Pregnant and breast-feeding patients

Linseed oil, derived from the flaxseed, has been used as a topical demulcent and emollient and as cable connector boxes a laxative, particularly for animals. Flax contains mucilages, cyanogenic glycosides, 10% to 25% linoleic acid, oleic acid proteins (albumin), xylose, galactose, rhamnose, and galacturonic acid. Cyanogenic acids, with the activity of a certain enzyme, have the potential to release cyanide. Linolenic, linoleic, and oleic acids are classified as omega fatty acids.The mucilaginous fiber absorbs and expands. The omega fatty acid component may decrease serum total cholesterol and low-density lipoprotein levels and may decrease platelet aggregation.Flax is available as capsules, flour, fresh flowering plant, oil, and whole seeds, in products such as Dakota Flax Gold, Flax Seed Oil, and Flax Seed Whole. Many cereals and pancake and muffin mixes contain flax.Reported usesFlax is used internally to treat diarrhea, constipation, diverticulitis, irritable bowel syndrome, gastritis, enteritis, bladder inflammation, and colons damaged by laxative abuse.

In traditional medicine flax is used for removal of foreign bodies in eyes, and in the treatment of coughs and colds, constipation, and urinary tract infections. It's also used as a poultice for skin inflammation.AdministrationGastritis, enteritis: Dosage is 1 tablespoon of the whole or bruised seed, not ground, mixed with 5 oz of liquid and taken two or three times a day. An alternative method involves soaking 5 to 10 g of whole seed in cold water for 30 minutes; the liquid is discarded, the seeds are ground, and 2 to 4 tablespoons are used as linseed gruelOphthalmic: A single moistened flaxseed is placed under the eyelid until the foreign object sticks to the mucous secretion from the seedTopical: A hot poultice or compress is made from 30 to 50 g of the flour and applied as needed.HazardsUse of flax may result in intestinal block-age. Because of its fibrous content and binding potential, drug absorption may be altered or prevented. Advise patient to avoid using flax within 2 hours of a drug.Those with an ileus, those with esophageal strictures, and those experiencing an acute inflammatory illness of the GI tract should avoid use.

Pregnant and breast-feeding patients and those planning to become pregnant should also avoid use.Clinical considerationsWhen flax is used internally, it should be taken with more than 5 oz of liquid per tablespoon of flaxseed.Instruct patient to drink plenty of water when taking flaxseed.Cyanogenic glycosides may release cyanide; however, the body only metabolizes these to a certain extent. At therapeutic doses, flax doesn't elevate cyanide ion level.Even though flax may decrease a patient's cholesterol level or increase bleeding time, it's not necessary to monitor cholesterol level or platelet aggregation.

Warn patient not to treat chronic constipation, other GI disturbances, or ophthalmic injury with flax before seeking appropriate medical evaluation because doing so may delay diagnosis of a potentially serious medical condition.If patient is pregnant, plans to become pregnant, or is breast-feeding, advise her not to use flax.Instruct patient not to take any drug for at least 2 hours after taking flax.Tell patient to remind pharmacist of any herbal or dietary supplement that he's taking when obtaining a new prescription.Advise patient to consult his health care provider before using an herbal preparation because a conventional treatment with proven efficacy may be available.Research summaryPreliminary evidence suggests that diets supplemented with ground flaxseed can improve the lipid profile of hypercholesterolemic patients, reducing certain atherogenic risk factors.

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