Antibiotics overprescribed in bronchitis

The inflammation of the respiratory and lung passages known as bronchitis is most often (at least 70% of the time) caused by a lingering viral infection. Antibiotics are useless for this condition, and may in fact cause harm, even though they are administered in over 80% of the cases of bronchitis that present clinically. These are the conclusions of Drs. Wenzel and Fowler, as reported in a clinical vignette published in the New England Journal of Medicine.
While bacterial bronchitis is certainly a possibility, and bacterial pneumonia (which can sometimes be a complication of untreated respiratory infections) certainly warrants aggressive treatment, it is ridiculous to jump right in with antibiotic treatment in most cases. So what is left? Watch and wait, according to modern medicine. And while I applaud the recent cautions concerning antibiotic use (aviod for ear infections; aviod for respiratory infections), and recognize the healthy fear antibiotic resistance has engendered in the medical community (finally! it only took 50 years), I cannot condone a "watch and wait" attitude, and that is not the strategy in my practice.
This is a perfect example of how a complementary therapy like herbalism, when integrated intelligently into the holistic picture of patient care, can contribute significantly to improved outcomes. Our strategies: boost immunity, encourage the natural eliminative function of the lungs and respiratory system, and guard against opportunistic infection. All of these goals are extremely amenable to herbal intervention, and the results are there (both empirically and as part of clinical trials) to prove it. Why can't all primary care providers take the road many are following, and suggest the advice of a competent herbalist for chronic or lingering bronchitis, rather than simply sending their patients away (or even worse, giving them a harmful treatment out of ignorance)?

So I agree: antibiotics are harmful in most cases of bronchitis. Leave your doctor's office, and go straight to your local herbalist to learn how to take care of yourself using plants that, very possibly, are growing in your garden or back yard.


Ginkgo and Alzheimer's

The leaves of Ginkgo biloba have an extensive reasearch history behind them, although their therapeutic use is fairly recent. Though many claims have been made about this ancient tree (mostly relating to memory, energy, mental function), there are some clear indications and effects that almost everyone agrees on: first, ginkgo increases circulation; second, it has a marked antioxidant and cell-protective effect; third, it influences biochemical mechanisms in the blood resulting in an net reduction of clotting power.
Recently, based primarily on the first two facts listed above, researchers have been focusing on ginkgo's use in treating Alzheimer's-related dementia. A trial released in 2004 showed promising results and began to elucidate some of the mechanisms in the brain (relating to neurotransmitter activity and the reduction of protein tangles) that contributed to its positive effect. Now, a new trial in the European Journal of Neurology (those Europeans, always messing around with herbs...) confirms the previous results and lends more credence to ginkgo as a good treament for slowing the progress of Alzheimer's disease. It also reinforces the idea that ginkgo has the effect of increasing ACh (acetylcholine, an important neurotransmitter in the brain and body) sensitivity, and is much better tolerated than the prescription drugs that are currently used.


What is "Yang"?

When speaking in terms of herbal "energetics", there are many classifications that can be used. These are helpful in defining herbal actions because they addresss the plant remedy from a holistic point of view, giving a broader "feel" of the herb's medicinal virtues. Sometimes (though not always), these classifications bear a striking connection to physical / biochemical characteristics - for instance, "yin" herbs tend to be more cooling, soothing, demulcent and rich in mucilage; "blood (xue) tonic" herbs may have a good supply of iron, or serve to increase erythropoiesis. Recently, an interesting study out of Hong Kong highlighted a potential biochemical connection to the energetic idea of "yang", always associated with warmth, increased vitality, and energy.
A systematic review of some "yang" botanicals showed that they invariably increase mitochondrial ATP-generating capacity. Deep inside our cells, the mitochondria create a proton gradient between two membranes by moving electrons through the electron-transport-cycle. This gradient is used to drive a transmembrane protein, ATP-synthase, which attaches a phosphate group to spent ADP, renewing its energy-generating ability. The protons can also move back down the gradient through "leak" channels, akin to a short-circuit, instead of through the ATP synthase protein. This has the net effect of generating warmth, and serves as a basic temperature-regulating mechanism for the body. So, it seems, "yang" herbs do in fact increase energy, vitality and warmth. But, as chinese medicine rightly points out, they might be contraindicated in severely depleted conditions (can't stoke the furnace without enough fuel) or in highly overheated, overstimulated conditions (obviously).

File this under the "science finally catches up" category.


Saffron Crocus and Depression

Crocus sativus, best known for its stigma and pollen (source of saffron, perhaps the most expensive spice in the world), has traditionally been linked to various medicinal effects, depending on the part used: from mood enhancement of the saffron itself, to the treatment of gout with the alkaloid colchinine found in its underground bulb. A very recent (6/06) study from Iran evaluated the use of the petals of this wonderful fall-blooming flower to determine its use in a small sample (n=40) of individuals who me the diagnostic criteria for mild to moderate depression. The results: "At 6 weeks, petal of C. sativus produced a significantly better outcome on Hamilton Depression Rating Scale than placebo (d.f.=1, F=16.87, p<0.001). There were no significant differences in the two groups in terms of observed side effects. The results of this study indicate the efficacy of petal of C. sativus in the treatment of mild-to-moderate depression".
The authors recommend additional research, and larger-scale trials. I fully agree!
What is most interesting to me about this study is the fact that the petals of the crocus were used, rather than the more commonly studied (and way more expensive) stigmas. The researchers used capsules filled with the powdered petals, but pending some additional pharmacological research, I would tentatively say that the traditional hydroalcoholic tincture might be equally, and perhaps more, effective. Nevertheless, this presents a sustainable, affordable, effective, beautiful, and easy-to-grow option for mild to moderate depression.
Full abstract from Phytomedicine.


Cannabinoids mellow out a spastic colon

Our bodies are riddled with receptors for the class of molecules, known as cannabinoids, that are found in large concentrations in marijuana. While it may be that our own endogenous anandamide-like substances are the reason for the presence of these receptors, it seems that in the plant world marijuana is the only source of cannabinoids we have available. Co-evolution, anyone?
Regardless, a preliminary investigation by Michael Camilleri, M.D. (Mayo Clinic), who has spent the last decade researching drugs, neurotransmitters, receptors and pharmacological pathways involved in irritable bowel syndrome and other spasmodic conditions of the lower bowel, shows promise for using cannabinoid receptors in the gut to help modulate these distressing conditions. Doctor Camilleri's plan: feed folks with sensitive digestive systems over a pint of chocolate milkshake after giving them a pill of Marinol, a synthetic THC (tetra-hydro-cannabinol). Without getting into what a pint of chocolate milkshake would do to me (or anyone really) if taken on an empty stomach, and whether that represents cruel and unusual punishment for someone with colitis or irritable bowel, it seems that the synthetic cannabinoid is one of the most effective remedies the good doctor has ever seen for the cramping and pain people experience after pounding said milkshake. The next step: back to the lab, to find a synthetic cannabinoid that "does not have psychoactive properties".
If you ask me, that seems like a time-consuming, expensive proposition. Over and over, folks who have used cannabinoids as medicine (for glaucoma, wasting syndrome, chemo-induced nausea, and bowel trouble) complain that the pharmaceuticals are not as effective as a crude, inhalable folk-preparation of the marijuana plant (a.k.a. "the joint"). One puff may not be psychoactive, but it still seems to be quite medicinal if you trust the reports of those who have tried. But the feds might not appreciate that (nor the pharmaceutical companies, for that matter). And we all know the best way to fund research is to come up with a good, actionable, patentable pharmaceutical, not some devil-weed - regardless how cheap, accessible, or useful it may be.


Kava-Kava doesn't seem to be liver-toxic at all.

Kava (Piper methysticum) has long been used in Polynesia as a relaxing beverage, made from the fresh roots in communal settings with the intention of promoting conviviality, community, and peace. While there are some anectdotal reports on long-term abuse leading to "kava skin" (patchy, scaly eruptions that disappear after kava is withdrawn), this plant was always considered safe until 2002, when Germany and other European countries banned its use after liver failure in a patient who had a history of liver disease grossly abused a strong Kava extract and died from liver failure (maybe we should ban whiskey too).
Anyway, in a study that just came out in Phytomedicine, we see interesting new information that, in animal models, doses of kava given daily don't seem to have any toxicity at all, even when administered for long periods of time. This seems to corroborate traditional info. Hopefully it will have an impact in Europe where the use of kava, a potent anxiolytic and relaxant, is still shunned after the 2002 decision.