Major interaction on record — check this product against your medications before combining. Based on 11 of 14 ingredients. Check your meds →
Dietary supplement

Plus Tri-Factor Formula with Zinc Ingredients & Drug Interactions

by 4Life

Plus Tri-Factor Formula with Zinc label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Plus Tri-Factor Formula with Zinc against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Plus Tri-Factor Formula with Zinc is a dietary supplement by 4Life with 14 active ingredients. Its ingredients are commonly taken for fatigue and low energy, athletic performance and stamina, respiratory and lung support.Based on those ingredients, 901 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Aloe Leaf Gel Extract, Shiitake Fruiting Body Extract, Maitake Fruiting Body Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Plus Tri-Factor Formula with Zinc by 4Life

Ask about any prescription or over-the-counter medication and we check it for interactions with Plus Tri-Factor Formula with Zinc by 4Life — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Plus Tri-Factor Formula with Zinc by 4Life

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Sep 10, 2026

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 1 of its 14 active ingredients.
  • “4Life Tri-Factor Formula” is a proprietary blend — the label gives one combined amount (300 mg) without saying how much of each component you get.
  • “Cordyvant Proprietary Polysaccharide Complex” is a proprietary blend — the label gives one combined amount (843 mg) without saying how much of each component you get.

Plus Tri-Factor Formula with Zinc contains 14 ingredients, including the proprietary blends 4Life Tri-Factor Formula and Cordyvant Proprietary Polysaccharide Complex, plus cordyceps mushroom extract (which may support athletic performance, though the evidence is not strong), zinc (for immune function and zinc deficiency), agaricus and shiitake and maitake mushroom extracts, oat seed extract (which may help with cholesterol), beta-sitosterol (which may support prostate and heart health), IP-6, baker's yeast extract, olive leaf extract, and aloe leaf gel extract. The capsule also contains gelatin and lemon powder as inactive ingredients.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: support and balance immune system function.
  • We looked for evidence on: Common cold, Immune support, Infection resistance, Respiratory health.
  • The closest evidence on file: Aloe is rated "Insufficient Reliable Evidence To Rate" for Common cold (Natural Medicines).
  • Also on file: Shiitake Mushroom is rated "Insufficient Reliable Evidence To Rate" for Common cold.

Zinc in this product is effective for treating zinc deficiency and likely effective for Wilson disease, and possibly effective for acne, age-related macular degeneration, and diabetes support. Oat seed extract is likely effective for managing cholesterol and supporting heart health.

Beta-sitosterol is likely effective for benign prostatic hyperplasia and possibly effective for heart disease. Cordyceps, agaricus, shiitake, maitake, aloe, and baker's yeast extract all have insufficient reliable evidence or have not shown clear benefit for their proposed uses in our data.

The evidence, ingredient by ingredient Cordyceps Agaricus Mushroom Olive Shiitake Mushroom Maitake Mushroom Ip-6 Beta-sitosterol Brewer's Yeast

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 10 of the 11 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 11 of 11.
  • General safety write-ups exist for 11 of 11.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Zinc is generally well tolerated in recommended doses (the tolerable upper limit is 40 mg daily for adults), though doses above that can raise the risk of copper deficiency. Common side effects from zinc include nausea, vomiting, abdominal cramps, diarrhea, and a metallic taste—usually dose-related.

Cordyceps is generally well tolerated short-term, though the evidence is limited; uncommon side effects include abdominal discomfort, constipation, diarrhea, and dry mouth, sometimes reduced if taken after food. A rare case of liver inflammation has been reported.

Agaricus mushroom is generally well tolerated as a food, but supplement safety is not fully established; common side effects include abdominal discomfort, diarrhea, and nausea, though rare cases of serious liver toxicity have been reported in cancer patients taking it with chemotherapy. Shiitake, maitake, and baker's yeast are generally well tolerated when used as foods or supplements at typical doses; gastrointestinal side effects (gas, bloating, diarrhea, nausea) are most common.

Aloe leaf gel is generally well tolerated topically but aloe latex (the yellow sap) can cause abdominal cramping and diarrhea, and long-term use can lead to potassium loss and weakness. Oat seed is well tolerated; common effects include bloating, gas, and flatulence if fiber intake increases too quickly.

During pregnancy, the safety data advises against cordyceps, agaricus mushroom, shiitake, maitake, IP-6, beta-sitosterol, and aloe latex. Zinc is likely safe in pregnancy in recommended amounts but likely unsafe in high doses; breastfeeding data rates zinc as likely safe.

For baker's yeast extract, oats, and olive leaf extract, there isn't enough data to know whether they are safe in pregnancy or breastfeeding—talk with your doctor or pharmacist for personalized advice.

Side effects, ingredient by ingredient Cordyceps Agaricus Mushroom Olive Shiitake Mushroom Maitake Mushroom Ip-6 Beta-sitosterol Brewer's Yeast

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 9 of the 11 matched ingredients can interact with medications — Maitake Mushroom, Cordyceps, Aloe, Shiitake Mushroom, Brewer's Yeast, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; heart-rhythm medications; lithium.
  • For scale: 901 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, double-check your medications with your doctor or pharmacist, especially: monoamine oxidase inhibitors (MAOIs—older antidepressants), blood thinners and antiplatelet drugs (including warfarin), antibiotics (quinolones, cephalexin, tetracyclines, and penicillamine), diabetes medications and insulin, immunosuppressants (like cyclosporine), the HIV drugs ritonavir and integrase inhibitors, the cancer drug cisplatin, diuretics, heart drugs like digoxin, and any other drugs your liver metabolizes. No interactions are documented in our data for olive leaf extract or beta-sitosterol, but that does not guarantee none exist.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

This product may be worth considering if you're interested in mushroom-based immune support, zinc supplementation, or oat-derived cholesterol support—but it has several important medication interactions you need to check first, especially with antibiotics, blood thinners, diabetes drugs, heart medications, and older antidepressants. If you take any regular medications, run them through the checker below or ask your doctor or pharmacist before starting.

Pregnant or breastfeeding individuals should talk with their provider first, since several ingredients lack sufficient safety data for those stages.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 11 of 14 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 2023.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Plus Tri-Factor Formula with Zinc, straight from the product label.

Brand 4Life
Barcode (UPC) 24075
Net contents 60 Capsule(s)
Market status On market
Date entered into DSLD Nov 22, 2023
DSLD ID 301043
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Plus Tri-Factor Formula with Zinc by 4Life, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
30
UPC/BARCODE
24075
IngredientAmount% DV
NanoFactor0 NP--
4Life Tri-Factor Formula300 mg--
Cordyvant Proprietary Polysaccharide Complex843 mg--
Cordyceps sinensis mycelia extract0 NP--
Zinc10 mg90%
Agaricus blazeii fruiting body extract0 NP--
UltraFactor XF0 NP--
OvoFactor0 NP--
Olive Leaf Extract0 NP--
Shiitake Fruiting Body Extract0 NP--
Maitake Fruiting Body Extract0 NP--
IP-60 NP--
Beta-Sitosterol0 NP--
Baker's Yeast Extract0 NP--
Aloe Leaf Gel Extract0 NP--
Oat Seed Extract0 NP--

Other ingredients: Gelatin, Lemon, Powder

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation

4Life Transfer Factor Plus Tri-Factor Formula is the premier 4Life product to help balance and support the immune system. Proprietary ingredients support your immune system's ability to respond quickly and effectively.

Made in the USA with quality ingredients from around the world

Brand IP Statement(s)

4Life Transfer Factor is protected by U.S. patents 6,468,534 and 6,866,868, with other patents pending.

Copyright 2021 4Life Trademarks, LLC

Precautions

Keep out of reach of children.

Contains ingredients from milk, egg, and soy.

General Statements

A product of 4Life

FDA Disclaimer Statement

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Seals/Symbols

Certified 4Life Transfer Factor

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: Take two (2) capsules daily with a meal.

Formula

4Life Transfer Factor

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Plus Tri-Factor Formula with Zinc by 4Life label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Plus Tri-Factor Formula with Zinc label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Plus Tri-Factor Formula with Zinc by 4Life

These are the 14 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

4Life Tri-Factor Formula

300 mg per serving
  • › NanoFactor
  • › UltraFactor XF
  • › OvoFactor

Zinc

Interacts with
67 drugs
10 mg per serving Form: Zinc Methionine

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...

Zinc monograph & interactions

Other (inactive) ingredients: Gelatin, Lemon, Powder. These complete the product’s ingredient list but are not active constituents.

Interaction report

Plus Tri-Factor Formula with Zinc by 4Life Drug Interactions

Want to check YOUR meds against Plus Tri-Factor Formula with Zinc?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
901Drugs
10 Major 742 Moderate 149 Minor

Ingredients driving the most interactions

Aloe Leaf Gel Extract 461
Shiitake Fruiting Body Extract 312
Maitake Fruiting Body Extract 260
Cordyceps sinensis mycelia extract 249
Baker's Yeast Extract 136

Individual Drug Interactions

The ingredients in Plus Tri-Factor Formula with Zinc interact with 901 drugs. Click any drug to see the details.

9 of the 14 ingredients in Plus Tri-Factor Formula with Zinc interact with drugs. Each result below shows which ingredient is responsible. Aloe Leaf Gel Extract Shiitake Fruiting Body Extract Maitake Fruiting Body Extract Cordyceps sinensis mycelia extract Baker's Yeast Extract IP-6 Agaricus blazeii fruiting body extract Oat Seed Extract Zinc

Each ingredient & the kinds of drugs it affects

For each ingredient in Plus Tri-Factor Formula with Zinc with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Aloe Leaf Gel Extract7 drug types · 461 drugs

Digoxin (Lanoxin)

Theoretically, aloe latex might increase the risk of adverse effects when taken with cardiac glycosides.
Overuse of aloe latex can increase the risk of adverse effects from cardiac glycoside drugs, such as digoxin, due to potassium depletion. Overuse of aloe, along with cardiac glycoside drugs, can increase the risk of toxicity.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, aloe gel might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
In vitro research shows that aloe gel can inhibit platelet aggregation. This inhibition was greater than that seen with celecoxib, but less than that seen with aspirin.

Likelihood Possible Evidence D
Antidiabetes Drugs

Aloe might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Preliminary clinical research suggests aloe gel might lower blood glucose levels and have additive effects when used with antidiabetes drugs. Monitor blood glucose levels closely.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, aloe latex might increase the risk of hypokalemia when taken with diuretic drugs.
Overuse of aloe latex might compound diuretic-induced potassium loss, increasing the risk of hypokalemia.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, aloe latex might increase the risk for fluid and electrolyte loss when taken with stimulant laxatives.
Due to cathartic laxative effects of aloe latex, concomitant use with other stimulant laxatives might compound fluid and electrolyte loss.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, aloe latex might increase the risk of bleeding when taken with warfarin.
Aloe latex has stimulant laxative effects. In some people aloe latex can cause diarrhea. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Advise patients who take warfarin not to take excessive amounts of aloe vera.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, aloe might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that aloe extract induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Aloe Leaf Gel Extract full monograph & interactions

Shiitake Fruiting Body Extract2 drug types · 312 drugs

Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, shiitake mushroom might decrease levels of drugs metabolized by CYP2D6.
In vitro studies suggest that the shiitake mushroom extract AHCC might induce the CYP2D6 enzyme. This effect has not been reported in humans.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, taking shiitake mushroom might decrease the effects of immunosuppressive therapy.
In vitro evidence suggests that shiitake mushroom extracts stimulate immune function.

Likelihood Possible Evidence D
Shiitake Fruiting Body Extract full monograph & interactions

Maitake Fruiting Body Extract3 drug types · 260 drugs

Antidiabetes Drugs

Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking maitake mushroom polysaccharide (MMP) can lower blood glucose levels in patients with types 2 diabetes.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Animal research shows that maitake mushroom can lower blood pressure.

Likelihood Possible Evidence D
Warfarin (Coumadin)

There is limited evidence that maitake mushroom may increase the anticoagulant effects of warfarin.
In a case report, a patient previously stabilized on warfarin developed an elevated international normalized ratio (INR) of 5.1 after taking maitake mushroom (Grifron-Pro Maitake D-Fraction) 1 drop/kg daily in three divided doses for one week. The elevated INR resolved after holding warfarin for two days, then reducing the dose by 11%. It is thought that the beta-glucan constituent of maitake mushroom might cause warfarin dissociation from proteins, resulting in increased free warfarin levels and increased warfarin effects.

Likelihood Possible Evidence D
Maitake Fruiting Body Extract full monograph & interactions

Cordyceps sinensis mycelia extract3 drug types · 249 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, cordyceps may increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
In vitro and animal research suggests that cordyceps extract inhibits platelet aggregation and function. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, concurrent use of cordyceps might interfere with immunosuppressive therapy.
Animal and in vitro research suggests that cordyceps stimulates the immune system. However, limited clinical research suggests that taking cordyceps may lower the necessary therapeutic dose of the immunosuppressant cyclosporine, which suggests that cordyceps may have an immunosuppressive effect.

Likelihood Possible Evidence B
Testosterone

Theoretically, concurrent use of cordyceps and testosterone might have additive effects.
Animal research suggests that cordyceps can increase testosterone levels. The clinical significance of this finding is unclear.

Likelihood Possible Evidence D
Cordyceps sinensis mycelia extract full monograph & interactions

Baker's Yeast Extract4 drug types · 136 drugs

Monoamine Oxidase Inhibitors (Maois)

Theoretically, taking brewer's yeast with MAOIs might increase the risk of hypertension.
Brewer's yeast contains tyramine. Taking brewer's yeast with MAOIs might increase the risk for hypertensive crisis.

Likelihood Likely Evidence D
Antidiabetes Drugs

Taking brewer's yeast with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking chromium-containing brewer's yeast can decrease levels of blood glucose in diabetic patients being treated with antidiabetes drugs.

Likelihood Possible Evidence B
Lithium

Theoretically, taking brewer's yeast with lithium might cause additive effects and side effects.
Some brewer's yeast products contains lithium.

Likelihood Possible Evidence D
Antifungals

Theoretically, taking antifungals with some brewer's yeast products might decrease the effectiveness of brewer's yeast.
Some brewer's yeast products contain live yeast. Therefore, simultaneously taking antifungals might kill a significant number of the organisms.

Likelihood Possible Evidence D
Baker's Yeast Extract full monograph & interactions

IP-61 drug type · 122 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, concomitant use of IP-6 with drugs that affect platelet aggregation may increase the risk of bleeding. In vitro IP-6 can inhibit platelet aggregation. This effect has not been demonstrated in humans.

Likelihood Unlikely Evidence D
IP-6 full monograph & interactions

Agaricus blazeii fruiting body extract1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, taking agaricus mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
In one clinical study in patients with type 2 diabetes who are stabilized on conventional oral hypoglycemic agents, 3 of 29 patients taking an agaricus mushroom extract 500 mg three times daily for 12 weeks reported hypoglycemia, compared to one of 29 patients in the placebo group.

Likelihood Possible Evidence D
Agaricus blazeii fruiting body extract full monograph & interactions

Oat Seed Extract2 drug types · 86 drugs

Antidiabetes Drugs

Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Consuming oats can decrease blood glucose in patients with diabetes. In those who require insulin, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.

Likelihood Possible Evidence D
Insulin

Concomitant use of oats and insulin might increase the risk of hypoglycemia.
In patients with insulin-dependent type 2 diabetes, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.

Likelihood Possible Evidence B
Oat Seed Extract full monograph & interactions

Zinc10 drug types · 67 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.

Likelihood Probable Evidence D
Cephalexin (Keflex)

Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.

Likelihood Probable Evidence B
Cisplatin (Platinol-Aq)

Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.

Likelihood Possible Evidence D
Integrase Inhibitors

Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.

Likelihood Possible Evidence D
Penicillamine (Cuprimine, Depen)

Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.

Likelihood Probable Evidence B
Quinolone Antibiotics

Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.

Likelihood Probable Evidence B
Ritonavir (Norvir)

Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.

Likelihood Probable Evidence B
Tetracycline Antibiotics

Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.

Likelihood Probable Evidence B
Amiloride (Midamor)

Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.

Likelihood Probable Evidence B
Atazanavir (Reyataz)

Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.

Likelihood Probable Evidence B
Zinc full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Plus Tri-Factor Formula with Zinc, from the product label.

4Life

Name
BioMedical Research Laboratories, LLC
Street Address
9850 South 300 West
City
Sandy
State
UT
ZipCode
84070
Phone Number
888-454-3374
Web Address
4Life.com
Pharmacist Counseling Corner

Plus Tri-Factor Formula with Zinc by 4Life: Common Questions

Does Plus Tri-Factor Formula with Zinc by 4Life interact with any medications?
Yes. Based on its ingredients, Plus Tri-Factor Formula with Zinc has a known interaction with 901 medications, including 10 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Plus Tri-Factor Formula with Zinc contains 14 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
What is cordyceps, and what is it supposed to do?
Cordyceps is a mushroom extract traditionally used to support athletic performance and energy, but research shows it's not reliably effective for that purpose. It's also been studied for sexual function, asthma, and lung health, but the evidence is insufficient to rate its usefulness. It is generally well tolerated short-term, though evidence is limited.
Can I take this if I'm on antibiotics?
The zinc in this product can reduce how well your body absorbs certain antibiotics—specifically quinolones (like ciprofloxacin), cephalexin, tetracyclines (like doxycycline), and penicillamine. Talk with your pharmacist about spacing the doses; often taking the antibiotic 2 to 6 hours before or after the supplement helps. Always check with your doctor or pharmacist before combining them.
Will this help my blood sugar if I have diabetes?
Several ingredients in this product—agaricus mushroom, maitake mushroom, aloe gel, and oat seed—may lower blood sugar. If you take diabetes medication or insulin, this could increase your risk of low blood sugar (hypoglycemia). Talk with your doctor or pharmacist before starting, so they can monitor you and adjust your medication if needed.
Is this safe to take while pregnant?
Several ingredients lack enough safety data for pregnancy—cordyceps, agaricus, shiitake, maitake, IP-6, beta-sitosterol, and aloe latex should all be avoided. Zinc is likely safe in normal pregnancy amounts. Baker's yeast extract and oats haven't been studied enough to know for sure. Talk with your doctor or pharmacist about whether this product is right for you during pregnancy.
Can I take this with blood thinners like warfarin?
Several ingredients theoretically increase bleeding risk when combined with blood thinners: cordyceps, IP-6, aloe gel, and possibly maitake mushroom (which has a case report with warfarin). This is a serious interaction. Talk with your doctor or pharmacist before taking this product if you use any anticoagulant or antiplatelet drug.
What are the most common side effects I might notice?
The most common side effects across the ingredients are gastrointestinal: abdominal discomfort, diarrhea, nausea, gas, and bloating. These are usually mild and often decrease if you take the product with food or gradually increase the dose. If you experience severe cramping, persistent diarrhea, or any other concerning symptom, stop and talk with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Plus Tri-Factor Formula with Zinc is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Plus Tri-Factor Formula with Zinc label
Go deeper

The Full Monographs Behind Plus Tri-Factor Formula with Zinc’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Cordyceps

Interacts with 249 drugs

Cordyceps is a fungus used in traditional Chinese medicine for energy, exercise performance, and lung and immune support. Human research is limited and mostly low quality, so its benefits ar...

Read the full Cordyceps monograph → Herb & supplement monograph

Agaricus Mushroom

Interacts with 86 drugs

Agaricus mushroom (often Agaricus blazei/subrufescens) is a culinary and medicinal mushroom studied mostly for possible immune and antioxidant effects. The human evidence is limited and not...

Read the full Agaricus Mushroom monograph → Herb & supplement monograph

Olive

Olive comes from the same tree that gives us olives and olive oil, and its leaf and fruit contain antioxidant compounds like oleuropein and hydroxytyrosol. Olive oil as part of a Mediterrane...

Read the full Olive monograph → Herb & supplement monograph

Shiitake Mushroom

Interacts with 312 drugs

Shiitake is a popular edible mushroom that is nutritious and safe to eat as food for most people. Some of its extracts (like lentinan and AHCC) have been studied as immune support, mainly al...

Read the full Shiitake Mushroom monograph → Herb & supplement monograph

Maitake Mushroom

Interacts with 260 drugs

Maitake is an edible mushroom long used as food and in traditional Japanese medicine, and it is being studied for possible immune, blood sugar, and blood pressure effects. The human evidence...

Read the full Maitake Mushroom monograph → Herb & supplement monograph

Ip-6

Interacts with 122 drugs

IP-6 (inositol hexaphosphate, also called phytic acid or phytate) is a natural compound found in high-fiber plant foods and sold as a supplement, often paired with inositol. It is most studi...

Read the full Ip-6 monograph → Herb & supplement monograph

Beta-sitosterol

Beta-sitosterol is a plant sterol that may modestly lower LDL ('bad') cholesterol and may help ease urinary symptoms from an enlarged prostate. Evidence is moderate for these uses and weaker...

Read the full Beta-sitosterol monograph → Herb & supplement monograph

Brewer's Yeast

Interacts with 136 drugs

Brewer's yeast is a nutrient-rich fungus that provides B vitamins, protein, and minerals, and a related yeast product (S. boulardii) is used for some types of diarrhea. Most other health cla...

Read the full Brewer's Yeast monograph → Herb & supplement monograph

Aloe

Interacts with 461 drugs

Aloe vera gel is widely used on the skin for minor burns and irritation, and some research suggests it may help. Aloe latex (the yellow part) is a strong laxative that can cause cramping and...

Read the full Aloe monograph → Herb & supplement monograph

Oats

Interacts with 86 drugs

Oats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a food, oats are safe for most people, and...

Read the full Oats monograph → Herb & supplement monograph

Zinc

Interacts with 67 drugs

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...

Read the full Zinc monograph →
Sources

Sources & How We Checked

Plus Tri-Factor Formula with Zinc's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 254 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Cordyceps 14 references
  1. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of an ancient Chinese herbal medicine: Cordyceps sinensis: part I. J Altern Complement Med 1998;4:289-303.
  2. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of a precious ancient Chinese herbal regimen: Cordyceps sinensis: part II. J Altern Complement Med 1998;4:429-57.
  3. Chen YJ, Shiao MS, Lee SS, Wang SY. Effect of Cordyceps sinensis on the proliferation and differentiation of human leukemic U937 cells. Life Sci 1997;60:2349-59. PubMed
  4. Zhao Y. [Inhibitory effects of alcoholic extract of Cordyceps sinensis on abdominal aortic thrombus formation in rabbits]. Chung Hua I Hsueh Tsa Chih (Taipei) 1991;71:612-5, 42.
  5. Chen GZ, Chen GL, Sun T, et al. Effects of Cordyceps sinensis on murine T lymphocyte subsets. Chin Med J (English) 1991;104:4-8.
  6. Zhu XY, Yu HY. [Immunosuppressive effect of cultured Cordyceps sinensis on cellular immune response]. Chung Hsi I Chieh Ho Tsa Chih 1990;10:485-7, 454.
  7. Hsu, C. C., Huang, Y. L., Tsai, S. J., Sheu, C. C., and Huang, B. M. In vivo and in vitro stimulatory effects of Cordyceps sinensis on testosterone production in mouse Leydig cells. Life Sci 9-5-2003;73(16):2127-2136. PubMed
  8. Ikumoto, T., Sasaki, S., Namba, H., Toyama, R., Moritoki, H., and Mouri, T. [Physiologically active compounds in the extracts from tochukaso and cultured mycelia of Cordyceps and Isaria]. Yakugaku Zasshi 1991;111(9):504-509. PubMed
  9. Wu, T. N., Yang, K. C., Wang, C. M., Lai, J. S., Ko, K. N., Chang, P. Y., and Liou, S. H. Lead poisoning caused by contaminated Cordyceps, a Chinese herbal medicine: two case reports. Sci.Total Environ. 4-5-1996;182(1-3):193-195. PubMed
  10. Hong T, Zhang M, Fan J. Cordyceps sinensis (a traditional Chinese medicine) for kidney transplant recipients (Review). Cochrane Database Syst Rev. 2015;(10):CD009698. doi: 10.1002/14651858.CD009698.pub2.
  11. Zhang HW, Lin ZX, Tung YS, Kwan TH, Mok CK, Leung C, Chan LS. Cordyceps sinensis (a traditional Chinese medicine) for treating chronic kidney disease (Review). Cochrane Database Syst Rev. 2014;(12):CD008353. doi: 10.1002/14651858.CD008353.pub2. PubMed
  12. Bee Yean O, Zoriah A. Efficacy of Cordyceps sinensis as an adjunctive treatment in hemodialysis patients: a systematic review and Meta-analysis. J Tradit Chin Med. 2019;39(1):1-14.
  13. Thurian D, Montani M, Stickel F. Drug-induced, mixed-type hepatitis following ingestion of Cordyceps sinensis. Int J Clin Pharmacol Ther 2022;60(2):115-120. PubMed
  14. Yu X, Mao Y, Shergis JL, et al. Effectiveness and safety of oral Cordyceps sinensis on stable COPD of GOLD stages 2-3: Systematic review and meta-analysis. Evid Based Complement Alternat Med. 2019;2019:4903671.

See these in context on the Cordyceps monograph →

Zinc 88 references
  1. Barceloux DG. Zinc. J Toxicol Clin Toxicol 1999;37:279-92.
  2. Eby GA, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother 1984;25:20-4. DOI
  3. Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
  4. Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
  5. Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
  6. Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
  7. Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
  8. Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
  9. Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
  10. Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
  11. Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
  12. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  13. Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
  14. Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
  15. Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
  16. Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet 1976;2:539-42. PubMed
  17. Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72. PubMed
  18. Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
  19. Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
  20. Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
  21. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  22. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
  23. Greenberg JE, Lynn M, Kirsner RS, et al. Mucocutaneous pigmented macule as a result of zinc deposition. J Cutan Pathol 2002;29:613-5. PubMed
  24. Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
  25. Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis 2001;33:1865-70. PubMed
  26. Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med 2001;111:103-8. PubMed
  27. Mossad SB. Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM 2003;96:35-43. DOI
  28. Leitzmann MF, Stampfer MJ, Wu K, et al. Zinc supplement use and risk of prostate cancer. J Natl Cancer Inst 2003;95:1004-7.. PubMed
  29. Jafek BW, Linschoten M, Murrow BW. Zicam Induced Anosmia. American Rhinologic Society 49th Annual Fall Scientific Meeting abstract. Orlando, Florida. September 20, 2003. http://app.american-rhinologic.org/programs/2003ARSFallProgram071503.pdf (Accessed 24
  30. Uebayashi H, Hatanaka T, Kanemura F, Tonosaki K. Acute anosmia in the mouse: behavioral discrimination among the four basic taste substances. Physiol Behav 2001;72:291-6.. PubMed
  31. Barrett S. Zicam Marketers Sued. United States District Court Western District of Michigan Southern Division, Filed October 14, 2003, Case No. 4:03CV0146.
  32. Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:181-90.. PubMed
  33. Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
  34. Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7. PubMed
  35. Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
  36. Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70. PubMed
  37. Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.
  38. Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
  39. Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
  40. Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.
  41. McBride K, Slotnick B, Margolis FL. Does intranasal application of zinc sulfate produce anosmia in the mouse? An olfactometric and anatomical study. Chem Senses 2003;28:659-70. PubMed
  42. Burd GD. Morphological study of the effects of intranasal zinc sulfate irrigation on the mouse olfactory epithelium and olfactory bulb. Microsc Res Tech 1993;24:195-213. PubMed
  43. Ducray A, Bondier JR, Michel G, et al. Recovery following peripheral destruction of olfactory neurons in young and adult mice. Eur J Neurosci 2002;15:1907-17. PubMed
  44. Mayer AD, Rosenblatt JS. Peripheral olfactory deafferentation of the primary olfactory system in rats using ZnSO4 nasal spray with special reference to maternal behavior. Physiol Behav 1993;53:587-92. PubMed
  45. DeCook CA, Hirsch AR. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
  46. Tisdall FF, Brown A, Defries RD. Persistent anosmia following zinc sulfate nasal spraying. JPed 1938;18:60-2. DOI
  47. Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
  48. Public Health Advisory. Loss of sense of smell with intranasal cold remedies containing zinc. U.S. Food and Drug Administration, June 16, 2009. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm166059.htm (Accessed 16 June 2009)
  49. Dooren JC. FDA warns against use of Zicam. The Wall Street Journal, June 16, 2009. Available at: http://online.wsj.com/article/SB124516778692319231.html#mod=djemHL?mg=com-wsj (Accessed 16 June 2009).
  50. Alexander TH, Davidson TM. Intranasal zinc and anosmia: the zinc-induced anosmia syndrome. Laryngoscope 2006;116:217-20.
  51. Health Canada / GlaxoSmithKline Consumer Healthcare. Association of long-term, excessive use of zinc-containing Poli-Grip products with myeloneuropathy and blood dyscrasias. February 18, 2010. Available at: http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medef
  52. GlaxoSmithKline Consumer Advisory. GlaxoSmithKline (GSK) warns about a potential health risk associated with long-term, excessive use of GSK's zinc-containing denture adhesives Super Polygrip Original, Ultra Fresh and Extra Care. February 18, 2010. Availa
  53. Science M, Johnstone J, Roth DE, et al. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ 2012;184:E551-61. PubMed
  54. Castilla-Higuero, L., Romero-Gomez, M., Suarez, E., and Castro, M. Acute hepatitis after starting zinc therapy in a patient with presymptomatic Wilson's disease. Hepatology 2000;32(4 Pt 1):877. PubMed
  55. Sharquie, K. E., Najim, R. A., Farjou, I. B., and Al Timimi, D. J. Oral zinc sulphate in the treatment of acute cutaneous leishmaniasis. Clin.Exp.Dermatol. 2001;26(1):21-26. PubMed
  56. Dreno, B., Moyse, D., Alirezai, M., Amblard, P., Auffret, N., Beylot, C., Bodokh, I., Chivot, M., Daniel, F., Humbert, P., Meynadier, J., and Poli, F. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of
  57. Moore, R. Bleeding gastric erosion after oral zinc sulphate. Br.Med J 3-25-1978;1(6115):754. PubMed
  58. Jafek, B. W., Linschoten, M. R., and Murrow, B. W. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004;18(3):137-141. DOI
  59. Simonart, T. and de, Maertelaer, V. Systemic treatments for cutaneous warts: a systematic review. J Dermatolog.Treat. 2012;23(1):72-77. PubMed
  60. Cochran, R. J., Tucker, S. B., and Flannigan, S. A. Topical zinc therapy for acne vulgaris. Int.J Dermatol. 1985;24(3):188-190. DOI
  61. Morgan, A. A. Bleeding gastric erosion after oral zinc sulphate. Br.Med.J. 5-13-1978;1(6122):1283-1284. PubMed
  62. Murphy, J. V. Intoxication following ingestion of elemental zinc. JAMA 6-22-1970;212(12):2119-2120.
  63. Lang, C. J., Rabas-Kolominsky, P., Engelhardt, A., Kobras, G., and Konig, H. J. Fatal deterioration of Wilson's disease after institution of oral zinc therapy. Arch Neurol. 1993;50(10):1007-1008. PubMed
  64. Fjellner, B. Drug-induced lupus erythematosus aggravated by oral zinc therapy. Acta Derm.Venereol. 1979;59(4):368-370. DOI
  65. Varas Lorenzo, M. J. Zinc acexamate and ranitidine in the short- and mid-term management of gastroduodenal ulcers. Curr Ther Res 21986;39:19-29.
  66. Bosch, F. and Jimenez, E. Post-marketing surveillance of zinc acexamate in peptic ulcer treatment. Clin Trials J 1990;27:301-312.
  67. DeCook, C. A. and Hirsch, A. R. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
  68. Crown LA, May JA. Zinc toxicity: denture adhesives, bone marrow failure and polyneuropathy. Tenn Med. 2012 Feb;105(2):39-40, 42.
  69. Dadamio J, Van Tournout M, Teughels W, Dekeyser C, Coucke W, Quirynen M. Efficacy of different mouthrinse formulations in reducing oral malodour: a randomized clinical trial. J Clin Periodontol. 2013 May;40(5):505-13. PubMed
  70. Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug PubMed
  71. Zittel S, Ufer F, Gerloff C, Münchau A, Rosenkranz M. Severe myelopathy after denture cream use--is copper deficiency or excess zinc the cause? Clin Neurol Neurosurg. 2014 Jun;121:17-8. PubMed
  72. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  73. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: Drug Interactions between Integrase Inhibitors and Other Drugs. AIDSinfo. July 14, 2016. Available at: https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescen
  74. Ding Y, Jia YY, Li F, et al. The effect of staggered administration of zinc sulfate on the pharmacokinetics of oral cephalexin. Br J Clin Pharmacol. 2012 Mar;73(3):422-7. PubMed
  75. Fallah R, Sabbaghzadegan S, Karbasi SA, Binesh F. Efficacy of zinc sulfate supplement on febrile seizure recurrence prevention in children with normal serum zinc level: A randomised clinical trial. Nutrition. 2015;31(11-12):1358-61. PubMed
  76. Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016;12:CD005436. PubMed
  77. Mahmoud AM, Al-Alem U, Dabbous F, et al. Zinc intake and risk of prostate cancer: Case-control study and meta-analysis. PLoS One. 2016;11(11):e0165956. PubMed
  78. Nagraj SK, George RP, Shetty N, Levenson D, Ferraiolo DM, Shrestha A. Interventions for managing taste disturbances. Cochrane Database Syst Rev. 2017 Dec 20;12(12):CD010470. PubMed
  79. Yee BE, Richards P, Sui JY, Marsch AF. Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta-analysis. Dermatol Ther. 2020:e14252. PubMed
  80. Janyajirawong R, Vilaichone RK, Sethasine S. Efficacy of zinc supplement in minimal hepatic encephalopathy: A prospective, randomized controlled study (Zinc-MHE Trial). Asian Pac J Cancer Prev 2021;22(9):2879-2887. PubMed
  81. Nakano M, Nakamura Y, Miyazaki A, Takahashi J. Zinc pharmacotherapy for elderly osteoporotic patients with zinc deficiency in a clinical setting. Nutrients 2021;13(6):1814. PubMed
  82. Tolino E, Skroza N, Mambrin A, et al. An open-label study comparing oral zinc to lymecycline in the treatment of acne vulgaris. J Clin Aesthet Dermatol 2021;14(5):56-58.
  83. Hunter J, Arentz S, Goldenberg J, et al. Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2021;11(11):e047474. PubMed
  84. Yamazaki K, Kageyama H, Fujiyama T, Ito T, Urano S, Honda T. A case of systemic contact dermatitis due to zinc supplements. Int J Dermatol 2022. PubMed
  85. Magham K, Han J, Eilbert W, Bunney EB. Severe copper deficiency anemia caused by zinc supplement use. Am J Emerg Med 2023;72:222. PubMed
  86. Sivakumar RR, Chinnaiah Govindareddy D, Sahoo J, Bobby Z, Chinnakali P. Effect of daily zinc supplementation for 12 weeks on serum thyroid auto-antibody levels in children and adolescents with autoimmune thyroiditis - a randomized controlled trial. J Pedi PubMed
  87. AlDhasee O, AlMalki H, AlKharashi N, AlJeraisy N, Al Deeb M. Acute zinc sulfate overdose: clinical presentation and management. BMJ Case Rep 2025;18(1):e263899. PubMed
  88. US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.

See these in context on the Zinc monograph →

Agaricus Mushroom 5 references
  1. Hsu CH, Liao YL, Lin SC, et al. The mushroom Agaricus Blazei Murill in combination with metformin and gliclazide improves insulin resistance in type 2 diabetes: a randomized, double-blinded, and placebo-controlled clinical trial. J Altern Complement Med 2
  2. Mukai H, Watanabe T, Ando M, Katsumata N. An alternative medicine, Agaricus blazei, may have induced severe hepatic dysfunction in cancer patients. Jpn J Clin Oncol 2006;36:808-10. PubMed
  3. Ohno S, Sumiyoshi Y, Hashine K, et al. Phase I clinical study of the dietary supplement, Agaricus blazei Murill, in cancer patients in remission. Evid Based Complement Alternat Med 2011, doi 10.1155/2011/192381.
  4. Suehiro M, Katoh N, Kishimoto S. Chelitis due to Agaricus blazei Murill mushroom extract. Contact Dermatitis 2007;56(5):293-4.
  5. Iwai N, Okuda T, Sawada R, et al. Interstitial lung disease associated with Agaricus blazei Murill in a patient with pancreatic ductal adenocarcinoma receiving gemcitabine-based therapy. Case Rep Gastroenterol 2022;16(1):229-234.

See these in context on the Agaricus Mushroom monograph →

Olive 2 references
  1. Liccardi G, D'Amato M, D'Amato G. Oleaceae pollinosis: a review. Int Arch Allergy Immunol 1996;111:210-7. PubMed
  2. Somerville V, Moore R, Braakhuis A. The effect of olive leaf extract on upper respiratory illness in high school athletes: A randomised control trial. Nutrients. 2019;11(2). pii: E358. PubMed

See these in context on the Olive monograph →

Shiitake Mushroom 67 references
  1. Hitosugi M, Kitamura O, Takatsu A, Yoshino Y. Autopsy case of duodenal obstruction from impacted mushroom. J Gastroenterol 1998;33:562-5. PubMed
  2. Hanada K, Hashimoto I. Flagellate mushroom (Shiitake) dermatitis and photosensitivity. Dermatol 1998;197:255-7. PubMed
  3. Levy AM, Kita H, Phillips SF, et al. Eosinophilia and gastrointestinal symptoms after ingestion of shiitake mushrooms. J Allergy Clin Immunol 1998;101:613-20. PubMed
  4. Murakami M, Kawabe K, Hosoi Y, et al. Decreased pulmonary perfusion in hypersensitivity pneumonitis caused by Shiitake mushroom spores. J Intern Med 1997;241:85-8. PubMed
  5. Matsui S, Nakazawa T, Umegae Y, Mori M. Hypersensitivity pneumonitis induced by Shiitake mushroom spores. Intern Med 1992;31:1204-6.
  6. Nakamura T. Shiitake (Lentinus edodes) dermatitis. Contact Dermatitis 1992;27:65-70.
  7. Ueda A, Obama K, Aoyama K, et al. Allergic contact dermatitis in shiitake (Lentinus edodes (Berk) Sing) growers. Contact Dermatitis 1992;26:228-33.
  8. Burikhanov, R. B., Wakame, K., Igarashi, Y., Wang, S., and Matsuzaki, S. Suppressive effect of active hexose correlated compound (AHCC) on thymic apoptosis induced by dexamethasone in the rat. Endocr.Regul. 2000;34(4):181-188.
  9. Gao, Y., Zhang, D., Sun, B., Fujii, H., Kosuna, K., and Yin, Z. Active hexose correlated compound enhances tumor surveillance through regulating both innate and adaptive immune responses. Cancer Immunol.Immunother. 2006;55(10):1258-1266. PubMed
  10. Ritz, B. W., Nogusa, S., Ackerman, E. A., and Gardner, E. M. Supplementation with active hexose correlated compound increases the innate immune response of young mice to primary influenza infection. J Nutr. 2006;136(11):2868-2873. PubMed
  11. Aviles, H., O'Donnell, P., Sun, B., and Sonnenfeld, G. Active hexose correlated compound (AHCC) enhances resistance to infection in a mouse model of surgical wound infection. Surg.Infect.(Larchmt.) 2006;7(6):527-535. PubMed
  12. Spierings, E. L., Fujii, H., Sun, B., and Walshe, T. A Phase I study of the safety of the nutritional supplement, active hexose correlated compound, AHCC, in healthy volunteers. J Nutr Sci Vitaminol.(Tokyo) 2007;53(6):536-539. PubMed
  13. Aviles, H., O'Donnell, P., Orshal, J., Fujii, H., Sun, B., and Sonnenfeld, G. Active hexose correlated compound activates immune function to decrease bacterial load in a murine model of intramuscular infection. Am J Surg. 2008;195(4):537-545. PubMed
  14. Ritz, B. W. Supplementation with active hexose correlated compound increases survival following infectious challenge in mice. Nutr.Rev. 2008;66(9):526-531. PubMed
  15. Terakawa, N., Matsui, Y., Satoi, S., Yanagimoto, H., Takahashi, K., Yamamoto, T., Yamao, J., Takai, S., Kwon, A. H., and Kamiyama, Y. Immunological effect of active hexose correlated compound (AHCC) in healthy volunteers: a double-blind, placebo-controll
  16. Mach, C. M., Fugii, H., Wakame, K., and Smith, J. Evaluation of active hexose correlated compound hepatic metabolism and potential for drug interactions with chemotherapy agents. J Soc Integr.Oncol. 2008;6(3):105-109.
  17. Wang, S., Welte, T., Fang, H., Chang, G. J., Born, W. K., O'Brien, R. L., Sun, B., Fujii, H., Kosuna, K., and Wang, T. Oral administration of active hexose correlated compound enhances host resistance to West Nile encephalitis in mice. J Nutr. 2009;139(3 PubMed
  18. Sumiyoshi, Y., Hashine, K., Kakehi, Y., Yoshimura, K., Satou, T., Kuruma, H., Namiki, S., and Shinohara, N. Dietary administration of mushroom mycelium extracts in patients with early stage prostate cancers managed expectantly: a phase II study. Jpn.J Cl PubMed
  19. Yin, Z., Fujii, H., and Walshe, T. Effects of active hexose correlated compound on frequency of CD4+ and CD8+ T cells producing interferon-gamma and/or tumor necrosis factor-alpha in healthy adults. Hum.Immunol. 2010;71(12):1187-1190.
  20. Lee, W. W., Lee, N., Fujii, H., and Kang, I. Active Hexose Correlated Compound promotes T helper (Th) 17 and 1 cell responses via inducing IL-1beta production from monocytes in humans. Cell Immunol. 2012;275(1-2):19-23.
  21. Daddaoua, A., Martinez-Plata, E., Ortega-Gonzalez, M., Ocon, B., Aranda, C. J., Zarzuelo, A., Suarez, M. D., de Medina, F. S., and Martinez-Augustin, O. The nutritional supplement Active Hexose Correlated Compound (AHCC) has direct immunomodulatory actio
  22. Roman, B. E., Beli, E., Duriancik, D. M., and Gardner, E. M. Short-term supplementation with active hexose correlated compound improves the antibody response to influenza B vaccine. Nutr Res. 2013;33(1):12-17. PubMed
  23. Uno, K., Kosuna, K., Sun, B., Fujii, H., Wakame, K., Chikumaru, S., Hosokawa, G., and Ueda, Y. Active Hexose Correlated Compound (AHCC) Improves Immunological Parameters and Performance Status of Patients with Solid Tumors. Biotherapy 2000;14(3):303-309.
  24. Ghoneum, M., Wimbley, M., Salem, F., McKlain, A., Attallah, N., and Gill, G. Immunomodulatory and anticancer effects of active hexose correlated compound (AHCC). Int J Immunother 1995;11:23-28.
  25. Thaiudom, S., Piyaniran, W., and Chutaputthi, A. A study of the efficacy of Active Hexose Correlated Compound (AHCC) in the treatment of chronic Hepatitis C patients at Phramongkutklao Hospital. The Medical News (Thailand) 2010;325:13-16.
  26. Smith, J. A., Hunter, R. J., Fujii, H., Wakame, K., and Wolf, J. Defining Synergistic Activity ofthe Combination of Active Hexose Correlated Compound (AHCC) with Liposomal Doxorubicin (Doxil). Presented at the 18th International Congress on Nutrition and
  27. Sia, G. M. and Candlish, J. K. Effects of shiitake (Lentinus edodes) extract on human neutrophils and the U937 monocytic cell line. Phytother.Res. 1999;13(2):133-137. DOI
  28. Fujiwara, K., Sato, T., Yonei, T., Genba, K., Nogami, N., and Yamadori, I. [A case of chronic hypersensitivity pneumonitis induced by shiitake mushroom spores]. Nihon Kokyuki.Gakkai Zasshi 2000;38(12):908-913.
  29. Lippert, U., Martin, V., Schwertfeger, C., Junghans, V., Ellinghaus, B., and Fuchs, T. Shiitake dermatitis. Br.J Dermatol. 2003;148(1):178-179.
  30. Lobanok, A. G., Babitskaia, V. G., Plenina, L. V., Puchkova, T. A., and Osadchaia, O. V. [Composition and biological activity of submerged mycelium of the xylotrophic basidiomycete Lentinus edodes]. Prikl.Biokhim.Mikrobiol. 2003;39(1):69-73. DOI
  31. Curnow, P. and Tam, M. Contact dermatitis to Shiitake mushroom. Australas.J.Dermatol. 2003;44(2):155-157. PubMed
  32. Mak, R. K. and Wakelin, S. H. Shiitake dermatitis: the first case reported from a European country. Br J Dermatol 2006;154(4):800-801. PubMed
  33. Sastre, J., Ibanez, M. D., Lopez, M., and Lehrer, S. B. Respiratory and immunological reactions among Shiitake (Lentinus edodes) mushroom workers. Clin.Exp.Allergy 1990;20(1):13-19.
  34. Liu, M., Li, J., Kong, F., Lin, J., and Gao, Y. Induction of immunomodulating cytokines by a new polysaccharide-peptide complex from culture mycelia of Lentinus edodes. Immunopharmacology 1998;40(3):187-198. PubMed
  35. Ade R, Sukut C, Wiser HJ, Shockman S, Buescher L. Shiitake dermatitis demonstrating Köebner phenomenon. Int J Dermatol. 2015;54(5):e179-81.
  36. Adler MJ, Larsen WG. Clinical variability of shiitake dermatitis. J Am Acad Dermatol. 2012 Oct;67(4):e140-1. PubMed
  37. Adriano AR, Acosta ML, Azulay DR, Quiroz CD, Talarico SR. Shiitake dermatitis: the first case reported in Brazil. An Bras Dermatol. 2013 May-Jun;88(3):417-9. PubMed
  38. Ampere A, Delhaes L, Soots J, Bart F, Wallaert B. Hypersensitivity pneumonitis induced by Shiitake mushroom spores. Med Mycol. 2012 Aug;50(6):654-7. PubMed
  39. Baran W, Batycka-Baran A, Maj J, Szepietowski JC. Shiitake dermatitis - now also in Poland. Acta Derm Venereol. 2015 Jan;95(1):102-3. PubMed
  40. Boels D, Landreau A, Bruneau C, et al. Shiitake dermatitis recorded by French Poison Control Centers - new case series with clinical observations. Clin Toxicol (Phila). 2014 Jul;52(6):625-8. PubMed
  41. Chu EY, Anand D, Dawn A, Elenitsas R, Adler DJ. Shiitake dermatitis: a report of 3 cases and review of the literature. Cutis. 2013 Jun;91(6):287-90.
  42. Corazza M, Zauli S, Ricci M, et al. Shiitake dermatitis: toxic or allergic reaction? J Eur Acad Dermatol Venereol. 2015 Jul;29(7):1449-51. PubMed
  43. Czarnecka AB, Kreft B, Marsch WCh. Flagellate dermatitis after consumption of Shiitake mushrooms. Postepy Dermatol Alergol. 2014 Jun;31(3):187-90. PubMed
  44. Dai X, Stanilka JM, Rowe CA, et al. Consuming Lentinula edodes (Shiitake) Mushrooms Daily Improves Human Immunity: A Randomized Dietary Intervention in Healthy Young Adults. J Am Coll Nutr. 2015;34(6):478-87.
  45. Hamer SE, Kulkarni K, Cohen SN. Shiitake dermatitis with oral ulceration and pustules. Clin Exp Dermatol. 2015 Apr;40(3):332-3. PubMed
  46. Hiernickel C, Metz S, Elsner P. Shiitake dermatitis: an impressive case report. J Dtsch Dermatol Ges. 2015 May;13(5):455-6. PubMed
  47. Karanovic S, George S, Topham E. Don't miss shiitake dermatitis: a case report. Br J Gen Pract. 2014 Aug;64(625):426-7. PubMed
  48. Kopp T, Mastan P, Mothes N, Tzaneva S, Stingl G, Tanew A. Systemic allergic contact dermatitis due to consumption of raw shiitake mushroom. Clin Exp Dermatol. 2009 Dec;34(8):e910-3. PubMed
  49. Lingström P, Zaura E, Hassan H, et al. The anticaries effect of a food extract (shiitake) in a short-term clinical study. J Biomed Biotechnol. 2012;2012:217164. PubMed
  50. Loo HV, Oon HH. Flagellate dermatitis following consumption of shiitake mushroom. Dermatol Reports. 2011 Oct 5;3(2):e21. PubMed
  51. Luber AJ, Ackerman LS. Flagellate shiitake mushroom dermatitis. Dermatol Online J. 2015 Aug 15;21(8). pii: 13030/qt7rm57553. DOI
  52. Mendonça CN, Silva PM, Avelleira JC, Nishimori FS, Cassia Fde F. Shiitake dermatitis. An Bras Dermatol. 2015 Mar-Apr;90(2):276-8.
  53. Netchiporouk E, Pehr K, Ben-Shoshan M, Billick RC, Sasseville D, Singer M. Pustular flagellate dermatitis after consumption of shiitake mushrooms. JAAD Case Rep. 2015 May 2;1(3):117-9. PubMed
  54. Nguyen AH, Gonzaga MI, Lim VM, Adler MJ, Mitkov MV, Cappel MA. Clinical features of shiitake dermatitis: a systematic review. Int J Dermatol. 2017 Jun;56(6):610-616. PubMed
  55. Poppe LM, Anders D, Kneitz H, Bröcker EB, Benoit S. Flagellate dermatitis caused by shiitake mushrooms. An Bras Dermatol. 2012 May-Jun;87(3):463-5. PubMed
  56. Pravettoni V, Primavesi L, Piantanida M. Shiitake mushroom (Lentinus edodes): a poorly known allergen in Western countries responsible for severe work-related asthma. Int J Occup Med Environ Health. 2014 Oct;27(5):871-4. PubMed
  57. Ricar J, Pizinger K, Cetkovska P. Shiitake dermatitis: a distinctive clinical entity. Int J Dermatol. 2013 Dec;52(12):1620-1. PubMed
  58. Shozushima M, Ohata K, Nonaka K, Matsuhashi N. Shiitake mushroom-induced ileus managed using double-balloon enteroscopy. Endoscopy. 2013;45 Suppl 2 UCTN:E437. PubMed
  59. Uslu U, Linkner RV. Shiitake mushroom dermatitis. Cutis. 2015 May;95(5):E11-2.
  60. Wang AS, Barr KL, Jagdeo J. Shiitake mushroom-induced flagellate erythema: A striking case and review of the literature. Dermatol Online J. 2013 Apr 15;19(4):5. DOI
  61. Tan J, Yuan K, Zuo J, et al. Two cases of small bowel obstruction due to a shiitake mushroom. Gastroenterol Rep (Oxf) 2019;7(4):298-300. doi: 10.1093/gastro/gox028. PubMed
  62. Boels D, Greillet C, Langrand J, et al. Shiitake dermatitis: experience of the Poison Control Centre Network in France from 2014 to 2019. Clin Toxicol (Phila) 2022. PubMed
  63. Miyagishima D, Inoue M, Kinjo K, et al. A case of bowel obstruction due to shiitake mushrooms: Diagnostic features on computed tomography. Intern Med 2022. PubMed
  64. Soga K, Mukai H, Kitae H. Management of shiitake mushroom-induced ileus using balloon enteroscopy. Dig Endosc 2022;34(4):e58-e59. PubMed
  65. Ma JY, Liu JW. Shiitake flagellate dermatitis. Mayo Clin Proc 2022;97(12):2192-2193. PubMed
  66. Booms A, Rashid Z, Al-Rubaie V, Bal A. Shiitake dermatitis: a case report of a rare mushroom-induced dermatitis in the United States. Int J Dermatol 2022. PubMed
  67. Sudy E, Urbina F. Shiitake dermatitis: clinical forms of presentation. Int J Dermatol 2023. PubMed

See these in context on the Shiitake Mushroom monograph →

Maitake Mushroom 8 references
  1. Kabir Y, Kimura S. Dietary mushrooms reduce blood pressure in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol (Tokyo) 1989;35:91-4. PubMed
  2. Kabir Y, Yamaguchi M, Kimura S. Effect of shiitake (Lentinus edodes) and maitake (Grifola frondosa) mushrooms on blood pressure and plasma lipids of spontaneously hypertensive rats. J Nutr Sci Vitaminol (Tokyo) 1987;33:341-6. PubMed
  3. Konno S, Tortorelis DG, Fullerton SA, et al. A possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients. Diabet Med 2001;18:1010. PubMed
  4. Chen JT, Tominaga K, Sato Y, et al. Maitake mushroom (Grifola frondosa) extract induces ovulation in patients with polycystic ovary syndrome: a possible monotherapy and a combination therapy after failure with first-line clomiphene citrate. J Altern Compl
  5. Hanselin MR, Vande Griend JP, Linnebur SA. INR elevation with maitake extract in combination with warfarin. Ann Pharmacother 2010;44:223-4. PubMed
  6. Talpur, N. A., Echard, B. W., Fan, A. Y., Jaffari, O., Bagchi, D., and Preuss, H. G. Antihypertensive and metabolic effects of whole Maitake mushroom powder and its fractions in two rat strains. Mol.Cell Biochem. 2002;237(1-2):129-136. PubMed
  7. Deng, G., Lin, H., Seidman, A., Fornier, M., D'Andrea, G., Wesa, K., Yeung, S., Cunningham-Rundles, S., Vickers, A. J., and Cassileth, B. A phase I/II trial of a polysaccharide extract from Grifola frondosa (Maitake mushroom) in breast cancer patients: i
  8. Wesa KM, Cunningham-Rundles S, Klimek VM, et al. Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study. Cancer Immunol Immunother 2015;64(2):237-47. PubMed

See these in context on the Maitake Mushroom monograph →

Ip-6 3 references
  1. Steinmetz KA, Potter JD. Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc 1996;96:1027-39. PubMed
  2. Vucenik I, Podczasy JJ, Shamsuddin AM. Antiplatelet activity of inositol hexaphosphate. Anticancer Res 1999;19:3689-93.
  3. Ikenaga T, Kakumoto K, Kohda N, Yamamoto T. Effect of Inositol Hexaphosphate (IP6) on Serum Uric Acid in Hyperuricemic Subjects: a Randomized, Double-Blind, Placebo-Controlled, Crossover Study. Plant Foods Hum Nutr. 2019 Sep;74(3):316-321. DOI

See these in context on the Ip-6 monograph →

Beta-sitosterol 7 references
  1. Berges RR, Windeler J, Trampisch HJ, et al. Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group. Lancet 1995;345:1529-32.
  2. Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol 1997;80:427-32.
  3. Wilt TJ, MacDonald R, Ishani A. beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review. BJU Int 1999;83:976-83. PubMed
  4. Oster P, Schlierf G, Heuck CC, et al. [Sitosterol in familial hyperlipoproteinemia type II. A randomized, double-blind, cross-over study]. Dtsch Med Wochenschr 1976;101:1308-11.
  5. Becker M, Staab D, Von Bergman K. Long-term treatment of severe familial hypercholesterolemia in children: effect of sitosterol and bezafibrate. Pediatrics 1992;89:138-42. DOI
  6. Prager N, Bickett K, French N, Marcovici G. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med 2002
  7. Lorenze A, Hsueh W, Nasr J. Beta-sitosterol-induced acute pancreatitis: A case report and review of the literature. Cureus. 2020;12(3):e7407. PubMed

See these in context on the Beta-sitosterol monograph →

Brewer's Yeast 6 references
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Lewis SJ, Freedman AR. Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. Aliment Pharmacol Ther 1998;12:807-22. PubMed
  3. Bahijiri, S. M., Mira, S. A., Mufti, A. M., and Ajabnoor, M. A. The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Saudi.Med.J. 2000;21(9):831-837. DOI
  4. Schrauzer, G. N. and de, Vroey E. Effects of nutritional lithium supplementation on mood. A placebo-controlled study with former drug users. Biol.Trace Elem.Res. 1994;40(1):89-101. PubMed
  5. Gayathri R, Aruna T, Malar S, Shilpa B, Dhanasekar KR. Efficacy of Saccharomyces cerevisiae CNCM I-3856 as an add-on therapy for irritable bowel syndrome. Int J Colorectal Dis. 2020;35(1):139-145. PubMed
  6. Mourey F, Decherf A, Jeanne JF, et al. Saccharomyces cerevisiae I-3856 in irritable bowel syndrome with predominant constipation. World J Gastroenterol 2022;28(22):2509-2522.

See these in context on the Brewer's Yeast monograph →

Aloe 41 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5. PubMed
  5. Luyckx VA, Ballantine R, Claeys M, et al. Herbal remedy-associated acute renal failure secondary to Cape aloes. Am J Kidney Dis 2002;39:E13. PubMed
  6. Rajasekaran S, Sivagnanam K, Ravi K, Subramanian S. Hypoglycemic effect of Aloe vera gel on streptozotocin-induced diabetes in experimental rats. J Med Food 2004;7:61-6.
  7. Williams MS, Burk M, Loprinzi CL, et al. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiat Oncol Biol Phys 1996;36:345-9. PubMed
  8. Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999;49:823-8.
  9. Bottenberg MM, Wall GC, Harvey RL, Habib S. Oral aloe vera-induced hepatitis. Ann Pharmacother 2007;41:1740-3. PubMed
  10. Rabe C, Musch A, Schirmacher P, et al. Acute hepatitis induced by an Aloe vera preparation: a case report. World J Gastroenterol 2005;11:303-4. PubMed
  11. Kanat O, Ozet A, Ataergin S. Aloe vera-induced acute toxic hepatitis in a healthy young man. Eur J Int Med 2006;17:589. PubMed
  12. Mueller SO, Stopper H. Characterization of the genotoxicity of anthraquinones in mammalian cells. Biochim Biophys Acta 1999;1428:406-14. PubMed
  13. Schorkhuber M, Richter M, Dutter A, et al. Effect of anthraquinone laxatives on the proliferation and urokinase secretion of normal, premalignant and malignant colonic epithelial cells. Eur J Cancer 1998;34:1091-8. PubMed
  14. Yang HN, Kim DJ, Kim YM, et al. Aloe-induced toxic hepatitis. J Korean Med Sci 2010;25:492-5. PubMed
  15. Choonhakarn C, Busaracome P, Sripanidkulchai B, et al. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J.Eur.Acad.Dermatol.Venereol. 2010;24:168-72. PubMed
  16. Ishii Y, Tanizawa H, Takino Y. Studies of aloe. IV. Mechanism of cathartic effect. (3). Biol Pharm Bull. 1994;17:495-7. PubMed
  17. Ishii Y, Tanizawa H, Takino Y. Studies of aloe. V. Mechanism of cathartic effect. (4). Biol Pharm Bull. 1994;17:651-3. PubMed
  18. Nelemans FA. Clinical and toxicological aspects of anthraquinone laxatives. Pharmacology. 1976;14 Suppl 1:73-7. PubMed
  19. Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19:326-31.
  20. Huseini HF, Kianbakht S, Hajiaghaee R, et al. Anti-hyperglycemic and anti-hypercholesterolemic effects of Aloe vera leaf gel in hyperlipidemic type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Planta Med. 2012;78:311-6
  21. Ferreira, M., Teixeira, M., Silva, E., and Selores, M. Allergic contact dermatitis to Aloe vera. Contact Dermatitis 2007;57(4):278-279.
  22. Choonhakarn, C., Busaracome, P., Sripanidkulchai, B., and Sarakarn, P. The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol 2008;158(3):573-577. PubMed
  23. Baretta, Z., Ghiotto, C., Marino, D., and Jirillo, A. Aloe-induced hypokalemia in a patient with breast cancer during chemotherapy. Ann.Oncol. 2009;20(8):1445-1446. PubMed
  24. Hunter, D. and Frumkin, A. Adverse reactions to vitamin E and aloe vera preparations after dermabrasion and chemical peel. Cutis 1991;47(3):193-196.
  25. Alvarez-Perea, A., Garcia, A. P., Hernandez, A. L., de, Barrio M., and Baeza, M. L. Urticaria due to aloe vera: a new sensitizer? Ann.Allergy Asthma Immunol. 2010;105(5):404-405. PubMed
  26. Hogan, D. J. Widespread dermatitis after topical treatment of chronic leg ulcers and stasis dermatitis. CMAJ. 2-15-1988;138(4):336-338.
  27. Savchak VI. Acute bullous allergic dermatitis due to local application of aloe leaves. Vestnik Dermatologii i Venerologii 1977;12:44-45.
  28. Nakamura, T. and Kotajima, S. Contact dermatitis from aloe arborescens. Contact Dermatitis 1984;11(1):51. PubMed
  29. Shoji, A. Contact dermatitis to Aloe arborescens. Contact Dermatitis 1982;8(3):164-167. PubMed
  30. Morrow, D. M., Rapaport, M. J., and Strick, R. A. Hypersensitivity to aloe. Arch Dermatol. 1980;116(9):1064-1065. DOI
  31. Cosmetic Ingredient Review Expert Panel. Final report on the safety assessment of AloeAndongensis Extract, Aloe Andongensis Leaf Juice,aloe Arborescens Leaf Extract, Aloe Arborescens Leaf Juice, Aloe Arborescens Leaf Protoplasts, Aloe Barbadensis Flower E
  32. Bhalang K, Thunyakitpisal P, Rungsirisatean N. Acemannan, a polysaccharide extracted from Aloe vera, is effective in the treatment of oral aphthous ulceration. J Altern Complement Med 2013;19(5):429-34.
  33. Hajheydari Z, Saeedi M, Morteza-Semnani K, Soltani A. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial. J Dermatolog Treat 2014;25(2):123-9.
  34. Jiménez-Encarnación E, Ríos G, Muñoz-Mirabal A, Vilá LM. Euforia-induced acute hepatitis in a patient with scleroderma. BMJ Case Rep 2012;2012. PubMed
  35. Lee J, Lee MS, Nam KW. Acute toxic hepatitis caused by an aloe vera preparation in a young patient: a case report with a literature review. Korean J Gastroenterol 2014;64(1):54-8. PubMed
  36. Guo X, Mei N. Aloe Vera - A Review of Toxicity and Adverse Clinical Effects. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev 2016;34(2):77-96.
  37. Hoogenboom TCH, Patel N, Cook NA, Williams R, Taylor-Robinson SD, Lim AKP. The effect of Aloe vera juice on liver enzymes and hepatic structure in a healthy population. Integr Med (Encinitas) 2020;19(3):30-4.
  38. Mushtaq S, Mushtaq Z, Sarfraz J, et al. Comparison of effect of aloe vera gel with aspirin and celecoxib on platelet aggregation. Professional Med J. 2020; 27(5):973-978. DOI
  39. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  40. Sabbaghzadegan S, Soltani MH, Kamalinejad M, Bahrami M, Kabir A, Dadmehr M. The effect of a standardized capsule of Aloe vera gel on the quality of life in patients with systolic heart failure: A randomized double-blind placebo-controlled clinical trial.
  41. Lewis ED, Crowley DC, Guthrie N, Evans M. Healthy adults supplemented with a nutraceutical formulation containing Aloe vera gel, rosemary and Poria cocos enhances the effect of influenza vaccination in a randomized, triple-blind, placebo-controlled trial. PubMed

See these in context on the Aloe monograph →

Oats 13 references
  1. Cooper SG, Tracey EJ. Small-bowel obstruction caused by oat-bran bezoar. N Engl J Med 1989;320:1148-9. DOI
  2. Pick ME, Hawrysh ZJ, Gee MI, et al. Oat bran concentrate bread products improve long-term control of diabetes: a pilot study. J Am Diet Assoc 1996;96:1254-61. PubMed
  3. Braaten JT, Scott FW, Wood PJ, et al. High beta-glucan oat bran and oat gum reduce postprandial blood glucose and insulin in subjects with and without type 2 diabetes. Diabet Med 1994;11:312-8.
  4. Rosario PG, Gerst PH, Prakash K, Albu E. Dentureless distention: oat bran bezoars cause obstruction. J Am Geriatr Soc 1990;38:608. PubMed
  5. Food and Drug Administration. Food labeling: health claims: oats and coronary heart disease. Fed Regist 1996;61:296-313.
  6. Foulke J. FDA Allows Whole Oat Foods To Make Health Claim on Reducing the Risk of Heart Disease. FDA Talk Paper. 1997. Available at: http://www.fda.gov/bbs/topics/ANSWERS/ANS00782.html.
  7. Chandalia M, Garg A, Lutjohann D, et al. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med 2000;342:1392-8. PubMed
  8. Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003;349:1360-8. . PubMed
  9. De Paz Arranz S, Perez Montero A, Remon LZ, Molero MI. Allergic contact urticaria to oatmeal. Allergy 2002;57:1215. . PubMed
  10. Delgado G, Kleber ME, Krämer BK, et al. Dietary intervention with oatmeal in patients with uncontrolled type 2 diabetes mellitus - A crossover study. Exp Clin Endocrinol Diabetes. 2019;127(9):623-629. PubMed
  11. Sobhan M, Hojati M, Vafaie SY, Ahmadimoghaddam D, Mohammadi Y, Mehrpooya M. The efficacy of colloidal oatmeal cream 1% as add-on therapy in the management of chronic irritant hand eczema: A double-blind study. Clin Cosmet Investig Dermatol. 2020;13:241-25
  12. Hou Q, Li Y, Li L, Cheng G, Sun X, Li S, Tian H. The metabolic effects of oats intake in patients with type 2 diabetes: A systematic review and meta-analysis. Nutrients. 2015;7(12):10369-87. PubMed
  13. González-Afonso M, Cañas JA, Sastre B, et al. A Case of Anaphylaxis After Ingestion of Oats: Research Into New Allergens. J Investig Allergol Clin Immunol 2022;32(6):506-508. PubMed

See these in context on the Oats monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team