I understand that a great many of you were unable to copy and paste the
whole URL. I did try to shrink it but it wouldn't link to the article. So
here goes:

 E-mail Article

Complementary Therapies in Nursing and Midwifery
Volume 9, Issue 3 , August 2003, Pages 155-156

doi:10.1016/S1353-6117(03)00044-1     Cite or link using doi
Copyright © 2003 Elsevier Ltd. All rights reserved.
Short Communication

The use of fenugreek for breast feeding women

Denise Tiran,

Department of Health and Social Care, University of Greenwich, Honeycomb
Building, Mansion Site Avery Hill, Campus, Avery Hill Rd., London SE9 2PQ,
UK

Received 30 April 2003;  accepted 8 May 2003. ; Available online 27 June
2003.

Fenugreek is widely used as a culinary spice and is frequently used in
Indian Ayurvedic and in Traditional Chinese Medicine, particularly as a
galactogogue to encourage lactation.[1] Little research appears to have
been undertaken on the effectiveness of this spice and the majority of
evidence for side-effects has arisen from case reports of complications.

Skin test patching appears to suggest a significant proportion of patients
susceptible to fenugreek allergy. For example, allergic reaction to
inhalation of fenugreek seed powder has resulted in wheezing, rhinitis and
fainting, while dermal application of fenugreek paste for dandruff of the
scalp in an asthmatic woman caused facial oedema, numbness of the head and
wheezing.[2] Mild gastrointestinal symptoms have also been reported. [3]
This may be due to allergenic chemicals occurring naturally within the
plant, or to the presence of substances such as nitrates from the soil in
which the plant is grown, as has occurred in certain areas of Jordan. [4]
Research on the use of fenugreek by non-insulin diabetic patients has shown
a small reduction in fasting and post-prandial blood sugar levels, but a
more statistically significant decrease in total cholesterol and
triglyceride levels of patients with coronary artery disease. [5 and 6]

Of more concern is the potential for fenugreek to interact with prescribed
pharmacological medications, notably warfarin[7, 8 and 9]. It is also
possible that fenugreek may potentiate antihypertensive and antidiabetic
medication [3] and increase the risk of bleeding in women requiring non-
steroidal anti-infammatories, especially aspirin. [10]

With reference to women who are breast feeding, the following
recommendations can be extrapolated from these findings:

 fenugreek should be used with caution in women who are asthmatic or who
have pre-existing gastrointestinal upset,
 doses should be as low as possible to achieve the required therapeutic
effect,
 skin patch testing in women with sensitive skin may be advisable,
 it should be avoided in women who are diabetic, hypertensive or who have
cardiac disease,
 women taking warfarin or aspirin should be advised against using fenugreek,
 women who choose to use fenugreek for its galactogoguic action should
refrain from using it for a prolonged period of time; it may be advisable
to perform blood clotting and blood glucose studies.


References
1. M.P. Gabay, Galactogogues: medications that induce lactation. J Hum
Lactation 18 3 (2002), pp. 274–279.

2. S.P. Patil, P.V. Niphdkar and M.M. Bapat, Allergy to fenugreek
(Trigonella foenumgraecum). Ann Allergy Asthma Immunol 78 3 (1997), pp. 297–
300.

3. E. Ernst, M.H. Pittler, C. Stevinson and A. White. The desktop guide to
complementary and alternative medicine: an evidence-based approach, Mosby,
Edinburgh (2001).

4. H.R. Takruri and M.A. Humeid, Nitrate levels n edible wild herbs and
vegetables common in Jordan. Nutr Health 6 2 (1988), pp. 88–89.

5. A. Bordia, S.K. Verma and K.C. Srivastava, Effect of ginger (Zingiber
officinale Rosc.) and fenugreek (Trigonella foenumgrecum L.) on blood
lipids, blood sugar and platelet aggregation in patients with coronary
artery disease. Prostaglandins Lekot Essent Fatty Acids 56 5 (1997), pp.
379–384.

6. R.D. Sharma, T.C. Raghuram and N.S. Rao, Effect of fenugreek seeds on
blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr 44
(1990), pp. 301–306.

7. H. Hartman and S. Bratman. Mosby's handbook of drug-herb and drug-
supplement interactions, Mosby, St Louis, MO (2003).

8. J.P. Lambert and A. Cormier, Potenital interaction between warfarin and
boldo-fenugreek. Pharmacotherapy 21 (2001), pp. 509–512.

9. A.M. Heck, B.A. De Witt and A.L. Lukes, Potential interactions between
alternative therapies and warfarin. Am J Health System Pharm 17 13 (2000),
pp. 1221–1227.

10. W. Abebe, Herbal medication: potential for adverse interactions with
analgesic drugs. J Clin Pharm Ther 27 6 (2002), pp. 391–401.

Ellen

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