="pone.0150089.t004" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pone.0150089.t004</object-id>
<label>Table 4</label>
<caption>
<title>Botanical ingredients contained in PFS with reported adverse effects.</title>
</caption>
<alternatives>
<graphic id="pone.0150089.t004g" xlink:href="pone.0150089.t004"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="left" rowspan="2" colspan="1">
<italic>Latin name</italic>
<xref ref-type="table-fn" rid="t004fn001">^</xref>
</th>
<th align="left" rowspan="2" colspan="1">Common name
<xref ref-type="table-fn" rid="t004fn001">^</xref>
</th>
<th align="center" colspan="11" rowspan="1">Number of counts</th>
</tr>
<tr>
<th align="center" colspan="7" rowspan="1">Total for country</th>
<th align="center" rowspan="1" colspan="1">TOTAL</th>
<th align="center" rowspan="1" colspan="1">1 ING
<xref ref-type="table-fn" rid="t004fn004">
<sup>a</sup>
</xref>
</th>
<th align="center" rowspan="1" colspan="1">2–3 ING</th>
<th align="center" rowspan="1" colspan="1">≥ 4 ING</th>
</tr>
<tr>
<th align="left" rowspan="1" colspan="1"></th>
<th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">FI</th>
<th align="center" rowspan="1" colspan="1">D</th>
<th align="center" colspan="2" rowspan="1">IT</th>
<th align="center" rowspan="1" colspan="1">RO</th>
<th align="center" rowspan="1" colspan="1">SP</th>
<th align="center" rowspan="1" colspan="1">UK</th>
<th align="center" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1"></th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Garden valerian</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">7</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>8</bold>
</td>
<td align="center" rowspan="1" colspan="1">7</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Tea</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>7</bold>
</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">Maidenhair tree</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>6</bold>
</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Paullinia cupana</italic>
</td>
<td align="left" rowspan="1" colspan="1">Guarana</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">2</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>6</bold>
</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Cynara scolymus</italic>
</td>
<td align="left" rowspan="1" colspan="1">Globe artichoke</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1">4</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>5</bold>
</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea angustifolia/purpurea</italic>
</td>
<td align="left" rowspan="1" colspan="1">Black Samson Echinacea/ Eastern purple coneflower</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>5</bold>
</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Olea europaea</italic>
</td>
<td align="left" rowspan="1" colspan="1">Olive</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>5</bold>
</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Oryza sativa + Monascus purpureus</italic>
</td>
<td align="left" rowspan="1" colspan="1">Red rice</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>5</bold>
</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Panax ginseng</italic>
</td>
<td align="left" rowspan="1" colspan="1">Chinese ginseng</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>5</bold>
</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Equisetum arvense</italic>
</td>
<td align="left" rowspan="1" colspan="1">Field horsetail</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>4</bold>
</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Allium sativum</italic>
</td>
<td align="left" rowspan="1" colspan="1">Cultivated garlic</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>3</bold>
</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Foeniculum vulgare</italic>
</td>
<td align="left" rowspan="1" colspan="1">Sweet fennel</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>3</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Glycine max</italic>
</td>
<td align="left" rowspan="1" colspan="1">Soybean</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>3</bold>
</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Saccharomyces cerevisiae</italic>
</td>
<td align="left" rowspan="1" colspan="1">Yeast</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">3</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>3</bold>
</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Aloe barbadensis/vera</italic>
</td>
<td align="left" rowspan="1" colspan="1">Barbados aloe</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Arthrospira platensis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Spirulina</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Betula spp</italic>
.</td>
<td align="left" rowspan="1" colspan="1">Birch</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Cassia angustifolia</italic>
</td>
<td align="left" rowspan="1" colspan="1">Alexandrian senna</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Citrus aurantium</italic>
</td>
<td align="left" rowspan="1" colspan="1">Sour orange</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Crataegus spp</italic>
.</td>
<td align="left" rowspan="1" colspan="1">Hawthorn</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Cichorium intybus</italic>
</td>
<td align="left" rowspan="1" colspan="1">Chicory</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Gossypium spp</italic>
.</td>
<td align="left" rowspan="1" colspan="1">Cotton</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Harpagophytum procumbens</italic>
</td>
<td align="left" rowspan="1" colspan="1">Devil's claw</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Melissa officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Common balm</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Oenothera biennis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Common evening primrose</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Pimpinella anisum</italic>
</td>
<td align="left" rowspan="1" colspan="1">Anise burnet saxifrage</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Plantago psyllium</italic>
</td>
<td align="left" rowspan="1" colspan="1">Psyllium</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Raphanus sativus var</italic>
.
<italic>niger</italic>
</td>
<td align="left" rowspan="1" colspan="1">Spanish black radish</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Rhamnus purshiana</italic>
</td>
<td align="left" rowspan="1" colspan="1">Cascara buckthorn</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Taraxacum officinale</italic>
</td>
<td align="left" rowspan="1" colspan="1">Common dandelion</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Urtica dioica</italic>
</td>
<td align="left" rowspan="1" colspan="1">Stinging nettle</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Zingiber officinale</italic>
</td>
<td align="left" rowspan="1" colspan="1">Garden ginger</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>2</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Achillea millefolium</italic>
</td>
<td align="left" rowspan="1" colspan="1">Common yarrow</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Arctium lappa</italic>
</td>
<td align="left" rowspan="1" colspan="1">Greater burdock</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Asparagus officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Garden asparagus</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Auricularia auricula-judae</italic>
</td>
<td align="left" rowspan="1" colspan="1">Jew's ear</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Brassica oleracea</italic>
</td>
<td align="left" rowspan="1" colspan="1">Cabbage</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Calendula officinalis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Pot marigold</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Citrus limon</italic>
</td>
<td align="left" rowspan="1" colspan="1">Lemon</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Coffea arabica</italic>
</td>
<td align="left" rowspan="1" colspan="1">Arabian coffee</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Cucurbita maxima</italic>
</td>
<td align="left" rowspan="1" colspan="1">Winter squash</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Cyamopsis tetragonoloba</italic>
</td>
<td align="left" rowspan="1" colspan="1">Guar</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Daucus carota</italic>
</td>
<td align="left" rowspan="1" colspan="1">Carrot</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Dunaliella salina</italic>
</td>
<td align="left" rowspan="1" colspan="1">"Green alga"
<xref ref-type="table-fn" rid="t004fn002">*</xref>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Fallopia japonica</italic>
</td>
<td align="left" rowspan="1" colspan="1">Japanese knotweed</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Filipendula ulmaria</italic>
</td>
<td align="left" rowspan="1" colspan="1">Queen of meadow</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Fucus vesiculosus</italic>
</td>
<td align="left" rowspan="1" colspan="1">Bladder wrack</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Hibiscus rosa-sinensis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Shoeblackplant</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Hippophae rhamnoides</italic>
</td>
<td align="left" rowspan="1" colspan="1">Seaberry</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Illicium verum</italic>
</td>
<td align="left" rowspan="1" colspan="1">Staranise tree</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Juniperus communis</italic>
</td>
<td align="left" rowspan="1" colspan="1">Common juniper</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Lepidium meyenii</italic>
</td>
<td align="left" rowspan="1" colspan="1">Maca</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Linum usitatissimum</italic>
</td>
<td align="left" rowspan="1" colspan="1">Common flax</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Malus domestica</italic>
</td>
<td align="left" rowspan="1" colspan="1">Apple</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Matricaria recutita</italic>
</td>
<td align="left" rowspan="1" colspan="1">German chamomile</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Nigella sativa</italic>
</td>
<td align="left" rowspan="1" colspan="1">Black cumin</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Panicum miliaceum</italic>
</td>
<td align="left" rowspan="1" colspan="1">Proso millet</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Passiflora incarnata</italic>
</td>
<td align="left" rowspan="1" colspan="1">Purple passionflower</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Picea spp</italic>
.</td>
<td align="left" rowspan="1" colspan="1">Spruce</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Peumus boldus</italic>
</td>
<td align="left" rowspan="1" colspan="1">Boldo</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Polyporus umbellatus</italic>
</td>
<td align="left" rowspan="1" colspan="1">Umbrella polypore</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Prunus africana</italic>
</td>
<td align="left" rowspan="1" colspan="1">Red stinkwood</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Punica granatum</italic>
</td>
<td align="left" rowspan="1" colspan="1">Pomegranate</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ribes nigrum</italic>
</td>
<td align="left" rowspan="1" colspan="1">European blackcurrant</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Serenoa repens</italic>
</td>
<td align="left" rowspan="1" colspan="1">Saw palmetto</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Spinacia oleracea</italic>
</td>
<td align="left" rowspan="1" colspan="1">Spinach</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Trigonella foenum-graecum</italic>
</td>
<td align="left" rowspan="1" colspan="1">Sicklefruit fenugreek</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Triticum spp</italic>
.</td>
<td align="left" rowspan="1" colspan="1">Wheat</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Vaccinium macrocarpon</italic>
</td>
<td align="left" rowspan="1" colspan="1">Cranberry</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Vaccinum vitis idaea</italic>
</td>
<td align="left" rowspan="1" colspan="1">Cowberry/lingonberry</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Viscum album</italic>
</td>
<td align="left" rowspan="1" colspan="1">European mistletoe</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ziziphus jujuba</italic>
</td>
<td align="left" rowspan="1" colspan="1">Common jujube</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" colspan="2" rowspan="1">1</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">
<bold>1</bold>
</td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total counts</bold>
</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">48</td>
<td align="center" colspan="2" rowspan="1">42</td>
<td align="center" rowspan="1" colspan="1">6</td>
<td align="center" rowspan="1" colspan="1">12</td>
<td align="center" rowspan="1" colspan="1">35</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">
<bold>144</bold>
</td>
<td align="center" rowspan="1" colspan="1">66</td>
<td align="center" rowspan="1" colspan="1">28</td>
<td align="center" rowspan="1" colspan="1">50</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Percentage of the total</bold>
</td>
<td align="left" rowspan="1" colspan="1"></td>
<td align="center" rowspan="1" colspan="1">33</td>
<td align="center" colspan="2" rowspan="1">29</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">8</td>
<td align="center" rowspan="1" colspan="1">24</td>
<td align="center" rowspan="1" colspan="1">0.7</td>
<td align="center" rowspan="1" colspan="1">100</td>
<td align="center" rowspan="1" colspan="1">45.8</td>
<td align="center" rowspan="1" colspan="1">19.4</td>
<td align="center" rowspan="1" colspan="1">34.7</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t004fn001">
<p>^ according to: for plants US Department of Agriculture (
<ext-link ext-link-type="uri" xlink:href="http://plants.usda.gov">plants.usda.gov</ext-link>
); for algae
<ext-link ext-link-type="uri" xlink:href="http://www.algaebase.org/">www.algaebase.org</ext-link>
; for fungi
<ext-link ext-link-type="uri" xlink:href="http://www.indexfungorum.org/">www.indexfungorum.org</ext-link>
</p>
</fn>
<fn id="t004fn002">
<p>* no common name</p>
</fn>
<fn id="t004fn003">
<p>FI = Finland; D = Germany; IT = Italy; RO = Romania; SP = Spain; UK = Unided Kingdom</p>
</fn>
<fn id="t004fn004">
<p>
<sup>a</sup>
ING = Ingredients (number of botanicals contained in the product associated with the adverse effect)</p>
</fn>
</table-wrap-foot>
</table-wrap>
<p>Considering the suitability of the botanical product used in relation to the physiological effect expected by the consumers, the choice was considered appropriate in 88% of cases. One case (ID 4) was considered non pertinent and nine (ID 8, 11, 12, 18, 23, 33, 44, 57, 74) judged as unlikely or with limited evidence. One consumer (ID 08) used a product containing 12 herbal ingredients, but only
<italic>Citrus aurantium</italic>
could claim to have tonic properties due to the presence of active amines. None of the herbal ingredients present have any reported immune activity [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
].</p>
<p>Since all cases were self-reported, it was not possible to establish causality of adverse effects on the basis of clinical evidence. The scientific literature was used to assess the likelihood of the adverse effects being associated with the botanical used and 56 out of 87 (64%) cases were defined as possible (52) or probable (4) according to 1) the daily dose and period of intake, and 2) the frequency and strength of scientific evidence. The most significant references are reported in
<xref ref-type="table" rid="pone.0150089.t003">Table 3</xref>
. The association was not confirmed for 28 cases. The interaction with conventional drugs was considered possible in three cases (ID 01, 15 and 17B). It is important to underline that comparing the list of conventional drugs used with the column “present or past main health problems”, there are several incongruences; this is due to the self-reported nature of information collected.</p>
<p>The frequency of self-reported adverse effects in relation to each botanical is reported in
<xref ref-type="table" rid="pone.0150089.t004">Table 4</xref>
; the total number of botanical ingredients contained in PFS with reported adverse effects was 72 and the total counts were 144. In most cases (46%), the PFS involved contained one ingredient. Forty botanicals (55.6% of the total) were associated with a single adverse event and 80% of them were included in PFS containing two or more ingredients. Considering the most prevalent botanicals associated with adverse effects, 14 were associated with 68 reported adverse effects, representing the 47.2% of the total counts. In particular, eight were due to
<italic>Valeriana officinalis</italic>
(seven of them in Spain), seven to
<italic>Camellia sinensis</italic>
, six to
<italic>Ginkgo biloba</italic>
and six to
<italic>Paullinia cupana</italic>
.</p>
<p>The association of adverse effects with different organ systems is listed in
<xref ref-type="table" rid="pone.0150089.t005">Table 5</xref>
.</p>
<table-wrap id="pone.0150089.t005" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pone.0150089.t005</object-id>
<label>Table 5</label>
<caption>
<title>Distribution of adverse effects among the different organ systems.</title>
</caption>
<alternatives>
<graphic id="pone.0150089.t005g" xlink:href="pone.0150089.t005"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<td align="left" rowspan="1" colspan="1">System</td>
<td align="center" rowspan="1" colspan="1">Number of reports</td>
<td align="center" rowspan="1" colspan="1">Percentage of total</td>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Gastrointestinal system</td>
<td align="right" rowspan="1" colspan="1">52</td>
<td align="right" rowspan="1" colspan="1">59.8</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Nervous system</td>
<td align="right" rowspan="1" colspan="1">15</td>
<td align="right" rowspan="1" colspan="1">17.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Cardiovascular system</td>
<td align="right" rowspan="1" colspan="1">4</td>
<td align="right" rowspan="1" colspan="1">4.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Skin and hair</td>
<td align="right" rowspan="1" colspan="1">3</td>
<td align="right" rowspan="1" colspan="1">3.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Hepatotoxicity</td>
<td align="right" rowspan="1" colspan="1">2</td>
<td align="right" rowspan="1" colspan="1">2.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Urinary tract</td>
<td align="right" rowspan="1" colspan="1">2</td>
<td align="right" rowspan="1" colspan="1">2.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Immune system (Allergy)</td>
<td align="right" rowspan="1" colspan="1">2</td>
<td align="right" rowspan="1" colspan="1">2.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Other</td>
<td align="right" rowspan="1" colspan="1">7</td>
<td align="right" rowspan="1" colspan="1">8.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="right" rowspan="1" colspan="1">
<bold>87</bold>
<xref ref-type="table-fn" rid="t005fn001">
<sup>a</sup>
</xref>
</td>
<td align="right" rowspan="1" colspan="1">
<bold>100</bold>
</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t005fn001">
<p>
<sup>a</sup>
The total number of adverse effects reported is 87 since 5 out of 82 consumers complained about two PFSs</p>
</fn>
</table-wrap-foot>
</table-wrap>
<p>Approximately 60% of adverse events were related to the gastrointestinal tract, distributed between gastric problems (where nausea was the most reported symptom) and intestinal effects (mainly diarrhoea).</p>
<p>The nervous system was the second most affected area with nine cases of insomnia, four of dizziness and two of migraine; the cardiovascular system was reported in four cases of tachycardia. The stimulating effects of botanicals containing caffeine can explain the insomnia and tachycardia reported by consumers 13, 46, 55, and 58, but in other cases, the effects were unexpected. An example is the case of insomnia due to
<italic>Valeriana officinalis</italic>
(ID 49 and ID 64), which is the opposite of the usual physiological effect, associated with this botanical [
<xref rid="pone.0150089.ref011" ref-type="bibr">11</xref>
–
<xref rid="pone.0150089.ref012" ref-type="bibr">12</xref>
].
<italic>Ginkgo biloba</italic>
was involved in three cases of insomnia and one of dizziness.</p>
<p>Hair and skin were affected in three cases. A case of hair loss was reported by consumer 10, taking
<italic>Equisetum arvense</italic>
3 units/day for 12 months. This adverse effect could be associated with the reported effect of
<italic>E</italic>
.
<italic>arvense</italic>
in reducing the bioavailability of thiamine after chronic consumption [
<xref rid="pone.0150089.ref050" ref-type="bibr">50</xref>
]. On the other hand, the role of thiamine deficiency in hair loss has been hypothesised but insufficiently documented [
<xref rid="pone.0150089.ref079" ref-type="bibr">79</xref>
]. Hepatotoxicity, defined as an increased level of liver enzymes, was reported by two consumers using red rice (
<italic>Oryza sativa</italic>
fermented by the fungus
<italic>Monascus purpureus</italic>
). Red rice is widely used in mild hypercholesterolemia, as a "natural" alternative to statins. Several side effects have been described in consumers using this ingredient, such as headache, dizziness, heartburn, gas and digestive tract discomfort, and it should be used cautiously by people suffering from liver disease and those at risk of it [
<xref rid="pone.0150089.ref052" ref-type="bibr">52</xref>
–
<xref rid="pone.0150089.ref053" ref-type="bibr">53</xref>
]. Allergies to
<italic>Allium sativum</italic>
and to a PFS containing
<italic>Melissa officinalis</italic>
and
<italic>Olea europaea</italic>
were reported by two consumers (ID 62 and ID 21, respectively).</p>
<p>A difficulty in swallowing was reported by a consumer (ID 19), using red rice to reduce blood cholesterol. Even though this effect has not been previously associated with red rice, there are some reports concerning the statins (having similar biological activity) for which the impaired swallowing was considered among possible symptoms of muscle degeneration [
<xref rid="pone.0150089.ref055" ref-type="bibr">55</xref>
].</p>
<p>
<xref ref-type="table" rid="pone.0150089.t006">Table 6</xref>
compares the plants most prevalently involved in adverse effects as reported by the PlantLIBRA project, in relation to: 1) data from the literature [
<xref rid="pone.0150089.ref009" ref-type="bibr">9</xref>
], 2) reports from Poisons Centers [
<xref rid="pone.0150089.ref080" ref-type="bibr">80</xref>
]; and finally from this study.</p>
<table-wrap id="pone.0150089.t006" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pone.0150089.t006</object-id>
<label>Table 6</label>
<caption>
<title>Plants most frequently involved in adverse effects as reported from three sources in the PlantLIBRA project.</title>
</caption>
<alternatives>
<graphic id="pone.0150089.t006g" xlink:href="pone.0150089.t006"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="center" colspan="2" rowspan="1">Review from literature [
<xref rid="pone.0150089.ref009" ref-type="bibr">9</xref>
]</th>
<th align="center" colspan="2" rowspan="1">Data from Poisons Centers</th>
<th align="center" colspan="2" rowspan="1">Self-reported adverse effects (PFS Consumer survey)</th>
</tr>
<tr>
<th align="left" rowspan="1" colspan="1">Plant</th>
<th align="right" rowspan="1" colspan="1">%
<xref ref-type="table-fn" rid="t006fn001">
<sup>a</sup>
</xref>
</th>
<th align="left" rowspan="1" colspan="1">Plant</th>
<th align="center" rowspan="1" colspan="1">%
<xref ref-type="table-fn" rid="t006fn001">
<sup>a</sup>
</xref>
</th>
<th align="left" rowspan="1" colspan="1">Plant</th>
<th align="center" rowspan="1" colspan="1">%
<xref ref-type="table-fn" rid="t006fn001">
<sup>a</sup>
</xref>
</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Glycine max</italic>
</td>
<td align="right" rowspan="1" colspan="1">19.3</td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="right" rowspan="1" colspan="1">14.3</td>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="center" rowspan="1" colspan="1">9.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Glycyrrhiza glabra</italic>
</td>
<td align="right" rowspan="1" colspan="1">12.2</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="right" rowspan="1" colspan="1">6.2</td>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="center" rowspan="1" colspan="1">8.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Camellia sinensis</italic>
</td>
<td align="right" rowspan="1" colspan="1">8.7</td>
<td align="left" rowspan="1" colspan="1">
<italic>Melissa officinalis</italic>
</td>
<td align="right" rowspan="1" colspan="1">4.3</td>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="center" rowspan="1" colspan="1">6.9</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Ginkgo biloba</italic>
</td>
<td align="right" rowspan="1" colspan="1">8.5</td>
<td align="left" rowspan="1" colspan="1">
<italic>Mentha x piperita</italic>
</td>
<td align="right" rowspan="1" colspan="1">4.3</td>
<td align="left" rowspan="1" colspan="1">
<italic>Paullinia cupana</italic>
</td>
<td align="center" rowspan="1" colspan="1">6.9</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Citrus aurantium</italic>
</td>
<td align="right" rowspan="1" colspan="1">5.1</td>
<td align="left" rowspan="1" colspan="1">
<italic>Passiflora incarnata</italic>
</td>
<td align="right" rowspan="1" colspan="1">4.3</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cynara scolymus</italic>
</td>
<td align="center" rowspan="1" colspan="1">5.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Cinnamomum verum</italic>
</td>
<td align="right" rowspan="1" colspan="1">4.7</td>
<td align="left" rowspan="1" colspan="1">
<italic>Paullinia cupana</italic>
</td>
<td align="right" rowspan="1" colspan="1">4.3</td>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea spp</italic>
.</td>
<td align="center" rowspan="1" colspan="1">5.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Cimicifuga racemosa</italic>
</td>
<td align="right" rowspan="1" colspan="1">4.7</td>
<td align="left" rowspan="1" colspan="1">
<italic>Glycyrrhiza glabra</italic>
</td>
<td align="right" rowspan="1" colspan="1">3.7</td>
<td align="left" rowspan="1" colspan="1">
<italic>Olea europaea</italic>
</td>
<td align="center" rowspan="1" colspan="1">5.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Echinacea purpurea</italic>
</td>
<td align="right" rowspan="1" colspan="1">4.1</td>
<td align="left" rowspan="1" colspan="1">
<italic>Ilex paraguariensis</italic>
</td>
<td align="right" rowspan="1" colspan="1">3.7</td>
<td align="left" rowspan="1" colspan="1">
<italic>Oryza sativa+ Monascus purpureus (Red rice)</italic>
</td>
<td align="center" rowspan="1" colspan="1">5.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Vitex agnus-castus</italic>
</td>
<td align="right" rowspan="1" colspan="1">3.9</td>
<td align="left" rowspan="1" colspan="1">
<italic>Panax ginseng</italic>
</td>
<td align="right" rowspan="1" colspan="1">3.1</td>
<td align="left" rowspan="1" colspan="1">
<italic>Panax ginseng</italic>
</td>
<td align="center" rowspan="1" colspan="1">5.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Hypericum perforatum</italic>
</td>
<td align="right" rowspan="1" colspan="1">3.9</td>
<td align="left" rowspan="1" colspan="1">
<italic>Citrus aurantium</italic>
</td>
<td align="right" rowspan="1" colspan="1">2.5</td>
<td align="left" rowspan="1" colspan="1">
<italic>Equisetum arvense</italic>
</td>
<td align="center" rowspan="1" colspan="1">4.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Panax ginseng</italic>
</td>
<td align="right" rowspan="1" colspan="1">3.3</td>
<td align="left" rowspan="1" colspan="1">
<italic>Cynara scolymus</italic>
</td>
<td align="right" rowspan="1" colspan="1">2.5</td>
<td align="left" rowspan="1" colspan="1">
<italic>Allium sativum</italic>
</td>
<td align="center" rowspan="1" colspan="1">3.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Valeriana officinalis</italic>
</td>
<td align="right" rowspan="1" colspan="1">2.8</td>
<td align="left" rowspan="1" colspan="1">
<italic>Dioscorea villosa</italic>
</td>
<td align="right" rowspan="1" colspan="1">2.5</td>
<td align="left" rowspan="1" colspan="1">
<italic>Foeniculum vulgare</italic>
</td>
<td align="center" rowspan="1" colspan="1">3.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<italic>Vitis vinifera</italic>
</td>
<td align="right" rowspan="1" colspan="1">2.8</td>
<td align="left" rowspan="1" colspan="1">
<italic>Allium ursinum</italic>
</td>
<td align="right" rowspan="1" colspan="1">1.9</td>
<td align="left" rowspan="1" colspan="1">
<italic>Glycine max</italic>
</td>
<td align="center" rowspan="1" colspan="1">3.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total cases</bold>
</td>
<td align="right" rowspan="1" colspan="1">
<bold>492</bold>
</td>
<td align="left" rowspan="1" colspan="1">
<bold>Total cases</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>161</bold>
</td>
<td align="left" rowspan="1" colspan="1">
<bold>Total cases</bold>
</td>
<td align="center" rowspan="1" colspan="1">
<bold>87</bold>
</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t006fn001">
<p>
<sup>a</sup>
number of counts/total cases</p>
</fn>
</table-wrap-foot>
</table-wrap>
<p>It is important to underline that the review from the literature did not separate cases due to botanicals used as food supplements or traditional medicines as was the case in the other two data reviews. Moreover, due to the very high number of botanicals in PFS, the review on the scientific literature included "only" 66 among the most frequently consumed botanicals. The lists of plants most reported by Poisons Centers and by the consumers' survey are similar, sharing five out 13 botanicals; among them
<italic>Valeriana officinalis</italic>
(garden valerian) and
<italic>Camellia sinensis</italic>
(tea) were in the first two positions. Moreover, a similar position in the ranking was occupied by
<italic>Paullinia cupana</italic>
(guarana),
<italic>Cynara scolymus</italic>
(globe artichoke), and
<italic>Panax ginseng</italic>
(chinese ginseng).</p>
</sec>
<sec sec-type="conclusions" id="sec011">
<title>Conclusions</title>
<p>The cases of adverse effects described here were self-reported and thus without any supporting clinical evidence; the agreement with data published in scientific papers and in particular with the survey performed by the PlantLIBRA project among Poisons Centers allows the following conclusions:</p>
<list list-type="order">
<list-item>
<p>As reported previously, severe adverse effects related to PFS are quite rare [
<xref rid="pone.0150089.ref080" ref-type="bibr">80</xref>
];</p>
</list-item>
<list-item>
<p>Mild or moderate adverse symptoms can be present but most of them do not require clinical support;</p>
</list-item>
<list-item>
<p>Data reported in this paper confirm that some plants are more frequently involved in adverse effects than others and can help family doctors, among other health professionals, to become aware about the possible consequences of the increasing use of food supplements containing botanicals;</p>
</list-item>
<list-item>
<p>This information could also be used to educate the public as to the possibility of adverse effects associated with the consumption of these food supplements.</p>
</list-item>
</list>
</sec>
</body>
<back>
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