Lack of energy is a constant theme in the lives of countless Americans. For many, tiredness is so routine that they accept it as a natural state. Family and work by themselves are exhausting; unexpected demands or a restless night can deplete the remaining energy reserves. What is to be done? The American answer is caffeine. Pick your flavor: coffee (then more coffee), energy drinks (which flavor and how tall?), sodas (nothing beats caffeine plus sugar!) and the list goes on. The idea is that, if the metabolism is flagging whip it harder or, better yet, throw in a quick burst of energy from a simple carbohydrate. Caffeinate, crash, repeat (perhaps several times throughout the day), then start over the next morning.

And start over we do. Ninety percent of all American adults ingest caffeine daily. It is the go-to stimulant of choice, so much so that for a while Wrigley was producing eight stick chewing gum packs each stick of which contained as much caffeine as half a cup of coffee. To be sure, it is not as if caffeine has no benefits. After all, people consume caffeine mostly to improve productivity and related outcomes, not for pleasure. But what if the lack of energy is really just the body's response to a lack of rest (sound sleep usually is an early casualty of too much caffeine) and to a failure to recover from demands placed on it day in and day out? Under such circumstances, the daily caffeine fix is always needed and creates the conditions of its own demand along with downsides. Fortunately, it is possible to get off this merry-go-round.

Controlling Caffeine
Researchers have often wondered why it is that tea, despite its caffeine content, tends to relax individuals without making them drowsy. Similarly, those engaging in meditation practices may drink tea to dispel mental sluggishness and yet not become mentally agitated, as is typical with the consumption of too much coffee. Black and green teas give somewhat different answers. Black tea, for instance, contains one or more compounds that open up the peripheral circulation and also reduce blood levels of cortisol, the stress hormone. Likewise, blood platelet activation, which is linked to blood clotting and to the risk of heart attack, was lower in the tea drinkers in a clinical trial and this group reported a greater degree of relaxation in the recovery period after a stressful task.1 This is good news for the 65 percent of adult Americans who suffer from daily stress. L-Theanine, found in green and oolong teas, is more complicated. In one trial in which caffeine (250 milligrams) increased self-rated alertness along with jitteriness and blood pressure, theanine (200 milligrams) antagonized the effect of caffeine on blood pressure, but did not significantly affect jitteriness, alertness or other aspects of mood.2 At a lower level of caffeine consumption (150 milligram), theanine (250 milligrams) actually further improved the normal cognitive benefits of caffeine.3 Affects on stress per se also are found with theanine, with the degree of benefit depending on conditions and individuals.

Various tests have demonstrated the anti-stress effects of L-theanine. One of the more revealing of these experiments examined brain wave patterns after the ingestion of theanine. This research built on the knowledge that humans produce specific patterns of electrical pulses on the surface of the brain that mirror brain states. The four primary wave patterns are known as the alpha, beta, delta and theta (a, b, d and q) brain waves, representing, respectively, 1) relaxed wakefulness, 2) excitation, 3) sound sleep, and dozing sleep.4

In one experiment, 50 women volunteers (aged 18–22 years old) were divided into high-anxiety and low-anxiety groups. Each group was given either 50 or 200 mg theanine in water once a week. Their brain waves were measured during the 60 minutes after ingestion. The measurements were repeated twice during a two-month test period. The results were a marked increase in a-waves starting roughly 40 minutes after ingestion. Researchers concluded that theanine rapidly enters the system when ingested and that it heightens the index of the brain wave that is known to be linked to a state of relaxed wakefulness. Researchers also have explored whether the response to theanine might be influenced by the level of anxiety found in test subjects. As might be expected, the greater degree of change is found in those manifesting high anxiety.

Theanine appears to protect against certain so-called "excitotoxins." It modulates the motor-stimulation associated with caffeine and it inhibits some of the actions of norepinephrine in the central nervous system, for instance. In tests with gerbils, theanine protected against the destruction of neurons induced ischemia, a condition that can lead to a rapid increase in glutamate in neurons and result in the death of these cells. Theanine taken in the evening may support improved sleep quality not by sedation, but through anxiolysis.5 The other herbs mentioned below also tend to improve sleep quality at least in part through the same mechanism.

Saffron for Replacing Jitters with Emotional Balance
Although small amounts of caffeine, meaning usually less than 400 milligrams per day, for the vast preponderance of individuals provides mostly an upside with little downside, excessive caffeine can lead to anxiety, physical and emotional "jitters," as well as insomnia. For many, black, oolong and green teas are more gentle alternatives to the concentrated caffeine of coffee, yet coffee is a preferred beverage for many. Moreover, caffeine is added to so many other pick-me-ups that individuals often are unaware of how much they are consuming throughout the day. Several herbs and spices are useful remedies to this excess. Saffron is one of these.

Saffron is far more than merely a spice that gives color to rice and paella along with a distinctive aromatic signature. Crocins are the source of saffron's coloring properties, whereas its aromatic aspects come from picrocrocins and safranal. Medical texts from ancient Egypt, Persia and the Roman Empire attest to healing properties, including pain relief and calming effects. Similarly, Chinese and Indian healing systems ascribe these and more benefits to saffron. Other healing aspects include the treatment of coughs, better movement of nutrients into tissues and aphrodisiac qualities.

At least eleven clinical studies have evaluated saffron for its impact on aspects of emotional balance, such as anxiety and depression. In comparative clinical trials, saffron intake after one or two weeks has proven to be comparable in efficacy to the drugs fluoxetine and imipramine. The mechanism of action seems to be the regulation of neurotransmitters.6 Other conditions that have been explored clinically with saffron include erectile dysfunction, vision, Alzheimer's disease and cosmetic benefits. In general, it is thought that there is a complementary action from more than twenty-five active compounds in saffron to yield the demonstrated clinical effects. One special extract that has been extensively clinically tested gives benefits when ingested at the level of 30 milligrams per day.

Lemon Balm's Calming Effects, Sleep Benefits
Another useful traditional herb is lemon balm (Melissa officinalis L.). Since the 19th Century, it has been recognized as being soothing during stress and anxiety. Lemon balm contains hydroxycinnamic and rosmarinic acids. Studies have shown that lemon balm consumption increases sleep quality, reduces stress and improves mood.7 Clinical trials have demonstrated the effects of lemon balm extract on cognitive health. Lemon balm improves cognitive performance by enhancing memory and accelerating the visual information processing.8,9 One high quality and tested extract is recommended at an intake level of 600 milligrams per day.

Blue Dogbane Is a Bane for Stress
Apocynum venetum L., commonly known as Luobuma in China, is a traditional and popular Chinese herb with a long history of use as a medicine and tea, both in Chinese and Uygur medicine. In fact, Apocynum venetum L. is mentioned in the ancient Dun Huang Manuscripts (written in the 5th to early 11th centuries A.D.) as a powerful longevity tonic. It especially is useful in cases of hypertension and anxiety.10 Among its other notable benefits is support for sleep. According to the official Chinese Pharmacopoeia, the herb calms the liver, soothes the nerves, treats palpitations and improves insomnia. As a tea in China, it is used especially for the elderly as a sleep aid and to reduce high blood pressure. Indeed, a commercial Luoboma "antihypertensive tea" is available commercially in the western province of China. Care should be taken to not confuse it with Indian Hemp (I), Apocynum androsaemifolium, poacynum pictum, I, or the blue dogbane native to Texas. Chinese White and Pink Dogbanes are inferior substitutes often presented as the same plant.

Anxiety afflicts more than forty million Americans, hence is hardly a minor issue. As already explored above, caffeine and "energy" drinks aggravate anxiety, jitteriness and blood pressure. The exact mechanisms of blue dogbane's action, which likely are multiple, only partially have been elucidated. For instance, the herb inhibits superoxide generated from both the NADPH oxidase and the xanthine/xanthine oxidase systems in the arteries. The upshot of these actions is that there is more nitric oxide (NO) available locally to relax the vessels.11 Rather than taking multiple grams of L-arginine to provide a building block precursor for the production NO, just a little bit of this herb prevents the excessive destruction of NO and achieves the same benefit. The vasculature dilation effects of the blue dogbane extract, including in the brain, can be considerable. The benefits for relaxation, cortisol and stress reduction are significant. Clinical work indicates that the extract induces deeper sleep, meaning that it makes sleep more restful.12

An interesting finding is that Apocynum venetum L. is a particularly rich source of isoquercitrin, the more active and much better absorbed form of the antioxidant quercetin. Some research suggests that Apocynum venetum L. is a safe alternative to St. John's Wort. Suggested consumption of the extract depends on its quality and the condition in mind; 50–150 milligrams represents typically suggested dosages.12

Southern Ginseng
Most Westerners have heard of ginseng and think that the Chinese name applies to only one species. However, in fact there are various "ginsengs" in Chinese medicine, each displaying particular benefits. Gynostemma pentaphyllum is "southern ginseng"; it also is called jiaogulan. It is considered to have powerful antioxidant and adaptogenic effects purported to increase longevity.13 The plant belongs to a family that includes cucumbers, gourds, and melons—its fruit is a small purple inedible gourd. It is little known in traditional Chinese medicine (TCM) because TCM is largely based on the dried materials that could be transported to the Imperial Court of the Chinese Emperors in Beijing. Research indicates significant effects of southern ginseng in the areas of blood glucose, improved insulin sensitivity, improved HbA1c (indicating improved glucose control in diabetics and reduced glycation) as well as other benefits.14

Although local Chinese traditions long have reported adaptogenic effects, the impact of jiaogulan on stress and related conditions only recently has been explored by Western allopathic research. Nevertheless, a body of animal trials currently backs traditional uses to support human resilience to physical and mental challenges. For instance, a 2012 paper reports that oral administration of the ethanol extract of Gynostemma pentaphyllum can increase host defense in immunocompromised situations such as stress-induced immunosuppression.15,16 A report from the next year indicates that there are anxiolytic effects of an herbal ethanol extract from Gynostemma pentaphyllum in mice after exposure to chronic stress.17 In yet another model of chronic stress and related anxiety disorders in mice, gypenosides, proposed active ingredients in the herb, improved stress-induced anxiety disorders by modulating brain dopamine and serotonin activities and corticosterone levels.18 (Corticosterone in mice plays the same role as cortisol in humans.) Finally, a recent randomized, double-blind, placebo-controlled clinical trial lasting 12 weeks demonstrated that an extract of Gynostemma pentaphyllum led to significant decreases in total abdominal fat area, body weight, body fat mass, percent body fat, and body mass index. (BMI).19 It is likely that more than one mechanism of action was important in bringing about these clinical results.

Magnesium
Do not forget magnesium! An estimated 68 percent of Americans do not consume the recommended daily allowance for magnesium. Some attribute this to modern dietary patterns, such as a failure to consume green vegetables and less refined grains. Others have observed that reduced magnesium levels can be attributed to food refining, processing and the use of industrial fertilizers, which typically lack magnesium. Magnesium deficiency has been associated with poor sleep quality, muscle tension and anxiety. Raising tissue levels with oral supplementation of magnesium may promote more restful sleep and relaxation. Preferred forms include magnesium glycerophosphate, magnesium malate and magnesium threonate. Each of these forms exhibits special characteristics based on its ligand. Better results with magnesium supplementation are realized with chronic usage to build up tissue stores.

Conclusion
Too often, the demand for more energy really is just a symptom of inadequate rest and poor quality sleep. The majority of adults is chronically stressed and sleep deprived. Good sleep affects alertness, energy, creativity, indeed, mental and physical performance and productivity in general. The common solution to being tired and under-performing is to consume caffeine in the form of coffee and energy drinks. There are alternatives, however, to the "caffeinate, crash, repeat" model of daily existence. Some of these alternatives support the positive effects of caffeine while mitigating the side effects. Others moderate jitteriness and "wired" effects of stimulants by reducing the stress hormone release found with too much stimulation. A common benefit of this approach is to improve the ability to sleep without forcing slumber and to make the time spent sleeping more restful.

References:

  1. Steptoe A, Gibson EL, Vuononvirta R, Williams ED, Hamer M, Rycroft JA, Erusalimsky JD, Wardle J. The effects of tea on psychophysiological stress responsivity and post-stress recovery: a randomised double-blind trial. Psychopharmacology (Berl). 2007 Jan;190(1):81-9. Epub 2006 Sep 30. Erratum in: Psychopharmacology (Berl). 2007 Jan;190(1):91.
  2. Rogers PJ, Smith JE, Heatherley SV, Pleydell-Pearce CW. Time for tea: mood, blood pressure and cognitive performance effects of caffeine and theanine administered alone and together. Psychopharmacology (Berl). 2008 Jan;195(4):569-77.
  3. Haskell CF, Kennedy DO, Milne AL, Wesnes KA, Scholey AB. The effects of L-theanine, caffeine and their combination on cognition and mood. Biol Psychol. 2008 Feb;77(2):113-22.
  4. Juneja LR, Chu D-C, Okubo T, Nagato Y, Yokogoshi H. L-Theanine––a unique amino acid of green tea and its relaxation effect in humans. Trends in Food Science & Technology 1999;10:199-204.
  5. Rao TP, Ozeki M, Juneja LR. In Search of a Safe Natural Sleep Aid. J Am Coll Nutr. 2015;34(5):436-47.
  6. https://www.naturalproductsinsider.com/whitepapers/2016/09/safrinside.aspx
  7. Cases J, Ibarra A, Feuillere N, Roller M, Sukkar S. Pilot trial of Melissa officinalis L. leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances. Mediterranean journal of nutrition and metabolism. 2011; 4(3): 211-8.1.
  8. Scholey A, Gibbs A, Neale C, et al. Investigation of a Melissa officinalis special extract on Cognition II: Human study - Lemon balm extract administered in confectionary bars. Agro FOOD Industry Hi Tech 2015; 26(2): 12-4.
  9. Kennedy D, Wake G, Savelev S, et al. Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (Lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties. Neuropsychopharmacology 2003; 28(10): 1871-81.
  10. Xie W, Zhang X, Wang T, Hu J. Botany, traditional uses, phytochemistry and pharmacology of Apocynum venetum L. (Luobuma): A review. J Ethnopharmacol. 2012 May 7;141(1):1-8.
  11. Lau YS, Ling WC, Murugan D, Kwan CY, Mustafa MR. Endothelium-Dependent Relaxation Effect of Apocynum venetum Leaf Extract via Src/PI3K/Akt Signalling Pathway. Nutrients. 2015 Jun 30;7(7):5239-53.
  12. Yamatsu A, Yamashita Y, Maru I, Yang J, Tatsuzaki J, Kim M. The Improvement of Sleep by Oral Intake of GABA and Apocynum venetum Leaf Extract. J Nutr Sci Vitaminol (Tokyo). 2015;61(2):182-7.
  13. Blumert, Michael; Jialiu Liu. Jiaogulan: China's "Immortality" Herb. (2003: Badger, CA: Torchlight Publishing.)
  14. https://examine.com/supplements/gynostemma-pentaphyllum/
  15. Im SA, Choi HS, Choi SO, Kim KH, Lee S, Hwang BY, Lee MK, Lee CK. Restoration of electric footshock-induced immunosuppression in mice by Gynostemma pentaphyllum components. Molecules. 2012 Jun 25;17(7):7695-708.
  16. Shang X, Chao Y, Zhang Y, Lu C, Xu C, Niu W. Immunomodulatory and Antioxidant Effects of Polysaccharides from Gynostemma pentaphyllum Makino in Immunosuppressed Mice. Molecules. 2016 Aug 19;21(8).
  17. Choi HS, Zhao TT, Shin KS, Kim SH, Hwang BY, Lee CK, Lee MK. Anxiolytic effects of herbal ethanol extract from Gynostemma pentaphyllum in mice after exposure to chronic stress. Molecules. 2013 Apr 12;18(4):4342-56.
  18. Zhao TT, Shin KS, Choi HS, Lee MK. Ameliorating effects of gypenosides on chronic stress-induced anxiety disorders in mice. BMC Complement Altern Med. 2015 Sep 14;15:323.
  19. Park SH, Huh TL, Kim SY, Oh MR, Tirupathi Pichiah PB, Chae SW, Cha YS. Antiobesity effect of Gynostemma pentaphyllum extract (actiponin):
  20. a randomized, double-blind, placebo-controlled trial. Obesity (Silver Spring). 2014 Jan;22(1):63-71.

Over the last decade, few dietary supplements have been in the news as much as curcumin and turmeric, the item from which curcumin and related compounds are extracted. The background for modern western interest is much older. Turmeric (Curcuma longa) is a yellow spice and a traditional remedy that has been used as a medicine, condiment and flavoring since 600 BC. The rhizome (underground stem) is the part of the plant that is harvested and ground to make the spice. In the Indian Ayurvedic tradition of healing and cooking, the yellow spice turmeric warms and activates the digestion and is useful in many aspects of healing. Both Ayurveda and Traditional Chinese Medicine (TCM) associate turmeric with the health of the liver, skin, digestive, lung, joint and muscle tissues.

Some of the key bioactive constituents found in turmeric are three kinds of curcuminoids, curcumin, demethoxylcurcumin, and bisdemethoxylcurcumin. All three components are structurally similar, although curcumin seems to be the most effective of these three. Curcumin and the related curcuminoids (the mention of curcumin often being shorthand for all three) appear to affect human health through antioxidant activity and possible modulation of 5-lipo-oxygenase (LOX) and cyclo-oxygenase (COX) enzymes. The true health potential of curcuminoids has always been hindered by notoriously poor oral bioavailability. This has become generally accepted in recent years with numerous studies in humans demonstrating severe absorption shortcomings even when curcumin is consumed in large quantities. As a result, researchers have sought ways to overcome this limitation in bioavailability.

Too often overlooked with the focus on turmeric's curcuminoids is the presence of a number of other bioactives in the rhizome. These include immune-stimulating polysaccharides, volatile oils and yet other constituents. Beyond conventional turmeric lie one or more related species, such as Indonesia's Java turmeric, which exhibit special benefits not associated with Indian turmeric.

Curcumin and the Curcuminoids

Curcuminoid bioavailability is low for a variety of reasons. First, solubility in water is quite poor, especially so at the low pH (acid conditions) found in the stomach. Once food leaves the stomach, the pH rises in the upper small intestine and this presents other challenges inasmuch as curcuminoids are subject to damage by digestive fluids under these more neutral conditions. To make matters worse, poor absorption is compounded by their quick excretion from the system. The preponderance of the curcuminoids that are consumed is eliminated intact from the gut. Some curcuminoids are absorbed into the circulation, but almost none can be found in the blood in their free forms. Instead, they are almost entirely converted into water-soluble metabolites in the intestine and liver and appear in the blood as glucuronide forms.

Curcuminoids exhibit strong antioxidant activity, enhance cellular resistance to oxidative damage, and provide antioxidant protection against DNA damage. They also enhance the body's natural antioxidant glutathione levels, which in turn aids the liver in detoxification. Joint health is one area of significant benefit. In research on people with suboptimal joint function, curcuminoids have been found to support a healthy inflammatory response while promoting comfort and flexibility. There are many other areas of benefits. Curcuminoids exert several protective effects on the gastrointestinal tract, most likely via antioxidant activity. A double-blind trial found turmeric helpful for people with indigestion and effective in animal research in promoting healthy digestive function. Via antioxidant activity, curcuminoids may help promote cardiovascular health, especially by decreasing the propensity of low density lipoprotein (LDL) to oxidize. Research continues to suggest that oxidized LDL is one of the more pernicious forms of cholesterol in relation to cardiovascular health. The benefits of most interest, albeit ones that cannot be mentioned directly for any dietary supplement due to FDA regulations, are in the area of cancer.

Success in translating these potentials into tangible results has been limited by inherently poor intestinal absorption, rapid metabolism, and limited systemic bioavailability. These factors help to account for the somewhat spotty record of curcumin in clinical trials. Seeking to overcome these limitations, food ingredient formulators have begun to employ a variety of approaches for enhancing absorption and bioactivity. Many of these strategies are attempts to improve upon the age-old practice of consuming turmeric in fat-based sauces, such as in fat-rich curries. However, there exists uncertainty as to how the various commercially available offerings compare to each other in terms of either uptake or efficacy and this uncertainty leaves lay individuals, physicians and nutritionists with a dearth of data for evaluating products. A typical conundrum: is bioavailability calculated based on the active ingredient(s) only or on the total volume of a formula? Five times the bioavailability may not be an advance if it requires a formula with five times the weight for delivery, e.g., taking one capsule of curcuminoids versus taking five capsules to deliver the same amount of curcuminoids in four capsules worth of excipients.

Controversies

Readers need to be extremely cautious regarding marketing claims as to the efficacy and bioavailability of curcumin products. For instance, one manufacturer of a curcumin product claims to offer a delivery format that upon ingestion leads to relatively large amounts of free curcumin in the blood, yet almost all other research indicates that the three curcuminoids are subject to rapid metabolism, both intestinal and hepatic. This means that almost no free curcumin can be found in the blood, only various metabolites and conjugates of these curcuminoids.1,2 Are these metabolites active? Curcumin metabolites retain at least some biological activity, but whether curcumin metabolites are as active as curcumin itself is not yet clear.3,4,5,6,7,8,9 In fact, the phenomenon in which turmeric extracts produce undetectable levels of free curcumin in plasma and nevertheless exhibit clinically significant effects speaks in favor of the biological relevance of curcuminoid metabolites.10,11,12 Still, it is doubtful that the conjugates of curcuminoids are able to pass the blood-brain barrier.13 This latter factor suggests that at least some of the benefits attributed to regular turmeric consumption via the diet are not derived from the curcuminoids.

More traps for the unwary abound. For example, rodentbased studies of bioavailability can be misleading due to the fact that rodents exhibit different curcumin pharmacokinetics compared to humans.14 Sometimes even claims regarding increased bioavailability in humans have failed spectacularly when revisited. One such claim is that inclusion of black pepper or one of its constituents, i.e., piperine (Bioperine), improves curcumin uptake. An early research study reported that a small quantity of piperine can enhance curcumin bioavailability "20-fold" in humans.15 In opposition to this conclusion, a recent independent analysis reported finding little increase in plasma free curcuminoid levels when using the commercially available C 3 Complex plus piperine systems.16 As another example of the issues that can arise is an ambiguous representation of the dosage tested in clinical trials. On this point, see the letters in a recent controversy over claims for a particular curcumin for exercise-induced muscle damage based on published research in which the dosages administered were, at the very least, unclear.17

Dietary Supplement Options
Various supplement options are examined in detail in "Beyond Yellow Curry: Assessing Commercial Curcumin Absorption Technologies," which can be freely downloaded from PubMed.18 This article and related background research suggest that particularly noteworthy commercial products based on concentrated curcuminoids include CurcuWIN™ (OmniActive Health Technology),19 Meriva® (Indena) and Theracurmin™ (Theravalues/P.L. Thomas).

What About Whole Turmeric?
Great emphasis has been placed on the curcuminoids found in turmeric, so much so that the average person might well believe that there is little else of worth in this spice. Nothing could be further from the truth! There are at least 200 known compounds in turmeric root, dozens of which appear to be active. Aside from the three major curcuminoids, known active compounds and families of compounds in turmeric include â-elemene, bisacurone, calebin A, curcumene, curdione, cyclocurcumin, volatile/fixed oils (turmerones and related compounds), bisabocurcumin, various proteins (biologically active molecular carriers, etc.), special dietary fibers (enhancers of the bioavailability of biologically active molecules), and acidic polysaccharides (immunomodulators).20

According to one company involved in advanced product development in conjunction with the famous curcumin researcher, Bharat B. Aggarwal, "the challenge is to recreate the curcumin inside the turmeric matrix effectively." It claims to have developed a novel way to recreate the turmeric matrix with active curcuminoids by a method known as Polar- Nonpolar Sandwich (PNS) technology. Potential benefits of this product, known by two different names, Cureit and Acumin (the latter in the American market via Novel Ingredients), are likely to be much broader than those that can be traced to curcuminoids alone. This approach has been discussed in these pages before—see "Beyond Synergy–the Entourage Effect in Nutrition and Herbalism" (TotalHealth Sep 2015). This new item, which consists of nothing other than specially treated turmeric without the addition of piperine, nanoparticles, liposomes, micelles, phospholipid complexes or their analogs, is being presented as supporting bone and joint health, cognitive function and general anti-aging benefits.21

Several clinical studies have been completed, although not yet published. A study conducted in rheumatoid arthritis patients showed that Acumin was beneficial. Active rheumatoid arthritis patients who received Acumin (either 250 or 500 mg twice per day) for a period of 90 days reported a statistically significant decrease in their clinical symptoms towards the end of the study.22 This result is similar to that reported with the use of 1,000 mg of a special delivery curcumin preparations, such as Meriva, over the same time range.23 Another Acumin clinical study examined comparative bioavailability issues, although these may not be particularly relevant given that Acumin is not a pure curcuminoid product. Both of these studies currently are under review for publication.

Because the Western pharmaceutical approach focuses on purified components rather than on matrixes of components, at the moment there is much more available research on curcuminoids than on turmeric as such. However, there is a growing body of evidence indicating the benefits of active compounds other than curcuminoids found in turmeric. Those who want the "entourage effect" and would like to try the whole herb approach with an activated turmeric now have an alternative to the regular consumption of curries and golden milk.

Java Turmeric
Beyond Indian turmeric, there is a related item that in at least one traditional Asian medical system is considered to be superior for many health purposes. Known as Java turmeric or Javanese turmeric due to its origins in Indonesia, C. xanthorrhiza is a plant of the ginger family Zingiberaceae, which grows widely in Southeast Asia. Java turmeric is related to the better known Indian turmeric and there is a large overlap in traditional and modern herbal uses, including anti-inflammatory, anticarcinogenic, wound healing and serum cholesterol-lowering.24 A number of constituents differ between Java and ordinary turmeric. Xanthorrhizol, in particular, is a sesquiterpenoid compound unique to Java turmeric. Among its known special benefits are hepatoprotective actions. An extract of the whole rhizome, likewise, has been shown to support liver health.25

An area that has been under-explored with Java turmeric, but in which this plant may exhibit special benefits, is immune function. For instance, in one animal experiment, chronic ingestion of an extract increased the proportion of splenic T cells.26 An in vitro trial examining mechanisms of action for immune response found that a polysaccharide in Java turmeric stimulates the immune functions of macrophages.27 Among the differences between Java turmeric and Indian turmeric are the following:

  • composition of the dried rhizome—curcuminoids (1.6–2.2 percent), xanthorrhizol (1.48–1.63 percent)
  • three nonphenolic diarylhepatanoids support normal inflammation response
  • acceleration of the metabolism of the lipids from extrahepatic tissues to the liver, thus increasing the excretion of cholesterol via the bile
  • secretion of bile acids (and bilirubin) and improvement in bile composition leading to the cholesterol found in bile being more likely to remain in solution (important for gallbladder function)
  • unlike bisdesmethoxycurcumin, does not inhibit bile flow

In powdered bulk form and other deliveries, Java turmeric has been available in the US via specialized Asian product sellers for decades and in Europe for centuries. (Indonesia was under Dutch rule from the mid-17th Century until 1949.) CUR-XZOL™ (Curcuma xanthorrhiza Roxb.) is a commercially available source of Java that is manufactured in a major Indonesian pharmaceutical facility. It is fully characterized and contains a specified amount of xanthorrhizol. On amazon.com it can be found in an American formula as "WILD JAVA TURMERIC."

References
  1. Ireson CR, Jones DJ, Orr S, et al. Metabolism of the cancer chemopreventive agent curcumin in human and rat intestine. Cancer Epidemiol Biomarkers Prev 2002;11(1):105–11.
  2. Pan MH, Huang TM, Lin JK. Biotransformation of curcumin through reduction and glucuronidation in mice. Drug Metab Dispos 1999;27(4):486–94.
  3. Ireson C, Orr S, Jones DJ, et al. Characterization of metabolites of the chemopreventive agent curcumin in human and rat hepatocytes and in the rat in vivo, and evaluation of their ability to inhibit phorbol ester-induced prostaglandin E2 production. Cancer Res 2001;61(3):1058–64.
  4. Sandur SK, Pandey MK, Sung B et al. Curcumin, Demethoxycurcumin, Bisdemothoxycurcumin, Tetrahydrocurcumin, and Turmerones Differentially Regulate Anti-inflammatory and Antiproliferative Responses Through a ROS-Independent Mechanism. Carcinogenesis 2007 Aug;28(8):1765–73.
  5. Sugiyama Y, Kawakishi S, Osawa T. Involvement of the beta-diketone moiety in the antioxidative mechanism of tetrahydrocurcumin. Biochem Pharmacol. 1996 Aug 23;52(4):519–25.
  6. Pfeiffer E, Hoehle SI, Walch SG, Riess A, Sólyom AM, Metzler M. Curcuminoids form reactive glucuronides in vitro. J Agric Food Chem. 2007 Jan 24;55(2):538–44.
  7. Kim JM, Araki S, Kim DJ, Park CB, Takasuka N, Baba-Toriyama H, Ota T, Nir Z, Khachik F, Shimidzu N, Tanaka Y, Osawa T, Uraji T, Murakoshi M, Nishino H, Tsuda H. Chemopreventive effects of carotenoids and curcumins on mouse colon carcinogenesis after 1,2-dimethylhydrazine initiation. Carcinogenesis. 1998 Jan;19(1):81–5.
  8. Pari L, Amali DR. Protective role of tetrahydrocurcumin (THC) an active principle of turmeric on chloroquine induced hepatotoxicity in rats. J Pharm Pharm Sci. 2005 Apr 30;8(1):115–23.
  9. Murugan P, Pari L. Effect of tetrahydrocurcumin on plasma antioxidants in streptozotocin-nicotinamide experimental diabetes. J Basic Clin Physiol Pharmacol. 2006;17(4):231–44.
  10. Sharma RA, McLelland HR, Hill KA, Ireson CR, Euden SA, Manson MM, Pirmohamed M, Marnett LJ, Gescher AJ, Steward WP. Pharmacodynamic and pharmacokinetic study of oral Curcuma extract in patients with colorectal cancer. Clin Cancer Res. 2001 Jul;7(7):1894–900.
  11. Mohammadi A, Sahebkar A, Iranshahi M, et al. Effects of Supplementation with Curcuminoids on Dyslipidemia in Obese Patients: A Randomized Crossover Trial. Phytother Res. 2013 Mar;27(3):374–9.
  12. Sharma RA, Euden SA, Platton SL, et al. Phase I clinical trial of oral curcumin: biomarkers of systemic activity and compliance. Clin Cancer Res 2004;10:6847–54.
  13. Pan MH, Huang TM, Lin JK. Biotransformation of curcumin through reduction and glucuronidation in mice. Drug Metab Dispos. 1999 Apr;27(4):486–94.
  14. Ireson CR, Jones DJ, Orr S, et al. Metabolism of the cancer chemopreventive agent curcumin in human and rat intestine. Cancer Epidemiol Biomarkers Prev 2002;11(1):105–11.
  15. Shoba G, Joy D, Joseph T, et al. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med 1998;64:353–6.
  16. Volak LP, Hanley MJ, Masse G, Hazarika S, Harmatz JS, Badmaev V, Majeed M, Greenblatt DJ, Court MH. Effect of a herbal extract containing curcumin and piperine on midazolam, flurbiprofen and paracetamol (acetaminophen) pharmacokinetics in healthy volunteers. Br J Clin Pharmacol. 2013 Feb;75(2):450–62.
  17. http://www.nutritionaloutlook.com/sports-energy/curcumin-reduces-symptoms-exercise-induced-muscle-damage-study-suggests.
  18. Douglass BJ, Clouatre DL. Beyond Yellow Curry: Assessing Commercial Curcumin Absorption Technologies. J Am Coll Nutr. 2015;34(4):347–58. Downloadable from https://www.ncbi.nlm.nih.gov/pubmed/25856323.
  19. Oliver JM, Stoner L, Rowlands DS, Caldwell AR, Sanders E, Kreutzer A, Mitchell JB, Purpura M, Jäger R. Novel Form of Curcumin Improves Endothelial Function in Young, Healthy Individuals: A Double-Blind Placebo Controlled Study. J Nutr Metab. 2016;2016:1089653.
  20. http://www.aureabiolabs.com/wp-content/uploads/2016/10/Aurea-Newsletter_August.pdf
  21. http://www.novelingredient.com/wp-content/uploads/2016/07/Acumin-Sell-Sheet.pdf
  22. http://www.aureabiolabs.com/wp-content/uploads/2016/10/Aurea-Newsletter_August.pdf and http://www.aureabiolabs.com/wpcontent/uploads/2016/08/Aurea-Newsletter_June.pdf
  23. Belcaro G, Cesarone MR, Dugall M, Pellegrini L, Ledda A, Grossi MG, Togni S, Appendino G. Product-evaluation registry of Meriva®, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis. Panminerva Med. 2010 Jun;52(2 Suppl 1):55–62.
  24. Oon SF, Nallappan M, Tee TT, Shohaimi S, Kassim NK, Sa'ariwijaya MS, Cheah YH. Xanthorrhizol: a review of its pharmacological activities and anticancer properties. Cancer Cell Int. 2015 Oct 21;15:100.
  25. Devaraj S, Ismail S, Ramanathan S, Marimuthu S, Fei YM. Evaluation of the hepatoprotective activity of standardized ethanolic extract of Curcuma xanthorrhiza Roxb. Journal of Medicinal Plants Research 2010 December;4(23):2512–7.
  26. Yasni S, Yoshiie K, Oda H, Sugano M, Imaizumi K. Dietary Curcuma xanthorrhiza Roxb. increases mitogenic responses of splenic lymphocytes in rats, and alters populations of the lymphocytes in mice. J Nutr Sci Vitaminol (Tokyo). 1993 Aug;39(4):345–54.
  27. Kim AJ, Kim YO, Shim JS, Hwang JK. Immunostimulating activity of crude polysaccharide extract isolated from Curcuma xanthorrhiza Roxb. Biosci Biotechnol Biochem. 2007 Jun;71(6):1428–38.

Garlic has been an important herbal remedy for centuries. Found in carvings and paintings on the walls of Egyptian tombs, dating from 3700 BC, garlic's uses as a remedy for cancer and other ailments are recorded in detail in Egyptian medical documents, dating from 1550 BC.

Modern studies and human observations have validated many medicinal effects of garlic and its potential to help lower the risk of various ailments, including colon cancer. The cancer preventive mechanisms of garlic, shown largely through research using KyolicTM Aged Garlic Extract® (AGE), an odorless supplement made from organic garlic by Wakunaga of America, are largely due to potent antioxidants, a high content of organosulfur compounds, an ability to stimulate immunological responsiveness, detoxify carcinogens, inhibit inflammation and prevent mutations that may lead to cancer.

Epidemiological Studies
Several population studies have found an association between a high intake of garlic and a reduced risk of certain cancers, including stomach and colon cancer. An analysis of the results of these studies, showed, that the higher the amount of garlic consumed, the lower the risk of stomach and colon cancer.

The "Iowa Women's Study"1 is a large prospective study investigating whether diet and other risk factors are related to cancer incidence in older women. Results of the study showed a strong association between garlic consumption and colon cancer risk. There was a 50 percent lower risk of colon cancer in women who consumed the highest amounts of garlic, compared to those consuming a low level.

Several population studies conducted in China and Italy also showed repeatedly that consumption of allium vegetables, onions and especially garlic was associated with a reduced risk of stomach and colon cancer, sometimes as low as 50 percent.

The Nature of Colon Cancer

Colon Cancer is the third leading cause of deaths in the United States. It is a multistage disease that is initiated by a series of mutations in DNA that give rise to adenomatous polyps, of a benign nature, that may progress to full blown cancer. Colon cancer can have hereditary components, and is found in families, but external factors including environmental factors, lifestyle and diet play important role in the development of the disease.

Colon cancer develops slowly, over a period of 10 to 15 years; though people over 50 are most prone to getting the disease, colon cancer can develop at any age. The disease usually begins as a non-cancerous polyp that can progress with time into cancer, screening by colonoscopy is effective in lowering the cancer risk and increasing the chance for cure, by detecting and removing emerging adenomatous polyps. Cancer screening by colonoscopy is recommended starting at the age of 50, though people with a family history of the disease may begin at an earlier age and be tested more often.

Diet and Lifestyle in Prevention
While screening is important in reducing risk, diet and lifestyle are critical in supporting the body's natural defenses, helping prevent the onset and growth of polyps and blocking their subsequent development into colon cancer.

Leading a physically active life, maintaining a healthy weight, not smoking and reduced levels of alcohol are important aspects of prevention; as diet goes, a diet rich in plant food, low levels of red meat and intake of milk products that contain calcium and vitamin D are some of the recommendations by the American Cancer Society.

Among the plant foods that have been associated with lowering the risk of colon cancer, garlic ranks as a highly effective protector. In some people a high consumption of fresh garlic may cause gastrointestinal adverse effects; such occurrences and the fact that the odor of garlic lingers on the skin and breath, prevents many from taking advantage of its health effects. Many have therefore turned to the odorless supplement Kyolic Aged Garlic Extract (AGE), as an effective way to seek protection against colon cancer. Currently, with over 700 scientific and medical publications showing the wide range of AGE health benefits, this odorless garlic supplement is the most researched and popular garlic supplement.

AGE a Natural Protectant against Colon Cancer
Kyolic Aged Garlic Extract (AGE), is produced by the Wakunaga Company from organically grown garlic, using a process of aging and extraction, at room temperature, for 20 months. Harsh volatile garlic components, such as allicin, are converted by this process to stable compounds, such as S-allyl cysteine, S-allyl mercaptocysteine and others. S-allyl cysteine is the major watersoluble organosulfur compound in AGE; it is a highly bioavailable and is used to standardize AGE, assuring quality control. The high quality control of AGE insures consistent efficacy in helping sustain consumer health, remaining the choice garlic preparation in clinical studies and research on the health effects of a garlic. AGE lacks harsh or toxic compounds, and can be ingested safely for years, for its health effects.

The wide range of AGE¡¦s anticancer actions has been reported in studies using model systems. Findings show that AGE and its organosulfur constituents inhibited colon cancer in a dose-dependent manner. In addition, AGE stimulated colon and liver glutathione S-transferases, enzymes assist in detoxifying carcinogens. Other studies have shown that AGE and its compounds with their high antioxidant action show anti-carcinogenic actions by scavenging toxic reactive oxygen species, unstable molecules that are waste products in metabolism, which have the ability to trigger cancer-mutations in DNA. Other effects of AGE found experimentally, were an inhibition of the binding of carcinogens to DNA, detoxifying carcinogens, blocking the proliferation of colon cancer cells and killing them by apoptosis, a mechanism of programmed cell death.

Human Studies

While epidemiological studies have shown the efficacy of garlic in lowering colon cancer risk, and experimental models found AGE and its components, largely water soluble S-ally cysteine and S-allyl-mercaptocysteine have anti-carcinogenic effects, the protective action of AGE and its efficacy in lowering the risk of colon cancer in humans had to be established by a clinical study.

To determine a potential protection against colon cancer in humans, Tanaka2 and colleagues carried out a randomized, double-blind, clinical trial, using high intake of AGE (AGE 2.4 ml/day) as an active treatment and low-dose AGE (AGE 0.16 ml/day) as a control.

The study enrolled 51 patients who were diagnosed with adenomatous polyps. Investigators assigned the patients randomly to two groups, after removing adenomas that were larger than 5 mm in diameter. Using colonoscopy, the investigators determined the number and size of adenomas before the patients began the intake of AGE (0 months) and at six and twelve months after intake. There were thirty-seven patients who completed the study; 19 in the active group, receiving AGE and 18 in the control group, receiving placebo.

The investigators found that in the control group the number of adenomas increased in linear fashion from the beginning of the study (baseline point); by contrast, in the group taking the high dose of AGE the size and number of adenomas were significantly suppressed, after the 12 months of treatment. These findings showed that the intake of Kyolic AGE has the potential to protect humans against colon cancer, by preventing the progression of precancerous colon adenomas into colon cancer.

The clinical study, showing AGE as a supplement with potential preventive effects against human colon cancer, adds to the results of several epidemiological studies showing a reduction of colon cancer by high garlic consumption.

At this point, with overwhelming evidence of garlic protection against colon cancer, it should be noted that a recent single prospective study from Harvard Medical School3, did not find a protective effect by the intake of fresh garlic. The study did not include AGE.

To possibly understand the discrepancy in results, it should be realized that the findings of efficacy by AGE in inhibiting the growth of precancerous adenomas and potentially inhibiting colon cancer, is partly due to the high standardization of its active ingredients. This is in contrast to fresh garlic cloves that cannot be standardized in the same way.

Depending on the conditions of their cultivation, garlic bulbs may contain up to 33 different lipid- and water-soluble organosulfur compounds, with varying inhibitory effects on colon cancer, as shown in laboratory studies.

In a prospective study, unknown are the number of bulbs (that means the dose of garlic components), that would be required for human intake to have an inhibitory effect on colon cancer. Food preparation methods are known to affect the potency of sulfur compounds in garlic. For example, microwave heating and oven cooking block the anti-cancer activity of some compounds in the fresh garlic. The Harvard study had no biomarkers that reflected the actual active garlic component in the human body.

By contrast, AGE is prepared at room temperature, with no heating in the process of its production, preserving its anticancer activity; in addition, S-allyl cysteine, the most prevalent organosulfur compound in AGE, has been shown experimentally to have a 98 percent bioavailability; this means it can be used potentially as a marker to reflect the intake of Aged Garlic Extract components.

References:

  1. Steinmetz KA, KushiLH, Bostick RM, et al Vegetables, fruit and colon cancer in the Iowa Women's Health Study. Am J. Epidemio.1994: 139:1-13.
  2. Tanaka S, Haruma K, Yoshihara M, Kajiyama G, Kira K, et al. Aged garlic extract has potential suppressive effect on colorectal adenomas in humans. J Nutr. 2006; 136:821S-826S.
  3. Meng S, Zhang X, Giovannucci EL, et al No association between garlic intake and risk of colorectal cancer. Cancer Epidemiol. In Press; On line Dec 12 2012.

Staying Healthy with NEW Medicine is a great work for everyone wishing to maintain and improve their health, written by a leader in integrative, holistic medicine. Dr. Elson is 40 years in practice as a lifestyle and preventive medicine philosopher-physician. This book is an octave above his original book, Staying Healthy with the Seasons, encompassing the practical integration of Natural and Eastern approaches into the Western Medical system. This synthesis can help people focus on enhancing health as a key to Staying Healthy.

NEW Medicine offers an integrated and practical vision that guides and empowers you to take more responsibility for your health and create better outcomes with lower costs. Dr. Haas states, "We hear so much about integrative medicine nowadays, but what does this really mean? Right after medical school and internship, I began integrating important ancient and modern systems of health care into my practice. I now refer to this as NEW Medicine: N for Natural, E for Eastern, and W for Western. Each system has its value, its strengths and weaknesses. Together they make up a truly integrative approach to health and healing and to treating many conditions."

Patrick Hanaway, MD, Chief Medical Officer for Functional Medicine and Medical Director for Functional Medicine at the Cleveland Clinic endorses NEW Medicine; "This book is essential education for all medical students and physicians, as well as anyone who has ever been (or will become) ill. I first read 'Staying Healthy with the Seasons' during medical school and it has had a profound effect on my career. In 'NEW Medicine' the root causes of health creation and disease causation clearly arise from the practical wisdom and vast experience of this pioneer in health and healing. Doctor is derived from the Latin docere means to teach. Dr. Elson Haas is a great teacher and a true healer."

Elson Haas, MD has been an integrative family physician since 1973 and is founder/director of the Preventive Medical Center of Marin (pmcmarin.com) in San Rafael, CA. Dr. Haas is the author of 10 books on health, nutrition, and detoxification, including Staying Healthy with Nutrition, The Detox Diet, The False Fat Diet, and the classic, Staying Healthy with the Seasons. His most recent book is Ultimate Immunity (Rodale 2015). Learn more at ElsonHaasMD.com.

The key to improving our health lies much more in our own hands than we realize—and it is time to take action. BETTER HEALTH STARTS NOW!

Staying Healthy with NEW Medicine

Elson Haas, MD
282 pages
ISBN: 069687807
Available from AMAZON

Over the last several months, there has been considerable debate between growers of medicinal mushrooms regarding the proper growing, identification and testing of these health products. As one party has put it, “Medicinal mushrooms are a category that has experienced high growth but few actual quality control standards.” These are not minor issues from the standpoint of health and efficacy or, for that matter, potentially from the standpoint of regulatory bodies. The chief protagonist in these discussions is Jeff Chilton, who has published somewhat detailed and technical articles under the heading of “Commercial Labeling of Medicinal Mushroom Products” (HerbalEGram: Volume 12, Issue 10, October 2015) and as a White Paper entitled Redefining Medicinal Mushrooms (Nammex Organic Mushroom Extracts | www.nammex.com). A much more accessible paper is available as “10 Questions to ask About Your Mushroom Supplement” (http://www.nammex.com/10-questions-to-ask-aboutyour-mushroom-supplement/). A response has come from Paul Stamets under the heading Beyond Beta-Glucans: Evolutions in Mushroom Science (October 15, 2015), albeit Stamets’ rejoinder really does more to detour the discussion into additional topics than to refute any one of Chilton’s positions.

The use of mushrooms for health and medicine is a millennial-old practice in China, Tibet and Japan. In a simplified sense, much of the debate between Chilton and Stamets comes down to observations and judgments of traditional medical systems as reflected in science and terminology versus new approaches based on radically altered growing and related practices. Traditionally and in most of the scientific literature, the items loosely termed “mushrooms” actually are divisible into three main components: mycelium, mushroom and spore. These are the different stages of growth and in traditional practices are viewed as typically manifesting quite different qualities when consumed. Likewise, in traditional Chinese medicine (TCM) and related systems, the growth medium and growing conditions are extremely important. Chilton’s general position is that the active component mix is far different for the fruiting body (i.e., the mushroom) than it is for the mycelium and that these fungi manifest very different component mixtures grown on their native mediums (wood, for instance) than grown on grains (corn, rice, etc.).

In fact, Chilton’s observations are borne out all the time with common foodstuffs. Under-ripe fruits, grains and vegetables exhibit quite different properties — not usually desirable, but occasionally advantageous — compared with their ripe versions. Bitter melon is an example of a wonderful food always eaten in its immature stage and never when fully ripe, just as the fully ripe seeds are avoided. Similarly, only dairy products from animals grazing on grass or grass silage yield the valued CLA (conjugated linoleic acid) and also more of a variety of other nutrients. Hence, common observations in areas other than mushroom growing tend to support Chilton’s general positions.

Is the Product from Fruiting Body (Mushroom) or Mycelium?
According to FDA regulations, a dietary supplement is required to provide identification of ingredients, including the part of the plant or other source used. In practice this means, for example, that reishi extracts should give the common name (reishi), the Latin identification (Ganoderma lucidum) and the part used (mycelium, fruiting body/mushroom, and/or spore). If a portion of the product consists of other material(s), such as remnants of the growth medium, these must be listed under “other ingredients.”

There are many good reasons for this regulation and these are clear in the case of mushroom powders and extracts. Once more taking reishi as the example, it is well established that a number of the compounds valued in traditional usage are found primarily or in greater quantities in the fruiting body. Such compounds include ganoderans and various triterpenes (119 or more are known, including ganoderic and ganoderenic acids). Adenosine and Ling Zhi-8 protein are found in both. These are compounds that modulate the effects of the extract to such an extent that in Chinese medical terms the “mushroom” or “fruiting body” is considered to be either “neutral” or even “cool,” hence although reishi is a powerful immunostimulant, it remains balanced and anti-inflammatory whereas mycelium extracts are considered to be “warm” or even “hot,” meaning potentially inflammatory and sensitizing. Spore extracts, likewise, are very immunoactive, meaning, again, that they will not lead to the same results as are expected from extracts of the fruiting body. There can be reasons for using the spores, but the purchaser should be aware of the implications inasmuch as spores/spore extracts do not have either the history of medicinal use or the body of research true of the mycelia and fruiting bodies.

Mycelium products usually are very inexpensive compared to the mushroom fruiting body and therefore commercially it is tempting to obscure the distinction between the two. The FDA, by the way, plainly states that mycelium products cannot be listed as mushroom, i.e., fruiting body. The FDA’s position on this issue is found in Compliance Policy Guide, Section 585.525 http://www.fda.gov/ICECI/ComplianceManuals/ComplianceP.

The Medium Is Important
Chilton refers to grain-grown mycelium as mycelium on grain (MOG). The mycelium in these products is not separated from the grain, so residual grain becomes a dominant feature of the MOG products. Of course, the mycelium has medicinal properties and much research demonstrates this fact. The contentious issues include the degree to which MOG is composed of grain and the differences between the mycelium and the fruiting body of a given species.

In his papers and at the Nammex website, Chilton supplies test data demonstrating that the concentrations of one or more important components, such as the particular beta-D-glucans that are prized from mushrooms, generally are very different between the grain-grown mycelium and the fruiting bodies. Similarly, the mixtures of the various compounds are different. Grown on traditional substrates or media, mushrooms produce triterpenes and other compounds that either are not seen or are found in much reduced amounts with grain-grown products. The reason for growing mycelium on grain, of course, is that it is very inexpensive compared to native growing mediums such as characterize mushrooms in their natural environment.

Powder or Extract?
Those who have looked at textbooks of traditional Chinese herbal prescriptions will know that dosages typically run into many grams of the raw materials that then are boiled in water to produce decoctions for drinking. Sometimes water-alcohol mixtures are used to extract compounds not readily watersoluble, sometimes herbs are fried in oils or charred, and so forth and so on. Relatively few herbs are consumed in their simple powdered states and those that are usually must be consumed in large quantities.

In practice, this means that extraction is necessary to concentrate the range of available active ingredients in amounts and in forms that can readily be ingested and absorbed. One obvious reason for extractions is greater bioavailability. For reishi, properly prepared extracts must include triterpenoids as well as the beta-D-glucan fractions. As Chilton notes, grains supply glucan fractions that may be, for instance, simply starch. Other glucan fractions can be fibers, such as the well-known glucan found in oat fiber. Supplement Facts panels should make clear that it is the active compounds that are being tested and listed. Vague terms such as polysaccharide are not useful. Merriam-Webster defines polysaccharide as “a carbohydrate that can be decomposed by hydrolysis into two or more molecules of monosaccharides; especially: one (as cellulose, starch, or glycogen) containing many monosaccharide units…” Better products often will make clear the extraction solvents, as well, e.g., water or water-alcohol.

Other Issues
Inasmuch as mycelium-based products will generally contain a fraction of the material used as the medium, if GMO grains are used, the end product will most likely contain GMO grain fractions and, quite possibly, the glyphosate or other compounds used to raise the grain. Such contaminations are extremely common in foodstuffs — recently, a test of a large number of beers made and sold in Germany found that every single one contained trace or more amounts of glyphosate with one containing 30 micrograms per liter.1 Unfortunately, wording indicating “combination” products and “full spectrum” products can confuse purchasers as to the amount of grain residues that remain. With mushrooms, as with most other foodstuffs, organic is best.

Those interested in the topic of medicinal mushrooms might want to spend time with the literature and websites listed at the beginning of this article.2 For medicinal mushrooms, as is often the case with other products, reliable information can be hard to come by. Nevertheless, self-education with regard to medicinal mushrooms may be even more important than with most other dietary supplements and herbs.

Endnotes:

  1. “Glyphosate weed killer found in German beers.” http://www.dw.com/en/glyphosate-weed-killer-found-in-german-beers-studyfinds/a-19072785.
  2. See Chapter 9 Ganoderma lucidum (Lingzhi or Reishi) in Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2011.

Synergy is a concept with which most of us are familiar. The texts on labels of dietary supplements often proclaim “synergistic effects”— indeed, so often that synergism sometimes is described as the most over-used term in the industry because synergy commonly is claimed where none exists. More interesting, and arguably far more important, are nutrient and related interactions that might seem to fall under the heading of synergy, yet in reality are quite different. One such type of interaction that is gaining traction in the world of biochemical and medical research goes under the heading of the entourage effect. Whereas synergism involves components each of which is active on its own and which in combination yield effects greater than the sum of the individual contributions, the entourage effect may involve components most of which on their own may exhibit little or no benefit or may yield benefits that are otherwise unrelated. The entourage effect as a concept helps to explain why nutrients often behave very differently in different circumstances, why seemingly identical clinical trials may yield contradictory findings and other anomalies that we meet all the time in medicine and nutrition.

SYNERGY
Synergism—the combined effects of two or more components is greater than the sum of the effects of the individual components acting alone

Many years ago, I was involved in the development of patentable forms of grape seed extract and their proanthocyanidin active components. We were exploring, among other things, how plant compounds work together with traditional antioxidant vitamins to provide protection that is superior to that of vitamins alone. People whose diet is rich in fruits and vegetables consume not only antioxidant vitamins, but also various polyphenols. Our starting point was that many of the benefits derived from eating such diets may be the result of synergism between the plant polyphenols and the better-known vitamin antioxidants. Plant polyphenols in this consideration were active antioxidant compounds, such as those found in tea, wine and grape juice. Overwhelming evidence supports the belief that excessive oxidation and free radical damage is linked to various disease states and even to aging. Yet studies in both animals and humans in which diets have been supplemented with antioxidant vitamins for long periods of time have yielded ambiguous results.

At the 219th American Chemical Society National Meeting held in San Francisco on March 26–30, 2000 researchers associated with the company Polyphenolics presented studies that supported supplementing the diet with special plant-derived nutrients and consuming more whole fruits and vegetables. One of our associates pointed out that antioxidant vitamins are present in the human body at levels typically twenty to several hundred times the level of plant polyphenols. This is one reason that so much less research has focused on the antioxidant vitamins in foods and relatively little research has been done on the antioxidant roles of the other compounds present. By 2000, however, it already was becoming clear that these non-vitamin plant antioxidants have an impact on the antioxidant status of the body that is much beyond their representation in the blood and tissues. For instance, at the conference it was explained that an extract from grape seeds given to human volunteers led to a much greater increase in the antioxidant capacity of the subjects’ blood than was theoretically possible based on the compound alone. This was a finding that called for explanation. A second set of tests helped to clarify the result of the first––the same grape seed extract demonstrated significant synergism when tested in vitro with the antioxidant vitamins C and E, either alone or in combination.

To establish a quantitative baseline for the antioxidant power of each of the compounds, tests used the standard cupric ion generation of oxidation to look at the impact of combining our grape seed extract (Vixox Gold™) with vitamins C and E to gauge the synergy of the combinations. Vitamin C, vitamin E and grape seed extract were each tested individually to determine their effects at several concentrations. These baselines were added to yield the “Sum of Individual Inhibitions” which then was compared with the “Actual Inhibitions When Tested Together.” The Actual Inhibitions minus the Sum of Individual Inhibitions times 100 yielded the percent of Synergism. This series of in vitro tests thus allowed the investigator to elegantly demonstrate the concentrations of maximal synergism amongst the three antioxidants. Strong synergism was shown for Vinox Gold™ plus vitamin C, for Vinox Gold™ plus vitamin E, and, finally, for Vinox Gold™ plus vitamin C and vitamin E.

Synergisms in the ranges shown above are good examples of why it is that consuming a diet rich in fruit and vegetables is so much more successful in terms of health than eating a diet based on refined carbohydrates, protein and fats. Refining the “big three” macronutrients and then “adding back” nutrients/ micronutrients loses the benefits of the plant compounds that otherwise are present in the original sources of carbohydrates and in partially refined oils, such as olive and sesame oils. The antioxidant vitamins are important, but they commonly provide their full potential benefits only when combined with various plant factors.

BEYOND SYNERGISM
Synergism is important, yet there are other arguably much more important factors that cannot be reduced to the concept of synergism. In another paper presented at the American Chemical Society National Meeting, Chithan Kandaswami of the State University of New York at Buffalo indicated that grape seed extract acts in ways other than as an antioxidant. The flavonoids found in grape seed along with chemically similar compounds found in other plants act to reduce the signals received by certain cell receptors involved in inflammation and tumor growth and to activate additional signals. Antioxidants commonly are found to help to reduce inflammation, but in this case the protective effect is different from an antioxidant benefit. When researchers attempt to elucidate mechanisms of action, compounds found in foods and herbs often exhibit signaling roles in the body with difficult to define effects and unknown active pathways.

To illustrate this, let’s take a simple example with implications that upend many supposedly established conclusions and vast amounts of research into the relation between nutrition and cardiovascular disease. Saturated fats, such as butterfat, long have been damned based mostly on marker studies as being atherogenic because such fats raise plasma total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). In 2015, it has become apparent that recommendations against saturated fats that have been in place since 1977 never had conclusive support from randomized controlled trials and that there is a case to be made that total cholesterol and, to some extent, even LDL-C, within a wide range actually are inversely related to total mortality! 1,2,3,4,5 This means that longevity studies based on endpoints (did the subjects live longer or not) routinely have found that in old age higher, not lower, levels of total and even LDL-C within a certain range are associated with better health and longer life. The reader may well ask, “How can so much have been wrong for so long?” One answer is that models based on interventions with pure substances often leave out actual dietary practices and suggest that foods which, in fact, are healthful instead are detrimental to health. Case in point, butterfat.

In 1993, one of the most important researchers exploring the health effects of fats in the diet, FA Kummerow, published an animal study using a model (swine) that is an almost perfect stand-in for humans in terms of lipids and cardiovascular disease to test the effects of consumption of margarine and butter on plasma lipids levels as different amounts of magnesium were consumed. The findings were telling regarding nutrient interactions. From the abstract:

Plasma lipids obtained from swine which had been fed butter or margarine at two dietary magnesium (Mg) levels indicated that the level of dietary Mg was more significant to plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels than was the presence of butter or margarine [i.e., omega-6 polyunsaturated fatty acids].…

    Studies in which the influences of dietary fats on plasma cholesterol were first noted were carried out on liquid diets deficient in Mg. Mg, a cofactor in the enzymes involved in desaturation of saturated fatty acids, is also necessary in desaturation of linoleic to arachidonic acid.
6 [Emphasis added.]

In other words, simply adding magnesium to the diet dramatically changed the effect of saturated fat on plasma lipids levels compared to polyunsaturated fat. Interestingly, butterfat, such as is found in full fat dairy, actually protects against diabetes and perhaps other components of the metabolic syndrome.7 The addition of magnesium in this example is not a form of synergy in the usual sense defined above. Instead, it is an instance of how in the diet the entourage effect often plays out.

THE ENTOURAGE EFFECT
Many herbalists long have held that in some cases plants yield better results than the natural products isolated from them, a type of “herbal synergism.” However, synergy in the simple sense introduced above involves the total of a particular benefit or effect being greater than the sum of its parts. This is illustrated by the example of delivering together blends of antioxidants whose antioxidant effects, through whatever combination of mechanisms, exceed the sum of their individual capacities as antioxidants. But what do we call the concept if one or more of the components exert no antioxidant effects of their own, may otherwise seemingly even be inert, yet magnify the outcome, reduce side effects and introduce new and unexpected benefits?

Increasingly in the scientific literature, this is called the entourage effect.8 Not surprisingly, the concept emerged with regard to herbs rather than standard pharmaceuticals because it does not lend itself readily to standard testing methodologies which depend upon “one cause, one effect” reasoning and testing. Nevertheless, examples of the entourage effect continuously are in evidence.

A good illustration of the superiority of a complex herbal extract versus “guaranteed potency” based on the ever greater purification of a single ingredient is Ma huang, a plant source of natural ephedra. Starting in the early 1990s and continuing for more than a dozen years, the combination of ephedra and caffeine was popular as a dieting aid because the mixture worked. Despite this fact, ephedra and its sources were banned due to fears of increased hypertension in vulnerable individuals. In the marketplace, relatively high dose extracts from plant sources were not economic beyond concentrations of six percent of the active alkaloid and this led to the widespread use of synthetic sources. Curiously, seriously elevated blood pressure was not normal with the plant source at reasonable levels of intake whereas elevated blood pressure was fairly typical with the synthetic. Why the difference? The answer lay with the entourage effect—in Ma huang there are a number of compounds that lower blood pressure and otherwise modulate the pressor effect of ephedra thus making the plant source far safer than the synthetic pharmaceutical source of ephedra.

Similar cases are found throughout herbalism. The important compound adenosine cannot be successfully supplemented in pure form by mouth, yet is bioavailable as a component of bears’/wild garlic.9 Likewise, the phytosterols beta-sitosterol and its glucoside in combination show significantly greater efficacy than the individual sterols at the same concentration, which is to say beta-sitosterol requires the presence of its typical form found in plants in order to be maximally active.10

A great current example of the entourage effect is cannabis in both its medical and recreational uses. Different strains of the plant that otherwise are analyzed as possessing essentially identical amounts of the “active” ingredients are reported by many or even most users as leading to quite different experiences. The reason is that the plant is the source of 60 or more cannabinoids alone, not just the famous THC and CBD, along with a host of non-cannabinoid compounds, such as terpenes. These differing combinations of compounds can activate or block binding to brain receptor sites and produce a variety of other regulatory effects.

These findings have wide-ranging implications, such as for the use of medical marijuana for cancer. For instance, cannabinoids typically have been used in experimental treatments just like other drugs to block one or another pathway or receptor site based on the genetic mutation theory of tumor development and growth. However, that model, which is the basis of most chemo- and related therapies, recently has taken quite a few hard nocks as it has become increasing apparent that cancers, like other cells and tissues in the body, depend upon epigenetics as much as or more than genetics.11,12

Epigenetics, according to one definition, refers to external modifications to DNA that turn genes “on” or “off.” These modifications do not change the DNA sequence, but instead, they affect how cells “read” genes.13

In epigenetic models of disease, targeting multiple pathways and influencing indirect as well as direct mechanisms is more effective than focusing on a single point.

A PRINCIPLE IN TRADITIONAL HERBAL FORMULATION

The entourage effect as a concept very recently has been harnessed by scientists at Harvard and several Central European universities to cover ways of visualizing the relationships between biological pathways.14An argument can be made a number of sophisticated traditional medical systems, such as those of the Tibetans and the Chinese, long have employed this type of modeling. Indeed, neither of these systems nor the related Indian Ayurvedic system traditionally used single herbs in treatments. As one recent compendium describes the principles of Traditional Chinese Medicine:

Chinese herbs are not used singly in treatment, but in combinations known as herbal formulas….Since a [sic] herbal combination has obvious advantages in treatment, the relationships between the herbs used in traditional Chinese medicine (TCM) have been carefully studied and certain types of relationship are identified. They are called the seven relations between herbs, e.g. mutual accentuation, mutual enhancement, mutual counteraction, mutual suppression, mutual antagonism, mutual incompatibility and single effect. Some of these are very useful in treatment, but some are harmful and therefore must be avoided.15

There are other ways of describing principles of formulation, such as major ingredients, directing ingredients, various modifying ingredients, etc., but the ideas are similar.

To illustrate these points, we can return to a Chinese formula that has been mentioned before in these pages, the fermented herb mixture known as Tai Li Wang. Also referred to as a mulberry and sea-buckthorn beverage concentrate to reflect its two most prominent ingredients, Tai Li Wang is suggested for individuals under stress, including mental and physical stress, those recovering from surgery or illness, requiring a large nutritional boost, individuals suffering gastrointestinal problems, and those looking for an anti-aging tonic. Other ingredients include black sesame, black plum, goji, Buddha’s hand, Chinese white olive, fu ling, chrysanthemum and jujube. Fermentation creates further complex components not found in the original herbs. The herbal tradition maintains that Tai Li Wang improves energy, supports the liver and kidney functions, increases blood components and supports their roles, is detoxifying, improves digestion and digestive functions (including being useful in both constipation and diarrhea), and is calming, including aiding sleep. In short, the formula is strengthening and balancing to the metabolism.

These effects refer to the entire formula and the components individually are generally mild in action. However, even mild herbs have limits. Take, for instance, Buddha’s hand. This is a mild herb related to citron that calms the liver and regulates certain types of energy. It is not used by itself if the physiologic system has been depleted due to diarrhea. Similarly, chrysanthemum typically is mild with the properties of cooling and calming, yet it should be used in moderation by those who have a weak digestive system or have diarrhea. The other herbs in the formula balance these constraints and in practice Tai Li Wang serves to normalize bowel function just as it serves to support immune function without causing inflammation and it promotes greater energy without being overly stimulating or depleting as is caffeine. In general, Tai Li Wang is a complex mixture of herbs consumed at really quite low levels as individual components, meaning that its benefits cannot be explained by the quantity of any one component, yet taken together these ingredients magnify the outcome, reduce side effects and introduce new and unexpected benefits.

CONCLUSION
As noted above, herbalists long have held that in some cases plants yield better results than the natural products isolated from them, a type of “herbal synergism.” One of the dangers of the modern “guaranteed potency herbs” and similar approaches to supplements is that the “guaranteed potency” that originally was meant to insure that the whole extraction was done properly has been deformed to reproduce the pharmaceutical model of pure substances and, as one consequence, leaving out important compounds found in the herbs and in the extracts as originally produced. Single compound and herbs can be combined for synergistic effects, to be sure, but it is easy to lose sight of the benefits, sometimes not at all minor, of the other compounds present in the herbs that may not constitute the active ingredients per se, yet are important for determining how the so-called active ingredients affect the body. This is the entourage effect. It is important in evaluating individual herbs and their extracts. Properly understood, it also can be understood as an organizing principle for a number of traditional medical systems, such as those of the Tibetans and the Chinese.

References

  1. Harcombe Z, Baker JS, Cooper SM, Davies B, Sculthorpe N, DiNicolantonio JJ, Grace F. Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart. 2015 Jan 29;2(1):e000196.
  2. Hamazaki T, Okuyama H, Ogushi Y, Hama R. Towards a Paradigm Shift in Cholesterol Treatment. A Re-examination of the Cholesterol Issue in Japan. Ann Nutr Metab. 2015;66 Suppl 4:1-116. doi: 10.1159/000381654.
  3. Ericson U, Hellstrand S, Brunkwall L, Schulz CA, Sonestedt E, Wallström P, Gullberg B, Wirfält E, Orho-Melander M. Food sources of fat may clarify the inconsistent role of dietary fat intake for incidence of type 2 diabetes. Am J Clin Nutr. 2015 May;101(5):1065–80.
  4. de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 2015 Aug 11;351:h3978.
  5. Morowitz HJ. Hiding in the Hammond Report. Hospital Practice 1975 Aug:35,39.
  6. Kummerow FA, Wasowicz E, Smith T, Yoss NL, Thiel J. Plasma lipid physical properties in swine fed margarine or butter in relation to dietary magnesium intake. J Am Coll Nutr. 1993 Apr;12(2):125–32.
  7. Op cit. note 3.
  8. Russo EB. Taming THC: potential cannabis synergy and phytocannabinoidterpenoid entourage effects. Br J Pharmacol. 2011 Aug;163(7):1344–64.
  9. Preuss HG, Clouatre D, Mohamadi A, Jarrell ST. Wild garlic has a greater effect than regular garlic on blood pressure and blood chemistries of rats. Int Urol Nephrol. 2001;32(4):525–30.
  10. Bouic PJ, Etsebeth S, Liebenberg RW, Albrecht CF, Pegel K, Van Jaarsveld PP. beta-Sitosterol and beta-sitosterol glucoside stimulate human peripheral blood lymphocyte proliferation: implications for their use as an immunomodulatory vitamin combination. Int J Immunopharmacol. 1996 Dec;18(12):693–700.
  11. Rozhok AI, DeGregori J. Toward an evolutionary model of cancer: Considering the mechanisms that govern the fate of somatic mutations. Proc Natl Acad Sci USA. 2015 Jul 21;112(29):8914–21.
  12. Epigenetics: A New Frontier in Cancer Research. AICR ScienceNow, Volume 20, Spring 2007 at http://preventcancer.aicr.org/site/News2?abbr=res_&id=11800
  13. http://www.livescience.com/37703-epigenetics.html
  14. Lex A, Partl C, Kalkofen D, Streit M, Gratzl S, Wassermann AM, Schmalstieg D, Pfister H. Entourage: visualizing relationships between biological pathways using contextual subsets. IEEE Trans Vis Comput Graph. 2013 Dec;19(12):2536–45.
  15. Yifan Yang. “Theories and concepts in the composition of Chinese herbal formulas” in Chinese Herbal Formulas: Treatment Principles and Composition Strategies. (Edinburgh and New York: Churchill Livingstone Elsevier, 2010.)

Marijuana, also known as cannabis, has been used as a botanical medicine for hundreds, and perhaps even thousands, of years. Research over the past 50 years has begun to shed more light on how this plant works in our bodies to produce some of the health and medical benefits researchers have identified thus far. Even the Surgeon General of the United States of America has declared, "We have some preliminary data showing that for certain medical conditions and symptoms, marijuana can be helpful."1

The most compelling evidence has shown that marijuana, or more specifically its medical constituents, cannabinol and THC, have properties that are beneficial in the following areas:2

  • The reduction of nerve related pain
  • Control of seizures
  • Improvement in sleep
  • Control of anxiety
  • Reduction of inflammation
  • Antioxidant protection
  • The treatment of specific cancers
  • Slowing the progression of Alzheimer's

How it Works
There are cannabinoid receptors on many cells throughout the body, including the brain, lungs, liver, kidneys and various part of our immune system. These receptors are activated when they are exposed to cannabinol and THC, causing the following observed reactions:

  • Higher levels of THC are responsible for the euphoric feelings associated with the smoking of marijuana.
  • When equal levels of cannabinol (CBN) and THC are present (1 to 1 ratio) there is a very significant impact on breast cancer cells, as well as other aggressive cancer cells. Scientists have observed cancer cells shrinking, dying and even reverting back to normal cell function.3
  • High levels of only CBN have been shown to provide symptomatic relief of neuropathic pain in adults with multiple sclerosis and rheumatoid arthritis. In fact, Health Canada has approved a new drug, Sativex, otherwise known as Cannabis sativa, for the treatment of the aforementioned conditions.4
  • Cannabinol has also exhibited anti-anxiety, anti-psychotic, anti-convulsant, neuroprotective effects, anti-inflammatory and anti-oxidant properties. It is this powerful combination of brain related benefits, which is thought to have the ability to slow the progression of Alzheimer's and possibly other brain related conditions.5

The interesting, and significant, finding in all of the research is that these health benefits are all possible without producing any of the euphoric reactions associated with marijuana. This is extremely important, since it is the recreational drug component that has been one of the barriers to the acceptance of cannabis being used for medical purposes. The two components need to be separated and treated completely differently in order to allow medical conditions to be treated objectively based on the emerging science.

The Deeper Cellular Understanding
More than 15,000 peer reviewed scientific articles have been published on the chemical and pharmacologic uses of cannabis and cannabinoids (CBD). There have also been 33 published controlled clinical trials, in the U.S., documenting the measurable benefits of treatments utilizing one of the cannabinoid components.6

It is important to explain more exactly how this botanical causes these beneficial reactions in the body.

  • Mediators are biochemicals, such as enzymes, that cause the up regulation (increase) or down regulation (decrease) of certain other biochemicals that control inflammation, pain messages, the genetic on and off switches for cancer and other important metabolic reactions. CBD is a mediator that up regulates the good chemicals and down regulates the bad or negative chemicals in the body leading to the prevention and/or the reversal of various health challenges.
  • Cannabinolic acid (CBDA) inhibits MDA-MB231, which stops breast cancer cells from spreading. And, CBD stops these same cells from multiplying. If breast cancer cells cannot multiply or spread, then the disease can be controlled to allow diet and other proven natural or pharmaceutical agents to kill the cancer cells or cause them to return to normal cellular activity.
  • Many cancers are enabled by a genetic on and off switch, known as the 1D-1 gene. CBD, in the form of cannabis oil extract was able to turn off the over expression of this 1D-1 gene, thus stopping cancer cells from moving to other tissues and, in some cases, causing these cancer cells to return to normal cellular function. This off switch by the cannabis oil extract proved effective for breast cancer, leukemia, lung cancer, ovarian cancer and brain cancer, all of which have normally occurring high levels of the 1D-1 gene.7

Detoxification - Systematically removing accumulated toxins from the body can significantly reduce the burden placed on the immune system and other important metabolic functions. This will allow more energy and immune protective activity to be directed at the primary health challenge. Proven detoxification methods include exercise, sauna, steam bathes, diet, specific supplements and intravenous treatments such as EDTA chelation therapy or hydrogen peroxide therapy. The existing level of toxicity can be measured via blood, hair and urine tests, as well as symptoms analysis. Then these same tests can be used to measure the success of various detoxification efforts. These detoxification efforts can then create a better environment for the use of various treatments, which can include cannabis.

Nutrition - The human body needs very high levels of essential oils, vitamins, minerals and enzymes in order for each of our 60 trillion cells to function properly. When cells are not properly nourished, this puts a strain on our organs and our operating systems, including the immune system. A diet of whole foods, including vegetables, fruits, nuts, seeds, healthy oils, omega fish and organic poultry will help to optimize cellular function, thus making treatment protocols more likely to achieve their desired results. This type of diet also helps to ensure a proper pH balance in the body (7.0 - 7.4), which is the ideal environment for optimal healing.

Stress Management - Stress is involved, or influences, about 80% of all health challenges and drains the body of vital nutrients, such as B vitamins. Using stress management techniques, such as yoga, meditation, deep breathing and hypnotherapy can help to reduce the impact of stress on treatment protocols for chronic disease. Reducing stress also helps to reduce acid levels in the body, thus insuring the maintenance of a healthy and healing pH level in the body.

Sleep Function - When we sleep, our bodies experience the most significant levels of balancing (homeostasis), detoxification and re-energizing. Therefore, it is very important to ensure sound sleep of at least 7 to 9 hours every night. Eating very little after dinner, avoiding caffeine and other stimulants and clearing the mind of troubling or perplexing topics best accomplish this. Some people may need to use calming audiotapes, meditation or supplements, such as 5HTP or melatonin to help achieve this state of sound sleep.

Cannabis for cancer treatment, the science

There have been many impressive scientific studies over the past several years on the effectiveness of hemp extracts in the treatment of various forms of cancer. Here is a partial list of these studies, which clearly illustrates the potential benefit for the medical application of hemp extracts against the most serious disease we know.

1. A study published in the British Journal of Cancer, conducted by the Department of Biochemistry and Molecular Biology at Complutense University in Madrid, determined that Tetrahydrocannabinol (THC) and other cannabinoids inhibit tumor growth. They were responsible for the first clinical study aimed at assessing cannabinoid antitumoral action. Cannabinoid delivery was safe and was achieved with zero psychoactive effects. THC was found to decrease tumor cells in two out of the nine patients.9

2. A study published in The Journal of Neuroscience examined the biochemical events in both acute neuronal damage and in slowly progressive, neurodegenerative diseases. They conducted a magnetic resonance imaging study that looked at THC (the main active compound in marijuana) and found that it reduced neuronal injury in rats. The results of this study provide evidence that the cannabinoid system can serve to protect the brain against neurodegeneration.10

3. A study published in The Journal of Pharmacology And Experimental Therapeutics already acknowledged the fact that cannabinoids have been shown to possess antitumor properties. This study examined the effect of cannabidiol (CBD, non-psychoactive cannabinoid compound) on human glioma cell lines. The addition of cannabidiol led to a dramatic drop in the viability of glioma cells. Glioma is the word used to describe brain tumor. The study concluded that cannabidiol was able to produce a significant antitumor activity.11

4. A study published in the Journal Molecular Cancer Therapeutics outlines how brain tumors are highly resistant to current anticancer treatments, which makes it crucial to find new therapeutic strategies aimed at improving the poor prognosis of patients suffering from this disease. This study also demonstrated the reversal of tumor activity in Glioblastoma multiforme.12

5. A study published in the journal Breast Cancer Research and Treatment, conducted by the California Pacific Medical Centre, determined that cannabidiol (CBD) inhibits human breast cancer cell proliferation and invasion. They also demonstrated that CBD significantly reduces tumor mass.13

6. A study published in The Journal of Pharmacology and Experimental Therapeutics determined that THC as well as cannabidiol dramatically reduced breast cancer cell growth. They confirmed the potency and effectiveness of these compounds.14

7. A study published in the Journal Molecular Cancer showed that THC reduced tumor growth and tumor numbers. They determined that cannabinoids inhibit cancer cell proliferation, induce cancer cell apoptosis, and impair tumor angiogenesis (all good things). This study provides strong evidence for the use of cannabinoid-based therapies for the management of breast cancer.15

8. A study published in the Proceedings of the National Academy of Sciences of the United States of America (PNAS) determined that cannabinoids inhibit human breast cancer cell proliferation.16

9. A study published in the Journal Oncogene, by Harvard Medical Schools Experimental Medicine Department, determined that THC inhibits epithelial growth factor induced lung cancer cell migration and more. They go on to state that THC should be explored as novel therapeutic molecules in controlling the growth and metastasis of certain lung cancers.17

10. A study published in The FASEB Journal by the Institute of Toxicology and Pharmacology, from the Department of General Surgery in Germany, determined that cannabinoids inhibit cancer cell invasion. Effects were confirmed in primary tumor cells from a lung cancer patient. Overall, data indicated that cannabinoids decrease cancer cell invasiveness.18

11. A study published in the journal Cancer Prevention Research, conducted by Harvard Medical School, investigated the role of cannabinoid receptors in lung cancer cells. They determined its effectiveness and suggested that it should be used for treatment against lung cancer cells.19

12. A study published in the journal Prostate illustrates a decrease in prostatic cancer cells by acting through cannabinoid receptors.20

13. A study published in the Indian Journal of Urology outlined multiple studies proving the effectiveness of cannabis on prostate cancer.21

14. Another study published in the British Journal of Pharmacology determined that clinical testing of CBD against prostate carcinoma is a must. That cannabinoid receptor activation induces prostate carcinoma cell apoptosis. They determined that cannabidiol significantly inhibited cell viability.22

15. A study published in the Journal Molecular Pharmacology recently showed that cannabinoids induce growth inhibition and apoptosis in mantle cell lymphoma. The study was supported by grants from the Swedish Cancer Society, The Swedish Research Council, and the Cancer Society in Stockholm.23

16. A study published in the International Journal of Cancer also determined and illustrated that cannabinoids exert antiproliferative and proapoptotic effects in various types of cancer and in mantle cell lymphoma.24

17. A study published in the journal Molecular Cancer Research conducted by the Department of Pharmacology and Toxicology by Virginia Commonwealth University determined that cannabinoids induce apoptosis in leukemia cells.25

18. A study published in the journal Molecular Cancer Research shows that cannabinoids are potent inhibitors of cellular respiration and are toxic to highly malignant oral tumors.26

19. A study published in Cell Death & Differentiation determined that THC reduces the viability of human HCC cell lines (Human hepatocellular liver carcinoma cell line) and reduced their growth.27

20. A study published in Cancer Research determined that cannabinoid receptors are expressed in human pancreatic tumor cell lines and tumor biopsies at much higher levels than in normal pancreatic tissue. Results showed that cannabinoid administration induced apoptosis. They also reduced the growth of tumor cells, and inhibited the spreading of pancreatic tumor cells.28

Who is against the medicinal use of marijuana?
There has been steady resistance to the legalization of marijuana. One of the biggest reasons is the confusion between recreational marijuana, medical marijuana and CBD. Medical marijuana is under the jurisdiction of individual states and allows Medical Doctors to utilize this product for pain relief, some eye disorders and other health challenges. Cannabidiol (CBD) is a non-medical hemp product approved in all fifty states as a health improvement nutritional supplement. This general resistance usually comes from older and/or more conservative people who view marijuana from only one perspective; it's use as a recreational drug. Many younger people see this as hypocrisy since alcohol and tobacco are legal and cause more problems in terms of ill health, lost productivity and death than marijuana could possibly cause. In addition to this general, albeit confused, resistance, there are other specific groups who are opposed to the legalization of marijuana, and remember, most of their reasons also do not properly distinguish between recreational use and medical use.

Cigarette Makers and Sellers - Unless the existing cigarette industry can control the marijuana industry, they will always lobby against it because they fear the loss of some of their huge profits from the sale of cigarettes.

Alcohol Makers and Users - This group will resist for the same reasons as the cigarette industry. If people switch from alcohol to marijuana use, there is a potential loss of millions, or even billions, of dollars in profits.

Prisons - Prisons are an economic growth industry for many communities and thousands of workers. Marijuana accounts for more than half of all drug arrests in the country. If recreational marijuana were legalized, all of these arrests and imprisonments would disappear. Private prisons would lose money, jobs would be lost and communities dependent on these jobs would suffer economically.

It also stands to reason that prison employee unions would also lobby against the legalization of marijuana.

Police Unions - Police also benefit from the illegal status of marijuana. About 1 million arrests each year involve the possession of marijuana. If marijuana were legalized, then there could be a reduced need for police officers and federal drug enforcement officers to search for marijuana growers, importers and users. Farmers would be licensed and prices would be stabilized, making this illegal industry far less viable.

Pharmaceutical Companies - If medical marijuana is proven to be as effective, inexpensive and safe as existing science is indicating, then many prescription and over-the-counter medications will no longer be necessary. This could cost big pharma billions, if not trillions, of dollars in profits.

Doctors, Hospitals and Insurance Companies - If some diseases were able to be treated more safely, effectively, and at less cost, the entire medical industry would have fewer high cost tests and treatments, leading to a dramatic loss of patients and profit.29

Final Thoughts
As usual, a proven health advancement is being resisted by special interests and a lack of clarity about its many benefits. It took years to gain the acceptance of prenatal vitamins, causing many babies to be born with birth defects and many mothers and babies to die unnecessarily. Co-enzyme Q10 can help prevent heart disease, reverse kidney disease and slow the advance of Parkinson's Disease. And vitamin D3 can help prevent breast cancer. All of these scientifically proven natural health benefits have been facing stiff resistance from special interests for years. Many millions of people will suffer and die prematurely due to the resistance to these and other similar health and medical breakthroughs.

Medical marijuana, cannabis, CBD and CBN have joined this list of evidence-based health solutions that are being resisted due to ignorance or greed or both. Patient advocates, scientists, progressive doctors and courageous media people are now working fairly independently to help advance the use of medical cannabis. If they could combine and better coordinate their efforts, perhaps medical marijuana, in all of its proven forms, could move forward much faster and spare the unnecessary suffering, pain and expense that is caused by the pursuit of profit over the health and welfare of our population.

References

  1. Mercola, Joseph, 2015. Top US Doctor Says Medical Marijuana May Help Some Conditions. Dr. Joseph Mercola's web site online, Feb. 17, 2015.
  2. Ibid
  3. Ibid.
  4. Costa, Barbara, et al.2007. The non-psychoactive cannabis constituent cannabidiol is an orally therapeutic agent in rat chronic inflammatory and neuropathic pain. Science Direct online. Originally from European Journal of Pharmacology 556 (2007) 75-83.
  5. Ibid.
  6. Mercola, Joseph, 2015. Top US Doctor Says Medical Marijuana May Help Some Conditions. Dr. Joseph Mercola web site online, Feb. 17, 2015.
  7. Ditchfield, Jeff and Thomas Mel, 2014. The Medical Cannabis Guidebook: The Definitive Guide To Using and Growing Medicinal Marijuana. Green Candy Press, San Francisco, CA.
  8. Schwartz, Carly, 2014, Marijuana Drastically Shrinks Aggressive Form Of Brain Cancer, New Study Finds. Huffington Post online.
  9. M Guzmán, M J Duarte, C Blázquez, J Ravina, M C Rosa, I Galve-Roperh, C Sánchez, G Velasco and L González-Feria. A pilot clinical study of Δ9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme. British Journal of Cancer (2006) 95, 197–203. doi:10.1038/sj.bjc.6603236
  10. M. van der Stelt, W. B. Veldhuis, P. R. Bär, G. A. Veldink, J. F. G. Vliegenthart, and K. Nicolay. Neuroprotection by Δ9-Tetrahydrocannabinol, the Main Active Compound in Marijuana, against Ouabain-Induced In Vivo Excitotoxicity. The Journal of Neuroscience, 1 September 2001, 21(17): 6475-6479;
  11. Paola Massi, Angelo Vaccani, Stefania Ceruti, Arianna Colombo, Maria P. Abbracchio and Daniela Parolaro. Antitumor Effects of Cannabidiol, a Nonpsychoactive Cannabinoid, on Human Glioma Cell Lines. JPET March 2004 vol. 308 no. 3 838-845
  12. Sofía Torres, Mar Lorente, Fátima Rodríguez-Fornés, Sonia Hernández-Tiedra, María Salazar, Elena García-Taboada, Juan Barcia, Manuel Guzmán and Guillermo Velasco. A Combined Preclinical Therapy of Cannabinoids and Temozolomide against Glioma. Mol Cancer Ther January 2011 10; 90
  13. McAllister SD, Murase R, Christian RT, Lau D, Zielinski AJ, Allison J, Almanza C, Pakdel A, Lee J, Limbad C, Liu Y, Debs RJ, Moore DH, Desprez PY. Pathways mediating the effects of cannabidiol on the reduction of breast cancer cell proliferation, invasion, and metastasis. Breast Cancer Res Treat. 2012 May;133(1):401-4.
  14. Alessia Ligresti, Aniello Schiano Moriello, Katarzyna Starowicz, Isabel Matias, Simona Pisanti, Luciano De Petrocellis, Chiara Laezza, Giuseppe Portella, Maurizio Bifulco and Vincenzo Di Marzo. Anti-tumor activity of plant cannabinoids with emphasis on the effect of cannabidiol on human breast carcinoma. JPET May 25, 2006 106.105247
  15. María M Caffarel, Clara Andradas, Emilia Mira, Eduardo Pérez-Gómez, Camilla Cerutti, Gema Moreno-Bueno, Juana M Flores, Isabel García-Real, José Palacios, Santos Mañes, Manuel Guzmán and Cristina Sánchez. Cannabinoids reduce ErbB2-driven breast cancer progression through Akt inhibition. Molecular Cancer 2010, 9:196
  16. Luciano De Petrocellis, Dominique Melck, Antonella Palmisano, Tiziana Bisogno, Chiara Laezza, Maurizio Bifulco, Vincenzo Di Marzo. The endogenous cannabinoid anandamide inhibits human breast cancer cell proliferation. Proc. Natl. Acad. Sci. USA Vol. 95, pp. 8375–8380, July 1998
  17. Preet A, R K Ganju, J E Groopman. Δ9-Tetrahydrocannabinol inhibits epithelial growth factor-induced lung cancer cell migration in vitro as well as its growth and metastasis in vivo. Oncogene (2008) 27, 339–346; doi:10.1038
  18. Ramer R, Bublitz K, Freimuth N, Merkord J, Rohde H, Haustein M, Borchert P, Schmuhl E, Linnebacher M, Hinz B. Cannabidiol inhibits lung cancer cell invasion and metastasis via intercellular adhesion molecule-1. The FASEB J. 2012 Apr;26(4):1535-48. doi: 10.1096/fj.11-198184. Epub 2011 Dec 23.
  19. Preet A, Qamri Z, Nasser MW, Prasad A, Shilo K, Zou X, Groopman JE, Ganju RK. Cannabinoid receptors, CB1 and CB2, as novel targets for inhibition of non-small cell lung cancer growth and metastasis. Cancer Prev Res (Phila). 2011 Jan;4(1):65-75. doi: 10.1158/1940-6207.CAPR-10-0181. Epub 2010 Nov 19.
  20. Mimeault M, Pommery N, Wattez N, Bailly C, Hénichart JP. Anti-proliferative and apoptotic effects of anandamide in human prostatic cancer cell lines: implication of epidermal growth factor receptor down-regulation and ceramide production. Prostate. 2003 Jun 15;56(1):1-12.
  21. Juan A. Ramos, Fernando J. Bianco. The role of cannabinoids in prostate cancer: Basic science perspective and potential clinical applications. Indian J Urol. 2012 Jan-Mar; 28(1): 9–14.
  22. De Petrocellis L, Ligresti A, Schiano Moriello A, Iappelli M, Verde R, Stott CG, Cristino L, Orlando P, Di Marzo V. Non-THC cannabinoids inhibit prostate carcinoma growth in vitro and in vivo: pro-apoptotic effects and underlying mechanisms. British Journal of Pharmacology 2013 Jan;168(1):79-102. doi: 10.1111/j.1476-5381.2012.02027.x.
  23. Gustafsson Kristin, Christensso Birger, Sander Birgitta, Flygare Jenny. Cannabinoid Receptor-Mediated Apoptosis Induced by R(+)-Methanandamide and Win55,212-2 Is Associated with Ceramide Accumulation and p38 Activation in Mantle Cell Lymphoma. Molecular Pharmacology November 2006 vol. 70 no. 5 1612-1620
  24. Gustafsson Kristin, Wang Xiao, Severa Denise, Eriksson Maeve, Kimby Eva, Merup Mats, Christensson Birger, Flygare Jenny, Sander Birgitta. Expression of cannabinoid receptors type 1 and type 2 in non-Hodgkin lymphoma: Growth inhibition by receptor activation. International Journal of Cancer 1 September 2008, Volume 123, Issue 5, pages 1025–1033
  25. Jia W, Hegde VL, Singh NP, Sisco D, Grant S, Nagarkatti M, Nagarkatti PS. Delta9-tetrahydrocannabinol-induced apoptosis in Jurkat leukemia T cells is regulated by translocation of Bad to mitochondria. Mol Cancer Res. 2006 Aug;4(8):549-62.
  26. Whyte DA, Al-Hammadi S, Balhaj G, Brown OM, Penefsky HS, Souid AK. Cannabinoids inhibit cellular respiration of human oral cancer cells. Pharmacology. 2010;85(6):328-35. doi: 10.1159/000312686. Epub 2010 Jun 2.
  27. Vara D, Salazar M, Olea-Herrero N, Guzmán M, Velasco G, Díaz-Laviada I. Anti-tumoral action of cannabinoids on hepatocellular carcinoma: role of AMPK-dependent activation of autophagy. Cell Death Differ. 2011 Jul;18(7):1099-111. doi: 10.1038/cdd.2011.32. Epub 2011 Apr 8.
  28. Arkaitz Carracedo, Meritxell Gironella, Mar Lorente, Stephane Garcia, Manuel Guzmán, Guillermo Velasco, and Juan L. Iovanna. Cannabinoids Induce Apoptosis of Pancreatic Tumor Cells via Endoplasmic Reticulum Stress–Related Genes. Cancer Res July 1, 2006 66; 6748
  29. Mercola, Joseph, 2015. Top US Doctor Says Medical Marijuana May Help Some Conditions. Dr. Joseph Mercola's web site online, Feb. 17, 2015.

Modern medicine often can perform marvels in treatment at the hospital, no doubt about it. Likewise, antibiotics and other pharmaceuticals frequently can save us from conditions that in a previous century would have been fatal. Missing, however, as most of us can attest either from personal experience or from having witnessed the post-hospital recovery of relatives and friends, are good options for supporting healing and recovery once medical treatments are over. “Taking it easy” in terms of exertion and food choices (“regular diet” or “special diet” as required) too often is the limit of available advice. Those interested in a catalog of standard medical advice might consult, “Managing the Adverse Effects of Radiation Therapy” at http://www.aafp.org/afp/2010/0815/p381.html. Conspicuously absent are solutions for the fatigue that is characteristic of recovery from chemotherapy and radiation.

Traditional medical systems around the world are much more focused on convalescence from illness and injury. Broths and soups are at home in European traditions, of course. In Indian and Chinese culture these variously are enriched with special herbs and spices. For instance, the Ayurvedic tradition makes use of a rice and dahl (yellow lentil) dish called kicharee that is prepared fresh daily for convalescence. This meal can be quite varied, yet typically contains a little ghee, onions, garlic, ginger and a variety of mild warming and digestive herbs and spices, with vegetables added to taste and as the patient grows stronger. Chinese tradition suggests chicken and meat/bone broths, soups and stews along with certain herbs, such as wolfberry, angelica, ginger, jujube (a special date), and so forth. Indeed, in Chinese medicine tonification to match various conditions is a sophisticated science. (See, for instance, http://www.shen-nong.com/eng/lifestyles/tcmrole_bufa.html) A section below discusses a really quite remarkable representative of this tradition: tai li wang mulberry and sea-buckthorn beverage concentrate. This ancient formula addresses some of the key weaknesses experienced by individuals who have undergone chemotherapy, radiation and surgery.

Chemotherapy and Radiation: Why Is Recovery So Hard?

Chemotherapy and radiation are based in large part on the greater susceptibility of cancer cells to damage than is true of normal cells. Cancerous tissues have certain metabolic advantages over healthy tissues that allow them to grow faster and to cannibalize surrounding tissues to feed themselves. This sometimes is called the “Warburg effect” after the Nobel Prize winner who first described it. Cancer’s growth advantage comes with certain downsides, such as greater susceptibility to damage by free radicals and many toxins. Chemotherapy works in part by being more toxic to cancer cells than to normal cells. Radiation treatments work similarly and also can act essentially as “surgery by another means.” In either case, there is lasting damage to basic health. Normal, yet faster growing tissues, which include the tissues that make up the digestive tract, can be affected with implications for digestion. More than just taste and smell change under such circumstances. The fundamental nutritional needs of the body may not be met in important ways with implications for the nervous and immune systems. Today, gut-brain and gut-immune interactions are rapidly expanding areas of research as scientists try to unravel the links of the digestive system to other aspects of health.

There are yet other pieces to the puzzle. Researchers have had difficulty in pinpointing just why chemotherapy and radiation treatments are so lasting in their negative effects despite what seemingly should be adequate rest and nutrition. A paper published in 2014 may have solved at least some of this riddle. Interestingly, the answer goes back to a part of the body always considered to be a fundamental source of basic life energy and the ability of the body to renew itself: the marrow of the bones.

A key element is hematopoietic stem cells, which are cells created and stored initially in the bone marrow and which give rise to not only new red blood cells, but also to many types of immune cells. In fact, in their normal state hematopoietic stem cells from the blood and marrow appear to be ordinary white blood cells. Nevertheless, when called upon, these self-renewing cells also renew countless blood and immune cells. The U.S. National Institutes of Health on the Internet provide extensive and useful information regarding stem cells and interested readers should make use of such tools for further knowledge.

Ionizing radiation, such as that used in oncology treatments, can cause extensive fatalities among hematopoietic stem cells. In some cancer treatments, the damage to the hematopoietic stem cell population can be so extensive that cells and marrow must be transplanted from healthy donors. Unfortunately, to paraphrase an observation from industry, generally “original equipment” works best. This observation goes beyond radiation treatment because it is not just radiation that damages these cells. Chemotherapy and aging also damage hematopoietic stem cells.

Back to that 2014 paper: One challenge to the renewal of hematopoietic stem cells that is particularly linked to exposure to chemotherapy and radiation appears to be a reduction in the level of a particular protein that is necessary for hematopoietic stem cell renewal and activation. University of San Diego researchers, using an animal model, discovered that mice deficient in the protein beta-catenin lacked the ability to activate a pathway known as Wnt signaling. This failure led to impaired hematopoietic stem cell regeneration and poor bone marrow recovery after radiation. The result was a much-reduced rate of overall recovery inasmuch as there was reduced production of red blood cells and immune cells.

Damaged hematopoietic stem cells thus are a major aspect of reduced immune function and join other factors that have been identified in depressed immune function, such as damaged and non-responsive immune memory cells, cells whose very presence depresses the body’s ability to renew itself and to respond to immune challenges. This issue was discussed briefly in the February 2015 issue of Total Health under the heading, “Caloric Restriction, Fasting and Nicotinamide Riboside. ” Since the publication of that essay, new modified fasts have become available for those who cannot tolerate going three to four days with only water for sustenance. The research team that did much of the pioneering work on this topic has published instructions on how to perform a series of five-day fasts that can achieve most of the results of the original program with less strain and inconvenience.

Tai Li Wang: An Ancient TCM Herbal Solution
Fasting helps renew the immune system and hematopoietic stem cells by causing damaged and badly programed cells to be removed from the system. This approach resembles the employment of fasting in the Ayurvedic tradition to “activate the fundamental digestive fire (agni) of the body” to cleanse impurities/toxins that otherwise cannot be destroyed. However, fasting is not itself a solution to many aspects of poor digestive health, reduced adrenal function and the need for nutrition that supports the production of new blood and immune cells. These basic challenges characterize the typical impact of chemotherapy and radiation on health and contribute to the chronic nature of the fatigue and reduced immune function that are aftermaths of these treatments. For these purposes, Traditional Chinese Medicine (TCM) offers a number of sophisticated tonification therapies. One of the very best is the fermented herb mixture known as Tai Li Wang.

Tai Li Wang is a traditional Chinese herbal formula that some argue was created during the Warring States Period (475– 221 B.C.). As is true of many such “secret” formulas throughout Chinese history, it is difficult to trace back the actual history of the formula, which was first made “public” only in 1857 and has been officially approved by the Chinese Department of Health since 1992. Today, Tai Li Wang is registered in Hong Kong as a Tradition Chinese Herbal Medicine and is available in a number of hospitals in South China. Sea buckthorn and wolfberry are two of the primary ingredients, which provides a hint at the age and origin of the formula. It was during the Warring States Period that the Great Wall was begun and that Chinese civilization entered into extensive interchange with Central Asia. Sea buckthorn and wolfberry both are native to what today is the mountainous area of Tibet and Sinkiang in far Western China, but for much of the last 3,000 years was part of various Central Asian states. Moreover, this is a fermented formula and fermentation was practiced mostly in Western and Northern China due to the harsh winters. Hence, the formula most likely originated in Central Asia and entered China during this early period of contact.

Also referred to as a mulberry and sea-buckthorn beverage concentrate to reflect its two most prominent ingredients, Tai Li Wang is suggested for individuals under stress, including mental and physical stress, those recovering from surgery or illness, requiring a large nutritional boost, individuals suffering gastrointestinal problems, and those looking for an anti-aging tonic. Other ingredients include black sesame, black plum, goji, Buddha’s hand, Chinese white olive, fu ling, chrysanthemum and jujube.

Fermentation is an important aspect of the preparation of the herbs. Not only does fermentation protect and concentrate actives from the herbs, but it also leads to the formation of new beneficial compounds not initially present. The flavor of the drink is acidic or vinegar-like.

Employing classic TCM terminology, it is said that the Tai Li Wang formula Tonifies and rights the qi, enriches and nourishes the liver and kidneys, nourishes the blood and boosts the essence, moistens the lungs and relieves coughing, fortifies the spleen and harmonizes the stomach, disperses food and transforms stagnation, astringes the intestines and relieves diarrhea, quiets the heart and calms the nerves, engenders the liquids and quenches thirst, soothes the throat and relieves coughing.

Westerners usually are not familiar with TCM terminology and phrasing, yet the meaning of the above is not as obscure as at first it might seem. Briefly, the herbal tradition maintains that Tai Li Wang improves energy, supports the liver and kidney functions, increases blood components and supports their roles, is detoxifying, improves digestion and digestive functions (including being useful in both constipation and diarrhea), and is calming, including aiding sleep. In short, the formula is strengthening and balancing to the metabolism. Those who have tried Tai Li Wang (the flavor is challenging) can attest that some of its effects are realized within two or three days. For instance, the detoxifying and normalizing benefits for the gastrointestinal tract appear quickly. The stool becomes darkened, even tarry, indicating bile release (the body disposes of most toxins via the bile), yet at the same time there is a normalizing effect on stool consistency. Hence, there is a physical indication of a rapid impact on gut function, water balance and almost certainly a profound impact on the gut microbiome.

With regard to recovery after chemotherapy and radiation, supporting digestion, bowel function and detoxification provides a necessary and significant foundation. These medical treatments create various toxins as a result of free radical production and overt tissue damage while at the same time inhibiting the normal clearance mechanisms. Likewise, one reason for the weight loss that is characteristic of chemotherapy and radiation, apart from the loss of appetite, taste and smell, is that the body goes into overdrive in its attempts to repair the damage to normal tissues and quite literally cannot keep pace with the rate of destruction or the demands for removing damaged materials from the system.

Next in importance after the support of the gastrointestinal foundation of detoxification and health is Tai Li Wang’s impact on blood components. As noted above, chemotherapy and radiation destroy large numbers of hematopoietic stem cells, thus leaving the body lacking in precisely those cells necessary to renew both red blood cells and many types of immune cells. Supporting a return to health in these areas is exactly the benefit described by TCM with the phrase, “nourishes the blood and boosts the essence.” Not just many medical treatments, but, similarly, chronic excessive physical exertion and aging reduce the ability to renew the blood and immune cells. Experience from animal experiments and human clinical practice demonstrates that the TCM characterization is correct, that there is an increase in red blood cells and immune function without any danger of a rise in inflammatory responses. For instance:

… LACA mice of different ages given 12.5 g/kg of a mulberry decoction … by gavage daily for ten days in succession experienced marked increases in T-lymphocytes. The mulberry decoction acted as a moderate trigger for lymphocyte transformation. Rosette test results on mice showed that black plum increased immunity in domestic rabbits. Immunity testing (SOI) of super optimal doses of sheep red blood cells (SRBC) showed that suitable doses of goji polysaccharides significantly regulated suppressor T cells (Ts) in geriatric mice while increasing Ts activity. Pachyman strengthened immunity in regular and tumor-bearing mice and strengthened the macrophage phagocytic function in mice, resulting in significantly higher counts of antibody secretory cells in the spleen and increased ANAE positive lymphocyte counts in tumor-bearing mice. This served to antagonize the thymic atrophy….

In short, Tai Li Wang is an interesting fermented nutritional beverage that supports many physiological functions according to Traditional Chinese Medical categories, modern experiments and clinical usage in South China.

Conclusion
Despite tremendous medical advances, allopathic medicine has not done a good job in addressing the needs of recovery after chemotherapy, surgery and radiation. Chemotherapy and radiation cause lasting damage to the body, including to the ability of the gastrointestinal system and supporting organs to eliminate toxins and derive nutrients from food. Likewise, these treatments are detrimental to hematopoietic stem cells, the cells that are necessary for the renewal of red blood cells and many types of immune cells. The fermented Chinese herbal beverage known as Tai Li Wang, according to both animal work and clinical practice, offers an approach to nutritionally supporting healing and recovery that brings an ancient discovery to the modern world.

References:

  1. Lento W, Ito T, Zhao C, Harris JR, Huang W, Jiang C, Owzar K, Piryani S, Racioppi L, Chao N, Reya T. Loss of â-catenin triggers oxidative stress and impairs hematopoietic regeneration. Genes Dev. 2014 May 1;28(9):995–1004.
  2. “‘Fasting-mimicking diet’ may promote health and longevity,” June 21, 2015 found at http://www.medicalnewstoday.com/articles/295647.php
  3. “Researchers Discover Fasting Can Significantly Prolong Life,” June 25, 2015 at http://readynutrition.com/resources/researchers-discover-fasting-can-significantly-prolong-life_25062015/
  4. Hong Kong] Application For Registration Of Proprietary Traditional Chinese Medicine, Pharmacological Effects Report: Pharmacological Effects Report for “Tai Li Wang” Mulberry and Sea-buckthorn Beverage Concentrate.
  5. http://www.angliatech.com/showcase/tailiwang/product_feature.php?lang=1

Given the increase in pathogens everywhere (bacterial, fungal, parasitic and viral), it is time to consider natural antibiotic alternatives that are without the negative side effects of pharmaceutical compounds. After years of downplaying the dangers of excessive use of antibiotics, the AMA has recently issued some important directives. To avoid the creation of an even greater number of highly resistant super germs, it is now believed that it is imperative for practitioners to be taught to use antibiotics far more sparingly. Given this current admonition, coupled with the fact that antibiotic use, aside from it's oral ingestion, is plentifully found and ingested via our food chain (poultry, fish, meats, eggs and dairy), a broad spectrum natural substance such as grapefruit seed extract (GSE) can be used widely and effectively.

Determining Antibiotic Efficacy:
Allen Sachs, D.C., C.C.N., author of The Authoritative Guide to Grapefruit Seed Extract, enumerates the following criteria for delineating the ideal antibiotic: "It must have broad spectrum application, be powerful and effective, non-toxic, have minimal impact on beneficial bacteria, be well researched, derived from natural sources, hypo-allergenic, biodegradable, compatible with other natural remedies and affordable." Considering that grapefruit seed extract meets all these specifications, Dr. Sachs notes it has proven itself safe, effective and non-toxic for topical and internal use with far-reaching internal, industrial and domestic application.

Application of grapefruit seed extract:
The diverse germicidal use of grapefruit seed extract would fill a recipe book. Indeed one finds GSE a diverse and indispensable function in the kitchen, suitable domestically and commercially as a sanitizer (for dishes and utensils), produce wash, adjunct ingredient to dish soaps and natural disinfecting solutions for counter tops, floors, sinks and refrigerators. Butcher blocks, a seedbed for harboring food-borne pathogens (salmonella bacteria), are easily sanitized by washing and then applying a 10-20 drop solution of GSE (diluted with water). Work it into the board with a damp sponge, leave it on for at least five minutes or just leave it to dry without rinsing.

Its benign aroma is an added feature, particularly for those with chemical sensitivities who find grapefruit seed extract a viable and pleasant alternative to the noxious fumes and reactions (skin, olfactory, lung) of commercial chemicals such as chlorinated compounds.

Bathroom Bugs and Toiletries:
Invisible predators lurk in nooks and crannies, particularly in restrooms. As an all-purpose disinfectant, 30-60 drops of grapefruit seed extract per 32 ounce spray bottle can be used alone or in combination with natural all-purpose cleaners to sanitize commodes, sinks, shower stalls, bathtubs and wastebaskets. The customary fumes emitted from grout cleaners, ammoniated compounds (glass and floor cleaners), and the multiple toxic chemical compounds used to clean bathrooms make this non-toxic approach favorable for anyone (in the workplace, at home, those with young children, around the aged, those with compromised lung problems or chemical sensitivities) who wants to preserve his/her health. Additionally, GSE 's economical virtues (reasonable price) enable one to reduce a cabinet full of chemicals in favor of a basic soap and natural disinfecting agent. Using powerful chemicals (like drugs) to control a situation is not necessarily the optimal way when a less toxic, non-invasive approach can be accessed without paying health consequences.

As a toiletry mainstay, GSE offers extensive and practical daily application (domestically and for travel). In liquid form GSE drops can be used in water piks as a germ-killing additive to destroy bacteria that cause plaque and gingivitis. Three drops added to five or six ounces of water is a basic oral rinse recipe. Put a drop of grapefruit seed extract on your toothbrush along with your regular natural toothpaste for added germ-killing effect.

Given the variety of grapefruit seed extract products currently available in the health market, a basic GSE toiletry arsenal includes gum cleanser (for disinfecting and relieving sore gums), ear drops, nail drops (for hand and toenail fungus) and foot powder (a superb alternative to commercial talcum powder). Applying grapefruit seed extract nail drops and using GSE in liquid soap (instead of an antimicrobial soap which destroys both friendly and unfriendly bacteria) is one healthy approach to maintaining hand/nail hygiene. GSE antifungal foot powder, aside from its application for athlete's foot, can be used as a deodorizing powder and overall body powder even for infants (to alleviate diaper rash). As a facial cleanser two to three drops of grapefruit seed extract with water or mixed with your favorite natural facial cleanser provides added antiseptic benefits. GSE herbal spray such as Imhotep's Ouch and Itch spray has versatile antiseptic utility as a deodorant or as a relief aid for poison oak/ivy, bug bites, sunburn, razor burn and scratches. GSE herbal throat relief spray (a mixture of herbs and GSE) can be carried in your purse or travel bag to soothe those unexpected throat tickles that occur at the most inconvenient times. GSE feminine douche is a viable alternative to the chemically laden, perfumed commercial versions.

A quick caveat about deodorants; grapefruit seed extract is not an antiperspirant. Rather it kills the bacteria, the source of odor. It does not impede sweating. From a health perspective it is unhealthy to block lymph channels from perspiring toxins which the body is eliminating. The skin, the body's largest organ for elimination, must be encouraged to breathe and excrete poisons. Minimizing offensive odors is the goal here, not sacrificing one's health for social etiquette. The commercial marketing caption "never let them see you sweat" convinces the public to sacrifice health for ego's sake. Would you control incontinence by plugging the urethra to avoid embarrassment? Would you sew the rectum closed to avoid eliminating at an inconvenient time? Often confined in foxholes for days, even our special armed forces catheterize themselves during intervals to facilitate elimination-graphically gruesome comparisons but they are on target. Blocking sweat glands is reckless and dangerous.

If you travel routinely, consider including GSE drops or caps in your travel bag. Treat any drinking water with a few drops and use judiciously as a preventative measure against unwanted parasitic visitors that take refuge in your food entrees and beverages. This practice should ward off Montezuma's revenge or traveler's diarrhea. A pocket-size spray bottle filled with pure water, a few GSE drops, some lavender oil and tea tree oil (test for sensitivity) makes a quick and easy natural antiseptic hand cleaner when lavatory facilities aren't readily accessible.

Candida Companions:
A discourse on grapefruit seed extract would be incomplete without addressing its pivotal role in controlling Candida proliferation. As an opportunistic fungus, Candida albicans is quickly becoming a household word. Normally inhabiting the gastrointestinal tract, mouth and throat, its overgrowth is responsible for debilitating symptoms ranging from oral thrush to leaky gut syndrome with simultaneous compounding emotional symptoms including depression and mood swings. Leo Galland, M.D. notes a twofold benefit (tolerance and effectiveness) using GSE instead of conventional antifungals (nystatin, amphotericin).

Canadian naturopath, Dr. David Bayley, finds GSE simpler to regulate (dosages) than other anti-yeast compounds, without the unpleasant after taste-an asset for any age group. He notes both its efficacy and economic virtues make it a desirable product. Although grapefruit seed extract leaves no aftertaste, it is still "the taste you love to hate," according to Dr. William Kellas. To camouflage the acrid flavor, GSE can be mixed with juice. Undiluted, its bitter taste may leave you puckering for hours.

Jay Gordon, M.D., recommends a dilution ratio of five drops per four ounces of water as a baby bottom "wash" with each diaper change. Dr. Gordon uses a similar dilution for treating refractory diaper rashes and oral thrush in children.

Institutional application for grapefruit seed extract

Bathing facilities:
As an alternative to conventional toxic chemicals, GSE is an effective and safe alternative for use in humidifiers (a source of algae and molds that increases susceptibility to upper respiratory infections) and as a germicide and chlorine alternative in the laundry (chlorine bleach destroys most organisms). In South American swimming and bathing facilities (including hot tubs and Jacuzzi) GSE extract commonly replaces bactericides, algaecides and fungicides. Noxious chlorinated bubbles and skin irritation are bypassed when substituted with GSE. When water clarity is not a priority, GSE can substitute for the aforementioned chemicals by itself, otherwise a combination of the two (grapefruit seed extract and chlorine) can be used simultaneously, since clouded water turbidity lacks eye appeal.

Laundry sanitation:
As a sanitizing agent in hospitals, grapefruit seed extract is a premiere additive for hospital laundry, resulting in linens that are bacteria and fungi free. Laundry operations manager at The Florida Hospital, Jerry Skidmore, C.L.M., finds peace of mind knowing that after a 30-year residency in the laundry industry, he has full confidence in GSE's antibacterial/antifungal properties to maintain sanitary linens. Confidence in GSE's germicidal capabilities is expanding its horizons to include application in hospital carpet shampooing machines. Ten to 15 drops of GSE per gallon reservoir is sufficient to destroy commonly known hospital pathogens (staph, strep, salmonella and aspergillus).

Medical facilities:
It is timely for medical facilities to take advantage of this non-toxic antimicrobial in critical health care areas since nosocomial infections are increasingly prevalent. Operating rooms are using GSE at higher dilutions for disinfecting/sterilizing purposes. Clinics incorporate GSE in their inhalators as part of their protocol for modulating respiratory infections. No telling how rapid the list of applications will multiply over time for this innocuous, safe, environmentally-friendly germicide. Staff, patients and visitors all reap GSE's benefits by avoiding toxic chemicals in favor of a safe antimicrobial with both expansive and inexpensive application for use internally and externally. Additionally, GSE's efficacy is punctuated by showing no demonstrable resistance, in contrast to pharmaceutical antibiotics.

Future prospects for grapefruit seed extract:
The sisterhood of economics and politics mitigates expanding in vitro testing of GSE to include in vivo studies, particularly for viral testing. Whereas antiprotozoan (fungal and bacterial) testing has proven effective for GSE, quality testing for viral application is tedious, aside from its economical hindrances. On a positive note "Grapefruit Seed Extract Report" cites several viral related studies that could catapult GSE research into future limelight. Microbiology/virology and GSE researcher William Shannon, Ph.D., cites promising grapefruit seed extract effectiveness in deactivating herpes simplex virus l and influenza type A2 virus. A South American lab satisfactorily tested GSE against measles virus and the USDA determined that four animal viruses (avian influenza, swine vesicular disease, foot and mouth disease and African swine fever) succumbed to GSE's activity.

Despite the current absence of a large labor pool and matching monetary resources to fund GSE research, there is hope that GSE's innocuous yet potent antimicrobial and germicidal potential will elicit scientific interest. Public interest and consumer demand will drive the market to respond to our needs. Grapefruit seed extract researcher and associate professor Dr. Roger Wyatt points to grapefruit seed extract's promising future as a subject to be researched for a fundamental reason: "The lack of toxicological properties of grapefruit seed extract is also impressive when one views the efficacy data . . . extremely small concentrations of the product can be used with marked beneficial results." Given the impressive status and safety report, GSE's versatility could readily become a household and commercial standard ingredient. Its inherent selling features appeal to a wide audience-it is safe, non-toxic, environmentally friendly, and it has broad spectrum anti- microbial and germicidal properties. Economics may be limiting it's research, but not it's availability nor it's utility in an era when the urgency for safe, efficacious germ inhibitors are at an all-time high.

Grapefruit seed extract should be handled cautiously at full strength. Avoid contact with eyes and skin. Avoid breathing vapors. Wash skin with water should GSE come in contact with skin directly. Bio/chem labs (manufacturers of Citricidal) notes this natural extractive is listed as GRAS (generally recognized as safe) and has been tested in both human and animals. It is recognized as non-toxic and at dilutions up to two percent considered non-irritating. It is also non-corrosive. Always test a product for allergenicity and sensitivity.

Applications and Dilutions for Grapefruit Seed Extract

  • Water pik: 3-4 drops GSE per reservoir.
  • Oral rinse: 3 drops per 5 ounces of water.
  • Toothbrush: l drop with or without toothpaste.
  • Facial cleanser: 2-3 drops applied to fingertips and massaged onto a pre-moistened face.
  • Skin disorders: 5-10 drops GSE mixed with l tablespoon of water applied to affected areas (athlete's foot, insect bites, skin irritations).
  • Nasal rinse: l drop per 1-2 ounces of water. Spray into nostrils with head upright, using eye dropper or nasal sprayer.
  • Dish/utensil sanitizer: 15-30 drops added to a sink of dishwashing water or to dishwasher.
  • Laundry sanitizer: 10 drops per small load, 15 drops per large load. (Best results obtained when used in final rinse.)
  • Traveler's diarrhea: 3-4 drops per 5 ounces of water taken daily as a preventative.
  • Toothbrush sanitizer: 5-10 drops per glass of water. (Soak tooth brush a minimum of 10 minutes.)
  • Sore throat: 3 drops GSE stirred into 5 ounces of water.(Use as a gargle.)
  • Douche: 1-3 drops per 6-8 ounces of water. Douche once a day for one week.
  • Scalp disorders (dandruff, etc.): 5-10 drops along with regular shampoo. (Massage into scalp. Leave it to set a few minutes. Rinse as usual.)
  • Produce/meat/poultry wash: 30 drops per sink full of cold water. (Or spray wash [10 drops GSE per 32-ounce spray bottle] vegetables, fruits, poultry and meats to extend shelf life.)
  • Cutting board sanitizer: 10-20 drops GSE applied to board after washing using, a wet sponge. (Let it sit five minutes. Rinse or leave it on without rinsing. Effective against a wide variety of microorganisms including salmonella.)
  • All purpose disinfectant: 30-60 drops GSE per 32-ounce spray bottle mixed with water. (Use on sinks, commodes, countertops, fixtures, floors, in wastebaskets or any location that harbors or breeds germs.)

In her 1962 groundbreaking book Silent Spring, Rachel Carson wrote: “For the first time in the history of the world every human being is now subjected to contact with dangerous chemicals, from the moment of conception until death.” Of course humans have always been exposed to potentially harmful chemicals from plants and other sources, but Rachel Carson’s point is well taken. Modern living exposes all of us to an unprecedented number of chemicals on a daily basis. This includes environmental toxins such as heavy metals, pesticides, industrial compounds and chemical byproducts, medications, cosmetic additives, inorganic chemicals, etc. These chemical substances, which are foreign to the biological system, are referred to as “xenobiotics.” The good news is that the body was designed to detoxify and excrete xenobiotics. The bad news is our bodies may not always be equipped to handle the volume of modern environmental pollutants and toxic substances. This problem may be exacerbated by the fact that the refining of many of our foodstuffs has caused them to provide considerably less of the nutrients that are essential to the detoxification process.1,2

Ramifications of toxic overload
The ramifications of toxic overload can vary from one individual to another. One possible ramification is multiple chemical sensitivities (MCS). MCS is a condition in which a person experiences various symptoms in response to being exposed to certain types of chemicals, primarily (but not limited to) those of petroleum and coal-tar derivation. The possible symptoms are many and may include headaches, fatigue, depression and an overall feeling of malaise and being sick. MCS seems to develop after consistent, long-term exposure to certain chemicals at home or in the workplace. Eventually, the person develops intolerance to these chemicals, and starts suffering from MCS. For many MCS people, a sensitivity reaction will occur when exposed to even minute amounts of the offending chemicals, which in turn, can lead to severe symptoms characteristic of the MCS condition.3

Of course, an individual may suffer from toxic overload without having full-blown MCS. In fact, the most common symptom of toxic overload is probably fatigue. Other common symptoms include headache, muscle and joint pain, irritability, depression, mental confusion, gastrointestinal and/or cardiovascular irregularities, flu-like symptoms or allergic reactions including hives, stuffy or runny nose, sneezing and coughing.4,5

Furthermore, some researchers have suggested that toxic overload may contribute to autoimmune diseases including inflammatory and rheumatoid arthritis,6,7 and neurological diseases such as Alzheimer’s and Parkinson’s.8

How to deal with toxic overload
The question of how to deal with toxic overload has a multi-part answer, which includes adapting to a healthier diet and reducing exposure to xenobiotics. The books Multiple Chemical Sensitivity by Gibson (2000, New Harbinger Publications, Inc.) and Staying Well in a Toxic World by Lawson (1993, The Nobel Press) provide good direction on how to do this. In addition there are four herbal teas, which if used correctly, may do much to help support and promote the body’s natural detoxification process. These teas include ginger root (rhizome), green tea, dandelion root and senna. Following is a discussion about the role that each of these herbal teas can play, including a subsequent explanation of how to use them as part of a detox program.

Circulation and ginger
Healthy circulation is of vital importance to an effective detoxification process.9 The fundamental reason for this is that toxins and metabolic wastes are flushed out of tissues and into circulation so they can be detoxified.10 If circulation is sluggish and toxins move more slowly through it, however, this may result in undesirable symptoms such as headache and fatigue.11

The root or rhizome (enlarged underground stem) of ginger (Zingiber officinale) is an herbal medicine that is valuable for the treatment of multiple problems, especially nausea. In fact, ginger has been reported to be effective in treating the nausea of seasickness, morning sickness and chemotherapy-induced nausea.12 Ginger is also a traditional carminative (gas relieving) herb,13 and has anti-inflammatory properties.14

For the purposes of detoxification, ginger is valuable since it promotes circulation, and has long been used for this purpose in Traditional Chinese Medicine. In fact, the most famous traditional medicinal practice of ginger is to promote the blood circulation for removing blood stasis and the mechanism is related to anti-platelet aggregation activity. In addition, ginger has a stimulatory action on heart muscle promoting circulation throughout the body. That increased circulation is thought to stimulate cellular metabolic activity.15,16

Liver detoxification pathways and green tea
Water-soluble toxins can pass through our bodies unchanged and be eliminated in the stool, sweat or urine. Fat-soluble toxins, however, cannot be excreted without undergoing metabolic transformation (detoxification) in the liver so that they can become water-soluble. Liver cells have sophisticated mechanisms to break down toxic substances. These include both endogenous (produced by the body) and exogenous (obtained from the environment; i.e., xenobiotics) substances. Every drug, chemical, pesticide and hormone, is broken down or metabolized via detoxification pathways in the liver called “phase 1” and “phase 2.” 17,18,19 During phase 1, a “functional group” is removed from the toxic molecule,20,21 and during phase 2 a water-soluble substance is coupled (attaching) or conjugated to the toxin. This makes the toxic molecule more water-soluble and therefore less toxic. If the molecule is large, it is then excreted via the bile. Otherwise, it is excreted in the urine.22,23

Green, Oolong and black tea are all made from the leaves of the same plant species, Camellia sinensis. Green tea, the world’s second most popular beverage after water, is perhaps best known for its antioxidant and thermogenic properties. It is the polyphenols in green tea, specifically the catechin polyphenols, which gives it biological and medicinal qualities.24

In fact, green tea polyphenols increase both phase 1 and phase 2 activities.25 Research shows that green tea may have liver protective properties.26,27,28,29 In addition, Green tea has been shown to block chromosomal (DNA) damage from chemicals in cigarette smoke.30 Perhaps not surprisingly, green tea polyphenols are associated with a reduced risk of certain cancers in humans.31 Other research has also shown an anticancer effect from these polyphenols,32 including an inhibition of metastasis in skin cancer cells.33 In short, the use of green tea helps improve phase 1 and 2 liver detoxification pathways.

Bile flow and dandelion root
Bile is a digestive aid for fats, produced by the liver and transported to the gallbladder where it is concentrated. It then passes through the common bile duct into the intestines where it helps digest fat.34 From the standpoint of detoxification, bile also has a function as previously stated: it serves as a vehicle for disposing of toxic molecules that are too large for disposal via urine.35,36 Essentially, those toxins just hitch a ride until they reach the intestines where they can ultimately be excreted.

Dandelion root (Taraxacum officinale) is a traditionally used liver herb that has been shown to help stimulate bile production and promote its flow.37,38 This supports the aforementioned detoxification process via the bile duct, promoting the elimination of wastes.39 In fact, Germany and other official European health agencies have approved the use of Dandelion root for disturbances in bile flow, and restoration of hepatic and biliary function.40

Intestinal waste elimination and senna
It is well understood that waste is excreted from the intestines or, more specifically, the colon. During this process, bile that was secreted into the intestines is also excreted. Since that bile also contains some toxins that hitched a ride, it makes sense to make sure that it does not linger for too long in the gut, otherwise some of the toxins may be re-absorbed (clearly not a good thing). Constipation is the most obvious cause of waste lingering too long in the gut.

Senna leaf (Senna alexandrina) is used extensively as a natural laxative, and has been shown in research to be effective for this purpose and for reducing constipation.41,42,43,44 Furthermore, when used appropriately on a short-term basis, senna has been shown to have a good safety profile.45,46 Sennosides, the active compounds in senna, are not absorbed, but instead are activated by bacterial enzymes in the colon.47 The result is that senna exerts its laxative effect by inducing fluid secretion, which increases colonic motility and colonic transit.48 In some instances, senna can cause abdominal pain and discomfort, cramps, and diarrhea;49,50 so it is important not to exceed recommended doses.

Directions on how to use the teas
Following are directions on how to use the herbal teas discussed in this article. First, make sure to use only organic teas since there is no point in adding additional toxins to the body in the form of pesticides that may have otherwise been sprayed on non-organic herbs. Second, assume that all of the teas should be made by adding one tea bag in a cup and adding eight ounces of boiling water. The steep time and number of servings will differ depending upon the herb (as indicated below):

As long as you steep the teas according to the times indicated, it is acceptable to consume them hot or cold (as iced tea). If you like, you can even mix the brewed ginger root, Green tea and dandelion root (but not the senna) into a single beverage to make it easier to drink. In either case, it will probably be more convenient for you to brew all of the tea for the day in the morning, rather than having to brew it at three different times during the day (unless you’d like to do it that way). In the case of senna, it would be best to brew and consume the single serving in the evening before bedtime.

These herbal teas can be used to support detoxification for as little as two weeks or for up to one month. A twice annual “Spring and Fall cleaning” is recommended.

Other considerations
The herbal teas discussed in this article are certainly not the only natural products capable of supporting and facilitating the detoxification process. Compounds from citrus fruit and the Brassica or cruciferous group of vegetables (e.g., cabbage, Brussels sprouts, broccoli, etc.), as well as the dietary supplement alpha lipoic acid are some examples of other effective detoxifying agents.51 Nevertheless, the teas discussed in this article can be effective adjuncts to a program for detoxification.

In addition, it would make good sense to eat a diet high in fruit and vegetables, drink plenty of liquids and get at least 25 grams of fiber per day to support overall detoxification. Finally, it should be noted that the use of these teas as part of a detoxification program are meant to be used for general health and wellness purposes. If you have a serious health condition, you should seek the help of a healthcare professional who is knowledgeable about the process before starting a detoxification program.

References:

  1. Rogers SA. Chemical Sensitivity: Breaking the Paralyzing Paradigm. Internal Medicine World Report 1992; February 1-14:15-16.
  2. Rogers SA. Chemical Sensitivity: Breaking the Paralyzing Paradigm. Internal Medicine World Report 1992; March 15-31: 8-31.
  3. Lawson L. Staying Well in a Toxic World. Chicago: The Nobel Press, Inc.; 1993.
  4. Lawson L. Staying Well in a Toxic World. Chicago: The Nobel Press, Inc.; 1993.
  5. Gibson PR. Multiple Chemical Sensitivity. Oakland, California: New Harbinger Publications, Inc.; 2000.
  6. Rooney PJ, Jenkins RT, Buchanan WW. A short review of the relationship between intestinal permeability and inflammatory joint disease. Clinical and Experimental Rheumatology 1990; 8(1):75–83.
  7. Smith MD, Gibson RA, Brooks PM. Abnormal bowel permeability in ankylosing spondylitis and rheumatoid arthritis. Journal of Rheumatology 1985; 12(2):299–305.
  8. Steventon, GB, Heafield MT, Sturman S, Waring RH, Williams AC. Xenobiotic metabolism in Alzheimer’s disease. Neurology, 1990;40(7):1095–8.
  9. Hyman M. Systems Biology, Toxins, Obesity, and Functional Medicine. Proceedings from the 13th International Symposium of The Institute for Functional Medicine. 2006:S134–9.
  10. Posadzki P, Smith TO, Lizis P. Lomi Lomi as a massage with movements: A conceptual synthesis? Altern Ther. 2009;15(6):44–9.
  11. Roundtree R. A functional approach to environmental toxins. Alternat Complement Ther. 2009;15(5):216–20.
  12. Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. British Journal of Anaesthesia 2000; 84(3):367–71.
  13. Blumenthal M, et al, (eds), The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications;1998:425–26.
  14. Srivastava KC, Mustafa T. Med Hypotheses. 1992;39(4):342–8.
  15. Ghosh AK. Zingiber officinale: a natural gold. IJPBS. 2011;2(1):283–94.
  16. Zadeh JB, Kor NM. Physiological and pharmaceutical effects of Ginger (Zingiber officinale Roscoe) as a valuable medicinal plant. Eur J Exp Biol. 2014;4(1):87–90.
  17. Murray Rk, Granner DK, Mayes PA, Rodwell VW. Harper’s Biochemistry, 25th ed. New York: McGraw Hill; 1999:780–6.
  18. Lüllmann H. Mohr K, Ziegler A, Bieger D. Color Atlas of Pharmacology, 2nd ed. Stuttgart: Thieme; 2000:32–9.
  19. Roundtree R. The Use of Phytochemicals in the Biotransformation and Elimination of Environmental Toxins. IN Medicines from the Earth 2003: Official Proceedings. Brevard, North Carolina: Gaia Herbal Research Institute;2003:115–128.
  20. Murray Rk, Granner DK, Mayes PA, Rodwell VW. Harper’s Biochemistry, 25th ed. New York: McGraw Hill; 200:780–6.
  21. Lüllmann H. Mohr K, Ziegler A, Bieger D. Color Atlas of Pharmacology, 2nd ed. Stuttgart: Thieme; 2000:32–9.
  22. Murray Rk, Granner DK, Mayes PA, Rodwell VW. Harper’s Biochemistry, 25th ed. New York: McGraw Hill; 200:780–6.
  23. Lüllmann H. Mohr K, Ziegler A, Bieger D. Color Atlas of Pharmacology, 2nd ed. Stuttgart: Thieme; 2000:32–9.
  24. Graham HN. Green tea composition, consumption, and polyphenol chemistry. Prev Med 1992;21:334–50.
  25. Stoner GD, Mukhtar H. Polyphenols as cancer chemopreventive agents. J Cell Biochem Suppl 1995; 22:169–80.
  26. Presser A. Pharmacist’s Guide to Medicinal Herbs. Petaluma, California: Smart Publications; 2000.
  27. Kuhn MA, Winston D. Herbal Therapy & Supplements: A Scientific & Traditional Approach. Philadelphia:Lippincott; 2000.
  28. Mills S, Bone K. Principles and Practice of Phytotherapy: Edinburgh;Churchill Livingstone; 2000.
  29. Blumenthal M, Goldberg A, Brinckmann J (eds). Herbal Medicine: Expanded Commission E Monographs: Newton, Massachusetts;Integrative Medicine Communications; 2000.
  30. Shim JS, Kang MH, Kim YH, Roh JK, Roberts C, Lee IP. Chemopreventive effect of green tea (Camellia sinensis) amonth cigarette smokers. Cancer Epidemiol Biomakers Prev 1995; 4(4):387–91.
  31. Mukhtar H, Ahmad N. Green tea in chemoprevention of cancer. Toxicol Sci 1999;52(2 Suppl):111–7.
  32. Suganuma M, Okabe S, Sueoka N, et al. Green tea and cancer chemoprevention. Mutat Res 1999;428:339–44.
  33. Menon LG, Kuttan R, Kuttan G. Anti-metastatic activity of curcumin and catechin. Cancer Lett 1999;141:159–65.
  34. Afdhal NH. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011.
  35. Murray Rk, Granner DK, Mayes PA, Rodwell VW. Harper’s Biochemistry, 25th ed. New York: McGraw Hill; 2000:780-786.
  36. Lüllmann H. Mohr K, Ziegler A, Bieger D. Color Atlas of Pharmacology, 2nd ed. Stuttgart: Thieme; 2000:32–9.
  37. Vogel G. Natural substances with effects on the liver. In: Wagner H, Wolff P (eds). New Natural Products and Plant Drugs with Pharmacological, Biological or Therapeutic Activity. Heidelberg: Springer-Verlag; 1977.
  38. Tierra M. International Journal of Alternative and Complementary Medicine. 1997; February:23–5.
  39. Salmond S. Australian Journal of Medical Herbalism. 1997;9(1):14–8.
  40. Blumenthal M, Goldberg A, Brinckman J (eds). Herbal Medicine: Expanded Commission E Monographs. Newton, Massachusetts: Integrative Medicine Communications; 2000:78–83.
  41. Godding EW. Laxatives and the special role of senna. Pharmacology 1988;36:230–6.
  42. Ramesh PR, Kumar KS, Rajagopal MR, et al. Managing morphine-induced constipation: a controlled comparison of an Ayurvedic formulation and senna. J Pain Symptom Manage 1998;16:240–4.
  43. Shelton MG. Standardized senna in the management of constipation in the puerperium: A clinical trial. S Afr Med J 1980;57:78-80.
  44. MacLennan WJ, Pooler AFWM. A comparison of sodium picosulphate (“Laxoberal”) with standardised senna (“Senokot”) in geriatric patients. Curr Med Res Opin. 1974;2:641–7.
  45. Godding EW. Laxatives and the special role of senna. Pharmacology 1988;36:230–6.
  46. Arezzo A. Prospective randomized trial comparing bowel cleaning preparations for colonoscopy. Surg Laparosc Endosc Percutan Tech. 2000;10:215–7.
  47. Godding EW. Laxatives and the special role of senna. Pharmacology 1988;36:230–6.
  48. Ewe K, Ueberschaer B, Press AG. Influence of senna, fibre, and fibre + senna on colonic transit in loperamide-induced constipation. Pharmacology 1993;47:242–8.
  49. Langmead L, Rampton DS. Review article: herbal treatment in gastrointestinal and liver disease--benefits and dangers. Aliment Pharmacol Ther 2001;15:1239–52.
  50. Sondheimer JM, Gervaise EP. Lubricant versus laxative in the treatment of chronic functional constipation of children: a comparative study. J Pediatr Gastroenterol Nutr 1982;1:223–6.
  51. Roundtree R. The Use of Phytochemicals in the Biotransformation and Elimination of Environmental Toxins. IN Medicines from the Earth 2003: Official Proceedings. Brevard, North Carolina: Gaia Herbal Research Institute; 2003:115–28.

Kathleen Barnes’ (LINK: www.kathleenbarnes.com) most recent book, Food Is Medicine: 101 Prescriptions from the Garden, is a comprehensive guide to the healing power of food, much of which you can grow in your own garden or buy at your local farmers market. Barnes offers food-based solutions to 101 health problems-ranging from the simplest—cuts and bruises, acne, insect bites or splitting nails—to the complex and serious ones, like diabetes, heart disease and cancer and dozens that fall in between.

Her early experience in the natural health movement began in the early ‘70s when, just out of college, Barnes’ friends and family thought she was “a little wacky” when she started talking about natural healing.

They asked:

  • Why brew a cup of sage tea when it was easier to take a swig of sugar- and drug-laden cough medicine?
  • Why wrap an infected cut with chewed wood sorrel rather than slapping on a little triple antibiotic from a tube?
  • Why chew a few fennel seeds or drink a cup of peppermint tea rather than take a Tums?
  • Why compost kitchen scraps when it is so easy to buy a bag of compost at the big-box garden center?
  • Why slave away under a hot sun, watering and weeding and battling bugs and blights, when a juicy tomato was as close as the local supermarket?

Why? Because all of these remedies and a simple lifestyle contribute to health and longevity, she told friends and family and anyone who would listen. Even when Barnes was in her twenties, health and longevity were her goals. More than 40 years later, they still are.

And, happily, in 2015, millions more have joined her “wacky” ways. Today, natural remedies are found on every drugstore shelf. Even the smallest of towns, like Barnes’ beloved mountain town of Brevard, NC, have thriving farmers’ markets, health food stores and cooperative gardens. Today, most of us are aware that eating five or more servings of fruits and vegetables daily can prevent and even treat a host of diseases and illnesses. More and more of us are becoming aware of the importance of eating fresh wholesome local food that can keep us healthy, prevent disease and extend our lives. Many of us are trying to save money by growing our own food. Some of us even know the secrets of treating ailments and illnesses with herbs, fruits and vegetables.

In this book, Barnes makes those secrets common knowledge. She shares the road to good health through the freshest of fruits and vegetables, what she has learned about health and healing with the right foods grown the right way.

While she realizes it is not realistic in our time-pressured modern world to expect her readers to grow every fruit and vegetable mentioned in Food Is Medicine, she opens the door to the secrets of healing with everyday foods available to everyone close to home.

Publisher: Take Charge Books, Brevard, North Carolina

Around the holidays, we are reminded of the most famous gifts in history, frankincense and myrrh, carried by the wise men. Today, perfumes, incense and candles are often infused with these two wonderful aromas. Both frankincense and myrrh have medicinal properties, so holistic practitioners suggest these for patients as dietary supplements and essential oils for various ailments. But what exactly is frankincense and myrrh?

They are both gummy resins that are tapped from the inner bark of two different trees that grow in the Arabian peninsula, Africa and India. A resin to a tree, is akin to a scab on our skin, so clearly, these resins are more protective to the shrub than plain sap.

I'll focus on frankincense right now which is rich in "boswellic acids," an ingredient that has strong anti-inflammatory benefits. While shopping, you may see it as "frankincense" or "boswellia" and it comes as a liquid extract taken orally, or capsules as well as essential oils which are used on the skin or in aromatizers.

Boswellia herb is always in my home. I will often buy the ingestible powder at my local apothecary, grind it in my coffee grinder for 5 seconds, and then encapsulate the finely ground powder. You can certainly buy commercially-prepared brands of this, you don't have to hand-create it like me!

Boswellia has been studied and found to prevent the growth of certain types of cancers in 'test tube' studies. In 2009, researchers examined AKBA or "acetyl-11-keto-beta-boswellic acid" and found positive benefits. This study was titled, Frankincense Superior to Chemotherapy in Killing Late-Stage Ovarian Cancer Cells. This is not the first study to suggest anti-cancer properties. The results of another study proved that frankincense oil could help with bladder cancer. The researchers concluded, "Frankincense oil might represent an alternative intravesical agent for bladder cancer treatment."

Now, it's time for myrrh which is another resin extracted from the Commiphora myrrha tree. Research confirms the presence of guggulsterones in myrrh which may help with cholesterol ratios, specifically by lowering LDL. Guggulsterones are blood thinners so be careful and don't combine with aspirin, NSAIDs, warfarin or other blood thinners. One more thing, pregnant women should avoid myrrh since it's a uterine stimulant.

The essential oil of myrrh is used topically to soothe your skin and help with gingivitis. So profound is myrrh's ability to heal damaged tissues, Greek soldiers carried it into battle with them to use for skin infections and gangrene. Myrrh is a strong anti-bacterial, anti parasitic and antifungal. Just like it's relative frankincense, myrrh also possesses strong anti-cancer properties. A Chinese test tube study published in 2013, found that "cycloartane-type triterpernoids" could destroy prostate cancer cells. Pretty impressive! In fact, just inhaling the scent of pure frankincense or myrrh can cause your brain and heart to respond favorably. Centuries may go by, but it's clear that frankincense and myrrh are still a wise gift of health.

Lemon balm (Melissa officinalis) is one of those herbal medicines that have been in use for thousands of years. Steeped in wine, lemon balm was used in ancient Greek and Roman cultures for various medicinal purposes, including the treatment of wounds and to treat venomous bites and stings.1 These same uses also occurred in traditional Indian medicine.2 Furthermore, old European medical herbals report its memory-improving properties.3 Modern uses tend to be more in the area of lemon balm’s calming effects, as well as its properties in soothing gastrointestinal complaints, although there has been some research in the area of cognitive function and antioxidant protection against radiation. This article will discuss the internal uses of lemon balm.

Calming Effects of Lemon Balm Anxiety disorders are common in many Western countries, and conventional drugs like benzodiazepines are often prescribed to relieve anxiety. However, these drugs have worrisome short-term and long-term side effects. Nervine herbs (herbs that quiet nervous excitement) have a long history of traditional use in relieving anxiety, insomnia, and mild depression. Case in point, lemon balm is often used as a mild mood elevator and calming herb in people with anxiety. It has been shown to improve attention and calmness in healthy volunteers,4 and reduce agitation in patients with mild to moderate Alzheimer’s disease (see discussion below under “Cognitive function”).5

In a double-blind, placebo-controlled, randomized, balanced-crossover study,6 18 healthy volunteers received two separate single doses of a standardized lemon balm extract (300 mg, 600 mg) and a placebo, on separate days separated by a 7-day washout period to assess laboratory-induced psychological stress. The results showed that the 600 mg dose improved the negative mood effects of the stress, with significantly increased self-ratings of calmness. In addition, a significant increase in the speed of mathematical processing, with no reduction in accuracy, was observed after ingestion of the 300 mg dose.

In Germany, lemon balm is licensed as a standard medicinal tea to help promote sleep. This is due to the fact that Germany’s Commission E (their version of the FDA for natural medicines) approved the use of lemon balm for nervous sleeping disorders.7 Likewise, ESCOP, the European Scientific Cooperative on Phytotherapy (an umbrella organization representing national herbal medicine or phytotherapy [aka, herbal medicine] associations across Europe), lists tenseness, restlessness and irritability among the uses for lemon balm.8 Furthermore, Health Canada has approved lemon balm for traditional use as an herbal medicine sleep aid (in cases of restlessness or insomnia due to mental stress).9 In addition, combining lemon balm with valerian root has also been shown to have benefit in sleep disorders. A combination of 80 mg lemon balm leaf extract and 160 mg valerian root extract three times daily improved the quality and quantity of sleep in healthy people,10 while the same dose once or twice daily decreased symptoms in children under age 12 years who have pathological restlessness.11

Soothing gastrointestinal complaints
As with its calming effects, in Germany lemon balm is also licensed as a standard medicinal tea for gastrointestinal tract disorders and approved by Commission E for functional gastrointestinal complaints.12 Similarly, ESCOP lists for symptomatic treatment of digestive disorders, such as minor spasms, among its internal uses.13 Also, Health Canada has approved lemon balm for traditional use as an herbal medicine to help relieve digestive disturbances, such as dyspepsia.14 The approved modern therapeutic applications for lemon balm are supportable based on its long history of use in well-established systems of traditional medicine, on phytochemical investigations, and on its documented pharmacological actions reported in in-vitro studies and in-vivo experiments in animals.15

Lemon balm has also been used in clinical research along with other herbs for soothing gastrointestinal complaints. In one study, breast-fed infants with colic who were given 97 mg lemon balm, 164 mg fennel and 178 mg German chamomile twice daily for a week had reduced crying times compared to placebo.16 In another research, a 1 mL combination of lemon balm plus peppermint leaf, German chamomile, caraway, licorice, clown’s mustard plant, celandine, angelica, and milk thistle given orally three times daily over a period of four weeks to people with dyspepsia (i.e. indigestion) significantly reduced severity of acid reflux, epigastric pain, cramping, nausea, and vomiting compared to placebo.17

Cognitive function
Some laboratory research has shown that lemon balm has cholinergic-binding properties, which means that it may have some of the cognitive and memory promoting effects of the neurotransmitter acetylcholine. To test this hypothesis, a randomized, placebo-controlled, double-blind, balanced-crossover study18 was conducted to investigate the effects of lemon balm on cognition and mood in 20 healthy, young participants. Single doses of 300, 600 and 900 mg of lemon balm extract (or matching placebo) were used at 7-day intervals. Cognitive performance was assessed immediately prior to dosing and at 1, 2.5, 4 and 6 hours thereafter. Results demonstrated improvements in cognitive function, as well as “calmness” at the earliest time points by the lowest dose, while “alertness” was significantly reduced at all time points following the highest dose. Overall, these results suggest that low doses of lemon balm may enhance calmness and high doses may have a mild sedative effect. A follow-up study showed essentially the same results.19

In addition, a 4-month, parallel group, placebo-controlled trial20 was undertaken to assess the efficacy and safety of lemon balm extract (60 drops/day) in 42 patients with mild to moderate Alzheimer’s disease. The results were that lemon balm extract produced a significantly better outcome on cognitive function than placebo, and those using lemon balm had significantly less agitation than those in the placebo group.

Antioxidant protection against radiation
Radiology staffs are exposed to persistent low-dose radiation during work. Consequently, a study21 was conducted to determine the capability of lemon balm tea to improve oxidative stress status in 55 radiology staff members. They were asked to drink lemon balm tea (made from a tea bag with 1.5g lemon balm leaf) for 30 days. Results showed that the lemon balm tea resulted in significant improvements in plasma levels of the antioxidant enzymes catalase, superoxide dismutase, and glutathione peroxidase. It also promoted a marked reduction in plasma DNA damage and lipid peroxidation. The researchers concluded that lemon balm tea markedly improved oxidative stress condition and DNA damage in radiology staff.

Dosage forms
Lemon balm can be used in the following dosage forms, using the following dosages:

Form

Dosage

Brewed herbal tea:

1.5g lemon balm leaf, 1 - 3 times per day1

Fluid extract:

2 - 4g dried equivalent, 1 - 3 times per day (1:1, 45% ethanol, 2 - 4 ml or 60 drops)2,3

Tincture:

0.4 - 1.2g dried equivalent, 1 - 3 times per day (1:5, 45% ethanol, 2 - 6 ml)4

Standardized extract:

80 - 97mg in combination with other herbs (as previously described)5,6,7,8

In the case of its use as a calming agent as well as its properties in treating gastrointestinal complaints, administering lemon balm as a brewed herb offers the additional benefit of delivering the herb as a warm beverage, adding to its soothing qualities

    References:
  1. Blumenthal M (ed) et al. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: Integrative Medicine Communications; 2000:230–2.
  2. Nadkarni KM. Indian Materia Medica. Bombay: Popular Prakashan; 1976:786.
  3. Blumenthal M (ed) et al. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: Integrative Medicine Communications; 2000:230–2.
  4. Abascal K, Yarnell E. Nervine herbs for treating anxiety Altern Compliment Ther. 2004 December:309–15.
  5. Akhondzadeh S, Noroozian M, Mohammadi M, Ohadinia S, Jamshidi AH, Khani M. Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: a double blind, randomized, placebo controlled trial. J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):863–6.
  6. Kennedy DO, Little W, Scholey AB. Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (Lemon Balm). Psychosom Med. 2004 Jul-Aug;66(4):607–13.
  7. Blumenthal M (ed) et al. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: Integrative Medicine Communications; 2000:230–2.
  8. ESCOP. Melissae folium. Monographs on the Medicinal Uses of Plant Drugs. Exeter, U.K. European Scientific Cooperative on Phytotherapy;1997.
  9. Monograph: Lemon Balm. Health Canada. Date Modified: 2008-3-17. Retrieved February 11, 2014 from http://webprod.hc-sc.gc.ca/nhpidbdipsn/monoReq.do?id=125&lang=eng.
  10. Cerny A, Shmid K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers (a double blind, placebo-controlled, multicentre study). Fitoterapia 1999;70:221–8.
  11. Muller SF, Klement S. A combination of valerian and lemon balm is effective in the treatment of restlessness and dyssomnia in children. Phytomedicine 2006;13:383–7.
  12. Blumenthal M (ed) et al. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: Integrative Medicine Communications; 2000:230–2.
  13. ESCOP. Melissae folium. Monographs on the Medicinal Uses of Plant Drugs. Exeter, U.K. European Scientific Cooperative on Phytotherapy;1997.
  14. Monograph: Lemon Balm. Health Canada. Date Modified: 2008-03-17. Retrieved February 11, 2014 from http://webprod.hc-sc.gc.ca/nhpidbdipsn/monoReq.do?id=125&lang=eng.
  15. Blumenthal M (ed) et al. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: Integrative Medicine Communications; 2000:230–2.
  16. Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breast-fed colicky infants. Phytother Res 2005;19:335-40.
  17. Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87.
  18. Kennedy DO, Scholey AB, Tildesley NT, Perry EK, Wesnes KA. Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). Pharmacol Biochem Behav. 2002 Jul;72(4):953–64.
  19. Kennedy DO, Wake G, Savelev S, Tildesley NT, Perry EK, Wesnes KA, Scholey AB. Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (Lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties. Neuropsychopharmacology. 2003 Oct;28(10):1871–81.
  20. Akhondzadeh S, Noroozian M, Mohammadi M, Ohadinia S, Jamshidi AH, Khani M. Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: a double-blind, randomized, placebocontrolled trial. J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):863-6.
  21. Zeraatpishe A, Oryan S, Bagheri MH, Pilevarian AA, Malekirad AA, Baeeri M, Abdollahi M. Effects of Melissa officinalis L. on oxidative status and DNA damage in subjects exposed to long-term low-dose ionizing radiation. Toxicol Ind Health. 2011 Apr;27(3):205–12.
  22. Monograph: Lemon Balm. Health Canada. Date Modified: 2008-03-17. Retrieved February 11, 2014 from http://webprod.hc-sc.gc.ca/nhpidbdipsn/monoReq.do?id=125&lang=eng.
  23. Monograph: Lemon Balm. Health Canada. Date Modified: 2008-03-17. Retrieved February 11, 2014 from http://webprod.hc-sc.gc.ca/nhpidbdipsn/monoReq.do?id=125&lang=eng.
  24. Akhondzadeh S, Noroozian M, Mohammadi M, Ohadinia S, Jamshidi AH, Khani M. Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: a double-blind, randomized, placebocontrolled trial. J Neurol Neurosurg Psychiatry. 2003 Jul;74(7):863–6.
  25. Monograph: Lemon Balm. Health Canada. Date Modified: 2008-03-17. Retrieved February 11, 2014 from http://webprod.hc-sc.gc.ca/nhpidbdipsn/monoReq.do?id=125&lang=eng.
  26. Cerny A, Shmid K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers (a double blind, placebo-controlled, multicentre study). Fitoterapia 1999;70:221–8.
  27. Muller SF, Klement S. A combination of valerian and lemon balm is effective in the treatment of restlessness and dyssomnia in children. Phytomedicine 2006;13:383–7.
  28. Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breast-fed colicky infants. Phytother Res 2005;19:335–40.
  29. Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279–87.

Cold, influenza (flu) and sinusitis are three common upper respiratory conditions that affect a great many people. Besides being upper respiratory infections, they also have in common that three herbs (Andrographis, Eleuthero and Echinacea) have been shown to be effective in their treatment. This article will discuss the research associated with these herbs on the aforementioned conditions. First, however, let's have a brief review of the conditions.

Cold, flu and sinusitis
Most people contract one or more colds every year. Viruses that infect cells of the upper respiratory tract cause a cold. Since there are over 200 different species and strains of these viruses, a cold caused by one virus does not protect a person from catching a cold caused by a different one. This explains why colds can occur one after another or several times a year.1

Influenza, or "flu," is a highly contagious viral respiratory infection. It is caused by orthomyxovirus types A, B, and C, which are spread by direct person-to-person contact or by airborne droplet spray. Flu generally occurs in the late fall and early winter and can reach epidemic proportions when a modified form of the virus emerges for which the population has no immunity. All age groups are susceptible, but the prevalence is highest in school-age children. Its clinical manifestations often resemble a severe form of the common cold.2

Sinusitis is a swelling of one or more nasal sinuses. It is caused by bacteria (streptococci, staphylococci, pneumococci, Haemophilus influenzae); viruses (rhinovirus, influenza virus, parainfluenza virus); and fungi (aspergilli, Dematiaceae, Mucoraceae, Penicillium sp.). Onset frequently occurs after an acute respiratory infection but may also be triggered by a dental procedure or gum infection, allergic rhinitis, diving or swimming episode, or sudden drop in temperature.3

Andrographis paniculata
Andrographis has a history of use in both Ayurvedic and traditional Chinese medicine.4 It contains a number of bitter constituents, which appear to have both immune-stimulating and anti-inflammatory activity.5 Double-blind studies have found that Andrographis may help reduce the severity of symptoms in individuals suffering from the common cold.6,7,8,9

Eleutherococcus senticosus
In the very recent past, Eleuthero was commonly called "Siberian Ginseng." Although this name was botanically incorrect since Eleuthero is not even in the same genus (plant family) as Panax ginseng, it was an understandable appellation since many of its functions were the same. For example, like Panax, Eleuthero shows excellent adaptogenic activity (an adaptogen is an agent that helps the body adapt to stress). Russian explorers, divers, sailors, and miners also used Eleuthero to prevent stress-related illness.10 In addition, evidence also suggests that Eleuthero may prove valuable in the long-term management of various diseases of the immune system, including HIV infection and chronic fatigue syndrome.11 Referred to as ci wu jia in Chinese medicine, it was used to prevent respiratory tract infections, colds and flu.

Echinacea purpurea
Echinacea is an immune stimulant/supporter, and is excellent in the prevention and treatment of colds and influenza. Research suggests that Echinacea supports the immune system by activating white blood cells (lymphocytes and macrophages).12 In addition, Echinacea appears to increase the production of interferon, which is important to the immune response of viral infections.13 In any case, a number of double-blind, clinical studies have confirmed Echinacea's effectiveness in treating colds and flu.14,15,16,17,18 However, some research suggests that Echinacea may be more effective if used at the onset of these conditions.19,20

Besides colds and flu, Germany's Commission E Monographs (an internationally authoritative source of credible information on the use of herbs for various disorders) indicates that among Echinacea's uses, this herb can be used to treat chronic infections of the respiratory tract.21

Combining the herbs
Now that we've briefly reviewed what each of these herbs can do individually with regard to upper respiratory infections, let's see what some of them can do when combined together.

Treating the Flu: Andrographis & Eleuthero
In two randomized, parallel-group clinical studies22, patients diagnosed with influenza (540 patients and 66 patients, respectively) were treated with a combination of Andrographis and Eleuthero, or nothing at all (in the control group). In both studies, the differences in the duration of sick leave (7.2 days vs. 9.8 days in the control group) and frequency of post-influenza complications indicated that the Andrographis/Eleuthero combination contributed to quicker recovery and reduced the risk of post-influenza complications. The results showed that in Andrographis/Eleuthero-treated patients the symptoms had become less pronounced and the temperature had returned more rapidly to normal values, and symptoms such as headache, muscle pain, and conjunctivitis disappeared sooner than in patients of the control group.

Treating the Common Cold & More: Andrographis & Eleuthero
Two randomized double-blind, placebo-controlled parallel group clinical trials were performed to investigate the effect of an Andrographis/Eleuthero combination in the treatment of uncomplicated upper-respiratory tract infections. This includes common cold, rhinitis, nasopharyngitis (Inflammation of the nasal passages and of upper sore throat) and pharyngitis (sore throat). There were 46 patients in one study, and 179 patients in another. In both studies, the total symptom score and total diagnosis score showed highly significant improvement in the Andrographis/Eleuthero group as compared with the placebo. Throat symptoms/signs, were found to show the most significant improvement. There was a 55 percent better improvement in the symptom score for the treatment group as compared with the placebo group.

Treating Upper Respiratory Infections & Sinusitis Andrographis & Eleuthero
A double blind, placebo-controlled, parallel-group clinical study was carried out to evaluate the effect of an Andrographis/Eleuthero combination in the treatment of acute upper respiratory tract infections, including sinusitis. Ninety-five individuals in the treatment group and 90 individuals in the placebo group completed the study according to the protocol. Temperature, headache, muscle aches, throat symptoms, cough, nasal symptoms, general malaise and eye symptoms were taken as outcome measures with given scores. The total score analysis showed a highly significant improvement in the Andrographis/Eleuthero combination group versus the placebo. The individual symptoms of headache and nasal and throat symptoms together with general malaise showed the most significant improvement while cough and eye symptoms did not differ significantly between the groups. Temperature was moderately reduced in the Andrographis/Eleuthero combination group. The authors of the study concluded that the Andrographis/Eleuthero combination had a positive effect in the treatment of acute upper respiratory tract infections and also relieved the inflammatory symptoms of sinusitis.

Treating the Common Cold: Andrographis & Eleuthero, and Echinacea
In this study, treatment with an Andrographis/Eleuthero combination was compared to treatment with an Echinacea purpurea extract, both together with a standard treatment for the common cold in 130 children aged between 4 and 11 years over a period of 10 days. The patients were assigned to one of the three groups. In the control group, 39 patients received only standard treatment. It was found that the treatment with the Andrographis/Eleuthero combination was significantly more effective than treatment with Echinacea when started at an early stage of uncomplicated common colds. The cold symptoms were less severe in the Andrographis/Eleuthero group, with benefits particularly pronounced in the amount of nasal secretion and congestion. Although Echinacea was not as effective as the Andrographis/Eleuthero combination in this study, it was still more effective than standard treatment alone.

Conclusions
Individually or in combination, Andrographis, Eleuthero and Echinacea have significant potential for treating upper respiratory infections, including colds, flu and sinusitis. For an acute infection, doses in the range of 340 mg Andrographis paniculata extract (providing 21 mg andrographolide and deoxyandrographolide), 39 mg Eleuthero extract (providing 2 percent total Eleutheroside B and Eleutheroside E) and 800 mg Echinacea purpurea herb extract, three times daily, will likely yield good results.

References

  1. Bruno G. Ailments & Natural Remedies. NewYork: Fifty-Ninth Street Bridge Publishing Corp.; 2001:75.
  2. Bruno G. Ailments & Natural Remedies. New York: Fifty-Ninth Street Bridge Publishing Corp.; 2001:103.
  3. Bruno G. Ailments & Natural Remedies. New York: Fifty-Ninth Street Bridge Publishing Corp.; 2001:195.
  4. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs: Monographs for the Western Herbal Practitioner. Queensland, Australia: Phytotherapy Press; 1996:96-100.
  5. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs: Monographs for the Western Herbal Practitioner. Queensland, Australia: Phytotherapy Press; 1996:96-100.
  6. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. J Med Assoc Thai 1991;74:437-42.
  7. Melchior J, Palm S, Wikman G. Controlled clinical study of standardized Andrographis paniculata extract in common cold-a pilot trial. Phytomedicine 1996;3:314-8.
  8. Hancke J, Burgos R, Caceres D, Wikman G. A double-blind study with a new monodrug Kan Jang: Decrease of symptoms and improvement in recovery from common colds. Phytother Res 1995;9:559-62.
  9. Cáceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine 1999;6:217-23.

Many physicians routinely prescribe hormone replacement therapy (HRT) to postmenopausal or even perimenopausal women. As a matter of fact, about 17.5 million American women were taking HRT in 1998, according to a national survey. HRT, however, is not without its health risks. Before discussing HRT risks and alternatives, let's first examine the rationale for HRT in association with menopause.

Menopause: Physiological Changes
Menopause refers to the stopping of menstruation and the end of the reproductive capacity of a woman. This event usually occurs around age 50 but may happen prematurely in some individuals before age 45 or artificially by the removal of the ovaries during a hysterectomy. As many as ten years before menopause, the ovaries begin to cease normal function. During this time, many basic physiological changes occur, including failure to ovulate; a decreased number of developing follicles and oocytes; a decreased level of the hormones estrogen and progesterone; and a rapid rise in follicle stimulating hormone (FSH), a pituitary hormone, as well as a gradual rise in luteinizing hormone (LH). These ovarian changes eventually result in the cessation of menstruation (amenorrhea) and infertility. In the years before menopause a woman may have irregular uterine bleeding, heavy enough in some instances to produce anemia. Postmenopausal bleeding indicates a need for immediate medical attention, because the incidence of uterine or cervical cancer after menopause ranges from 15 to 30 percent of women.

Menopause: Symptomology
Most symptoms that occur during menopause result directly from the estrogen deficiency produced by the failing ovaries. It can be difficult to distinguish these symptoms from those caused by the normal aging process or from the social and domestic pressures faced by middle-aged women. Physical symptoms include hot flashes, night sweating, and tension or migraine headaches. These temporary symptoms contribute to the overall irritability and insomnia that normally occurs during this time. Osteoporosis, caused by severe or prolonged bone loss as a result of estrogen deficiency, affects 35 percent of women after a natural menopause. Psychological symptoms of menopause may include anxiety, depression, irritability, diminished energy, difficulty with concentration, and tension. Many women experience heightened libido after menopause because they know they can no longer get pregnant. However, emotional problems can cause a decline in sexual activity in some women.

The Benefits of HRT
Conventional medical treatment for menopause often involves HRT pharmaceutical hormones. It has been well documented for several decades that HRT can be an effective remedy for the hot flashes and sleep disturbances that often accompany menopause. Hormone replacement therapy has also consistently been shown to decrease vaginal discomfort by increasing the thickness, elasticity, and lubricating ability of vaginal tissue. Urinary tract tissue also becomes thicker and more elastic, which may reduce the incidence of stress incontinence and urinary tract infections. Furthermore, some physicians and medical agencies have advised that HRT may even decrease the risk for heart disease in postmenopausal women. These potential benefits of HRT are all well and good-and if this were the end of the story, I wouldn't have written this article. Unfortunately, there are health risks associated with HRT.

The Risks of HRT
Heretofore, the main concerns about HRT centered on the risk of endometrial cancer, ovarian cancer, and breast cancer, especially after long-term use (more than 10 years).1 For example, some studies suggest that HRT is associated with a one to 30 percent increase in the risk of breast cancer.2 Another study conducted by the American Cancer Society followed 211,581 postmenopausal women who had no history of cancer at the time of enrollment. Results of follow-up from 1982 through 1996 showed that women who used HRT for 10 or more years had an increased risk of dying from ovarian cancer, compared with women who had never used HRT or had used it for less than 10 years.3

Recently, another potential risk issue regarding HRT and cardiovascular health has emerged. New recommendations by the American Heart Association, released on July 23, 2001, indicate that women who have had a heart attack or stroke do not benefit from HRT and may even increase their risk of suffering another attack.

This is based upon research where researchers randomly assigned women with known heart disease to take either hormones or a placebo. The researchers found no difference between the two groups in fatal or nonfatal heart attacks after four years. In the first year of the study, women taking hormones had 52 percent more heart-related illnesses than the placebo group. Then, a separate study testing estrogen in women with a previous stroke found that those who took the hormone suffered a higher incidence of fatal strokes than those who took a placebo.4

This new AHA position removes one of the main reasons many women take hormones-to reduce their risk of heart disease, which kills more than 226,000 American women a year, making it the number one cause of death in U.S. women.

Finally, a landmark study was published in the July 2002 issue of JAMA, which included 16608 postmenopausal women aged 50-79 who were using HRT as Estrogen plus progestin. The researchers found a significantly increased risk of a heart attack or stroke beginning in women's first year of HRT use. In addition, the risk of breast cancer jumped after four years of HRT use. The researchers concluded that overall health risks exceeded benefits from use of combined estrogen plus progestin, and that "the results indicate that this regimen should not be initiated or continued for primary prevention of CHD [coronary heart disease]." 5

Does all this mean that women who are currently using HRT should discontinue their medication; or that women who are not yet using HRT should not do so? After the aforementioned JAMA study was published, the position of the National Institutes of Health (who sponsored the study) was to urge women who currently use HRT to talk with their doctors about what to do.6 Certainly this is a personal decision, which can only be made by a woman and her doctor. Nonetheless, some women who are concerned about conventional HRT have turned to natural HRT alternatives.

Phytoestrogens: Natural Alternatives to HRT
Natural alternatives to HRT include the use of phytoestrogens. Phytoestrogens are natural components from plants, which bind to estrogen receptors in the body. Make no mistake, phytoestrogens are not actually estrogen, but since they are capable of binding to estrogen receptors, they can "fool" the body into thinking and reacting as though there were more estrogen present. Furthermore, since they are not actually estrogen, phytoestrogens are not a risk factor in the development of breast or female reproductive system cancers. As a matter of fact, research suggests that certain phytoestrogens may even help to reduce the risk of these cancers, and promote a healthy cardiovascular system. Some of the most effective phytoestrogens can be found in Soy, Black Cohosh, Red Clover Leaf, Licorice Root, and Wild Yam. In addition, certain nutrients may also play a valuable role during menopause.

In fact, The American College of Obstetricians and Gynecologists (ACOG) now recommends three botanicals for management of menopausal symptoms. These are Black Cohosh, Soybean (isoflavones) and St. John's Wort (SJW for symptoms of depression, not for any direct impact on female hormonal biochemistry).

Soy
The protein fractions of soybeans contain an interesting group of substances called isoflavones. The ACOG suggests that short-term use of the phytoestrogens in soy may be helpful for relieving hot flashes and night sweats.8 In addition, research also indicates that these isoflavones may provide some very specific benefits, including cancer prevention, cholesterol reduction, and building bone density.

Cancer prevention
The isoflavones in soybeans have been shown to have anti-cancer effects. Apparently, the isoflavones have phytoestrogenic and antioxidant properties. One particular isoflavone called genistein (and possibly another called daidzein) has been proposed to contribute an important part of the anti-cancer effect of soy isoflavones. As a matter of fact, genistein in soy is considered by some researchers to be responsible for the lower rate of breast cancer observed in Asian women consuming soy.

The effect of genistein was tested in one study in five human breast cancer cell lines. Genistein inhibited the growth of each of these cancer cells.9 Similar studies using genistein also showed significant inhibitory effects on breast cancer cells. It seems that genistein affects estrogen receptors in such a way as to prevent breast cancer growth.10 This estrogen altering response was also apparent in another study, which examined the influence of total soy isoflavones in six premenopausal women for one month. The result was that menstruation was delayed and cholesterol concentrations decreased 9.6 percent.11

Furthermore, soy's anti-cancer effects are not limited to breast cancer. Researchers conducted test-tube research on human and animal bladder cancer cell lines, using pure soy isoflavones and soy phytochemical concentrate. The results were that both the pure soy isoflavones (genistein, genistin, daidzein, and biochanin A) and soy phytochemical concentrate inhibited growth of human and animal bladder cancer cell lines. Animal research also demonstrated that the ability of genistein, soy phytochemical concentrate, and soy protein isolate to inhibit the growth of bladder cancer in the animal (not in the test-tube). Genistein, dietary soy phytochemical concentrate, and dietary soy protein isolate reduced tumor size by 40, 48, and 37 percent, respectively, as compared with controls.12

Cholesterol reduction
Research indicates that substituting soy protein for animal protein may lead to reductions in plasma cholesterol. Three separate studies investigated the effect of soy products and isoflavones on the blood lipid levels of 74 postmenopausal women over a 6-month program. Forty grams of test protein were incorporated into the subjects' diets. The test protein was either isolated soy protein containing moderate amounts of isoflavones (ISP56), isolated soy protein containing higher amounts of isoflavones (ISP90), or casein and nonfat dry milk. The results were that both groups consuming the isolated soy protein diets had increased HDL levels (the "good" cholesterol). A significant lowering of non-HDL cholesterol (the "bad" cholesterol) was found in the groups consuming either of the isolated soy proteins in comparison to the group consuming casein dry milk protein. The results indicate that a low cholesterol, low saturated fat diet, combined with soy protein therapy may be effective in positively changing the ratio of HDL to non-HDL in postmenopausal women with high cholesterol levels.13 Although this research is very good, there is even more impressive research regarding soy and cholesterol reduction.

A meta-analysis (an analysis of many studies that examine the same topic) published in The New England Journal of Medicine clearly demonstrated that soybean protein (which contain isoflavones) has significant cholesterol lowering properties.14 This meta-analysis examined 38 controlled clinical trials. The average soy protein intake was 47 grams per day. The following net changes were associated with the soy intake: total cholesterol decrease of 9.3 percent, LDL cholesterol decrease of 12.9 percent, and triglyceride decrease of 10.5 percent.

Building bone density
A review of interventional trials examining isoflavones and bone in animals and humans suggest that including them in the diet results in reduction in bone resorption caused by estrogen deficiency.15 For example, researchers at the University of Illinois at Urbana-Champaign decided to examine the effects of soy protein and its isoflavones on bone density in postmenopausal women. Sixty-six, postmenopausal women were randomly assigned to one of three dietary treatment groups for 24 weeks. One group consumed 40 grams of protein per day obtained from casein and nonfat dry milk. Another group obtained their 40 grams of protein from isolated soy protein containing 1.39 isoflavones per gram of protein (providing a total of 56 mg of isoflavones). The last group consumed their protein from isolated soy protein containing 2.25 mg isoflavones per gram of protein (providing a total of 90 mg of isoflavones). Bone density was measured twice during the study. The results showed that significant increases occurred in both bone mineral content and density in the soy group that received 90 mg of isoflavones. No other effects on bone density were seen in the other soy protein group or the casein group. This study successfully showed that soy protein providing 90 mg of isoflavones daily is effective in decreasing the risks of osteoporosis in postmenopausal women. The authors of this study pointed out that this discovery about the benefits of soy are important for postmenopausal women who cannot or choose not to undergo hormone replacement therapy, which is usually used for prevention and treatment of these two diseases.16

Black Cohosh
Black Cohosh has a long and successful history as a support herb used by menopausal women. An extract of Black Cohosh contains phytoestrogens that can reduce luteinizing hormone (LH) secretion.17,18 Surges of LH are associated with hot flashes in menopausal women.

A newer, highly standardized extract of Black Cohosh has created a great deal of excitement internationally due to the results of a large open study employing 131 doctors and 629 patients. The type of extract used standardized for its triterpene glycosides, calculated as 27-deoxyacteine. Within six to eight weeks, over 80 percent of the patients experienced improvements in both physical and psychological symptoms. These symptoms included hot flashes, profuse perspiration, headache, vertigo, heart palpitation, ringing in the ears, nervousness/irritability, sleep disturbances, and depressive moods. Most patients reported noticeable benefits within four weeks. After six to eight weeks complete resolution of symptoms were achieved in a high number of patients.19

Red Clover
Finnish investigations of the phytoestrogen content of various plants revealed that Red Clover contained biologically active estrogenic isoflavones, especially biochanin.20 Furthermore, Red Clover has been shown to improve the elasticity of arteries in menopausal women, which is important given the increased cardiovascular risk associated with menopause.21 Ethnobotanist Steven Foster has described some research, which even shows that the phytoestrogens in Red Clover was found to inhibit the activation of cancer cells.22

Licorice root
Although often used for its gastrointestinal benefits / anti-ulcer benefits,23 Licorice root also contains phytoestrogens, which have been shown to induce ovulation in women with irregular periods.24 In addition, the journal Alternative and Complementary Therapies has indicated that Licorice root helps to balance estrogen and progesterone levels;25 clearly a benefit for the menopausal woman.

Wild Yam
Wild Yam contains diosgenin, which has phytoestrogenic properties.26 One of the reported uses of this botanical is in the treatment of menopausal symptoms.27

Pantothenic acid
Since menopause can be a very stressful state of being for many women, it can potentially affect the adrenal glands, which are often considered to be the "stress glands." This is somewhat problematic, since the adrenal glands produce the hormone DHEA, which can be converted into estrogen to help take over the production of estrogen when the ovaries cease to produce it. When the adrenals are stressed, however, this production of DHEA may be somewhat impaired. Pantothenic acid may be able to help. Pantothenic acid is intimately involved in adrenal function, and the production of adrenal hormones associated with stress.28 Administration of pantothenic acid has been shown to significantly increase the production of adrenal hormones in both animal and human studies.29,30

Magnesium
Some researchers have suggested that women who are not using HRT should consider the use of certain natural substances as an alternative-including magnesium, which may prove to be effective in prevention and treatment of menopausal-related symptoms.31 Of course magnesium supplementation during menopause makes sense for other reasons as well. For example, research overwhelmingly supports the use of calcium supplementation, alone or in combination with other therapies for slowing or stopping the progression of osteoporosis32-a disease, which is common postmenopausal. One potential problem with calcium supplementation, however, is an increased risk of calcium stone formation. Concomitant supplementation with magnesium may reduce this risk and improve mineralization in the bone.33 This is really no surprise when you consider that magnesium regulates active calcium transport. In fact, at the end of a 2-year study on menopausal women, magnesium supplementation appeared to have prevented fractures and resulted in a significant increase in bone density.34

Boron
Speaking of osteoporosis, research shows that chronically low intakes of the trace mineral boron may pre-dispose people to osteoporosis.35 Changes caused by boron deprivation include reduced blood levels of calcium, as well as in increase in urinary excretion of calcium. Boron deprivation causes changes similar to those seen in women with postmenopausal osteoporosis, and this mineral is needed to prevent the excessive bone loss, which often occurs in postmenopausal women and older men.36 In addition, studies have reported possible improvements in bone mineral density in women who were supplemented with boron.37 For example, research has found that supplementation with 3mg daily of the boron reduced urinary loss of both calcium and magnesium.38

Conclusion
Given the recent and ongoing concerns about health risks associated with HRT, the use of phytoestrogen supplements and other key nutrients may be a wise alternative. I encourage women to discuss this option with their physicians.

References
  1. National Cancer Institute: Cancer Facts "Menopausal Hormone Replacement Therapy" http://cis.nci.nih.gov/fact/3_10.htm
  2. Anoymous, Am J Nat Med, (1996) 3(4) p 7-10.
  3. National Cancer Institute: Cancer Facts "Menopausal Hormone Replacement Therapy" http://cis.nci.nih.gov/fact/3_10.htm
  4. Okie S. Study: Hormones Don't Protect Women From Heart Disease. Washington Post (2001) Tuesday, July 24. Page A1
  5. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled Trial. JAMA. 2002;288(3):321-333.
  6. Study On Risks Of Estrogen-Progestin Combination To Treat Symptoms Of Menopause Prompts Many Questions. Associated Press. July 10, 2002.
  7. The American College of Obstetricians and Gynecologists. ACOG Practice bulletin: Use of botanicals for management of menopausal symptoms. 2001 June 20:
  8. National Cancer Institute: Cancer Facts "Menopausal Hormone Replacement Therapy" http://cis.nci.nih.gov/fact/3_10.htm
  9. Pagliacci, M., et al, Eur J Cancer, (1994) 30A(11) p 1675-82.
  10. Wang, T., et al, Carcinogenesis, (1996) 17(2) p 271-5
  11. Cassidy, A., et al, Am J Clin Nutr, (1995) 62(1) p 151-3.
  12. Zhou JR, et al, Cancer Research (1998) 58:5231-5238.
  13. Baum J, et al, American Journal of Clinical Nutrition (1998) 68:545-551.
  14. Anderson, J., et al, New Eng J Med, (1995) 333, p 276-82.
  15. Scheiber MD, Rebar RW, Menopause (1999) 6(3):233-41.
  16. Potter SM, et al, Am J Clin Nutr (1998) 68(suppl):1375S -1379S
  17. Brinker, F., The Eclectic Medical Journals, (1996) 2(1) p 2-4.
  18. Duker, E., et al, Planta Med (1991) 57(5) p 420-7.
  19. Anoymous, ibid.
  20. Saloniemi, H., et al, Proc Soc Exp Biol Med (1995) 208(1) p 13-7.
  21. Nestel, PJ, et al, J Clin Endocrinol Metab (1999) 84(3):895-8.
  22. Foster, S., 101 Medicinal Herbs: An Illustrated Guide (1998), Interweave Press, Loveland, Colorado, pp. 168-9.
  23. Foster, S., pp. 132-3.
  24. Reichert, R., Quarterly Review of Natural Medicine (1994) Spring, p 27-33.
  25. Kelly, J. Alternative and Complementary Therapies (1996) November/December, pp. 348-353.
  26. Mirkin, G., JAMA (1991) 265(7) p 912.
  27. Fetrow C, Availa J, Professional's Handbook of Complementary & Alternative Medicines (1999) Springhouse Corp., Springhouse, Pennsylvania, p. 666-668.
  28. Kutsky R, Handbook of Vitamins and Hormones (1973) Van Nostrand Reinhold Company, New York. pp. 208.
  29. Tarasov IuA, Sheibak VM, Moiseenok AG, Vopr (1985) 4
  30. Fidanaza A, Floridi S, Lenti L, Boll Soc Ital Biol Sper (1981) 57(18):1869-72.
  31. Kass-Annese B. Alternative therapies for menopause. Clinical obstetrics and gynecology (2000) 43(1):162-83.
  32. Laulert L, et al, Revista brasileira de enfermagem (1995) 48(2):161-7.
  33. Celotti F; Bignamini A. Dietary calcium and mineral/vitamin supplementation: a controversial problem. Journal of international medical research (1999) 27(1):1-14.
  34. Sojka JE; Weaver CM. Magnesium supplementation and osteoporosis. Nutrition reviews (1995) 53(3):71-4.
  35. Bunker VW, British journal of biomedical science (1994) 51(3):228-40.
  36. Nielsen FH, Magnesium and trace elements (1990) 9(2):61-9.
  37. Volpe SL, Taper LJ, Meacham S, Magnesium research (1993) 6(3):291-6.
  38. Nielson FH, et al, FASEB J (1987) 1:394-97.

An antibiotic might be described as an antibacterial agent that inhibits bacterial growth or kills bacteria. However, colds and many other upper respiratory infections, as well as some ear infections, are caused by viruses, not bacteria. If antibiotics are used too often for things they can’t treat—like colds or other viral infections—they can stop working effectively against bacterial infections. This phenomenon is known as antibiotic resistance, and is a direct result of antibiotic overuse.1 As it currently stands, antibiotic overuse represents a significant health risk to modern society. This article will examine antibiotic overuse, as well as the use of herbal medicines that may present a viable alternative to the use of antibiotics or when antibiotics are not indicated.

A Historical Perspective
At the beginning of the 20th century, illnesses caused by infectious diseases ranked as the most common cause of death in North America. By the middle of the century, the diagnosis, prevention, and management of infectious diseases had advanced dramatically, raising false hopes that many infectious diseases would be eliminated by the end of the 20th century. Unfortunately, clinicians, public health officials, and microbiologists have confronted an unprecedented number of resurgent and “new” infectious diseases on a global scale, with antibiotic resistance being among the new diseases represents one of the most serious threats to human health, and a serious threat to the treatment of infectious diseases.2

Ramifications Of Antibiotic Resistance
The overuse of antibiotics contributes to the emergence of antibiotic-resistant infections (ARIs) that are costly and difficult to treat.3,4 Ongoing and consistent use of antibiotics allows microbes the opportunity to evolve, enabling them to efficiently adapt to new environments. A single dose of antibiotics leads to a greater risk of resistant organisms to that antibiotic in the person for up to a year.5 Drug-resistant “superbug” infections, such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficle, are a significant cause of mortality. In 2005, more than 95,000 people in the U.S. developed severe MRSA infections, which led to 9,000 deaths.6,7 In the U.S., ARIs are responsible for $20 billion in excess health care costs, $35 billion in societal costs and $8 million in additional hospital days. Reducing ARIs by just 20 percent would save $3.2 to $5.2 billion in health care costs each year and eliminate up to $11.3 million in additional in-hospital days for patients with ARIs.8 Even mainstream media has recognized the problem.

According to a report by CBS News:
Antibiotic overuse has led to the growth of drug-resistant strains of bacteria. Each year 90,000 Americans die from health care-associated infections, many of which are drugresistant. And, the number is growing. From 1993 to 2005 the number of hospital stays involving Methicillin-resistant Staphylococcus aureus (MRSA)—bacteria that causes severe infections such as bloodstream infections, surgical site infections, or pneumonia—went up from 1,900 to 368,000 in the U.S. alone. Deaths due to Clostridium difficle—bacteria commonly known as C. diff that causes several diarrhea and intestinal problems—went up 35 percent each year from 1999 to 2004.9

Reasons For Antibiotic Overuse
So why are antibiotics overused in the first instance? The answer is four-pronged. First, determining if an infection is viral or bacterial is expensive and time-consuming and concerns over malpractice lead many physicians to over-prescribe antibiotics.10,11 Second, some patients pressure providers to prescribe antibiotics for conditions for which they are inappropriate, such as the common cold or sore throat, or inappropriately save antibiotics for later use, both of which can lead to increased antibiotic resistance.12,13 Third, approximately 70 percent of antibiotics used in the U.S. are used in the non-therapeutic (prophylactic) treatment of livestock cattle, swine, and poultry, and although the FDA issued voluntary guidelines in 2010 urging farmers not to use antibiotics for livestock growth, the guidelines are not yet mandatory.14,15 Fourth, evidence-based research on appropriate and inappropriate antibiotic use is often lacking in the medical community.16 A fifth reason may be public ignorance.

An Unfortunate Case Of Ignorance
Part of the growing problem of antibiotic resistance in the United States may be attributed to the fact that many Americans don’t know what the drugs should be used for and what they can actually do. The Pew Charitable Trusts in conjunction with the Centers for Disease Control and Prevention (CDC) surveyed 1,004 adults about their understanding about the use of antibiotics. In addition, they asked focus groups of frequent antibiotic users as well as a cross section of adults about their antibiotic-use beliefs and habits. Only 44 percent of surveyed Americans recognized as somewhat or a big problem that some diseases are becoming resistant to antibiotics. While 90 percent of Americans recognize that antibiotics can fight bacterial infections like strep throat, more than one-third falsely believe that they are also effective at fighting viral infections like the common cold. Furthermore, only 47 percent of Americans realize that their overuse of prescription antibiotics can harm others beside themselves.17

What Is The Goal?
In considering herbal alternatives to antibiotics, it is important to examine the intended goal in using the specific herbal medicine. Is the purpose of the herb to 1) stimulate and promote your body’s own healthy immune response, 2) directly do battle with bacteria, or 3) both? From my perspective as a credentialed herbalist and nutritionist, it is important to do both. First and foremost, you should always strive to make your immune system as healthy and functional as possible. This way, when unwanted bacteria and viruses do invade, your immune system will be in a good position to fit back. Following is a discussion of a few key herbs (and a few other dietary supplements) that can help you achieve these goals. Please keep in mind that given the space limitations of this article, it will not be possible to address all immune/antibacterial herbs. However, for a comprehensive treatise on the topic, I recommend Herbal Antibiotics: Natural Alternatives for Treating Drug-Resistant Bacteria, by Stephen Harrod Buhner.

Diet And The Immune System
Before jumping into the herbs, I just want to say a couple of words about your diet. It is important to restrict sugar since sugar interferes with the ability of white blood cells to destroy bacteria. I’m not talking about the type or amount of sugar you get from eating fruit, but rather the amount you get from drinking soda and eating sweets and other junk food. Likewise, alcohol interferes with a wide variety of immune defenses, and excessive dietary fat reduces natural killer cell activity. So just eating a healthy diet can be beneficial for good immune function.18 Now, onto the herbs.

Echinacea
Arguably, Echinacea is the granddaddy of all immune-enhancing herbs. Best known for its use in the treatment of the common cold, there are three species of Echinacea commonly used in herbal medicine: Echinacea purpurea, E. angustifolia, and E. pallida (of these, the first two are most popular). The aerial (above ground) parts of the herb and the root contain the medicinal components, including phenolics, caffeic acid esters (e.g., echinacosides), flavonoids, alkylamides, volatile oils, polysaccharides, polyacetylenes.19

Echinacea is an immune stimulant/supporter. It is excellent in helping to prevent and treat colds and influenza. Research reveals that Echinacea supports the immune system by activating white blood cells (lymphocytes and macrophages).20 Echinacea also increases the production of interferon, an immune component that is important in responding to viral infections.21

Several double-blind, clinical studies have confirmed Echinacea’s effectiveness in treating colds and flu.22,23,24,25 However, some research suggests that Echinacea may be more effective if used at the onset of these conditions.26,27 One study involving 238 subjects confirmed that Echinacea was safe and effective in producing a rapid improvement of cold symptoms. In the subgroup of patients who started therapy at an early phase of their cold, the effectiveness of Echinacea was most prominent.28 In a similar study, 246 subjects with a cold were treated with Echinacea preparations or a placebo. Those treated with the Echinacea preparations experienced a reduction of symptoms, significantly more effective than the placebo. The researchers concluded that the Echinacea preparations “represent a low risk and effective alternative to the standard symptomatic medicines in the acute treatment of common cold.”29

In a meta-analysis of 14 studies30, researchers found that taking Echinacea cut the risk of catching the common cold by 58 percent, and if subjects already had a cold it decreased the duration by 1.4 days. In one of the studies, Echinacea taken in combination with vitamin C reduced cold incidence by 86 percent, and when the herbal was used alone the incidence of cold was reduced by 65 percent. The bottom line is that when used appropriately, Echinacea is effective in preventing and treating the common cold.

NOTE: A much-publicized study from the July 28, 2005 issue of the New England Journal of Medicine concluded that Echinacea did not have a significant effect on infection with a rhinovirus (one of the 200 viruses that can cause the common cold), but the methodology has been strongly questioned by herbal experts. One such error in methodology is the fact that the study did not use a commercially available product, and dosage was lower than the dose typically used in research and common practice.

Besides colds and flu, Germany’s Commission E Monographs (an internationally authoritative source of credible information on the use of herbs for various disorders) indicates that among Echinacea’s uses, this herb can be used to treat chronic infections of the respiratory tract.31 Other current and evidence based uses of Echinacea include, but are not limited to: Vaginal candidiasis, ear, urinary and sinus infections, allergies, herpes, cystitis, bronchitis, prostatitis, tonsillitis, and laryngitis.32

A good dosage range for Echinacea extract is 200–300 mg, jumping up to 900–1200 mg daily (in 3–5 divided doses) for acute infection (e.g. cold or flu).33 While some sources have suggested that Echinacea should not be used with drugs intended to suppress the immune system, such suggestions are speculative and lack clinical documentation.34

At this point is should also be noted there is a popular misconception that Echinacea should only be used for a limited period of time, since it will cease its effectiveness otherwise. This misconception was based upon misinterpretations of a specific study on Echinacea, which demonstrated decreased immune activity after about 10 days.35 However, if the study is carefully read, it is clear that the Echinacea was only administered for five days; after which point it was discontinued. Only when it was discontinued did immune activity begin to decline; and even then it still remained elevated above normal for a few days.36 Furthermore, other research (as well as a history of traditional use) support the effectiveness of Echinacea when used for extended periods of time.11

Andrographis and Eleutherococcus senticosus
Andrographis paniculata has a history of use in both Ayurvedic and traditional Chinese medicine.37 It contains a number of bitter constituents, which appear to have both immune-stimulating and anti-inflammatory activity.38 Double-blind studies have found that Andrographis may help reduce the severity of symptoms in individuals suffering from the common cold.39,40,41,42

In the very recent past, Eleutherococcus senticosus, or Eleuthero for short, was commonly called “Siberian Ginseng.” This name was botanically incorrect since Eleuthero is not even in the same genus (plant family) as Panax ginseng. Nevertheless, like Panax species, Eleuthero shows excellent adaptogenic activity (an adaptogen is an agent that helps the body adapt to stress). Russian explorers, divers, sailors, and miners also used Eleuthero to prevent stress-related illness.43 In addition, evidence also suggests that Eleuthero may prove valuable in the long-term management of various diseases of the immune system, including HIV infection and chronic fatigue syndrome.44 In Chinese medicine, it was used to prevent respiratory tract infections, colds and flu.

Of particular interest is using a combination of Andrographis and Eleuthero to treat upper respiratory infections. In two randomized, parallel-group clinical studies45, patients diagnosed with influenza (540 patients and 66 patients, respectively) were treated with a combination of Andrographis and Eleuthero, or nothing at all (in the control group). In both studies, the differences in the duration of sick leave (7.2 days versus 9.8 days in the control group) and frequency of post-influenza complications indicated that the Andrographis/Eleuthero combination contributed to quicker recovery and reduced the risk of post-influenza complications. The results showed that in Andrographis/Eleuthero-treated patients the symptoms had become less pronounced and the temperature had returned more rapidly to normal values, and symptoms such as headache, muscle pain, and conjunctivitis disappeared sooner than in patients of the control group.

In addition, two randomized double-blind, placebo-controlled parallel group clinical trials46 were performed to investigate the effect of an Andrographis/Eleuthero combination in the treatment of uncomplicated upper-respiratory tract infections. This includes common cold, rhinitis, nasopharyngitis (Inflammation of the nasal passages and of upper sore throat) and pharyngitis (sore throat). There were 46 patients in one study, and 179 patients in another. In both studies, the total symptom score and total diagnosis score showed highly significant improvement in the Andrographis/ Eleuthero group as compared with the placebo. Throat symptoms/signs, were found to show the most significant improvement. There was a 55 percent better improvement in the symptom score for the treatment group as compared with the placebo group.

Also, a double-blind, placebo-controlled, parallel-group clinical study47 was carried out to evaluate the effect of an Andrographis/Eleuthero combination in the treatment of acute upper respiratory tract infections, including sinusitis. Ninetyfive individuals in the treatment group and 90 individuals in the placebo group completed the study according to the protocol. Temperature, headache, muscle aches, throat symptoms, cough, nasal symptoms, general malaise and eye symptoms were taken as outcome measures with given scores. The total score analysis showed a highly significant improvement in the Andrographis/Eleuthero combination group versus the placebo. The individual symptoms of headache and nasal and throat symptoms together with general malaise showed the most significant improvement while cough and eye symptoms did not differ significantly between the groups. Temperature was moderately reduced in the Andrographis/Eleuthero combination group. The authors of the study concluded that the Andrographis/Eleuthero combination had a positive effect in the treatment of acute upper respiratory tract infections and also relieved the inflammatory symptoms of sinusitis.

Doses of Andrographis/Eleuthero should be in the range of in the range of 340 mg Andrographis paniculata extract (providing 21 mg andrographolide and deoxyandrographolide), 39 mg Eleuthero extract (providing 2 percent total Eleutheroside B and Eleutheroside E).

Berberine
Berberine is a bitter-tasting, yellow, plant alkaloid found in the roots of various herbs, including goldenseal (Hydrastis canadensis), barberry (Berberis vulgaris), Oregon grape (Berberis aquifolium), goldthread (Coptis chinensis) and tree turmeric (Berberis aristata). This compound has a long history of medicinal use in Chinese and Ayurvedic medicine. Berberine containing plants may help promote immune response by increasing the production of antigen specific immunoglobulins,48 and may also have a direct effect against bacteria.49,50 For example, berberine may help fight urinary tract infections since it inhibits bacteria from adhering to the wall of the urinary bladder.51 One possible mechanism by which this takes place is that berberine might inhibit bacterial sortase, a protein responsible for anchoring bacteria to cell membranes.52 Berberine was also shown to be effective in an integrative treatment against patients with chloroquine-resistant malaria53 and bacterial-induced diarrhea.54

In addition, berberine has activity against Candida yeast.55 In fact, berberine was demonstrated to be effective in reducing the growth of the invasive mycelial form of Candida albicans.56 In addition, extracellular enzymes secreted by Candida albicans are considered to be responsible for penetration of the yeast into host cells, and general overgrowth. Berberine has been shown to reduce these enzymes and the consequent adherence of Candida to epithelial cells. Furthermore, berberine was able to suppress symptoms of Candida overgrowth and accelerated elimination of the yeast.57

Regardless of the herbal source, try to get 400 mg berberine daily.

Shiitake and AHCC
For thousands of years, mushrooms have been used as both food and medicine in various cultures. One of those mushrooms, Shiitake (Lentinula edodes)58, is currently used for promoting healthy immune function59, healthy liver function60 and modulating the unwanted growth of mutated stomach61 and pancreas cells62, and has been validated in scientific literature for these purposes.

Active Hexose Correlated Compound (AHCC) is an extract derived from Shiitake, as well as other species of Basidiomycete family of mushrooms. AHCC is a mixture of polysaccharides, amino acids, lipids, and minerals. Oligosaccharides make up about 74 percent of AHCC.63 Like its predecessor, AHCC has antioxidant effects, and is thought to act as a biological response modifier. It seems to promote the activity of natural killer (NK) cells in patients with unwanted growth of mutated cells. In animal models, it also seems to protect against carbon tetrachloride-induced liver damage, promote healthy blood glucose levels within a normal range, and decrease apoptosis (i.e., programmed cell death) of the thymus.64

AHCC demonstrated early clinical promise in promoting healthy immune response. This was shown in animal research where AHCC helped restore immune response that had been negatively affected by trauma, infection, and food deprivation.66 In humans, the effect of AHCC on immune response was investigated by measuring the number and function of circulating dendritic cells (DCs), a type of immune cell, in healthy volunteers. Twenty-one healthy volunteers were randomized to receive placebo or AHCC for four weeks. The results were that the AHCC group had a significantly higher number of total DCs compared to when they first started the study, and compared to the control subjects. Other types of immune cells were also significantly increased in the AHCC group compared to controls.67

The effects of AHCC in a clinical setting were examined in patients who had surgery for the undesirable growth of mutated liver cells. A total of 269 patients participated in the study, with 113 receiving AHCC. The results were that the AHCC group had a significantly longer period of no recurrence of mutated liver cells, and an increased overall survival rate when compared to the control group.68

A prospective cohort study was performed with 44 patients with undesirable growth of mutated liver cells. All of the patients underwent supportive care. Survival time, quality of life, clinical and immunological parameters related to liver function, cellular immunity, and patient status were determined. Of the 44 patients, 34 and 10 received AHCC and placebo (control) orally, respectively. Patients in the AHCC treated-group had a significantly prolonged survival when compared to the control group, and quality of life in terms of mental stability, general physical health status, and ability to have normal activities were significantly improved after three months of AHCC treatment.

An effective daily dose is 3–6 grams AHCC daily.

Pomegranates
Pomegranates are high in polyphenolic compounds, making its juice higher in antioxidant activity than red wine and green tea.70 The most abundant of these compounds is ellagic acid, which has been shown in research to be the antioxidant responsible for the free-radical scavenging ability of pomegranate juice.71 According to some researchers72, the actions of pomegranate’s components suggest a wide range of clinical applications for the treatment and prevention of cancer, as well as other diseases where chronic inflammation is believed to play an essential developmental role, suggesting immune modulatory activity. Of particular interest where ARIs are concerned, one study73 found that pomegranate had specific antibacterial activity against MRSA. The authors of that study suggest a beneficial effect from the daily intake of pomegranate “as dietary supplements to augment the human immune system’s antioxidant, antimalarial and antimicrobial capacities.”

The consumption of 2–8 ounces of pomegranate juice is a good daily dose.

Other Dietary Supplements For General Immune Response
In terms of dietary supplements, there are some general immune-promoting nutrients, which may have benefit promoting immune response:

  • Vitamin A—Plays an important role in immune system function and helps mucous membranes, including those in the lungs, resist invasion by microorganisms.74 Daily dose: 5,000-10,000 IU.
  • Vitamin C—Stimulates the immune system by both elevating interferon levels and enhancing the activity of certain immune cells.75 Daily dose: 500-1000 mg. Increase to 1000 mg every other waking hour during acute infection.
  • Zinc—Marginal deficiencies result in impairments of immune function.76 Supplementation with zinc has been shown to increase immune function in healthy people.77 Daily dose: 15 mg. Increase to 15 mg, three times daily in lozenge form during acute infection.
  • Probiotics—Probiotics are well established for their role in immune health, and have been shown to have efficacy in the treatment of bacterial vaginosis78,79 and irritable bowel syndrome.80 Daily dose: 5–10 billion CFU of Lactobacillus and/or Bifidobacteria species.

Conclusion
In addition to those listed, there are many other herbs with value to the immune system and/or with antibacterial properties. These include Astragalus membranaceus, Picrorrhiza kurroa, Thuja occidentalis and Green tea, just to name a few. If it wasn’t included in this article, don’t assume it doesn’t have value. The fact is, it most likely does but I could only choose a few to discuss here. In any case, use of the herbs and other supplements discussed in this article may help you support and maintain a healthy immune system, which is your best defense against any bacteria and viruses. Likewise, some of these herbs may also have direct effects against specific microorganisms. Nevertheless, if you are sick you should see your doctor to have your individual situation assessed.

Link to References

Senile purpura (also known as "Actinic purpura," and "Solar purpura") was first described by Bateman1 in 1818 when he noted dark purple blotches and determined that they were due to the extravasation of blood into the dermal tissue. Patients with this condition develop persistent dark purple ecchymoses, which are characteristically confined to the extensor surfaces of the hands and forearms.2 Unlike other ecchymoses, which evolve into brown patches, senile purpura tends to fade to fainter shades of purple, although residual brown pigmentation may persist for weeks to months, or may be permanent.3,4 Although cosmetically displeasing, the disorder has no health consequences. Nevertheless, patients with senile purpura are often embarrassed by their purple blotches, and will tend to wear concealing clothing in an attempt to prevent exposure.

Causes
The purple ecchymoses and patches of this condition occur because red blood cells leak out of capillaries into the dermal tissue. This extravasation is secondary to the fragility of the blood vessel walls caused by chronic sun exposure with the resultant ultraviolet radiation, which induces dermal tissue atrophy. Because of the ultraviolet-induced atrophy, the connective tissue of the dermis is no longer able to adequately support the microvasculature. As a result, even minor trauma can tear the capillaries, leading to the extravasation of blood.5

Senile purpura may also be a sign of collagen loss in skin and bone. Women have less collagen than men and it decreases by one percent a year in exposed and unexposed skin. These changes in skin collagen may correspond to changes in bone density. It is hypothesized that changes in skin collagen also occur in bone collagen, leading to the associated changes in bone density.6

Epidemiology
In the United States, the occurrence of senile purpura is almost exclusively limited to the elderly population, commonly found in approximately 11.9 percent of those older than 50 years. Its prevalence markedly increases with years of exposure to the sun and is more pronounced in fair-skinned individuals than in others. Both sexes are equally affected.7

Conventional treatment
There is no conventional medicine for senile purpura.

Integrative treatment
Integrative treatment for senile purpura is effective, and may consist of using key nutraceuticals and one homeopathic remedy. Following is a discussion of these.

Vitamin C
Vitamin C is required for the synthesis of collagen, an important structural component of blood vessels, tendons, ligaments, and bone.8 Symptoms of scurvy, the classic vitamin C deficiency disease, include bleeding and bruising easily. These symptoms appear to be related to the weakening of blood vessels and connective tissue, both of which contain collagen.9 Consequently, maintaining healthy vitamin C status would appear to be an important consideration in the prevention of purpura. This was found to be the case in a double-blind, placebo-controlled trial10 of 94 elderly patients with initially low levels of vitamin C. After two months of vitamin C supplementation, clinical improvement was indicated by reductions in purpura and petechial hemorrhages (i.e., a small discrete capillary hemorrhage under the skin).

NOTE: Flavonoids help improve the absorption of vitamin C.11,12 Consequently, any of the following flavonoids have value from that perspective. In addition, they offer other benefits as indicated.

Rutin
Rutin is a flavonoid, an antioxidant, a free radical scavenger, and an iron-chelator.13,14 In solar purpura, the value of an antioxidant is to help reduce potential oxidative damage from the sun's UV-rays.

Furthermore, rutin has been reported to decrease capillary fragility and permeability.15 In an 8-month trial,16 oral treatment with rutin significantly decreased (P<0.05) in capillary filtration. In other research,17,18,19 treatment with rutin also significantly decreased capillary filtration.

Citrus bioflavonoids
Citrus bioflavonoids have antioxidant effects and include diosmin, eriodictyol, hesperidin, neohesperidoside, naringenin, eriocitrin, neodiosmin, rutinoside, chrysoeriol, isorhamnetin, limocitrin, limocitrol, isolimocitrol, and others.20,21 In animal models of diabetes, a diet containing citrus flavonoids consisting of 0.2 percent eriocitrin and 0.2 percent hesperidin results in reduced measures of oxidative stress after 28 days of treatment.22

Hesperidin
Hesperidin alone is frequently used for vascular conditions such as hemorrhoids and varicose veins since it helps improves venous tone, reduces stasis, restores normal capillary permeability, and improve lymphatic drainage. Hesperidin can also reduce the generation of free radicals.23,24,25,26 A randomized, controlled, crossover study27 also demonstrated that hesperidin provides vascular protective effects, including protective effects on the microvascular endothelium.

Eriocitrin
In animal research, the lemon flavonoid, eriocitrin was shown to be effective in the prevention of oxidative damage.28 Similar research demonstrated an increase in plasma antioxidant activity increased following oral administration of eriocitrin.29 Additional research has also shown eriocitrin's antioxidant activity.30

Arnica montana
The homeopathic remedy Arnica montana is commonly used to treat bruising. In a randomized, double-blind, placebo-controlled clinical trial,31 A. montana was used on 29 face-lift patients to assess efficacy in reducing bruising. The results were that patients treated with A. montana were found to have a smaller area of ecchymosis on postoperative days 1, 5, 7, and 10, with these differences reaching statistical significance on postoperative days 1 and 7.

A. montana's effectiveness in reducing bruising may be related to its ability to reduce bleeding. In another double blind, placebo-controlled, randomized, clinical trial,32 treatment with A. montana and Bellis perennis was found to reduce postpartum blood loss, as compared with placebo.

Combining rutin with vitamin C
In an open pilot study,33 oral rutin and vitamin C were administered to three patients with chronic progressive pigmented purpura (PPP), a different type of purpura. At the end of the 4-week treatment period, complete clearance of the skin lesions was achieved in all three patients. No adverse reactions were noted. All patients remained free of lesions at the end of 3-months treatment. A case report34 on another patient with PPP showed similar benefits when supplemented with rutin and vitamin C.

Combining vitamin C, rutin, citrus bioflavonoids, hesperidin, eriocitrin and A. montana
A six-week, randomized, multicenter, placebo-controlled, double-blind study35 was undertaken to evaluate the efficacy of a dietary supplement combining vitamin C, rutin, citrus bioflavonoids, hesperidin, eriocitrin and A. montana in the treatment of senile purpura. Seventy patients with senile purpura were enrolled and 67 completed the study. Subjects were randomized into two groups receiving either a supplement blend or placebo medication, which was taken orally twice daily for six weeks.

The results were a statistically significant reduction in the number of new purpura lesions in the skin area undergoing clinical study. At the end of six weeks, the supplement blend treated group showed a 50 percent reduction in purpura lesions from baseline. Patient self-assessment of the effectiveness of the medication echoed the results of an investigator global assessment with a statistically significant improvement in the skin's appearance noted by the patients receiving the supplement. No adverse effects were noted by either the patients or investigators. The authors of this study concluded that the supplement blend appears to both safely and effectively diminish skin bruising in patients with senile purpura.

Conclusion
Patients with senile purpura are often embarrassed by their purple blotches. Integrative treatment with vitamin C, key flavonids and the homeopathic A. montana has been show to result in a 50 percent reduction in skin purpura lesions.

References

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  3. Scheinfeld NS. Skin Disorders in Older Adults: Vascular, Lymphatic, and Purpuric Dermatitides, Part 1. Consultant. 2009 Jun 15;49(6). Retrieved January 12, 2012 from http://www.consultantlive.com/skin-diseases/content/article/10162/1421703#.
  4. The Merck Manual for Healthcare Professionals. Last full review/revision April 2009 by James N. George, MD. Content last modified April 2009. Retrieved January 12, 2012 from http://www.merckmanuals.com/professional/hematology_and_oncology/bleeding_due_to_abnormal_blood_vessels/senile_purpura.html?qt=solar%20purpura&alt=sh.
  5. Schwartz RA. Actinic Purpura Clinical Presentation. WebMD Professional. Updated April 25, 2011. Retrieved January 12, 2012 from http://emedicine.medscape.com/article/1087008-clinical#a0218.
  6. Shuster S. Osteoporosis, a unitary hypothesis of collagen loss in skin and bone. Med Hypotheses. 2005;65(3):426-32.
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  8. Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.
  9. Food and Nutrition Board, Institute of Medicine. Vitamin C. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington D.C.: National Academy Press; 2000:95-185.
  10. Schorah CJ, Tormey WP, Brooks GH, Robertshaw AM, Young GA, Talukder R, Kelly JF. The effect of vitamin C supplements on body weight, serum proteins, and general health of an elderly population. Am J Clin Nutr. 1981;34(5):871-6.
  11. Vinson JA, Bose P. Comparative bioavailability to humans of ascorbic acid alone or in a citrus extract. Am J Clin Nutr 1988;48:601-4.
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  13. Kostyuk VA, Potapovich AI. Antiradical and chelating effects in flavonoid protection against silica-induced cell injury. Arch Biochem Biophys 1998;355:43-8.
  14. Escarpa A, Gonzalez MC. High-performance liquid chromatography with diode-array detection for the determination of phenolic compounds in peel and pulp from different apple varieties. J Chromatogr A 1998;823:331-7.
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  16. Cesarone MR, Belcaro G, Ippolito E, et al. Clinical improvement in chronic venous insufficiency signs and symptoms with Venoruton® (HR): an 8-month, open-registry, cost-efficacy study. Panminerva Med. 2010;52(2 Suppl 1):43-8.
  17. Belcaro G, Cesarone MR, Ledda A, et al. 5-Year control and treatment of edema and increased capillary filtration in venous hypertension and diabetic microangiopathy using O-(beta-hydroxyethyl)-rutosides: a prospective comparative clinical registry. Angiology. 2008;59 Suppl 1:14S-20S.
  18. Cesarone MR, Belcaro G, Ricci A, et al. Prevention of edema and flight microangiopathy with Venoruton (HR), (0-[beta-hydroxyethyl]-rutosides) in patients with varicose veins. Angiology. 2005 May-Jun;56(3):289-93.
  19. Cesarone MR, Belcaro G, Pellegrini L, et al. HR, 0-(beta-hydroxyethyl)-rutosides; (Venoruton): rapid relief of signs/symptoms in chronic venous insufficiency and microangiopathy: a prospective, controlled study. Angiology. 2005;56(2):165-72.
  20. Williams HL, Maher FT, Corbin KB, et al. Eriodictyol glycoside in the treatment of meni'ere's disease. Ann Otol Rhinol Laryngol 1963;72:1082-101.
  21. Ranganna S, Govindarajan VS, Ramana KV. Citrus fruits. Part II. Chemistry, technology, and quality evaluation. A. Chemistry. Critical Rev Food Sci Nutr 1983;19:313-86.
  22. Miyake Y, Yamamoto K, Tsujihara N, Osawa T. Protective effects of lemon flavonoids on oxidative stress in diabetic rats. Lipids 1998;33:689-95.
  23. Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surgery 2000;87:868-72.
  24. Cospite M. Double-blind, placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology 1994;45:566-73.
  25. Di Carlo G, Mascolo N, Izzo AA, Capasso F. Flavonoids: Old and new aspects of a class of natural therapeutic drugs. Life Sci 1999;65:337-53.
  26. Koyuncu H, Berkarda B, Baykut F, et al. Preventive effect of hesperidin against inflammation in CD-1 mouse skin caused by tumor promoter. Anticancer Res 1999;19:3237-41.
  27. Morand C, Dubray C, Milenkovic D, Lioger D, Martin JF, Scalbert A, Mazur A. Hesperidin contributes to the vascular protective effects of orange juice: a randomized crossover study in healthy volunteers. Am J Clin Nutr. 2011;93(1):73-80.
  28. Minato K, Miyake Y, Fukumoto S, Yamamoto K, Kato Y, Shimomura Y, Osawa T. Lemon flavonoid, eriocitrin, suppresses exercise-induced oxidative damage in rat liver. Life Sci. 2003;72(14):1609-16.
  29. Miyake Y, Shimoi K, Kumazawa S, Yamamoto K, Kinae N, Osawa T. Identification and antioxidant activity of flavonoid metabolites in plasma and urine of eriocitrin-treated rats. J Agric Food Chem. 2000;48(8):3217-24.
  30. Davies N, Ohgami Y, Remsberg C, Yanez J. Eriocitrin and Eriodictyol: Anti-Cancer Activity, Anti-Oxidant Capacity, and Stereospecific Disposition in Rats, Humans, and Lemonade Tracks: Contributed Papers: In-Vivo Metabolism. 2006 AAPS Annual Meeting and Exposition. Monday, October 30, 2006. Retrieved January 12, 2012 from http://abstracts.aapspharmaceutica.com/expoaaps06/cc/forms/attendee/index.aspx?content=sessionInfo&sessionId=456.
  31. Seeley BM, Denton AB, Ahn MS, Maas CS. Effect of homeopathic Arnica montana on bruising in face-lifts: results of a randomized, double-blind, placebo-controlled clinical trial. Arch Facial Plast Surg. 2006;8(1):54-9.
  32. Oberbaum M, Galoyan N, Lerner-Geva L, Singer SR, Grisaru S, Shashar D, Samueloff A. The effect of the homeopathic remedies Arnica montana and Bellis perennis on mild postpartum bleeding--a randomized, double-blind, placebo-controlled study--preliminary results. Complement Ther Med. 2005;13(2):87-90.
  33. Reinhold U, Seiter S, Ugurel S, Tilgen W. Treatment of progressive pigmented purpura with oral bioflavonoids and ascorbic acid: an open pilot study in 3 patients. J Am Acad Dermatol. 1999;41(2 Pt 1):207-8.
  34. Laufer F. The treatment of progressive pigmented purpura with ascorbic acid and a bioflavonoid rutoside. J Drugs Dermatol. 2006;5(3):290-3.
  35. Berlin JM, Eisenberg DP, Berlin MB, Sarro RA, Leeman DR, Fein H. A randomized, placebo-controlled, double-blind study to evaluate the efficacy of a citrus bioflavanoid blend in the treatment of senile purpura. J Drugs Dermatol.
2011;10(7):718-22.

The common honeybee is a fascinating little insect that offers us humans some valuable natural foods with health-promoting benefits. These "super foods" include bee pollen, royal jelly and propolis.

Bee Pollen
Bee pollen is the pollen gathered from plants by honeybees, and brought back to their hive. Bee pollen contains all of the eight essential amino acids in amounts that vary between five to seven times the levels found in equal weights of traditional high protein foods. It also contains vitamins A, D, E, K, C and bioflavonoids, as well as the complete B-complex, especially pantothenic acid (B5) and niacin. The high levels of vitamin B5 are particularly beneficial for the adrenal glands, which are adversely effected during stress. Bee pollen has been used traditionally as an anti-aging food, and an energy food. As a matter of fact, it has been used by a number of Olympic athletes to improve their performance.

Antioxidant/anti-aging
The oxidative damage caused by free radicals have been implicated in quite a number of disease processes, and is the primary factor in aging. Antioxidants are capable of providing protection, sometimes significant protection, against this oxidative damage. Interestingly, bee pollen appears to provide significant antioxidant activity, which may explain its traditional use as an anti-aging food. One animal study demonstrated that bee pollen (as well as beta-carotene oil) was able to abolish the effects of harmful ionizing radiation on the brain. This was a function of bee pollen's antioxidant properties.1 X-rays can activate lipid peroxidation (i.e., free radical activity) in the liver, and adversely affect liver glutathione (i.e., antioxidant) systems. Animal research has shown that bee pollen is able to normalize the activity of important glutathione system enzymes in the liver.2 Another study demonstrated that bee pollen was able to markedly decrease lipoperoxide levels in animals fed a limited diet, compared to animals not receiving bee pollen.3

Free radicals can also contribute towards lipofuscin, also known as age pigments and liver spots. These are commonly seen as small brownish spots on the back of hands on elderly people. Liver spots are actually an outward sign of internal toxic accumulation of lipofuscin; including, but not limited to vital nerve centers such as the brain. Such toxic accumulation of lipofuscin can block nutrient absorption in the cells. Animal research has shown that bee pollen markedly reduces lipofuscin in the cardiac muscle (heart), significantly inhibits the increase of lipofuscin in cardiac muscle, liver, brain and adrenal gland cells.4

Increase red blood cells & hemoglobin
Traditionally, bee pollen has been used as a food to help increase energy levels. One possible explanation for this use is that bee pollen helps to increase red blood cells, and the hemoglobin component of red blood cells. Since it is the hemoglobin in red blood cells that carry oxygen for energy metabolism, this may explain the relationship between bee pollen and energy. For example, in one animal study, bee pollen resulted in increases in hemoglobin and serum iron.5 In a study on humans, bee pollen and several other Chinese herbs were found to increase the number of red blood cells.6

Bee Propolis
Propolis is a resinous substance collected from various plants by bees. It is used in the construction of, and to seal the cracks in, the beehive. For this reason, propolis is often referred to as "bee glue." It is a mixture of resin, essential oils and waxes, and also contains amino acids, minerals, ethanol, vitamin A, B complex, E, and flavonoids.7 In addition to its construction adhesive application, propolis also has antimicrobial properties, which helps to prevent microorganisms from entering the hive and causing illness.

Antibacterial/antifungal activity
In-vitro (i.e., "test tube") research has demonstrated that propolis has significant antibacterial activity, and also helps to reduce oxidation potential.8 Other research has also verified that the growth of bacteria (particularly Gram-positive bacteria) is inhibited by propolis.9,10,11 In addition to its antibacterial properties, propolis has also been found to have antifungal effects against Candida albicans.12 Furthermore, research has shown that propolis has specific antibacterial activity against several strains isolated from patients with infections in their upper respiratory tracts.13

Dental research
Some interesting dental studies have also been conducted on the value of propolis, including its antibacterial properties. In one study, propolis was found to inhibit certain enzymes and bacteria that are chief culprits in the formation of dental caries (cavities).14 Other research on propolis has also demonstrated a similar antibacterial effect, including a reduction of bacteria in saliva.15

Another dental-related value of propolis is its desensitizing properties for teeth. In one study, propolis was administered to 26 women over a period of four weeks. The women were tested for teeth sensitivity by two methods: 1) cold air stimuli, and 2) subjective reporting of pain. Eighty-five percent of the subjects in this study reported that they were highly satisfied; the propolis had significant desensitizing effects on their sensitive teeth.16

Anti-viral activity
Besides its antibacterial properties, propolis has also demonstrated significant antiviral properties, particularly where cold viruses are concerned. For example, in one study, preschool and school children were treated with propolis during the cold season. Favorable effects of propolis treatment were observed, including a lowering of the number of cases of common cold with acute or chronic symptoms, and decrease and suppression of the viruses and other microbes in the upper airways.17 Other research demonstrated that propolis was effective in shortening the duration of a cold. Specifically, regression of symptoms occurred in the first day of propolis therapy, and the complete recovery followed in one day in five patients, in two days in16, and in three days in three. The placebo group had full recovery in 4.80 days. In the propolis-treated group the symptoms lasted 2.5 times shorter than in placebo one.18

Propolis also has promising antiviral properties against herpes viruses.19 In-vitro research has shown that propolis has activity against herpes simplex virus type 1, reducing viral activity and replication.20 Other in-vitro research has also shown that the flavonoids found in propolis caused a reduction of intracellular replication of herpes virus strains.21

Finally, in one in-vitro study propolis was found to suppress the replication of HIV 1 virus, as well as modulate immune responses.22

Two to four tablets of propolis daily are typically used.

Royal Jelly

Royal jelly is a substance produced by worker honeybees. If fed to an ordinary female bee in the larval stage, royal jelly will transform her into the queen bee. As a queen, she will grow 1½ times normal size, become extremely fertile and lay over a thousand eggs each day. Incredibly, she may live over five years while all the other bees live only a few weeks. The only difference is that she receives royal jelly while the others don't.

The chemistry of royal jelly
Royal jelly is a complex mixture of proteins (12%), sugar (12%), fats (6%) and variable amounts of minerals vitamins and pheromones. About 15 percent of royal jelly is 10-hydroxy-trans-(2)-decanoic acid (HDA), which is probably the substance that causes the queen bee to grow so large. Royal jelly is particularly rich in B vitamins, with pantothenic acid dominating.

Royal jelly folk use
Royal jelly has a history of folk use as a skin tonic and hair growth stimulant. The skin benefits are supposed to include a nourishing process that reduces wrinkles, although there is no actual scientific research that supports these claims (or the hair growth claims). Royal jelly has also been considered to be a general tonic that has a general systemic action rather than any specific biological function, which benefits menopause and sexual performance. Perhaps it's most significant use has been as an aid for increasing energy.

Royal jelly research
Scientific research on royal jelly has revealed that it possesses antitumor activity in experimental mouse leukemia's.23 Additional research has demonstrated that royal jelly has antibacterial activity against Gram positive bacteria, but not against Gram negative bacteria.24 Furthermore, research with chronically diabetic rats demonstrated that royal jelly possesses an anti-inflammatory action and is able to augment wound healing.25 Royal jelly has also been shown to prevent the cholesterol elevating effect of nicotine26 , and has lowered serum cholesterol in animal studies.27 Some research has also demonstrated that royal jelly can lower cholesterol levels in humans.28,29 Cholesterol lowering research has shown that the typical dose used for this purpose is 50 100 mg daily.30

References:

  1. Anan'eva TV, Dvoretskii AI, Radiatsionnaia biologiia, radioecologiia (1999) 39(2 3):341 4
  2. Bevzo VV, Grygor'eva NP, Ukrainskii biokhimicheskii zhurnal (1997) 69(4):115 7.
  3. Qian B; Zang X; Liu X, Chung kuo chung yao tsa chih (1990) 15(5):301 3, 319.
  4. Liu X, Li L, Chung kuo chung yao tsa chih (1990) 15(9):561 3, 578.
  5. Xie Y, Wan B, Li W, Hua hsi i k'o ta hsueh hsueh pao (1994) 25(4):434 7.
  6. Iversen T, et al, Journal of ethnopharmacology (1997) 56(2):109 16.
  7. Mahmoud AS, Almas K, Dahlan AA, Indian journal of dental research (1999) 10(4):130 7.
  8. Drago L, et al, Journal of chemotherapy (2000) 12(5):390 5.
  9. Kobayashi N, et al, In vivo (2001) 15(1):17 23.
  10. Marcucci MC, et al, Journal of ethnopharmacology (2001) 74(2):105 12.
  11. Grange JM, Davey RW, Journal of the Royal Society of Medicine (1990) 83(3):159 60.
  12. Koo H, et al, Archives of oral biology (2000) 45(2):141 8.
  13. Focht J, et al, Arzneimittel Forschung (1993) 43(8):921 3.
  14. Park YK, et al, Current microbiology (1998) 36(1):24 8.
  15. Steinberg D, Kaine G, Gedalia I, American journal of dentistry (1996) 9(6):236 9.
  16. Mahmoud AS, Almas K, Dahlan AA, Indian journal of dental research (1999) 10(4):130 7.
  17. Crisan I, et al, Romanian journal of virology (1995) 46(3 4):115 33.
  18. Szmeja Z, et al, The Polish otolaryngology (1989) 43(3):180 4.
  19. Esanu V, Virologie (1981) 32(1):57 77.
  20. Amoros M, et al, Journal of natural products (1994) 57(5):644 7.
  21. Debiaggi M, et al, Microbiologica (1990) 13(3):207 13.
  22. Harish Z, et al, Drugs under experimental and clinical research (1997) 23(2):89 96
  23. Tamura T, Fujii A, Kuboyama N, Nippon Yakurigaku Zasshi (1987) 89(2):73 80.
  24. Fujiwara S, et al, J Biol Chem (1990) 265(19):11333 7.
  25. Fujii A, et al, Jpn J Pharmacol (1990) 53(3):331 7.
  26. Abou Hozaifa BM, Badr El Din NK, Saudi Med J (1995) 16:337-42.
  27. Abou Hozaifa BM, Roston AAH, El Nokaly FA, J Biomed Sci Ther (1993) 9:35B44.
  28. Cho YT, Am Bee J (1977) 117:36-39.
  29. Liusov VA, Zimin IU, Kardiologia (1983) 23:105-9 [in Russian].
  30. Vittek J, Experientia (1995) 51:927-35.

A Supplement for Diabetes, Body Composition, Cardiovascular Health & Antioxidant Protection

Don't you just love the smell and taste of cinnamon in a warm, gooey cinnamon bun? As it turns out, the cinnamon may actually provide you with some significant health benefits (although the same can't be said of the gooey bun; sorry). So let's take a closer look at cinnamon.

Background
The use of cinnamon for health is not new. In fact, cinnamon bark has been used for several thousand years in traditional Eastern and Western systems of medicine, for such purposes as anorexia, bloating, dyspepsia with nausea, flatulent colic, and spastic conditions of the GI tract.1 Cinnamon also has a history of traditional use in Korea, China and Russia for treating people with diabetes.2

So what is it about cinnamon that gives it these medicinal properties? The answer is its natural constituents. Specifically, it is the volatile oils (such as eugenol and cinnamaldehyde) as well as the phenolic compounds (such as polyphenol type-A polymers).3,4

Modern research
In addition to traditional use, modern research has demonstrated a number of benefits resulting from cinnamon supplementation. These include improvements in blood sugar for type 2 diabetics, improvements in body composition (e.g., increased lean mass), improvements in cardiovascular parameters, and substantial antioxidant properties. Following is a brief overview of this research.

Improvements in blood sugar
In research by Khan et al5, subjects with type 2 diabetes who took 1, 3 or 6 grams of cinnamon per day for 40 days lowered fasting blood sugar by 18 to 29 percent. The highest dose produced the most rapid response, although the lowest dose produced the most sustained response over the course of the study.

A more recent placebo-controlled, double-blind study6 was conducted on 79 patients with type 2 diabetes mellitus. Subjects were given 336 mg daily of a water-soluble cinnamon extract (corresponding to 3g of cinnamon powder) or a placebo for four months. Those using the cinnamon experienced a significant 10.3 percent reduction in fasting blood sugar, compared to a non-significant 3.4 percent reduction in the placebo group.

In a placebo-controlled, double-blind study by Ziegenfuss et al7, 21 adults with metabolic syndrome (i.e., prediabetes) were given a water-soluble cinnamon extract (500 mg per day) or a placebo for 12 weeks. The results were that 83 percent of those given the extract experienced a significant decrease (about eight percent) in fasting blood sugar, compared to only 33 percent in the placebo group who experienced a decrease.

Improvements in body composition
In the aforementioned study by Ziegenfuss et al8, the subjects also experienced a significant alteration in body composition. Their body fat decreased by 0.7 percent, and their muscle mass increased by 1.1 percent. These changes took place without alterations in the diet or physical activity of the subjects.

Improvements in cardiovascular parameters
In the previously cited study by Khan et al9, type 2 diabetics who were given 1, 3 or 6 grams of cinnamon a day for 60 days experienced significant drops in triglycerides (23 to 30 percent), low-density lipoprotein (LDL) cholesterol (7 to 27 percent), and total cholesterol (12 to 26 percent).

In the Ziegenfuss et al10 study, cinnamon resulted in a 3.8 percent reduction in systolic blood pressure. Likewise, other research11 demonstrated that cinnamon was able to reduce systolic blood pressure in spontaneously hypertensive rats.

Substantial antioxidant properties
As stated previously, cinnamon contains polyphenols. This is important since polyphenols are potent antioxidant compounds, which can help to reduce the oxidative damage caused by free radicals.12 According to Webb13, a recent study assessed antioxidant status and oxidative damage in 11 obese, prediabetic subjects given a water-soluble cinnamon extract, compared to10 obese, prediabetic subjects given a placebo. Those who received the cinnamon experienced a 14 percent reduction in markers of oxidative damage, as well as an increase in markers of total antioxidant capacity.

Cinnamon Safety
When used orally and appropriately, cinnamon is a safe supplement.14 As a matter of fact, cinnamon has Generally Recognized as Safe (GRAS) status in the United States.15 In pregnancy, cinnamon is likely safe when consumed in amounts commonly found in foods16, but may not be safe when used orally in amounts greater than those found in foods.17

Cinnamon Dosage
Based upon the research discussed, an appropriate dose of cinnamon would range between 500-3000 mg daily.

References

  1. Blumenthal M, Goldberg A, Brinckmann J (eds). Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000.
  2. Kim SH, Hyun SH, Choung SY. Anti-diabetic effect of cinnamon extract on blood glucose in db/db mice. Journal of Ethnopharmacology 2006 104:119-123.
  3. Blumenthal M, Goldberg A, Brinckmann J (eds). Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000.
  4. Webb D. A scientific review: Cinnamon and its role in diabetes. Sarasota, FL: Integrity Nutraceuticals International; n.d.
  5. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26:3215-8.
  6. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. European Journal of Clinical Investigation 2006; 36:340-344
  7. Ziegenfguss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a Water-Soluble Cinnamon Extract on Body Composition and Features of the Metabolic Syndrome in Pre-Diabetic Men and Women. Journal of the International Society of Sports Nutrition 2006; 3(2):45-53.
  8. Ziegenfguss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a Water-Soluble Cinnamon Extract on Body Composition and Features of the Metabolic Syndrome in Pre-Diabetic Men and Women. Journal of the International Society of Sports Nutrition 2006; 3(2):45-53.
  9. Khan A, Safdar M, Ali Khan M, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26:3215-8.
  10. Ziegenfguss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a Water-Soluble Cinnamon Extract on Body Composition and Features of the Metabolic Syndrome in Pre-Diabetic Men and Women. Journal of the International Society of Sports Nutrition 2006; 3(2):45-53.
  11. Preuss HG, Echard B, Polansky MM, Anderson R. Whole Cinnamon and Aqueous Extracts Ameliorate Sucrose-Induced Blood Pressure Elevations in Spontaneously Hypertensive Rats. Journal of the American College of Nutrition 2006; 25(2):144-150.
  12. Shobana S, Naidu KA. Antioxidant activity of selected Indian spices. Prostaglandins Leukot Essent Fatty Acids 2000; 62(2):107-110.
  13. Webb D. A scientific review: Cinnamon and its role in diabetes. Sarasota, FL: Integrity Nutraceuticals International; n.d.
  14. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  15. FDA. Center for Food Safety and Applied Nutrition, Office of Premarket Approval, EAFUS: A food additive database. Available at: vm.cfsan.fda.gov/~dms/eafus.html.
  16. FDA. Center for Food Safety and Applied Nutrition, Office of Premarket Approval, EAFUS: A food additive database. Available at: vm.cfsan.fda.gov/~dms/eafus.html.
  17. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.

Ashwagandha (Withania somnifera) is an herb that grows in India, Pakistan, Afghanistan, Spain, parts of the Middle East, Africa, and the Canary Islands. It is sometimes called "Indian ginseng," probably because it is employed as an adaptogen or tonic in Ayurvedic traditional medicine.1 It is not, however, related to "true" ginseng (P. ginseng, P. quinquifolium). The root is used medicinally, although the seeds, shoots, juice and leaves have all been used traditionally as well.2

Phytochemical contents
Ashwagandha has been found to contain steroidal lactones called withanolides. Much of the pharmacological activities Ashwagandha are attributed to the presence of these steroidal lactones.3,4 In addition, the roots provide alkaloids, 18 fatty acids, beta sitesterol, polyphenols and phytosterols.5

Common uses
Traditional use of Ashwagandha includes its use as an aphrodisiac. As a folk remedy, it has a long list of uses. It is listed in the Indian Materia Medica, and is part of Ayurvedic, Siddha, and Unani traditions. Published research on Ashwagandha reveals a variety of potentially valuable and diverse uses for improving and supporting health. Following is a discussion of each of these potential uses.

Chemotherapy and radiation therapy Chemotherapy and radiation therapy are commonly used to treat individuals with cancer. One problem associated with both of these treatments are that they can reduce white blood cell (WBC) count; and chemotherapy can cause mylosuppression-a reduced capacity of bone marrow to produce WBC. In turn, this can lead to patient susceptibility to other infections. Animal research has shown that Ashwagandha is capable of increasing WBC count when used with either chemotherapy or radiation therapy.6,7 Similar research has shown that this herb can also reduce mylosuppression in association with chemotherapy.8

In addition, several studies have shown Ashwagandha to be effective at inhibiting tumor growth in test animals while enhancing radiosensitivity, the ability of radiation therapy to kill tumor cells.9,10,11,12,13,14 In one study, Ashwagandha was able to inhibit tumor growth in animals even without radiation therapy.15

Immune function
Besides it potential for treating cancer, research has shown that Ashwagandha is capable of improving immune function. This was demonstrated in one study where mice experienced an increase phagocytosis and intracellular macrophage activity against a pathogen when given a daily dose of Ashwagandha.16 In another study on mice, Ashwagandha was shown to improve the tumor-fighting ability of macrophages in relation to a known carcinogen.17 Ashwagandha has also prevented myelosuppression in mice treated with immunosuppressive drugs, and led to a significant increase in hemoglobin concentration, red blood cell count, white blood cell count, platelet count, and body weight, in addition to providing immunostimulatory activity.18

Finally, in a series of experiments, various techniques were used to suppress the immune response of mice, then subjected them to infectious organisms. In each experiment, mice pretreated with one of six herbs, including Ashwagandha, fared significantly better than control mice. Mice receiving the herbs demonstrated faster recovery, less disease, and lower mortality. These herbs blunted artificially-induced neutropenia (a deficit of neutrophils, a type of white blood cell) and stimulated leucocytosis (an increase of white blood cells). In treatments that employed both antibiotics and these herbs the combination produced a significantly greater healing effect than either treatment used alone. The herbs also reduced stress-induced damage.19

Antioxidant activity
Apparently, one of Ashwagandha's mechanisms of action is that it has significant antioxidant activity. In one study, Ashwagandha significantly reduced free radical oxidation in the livers of mice, while concurrently increasing the activity of antioxidant enzymes such as superoxide dismutase (SOD) and catalase.20 Other research has shown that Ashwagandha reduced free radical activity in stress induced animals.21 In another study, Ashwagandha administered once daily for 21 days, induced a dose related increase in SOD, catalase, and glutathione peroxidase in rats.22 One interesting study showed that as part of an Ayurvedic herbal formulation, Ashwagandha increased SOD activity in the pancreas of diabetic rats.23

Brain chemistry
Ashwagandha has also been used in the treatment of mental and emotional well-being, since it can influence brain chemistry in positive ways. For example it has been shown to be capable of improving memory and enhancing cognitive function in animal research by improving acetylcholine activity in the brain and binding to acetylcholine receptor sites.24 This herb also has GABA mimetic activity-that is it can mimic some of the activity of the relaxing neurotransmitter GABA.25 Clinical trials have shown that Ashwagandha can alleviate a reactive type of depression without sedating. Instead, it "optimizes mental and psychomotor performance by easing the mental stress bundle."26

Aphrodisiac
In a clinical trial of ashwagandha on the aging process in over 100 men, 71.4 percent of the men reported improvement in their capacity of sexual performance. These responses seem to support the herb's traditional use as an aphrodisiac.27

Anti-inflammatory & anti-arthritic activity
Ashwagandha has demonstrated some very effective anti-inflammatory activity. In fact, in one study its anti-inflammatory activity was comparable to that of a 5-mg/kg dose of hydrocortisone.28 In another study, five plants were assessed for their anti-inflammatory activity. Results showed that while each of the plants possessed varying degrees of anti inflammatory activity, Ashwagandha possessed the greatest.29

Perhaps the anti-inflammatory activity of Ashwagandha explains its efficacy in arthritis. In a one-month study, a combination of Ashwagandha, Boswellia serrata, Tumeric, and zinc were given to 42 patients with osteoarthritis. At the end of the study, there was a significant drop in severity of pain and disability.30

Anti-stress & anabolic activity
Given their relative similarities in function, a comparative study was performed on Ginseng (Panax ginseng), and Ashwagandha (Withania somnifera). Using aqueous suspensions of the powdered root, each herb was tested in mice: (1) for anti-stress activity (by the swimming endurance test); and (2) anabolic activity (by the weight measurement of body weight and levator ani muscle). In the swimming endurance test, Ashwagandha and Ginseng each showed anti-stress activity as compared to the control group, although the activity was higher with Ginseng. In the anabolic study, the mice treated with Ashwagandha showed a greater gain in body weight than those treated with Ginseng, although significant anabolic activity was observed for both herbs.31

Morphine dependence
Although only tested thus far in mice, Ashwagandha may help reduce dependence on morphine. In a 10-day study, Ashwagandha, helped prevent tolerance to morphine from developing. This is important since developing a tolerance for a drug often leads to increased doses and abuses. Also, Ashwagandha suppressed morphine withdrawal jumps, a sign of the development of dependence to morphine.32

Glandular support
As if all of the aforementioned benefits weren't sufficient, Ashwagandha also supports the function of the thyroid, liver and pancreas. After being administered on a daily basis for 20 days, mice experienced an increase in both T3 and T4 thyroid hormones. In the same study, Ashwagandha also decreased free radical activity in the liver.33 In another study, a combination of Ashwagandha and other herbs (Tinospora cordifolia, Eclipta alba, Ocimum sanctum, Picrorrhiza kurroa and shilajit) administered once daily for 28 days decreased blood sugar levels in diabetic rats, and decreased free radical activity in their pancreas as well. This activity in the pancreas is important since the reduction in blood sugar may be due to pancreatic free radical scavenging activity, which protects the cells that produce insulin.34

Safety
To determine any potential toxicity of Ashwagandha (as well as Panax Ginseng), a study was conducted in rats with 90 days oral administration using three doses. Food consumption, body weight, haematological, biochemical and histopathological parameters were studied. The results were that brain, heart, lung, liver, spleen, kidneys, stomach, testis and ovaries were normal on gross examination and histopathologically. Sub-acute toxicity studies in rats did not reveal any toxicity.35 Apparently, Ashwagandha is a safe herb. Even so, one research has suggested that Ashwagandha is contraindicated during pregnancy.36

References

  1. Choudhary M, et al, Phytochemistry (1995) 40(4):1243-6.
  2. Lindner S, Australian Journal of Medical Herbalism (1996) 8(3):78-82.
  3. Choudhary M, et al, Phytochemistry (1995) 40(4):1243-6.
  4. Elsakka M, et al, Rev Med Chir Soc Med Nat Iasi (1990) 94(2):385 7.
  5. Ibid.
  6. Davis L, Kuttan G, J Ethnopharmacol (1998) 62(3):209 14.
  7. Kuttan G, Indian J Exp Biol (1996) 34(9):854 6.
  8. Praveenkumar V, et al, Tumori (1994) 80(4):306 8.
  9. Ganasoundari A, Zare SM, Devi PU, Br J Radiol (1997) 70(834):599 602.
  10. Devi PU, Indian J Exp Biol (1996) 34(10):927 32
  11. Sharad AC, et al, Acta Oncol (1996) 35(1):95 100.
  12. Devi PU, Int J Radiat Biol (1996) 69(2):193 7.
  13. Devi PU, Sharada AC, Solomon FE, Cancer Lett (1995) 95(1 2):189 93.
  14. Devi PU, Sharada AC, Solomon FE, Indian J Exp Biol (1993) 31(7):607 11.
  15. Devi PU, et al, Indian J Exp Biol (1992) 30(3):169 72.
  16. Dhuley JN, Immunopharmacol Immunotoxicol (1998) 20(1):191 8.
  17. Dhuley JN, J Ethnopharmacol (1997) 58(1):15 20
  18. Ziauddin M, J Ethnopharmacol (1996) 50(2):69 76.
  19. Dahanukar S, Thatte U, Phytomedicine (1997) 4(4):359-368.
  20. Panda S, Kar A, J Pharm Pharmacol (1998) 50(9):1065 8.
  21. Dhuley JN, J Ethnopharmacol (1998) 60(2):173 8.
  22. Bhattacharya SK, Satyan KS, Ghosal S, Indian J Exp Biol (1997) 35(3):236 9.
  23. Bhattacharya SK, Satyan KS, Chakrabarti A, Indian J Exp Biol (1997) 35(3):297 9.
  24. Schliebs R, et al, Neurochem Int (1997) 30(2):181 90.
  25. Mehta AK, et al, Indian J Med Res (1991) 94:312 5.
  26. Katiyar CK, et al, Immunomodulator Products from Ayurveda: Current status and future perspectives. In: Immunomodulation, S.N. Upadhyay (Ed), (1997) Narosa Publishing House, New Delhi, India, pp. 163-187.
  27. Linder, op cit
  28. al Hindawi MK, al Khafaji SH, Abdul Nabi MH, J Ethnopharmacol (1992) 37(2):113 6.
  29. Al Hindawi MK, et al, J Ethnopharmacol (1989) 26(2):163 8.
  30. Kulkarni RR, et al, J Ethnopharmacol (1991) 33(1 2):91 5.
  31. Grandhi, et al, Journal of Ethnopharmacology (1994) 44:131-135.
  32. Kulkarni SK, Ninan I, J Ethnopharmacol (1997) 57(3):213 7.
  33. Panda S, Kar A, J Pharm Pharmacol (1998) 50(9):1065 8.
  34. Bhattacharya SK, Satyan KS, Chakrabarti A, Indian J Exp Biol (1997) 35(3):297 9.
  35. Aphale AA, et al, Indian J Physiol Pharmacol (1998) 42(2):299 302.
  36. Linder, op cit

Culinary herbs seldom began their human histories as mere flavorings. Indeed, the kitchen herb and spice rack could reasonably be dubbed the kitchen medicine chest and several useful books have done just that. Oregano is a good example of a culinary herb that leads a double life. In much of the world, this plant continues to be used not just to flavor and preserve food, but also to disinfect surfaces and wounds, to calm the stomach, and much more. For some of these purposes, oregano extracts may still be as good or better than many of the modern alternatives. In other words, the health benefits of oregano are not only "traditional" or "folk remedies."

In recent years, oregano has been surprisingly well studied. Harry Preuss of Georgetown University Medical Center, for instance, over the last decade has published five studies on oregano and other essential oils with results that are impressive. For uses as diverse as from antibiotics to weight loss, oregano and its constituent compounds are attracting new interest in an old remedy.

Snapshot of Oregano

Oregano (Origanum vulgare) is in the same family as rosemary, thyme and the mints. Also called "wild" or "winter" marjoram, it is not to be confused with the related "sweet" marjoram. A further distinction often is made in the health food industry between the oregano cultivated for culinary uses and the species that grow wild, particularly in the Eastern Mediterranean. The latter have a much stronger flavor and aroma reflecting their higher content of certain essential oils.

Constituents of oregano vary with the species, the growing area and the season. The chief active constituents of oregano are a volatile oil known as carvacrol along with the related compound thymol, which is more characteristic of the herb thyme. Also found are the precursor molecule p-cymene and smaller amounts of a variety of other phenolic compounds. Most of the volatile compounds found in oregano are terpenes. Although it might seem to be a foreign term from chemistry, almost everyone is familiar with one or more terpenes—probably the best known terpene is limonene, the highly aromatic compound found in the peel of oranges and the chief component of orange oil.

A number of the most ancient employments for oregano remain common. Uses attributed to Hippocrates and the Greek medical tradition include as an antiseptic, a cure for stomach complaints and as a solution to respiratory ailments. Other uses sometimes suggested include rheumatoid arthritis, urinary tract infections, headaches, convulsions and fatigue (the last being common in 19th Century materia medica manuals). A favored use both in the past and today is for parasites.1 The essential oil exhibits diuretic, expectorant and antispasmodic properties as well as a stimulant effect on bile production.2

Modern Experimental Science Takes a Look at Oregano

Much of the focus of contemporary oregano research has been on its benefits against fungal and bacterial infections. Some eighty percent of all antibiotics produced in the US are fed to animals, a seriously bad practice that creates reservoirs of resistant bacteria that then are transmitted to humans via food and other vectors.

In the first of several studies, researchers at Georgetown University Medical Center examined a number of volatile aromatic oils for their benefits.3 Oregano oil, which today primarily is used as a food flavoring agent, was hypothesized to possess a broad spectrum of in vitro antimicrobial activities attributable to the high content of phenolic derivatives such as carvacrol and thymol. In a study published in 2001, the antifungal properties of oregano oil were examined both in vitro and in vivo using the yeast Candida albicans as the exemplar fungal model. In an animal model of systemic candidiasis using mice, consumption of oregano oil supplied in olive oil led to 80% survival at 30 days versus none in the animals fed only olive oil. Carvacrol, the major constituent of the oil, was similarly effective, yet visual observation found that the mice consuming the oregano oil presented a cosmetically superior clinical appearance. This trial showed that oregano oil warrants further examination for possible benefits in pathogenic fungal infections.

A second trial explored the benefits of oregano oil and the coconut oil fraction monolaurin against one of the more common bacterial infective agents, Staphylococcus aureus.4 As before, both in vitro and in vivo tests were carried out. In vitro, oregano oil was the most successful of the essential oils tested. In mice, systemic infection with S. aureus is routinely and rapidly fatal. This particular trial found that all 14 mice in the untreated arm of the study died within a one week period. Of the oregano oil treated mice, six of fourteen were still alive at 30 days. This compared favorably with the survival rates of those receiving daily vancomycin (7/14) and monolaurin (4/8). Over 60% of mice survived when receiving a daily combination of oregano oil and monolaurin (5/8). This trial therefore demonstrated that oregano oil, either alone or in combination with monolaurin, warrants further examination for possible use for prevention and therapy of Staphylococcus aureus infections. Numerous studies, in fact, have been undertaken since this one and have demonstrated, for instance, activity against methicillin-resistant staphylococci.5 In a world of increasing resistance to antibiotics, this is significant.

Needless to say, staphylococci are not the only bacterial pathogens against which new active agents are required. A third test conducted at Dr. Preuss' laboratory examined the efficacy in vitro of oregano and several other essential oils as well as monolaurin against a variety of gram-positive and gram-negative bacteria. Oregano oil proved active against all the tested pathogens except B. anthracis Sterne.6

The successful use of oregano oil against parasitic infections has been mentioned already.

New Research Directions for Oregano

Two interesting developments in modern research may break new ground for uses of oregano oil. The first involves insulin metabolism. Researchers in 2005 examined the ability of various combinations of essential oils such as fenugreek, cinnamon, cumin, oregano, etc. to enhance insulin sensitivity. As a first approximation, they examined the effects of these natural products on Zucker fatty rats, a model of obesity and insulin resistance, and spontaneously hypertensive rats, a model of genetic hypertension. The ability to alter systolic blood pressure (the upper figure) in rat models is the most sensitive early index of insulin sensitivity. In this particular trial, various combinations of essential oils lowered blood pressure in both rat species, suggesting improved insulin sensitivity.7

The story does not end with blood pressure data. Relatedly, a mouse study found that carvacrol appears to inhibit visceral adipogenesis (the creation of new fat cells in belly fat tissue) and it also attenuates the production of pro-inflammatory cytokines in these tissues.8 Work in another model, this one with induced edema in the paws, demonstrated anti-inflammatory and anti-ulcer protections, as well.9

Finally, there is information emerging regarding oregano's protection against prostate cancer. According to Dr. Supriya Bavadekar, PhD, RPh, Assistant Professor of Pharmacology at Long Island University's Arnold & Marie Schwartz College of Pharmacy and Health Sciences, the lead scientist for work presented at a conference in 2012, "Some researchers have previously shown that eating pizza may cut down cancer risk. This effect has been mostly attributed to lycopene, a substance found in tomato sauce, but we now feel that even the oregano seasoning may play a role."10

Safety and Usage of Oregano

Oregano and oregano oil are generally considered as safe (GRAS). However, caveats do apply. Large amounts of either may irritate the gastrointestinal tract. Concentrated amounts taken internally especially should be avoided in pregnancy and lactation. Also, the essential oil can be an irritant not just to the gastrointestinal tract, but to the skin, hence topically the essential oil usually is applied only as part of a prepared ointment.

For intestinal parasitic infection, an emulsified oil of oregano has been used in a dose of 200 mg three times daily for 6 weeks, but such treatments need to be overseen by an experienced physician. Traditionally for other purposes, a typical dose is one cup of tea made by steeping one heaping teaspoon of the dried leaf in 250 mL boiling water 10 minutes. Alternatively, 19th Century herbals and medical manuals suggested 2 - 5 drops / day of the essential oil taken on a sugar cube for gastrointestinal issues and as an aromatic stimulant.

References:
  1. Force M, Sparks WS, Ronzio RA. Inhibition of enteric parasites by emulsified oil of oregano in vivo. Phytother Res 2000:14:213-4.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. Manohar V, Ingram C, Gray J, Talpur NA, Echard BW, Bagchi D, Preuss HG. Antifungal activities of origanum oil against Candida albicans. Mol Cell Biochem. 2001 Dec;228(1-2):111-7.
  4. Preuss HG, Echard B, Dadgar A, Talpur N, Manohar V, Enig M, Bagchi D, Ingram C. Effects of Essential Oils and Monolaurin on Staphylococcus aureus: In Vitro and In Vivo Studies. Toxicol Mech Methods. 2005;15(4):279-85.
  5. Nostro A, Blanco AR, Cannatelli MA, Enea V, Flamini G, Morelli I, Sudano Roccaro A, Alonzo V. Susceptibility of methicillin-resistant staphylococci to oregano essential oil, carvacrol and thymol. FEMS Microbiol Lett. 2004 Jan 30;230(2):191-5.
  6. Preuss HG, Echard B, Enig M, Brook I, Elliott TB. Minimum inhibitory concentrations of herbal essential oils and monolaurin for gram-positive and gram-negative bacteria. Mol Cell Biochem. 2005 Apr;272(1-2):29-34.
  7. Talpur N, Echard B, Ingram C, Bagchi D, Preuss H. Effects of a novel formulation of essential oils on glucose-insulin metabolism in diabetic and hypertensive rats: a pilot study. Diabetes Obes Metab. 2005 Mar;7(2):193-9.
  8. Cho S, Choi Y, Park S, Park T. Carvacrol prevents diet-induced obesity by modulating gene expressions involved in adipogenesis and inflammation in mice fed with high-fat diet. J Nutr Biochem. 2012 Feb;23(2):192-201.
  9. Silva FV, Guimarães AG, Silva ER, Sousa-Neto BP, Machado FD, Quintans-Júnior LJ, Arcanjo DD, Oliveira FA, Oliveira RC. Anti-inflammatory and anti-ulcer activities of carvacrol, a monoterpene present in the essential oil of oregano. J Med Food. 2012 Nov;15(11):984-91.
  10. Federation of American Societies for Experimental Biology (FASEB). "Component of pizza seasoning herb oregano kills prostate cancer cells." ScienceDaily, 24 Apr. 2012. Web. 23 Jan. 2013.

The Amazon rainforest, the largest rainforest on earth, has been targeted by pharmaceutical companies for over a century as a rich source of new plant-derived drugs. The Amazon rain forest is even more so a treasure trove of botanicals for the dietary supplement industry. This rain forest stretches over a billion acres in Brazil, Venezuela, Columbia, and the eastern Andean area of Ecuador and Peru. It is home to hundreds of thousands of plants, many of which are used as folk medicines.

Among the many beneficial traditional Amazon botanicals which have emerged in recent years, Uña de gato, or Cat's Claw (Uncaria tomentosa), is one of the most beneficial of all. A woody vine, the plant earns its name due to its sharp, claw-like thorns. Dispersed throughout Central and South America, cat's claw has been used for centuries by native tribes. The entire Uncaria genus, of which there are 60 or so known species, occurs in the tropics. These are coarse shrubs which climb by means of sharp spines or thorns. One species, Uncaria guianensis, is also called cat's claw. But this species lacks the same broad use and science as Uncaria tomentosa.

Good Ghost, Bad Ghost
One of the tribes most associated with cat's claw is the Ashaninka. Their tribal name means "belonging to the Inca." Formerly fierce warriors, the Ashaninka served as the last line of stubborn and dangerous defense against the Spanish conquest of Peru and the eventual destruction of the Incan empire. Many Ashaninka people live in the Chanchamayo region of the Peruvian Amazon, an area of hilly and mountainous rain forest. According to the Ashaninka healers, there are two types of cat's claw, good ghost plants and bad ghost plants. The Ashaninka call the good ghost cat's claw Saventaro, meaning powerful plant. You have to be an expert to know the difference. Fast-forwarding to the scientific present, scientists now have identified two distinct chemotypes of cat's claw. The good ghost cat's claw plants contain POA's or pentacyclic oxindole alkaloids. These compounds provide significant benefits to health. But the so-called bad ghost plants contain TOA's, tetracyclic oxindole alkaloids, which actually counteract the beneficial effects of the plant. The Ashaninka explanation of which plants to use and which to avoid are affirmed and explainable by modern scientific analysis. The bridge between traditional knowledge and scientific rigor is being established with thousands of medicinal plants worldwide. Among medicinal plants from Amazonia, Saventaro is a science heavyweight.

Powerful Plant
On a hot, sunny day, I stood overlooking a long green river valley outside of La Merced Peru with Johannes Keplinger, a bright and talented Austrian familiar with that region, the Ashaninka people, and Saventaro cat's claw. His father, Klaus Keplinger, is a pioneer in the study and promotion of cat's claw, or Saventaro. Klaus Keplinger is a true friend of the Ashaninka people, and has worked hard for decades on their behalf. Elder Keplinger's dedication to the cat's claw cause traces back to an influential meeting with a shaman in 1959, when he took part in a mountaineering expedition in Peru. The Ashaninka shaman told Keplinger about a healing plant. That plant was Saventaro, the POA chemotype, or good ghost cat's claw. In the early 1970's Keplinger was told about a successful cancer treatment of a friend, using cat's claw. Keplinger returned to the Chanchamayo region in 1975, and has worked with the Ashaninka people in the sustainable harvesting and initial processing of the POA chemotype of cat's claw, Saventaro, for eventual manufacture into a standardized extract. Keplinger's son Johannes now is responsible for the project, which operates in Austria under the name Immodal Pharmaka.

Joining Johannes and me were photographer Donna Horn and an Ashaninka Indian named Josias Macuyama. We were together to visit every aspect of the world of Saventaro cat's claw, from the forest to drying harvested material. Donna shot photographs throughout the entire trip, while Josias works directly with the Keplinger family in the Saventaro cat's claw project. Josias is an influential and respected man in the Ashaninka world. As one of the tribe, he knows the challenges his people face. At the same time, Josias enjoys a European education, and a broader world perspective. The four of us made a friendly and cooperative quartet as we travelled throughout the Chanchamyo region of the Peruvian Amazon, meeting with a broad range of people involved with Saventaro cat's claw.

We hiked into the hot rainforest to see cat's claw plants with a couple of native Ashaninka harvesters named Mario and Nestor, and a local medicine man Manuel Harena. There we witnessed first hand how Ashaninka people harvest Saventaro cat's claw in three ways that set them apart from others. First the harvesters visually determining whether a plant is the right chemotype. Secondly, they harvest root material instead of bark, which is more common. Additionally, they maintain a sustainable harvesting project in thousands of acres of rain forest, protecting the natural habitat and preventing depletion of cat's claw supplies. The Ashaninka use GPS units to identify exact locations of cat's claw plants, which can be huge, twining through an acre or more of forest, winding around trees, taking over a lot of ground. Each plant is tagged with an identification code. Up to one third of the lateral roots of a plant is harvested, and then that plant is left alone for ten years before any further harvesting takes place. This enables new lateral roots to grow, and contrasts sharply with harvesting of cat's claw in many other regions, where plants are cut down and ripped up, dried and ground, decimating forest and depleting supplies of this potent rain forest medicine.

Compounds in Cat's Claw
The phytochemistry of cat's claw, Uncaria tomentosa has been very well studied. Uncaria tomentosa contains numerous phytochemicals that account for the plant's traditional and current uses. The highly studied oxindole alkaloids, notably the POA's, demonstrate immune-modulating and antileukemic activity. Other constituents called quinovic acid glycosides show anti-inflammatory and antiviral activity. Antioxidant phenols and plant sterols contribute to the plant's anti-inflammatory properties. Yet another group of cat's claw compounds called carboxyl alkyl esters demonstrate immune-enhancing, anticancer, and anti-inflammatory activity, as well as cell-repairing properties.

In his Amazonian Ethnobotanical Dictionary, botanist Dr. James A. Duke describes the use of cat's claw in Peru for anti-inflammatory, and cytostatic (retards tumor cells) purposes. In popular literature, cat's claw is increasingly promoted for its well established immune enhancing properties. Studies support the traditional use of cat's claw for anti-inflammatory and immune-enhancing purposes. By helping to prevent and repair damage to DNA, cat's claw may possibly prove to be a bonafide life extender.

Cat's Claw Benefits
Studies conducted with the POA chemotype of cat's claw show that these agents possess anti-inflammatory, antimutagenic, antiviral and immune-stimulating properties. The POA alkaloids in the vine demonstrate immune-enhancing activity by producing an increase in phagocytosis, a process by which potentially harmful materials are "eaten" by protective cells. In studies of quinovic acid glycosides in the plant, researchers observed significant anti-inflammatory activity. Additionally, these same compounds were shown to inhibit several types of common viruses. In studying triterpenoid saponins, scientists observed that these chemical agents inhibited the growth of some tumor cells. In Austria, Saventaro cat's claw extract is prescribed by physicians under the name Krallendorn for the treatment of rheumatoid arthritis. In many cases, it enables sufferers of this disease to gradually ease off of medication and live normal lives. The extract demonstrates benefit as an adjunct to chemotherapy and radiotherapy in cancer treatment, and improves overall parameters of health in cases of various cancers. Saventaro cat's claw also helps to treat viral infections including Herpes simplex and Varicella zoster, and improves immune function and several parameters of life quality in cases of HIV and Aids. This phytochemical-packed Amazonian plant has become a highly studied and effective medicine.

Cat's Claw and Sustainability
One challenge we face in the era of modern plant medicine is how to engage in herbal work in a manner that sustains plants, people and the natural environment. In addition to harvesting Saventaro cat's claw root in an eco-friendly way, the collaboration between Immodal and the Ashaninka people provides other benefits. Harvesters of Saventaro cat's claw root are paid a fair daily wage that exceeds local wages. They are additionally paid per kilo of lateral roots harvested. After that, additional funds accrue to the Ashaninka villages for medicine and education. This type of green business bodes well for the future.

Some people state that the Amazon rain forest should be better protected, because someday we may find an extraordinary rainforest remedy that is a true lifesaver, one that treats serious diseases and provides extraordinary health benefits. We don't need to wait for some future discovery to start taking better care of one of the greatest geographic resources on earth. The traditional native medicine cat's claw is that extraordinary rainforest remedy. The POA chemotype of cat's claw, called Saventaro by the Ashaninka Indians, demonstrates profound medicinal value. Its immune-modulating, antiviral, antitumor and anti-inflammatory effects make Saventaro a medicine deserving of greater recognition and more widespread use.



Written by Suzanne M. Diamond, M.Sc.

Four humble herbs with an impressive history for helping people to improve their health and overcome disease include burdock root (Arctium lappa L.), sheep sorrel herb (Rumex acetosella L.), Indian rhubarb root (Rheum officinale L.) and slippery elm bark (Ulmus rubra Muhl.). A traditional herbal formulation made with these four herbs is gaining recognition as a good remedy for treating a wide range of health problems. The below information covers some of the impressive research on these four herbs and helps to shed light on how this synergist blend can afford so many profound health benefits.

BURDOCK ROOT (Arctium lappa L.) Not far from your doorstep, if you look, you can usually find the soft green leaves of burdock, common in most neighborhoods— and based on much scientific and historical data, the root of this plant can dramatically enhance your health by boosting your immune system, improving digestion and thwarting cancer in many different ways. Regularly incorporating burdock root in your daily regime may even be able to increase your lifespan based on anti-aging results found with animals. There are many other documented and accepted health benefits of regularly drinking burdock root tea based on the German Pharmacopoeia, including the relief of gastrointestinal complaints and bone and joint conditions.

Burdock root, also known as gobo or Poor-man’s potatoes, is an important food in Japan known for its many healing properties. Burdock root can safely be eaten as a root vegetable and is popularly eaten by Japanese people and sushi lovers of all nationalities. When grown in loamy soil, the root grows into a very long, creamy colored tap root similar in appearance to a carrot but much longer. It can grow deeper than most root veggies and is known as a good source of trace elements and minerals accessed from deeper soil layers. Unlike carrots and potatoes, burdock root does not contain starch it contains complex carbohydrates called fructo-oligosaccharides (FOS) including 27–45 percent inulin. When people eat starchy roots, this causes a sharp rise in blood sugar and blood insulin levels. But burdock root provides the body with soluble fibers that do not affect blood sugar or blood insulin levels. This makes burdock root and FOS particularly beneficial for diabetics. FOS and inulin have many scientifically documented health benefits including acting as a beneficial prebiotic by feeding beneficial intestinal microflora (BIM) while also eliminating potential gut pathogens, optimizing colonic pH, boosting bone strength through increasing calcium and mineral absorption from food, supporting serum enterolactone and enterodiol concentrations, helping to control blood sugar levels and reducing cholesterol. Other foods that contain inulin include chicory root, onions, Jerusalem artichokes and bananas.

According to Bengmark (2005), researching out of the Institute of Hepatology, University College, London Medical School, U.K., inulin has prebiotic qualities and can affect intestinal immune cells and potentially repair the gut wall and thereby improve overall immune function. Several recent scientific studies have documented significant immune-enhancing effects of inulin and oligofructose.

Taking herbal formulas that contains burdock root, rich in natural oligofructose and inulin, have been found to afford many digestive benefits and favorable results have been shown with a number of digestive disorders according to Tamayo and colleagues (2000).

SHEEP SORREL (Rumex acetosella L.) Sheep sorrel is a common herb found abundantly at roadsides and is otherwise known as sour grass because of its tart leaves. The leaves are popularly used in herbal teas for rejuvenating health and cleansing toxins from the body. Sheep sorrel has powerful phytoestrogen activity (phytoestrogen means plant-estrogen) based on in vitro studies conducted by U.S. hormone researcher, Dr. David Zava in 1998. Sheep sorrel came in tenth out of 150 herbs tested for phytoestrogen activity; the list was headed by soy beans, licorice root and red clover herb, all legumes wellknown for their phytoestrogen activity.

Sheep sorrel is an important component of ESSIAC® tea and products, together with three other herbs, burdock root, slippery elm bark and Indian rhubarb root. Early research on sheep sorrel herb by famed Canadian nurse Rene M. Caisse and R.O. Fisher, M.D., in Ontario in the 1920s and 30s, found that sheep sorrel liquid extract given to mice with artificially induced tumors caused cancerous tumors to markedly regress and disappear. The other herbs in ESSIAC were said to help with cleansing and eliminating the dead cancer cells and other toxins from the system. Nurse Rene Caisse also reputedly had success with treating cancer patients with ESSIAC together with sheep sorrel extract—including one case cured and two cases improved accepted by a Cancer Commission set up by the Canadian Government in the 1939. There are many more anecdotal reports and some well documented cases of success with ESSIAC for dramatically improving people’s health very quickly.

Human clinical studies with other phytoestrogen-rich foods and herbs, such as flaxseed and red clover, have also produced profound anti-cancer results. For instance, clinical studies with breast cancer patients given muffins containing 50 grams of ground flaxseed daily (flaxseed contains phytoestrogens called lignans in its seed coat) versus placebo muffins (without flaxseed) conducted by Dr. Paul Goss, Dr. Lilian Thompson and colleagues in 2000 at the Princess Margaret Hospital in Toronto, Canada, and a further clinical study conducted by these same researchers with post-menopausal breast cancer patients taking 25 grams of flaxseed daily documented significant anti-cancer effects within 30 to 40 days. A study done with a prostate cancer patient in Australia reported by Dr. Fredrick O. Stevens (1997) and a further randomized, placebo-controlled clinical study with prostate cancer patients conducted by Dr. Jarred and colleagues in England (2002) using red clover isoflavonoid extracts (160 mg/daily for only seven days in the case study and for 30–40 days in the clinical trial) have documented strong anti-cancer effects for red clover isoflavonoid phytoestrogens within days/weeks based on tumorectomies. There were no serious negative side effects noted in any of these studies.

Foods and herbs rich in phytoestrogens, such as flaxseed (lignans), burdock root (isoflavones), burdock seed (lignans), milk thistle seed (lignans), red clover (isoflavones), soybean (isoflaonves), kudzu root (isoflavones), etc., once eaten, are metabolized within the gut by beneficial intestinal bacteria and the isoflavonoids and lignans that they contain significantly increase serum enterolactone and enterodiol concentrations. According to research conducted by the Australian company, Novogen, certain phytoestrogen metabolites function to inhibit anti-apoptosis proteins in cancer cells thereby causing cancer cells to go through apoptosis or programmed cell death without harming normal cells. Simply put, phtoestrogen-rich foods and extracts can cause cancer cells to simply die and be cleansed from the body without causing terrible side effects. Many phytoestrogens have also been shown to stimulate beneficial anti-cancer enzymes. The powerful and safe anti-cancer activity of phytoestrogen-rich foods and herbs may help to explain the myriad anecdotal reports of spontaneous remissions in cancer patients and miracle cancer cures documented over the centuries with various herbs and herbal combinations. More research is needed in this area to clearly define the anti-cancer activity of different phytoestrogens.

Many foods, herbs and supplements contain beneficial phytoestrogens and other natural anti-cancer compounds that help to balance hormones in different ways. Sheep sorrel appears to be one that may have great promise for cancer patients. Further human clinical studies with sheep sorrel are needed to confirm the beneficial estrogen modulating and anti-cancer activity of its phytoestrogens and other active ingredients.

SLIPPERY ELM INNER BARK
(Ulmus fulva Michx. and U. rubra Muhl.) Slippery elm bark has a long history of use as a medicine and also as a food that can be eaten like gruel and is commonly made into lozenges for sore throats and coughs. The inner bark of this tree has been used as folk remedy for treating cancer and other conditions including: respiratory problems, throat irritation, fever, abscesses, dysentery, urinary and kidney inflammations.

Choi and colleagues (2002) at Pusan National University in Korea studied slippery elm bark and found that it exhibited dose-dependent peroxynitrite scavenging activities. According to Langmead and colleagues (2002) at the Academic Department of Adult and Paediatric Gastroenterology, London, U.K., slippery elm bark also exhibited potent antioxidant activity using in vitro tests based on chemiluminescence used to detect herbal effects on generation of oxygen radicals by mucosal biopsies from patients with active ulcerative colitis. These researchers concluded that slippery elm and other herbal extracts merit formal evaluation as novel therapies in inflammatory bowel disease.

Lans, Turner, Khan and Bauer (2007) report the use of Ulmus fulva Michx. in ethnoveterinary medicines used to treat endoparasites and stomach problems in pigs and pets in British Columbia, Canada. The authors note that Ulmus fulva, along with other plants used for this purpose, have mid- to high-level validity for their ethnoveterinary use as anthelmintics (deworming agents).

Five case studies of patients with psoriasis following a dietary regimen including a pinch of slippery elm bark taken daily with meals found relief of symptoms according to Brown and colleagues (2004) at the University of Hawaii at Manoa, Honolulu, U.S. The five psoriasis cases, ranging from mild to severe at the study onset, improved on all measured outcomes over a six-month period.

INDIAN RHUBARB ROOT
(Rheum officinale L.)
Michael Castleman in his book, Medicinal Herbs describes rhubarb (medicinal rhubarbs, Rheum officinale and R. palmatum; and garden rhubarb, R. rhaponticum noted as having similar but less powerful action) as an odd plant: its roots are medicinal; its stems make tasty pies but its leaves are poisonous. He also notes that Chinese physicians have used rhubarb root since ancient times prescribing it externally as a treatment for cuts and burns and internally in small amounts for dysentery while large amounts have powerful laxative action. Formerly, the root was an important drug in many army camps, said to stop dysentry in its tracks. The active ingredients of Indian rhubarb root include emodin and aloe-emodin, rhein and other anthracene derivatives.

Conclusion: According to many studies, adding a time-tested herbal formula with these humble herbs to your daily menu may bring a boon to your health resulting in many immediately noticeable benefits to your well-being.

Formal clinical trials are warranted to evaluate the real anticancer effects of formulas containing these four herbs. Such clinical studies need to be carefully designed, placebo controlled clinical trials with cancer patients scheduled for tumorectomies but not receiving chemo or radiation, in order to avoid confounding variables from these treatments (i.e. similar in design to studies assessing the anticancer effects of flaxseed and red clover).

For references send a S.A.S.E. to totalhealth.

Endocrinologists have known for a long time that testosterone increases the body’s ratio of lean muscle mass to fat. In both animals and humans, tongkat ali extract increases muscle mass. In a study of men, half of the subjects ingested tongkat ali extract and half did not. In an eight-week physical training program the men who consumed tongkat ali extract experienced greater gains in muscle mass and strength than those who did not. This demonstrates the powerful anabolic properties of tongkat ali. Instead of turning to the use of dangerous and potentially lethal steroids, perhaps more athletes will opt for tongkat ali. In Malaysia, many professional field hockey players use tongkat ali extract as an androgen and swear to its performance-enhancing effects.

The Extract Secret
Dr. Johari has solved a problem with tongkat ali extraction: “One of the things we found is that when organic solvents are used to extract tongkat ali, you get a number of toxic compounds, especially the quassinoids, in the extract.” To get around this problem, Dr. Johari began to experiment with a water extract. Using water, pressure, a very specific range of temperature and freeze drying, he was able to develop a proprietary tongkat ali extract with a very low quassinoid level and high amounts of the active glycoproteins. That extract has been used in all the animal and human studies that have been conducted on tongkat ali. In the United States, Dr. Johari’s proprietary tongkat ali extract goes by the name LJ100. I asked him how much LJ100 tongkat ali extract people should take. “We have found that men need about 100 mg (milligrams) of extract per day, while women need about 50 mg,” he said.

Tongkat Ali and Sexuality
Dr. Ismail Tamby directs the Human Reproduction Specialist Center in the Malaysian capital of Kuala Lumpur. Dr. Tamby is one of the foremost experts on reproductive health in Southeast Asia. He works with men and women in all cases of sexual dysfunction, reproductive disorders and fertility problems. He is also the leading medical expert on the effects of tongkat ali root extract on human subjects. In his work with men, Dr. Tamby has found that use of tongkat ali extract significantly increases testosterone production. He said, “I was very skeptical at first about this type of thing, using some plant to change hormone levels. But I did some work with it and tongkat ali turned out to be highly potent. In our studies, we found that tongkat ali extract increased the serum level of testosterone considerably.” I asked Dr. Tamby if the men in his study experienced renewed sexual vitality or heightened sexual desire. “Oh, yes, most definitely,” he said. “The men found that tongkat ali boosted their sex drive quite a lot. I think that for low libido, tongkat ali extract is very valuable. I have seen this result for myself and can say that this plant really works.”

Dr. Tamby conducted the PADAM study in which he investigated partial androgen deficiency in males. He selected 30 adult males of various ages, assessed their testosterone levels and then gave them 100 mg of tongkat ali extract daily. The testosterone levels of all the subjects rose, from somewhat to a lot, depending on age. Dr. Tamby’s study resulted in a 91 percent improvement in libido, a reported 73 percent improvement in sexual function and an 82 percent psychological improvement relative to sex among the men who participated in the study. His work shows that while the level of testosterone in the blood decreases with age, tongkat ali can reelevate the level of this important sex hormone.

Using Tongkat Ali
Dr. Johari, Dr. Tamby and other experts involved with this plant recommend around 100 milligrams of FDAE (freeze-dried aqueous extract, or LJ100) tongkat ali daily for men, and around 50 milligrams for women, to boost testosterone, enhance sexual function, increase ATP production and improve lean muscle mass.

Though tongkat ali extract is by no means a cure-all, it does offer a solution to some of the vexing problems of aging. Demonstrating a high level of safety, tongkat ali delivers youth-enhancing effects. For this reason, its increased use in dietary supplements seems guaranteed.