Devil's claw (Harpagophytum procumbens DC)
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| Devil's
claw |
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Devil's claw ( Harpagophytum procumbens ) originates from the
Kalahari and Savannah desert regions of South and Southeast Africa. In these
parts of the world, devil's claw has historically been used to treat a wide
range of conditions including fever, malaria and indigestion. The medicinal
ingredient of the devil's claw plant is extracted from the dried out roots.
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Currently, the major uses of devil's claw are as an anti-inflammatory and pain
reliever for joint diseases, back pain and headache. There is currently
widespread use of standardized devil's claw for mild joint pain in Europe.
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Potential side effects include gastrointestinal upset, low blood pressure, or
abnormal heart rhythms (increased heart rate or increased heart squeezing
effects).
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Traditionally, it has been recommended to avoid using devil's claw in patients
with stomach ulcers, or in people using blood thinners (anticoagulants such as
warfarin/Coumadin®).
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!ao!ao, //xsamsa-//oro, //xemta='eisa (Kung bushman), //khuripe//khams
(Damara/Nama), Afrikanische Teufelskralle (German),
Algophytum®, Arthrosetten H®, Arthrotabsm®, Artigel®, artiglio
del diavolo, arpagofito (Italian), Artosan®, Defencid®, Devil's
Claw Capsule®, Devil's Claw Secondary Root®, Devil's Claw Vegicaps®,
Doloteffin®, duiwelsklou (Afrikaans), ekatata
(Ndonga, Kwangali), elyata (Kwanyama), Fitokey
Harpagophytum®, grapple plant, griffe du diable (French),
Harpadol®, Hariosen®, HarpagoMega®, Harpagon®, Harpagophyti radix
(Latin ) , Harpagophytum zeyheri,
Jucurba N®, kloudoring (Afrikaans), likakata
(Gciriku, Shambyu), otjihangatene (Herero), Pedaliaceae
(family), Rheuma-Sern®, Rheuma-Tee®, Salus®, sengaparile
(Senegalese), Südafrikanische Teufelskralle, Trampelklette (German),
Venustorn ( Danish), Windhoek's root, wood spider.
These uses have been tested in humans or animals. Safety
and effectiveness have not always been proven. Some of these conditions are
potentially serious, and should be evaluated by a qualified healthcare provider.
| Uses based on scientific evidence |
Grade* |
| Degenerative joint disease/osteoarthritis
There is increasing scientific evidence suggesting that devil's claw is
safe and beneficial for the short-term treatment of pain related to
degenerative joint disease or osteoarthritis (8-12 weeks), and may be
equally effective as drug therapies such as non-steroidal
anti-inflammatory drugs like ibuprofen (Advil®, Motrin®), or may allow
for dose reductions or stopping of these drugs in some patients.
However, most studies have been small with flaws in their designs.
Additional well-designed trials are necessary before a firm conclusion
can be reached.
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B |
| Low back pain
There are several human studies which support the use of devil's claw
for the treatment of low back pain. However, most studies have been
small with flaws in their designs, and many have been done by the same
authors. Therefore, although these results can be considered promising
early evidence, additional well-designed trials are necessary before a
firm conclusion can be reached. It is not clear how devil's claw
compares to other therapies for back pain.
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B |
| Appetite stimulant
Traditionally, devil's claw was commonly used as an appetite stimulant,
and this remains a popular use. However, there is no reliable scientific
evidence in this area, and it remains unclear if devil's claw is
beneficial as an appetite stimulant.
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C |
| Digestive tonic
Devil's claw is popular as a digestive tonic for the relief of
constipation, diarrhea, and flatulence. However, there is no reliable
scientific evidence in this area, and it remains unclear if devil's claw
is beneficial for these uses.
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C |
*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.
Grading rationale
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often
have not been thoroughly tested in humans, and safety and effectiveness have
not always been proven. Some of these conditions are potentially serious, and
should be evaluated by a qualified healthcare provider.
Allergies, analgesic, anorexia, antiarrhythmic, antiphlogistic, atherosclerosis,
bitter tonic, blood diseases, boils (topical), child-birth difficulties,
choleretic, climacteric problems, diabetes, diuretic, dysmenorrhea, dyspepsia,
edema, fever, fibromyalgia, fibrositis, gall bladder tonic, gastrointestinal
disorders, gout, headache, heartburn, hyperglycemia, hyperlipidemia,
indigestion, liver tonic, malaria, migraine, myalgia, neuralgia, nicotine
poisoning, sedative, skin cancer (topical), skin ulcers (topical), sores
(topical), tendonitis, urinary tract infection, vulnerary for skin injuries
(topical).
The below doses are based on scientific research,
publications, traditional use, or expert opinion. Many herbs and supplements
have not been thoroughly tested, and safety and effectiveness may not be proven.
Brands may be made differently, with variable ingredients, even within the same
brand. The below doses may not apply to all products. You should read product
labels, and discuss doses with a qualified healthcare provider before starting
therapy.
Adult Dosing (18 years and older):
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In general, a liquid extract (1:1 in 25% ethanol) 0.10-0.25 milliliter three
times daily has been used. For appetite loss or stomach discomfort, 1.5 grams
daily in decoction or preparations with adequate bitterness has been used. For
low back pain or osteoarthritis, 2-9 grams daily of crude extract or
equivalent amounts of extract has been used. As tablets, 600 to 1,200
milligrams (standardized to contain 50 to 100 milligrams of harpagoside) by
mouth three times per day has been used. For treatment of painful
osteoarthritis, treatment for 2-3 months is often recommended. A doctor should
be consulted if symptoms continue for longer.
Children (younger than 18 years)
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Not recommended in children. The dosing and safety of devil's claw have not
been studied thoroughly in children, and safety is not established.
The U.S. Food and Drug Administration does not strictly
regulate herbs and supplements. There is no guarantee of strength, purity or
safety of products, and effects may vary. You should always read product labels.
If you have a medical condition, or are taking other drugs, herbs, or
supplements, you should speak with a qualified healthcare provider before
starting a new therapy. Consult a healthcare provider immediately if you
experience side effects.
Allergies
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People with allergies to Harpagophytum procumbens should
avoid devil's claw products.
Side Effects and Warnings
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At recommended doses, devil's claw is traditionally believed to be well
tolerated. Whether use of devil's claw for longer than 3-4 months is safe or
effective is unknown.
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There are reports of headache, ringing in the ears, loss of taste and
appetite, and diarrhea in those taking this herb. Devil's claw may affect
levels of acid in the gastrointestinal tract and should be avoided by people
with gastric (stomach) or duodenal (intestinal) ulcers. Devil's claw should be
used cautiously in patients with gallstones.
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Devil's claw may change the rate and force of heartbeats (chronotropic and
inotropic effects). Individuals with heart disease or arrhythmias (abnormal
heart rhythms) should consult their cardiologist or primary care physician
before taking devil's claw.
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In theory, devil's claw may lower blood sugar levels. Caution is advised in
patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or
supplements that affect blood sugar. Serum glucose levels may need to be
monitored by a healthcare provider, and medication adjustments may be
necessary.
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In theory, devil's claw may increase the risk of bleeding. Caution is advised
in patients with bleeding disorders or taking drugs that may increase the risk
of bleeding. Dosing adjustments may be necessary. Patients may need to stop
taking devil's claw before some surgeries, and should discuss this with their
primary healthcare provider.
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Devil's claw products may be contaminated with other herbs, pesticides,
herbicides, heavy metals, or drugs.
Pregnancy and Breastfeeding
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Devil's claw may stimulate contractions of the uterus and cannot be
recommended during pregnancy and breast-feeding. Patients should be aware that
many tinctures contain high levels of alcohol and should be avoided during
pregnancy.
Most herbs and supplements have not been thoroughly
tested for interactions with other herbs, supplements, drugs, or foods. The
interactions listed below are based on reports in scientific publications,
laboratory experiments, or traditional use. You should always read product
labels. If you have a medical condition, or are taking other drugs, herbs, or
supplements, you should speak with a qualified healthcare provider before
starting a new therapy.
Interactions with Drugs
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Devil's claw may lower blood sugar levels. Caution is advised when using
medications that may also lower blood sugar. A qualified healthcare provider
should monitor patients taking drugs for diabetes by mouth or insulin closely.
Medication adjustments may be necessary.
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In theory, devil's claw may have an additive effect if taken with drugs used
for pain, inflammation, high cholesterol and gout.
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Devil's claw may add to the effects of drugs that reduce cholesterol levels.
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Devil's claw may increase stomach acidity and therefore may affect drugs used
to decrease the amount of acid in the stomach, such as antacids, sucralfate,
ranitidine (Zantac®) and esomeprazole (Nexium®). If you are taking any of
these drugs, consult a qualified health care professional or pharmacist before
taking devil's claw.
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Because devil's claw may affect heart rhythm, heart rate and the force of
heartbeats, individuals taking prescription drugs such as antiarrhythmics or
digoxin (Lanoxin®) should consult their health care provider before taking
devil's claw.
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In theory, devil's claw may increase the risk of bleeding when taken with
drugs that increase the risk of bleeding. Some examples include aspirin,
anticoagulants ("blood thinners") such as warfarin (Coumadin®) or
heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal
anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®,
Aleve®).
Interactions with Herbs and Dietary Supplements
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In theory, devil's claw may lower blood sugar levels. Caution is advised when
using herbs or supplements that may also lower blood sugar. Blood glucose
levels may require monitoring, and doses may need adjustment
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In theory, devil's claw may interfere with other herbs and dietary supplements
that affect heart rhythm, heart rate and the force of heartbeats. Notably,
bufalin/Chan Suis is a Chinese herbal formula that has been reported as toxic
or fatal when taken with cardiac glycosides.
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Devil's claw may add to the effects of herbs and dietary supplements that are
used for pain or inflammation.
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Devil's claw may reduce cholesterol concentrations, and may add to the
lipid-lowering effects of fish oil or garlic.
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In theory, devil's claw may increase the risk of bleeding when taken with
herbs and supplements that are believed to increase the risk of bleeding.
Multiple cases of bleeding have been reported with the use of Ginkgo
biloba , and fewer cases with garlic and saw palmetto. Numerous other
agents may theoretically increase the risk of bleeding, although this has not
been proven in most cases.