Echinacea effective (we knew that)

A meta-analysis of multiple trials covering over 1,500 people and published in the Lancet not only revealed that Echinacea helps avert and shorten colds and flus, but also got substantial press coverage in the mainstream media. Nothing new for herbalists - merely a vindication of what we have known for a while: when taken at adequate doses in the real world, Echinacea species really are effective. Beyond colds and flus, I often use this plant for topical bacterial (e.g. Staph) infections, to excellent effect -- and considering drug-resistant staph may be much more widespread than we thought, Echinacea will become much more important than it already is.
As far as the new meta-analysis goes, HerbalGram wrote a review, and USA Today gave mass media's take.

New FDA rules for herbal preparations, practitioners

The final rule on good manufacturing practices for herbal / nutritional supplements just got handed down this weekend. While it leaves some leeway for self-regulation, it does mandate some very difficult requirements, especially for practitioners who are essentially "manufacturing" a product each time they blend a tincture. These rules have been a long time coming, and will be phased in for small companies by 2011...
We need to dissect the full document and consider it with the advancing Traditional Medicines Congress (and its opposition) in an attempt to understand the very real changes herbalism will face in the coming years. Let's stay informed and keep our voices heard.

High-dose Ginkgo extract helps control anxiety

The standardized extract of Ginkgo biloba, used for managing cardiovascular disease, improving blood oxygenation, reducing inflammation in colitis, and slowing the decline of brain function as we get older, seems now to reduce anxiety in people of all ages.
A new study (107 subjects) showed very significant improvement in the symptoms associated with "generalized anxiety disorder". The product used was EGb 761, the usual extract standardized to 24% ginkgo-flavone glycosides and 6% terpenoids. The dose was higher than what I often suggest, and the authors noticed a dose-dependent reduction in symptoms (they were giving 480mg and 240mg of extract daily).

Perhaps a bad idea?

Trying to stimulate the immune system into producing antibodies to the active form of angiotensin, an enzyme involved in the complex balance of chemicals that regulate blood pressure, might not be the safest point of intervention for this disease. Considering the prevalence of autoimmune conditions, I would be concerned about the possibility of long-term effects. Nevertheless, according to the New Scientist, Cytos Biotechnology in Zurich seems to be trying out such a "vaccine".

Perhaps we should start training the immune system to attack a variety of other targets as well! Neurotransmitters for "mood disorders"? Hormones? I'm sure the resulting inflammation would be negligible.

Soy isoflavone helps bone density

Research from the University of Messina in Italy points to genistein, and isoflavone from soy (Glycine max), as a possible treatment for poor bone density and osteopenia in post-menopausal women. While the scientists didn't track fractures or other negative outcomes of poor bone density, they did document an increase in BMD in the treatment arm of the study (the whole study included 389 women). The general conclusions indicate that soy contains phytoestrogenic isoflavones that reverse the trend of bone loss that occurs in post-menopausal women.
The researchers caution that, genistein being a phytoestrogen, the use of soy is dangerous for those with a history of endometrial or breast cancer (considered to often be estrogen-dependent). In response, I offer two considerations: first, no research has even indicated conclusively that phytoestrogens stimulate cancer in vivo, and additional research points to the possible cancer-preventive role of these chemicals. Second, ethnic and geographic groups that traditionally use an abundance of soy in their diet generally show lower rates of breast cancer.
As with many plant chemicals taken in their unadulterated states (and especially as crude, whole preparations), I suspect soy isoflavones play an amphoteric role in the human physiology, increasing what is deficient and reducing the effects of that which is excessive -- in this case, helping to modulate the effects of estradiol.

Plants recognize their siblings

We already know that the rhizosphere, the zone of soil around the roots of plants, is teeming with chemical signals from the plants themselves as well as from symbiotic bacteria, fungi, and other life. This chemical crosstalk is akin to the air-based communication accomplished through pheromones (in humans, other mammals, insects, etc...), and undoubtedly provides a rich, stimulating and ongoing dialogue for the plants.
In many cases, chemicals secreted from plant roots contribute to survival: witness allelopathy, the ability of some plants such as wormwood, goldenrod, or many cover crops to inhibit the growth of other species in their rhizospheres. It has always fascinated me that the plants can recognize members of their own species and selectively inhibit the growth of everything else -- but after all, they are different species, and a genetic resistance to a poison is not difficult to imagine.
Now, in a beautiful study published in Biology Letters, we learn that members of the same species alter their competitive behavior based on whether or not they are growing next to their siblings (plants grown from seed that came from a single parent). Seedlings of Cakile edentula, a variety of wild mustard, grow much more dense and aggressive root structures when next to members of their own species that come from different parents. This is a remarkable level of sensitivity to a very slight variation in genetic structure -- but should come as no surprise to herbalists who are quite familiar with plants' ability to sense, perceive, process, and alter their behavior in concert with their environments.

Trouble for antibiotics

Antibiotic resistance has been all over the news lately, with the media spotlight focused on the case of a man with extensively-drug-resistant tuberculosis who somehow eluded border checkpoints across Europe, Canada and the U.S.
We thought we had TB "licked", right? But the pesky little bug has somehow adapted to changing environmental conditions, and now modern medicine is left in a global panic when faced with the possible spread of a TB strain resistant to most available dugs. Treatment is expensive, long, and not always effective - and the specter of an even more powerful "superbug" looms large.

Hospitals, with their ubiquitous use of antibiotics, have long been havens for some ultra-potent, resistant strains of common bacteria like staph (Staphylococcus aureus). This bug can cause skin infections and systemic sepsis in the worst cases, but our immune systems usually take care of it pretty well (especially with a little Echinacea, an excellent remedy for this pathogen). In hospitals, a strain called MRSA (methycillin-resistant-staph-aureus) has been giving doctors headaches for a good while, ever since methycillin was extensively prescribed to kill bacteria that had become immune to penicillin. Now, they use vancomycin (ultra-strong antibiotic) to treat MRSA, but VRSA has already evolved and modern science has NO treatment available for this new bug. Things don't look too hopeful for the wonderdrugs that, in the 1950s, were heralded as the "end of infectious disease".

If this weren't enough, it turns out that MRSA has been spreading outside hospitals as well. A recent study showed a seven-fold increase in these cases over the period from 2000 to 2005, and this is just in the Chicago area. This is a concern because not only are these bacteria resistant to antibiotics, but they are generally more aggressive in the physiology as well, and can become lethal more quickly and easily than their original counterparts. Nevertheless, they still respond well to herbal treatment, especially if detected early.

In the wake of these types of reports (which have been ongoing), along with analyses that show how widely overused antibiotics are, modern medicine has been urging a less liberal prescription strategy so we can have these powerful drugs available when we really need them (i.e., not for your common cold)! And here's another reason: last month a broad analysis of over 13,000 children in Manitoba, Canada showed that antibiotic use in the first year of life substantially increases asthma later on, presumably by confusing and weakening the kids' immunity. The more frequent and more powerful the antibiotics, the greater the risk for asthma.

So, in the end, antibiotics seem to be less effective as time goes on, and actually quite harmful in some cases. More and more, it will be up to herbalists to pick up the pieces of our short and misguided love affair with these drugs. If you want to learn more, here's a good place to start.

Vermont Center for Integrative Herbalism

We've started a new non-profit venture in Montpelier, focused on providing free herbal services (including access to a well-stocked apothecary) and a comprehensive herbalist training program. I've been personally involved in this work for over 7 years, and the momentum my friends and I have generated seems to be coalescing this Summer into what I hope will be a useful and powerful new resource for the Central Vermont community.
Read more from the Times Argus; or visit the website of the Vermont Center for Integrative Herbalism. And, if you're in Montpelier, Vermont this Friday evening, you can come visit at our benefit dinner and silent auction.

Cannabinoids and skin allergies

Fresh research published in Science seems to hint at a topical anti-allergic effect for cannabinoids. The trial was done in mice using an artificial allergen, and the research proceeded in two steps: first, the scientists found that mice genetically engineered to lack cannabinoid receptors were much more sensitive to environmental allergens like nickel. I suspect the mice were modified as part of Dr. Karsak's ongoing obsession with understanding the role that mammalian cannabinoids (which occur naturally in our bodies, as well as in mice -- one example is anandamide) play in a variety of processes, from atherosclerosis, to generalized inflammation, to mood.
Anyway, Karsak and the rest of the research team decided to take things a step further, and see if cannabinoids from Cannabis itself could reduce skin sensitivity in normal mice. So they cooked up some kind of marijuana salve and applied it to mice that had been exposed to a synthetic allergen (2,4-dinitrofluorobenzene). The results: a 50% reduction in inflammation and swelling. While the mechanism of action is still unclear, preliminary evidence seems to point to cannabinoids' role in modulating the expression of genes that code for pro-inflammatory compounds like histamine. I'd be curious to hear more about this: it could help explain how effective marijuana has been in curbing GI and upper respiratory inflammation (colitis, asthma, e.g.) in previous studies, some of which were in humans.
One final note of wisdom from Roman Rukwied, a pain and inflammation researcher: "We are far before the day when we could say 'oh, I have a nickel allergy. I will smoke marijuana and I won't have it anymore'," he says. "That is definitely not the case." Fair enough.

American Ginseng helps cancer-related fatigue

Panax quinquefolium, the gentler ginseng native to the Northeastern U.S., received an endorsement at this year's annual meeting of the American Society of Clinical Oncology. Debra Barton, of the Mayo Clinic, described how patients with fatigue and short (6 month) life expectancies were given P. quinquefolium for 8 weeks, at varying doses. The results seem to point to a marked improvement in vitality and a reduction of fatigue-like symptoms.

282 patients were given placebo, 750mg, 1000mg, or 2000mg of ginseng. The product was Wisconsin-grown American ginseng root, dried and encapsulated. All the patients in the active treatment groups reported improvement greater than placebo, with the higher doses showing greater positive response. Toxicity was absent in all treatment groups. The authors of the study seemed generally pleased with ginseng's effects and recommend additional research.

In my opinion, the doses used were still a little low. Traditionally, 3-4 grams a day are given, especially in conditions where the life force is severely challenged (as in this study's treatment group). Quality of life could be improved further not only by increasing the dose of ginseng, but also by selecting additional adaptogens and other herbs suited to the individualized constitutions of the people involved. Nevertheless, even in this one-size-fits-all approach, the life-enhancing power of this woodland plant still comes through. I am reminded of stories that talk about court physicians in China giving massive doses of prized ginseng roots to the Emperor during the last months/weeks of his life, to keep him active and alert in extremis so that the final affairs of the State could be settled.
One final note: beware, generally, of Wisconsin ginseng. It is often grown in massive industrial lots, covered with shade cloth, fed chemical fertilizers and liberally doused with fungicides. Insist on organically grown, preferably woods-grown organic, roots.

Herbal support for runners

In honor of last Sunday's marathon in Burlington, VT, I offer some of my favorite herbs for dealing with common complaints runners (and especially distance runners) mention.
Chamomile (Matricaria recutita, Anthemis nobilis) is an excellent antispasmodic for the stomach and intestines. A mild tea (2 TBS of flowers brewed in 1 quart of hot water) relieves the cramping, "stitches", spasming, and gas that can develop over the course of a long run. Carry some with you - no more than 8oz for every 13 miles is necessary - and take little sips every few miles to help control gastrointestinal symptoms. The tea can be taken cold, and has a pleasant and refreshing flavor. Mix with a little maple syrup if desired for an extra sugar boost.
Rhodiola (Rhodiola rosea) is perhaps my favorite performance enhancer, working very well in the short term, reducing fatigue and improving your muscle's utilization of glucose and oxygen. Try 120 drops (about 4ml) of a liquid extract 20-40 minutes before a race. Because it gives you a "little extra" (without the dangers of stimulants like Ephedra), I save it for races and don't use it during training. Eleuthero (Eleutherococcus senticosus) is good as well, but needs to be taken for a few weeks for optimal effect.

Recovery and injury treatment can be a long and difficult process. Muscles bounce back quickly - feed them with adequate sugars and a little good quality protein. Ligaments and tendons, on the other hand, take a lot more effort. I've experimented with a variety of internal and external treatments, and have come to prefer the following regimen:
First off, gentle movement (walking or slow jogging) is preferable to just resting. This allows all the sinews in your legs to warm up, making the next step more effective.
Secondly, stretching after running is crucial. There are a variety of techniques out there - do your research and find what works for you. I like to allow at least 15-20 minutes for stretching, even after a short 3-mile run.
Thirdly, ice is your friend. After stretching, apply ice to problem areas for 5 to 10 minutes, and follow with a warm shower or compress. You can then apply Arnica (Arnica montana) gel or oil if there is any inflammation with swelling.
St. John's Wort (Hypericum perforatum) oil is helpful if you have radiating nerve pain, like a pinched nerve in your shoulders, or sciatic nerve pain running down the back of your leg. Rub a liberal amount of the oil on the problem area(s).
For long-term support in the health of ligaments and tendons, I rely on two herbs in particular: Horse chestnut (Aesculus hippocastanum) and Gotu Kola (Centella asiatica). Both help improve circulation and reduce inflammation. They can be taken as liquid extracts (Gotu Kola must be prepared fresh, in my opinion, to be most effective), and Horse chestnut tincture can be applied topically as well to excellent effect. I have used and recommended these herbs in combination for conditions like IT band syndrome, achilles tendonitis, plantar fasciitis, and the general sprains and strains of running. They work quite well, along with ice and stretching, over the course of a few weeks.

As the summer season comes into full bloom, keep on running (or hiking, or walking, or swimming, or paddling, or simpy playing) and stay injury-free with herbs!

Northern Willow-herb

Also called "small-flowered", Epilobium parviflorum is a member of the Onagraceae, the same family to which Evening Primrose belongs. The genus is rich with many species that have extensive references in the literature, especially from the Eclectics, but this species seems to be a little less well-known. I've been dancing back and forth with this plant for a few years: first, pulling it as a weed. Then, appreciating its flavor on hot summer days. Drinking its tea. Preparing a tincture. Introducing it to some clients. It really is a helpful herb, though unassuming (funny how often these two qualities go hand in hand); and since Rebecca is hosting a blog party on less common botanicals, this one fit the bill, at least for me.
Its Latin name means "a small flower on the end of a tube", and that describes the inflorescence well (serving also as something of a signature, if you ask me). The flower itself is beautiful, small and delicate, with four deeply notched purple petals, revealing itself a bit later in the season (late June / early July) up here in Vermont.

Later, in August, the long ovaries open to reveal seeds that float off on fine down, much more delicate than that of milkweed but similar in behavior. It spreads quite easily, but behaves well: its root is divided, and easy to pull if you're so inclined.
I've been using the leaves for medicine, and my feeling is that they are most potent right now, before the flower heads start forming. They are opposite, a finely toothed and almost glossy, with deep veins and a slightly maroon color at the base, where they clasp the stem tightly. As the plant ages, the leaves spread out a little bit, and become smaller as they grow up the stem. Straight off the plant, the leaves taste sour and are a bit astringent, but have a roundness and "butteriness" that balances out the tannins well. As an infusion, the flavor becomes a bit more complex and bitter, but retains the round fullness I've come to associate with more aromatic plants. Hmm.
The tincture of the fresh leaves, prepared at about 60% alcohol b/v, is less astringent than the infusion and more bitter. I've come to favor it for medicinal use, as I believe the sterols it contains are better extracted by this method.
The whole plant contains polyphenolic compounds in the broad family of tannins, related somewhat to the catechins found in tea or the more widely distributed flavonoid polyphenols. Specifically, a compound called oenothein has been identified and linked to some of its medicinal action (at least, on enzyme models in a petri dish). Additionally, plant sterols (such as beta-sitosterol specifically) are present in appreciable quantities. Part of its "round" flavor may also be related to the good amount of mucilage it contains.

Historically, the whole genus is used for gastrointestinal complaints, mostly characterized by bloating and inflammation (I definitely consider this a cooling herb). Colitis and "irritable bowel" might be good modern names for what goes on in a gut that could benefit from the willow-herbs: too fast, too sour, crampy and stressed. Generally, a loose stool (though I suppose it would help in either loose or dry stools if the constitutional profile fit). Modern research seems to agree that Epilobium would make a great medicine for mice with stressed out intestines. I can see how a gently astringent, mucilage-rich plant would help slow the GI tract down a bit, thereby improving digestion and absorption. To this end, a tea would be best (you're not really after the sterols), combined perhaps with agrimony or chamomile.
But Epilobium parviflorum specifically, due to its rich phytosterol content as well as the oenothein, has found a place in my apothecary for helping men who are having prostate problems: swelling of this gland results in obstructed urine flow, which causes much discomfort and a dribbly, unsatisfying urine stream. The research on oenothein seems to suggest that this compound has an effect of the enzyme 5-alpha-reductase, responsible for converting testosterone to DHT (dehydrotestosterone, a reduced form of the hormone) which has pretty conclusively been implicated in prostatic inflammation. Additional research shows that the whole plant has broad-spectrum anti-inflammatory effect, which certainly helps. I suspect that its name may have come from this ability to control swelling and inflammation, much like the willow tree does. Regardless, I combine it to good effect with cleavers and yarrow for treating prostatic inflammation and hypertrophy - and I'm excited to move away from using the non-bioregional saw palmetto for this purpose! It seems to work better, anyway.

General info on other Epilobiums from Maude.
Research on non-proliferative effect of various Epilobiums.
Some say Epilobium species have antifungal effects, systemically and topically.
Science says: bumblebees love it! (especially its most symmetrical flowers)

A collection of late spring ephemerals

This seems to be a season of airy, white flowers. We caught a few in between some May rain showers, gracing the woodlands and pleasing the pollinators...


Foamflower (Tiarella cordifolia) is rich in tannins and other astringent compounds, but as is often the case with medicinal herbs, is also mucilaginous and soothing. Generally, the root and leaves are used, brewed into an astringent and tonic preparation for digestive complaints (indigestion, gallbladder colic) and urinary inflammation (including kidney stones).






Goldthread (Coptis canadensis) is a beautiful Ranunculus family plant (notice the multiple green carpels, each leading to a single seed later in the season). Its root is like a bright yellow string cris-crossing the humus, and is used as a "damp-heat" clearer (digestive torpor with inflammation, mostly) with similar qualities to goldenseal (another Ranunculus) and a similar chemical profile.















I was excited to find over a dozen dwarf ginsengs (Panax trifolium) in flower by a marshy, rocky spot off the main trail. This plant is a close relative to the more prized American ginseng, but is much tinier (4" tall) and its leaves are less rounded. Traditionally, it provided an important source of nourishing food (it's also called "groundnut" due to its tuberous root) that has the same sort of sweet /round flavor other that other members of the Panax genus have. Its medicinal qualities are very similar to American ginseng, though weaker: tonic, adaptogenic, enhancing energy and endurance without being overstimulating. A beautiful, classic Aralia flower: they always remind me of fireworks. An interesting fact about the dwarf ginseng: individuals can be male or hermaphroditic (this one appears to have only male flowers) and can change from season to season, or within the short flowering season itself, depending on needs.



Toothwort (Dentaria diphylla) is delicious. A spicy woodland Brassica, it was used as a circulatory warmer and "antispasmodic nervine" (as described by Cook). Smart spider is waiting.













A beautiful painted trillium (T. undulatum), though a bit past its prime and not exactly ephemeral (its flowers have appeared on woods walks for a few weeks now), certainly deserves a little attention... The root was traditionally employed, as a parturient and nervine.



Finally, a shot of some Solomon's seal (Polygonatum multiflorum) arching over Canada mayflowers (Maianthemum canadense) in a rocky crack.

Milk Thistle and mushroom poisoning

Milk thistle (Silybum marianum) has a long history of use in liver disease. A report in the current issue of HerbalGram highlights its effectiveness in one of the worst, most acute cases of liver damage: that which occurs from ingesting the deathcap mushroom, Amanita phalloides. A proprietary intravenous administration of milk thistle has been approved and used in Europe for some time as an effective antidote to this poisoning; in the United States, such approval is lacking and thus no effective antidote exists.
As the Santa Cruz Sentinel reports, six people who ate deathcap mushrooms over New Years 2007 were rushed to the local hospital, where the doctors, in a desperate search for something that could help reverse the rapid destruction of their patient's livers and thus save their lives, came across milk thistle as a proven antidote. Unfortunately, the herbal medicine was unapproved by the FDA. Not willing to give up, the doctors petitioned the FDA for an emergency IND (Investigational New Drug) status for the milk thistle extract, and in the interim gave the patients oral silymarin from a natural foods store. The FDA granted the request, and the IV extract was immediately shipped from Europe. Five of the six patients had a complete reversal of symptoms, their lives saved. The sixth, a woman 83 years old, succumbed to kidney failure. Even still, Dr. Mitchell (the attending physician) commented that "...her liver function was improving because of her treatment, and unfortunately factors other than her liver resulted in the final complications".
This simple remedy does not need to be administered intravenously except in the most dire circumstances, as in this case. For most diseases involving liver damage and inflammation, the oral intake of crushed milk thistle seed (1 to 3 TBS daily) is more than adequate for hepatic protection.

Paul Stamets and mycoremediation

Reality Sandwich, a new online venture started by Daniel Pinchbeck and others (quite interesting in its own right), reminds us of the power of mushrooms and their mycelia by discussing the work of Paul Stamets (Fungi Perfecti). Beyond their use as powerful medicines, mushrooms have the ability to decontaminate sites polluted with hydrocarbons and other toxins. For a more complete discussion, and if you have an hour to spare, check out this fascinating lecture Paul gave in 1999.

Sweet Violets

Spring advances, and flowers are blooming everywhere! Herbalists' lawns tend to look a bit messier than average this time of year (I'm still letting the dandelion greens grow, too) - but how can you mow down these beauties??

Trumpet tree

A couple of years ago, when I was in Belize with Anne hiking around the rainforest, exploring Mayan power sites, and talking to a range of different plant people, two main species came up over and over: the cockspur acacia (A. cookii, A. cornigera) and the trumpet tree (Cecropia spp). The former was always touted as a remedy for snakebite, and the presence of cardioactive glycosides in its bark may be potentially related to this traditional use (slowing the heart rate and perhaps decreasing the circulation of poison). "It won't cure it", one gentleman told me, "but it will give you time to get to help, even if you have to walk a long distance". Seemed like a useful tip.
The latter, a middle canopy plant known as the trumpet tree, seemed to have a special place in the hearts of nearly everyone I spoke with who knew anything about the jungle. "It's the toucan's favorite". "The stems, which are hollow, can be used as a trumpet". "We use it to communicate with the spirits" (hollow stemmed plants often have this power, as with the Elder tree). "It makes high blood pressure go away". "It helps with men's issues". Fresh research now points to the power of this plant in treating hypertension and the bronchiospasm of asthma. Though these studies are from animal models, I feel more confident about their conclusions (the authors speculate a Ca-channel blocking activity) given the wealth of traditional information that is available.
From Phytomedicine:
Antihypertensive effect
Antispasmodic effect in bronchial asthma

File another one under the "Science plays catch-up" tab.

Phytoestrogens and phthalates

A recent (end of January) case report generated a lot of furor in the herbal community by implying that certain soaps and body care products containing lavender and tea tree oil were causing abnormal breast growth in young boys. There are numerous reasons why this conclusion is suspect (to say the least); check out the herbsandinfluenza blog for a quick recap.
What I was immediately concerned about was the lack of investigation on the effects of common plasticizers and parabens that are present in many of these skin care products. Phthalates are a common, dangerous, and highly estrogenic class of chemicals that are part of this mix. A new report published in the journal Environmental Health Perspectives analyzes the urine of prepubescent girls for estrogenic compounds. The conclusions: enterolactones (byproduct of plant lignans such as those contained in flax) and phthalates were the most common urinary metabolites found in these girls. And while plant lignans have been consumed since we've existed as a species, phthalates are very new - and generally much more potent in the physiology.
In light of this new information, I believe that the original report on breast growth in young boys should be taken more seriously: not as a warning sign that lavender will disrupt everyone's endocrine system, but that artificial compounds present everywhere in our consumer products and sporting a very long half-life are skewing the hormonal balance not only of our species, but probably of the entire environment. Perhaps some follow-up research will come out of this, and plastic packaging will be reconsidered (don't hold your breath).

Bloodroot

Bloodroot (Sanguinaria canadensis) flowers glistening in the spring sun.

Medicine: evidence based vs. observational

A 2003 report from the British Medical Journal serves as a good commentary on medicine's current obsession with evidence-based knowledge: an attitude that dismisses "traditional", "empirical", and "observational" reports and analyses as somehow inadequate for determining the safety and efficacy of treatments.
The authors make an interesting case. Especially if you're gravitationally challenged.