Passionflower and Sleep

Passionflower (Passiflora incarnata) is one of my favourite herbs. Passionflower is beneficial for reducing stress and anxiety, and improving sleep. I use it in combination with Ashwagandha (Withania), Chamomile, Lavender, Lemon Balm, and Ziziphus. Combining with Magnesium is helpful in reducing muscle cramps, aches and pains, and good for overall relaxation.

A double-blind, placebo-controlled trial investigated the effects of Passionflower herbal tea on sleep quality. The study was measured using sleep diaries validated by polysomnography. Sleep quality showed a significantly better rating for Passionflower compared with placebo (t(40) = 2.70, p < 0.01).

Reference: Ngan A, Conduit R. A double-blind, placebo-controlled investigation of the effects of Passiflora incarnata (passionflower) herbal tea on subjective sleep quality. Phytother Res. 2011 Aug; 25(8): 1153-9.

Pyrrole Disorder update

Pyrrole disorder can be described as a complex disorder. The causes of pyrrole disorder are not completely understood. There has been an influx of people with potential pyrrole disorder in clinic in the last year or so, especially since the website post last year.

All humans excrete small quantities of hydroxyhemopyrrolin-2’one (HPL) in urine. The level of HPL is tested via a urine test. The level of HPL increases with physical or emotional stress. Elevated HPL has been observed in people with depression. Some laboratories have set the normal concentration of HPL in urine as less than 25 μg/dL. However, practitioners may associate HPL levels twice that amount as being elevated.

The signs and symptoms of pyrrole disorder are similar to that of vitamin B6 and zinc deficiency. The HPL molecule can bind up zinc and vitamin B6 and excrete them, leading to a deficiency.

Hopefully research will provide more information about Pyrrole Disorder the next few years. One of my aims is to conduct clinical trials investigating the levels of HPL and mental health, especially in depression and anxiety, and cardiometabolic disease.

Milk Thistle for Liver Health

Milk Thistle (Silybum marianum) is one of my favourite herbs for liver health. Milk Thistle is the most well-researched plant in the treatment of liver disease.

The active complex of Milk Thistle is a lipophilic extract from the seeds of the plant and is composed of three isomer flavonolignans (silybin, silydianin, and silychristin) collectively known as silymarin. Silybin is a component with the greatest degree of biological activity and makes up 50% to 70% of silymarin. Silymarin is found in the entire plant but it is concentrated in the fruit and seeds. I always look for products that note the Silybin content.

Silymarin acts as an antioxidant by reducing free radical production and lipid peroxidation. It has antifibrotic activity and may act as a toxin blockade agent by inhibiting binding of toxins to the hepatocyte cell membrane receptors. In animals, silymarin reduces liver injury caused by alcohol, Paracetamol (acetaminophen), carbon tetrachloride (CCl4), radiation, iron overload, phenylhydrazine, and cold ischaemia. Silymarin has been used to treat alcoholic liver disease, acute and chronic viral hepatitis, and toxin-induced liver diseases.

When formulating liquid herbs or prescribing tablets/capsules/powders for liver and digestive health, I always include Milk Thistle. It is essential.

Reference: Abenavoli L et al. Milk thistle in liver diseases: past, present, future. Phytother Res. 2010 Oct; 24(10): 1423-32.

Pyrrole Disorder

Pyrrole disorder can be described as a complex disorder. The causes of pyrrole disorder are not completely understood.

All humans excrete small quantities of hydroxyhemopyrrolin-2’one (HPL) in urine. The level of HPL increases with physical or emotional stress. Some laboratories have set the normal concentration of HPL in urine as 2 to 25 μg/dL. However, practitioners may associate HPL levels twice that amount as being elevated.

The signs and symptoms of pyrrole disorder are similar to that of vitamin B6 and zinc deficiency.

Hopefully research will provide more information about Pyrrole Disorder the next few years.

Effect of omega-3 fish oil on cardiovascular risk in diabetes

PURPOSE:

Diabetes and cardiovascular disease are major public health concerns worldwide and are leading causes of morbidity and mortality. People with type 2 diabetes are at an increased risk for cardiovascular disease. Diet has a substantial affect on the progression of many diseases, including diabetes, cardiovascular disease, osteoporosis, and arthritis. Omega-3 polyunsaturated fatty acids (long-chain polyunsaturated fatty acids [LC-PUFA]) have long been attributed to the maintenance of health and may be of benefit in reducing cardiovascular risk. The purpose of this review is to investigate the possible roles of omega-3 in reducing cardiovascular risk in patients with diabetes.

 METHODS:

A literature search was conducted from the Medline, EBSCO, and EMBASE databases. Articles that addressed diabetes, cardiovascular disease, or omega-3 were included.

 RESULTS:

Reviews and studies reported an association with fish and omega-3 LC-PUFA consumption and decreased total cardiovascular mortality (approximately 15%-19%), along with decreased platelet activation and aggregation, improved lipid profiles, including reduction of triglycerides and very low-density lipoprotein (VLDL), decreased inflammation, and lowered blood pressure.

 CONCLUSION:

Diets higher in fish and omega-3 LC-PUFA may reduce cardiovascular risk in diabetes by inhibiting platelet aggregation, improving lipid profiles, and reducing cardiovascular mortality. Fish and omega-3 LC-PUFA can be recommended to people with diabetes and included into a diabetes management program.

McEwen B, Morel-Kopp MC, Tofler G, Ward C. Effect of omega-3 fish oil on cardiovascular risk in diabetes. Diabetes Educ. 2010 Jul-Aug;36(4):565-84. (http://www.ncbi.nlm.nih.gov/pubmed/20534874)

Chromium for Glucose Metabolism

Chromium is an essential mineral that is required for carbohydrate and lipid metabolism. Glucose intolerance and insulin resistance are on the rise. For improving glucose tolerance and reducing insulin resistance, I typically combine Chromium with the herbs Cinnamon, Garcinia, and Gymnema. I first read about Gymnea in my first year of study in 1996 and did a major herbal assignment on it the same year. I have people add Cinnamon to smoothies. Regarding nutrients, I combine Chromium with the trio of Zinc, Magnesium, and Vitamin B6, which all help with the metabolism of carbohydrates and glucose. Depending on the individual situation, I might prescribe 200 micrograms of Chromium 2-3 times daily with food.

Consumption of refined foods, including simple sugars, exacerbates the problem of insufficient dietary Chromium since these foods are not only low in dietary Chromium but also enhance additional Chromium losses. Chromium losses are also increased due to pregnancy, strenuous exercise, infection, physical trauma and other forms of stress.

Supplementation of Chromium often leads to significant improvements in glucose tolerance, serum lipids including high-density lipoprotein cholesterol, insulin, and insulin binding. Chromium also tends to normalise blood glucose. Chromium supplementation of subjects with elevated blood sugar following a glucose load leads to a decrease in blood sugar while hypoglycaemics respond to supplemental Chromium by an increase in hypoglycaemic glucose values, increased insulin binding and alleviation of hypoglycaemic symptoms.

References:

Anderson RA. Chromium metabolism and its role in disease processes in man. Clin Physiol Biochem. 1986; 4(1): 31-41.

Anderson RA. Chromium, glucose tolerance, and diabetes. Biol Trace Elem Res. Jan-Mar 1992; 32: 19-24.

Ginkgo and Memory

I have a special interest in improving memory and cognition. Ginkgo has numerous benefits for memory, cognition, circulation, antioxidant capacity, regulation of neurotransmitters. I often combine Ginkgo with Brahmi, Schisandra, Choline, and B Vitamins. Choline is very useful for regulating stress and neurotransmitters (especially acetylcholine). If stress is impacting memory and focus, I add Ashwagandha, Lemon Balm, and Passionflower. If tiredness and fatigue are making it hard to focus, I consider Panx Ginseng or Siberian Ginseng, depending on the situation.

Reference: Diamond BJ et al. Ginkgo biloba extract: mechanisms and clinical indications. Arch Phys Med Rehabil. 2000 May; 81(5): 668-78.

Rehmannia for Stress and associated conditions

Rehmannia (Rehmannia glutinosa) is a widely used traditional Chinese herb. It is used to nourish Yin and invigorate the kidney in traditional Chinese medicine (TCM) and has a very high medicinal value. Studies show that Rehmannia glutinosa and its active principles possess wide pharmacological actions on the blood system, immune system, endocrine system, cardiovascular system, and the nervous system. I regularly use Rehmannia for stress and anxiety conditions and regularly combine with Ashwagandha, Chamomile, Passionflower, Rhodiola, Schisandra, Ziziphus, Magnesium, and the B Vitamins. It combines well with classic adaptogen herbs.

Reference: Zhang R-X et al. Rehmannia glutinosa: review of botany, chemistry and pharmacology. J Ethnopharmacol. 2008 May 8; 117(2): 199-214.

Herbal teas are on their way

I’ve always seen food as medicine and herbal teas play a very big role in supporting and improving health. I have used herbal teas and combinations of loose herbal teas in my clinic for many years. During high school I did a subject in business that allowed me to work under a herbalist in a health food store. This experience brought forward my love of herbal teas.

I’ve just started a PhD at the University of Sydney. I will be researching the effects of fish oil (omega-3) in cardiovascular disease. It’s going to be a lot of work, but I’m really looking forward to it. Food as medicine 🙂 .

I am currently creating a herbal tea brand that will be available in the future. I am going to try to have the herbal teas certified organic. I’m very excited about this. A dream coming true. Stay tuned…

Potential of Gymnema in Metabolic Syndrome

Gymnema (Gymnema sylvestre) is a herb I regularly use for patients with metabolic syndrome, glucose intolerance, and insulin resistance. I first learned about Gymnema in my first year of studying Naturopathy in 1996. I generally combine Gymnema with Cinnamon, Chromium, Garcinia, Magnesium, Milk Thistle, Vitamin B6, and Zinc. I find this combination very helpful in people with glucose intolerance, insulin resistance, and metabolic syndrome. The Magnesium, Vitamin B6, and Zinc can be taken as separate supplements or found in combination. Milk Thistle improves liver health, which can be an issue with some people with metabolic syndrome.

Some of the benefits of Gymnema include increasing the secretion of insulin and utilisation of glucose, cholesterol lowering properties, anti-inflammatory, hepatoprotective, and modulation of taste, particularly suppressing sweet taste sensations.

I found an article from 1926 which stated that Gymnema leaves reduced the taste sensation of sugar.

Getting excited. A couple of days until I start my PhD at the University of Sydney. Woohoo.

References:

Gharpurey KG. Gymnema Sylvestre in the Treatment of Diabetes. Ind Med Gaz. 1926 Mar; 61(3): 155.

Kanetkar P et al. Gymnema sylvestre: A Memoir. J Clin Biochem Nutr. 2007 Sep; 41(2): 77-81.

Porchezhian E, Dobriyal RM. An overview on the advances of Gymnema sylvestre: chemistry, pharmacology and patents. Pharmazie. 2003 Jan; 58(1): 5-12.

Chaste Tree for the relief of symptoms of the premenstrual syndrome

Chaste Tree (Vitex agnus-castus) is very beneficial for the relief of symptoms of the premenstrual syndrome (PMS). It is one of my favourite herbs for women’s health and regularly prescribe it. Depending on the presenting symptoms, I typically combine Chaste Tree with other herbs, such as Dong Quai, Corydalis, Crampbark, Dandelion Root, Ginger, Milk Thistle, Paeony, and Turmeric. This combination covers most women’s health issues. Ginger and Turmeric work via anti-inflammatory effects. Corydalis and Crampbark help with pain relief. Dandelion Root and Milk Thistle are for liver function and Milk Thistle improves detoxification. Dong Quai and Paeony are for female reproductive health and have been found beneficial for premenstrual syndrome. I increase broccoli for its health benefits and suggest to consume it every day. Big fan of Broccoli and one of my favourite vegetables. Highly nutritious. I co-prescribe Magnesium and tend to prescribe 150-200 mg twice daily. I may prescribe an additional dose if bad cramping and pain. Vitamin B6 is for hormone and neurotransmitter regulation. It also works with the metabolism of delta-6 desaturase and the metabolism of fatty acids. Depending on the situation, I might increase Vitamin B3 for its circulation effects, along with energy production, neurotransmitter regulation, and metabolism of fatty acids. Vitamin C can be added for additional antioxidant and anti-inflammatory effects. I am a big fan of Ashwagandha and regularly prescribe it for anxiety, stress, and as an adaptogen. Ashwagandha is very beneficial for supporting women’s health, particularly with PMS, anxiety, and stress.

A randomised, double blind, placebo controlled, parallel group comparison over three menstrual cycles. The trial consisted of either active (fruit extract ZE 440: 60% ethanol m/m, extract ratio 6-12:1; standardised for casticin; one 20 mg tablet once daily) or placebo (matched for appearance, size, colour, taste, and smell).

Main outcome measures: Main efficacy variable: change from baseline to end point (end of third cycle) in women’s self assessment of irritability, mood alteration, anger, headache, breast fullness, and other menstrual symptoms including bloating. Secondary efficacy variables: changes in clinical global impression (severity of condition, global improvement, and risk or benefit) and responder rate (50% reduction in symptoms).

Improvement in the main variable was greater in the active group compared with placebo group (P<0.001). Analysis of the secondary variables showed significant (P<0.001) superiority of active treatment in each of the three global impression items. Responder rates were 52% and 24% for active and placebo, respectively.

Chaste Tree was found to be an effective and well tolerated treatment for the relief of symptoms of the premenstrual syndrome.

Reference: Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ. 2001 Jan 20; 322(7279): 134-7.

PS I am enjoying writing these articles for my website on top of the regular newsletter mailouts. Eventually I will reduce the number of mailouts and focus on my website as in the future it will be more accessible for people and reduce paper.

Chamomile, Fennel, and Lemon Balm in the treatment of breastfed colicky infants

A randomised, double-blind, placebo-controlled trial was to investigate the effectiveness and side effects of a phytotherapeutic agent with Matricariae recutita (Chamomile), Foeniculum vulgare (Fennel), and Melissa officinalis (Lemon Balm) in the treatment of infantile colic.

The daily average crying time for the treatment group was 201.2 minutes per day (SD 18.3) at the baseline and 76.9 minutes per day (SD 23.5) at the end of the study; for the placebo it was 198.7 minutes per day (SD 16.9) and 169.9 minutes per day (SD 23.1) (p < 0.005). Crying time reduction was observed in 85.4% subjects for the treatment group and in 48.9% subjects for the placebo (p < 0.005). No side effects were reported.

Conclusion: This study shows that colic in breastfed infant improved within 1 week of treatment with an extract based on Chamomile, Fennel, and Lemon Balm.

My comment: Very promising results. Could Chamomile, Fennel, and Lemon Balm show benefit in children and adults with bloating, distension, and other digestive issues? I have been using these herbs, plus others (such as Turmeric and Milk Thistle), for the management of digestive conditions since the beginning of my career.

Savino F 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 breastfed colicky infants. Phytother Res. 2005 Apr; 19(4): 335-40.

Rhodiola: an Adaptogen

Rhodiola (Rhodiola rosea) is a popular plant in traditional medical systems in Eastern Europe and Asian with a reputation for stimulating the nervous system, decreasing depression, reducing irritability, enhancing work performance, and improving fatigue. Rhodiola is classed as an adaptogen. An adaptogen has the ability to increase resistance to a variety of physical, chemical, and biological stressors. I often combine Rhodiola with Ashwagandha, Ginkgo, Lemon Balm, Passionflower, Rehmannia, Magnesium, and B Vitamins for stress, anxiety, memory, cognition, irritability, and fatigue, among other health conditions.

Reference: Kelley GS. Rhodiola rosea: a possible plant adaptogen. Altern Med Rev. 2001 Jun;6(3):293-302.

Tribulus terrestris for Men’s health

I have been using Tribulus (Tribulus terrestris) since 1998 for men’s health, particularly for libido, stamina, and endurance. I was treating several rugby league players in 1999 for stress and fatigue. A common issue they had was low libido due to all the training they did as they were elite players who were in First Grade and were representatives. Tribulus greatly benefitted them. They found they had more energy during the game and performed better overall because they felt better.

I often combine Tribulus with Ginkgo, Ginsengs (American, Korean, Siberian), Ashwagandha, Rhodiola, Vitamin B3, and Zinc. If there is muscle tension and stress, I will add Magnesium at 150-200 mg twice daily. Vitamin B3 and Ginkgo are very helpful for improving circulation and work as vasodilators.

Reference: McKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence. Altern Med Rev. 2004 Mar; 9(1): 4-16.

Vitamin D, Calcium, and Bones

Vitamin D is critically important for the development, growth, and maintenance of a healthy skeleton from birth until death. It plays an essential role in maintaining healthy mineralised bones of the skeleton. The major function of vitamin D is to maintain calcium homeostasis. Vitamin D increases the efficiency of the intestine to absorb dietary calcium. When there is inadequate calcium in the diet, vitamin D communicates to the osteoblasts that signal osteoclast precursors to mature and dissolve the calcium stored in the bone. Vitamin D deficiency is a major unrecognised health problem. Vitamin D deficiency has long lasting effects. It causes rickets in children, osteomalacia, and osteoporosis in adults. Chronic vitamin D deficiency may have serious adverse consequences.

I see the numerous benefits of Vitamin D on improving health (above that of bone health) and see supplementation of Vitamin D increasing in the next few years due to its various health benefits.

References:

Holick MF. Vitamin D: A millenium perspective. J Cell Biochem. 2003 Feb 1; 88(2): 296-307.

Holick MF. Vitamin D and bone health. J Nutr. 1996 Apr; 126(4 Suppl): 1159S-64S.

Holick MF. Calcium and vitamin D. Diagnostics and therapeutics. Clin Lab Med. 2000 Sep; 20(3): 569-90.

Effects of kelp supplementation on thyroid function in euthyroid subjects

Kelp has numerous health benefits, including thyroid, hair, and skin health.

A double-blind prospective clinical trial was conducted involving 36 healthy euthyroid (thyroid gland is functioning normally) subjects. Subjects were randomly assigned to receive placebo (4 alfalfa capsules per day), low-dose kelp (2 kelp capsules and 2 alfalfa capsules per day), or high-dose kelp (4 kelp capsules per day) for 4 weeks. Thyrotropin (thyroid-stimulating hormone or TSH), free thyroxine, and total triiodothyronine (T3) were assessed at weeks 0, 4, and 6. Response to thyrotropin-releasing hormone stimulation, urinary iodine excretion, and basal metabolic rate were determined at weeks 0 and 4.

TSH concentrations did not differ significantly between week 0 and week 4 in the placebo group (P = 0.16) but increased significantly in both the low-dose kelp (P = 0.04) and high-dose kelp (P = 0.002) groups. Free thyroxine concentrations decreased slightly but significantly after 4 weeks of placebo but were unchanged in the low-dose and the high-dose kelp groups. In contrast, total triiodothyronine (T3) levels did not differ significantly after 4 weeks of placebo or low-dose kelp therapy but were significantly decreased after high-dose kelp therapy (P = 0.04). Similarly, the thyrotropin-releasing hormone stimulation test showed no significant change in poststimulation TSH after 4 weeks in the placebo or low-dose kelp groups but revealed a significantly increased response after high-dose kelp therapy (P = 0.0002). The 24-hour urinary iodine excretion showed dose-dependent increases in the two kelp study groups. All thyroid laboratory values returned to baseline 2 weeks after cessation of kelp supplementation, except for TSH in the high-dose kelp group, which was significantly decreased.

Conclusion: Short-term dietary supplementation with kelp significantly increases both basal and poststimulation thyroid-stimulating hormone (TSH). These findings corroborate previous studies on the effects of supplemental iodide given to euthyroid subjects for a similar period.

Clark CD et al. Effects of kelp supplementation on thyroid function in euthyroid subjects. Endocr Pract. Sep-Oct 2003; 9(5): 363-9.

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