Diagnosing by smell

Smelling the breath and body odor of a sick person has long been considered an important part of the herbalist's examination, regardless of your tradition and approach. Modern scientists have also been aware for a while that "bad breath" is not simply a condition of overgrowth of oral bacteria, but that it can also be linked to a variety of unbalanced internal processes (see this review for a summary). Now, a machine that analyzes volatile compounds in a patient's breath has been shown to detect the presence of lung cancer pretty reliably (3/4 of the time, with a misdiagnosis rate of about 25%). Neat idea -- but it's interesting to note that folks trained in Traditional Chinese Medicine started using the ultra-sensitive noses of cute poodles to do the exact same thing a few years ago.
Though our olfactory apparatus isn't as sharp as a dog's, we may still have some capacity to use information garnered from the breath and body odor of sick folks to understand what's going on. I recall a brief conversation I had at the last International Herb Symposium, while sipping Kava punch at the herbalist's Ball, where a gentleman whose name I can't remember was discussing olfactory diagnosis. An expert in the process had apparently teamed up with a perfumist and created a whole kit of scents, each of which exactly mimicked the "scent" of an individual disease. If anyone knows more about this, please let me know! I'd love to look, or smell, a little deeper...

Database of diabetes herbs

ProGene Bio, an Indian company, has put together lots of recent research on medicinal plants used in diabetes and the management of blood sugar. The database is extensive, covering over 380 botanical species, but is a bit difficult to navigate unless you know the exact Latin binomial of the plant you're looking for. Nevertheless, browsing is always an option, and if you are looking for "scientific evidence" of an herb's use in diabetes control, this option might be a bit easier than a straight PubMed search...
(see Cinnamon, for example).


Cinnamon and blood sugar

Swedish researchers published a small but interesting trial of Cinnamon (Cinnamonum verum) in the American Journal of Clinical Nutrition. Fourteen non-diabetics were in the group, and half received cinnamon powder at a dose of 6 grams in their rice pudding (clearly, not a blinded trial and much less tasty for the control group).
Then, starting 15 minutes after the pudding and continuing for an hour and a half, they measured both the rate of gastric emptying and the blood sugar rise. Cinnamon slowed both down, but the effect was much greater for the blood sugar itself.
It seems to me that we are watching the synergy of crude plant preparations here: the gut is slowing down, relaxing due to the carminative volatile oils in the ground cinnamon bark. At the same time, mucilage present in the powder is binding the sugars from the meal, slowing their release into the bloodstream. Finally, there are biochemical reasons, at the level of the cell surface and the cytoplasm, why Cinnamon seems to control postprandial blood sugar very well (see additional recent studies below), but this basic idea works well for any volatile / mucilage (carminative / demulcent) combination. I hope we stay away from the idea of refining and patenting a constituent from cinnamon to treat diabetes.
The other interesting point from a clinical perspective is that this trial uses a nice (6g) dose of cinnamon for a single meal. As the studies below show, lower doses (1g to 2g per day) don't seem to do very much. This makes sense, as you need some bulk of mucilage and 1 gram of powder is a very small amount; additionally, a dose of 6g to 12g a day is much more in line with traditional usage.

Related research, via PubMed:

Altschuler JA, Casella SJ, MacKenzie TA, Curtis KM.

Free Full TextThe effect of cinnamon on A1C among adolescents with type 1 diabetes.
Diabetes Care. 2007 Apr;30(4):813-6.
PMID: 17392542 [PubMed - indexed for MEDLINE]

Pham AQ, Kourlas H, Pham DQ.

AbstractCinnamon supplementation in patients with type 2 diabetes mellitus.
Pharmacotherapy. 2007 Apr;27(4):595-9.
PMID: 17381386 [PubMed - in process]

Cao H, Polansky MM, Anderson RA.

AbstractCinnamon extract and polyphenols affect the expression of tristetraprolin, insulin receptor, and glucose transporter 4 in mouse 3T3-L1 adipocytes.
Arch Biochem Biophys. 2007 Mar 15;459(2):214-22. Epub 2007 Jan 25.
PMID: 17316549 [PubMed - indexed for MEDLINE]

Subash Babu P, Prabuseenivasan S, Ignacimuthu S.

AbstractCinnamaldehyde--a potential antidiabetic agent.
Phytomedicine. 2007 Jan;14(1):15-22. Epub 2006 Nov 30.
PMID: 17140783 [PubMed - indexed for MEDLINE]

Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A.

AbstractEffects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2.
Eur J Clin Invest. 2006 May;36(5):340-4.
PMID: 16634838 [PubMed - indexed for MEDLINE]

Vanschoonbeek K, Thomassen BJ, Senden JM, Wodzig WK, van Loon LJ.

Free Full TextCinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients.
J Nutr. 2006 Apr;136(4):977-80.
PMID: 16549460 [PubMed - indexed for MEDLINE]

Kim SH, Hyun SH, Choung SY.

AbstractAnti-diabetic effect of cinnamon extract on blood glucose in db/db mice.
J Ethnopharmacol. 2006 Mar 8;104(1-2):119-23. Epub 2005 Oct 5.
PMID: 16213119 [PubMed - indexed for MEDLINE]

Verspohl EJ, Bauer K, Neddermann E.

AbstractAntidiabetic effect of Cinnamomum cassia and Cinnamomum zeylanicum in vivo and in vitro.
Phytother Res. 2005 Mar;19(3):203-6.
PMID: 15934022 [PubMed - indexed for MEDLINE]

Cannabis and psychosis

The current issue of the Lancet published a meta-analysis of multiple trials concerning the use of cannabis and its association with mental illness. There were 35 longitudinal studies selected for the analysis. All of them followed patients starting before any mental illness, and included cannabis use as a variable along with many other factors, such as personality, background, use of other drugs. 7 out of 35 trials concerned "psychosis" (ranging from 'mild symptoms' to 'schizophrenia') and were the only ones that showed any connection with cannabis use. Conditions of mental illness such as depression, mood disturbances, or others did not have any connection.
The study's authors rightly point out that there can be no way to say for certain that there is a direct causal link between smoking pot and experiencing at least one major psychotic episode (and the definitions are a bit of a problem for me here as well), but that caution, especially in folks with a personal or family history, is warranted. In the end, I would have to agree -- but this is true of any medicine, really...
There is a brief (6-minute) interview with the study's author here.


Docs and nurses use "alternative medicine"

An interesting report details the uses of herbs and dietary supplements by doctors, nurses, and other mainstream health care providers. Although it focuses on clinicians enrolled in an online course about alternative medicine and supplements, the study still gives some interesting tidbits: first off, over 80% of the practitioners used some form of herb or supplement. The top choices are things like multivitamins and specific vits; but herbs such as green tea, chamomile, flax, cinnamon and Echinacea are right up there. I keep saying that things are changing with the new batches of allopaths coming out of the medical and nursing schools: I hope the positive attitudes can translate to good education, both of the care providers and their patients!

Salacia oblonga for type 2 diabetes

A tropical shrub used in Ayurveda for controlling obesity and its associated health complications, Salacia oblonga (a.k.a. Saptrangi) has shown promise in some limited trials that looked at its ability to reduce high blood sugar in diabetes. A new trial goes into more detail: the extract of the root and stems of this plant lowered post-meal blood glucose by about 25%, while also reducing the amount of circulating insulin in the blood. Thus, it seems to sensitize the physiology to insulin, which reverses the trend of insulin resistance seen in type 2 diabetes. A 25% reduction is significant: it could bring a diabetic patient with postprandial blood glucose levels over 150 down to the "normal" range of 120.


Curcumin and Alzheimer's

Though these findings come from a test tube, the results are nonetheless pretty interesting: a study carried out at UCLA reveals that immune cells are much more active against the amyloid plaques thought to contribute to Alzheimer's disease when treated with curcumin, one of the many compounds in turmeric.
This delicious rhizome in the ginger family has been conclusively shown to have anti-inflammatory power, and now this in-vitro research seems to hint at power beyond simple reduction of inflammation.
Amyloid plaques, which are tangles of protein thought to interfere with neuronal function in Alzheimer's disease, have a close link to inflammatory processes. Perhaps ongoing ingestion of turmeric in the diet can have a protective effect if initiated early on in life. I'd be interested in epidemiological reviews of the incidence of Alzheimer's in cultures who use a lot of curry (rich in turmeric) versus those who use none...


Solarfest 2007 - green buildings!

This summer festival highlights sustainable energy and building technologies. I've been asked to talk about the laboratory and apothecary here at Grian Herbs, and share a slideshow that documents the construction of this straw-bale passive-solar building we've been using to host classes, do tincture production, and grow tropical botanicals year-round. Here are a few pictures:

The hemlock timber frame

The bale walls going up

A first coat of clay plaster...


Vitex and Gotu Kola in the greenhouse.

Inside, the classroom and processing spaces.

And a peek inside the apothecary...


Red Reishi - safety update

Ganoderma lucidum, the Red Reishi shelf mushroom, and its closely allied species Ganoderma tsugae (native to the Northeast U.S.), are some of my favorites for rebalancing immune function and harmonizing liver metabolism. Excellent for allergies, autoimmune conditions, and cancer, this mushroom has always enjoyed a traditional reputation for safety. Now, a small in-vivo trial published in the American Journal of Chinese Medicine confirms its general safety by looking at markers of immunity and inflammation in healthy subjects receiving 2 grams of Reishi extract twice a day for ten days. Perfectly safe, are the conclusions.
I use a double-extraction process for most medicinal mushrooms, in order to obtain both the alcohol-soluble phenolic compounds and the more traditional water-soluble polysaccharides. With the addition of a little gylcerin in the menstruum, the extract stays well-emulsified and isn't quite so bitter.


Chocolate in hypertension

A new, in-vivo German trial shows that even modest amounts of dark chocolate, consumed daily two hours after dinner, has positive effects on reducing high blood pressure. In comparing the consumption of dark vs. white chocolate (the latter not being chocolate at all), blood pressure was effectively lowered in the treatment arm of 44 adults aged 56-73.
I've written about chocolate before, and this new research just confirms that even tiny doses of cocoa flavonoids (under 30 calories /day!) benefit the circulatory system in many ways. Of course, I would recommend a bit more -- but as the study's authors comment, don't blow your calorie budget!


Jumping to conclusions

For your enjoyment, the conclusions of a pilot study on warfarin / herb interactions:

The present survey highlights the potential risk of confidence with the 'natural world', the lack of discussion on this argument among health care providers and patients on warfarin therapy and the need to monitor strictly the INR value.
To this I would add (especially in the wake of recent experience): increased levels of physician education on the effects of the 'natural world' might help increase their confidence (heresy, I know). Many botanicals are perfectly safe to use in conjunction with anticoagulant therapy; others are not. A clear understanding of the underlying pharmacology and physiology is the best place to start.

I just couldn't get over how the first conclusion of this study, which rightly identifies poor communication between docs and patients and highlights the dangers that result, was to lay the blame at the feet of the 'natural world'. Fortunately, I think this kind of attitude is waning (eternal optimist).

Some plants from Cape Breton

Our camping excursion to the Highlands National Park on Cape Breton island offered a wide diversity of environments to explore. Lots of terrain had poor, thin soils and supported acidic "barrens", covered in heaths and moss.
The few black spruces are probably over 100 years old, and though barely 10 feet tall are covered in Usnea.

Heath groundcover

Reindeer moss

In places where the barrens got more soggy, fens developed and more specialized plants thrived, like this Sundew (Drosera intermedia, the spoonleaf sundew).

Pitcher plant (Sarracenia purpurea)

Dragon's mouth (Arethusa) orchid

Labrador tea (Ledum palustre)

Bogbean (Menyanthes trifoliata) a.k.a. Buckbean

Local Larch (Larix)

Out by the coast, we find familiar friends.

Yarrow (Achillea millefolium)

Red Clover (Trifolium pratense)

A Campanula (C. rotundifolia, perhaps)

And, a bit further into the woods, a white bog orchid (Habenaria dilatata)