CCoPE
Date: 2000-10-30

Question:
I am taking care of a 36 yo woman at 28 weeks pregnancy; she has a poorly differentiated breast Ca treated in August with L mastectomy. Lymph nodes were negative. She has declined chemo to date despite recommendation by the medical oncologist. The chemo recommended was Adriamycin and cyclophosphamide. She is taking numerous herbal remodies, Q-10 Plus, Coenzyme Q 10, Imm Power, Ultra CLA, Colostrum, 851 SuperEutrophic, Galiium-Heal, Citrous Pectin, Immuni -T, Lymphosot, E Jiao Tonic, Miatake Mushroom, Supermilk Thistle Ultraclear. Do you have any information on these remedies in pregnancy?

Answer:
Thank you for this very interesting question. As the use of herbal products increases in popularity, the Motherisk Program has experienced an increased number of inquiries regarding the use of these herbs in pregnancy. Since these products are not regulated we would ask that you identify them according to their ingredients/constituents. Please do so for Imm Power, Ultra CLA, Colostrum, 851 SuperEutrophic, Galium-Heal, Citrous Pectin, Immuni-T, Lymphosot, E Jiao Tonic, and Miatake Mushroom. We have tried to provide information on Q-10 Plus, Coenzyme Q10, and Supermilk Thistle Ultraclear. The remedies Q-10 Plus and Coenzyme Q10 should contain ubiquinones, a series of coenzymes involved in mitochondrial electron transport. Products containing coenzyme Q10 are normally used as anti-oxidants. Toxicity would not be expected with coenzymes since they are normally found in the body. One of the coenzymes (ubiquinone-9) was not shown to be teratogenic in mice and rats. One research group reported that coenzyme Q10 increased in maternal plasma during each trimester of pregnancy. No studies were found addressing the safety of this product in pregnancy. One ingredient in Supermilk Thistle Ultraclear is likely milk thistle (Silybum marianum), however, other ingredients would need to be reviewed as well. The active constituent is called silymarin. This herbal remedy has been used in liver disorders as an antihepatotoxin. Silymarin was not teratogenic when studied in pregnant rats and rabbits. In a published abstract, 15 pregnant women were reported to have been given 330mg/day of silymarin over a 15 day period for cholestatic disorders. Gestational age at time of use and pregnancy outcome were not reported. Safety of milk thistle in pregnancy has not been established. We hope that you find this information useful and would be pleased to review any of the above products once we can identify their constituents.