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Flax Herb Information - Precautions to be kept in mind while using Flax

Common Trade Names

Badean's Flax Oil, Badean's Vita-Flax, Flaxseed

Common Forms

Available as capsules, powder, softge1 capsules (1,000 mg), oil, and seeds.

Source for Flax Herb

Flaxseed is the soluble fiber mucilage obtained from the fully developed seed of Linum usitatissimum and is sometimes used in poultices.

Chemical Components

Flaxseed and flaxseed oil (linseed oil) are rich (30% to 45%) in unsaturated fatty acids, including linolenic, linoleic, and oleic acids. About 3% to 6% of the plant contains soluble fiber mucilage consisting of galactose, arabinose, rhamnose, xylose, galactuonic, and mannuronic acids. Seed chaff and leaves contain cyanogenic glycosides, linamarin, linustatin, and nicolenustatin. Linamarase can potentiate cyanide release from linamarin. The plant also contains 25% protein. Some products contain additional essential fatty acids, fiber, vitamins, and minerals.

Actions

Flaxseed is a rich source of plant lignans and is reported to have weak antiestrogenic, estrogenic, and steroidlike activity. Diets high in flaxseed may lower the risk of breast and other hormone-dependent cancers, but this premise awaits clinical confirmation A review focuses on the therapeutic potential of these phytoestrogens found in flaxseed (and soybeans) and the epidemiological, laboratory, and clinical evidence surrounding application for their use.

Flaxseed supplementation in 28 postmenopausal women significantly increased urinary excretion of certain estrogen metabolites in a linear, dose-repsonse manner.

In humans, linolenic acid decreases total cholesterol and LDL levels. One study in humans noted a decrease in thrombin-mediated platelet aggregation .

Reported Uses and Benefits

Flax has been used for constipation, functional disorders of the colon resulting from laxative abuse, irritable bowel syndrome, and diverticulitis. Externally, flax has been made into a poultice and used to treat areas of local inflammation.

Flaxseed muffins were evaluated for their potential in treating hyperlipidemia . A randomized, crossover trial was conducted of 29 patients with hyperlipidemia who ingested either flaxseed muffins (50 g of partially defatted flaxseed per day) or wheat bran muffins (control) for two 3-week treatment periods. Also, all subjects followed NCEP step II diets. On average, the flax muffins reduced total cholesterol levels by 4.6%, LDL levels by 7.6%, apolipoprotein B levels by 5.4%, and apolipoprotein A1 levels by 5.8% (all P<;.001), while having no effect on HDL levels, as compared with the control group.

Another study determined that linolenic acid supplement, derived from flax, arginine, and yeast RNA, improved weight gain in some patients with HIV infection .

Dosage

For all systemic uses, I to 2 tbsp of oil or mature seeds daily P.O. in divided doses b.i.d. or t.i.d. Average dose is I oz of oil or mature seeds daily.

For topical use, 30 to 50 g of flax meal applied as a hot, moist poultice or compress as needed.

Adverse Reactions

GI: diarrhea, flatulence, nausea.

Other: anaphylaxis.

Interactions

Laxatives, stool softeners: May increase laxative actions of flax. Avoid administration with flax.

Oral drugs: May diminish absorption of oral drugs. Separate doses by at least 2 hours.

Contraindications And Precautions

Flaxseed is contraindicated in pregnant or breast-feeding patients because its hormonal effects may cause teratogenicity or spontaneous abortion. Avoid its use in patients with prostate cancer or suspected or actual ileus.

Special Considerations

1. Monitor for potential toxicity related to oral ingestion of flax; cyanosis is a symptom of flax toxicity.
2. Encourage the patient to drink plenty of fluids to minimize the risk of flatulence.
3. Instruct the patient to refrigerate flaxseed oil to prevent breakdown of the essential fatty acids.
4. Inform the patient that other cholesterol-lowering therapies exist that have been proven to improve survival and lower the risk of cardiac disease; flax has no such clinical support.
5. Instruct the patient not to ingest immature seeds and to keep flax out of the reach of children and pets.
6. Inform the patient that the long-term risks of flax use are unknown.
7. Encourage the patient to report decreased effects of other drugs being taken.

Points of Interest

Flax has been used as a source of fiber for weaving and clothing for more than 10,000 years. Linseed oil, derived from flax, has been used in paints and varnishes and as a waterproofing agent. Flaxseed cakes are used as a food source for cattle.

Commentary

Supplementation of flax as a source of omega-3 fatty acids and its value in the treatment of inflammatory diseases warrant further investigation. Of particular interest are the phytoestrogens contained in flaxseed and their potential for therapeutic application in breast cancer, lipid disorders, and postmenopausal conditions. The potentially toxic components (cyanogenic nitrates) and the potential mutagenic effect of flax require further study to determine if its long-term safety profile would offset any potential benefit on morbidity and mortality. Additional clinical trial data are needed before definitive recommendations for its consumption can be made.