I've been reading lately on Lactnet about using various herbs for medicinal purposes while breastfeeding.  Just finished reading this article in Environmental Nutrition and thought it might be of interest.

The Sometimes Risky Business of Mixing Herbs and Medicines

Q. Is it safe to take herbal preparations if I'm taking other medications?

A. Not necessarily. A recent report in The New England Journal of Medicine suggests it wasn't harmless for one 70-year old man. He experienced temporary episodes of blurred vision after taking two 40-milligram tablets of Ginkoba a day for a week, in addition to aspirin he had taken daily for three years after heart-bypass surgery. Examination revealed bleeding from the iris in his eye. When he stopped the gingko (but continued the aspirin), the bleeding stopped.
  
What happened? Gingko biloba extract contains a compound, gingkolide B, which prevents blood platelets from clotting, in effect "thinning" the blood, just as aspirin does. Varro Tyler, Ph.D., a noted pharmacognosist, suspects the combination of gingko and aspirin, along with some pre-existing weakness in the vessel of the eye, caused the bleeding.
  
Drug interactions are well-known to physicians and pharmacists and well-documented in resources such as the Physician 's Desk Reference (PDR). But in the largely unexplored territory of herbal medicine, potential interactions have not been well-researched, and no standard reference exists. This lack of information leaves consumers vulnerable to unidentified and potentially dangerous interactions between prescription and over-the-counter drugs and any dietary supplements, including herbs.
  
The message here is not that gingko is inherently dangerous. Instead, it is a broad caution that some herbs, alone or when combined with others, can unexpectedly alter a drug's action. This is especially true when an herb and a drug have similar biological activity.
  
Gingko is not the only herb with anticoagulant properties. Garlic, ginger and ginseng all inhibit blood clotting, as does white willow bark, the plant from which aspirin was originally isolated. Danshen, widely used in Chinese herbal medicine, is a particularly potent anticoagulant that experts caution against using cavalierly.
  
If you combine any of these herbs with other known blood "thinners," like warfarin (Coumadin), aspirin, vitamin E or fish oils, the results may be more than what the doctor ordered. While each may prevent the blood clots that can trigger heart attacks and strokes caused by lack of blood flow, combining them may cause bleeding, possibly even a hemorrhagic stroke.
  No one knows what other herb combinations may prove troublesome; only time and research will tell. But, says Tyler, the likelihood of an adverse reaction increases the bigger the dosage and the longer you take it. Until research catches up with the popularity of natural remedies, think twice before downing too many herbal supplements, especially on top of medications. Here's how to minimize risk:

* Before experimenting with an herb, learn the basics of how and why it reportedly works. Be wary if you take other supplements or medications with similar medicinal activity. (EN's most trusted resource is Varro Tyler*s The Honest Herbal, 1993, Haworth Press, Inc., Binghamton, NY.)

* Tell your doctor about all supplements you are taking, including herbs, vitamins, minerals, homeopathic remedies and extracts. Prepare a list and update it regularly. Ask your pharmacist about possible interactions.

* If you experience side effects, stop the supplement immediately and report the problem to your physician.

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ENVIRONMENTAL NUTRITION  Oct/Nov1997