Tribulus terrestris

Known Contraindications

• • Kidney Yin deficiency without damp-heat (formula is strongly draining)
• • Pregnancy (Da Huang and diuretics)
• • Qi deficiency with profuse clear urination (wrong pattern)
• • Monitor renal function in patients with pre-existing kidney disease
• • Mu Tong species caution: use Akebia trifoliata, NOT Aristolochia manshuriensis (nephrotoxic aristolochic acid)
• • Severe renal impairment (GFR < 30)
• • Obstructive uropathy requiring surgical intervention
• • Pregnancy
• • Concurrent lithium therapy (diuretic effect alters lithium levels)
• • Vata-predominant Mutra Krichra without Pitta/Kapha involvement
• • During active renal colic (provide pain management first)
• • Severe renal obstruction requiring surgical intervention
• • Hot, dry constitutions (choleric temperament)
• • Sue Mizaj Haar of kidneys in acute phase (extremely hot kidney temperament)
• • Active urinary hemorrhage
• • Severe renal impairment
• • Urinary obstruction requiring surgical intervention
• • Ispaghula: intestinal obstruction
• • Concurrent hormone therapy
• • Prostate cancer or hormone-dependent cancers
• • Concurrent antihypertensives (additive effect)
• • Liver disease
• • Active pregnancy (used to promote conception, not during pregnancy)
• • Hormone-sensitive conditions
• • Concurrent lithium therapy (diuretic effect alters levels)
• • mKhris-pa kidney conditions with heat signs (warming nature may aggravate)
• • Active urinary tract infection with fever
• • Dehydration
• • Concurrent diuretic medications
• • Weakness or dehydration (excessive diuresis)
• • Pregnancy (traditional contraindication — uterine stimulant)
• • Yin deficiency with heat (may further dry fluids)
• • Concurrent diuretic medications (additive effect)
• • Hormone-sensitive conditions (weak phytoestrogenic activity reported)