Effect of chamomile intake on blood coagulation tests in healthy volunteers: a randomized, placebo-controlled, crossover trial.
And Tea
Chamomile
Coagulation
Herbal
Prothrombin time
Journal
Perioperative medicine (London, England)
ISSN: 2047-0525
Titre abrégé: Perioper Med (Lond)
Pays: England
ID NLM: 101609072
Informations de publication
Date de publication:
20 Sep 2023
20 Sep 2023
Historique:
received:
20
02
2023
accepted:
31
08
2023
medline:
21
9
2023
pubmed:
21
9
2023
entrez:
20
9
2023
Statut:
epublish
Résumé
Chamomile is consumed worldwide for enjoyment and its potentially desirable properties. Widespread patient resource websites, however, discourage preoperative chamomile intake, lest bleeding could worsen. This precaution, though, stems largely from indirect evidence in one case report. To evaluate if chamomile ingestion impacts coagulation assays via coumarin-like substances, we designed a randomized, placebo-controlled, crossover study. Healthy volunteers were randomized to three interventions in a cross-over-design spanning 5 weeks per subject. Interventions included 7-day consumption of chamomile tea (3 tea bags × 3 times daily = 9 tea bags daily), a chamomile extract capsule (3 times daily), or a placebo capsule (3 times daily). A 7-day washout period elapsed between intervention periods. The primary outcome was the change in prothrombin time (PT) before vs. after each intervention. Secondary outcomes included changes in the international normalized ratio (INR), activated partial thromboplastin time (aPTT), thrombin time (TT), reptilase time (RT), and fibrinogen (FG) surrounding each intervention. All 12 enrolled subjects were randomized and completed the study. The primary outcome of PT change (mean ± SD) was similar across interventions (chamomile tea = - 0.2 ± 0.4 s, extract capsule = - 0.2 ± 0.4 s, and placebo capsule = 0.1 ± 0.5 s; p = 0.34). INR change was 0 s (p = 0.07) for each intervention. The aPTT, TT, RT, and FG, did not change significantly across interventions (p = 0.8, p = 0.08, p = 0.8, and p = 0.2 respectively). Chamomile intake by tea or capsule does not prolong PT. These findings challenge the notion to avoid perioperative chamomile intake in patients not taking warfarin. ClinicalTrials.gov, NCT05006378; Principal Investigator: Jonathon Schwartz, M.D.; Registered August 16, 2021.
Sections du résumé
BACKGROUND
BACKGROUND
Chamomile is consumed worldwide for enjoyment and its potentially desirable properties. Widespread patient resource websites, however, discourage preoperative chamomile intake, lest bleeding could worsen. This precaution, though, stems largely from indirect evidence in one case report. To evaluate if chamomile ingestion impacts coagulation assays via coumarin-like substances, we designed a randomized, placebo-controlled, crossover study.
MATERIALS AND METHODS
METHODS
Healthy volunteers were randomized to three interventions in a cross-over-design spanning 5 weeks per subject. Interventions included 7-day consumption of chamomile tea (3 tea bags × 3 times daily = 9 tea bags daily), a chamomile extract capsule (3 times daily), or a placebo capsule (3 times daily). A 7-day washout period elapsed between intervention periods. The primary outcome was the change in prothrombin time (PT) before vs. after each intervention. Secondary outcomes included changes in the international normalized ratio (INR), activated partial thromboplastin time (aPTT), thrombin time (TT), reptilase time (RT), and fibrinogen (FG) surrounding each intervention.
RESULTS
RESULTS
All 12 enrolled subjects were randomized and completed the study. The primary outcome of PT change (mean ± SD) was similar across interventions (chamomile tea = - 0.2 ± 0.4 s, extract capsule = - 0.2 ± 0.4 s, and placebo capsule = 0.1 ± 0.5 s; p = 0.34). INR change was 0 s (p = 0.07) for each intervention. The aPTT, TT, RT, and FG, did not change significantly across interventions (p = 0.8, p = 0.08, p = 0.8, and p = 0.2 respectively).
CONCLUSIONS
CONCLUSIONS
Chamomile intake by tea or capsule does not prolong PT. These findings challenge the notion to avoid perioperative chamomile intake in patients not taking warfarin.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov, NCT05006378; Principal Investigator: Jonathon Schwartz, M.D.; Registered August 16, 2021.
Identifiants
pubmed: 37730613
doi: 10.1186/s13741-023-00339-7
pii: 10.1186/s13741-023-00339-7
pmc: PMC10510223
doi:
Banques de données
ClinicalTrials.gov
['NCT05006378']
Types de publication
Journal Article
Langues
eng
Pagination
51Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Mol Med Rep. 2010 Nov 1;3(6):895-901
pubmed: 21132119
Am J Clin Nutr. 2004 May;79(5):727-47
pubmed: 15113710
Ann Pharmacother. 2000 Jun;34(6):729-33
pubmed: 10860133
Medicine (Baltimore). 2020 Jan;99(2):e18698
pubmed: 31914073
Clin Pharmacol Ther. 2012 Apr;91(4):709-17
pubmed: 22398967
Pharmacol Ther. 1997;73(1):67-74
pubmed: 9014207
Plant Foods Hum Nutr. 2012 Jun;67(2):129-35
pubmed: 22410959
Food Chem. 2013 Nov 1;141(1):54-9
pubmed: 23768326
J Sep Sci. 2014 Oct;37(19):2797-804
pubmed: 25073627
JAMA Intern Med. 2014 Mar;174(3):409-16
pubmed: 24445404
CMAJ. 2006 Apr 25;174(9):1281-2
pubmed: 16636327
Mayo Clin Proc. 2007 Jul;82(7):864-73
pubmed: 17605969
Biomed Res Int. 2013;2013:963248
pubmed: 23586066
Life Sci. 2006 Jan 18;78(8):856-61
pubmed: 16137701
Ann Intern Med. 2006 Mar 7;144(5):364-7
pubmed: 16520478
EPMA J. 2019 Jan 8;10(1):51-64
pubmed: 30984314
Basic Clin Pharmacol Toxicol. 2007 Aug;101(2):73-7
pubmed: 17651305
Arch Pathol Lab Med. 2002 Apr;126(4):499-505
pubmed: 11900586
Med Clin North Am. 1998 May;82(3):601-11
pubmed: 9646782
Int J Biol Macromol. 2013 Oct;61:218-29
pubmed: 23831537
Am J Clin Pathol. 2002 Aug;118(2):263-8
pubmed: 12162688