FDA herbal regulation update

I'd written a few weeks ago about the FDA's shift in perspective regarding herb and supplement regulation. It seems now that the comment period for their new position has been extended until the end of May.
Links:
FDA docket.
Comment page.

Farms, Food and Obesity

"You are what you eat" (or, for many herbalists, "You are what you assimilate"): important adages, helping to bring the idea of good, whole food up from the nether reaches of our consciousness. Michael Pollan, whom I believe to be a pretty observant plant person, has given this age-old wisdom a bit of a twist in a New York Times Magazine article entitled "You are what you grow". The general idea is that part of the problem with the modern "obesity epidemic" are the basic ingredients of the modern American diet: cheap, industrialized corn, wheat, and soy (sugar, starch and oil - with a little food coloring, salt, and some hydrogenation, you can make almost anything you want), and the government subsidies that keep it all flowing. There are some interesting socioeconomic observations in this article as well. All in all, a fascinating take on the roots of cultural wellness, and our often self-defacing relationship with food.

An update from Vermont

Well, it's the third time this spring that I've seen the snow melt from the gardens, and I'm hoping this time it's for good! A remarkable April has given the daffodils a bit of pause - but I know they're hardy and a little white stuff won't hurt them at all. Up here, the woods and fields know better than to burst into flower at the first signs of warmth -- so we are a bit luckier than folks in the rest of the country who have seen damaging frosts and snows that virtually eliminated crops of almonds, peaches, apples, pears and other fruits that rely on early spring blossoms.
In the warmth of my greenhouse, the last few days have been the perfect time to start a second round of herb seeds for the beds that were under cover-crop last season. Some highlights: Ashwagandha, Stevia, Arnica chamissonis, Spilanthes, Tulsi, various Datura species, Belladonna. These will hopefully find happy homes alongside the standbys like Echinacea and Calendula. Many others (mostly self-seeders like the poppies) are already beginning to grow stronger as the sun hits the garden beds. And last night, a beautiful and meditative end to the day, as the moon's new crescent reaffirmed the tide of growth that is sweeping over these ancient hills. Winter's great -- but so is Spring! Green growth, here we come!

Soy, broccoli and breast cancer

Researchers at UCLA just reported some interesting results at a recent meeting of the American Association for Cancer Research. It involves a flavone from soy, genistein, and a secondary metabolite of cruciferous vegetables (broccoli, kale, etc...). Both of these compounds were tested in vitro on human breast cancer cell lines, and the results seem to indicate that, in controlled lab conditions, these botanical constituents inhibit the cancer cells' ability to metastasize, or spread to other areas. This is important in cancer therapy, since it is the spread of the disease to vital organs such as the lungs, liver, or kidneys that ultimately proves fatal.
The flavones and diindolymethane confound the cancer cells' ability to recognize cellular surface receptors from other tissues, lessening their ability to latch on to new surfaces and thus preventing their spread. And while this report provides interesting and encouraging evidence, it should be taken with a grain of salt: so far, the data is very preliminary and come from cells cultured in a petri dish. Nevertheless, it shouldn't surprise herbalists that flavones have cancer-protective effects: this broad family of plants has been shown to protect us from cellular mutations, DNA damage, oxidative stress, and metastasis time and time again.

The FDA's regulatory plans...

Last December, the FDA issued a comprehensive position paper on "complementary and alternative medicine" (CAM), offering an opinion that deviates pretty radically from current practice. In the United States, there is still a large degree of freedom in choosing herbal medicines, dietary supplements, massage and other somatic therapies, and "functional foods" (like juices) as part of a comprehensive treatment plan. This most recent position paper proposes to bring all of the above under FDA regulation, which (in a worst-case scenario) might even lead to the criminalization of gardeners who grow medicinal herbs. While I can't see how this would be enforced, it does seem to add another voice to the growing governmental chorus that has been pushing against health freedom and the DSHEA (Dietary supplement, health and education act) under which we've been operating for over ten years now.
Here is a link to the FDA recommendations; additionally, please note that the comment period is still open. It is important to offer our opinions on this matter, as there is some historical precedent for the government listening to public comment (as occurred with the organic foods standards in the U.S.). I know, I'm an optimist, but it certainly can't hurt to make our voices heard. Here is the FDA comment page for this paper. Please tell your friends. Someone has to push back.

What were they thinking?

Here's further proof that if you spend enough time away from the forest and fields, whole foods, and our plant allies, your brain eventually turns to mush.
Researchers at Northwestern University published a new method for generating flavonoids in a laboratory. Previous efforts by organic chemists had resulted in failure, primarily because flavonoids are chiral molecules that have a single "handedness" in nature, and all the lab processes to date have generated an equal mix of both left and right handed molecules, which greatly limits their usefulness while also increasing their toxicity. Well, using a catalyst from Cinchona (Peruvian bark - quinine), these folks managed to synthesize flavonoids that are all identical to those found in nature. They started by replicating the constituents found in milk thistle and soy. The hope: new drugs to treat cancer.
Ok. The goal is admirable, and I respect the chemists' desire to find new therapies for cancer. But flavonoids are one of the most abundant and bioavailable of all plant constituents, being responsible for color (other than green) in plants. They are found in coffee, chocolate, peppers, corn, berries, flowers ... the list could go on forever. So why spend all this time on trying to find synthetic ones? Karl Scheidt, one of the researchers, says he wants "... to get selectivity and specificity using chemistry. A naturally occurring flavonoid may not have all the characteristics you want -- it may not be potent enough, for example -- but with chemistry you can go in and modify that structure, imbuing the molecule with more desirable traits, such as binding more effectively to a protein of interest or being less toxic to normal cells."
Ok. I can understand this goal as well. But here, in my opinion, is the bottom line (and the reason why you can really see that the chemists' brains are a bit disconnected): we have evolved on this planet side-by-side with plants. The way our DNA expresses, the way the cellular machinery works, the way cancer is (or isn't) controlled, are all intimately tied to the environment in which we evolved. Plant flavonoids have profound effects on all of those processes, and by definition they are eminently compatible with our physiologies (we are really part of the same being). The effects of a modified flavonoid not found in nature are wholly unknown in vivo. However, the benefits of a colorful, plant-rich, whole-foods diet are well researched and obvious to any herbalist. Why are we wasting time trying to develop weird unnatural therapies that are only used after the fact (i.e. after cancer has become detectable)? Why are we not devoting huge chunks of our governmental infrastructure to developing community gardens, promoting whole, fresh plant foods, and using natural flavonoids to prevent cancer in the first place?
I appreciate the intention behind this research. But I do feel that pursuing such strategies long-term will only lead to further disconnection from Nature, and thus further disease.

Can Coleus help in stubborn urinary infections?

Coleus forskholii, a tropical member of the Mint family, has been used in Ayurveda for thousands of years. Recent research points to its role in increasing levels of intracellular cAMP (cyclic adenosine mono-phosphate), a secondary messenger involved in a variety of biochemical processes. Increasing levels of cAMP has numerous, system-wide effects that mostly relate to "yin"-like changes: reduced inflammation, blood pressure, anxiety, irritability; and increased activation of GABA neurons (here is a useful summary of the research and biochemistry of Coleus).
Now, in a study that is receiving lots of media attention, scientists have found that Coleus extracts are useful in chronic urinary tract infections (UTIs) by reducing the adherence and number of bacterial colonies that hide in the folds of the bladder. Coupled with antibiotics, the study reports, these extracts lead to a more complete and long-lasting remission from UTIs.
Some problems with this research: first, it was done on an animal model (mice). And while cells lining the inside of the mouse bladders did "kick out" bacteria when exposed to Coleus, the plant extract was injected directly into the bladder and bladder tissue. This method is not too practical for us herbalists, and the study reveals nothing about the pharmacodynamics of orally-administered Coleus. So, interesting information. But despite the media attention, not incredibly useful... Hopefully this will spur additional research.

Hawthorn in congestive heart failure

The cardiologists met last month in New Orleans to review new strategies, therapies, and research related to cardiovascular health. Among the presentations, a new European study on hawthorn (Crategus species) leaves gave some interesting evidence that this herb, traditionally used for a range of cardiovascular ailments, has a positive effect on congestive heart failure, reducing mortality and improving quality of life. While the study is controversial (some argue that it shows no benefit for hawthorn over placebo), there are some undeniable positive results which, when coupled with the wealth of traditional use, keeps me coming back to my bottle of Vermont hawthorn tincture.
Traditionally, herbalists use the ripe red berries of this storied tree. Modern research has identified a spectrum of flavonoid-family chemicals in all parts of the plant (well, except the bark...), and research has therefore expanded into analyzing the therapeutic effects of leaf and flower, too - and the results, as this recent research shows, have been positive.
Some details:

• A total of 2,681 patients with markedly impaired left ventricular function - indicating advanced congestive heart failure - were randomized to hawthorn extract or placebo for a duration of two years.
• All patients were already receiving pharmacological therapy with ACE-inhibitors (83 %), beta-blockers (64 %), glycosides (57 %), spironolactone (39 %) and diuretics (85 %).
• Researchers saw a 20 percent reduction in cardiac-related deaths among patients on hawthorn extract, extending patients' lives by four months during the first 18 months of the study. The safety of the compound was confirmed by a lower number of adverse events among the study group than those on placebo.
• Patients taking hawthorn showed significant relative-risk reductions in the secondary end point of cardiac mortality after six months (by 41%, p=0.009) and 18 months (by 20%, p=0.046) but not at the 12-month or 24-month follow-ups (by 18% and 10%, respectively).
• The protection was significantly stronger among the 70% of patients with ischemic disease. Researchers hypothesized the hawthorn extract is protective probably by being anti-ischemic.

The hawthorn extract "... is safe in patients with more severe congestive heart failure and left ventricular ejection fraction lower than 35 percent," said Dr. Holubarsch of Median Kliniken Hospitals in Bad Krozingen, Germany, and lead study author. "It postpones death of cardiac cause after 18 months and sudden cardiac death in an important subgroup of patients."

Another piece of evidence indicating the general life-promoting quality of colorful, flavonoid-rich plant foods! Additionally, continued reinforcement of hawthorn's beneficial effect on the cardiovascular system. My only complaint: as usual, this study uses a proprietary brand-name hawthorn preparation code-named WS 1442 (a standardized extract, 5:1, of hawthorn leaves and flowers produced by the Dr. Wilmar Schwabe Co. of Karlsruhe, Germany, standardized to contain 18.75% oligomeric procyanidins, a sub-class of the flavonoid family of phytochemicals). Sure, this makes the little pill easier to to take and consistent in dosage. But I bet study participants would have enjoyed a good hawthorn berry jam and/or delicious infusions of the spring leaves and flowers, maybe blended with a little linden flower (Tilia species) and lemon balm (Melissa officinalis).

Hawthorn Berry and Black Currant* Jam, from moonwiseherbs.com

-2 quarts Hawthorn berries
-1 quart Black Currants
-1-cup honey (or to taste)
-water to cover

(*Black Currants are high in pectin and make a great addition to thicken any jam or jelly.)

1. Place berries in a pot.
2. Cover with water (2 inches above the berries)
3. Add honey
4. Simmer until mixture thickens, (most of the liquid will be evaporated and the jam will thicken quickly when on a spoon that has been removed from the heat)
5. Run the mixture through a food mill, to remove seeds and stems.
6. Place back in the pot add a quart of water and simmer again until mixture is quite thick.

To can:

-Simmer canning jar lids
-Place mixture in clean canning jars
-Place lids on top
-Place jars in a canning kettle, cover with water (2 inches above the jar)
-Bring to a boil and boil for the appropriate time frame for the jar size: ½ pint 10 minutes, pints 15 minutes, quarts 20 minutes.

Vermont doctors respond to pharma gifts report

David Johnson, MD, President of the Vermont Medical Society, comments on the recent report from the Vermont Attorney General's office on gifts to doctors by pharmaceutical companies (Times Argus):

"As the JAMA article [referencing the report] noted, pharmaceutical companies can designate spending on physicians as a "trade secret," which prevents the public from finding out about it. Many companies are doing this. The Vermont Medical Society supports eliminating the trade secret exception, so that all pharmaceutical marketing spending becomes public record.

Why do physicians accept payments worth more than $25 in the first place? The vast majority of this spending is in the form of food served during educational sessions on new medications. Physician offices are very busy, so the best time to hold these sessions with pharmaceutical representatives is over lunch. Nurses and other office staff members also participate, but for reporting purposes Vermont's law requires that the cost of their meals be attributed to practitioners in the office who can legally prescribe medications. For example, the cost of a lunch for an eight-person office staff is split between the two physicians in a practice. Because of that, the meal amounts reported for doctors are inflated and trigger the reporting threshold.

There are other steps being considered by the Legislature that will greatly reduce pharmaceutical manufacturers' influence over physicians. The most important is a bill supported by the Vermont Medical Society that would stop chain pharmacies from selling data on your physician's prescribing habits to the drug manufacturers, who in turn use this information to push their expensive products – and drive up health care costs. Halting the sale of this information will take away the most powerful weapon that pharmaceutical marketers have".

David Johnson, M.D., is the president of the Vermont Medical Society.

Cranberry for urinary tract infections

Phytomedicine reports on a pilot study that seems to corroborate the idea that regular consumption of cranberries (or cranberry extract / juice) can help prevent recurrent urinary tract infections (UTIs). Though the study followed only 12 women, it selected those women based on frequency of UTIs (6 over the last year) and followed them for 12 weeks of cranberry therapy.
The results: none experienced UTIs during the 12 weeks of the primary trial. The women were followed for 2 years total, and 8 continued with the cranberry extract during those years. None of those taking the cranberry had a UTI during the follow-up time either!
Previous research seems to point to cranberry's ability to limit bacterial adhesion and the formation of bacterial biofilms in the urinary tract (and oral cavity, by the way). Adding this new, in-vivo information to the mix might help not only to relieve the often painful and distressing symptoms of recurring UTIs, but also to reduce the administration of potent antibiotics like Cipro.

Gifts to doctors from big pharma

A article came out last week in JAMA providing some details from the Vermont and Minnesota reports that track "donations" made to doctors by the pharmaceutical companies. These monies, gifts, dinners, and trips have been disclosed to these two states as part of new laws supposedly enforcing regulations on gifts to doctors - but whether this regulation has any "teeth" is very debatable. For example, the Vermont law allows non-disclosure if the company can claim the gift is related to a "trade secret": not surprisingly, this loophole was abused.
Nevertheless, some interesting data emerges from the Vermont report:

• In Vermont, 58 pharmaceutical companies said they made payments totaling $5.58 million in payments over the two years studied -- but they disclosed details for only 12,227 payments totaling $2.18 million. Another $3.41 million in payments were not disclosed based on the trade secret claim.
• Of the companies reporting payments in Vermont, 13 companies during the first year studied and 10 more during the second year designated their payments as trade secrets.
• The median payment in Vermont was $51 (range 0.22 to $63,458). Twenty-three percent of the 12,227 payments to Vermont doctors were for $100 or more.
• About two-thirds of the $100 or greater payments in Vermont were in the form of food and 24.4% were cash, check, honoraria, or donation.
• In Vermont, 28.4% of the $100 or more payments were designated for education, 25.5% to cover detailing, and 14.1% for speakers.

You wonder why the prescription drug machine keeps rolling on, despite Vioxx, women's HRT, antibiotic overuse, and so much more. Sometimes I really feel bad for the dedicated medical staff that really has only one option - drugs - to help improve the lives of patients. Then I think about the free trips to Hawaii...

Antibiotics overprescribed for sinusitis

We've been following a trend in medical research that has been casting antibiotic use in a new light (see previous: 1, 2). As drug-resistant bacteria continue to evolve and spread, the healthcare establishment is responding by trying to avoid antibiotic use in cases that are self-limiting, or where viral causes are often to be suspected. A few years ago, ear infections. Next, bronchitis. Now, sinusitis: a new study underlines that antibiotics are grossly overprescribed in this condition, and casts some doubts on the use of inhaled corticosteroids as well.
Acute sinus infections (most often viral) tend to clear up fairly well on their own. The problems can come when the infection becomes chronic, often seeing folks take multiple trips to a doctor for a prescription of Amoxicillin. Not the best strategy, it seems - for your personal health, or for the health of the environment (which, truly, isn't really separate from you, but we won't get into philosophical expounding...). So consider some tried-and-true herbal therapies:

• a nice, hot tea of red clover blossoms. Consider mixing in some goldenrod flowers - and, if you or someone you love is feeling a little 'fussy', some catnip leaves as well.
• tincture of lobelia and myrrh, rubbed around the sinus area (around the eyes, nose, even the back of the neck - be careful not to get any in your eyes!!!).
  
• if you're prone to allergies (often an aggravating / complicating factor), try red Reishi or a fresh stinging nettle extract.
• nasal irrigation (neti).

Echinacea and/or eyebright may not be bad ideas either. Consult with your local herbalist to see what blend might be best matched to your whole self!

Herb use roundup

Here is a quick review of some information that can shed light on who is using herbal and complementary medicines today. My comments at the end.

• Alternative Therapies (vol 13, number 2, March/April 2007) produced two interesting studies on herb use. In the first, a survey was conducted amongst over 30,000 adults asking about the use of a limited number of herbs and supplements (29 of 35 were herbal). During the last year, about 20% of respondents reported using one of the products. Factors associated with use were: age 45 to 64; being uninsured; being female; living in the West; using prescription and OTC medicines; having education beyond high school; and being of non-Hispanic ethnicity. The most common herbs: Echinacea, ginseng, ginkgo, garlic - most often used for head and chest colds, followed by muscoloskeletal complaints, and GI tract issues. Crucially, over half of respondents did not inform their primary care doctors about the use of herbs. Cost of conventional treatment was often cited as a factor leading to herb use.
• The second study in Alternative Therapies followed over 800 people coming through outpatient clinics in San Jose, California. The population here was about 45% Hispanic, but of those who used herbs, 52% were Hispanic - suggesting a contradiction to the above study. Herb use was assessed for potential interaction with conventional treatment, and where the potential existed, case history was reviewed to see if any adverse events had actually occurred. The conclusions: about 15% of those surveyed used herbal medicines. Adverse interactions were deemed possible in 40% of those users. These theoretical interactions included potentiation of hypoglycemic medicines; potentiation of anticoagulant medications; interaction with the metabolism of statin and other drugs through effects on liver metabolism; effects on blood pressure; and effects on clotting time. Actual adverse events were only observed in 7% of total herb users, and the severity of these events was generally rated as mild.
• The Australian and New Zealand Journal of Obstetrics and Gynaecology released a report showing that women who pursue fertility treatments are much more likely than average to be using complementary and herbal therapies (as recommended by naturopathic doctors and/or herbalists). In this case, the authors of the prospective study also found that such use of non-traditional therapies is rarely reported to the "conventional" doctor.

Not all of this is new information for herbalists. What comes out loud and clear to me are two main things: first, many people aren't talking to their doctors about herbs and supplements they are taking. While the first study listed above does go into why this may be, the main reason in my opinion is the attitude that conventional medicine has put forth over the last 60+ years, especially in the United States. Pushing "unscientific" medicine away has led not only to the greatest health care crisis our country has ever seen, it has also kept care providers in the dark about what the public is doing to address the holes in the modern healthcare machine.
The second striking fact is that, generally speaking, herbs have very few adverse events associated with them, and that these are most likely linked to the concomitant use of prescription medicines. This, at first, is reassuring - but when we factor in the knowledge that doctors aren't really getting the full picture before they prescribe powerful drugs, I feel a bit less calm.
My recommendations: doctors need to ask more questions. Herbalists need to speak up more, and try to help doctors understand everything their patients are doing. We are living in a world where "modern medicine" is not the only treatment modality! I'm not sure everyone involved in health care, let alone clients and patients, has a clear grasp of this fact. The future lies in an integrative approach, and while this holds great promise, it requires clear communication.

Grian Herbs

A little redesign and reorganization, and the new website is complete. Yes, we do sell products there - but there's also a lot of other useful information.

Drug Warnings

The FDA has put out two press releases in recent days, one that focuses on prescription sleep aids, the other on drugs that stimulate erythropoiesis (the formation of new red and white blood cells in the bone marrow).
As far as drugs like Ambien, Lunesta, Halcyon and others go, we're informed that consumers need to be advised of certain risks associated with these sleep aids:

• Anaphylaxis (severe allergic reaction) and angioedema (severe facial swelling), which can occur as early as the first time the product is taken.

• Complex sleep-related behaviors which may include sleep-driving, making phone calls, and preparing and eating food (while asleep).

Seems pretty common-sense to try herbal and other alternatives first, especially considering the cost difference.

What is even more concerning to me (and don't even get me started on cost in this case: Procrit often runs into the $2000 / month range) are the new black-box warnings for the anti-anemia drugs given to so many folks who are receiving chemotherapy. These have been touted as ways to keep red blood cell counts elevated in these patients. Some highlights:

• Aranesp, Epogen, and Procrit and other erythropoiesis-stimulating agents increased the risk for death and for serious cardiovascular events when dosed to achieve a target a hemoglobin of greater than 12 g/dL.
• ...shortened overall survival and increased deaths attributed to disease progression in patients with metastatic breast cancer receiving chemotherapy.
• Patients treated before surgery with epoetin alfa to reduce allogenic red blood cell transfusions had a higher incidence of deep vein thrombosis.
  
• for example: "The FDA was notified in February 2007 of the final results of a double-blind, placebo controlled study to evaluate whether use of epoetin alpha in anemic non-small cell lung cancer patients not on chemotherapy improved their quality of life. The epoetin alfa dose was titrated to maintain a hemoglobin level of 12 to 14 g/dL; epoetin alfa was dosed at 40,000 IU every week. The study was terminated early when the data safety monitoring committee determined that the median time to death was 68 days in the epoetin alfa arm versus 131 days in the placebo arm (P=0.040 and the majority of deaths were due to disease progression. Also treatment with epoetin alfa did not significantly reduce the need for transfusion or improve the quality of life".

How about two excellent rooty preparations, made from cheap, abundantly growing plants, and which are certainly safer and probably more effective?

Astragalus root
Rehmannia root

An easy way to prepare these herbs is as a decoction. Using 4 heaping tablespoons of Astragalus root and 2 of prepared Rehmannia root (both available at a good herb store) per gallon of water, create a broth by simmering in a covered pot for at least an hour, better still for 3 or 4, adding water as necessary. Strain, and keep in the fridge. 12-16 ounces three times a day can be taken with meals.

Endangered plants and Mountaintop Removal

The herbwife already brought to our attention the insane mining practice of mountaintop removal. Now Herbalgram has published an excellent article which will hopefully ignite a bit more of a furor in the herbal community around stopping this craziness. Sure, endangered plants are being wiped out by the truckful - actually, by the moutainful. But what of the mountains themselves? They hold powerful spirits that are essential for the health of our souls, ecosystems, weather patterns, and more. I think of all the talk of new "clean coal" plants, a supposed "alternative" energy source. At what cost?

American Ginseng and Colds

The American Botanical Council is very excited about a proprietary Panax quinquefolius preparation (Cold-FX) and has released a comprehensive monograph on this herbal product. The bottom line: Cold-FX seems to be quite good at preventing colds and flus, when taken at moderate doses, and even effective in managing symptoms once the cold has started, when taken at much higher doses. The best research that isn't partially funded by the manufacturers comes out of Canada and is a trial involving over 300 people - and the results are indeed interesting.
I reviewed the pharmacology of this product, and it seems to isolate the polysaccharide fraction from ginseng roots. There has been a good amount of research around these compounds (Clinical Microbiology Review, e.g.), and some have proposed that complex sugars such as rhamnose, galactose and arabinose present in genera such as Larix, Echinacea, Andrographis, Eleutherococcus, and Panax are at least partially responsible for their immune-enhancing power. Human studies seem to point at increased proliferation of CD4 T-cells and NK cells of the immune system, although why this happens still remains a mystery. Perhaps the polysaccharides have some similarities to the sugar-like antigens on the surface of bacterial cell walls - but that is simply speculation.
In sum, I think this is further evidence that dietary polysaccharides have a positive effect on human immunity. But don't rely on expensive proprietary products to get these chemicals into your diet: consider an excellent soup stock made of bones and/or seaweeds, astragalus, reishi, and ginseng (American and/or Siberian). You can freeze this preparation in ice cube trays after simmering it for 4-6 hours in a crock pot, and take 2-3 ice cubes in warm water during the cold and flu season. This is a tried-and-true, ancient (minus the ice cubes) way of using these excellent herbs.

Lunar eclipse

Not exactly an herbal topic, but for those of us who enjoy gazing at the full moon, tonight may hold a special treat. On the East coast, moonrise (around 5:45pm, in the dusk hours) will bring an already-completely-eclipsed disk of the moon. It will be visible in the east, reddish-orange, and slowly return to its fully illuminated form over the course of the next hour. If the weather cooperates where you are, this eclipse promises to be quite spectacular: the twilight colors of sunset on one side of the sky, a fiery red moon on the other. Enjoy it! Next chance comes in August.

Garlic gets a bad review

Well, a trial conducted at Stanford University that followed almost 200 patinents has found no evidence that garlic lowers levels of LDL ("bad") cholesterol and general blood lipidity. HerbalGram's review of the study is a good summary, if you don't want to read the whole thing.
Aside from the inevitable media frenzy over this (best headline award: "Garlic stinks for lowering cholesterol"), the study does seem to be a fairly well-crafted, in vivo trial. My only quibble comes with the dose on the fresh garlic, which is very low at 4 grams (about 1 clove) daily. I usually suggest more like 4-5 cloves a day, and generally prefer the whole-plant preparations to health food store pills like Kyolic or Garlicin. In my practice, I have seen these levels of consumption have an impact on total cholesterol and LDL levels when used as part of a balanced, plant-rich, fiber-rich diet.
I think we can draw two lessons from this new information: first off, as the HerbalGram review points out, it may be that garlic has a more potent anticholesterol effect in folks who have seriously elevated levels, not just mildly elevated ones. Secondly, garlic has powerful effects on other markers of cardiovascular disease such as hypertension and vascular inflammation. It may be that, again, we are taking serum cholesterol too seriously as a causative factor in CV disease - and that garlic will reduce blood lipids only in cases where there is actual vascular damage, progressive atherosclerosis, and hypertension.
This study says nothing, of course, about garlic's power to combat infection, address colds and flus, or deal with intestinal parasites and infections - although it does detail effects on breath and body odor, thankfully.

Chaga and cancer

Medicinal mushrooms have a long history of use for modulating immunity, protecting against cancer, and just generally strengthening the system (see, for instance, Rebecca's post on shiitakes). I spend long hours all year round looking for polypores (shelf-mushrooms, generally) in the woods around here, and there is one that can be found and harvested any time of year: the Chaga mushroom, also known as the Clinker polypore, or Inonotus obliquus in the old tongue. Folk medicine, especially in Siberia where these birch-loving fungi grow in abundance, has long regarded the Chaga as a premiere anti-cancer remedy. I generally find it growing on members of the Betula genus (birches, most often golden birches), often ones that are a bit sick. The Chaga almost looks like a cancerous outgrowth from the bark of these trees - an interesting signature. Some have speculated that the fungus acts somewhat as a processing lab for the betulin in birches, a compound that has received much attention as an anti-cancer agent.
I have used Chaga extensively, along with other mushrooms, to support comprehensive protocols for cancer management. Recently, scientific evidence has been building on this particular fungus. Hopefully soon we will get some human data, but for now here's a brief roundup:

Anti-tumor activity of two isolates from Chaga (animal model...)
Antimitotic activity of aqueous extracts of Inonotus (in vitro)
Antioxidant effect of Inonotus (in vitro)
Melanin complex in Chaga (biochemical analysis)
(Melanin has received attention as a potent botanical immunomodulator, perhaps linked to some of Echinacea's immune-enhancing effects).

I use a custom-made double extract of Chaga in my practice. The mushrooms are harvested, stored for a few weeks (not really to dry them, just to get them a bit 'cured') and then divided into two equal portions. You will need a good, sharp saw to cut it in half, and then a heavy hammer / hatchet to chop them up into manageable chunks (about the size of an almond). I steep the first half in a menstruum (solvent) made of 70% alcohol, 20% water, and 10% vegetable glycerin (in a 1:5 ratio, weight of Chaga to volume of menstruum). This tincture favors the phenolic compounds listed in the first study above. After 4-6 weeks of steeping, I strain the tincture and set it aside.
The second half (saved now for many weeks) I place in a crockpot with twice the volume of water as the volume of the strained tincture, and set it to a slow cook for about 48 hours. The goal is to cook it down and strain it so the amount of water extract equals the amount of strained tincture (add water during the cooking process if necessary). Finally, let everything cool down to room temperature, and whisk the two extracts together. Final alcohol percentage is 35%. The color: mahogany brown, beautiful and rich. The flavor: bittersweet, deep and woody, with overtones of humus. Strong healing medicine!