Plant medicine heals more than just people

We often discuss how effective plants can be at supporting and gently bringing human beings back to a state of "wellness" (meaning that resiliency, vibrancy, passion are maximized). I've spent a lot of time exploring how this happens, reading through the historical record and perusing modern research, and on balance it seems pretty clear that medicinal herbs, trees, mushrooms and more are good at helping folks in need. But that's not what I want to discuss today.
Rather, I'd like to posit the idea that working intimately with the botanical world alters our lives in ways that transcend individual health. Of course, this is not a surprising idea: reality mirrors itself, and the skin is barely more than an illusory boundary. Nevertheless, as a person whose life was redirected, and perhaps saved, by trees and herbs, I want to share three ways in which these allies can have powerful effects beyond the individual.

First, the people. Herbalists, gardeners, and other plant folk are consistently the most cooperative and compassionate people with whom I've had the pleasure of working. They share knowledge freely, contributing to a vibrant living oral (and now digital) tradition. They are often excellent communicators, speaking easily in language of metaphor and myth, forest and field. Even the most "beginning" herbalists have taught me amazing lessons and come up with amazing insights - which is why I avoid ranking plant people based on experience, training, or whatever else. Nature's gifts aren't reserved for the well-learned - and those of us who have spent a lot of time studying may find that, in the end, we return to the simple source of life for lasting truth, and books fall away in the light of the green world. This engenders gratitude, and may be the reason plant people are generally gentle, compassionate, and giving. They are often amazingly creative, too - coming up with new pictures, herbal formulae, and solutions where science falls short. I don't mean to disparage any way of "knowing", as all ways are necessary. I simply feel that knowing through plants is so very beautiful, and makes its people beautiful, too.

Next, herbal medicine has a way of reconnecting our species to nature. Clearly a no-brainer: we get outside more, we tend to eat differently, we appreciate a woodland walk differently when we have an intimate knowledge of the green folk living all around us. This gets into our heads slowly, insidiously, and deliciously. Before we know it, we may find ourselves kneeling on a city sidewalk looking at plantain (the horror)! But I feel like the gift of reconnecting to nature that herbal medicine offers us is most clearly evident in what happens when nature and wild plants are removed from human life: this is what, in Western culture, we've been working on for a few hundred years. The results are dramatic: epidemics of chronic disease affect the population, not because of the rise technological medicine, but because of a removal of traditional medicine! Additionally, to support homogenized, un-wild, unchallenging food systems we are also creating epidemics of chronic disease in the environment: new chemical signals that affect fertility, waste material that alters climate and ecosystem balance, disorganized living arrangements that sprawl over the landscape. I may be overly optimistic, but I believe that we don't need to remove technology to fix these issues: we simply need to bring plants back in to daily life. Once we develop the botanical habit, herbs begin to mess with our heads (where we all too often live). As we lose our heads, we save our spirit - and spirit being all-encompassing and transcending the human species, we participate in a more sustainable dance with the rest of nature.

Which leads me to my final point of appreciation for herbal medicine: mystery. Anyone who has seen a plant effect a cure knows that there is something magical about this process, as it may never be able to be replicated again. The herbalist, plant, and client have somehow managed to work together, in that one timeless moment, and the feeling all (plant included!) are left with is similar to what you feel when you run in to a random friend in a random place at just the right moment. It is synchronicity beyond coincidence, and we glimpse for an instant what it is like to be the immortal Universe. A healing modality that respects and welcomes mystery is my kind of medicine: because in the end, no matter how much we dress it up or understand its details, a human physiology brought back in to balance always reveals an awe-inspiring mystery. All good scientists know this. Einsten, for instance, tells us:

The most beautiful experience we can have is the mysterious. It is the fundamental emotion that stands at the cradle of true art and true science. Whoever does not know it and can no longer wonder, no longer marvel, is as good as dead, and his eyes are dimmed.

I have great faith in the power of herbal medicine to heal not only people, but also culture, species, and ecology. It's really pretty simple: we really need plants in our lives. Even only a little bit. And once their green tendrils begin to grow in our hearts, like the first pea vines of spring, there is no turning back. Thank goodness - thank greenness.
In gratitude, I leave you with the words of Peter Conway, English herbalist, philosopher, and erstwhile humorist.

The future of herbal medicine is the past of herbal medicine - self care & psychedelics - serious...

Joyful herbs for the darker days

All of us feel the loss of daylight to a certain extent. For some, it may be occasional sluggishness, less motivation to get outside and exercise, or less of a desire to spend time with friends and family. Others may feel even deeper withdrawal, or experience less control over anxiety and the sometimes overwhelming responsibilities of daily life. To a certain extent, the culture has tried to address this by consistently packing in times of remembrance, celebration, and family during the darkest months of the year – but by the time it’s all over (or even during the often stressful holidays), there are still many months of darker days left and it is usually at this time that folks express the desire for more fun, more joy, more light.

Aside from creating internal tension by working the same schedule regardless of season every single week of the year, darkness literally affects our mood, in a pattern that has been fairly well characterized and is known as seasonal affective disorder, or SAD. This pattern can carry a significant depression along with it, though most often it is a period of withdrawal, sadness, and perhaps increased anxiety whose chief feature is that it occurs as the daylight wanes.

So what can be done? Naturally, being outside is extremely important. Feeling sunlight directly on the skin, for even 30 minutes a day, can have substantial benefits! Some choose to install and operate full-spectrum lighting in their homes. As an extension of this, folks also supplement with between 1,000 and 4,000 IUs of vitamin D daily. This important nutrient is essential for those who suffer from a seasonal sadness pattern. But there are some specific medicinal plants that can reinforce these sun-seeking impulses, while at the same time buffering the symptoms of sluggishness, sadness, anxiety and withdrawal. All of this put together helps us not only feel better during the winter months, but also perform better at work, play, and family gatherings.

 

Pulling out of the “hole”: stronger botanicals for SAD

 

St. Johnswort (Hypericum perforatum) has a well-deserved reputation as a good herb for mild to moderate depression, and clinical research has confirmed its effectiveness for this condition. SAD, usually a moderate case, responds extremely well to this plant, which not coincidentally has a long history of solar mythology tied to it. Though also useful for anxious conditions, it is better suited to the depressive side of the winter blues, where it warms, enlivens, and improves circulation.

Consider between ½ tsp and 1 tsp (3-5ml) of a good, fresh tincture prepared from the whole buds and flowering tops. This extract can be taken up to 5 times a day – though it should never be consumed alongside conventional medication without checking with an herbalist first.

Mimosa (Albizia julibrissin) is perhaps a bit less well-known, but is a stellar and powerful plant for supporting darker, sadder moods characterized by apathy and withdrawal. It comes from the flower and bark of a medium-sized tree, and has an astringent and somewhat acrid flavor. The tincture is usually taken at a dose of 30 drops all the way up to 1 tsp (1-5ml) twice a day.

Rhodiola (R. rosea) is an anti-stress, energy-enhancing tonic. As such, it lessens the pressures our psyches may feel when we are also sluggish or anxious from the changes in daylight. And of all the “stronger” herbs, it has the greatest affinity for the overwhelmed and frazzled type, where it also serves the purpose of enhancing and evening out energy throughout the day. ½ tsp once, or sometimes twice, a day usually suffices to add spark back into a tired life – and sometimes enough spark to start back in to an exercise program, a snowshoe adventure, or that wintertime project you were putting off…

Aromatic plants: a daily habit to keep us happy, focused, and “in the flow”

            Plants with strong smells, rich in volatile essential oils, have been used throughout history as ways to facilitate ceremony, mark momentous (large or small) events, reduce the effects of stress on the human system, and spark creative focus. They accomplish this by quite literally balancing the level of internal tension we experience: tension in our internal organs, along our nerves, in our skeletal muscle. Though probably best to consume them daily, they make a more frequent appearance in my life from about mid-September to mid-March – the darker half of the year. All of the plants below can be combined together, are very safe to use alone or in concert with conventional medication, and are perhaps somewhat interchangeable. Find a few that you like, and try to start consuming them regularly before mood becomes an issue: it’s always easier to prevent a downslide than it is to climb back out of a dark hole.

Holy Basil (Ocimum sanctum, aka Tulsi) reduces inflammation in the body, buffers the effects of stress, calms anxiety and gladdens the heart – all while tasting delicious as a simple cup of tea! Various teabags prepared with Tulsi are available today, and almost all are delicious, safe, and effective when used habitually (2-3 cups of tea a day). The tincture too can help, when at least ½ tsp is taken twice a day, perhaps alongside other herbs.

Frankincense (Boswellia species) is a resin from an east African / Arabian tree. It is traditionally burned as incense, but its internal use is also storied and has been receiving a lot of attention over the last decade.  It seems very useful at controlling inflammation, especially in nervous system and cardiovascular tissue, but has important mood-balancing effects as well. It is a rich and sensuous ally for the darker days. Typically ¼ tsp to ½ tsp of the “tears” (amber-like resin chunks) are eaten daily.

Lemon Balm (Melissa officinalis) has a delightful scent that is enlivening and makes for a happy heart. It brews a delicious tea, and its aromatic constituents are antidepressant and very, very useful in anxiety. Clinical research shows that consuming a strong cup of Lemon Balm tea (2TBS of leaf per cup) or its extract (1tsp per dose) lessens anxiety and uplifts the frazzled, overwhelmed person for up to six hours! That said, I usually recommend at least 3 cups or doses a day.

Rose (various Rosa species, the stronger scented the better) holds a sad heart and nourishes it. In clinic, its specific use centers around trauma, physical or emotional, and the withdrawal and closed-heartedness that can result. But it is also quite applicable in any context where sadness is overwhelming the ability to enjoy and engage life. Typically not used alone, Rose makes an amazing addition to tea blends and extract formulas for sadness and apathy. Use about 1tsp of petals per cup of tea, or 30-60 drops of tincture. If you can find a “rose elixir” (Avena Botanicals makes an amazing one), 5-50 drops can be used as needed to mend a broken heart.

Pine (Pinus species, often P. alba or white pine), along with spruce and fir, is an evergreen that has always been associated with the darker winter months. It’s for reasons that are more than celebratory that its fronds are brought indoors to decorate the home when the light is waning: the smell is uplifting, antidepressant, and energizing. It is also a great source of vitamin C and very good for the lungs. I’ve only ever used a tea of the fresh needles, regardless of species: about 1TBS of chopped needles steeped in a cup of hot water, taken 2-3 times a day.

Finally, Oats (Avena sativa) is the most nourishing of the bunch. It may be needed for folks who have experienced a SAD pattern for years, or who are perhaps getting worse and worse with every dark season’s passing. It also makes a good tonic for those used to burning the candle at both ends – all in all, not the strongest and immediately relieving anxiety and depression, but the secret ingredient for building resistance to stress and weathering the lack of sunlight with greater grace. Typically a tea is made with 2TBS of unripe, dried oat seedheads per cup of hot water – and 3-4 cups are consumed every day.

There is extensive research correlating the use of highly scented plants (think lavender, for example, or peppermint) to less tension, stress, anxiety and sadness. People have consumed these plants in a range of ways: as teas and extracts, but also as aromatherapy essential oil blends, in room diffusers, as incense, or in bath sachets. Other plants, such as white sage, pine, and citrus fruits, are brought into the home for decoration (and their noticeable medicinal effects). One way or another, it does us all a lot of good to share our space and lives with these sweet-smelling herbs: and it may be that the rise in patterns such as SAD in our culture parallels the loss of these allies in our environment. Many of the scented candles used for the holidays are artificially aromatic nowadays, their medicinal effects unclear (and perhaps even detrimental, as they might lead to hypersensitivity symptoms). So consider real plants, wreaths of evergreen fronds, and true potpourri and mulling spices as part of your seasonal rituals: there are good reasons for these customs, and a happy heart may be the most important!

The bitter flavor and the bitter herbs: trust and embrace!

I had the opportunity recently to spend some time talking with Jovial, whom I've known for a while but who recently started the excellent herbal bitters company Urban Moonshine. The focus was often on the bitter extracts themselves (the tincture blend she makes is actually pretty tasty and mellow compared to some of the wormwood / artichoke / mahonia combinations I've made up for clients in the past), but we ranged off into more philosophical realms pretty quickly.
The discussion kept coming back to a few key points: the bitter flavor, when obtained through whole plants (and yes, I consider crude tinctures to be whole plant products), has a historical grounding in the culture of eating itself, and thus consuming it is a "well-connected" (relationship-rich) practice; it enables optimal digestion (and beyond) by relying on the physiology's innate wisdom and regulatory mechanisms; and it provides an essential challenge and avenue for growth for the human being. When habitually used, the bitter flavor turns the gut on, without second-guessing what it needs. And a happy belly, as any herbalist can tell you, is perhaps the most crucial element for overall vibrancy and health.
Bitter herbs and roots have myriad impacts on digestion and beyond. To review those was not the purpose of our discussions; for that, I refer you to Danielle's excellent article, published by the Weston Price Foundation. Right now, I simply ask you to take a step back, recognize that individuals are actually pieces of cultural and ecological webs, and think a little bigger.

As Michael Pollan astutely observed, the American culture lacks a rooted cuisine, a context in which meals are prepared and shared. This is evident in the food choices most commonly available: processed grains, proteins and fats with few vegetables and fewer whole ingredients, where both flavor and nutrition are reintroduced after the fact based on currently available nutrition science. It is no wonder therefore that the bitter flavor, most often found in whole plant ingredients and in the spices added to meals that are a part of a culinary context, is entirely absent from the American food offering: it is neither useful nor pleasureable to the typical food industry manufacturer, nor to the typical palate. Additionally, it is usually the secondary plant metabolites - such as flavonoids and iridoids - that are responsible for bitterness. These are, unfortunately, still seen as inconveniences to be removed (until they're labeled as "nutrients" or  "vitamins", at least).
In all traditional cuisines, bitterness features as both a part of the basic menu choices and also as the separate mealtime ritual of the aperitif or digestif. In the former case, we see the use of bitter greens, whole grains, and even spice selections that use the bitter flavor to complement and highlight the sweeter and saltier components of the meal. In the latter case, bitter is given its own starring role based on the consistent cultural awareness that it is important to spend some time before and/or after eating being mindful of the meal and of one's company, and that a digestif encourages these important connections through a shared ritual with a very real pharmacological basis. I remember this growing up in Italy. Definitely not too fond of the stuff at the time...

That pharmacological basis is rooted in the herbal bitter's ability to increase digestive and hepatic secretions at just the right time, i.e., when strong digestion is most important. For thousands of years humans have known this to be true (which is why we see it in all traditional cuisines); in fact, the use of bitters predates the arrival of the human species (witness the bear's springtime Osha ritual)! The fact that bitterness is essential in maintaining optimal digestive health and ameliorating all the inflammatory conditions associated with flagging digestion seems, however, lost on the American supplement industry: we are seeing an increased reliance on digestive enzymes and increasingly complex probiotic cocktails. This is not surprising, and simply another manifestation of the same "nutritionism" (quoting Pollan) that seeks to enrich white flour after the fact instead of advocating for a whole grain to begin with. Every year a new combination of these products appears on the market, purportedly based on the latest science; and while this may be the case, we are deluding ourselves if we ever believe that an artificial source of digestive secretions or flora will function with the wisdom and flexibility of our bodies' own juices. Time and time again this point has been driven home (just last year, for instance, we had no idea that gut flora falls into three distinct ecological "biomes" that vary person to person), but rather than turning to whole plants to balance our physiological responses, we keep pursuing supplementation from external sources without any trust in our bodies' innate abilities.

Why is this? Ultimately, since industrialization, humankind has pursued the goals of ease, comfort, and convenience with the idea that activities such as manual labor and foods such as coarse, whole-wheat bread are undesirable. These goals may, perhaps, be rooted in some misguided desire to achieve a species-wide "aristocracy", or at least the trappings thereof. This obviously hasn't worked, and food security is still a major (and growing) issue even in so-called "first world" countries such as the US. In the end, these pursuits have netted us one thing: they have removed the challenge from our daily physical lives. Intellectual challenge may still exist (though others might argue that television and media largely remove this, as well) - but some of the key daily challenges all animals must endure, such as physical exertion and the consumption of the bitter flavor, are all but gone. They have been purposefully removed, and we are only now beginning to see what that means for our culture and our species. Without challenge, life ceases to expand, to improve, to creatively build. And while the importance of exercise is beginning to be recognized, the crucial role of the bitter flavor as a "workout for your digestion" has been largely neglected. How can we use a digestive enzyme to supplement an unchallenging diet and an atrophied digestion? It is like using an anabolic steroid instead of exercise. Recent research is showing how, in conditions of diabetes and pancreatic insufficiency, external enzyme supplementation actually does more harm than good by disrupting the physiology's attempts to seek balance in an imbalanced world. This comes back yet again to the lack of trust in our bodies' innate ability to thrive when well connected to Nature.

Interestingly, when thinking about the balance of energy in the ecosystem we call Gaia, it is useful to pause and consider the lack of challenge to the average American's palate through the absence of bitterness. If a challenge is removed from one piece of the web of life, it is likely to show up elsewhere! When you stop to look at this fact, as Jovial pointed out to me, you can see that the pursuit of comfort and sweetness in our diets has shifted the costs our species should be enduring daily onto the rest of the ecosystem: a corn and soy based industrial agriculture is relentlessly polluting and depleting the ecology for a goal that, in the end, actually leaves both humanity and Gaia much weaker.

So, can the addition of bitters into the American diet on a daily basis provide a reconnection to Nature, sabotage the industrial food machine by shifting the palate away from flavorless simple sweet and salty, and re-enliven our tongues and stagnant, unchallenged bellies? It is certainly more complex than that - but the maligned Dandelion, with its unrelenting yellow flag, offers itself yet again as a catalyst for healing not only individual imbalances, but the wider ecological rifts we've seen develop over the last century. Perhaps it's time to start listening.

Herbs for Athletes

Lots of folks are getting back outside and becoming more active as Spring (finally!) moves forward. When we stop to consider how much our physical frame and physiological systems endure for even a moderate walk around town (coordination, tendon stretching, impact buffering, blood sugar changes, and more), it’s remarkable that human beings perform so well when engaged in physical activity! Good pre- and post-workout nutrition is crucial, as quality fuels provide a lot more than just energy to our bodies, but beyond eating well, herbal support can address three key areas that are important for athletic types and for anyone who is even moderately active: preventing problems, enhancing stamina and endurance, and treating any injuries that might sideline us. Usually herbs are used internally for the first two areas of focus, and in treating injuries external and internal therapies can play a role.

Prevention: strong blood, good circulation, supple connective tissue.

The areas that tend to get the most abuse in many athletic disciplines (even walking) are the joints, ligaments that surround them, and the tendons that attach muscle to bone and joints. Muscles themselves can also experience strains and tears, but these usually heal more quickly than those in joints or connective tissue.

Stretching and listening to your body are, obviously, crucial. Beyond this there are some key preventive strategies where herbs can really help.

· First, it is important to build and maintain “strong blood”. This really means that the blood should have excellent oxygen-carrying capacity and plenty of red blood cells and hemoglobin, so that muscle tissue receives all the oxygen it requires for healthy aerobic activity. When starved and forced to work anaerobically (without oxygen) for any length of time, muscles are more susceptible to injury. Additionally, “strong blood” usually includes the idea of “clean blood”, a somewhat mysterious herbal concept, which usually means that there are fewer reactive free radicals present in the bloodstream. The blood itself is therefore less pro-inflammatory. Inflammation is, of course, at the root of much joint pain, chronic fascia, tendon, and ligament pain, and more.

Astragalus builds the oxygen-carrying capacity of the blood. It also is a preventive agent for common viral infections, often the bane of athletes. You can simmer a few tablespoons of the root with vegetables and/or bones when making a soup stock, or take about 500-1,000mg twice a day in capsule form.

Ginkgo is not that useful to strengthen blood, unless you’re moving to higher altidude (over 5,000 ft or more) and you aren’t used to the lower levels of oxygen one finds up there. 240mg daily of the standardized extract for 3-5 days prevents altitude sickness and speeds the blood’s adaptation to the new environment.

Curcumin form Turmeric has a host of beneficial functions in the body, but for athletes one of its most important is the ability to reduce inflammation overall by acting as an antioxidant and liver balancer. It is used for chronic joint pain and injury, but is an excellent preventive agent as well. To this end, we usually use about 1,000mg of curcumin daily, taken with a little black pepper in the middle of a meal.

Fish oil and other omega-3 fatty acid sources (lots of greens, flax seed for example) are another class of nutrients essential for keeping overall inflammatory burden in check. We suggest 2g daily for maintenance, and up to 4-6g daily during peak, intensive training.

One final nutrient is related to the side effect of a commonly prescribed class of medication. Statin drugs (lipitor, zocor, et. al.) are used to treat high cholesterol, but have the unfortunate side effect of depleting Co-Q10 from cells. I recommend this supplement for athletes who are taking statin drugs and notice an increase in fatigue.

· Blood with a good capacity to carry oxygen and control the production of inflammatory chemicals is a great start, but beyond this we also need to ensure adequate circulation. This is for the muscles again, but even more crucial for tendons and ligaments where circulation is notoriously poor to begin with.

Gotu Kola is a water-loving ground cover plant that grows quite well as an annual in Vermont. It is a tonic for connective tissue and also improves circulation and oxygenation of all organs of the body. The daily dose is 3-5 fresh leaves, or about that many droppers full of a liquid extract (tincture). 3 capsules a day is ok if nothing else can be found.

Hawthorn berries, Blueberries, and other colorful berry fruits are fantastic sources of bioflavonoids which improve circulation, reduce inflammation, and protect the heart and capillaries so they can continue to perform as efficiently as possible. Aim for ¼ to ½ cup a day of mixed berries, fresh or (even better) frozen. Jam preparations are also acceptable.

Caffeine should be used with caution. While a little seems to boost performance somewhat, it can also restrict circulation to the heart and muscles when overconsumed, leading to premature fatigue. Play it by ear – I typically find that 1-2 cups of coffee is fine. Black tea has less caffeine and way more circulatory-enhancing and anti-inflammatory antioxidants, too.

Performance: herbs that improve speed and endurance and enhance recovery

Most athletes are interested in ways, beyond training, that they can support themselves as they push the body further in distance, speed, intensity, or all of the above. Usually, one reaches a limit where the physiology’s ability to absorb more training and improve hits a plateau, and continued exertion can lead to burnout, injury, or both. Generally speaking, the “adaptogenic” herbs can push that limit back, allowing for more exertion, improvement, and therefore greater performance. Here are three excellent and effective adaptogens to help us bounce back faster from hard training and also improve performance in the short term.

Rhodiola rosea is the root of an Arctic plant traditionally used to support stress and counteract fatigue. Exercise is perhaps the “purest” embodiment of physical stress on the system, and Rhodiola can help both in the short term (before a race, e.g.) and long term by pushing back the threshold of fatigue and getting us quickly ready for the next workout. Try a liquid extract, using about ½ teaspoon once or twice a day during training, or ½ to 1 teaspoon before a challenging workout or race.

Eleuthero (a.k.a. Siberian Ginseng) is a classic athlete’s tonic. It was first researched in Russia to enhance the stamina of its soldiers and cosmonauts, but quickly found its way into the athletic programs as well because it is effective. 2-3g of the root are consumed daily.

Cordyceps is actually a mushroom, not an herb, and there is some conflicting research showing that it may increase performance and endurance when taken regularly. Some of the recent clinical evidence did not show much effect; my feeling is that it helps individuals who might be already in a depleted state (i.e. coming back from an injury, or following a taxing race). Typically between 500 and 1000mg are consumed daily.

Treating common injuries: anti-inflammatory herbs and connective tissue repair

In working with active people, it seems that the issues that come up over and over again either involve connective tissue (sprains, tendonitis, fasciitis) or joints and articulations (arthritis, bone spurs). The preventive health strategies discussed above are important, of course, as is a concerted program of rest and physical therapy to rehabilitate the injury. Beyond this, we have a lot of great herbs to use both topically (on the site of pain) and internally that are a great alternative to ibuprofen.

Arnica is used topically as an oil or gel, and internally as a homeopathic remedy (usually the latter is at a 30C potency). It reduces inflammation, prevents bruising, and just greatly speeds the recovery process for almost any injury, but especially sprains (twisted ankle, e.g.) and trauma (bashes, falls, etc). For more nagging, chronic injuries such as tendonitis, runner’s knee, IT band syndrome, fasciitis and more, Arnica is less useful but can still be helpful, especially if combined with Horsechestnut (see below).

Ginger makes an excellent compress for sore muscles or for specific areas of inflammation around a joint or tendon. Brew a strong tea by steeping 1 TBS of powder in a cup of hot water for 5 minutes, then soak a cloth with the tea and apply to the affected area a few times a day.

Wintergreen essential oil is another excellent liniment, more for arthritic and other chronic joint complaints. It’s a bit too strong to use “neat”, or undiluted, so use about 10-15 drops of oil in 1 ounce of a carrier oil such as olive or grapeseed oil. It has a very cooling quality, and works well in alternation with the ginger compress.

Horsechestnut is a remedy often used internally for varicose veins and chronic inflammation throughout the body. In Europe, it is also used topically for any type of connective tissue injury or chronic inflammation – sprains, and tendon/ligament/fascia injuries. The liquid extract is a great way to use this plant both ways: 45 drops twice a day internally, and rubbed directly onto the affected area topically twice a day. It reduces not only inflammation but also the swelling associated with it.

Final note: often many of these herbs are employed at the same time, depending on the situation at hand. For instance, a combination liquid formula made with Hawthorn, Gotu Kola, and Horsechestnut could be used to speed recovery from a twisted knee and prevent recurrence at the same time. Additionally, the concomitant use of internal and external herbs along with physical therapy that strengthens the muscles and connective tissues around the injured area yields the best results.

Some sping tonic formulas for extraction

You can reference these herbs in a previous entry, which goes in to Spring roots, leaves, tonics and cleansing at length. Below are just some ideas on combinations.

1 ounce is almost 30 grams

extract in a pint / quart jar with about 15 ounces of alcohol

Dandelion root 30g

Burdock root 30g

Sarsaparilla 30g

Nettle 15g

Gentle revitalizer, especially if the skin gets dry and bothersome by the end of Winter

Dandelion root 15g

Spikendard root 15g

Echinacea root 40g

Wintergreen 7g

Mustard 13g

Enhance immunity and protect/reawaken the respiratory system

Dandelion root 30g

Yellowdock root 30g

Goldthread root and leaf 7g

Cleavers 13g

Enhance liver function and correct feelings of being “swollen”, sluggish

Sarsaparilla 30g

Wild Sarsaparilla 30g

Dwarf Ginseng (fresh) 30g

Dandelion root 30g

Overall hormone and adrenal tonic; reawakens, counteracts fatigue

Love, Fertility and Reproductive Health

The traditional strategies for enhancing libido and improving lovemaking usually involve two components: stimulate circulation and good blood flow to the erogenous zones of the body, and relax the mind so it can shed the cares of the day. Many of the traditional aphrodisiac plants hit either one or both of these bases!

For a really healthy love life, consider a shared exercise program as well. Men who exercise regularly have much lower incidence of erectile dysfunction – and the same goes for women whose libido may be suffering.

Finally, if fertility for men or women is an issue, consider adding some simple and safe herbal adaptogens with affinity to the reproductive organs into your daily habits. Shatavari for women, rich in plant estrogens, can support healthy ovulation and encourage conception. And Maca for men can increase sperm counts and motility. Taken daily, these plants can make a difference if part of a comprehensive fertility protocol.

Aphrodisiac “Bliss Balls” Recipe:

Mix together:

1 ½ cup almond butter

1 cup honey

Blend together and slowly add to the honey/butter mix:

2 cups cacao powder

2TBS Ashwagandha root powder

4TBS Maca root powder

2TBS Muira Puama bark powder

2TBS Shatavari root powder

Roll into balls about 2 inches in diameter. You can then dust them in cocoa powder or roll them in dried shredded coconut or dehydrated crushed raspberries

Valentine's Hot Cocoa

Prepare an infusion (tea) with:

About 1 teaspoon of Damiana leaves

About 1 teaspoon of crushed Rose petals

A trace of Cayenne if desired

Steep for about 5 minutes, then strain. Add:

1 TBS Cocoa powder

1 teaspoon (or more to taste) of Honey

Stir well and enjoy warm!

The above amounts are for 1 cup. Scale up for multiple cups.

Maca, Lepidium meyenii

The root of this perennial plant comes to us from the Andes of South America, where its extremely nutritious tuberous taproot serves as a food and general tonic. Recently, it has gained a reputation as an aphrodisiac for men and women, enhancing circulation, improving the quality of spermatic fluid, and positively affecting the central nervous system with its relaxing yet invigorating qualities.

Muira puama, Ptychopetalum spp.

Also known as “potency wood”, the bark of this Amazonian shrub has a stimulant and aphrodisiac quality, which increases circulation and enhances libido in both sexes.

Shatavari, Asparagus racemosus

The root of this cousin of garden Asparagus comes to us from the Indian subcontinent. It is juicy and demulcent in quality, increasing lubrication and quality of sexual fluids for men and women, though it’s traditionally thought of as a woman’s herb. It is also known as “she of a hundred lovers”, but its powers are not limited to improved sexual function: it also functions as an adaptogen, lessening the effects of stress and tension on the human system.

Ashwagandha, Withania somniferum

Another plant from the Indian Ayurvedic tradition, this root of the nightshade family is also known as “horse root”, a reference to stamina and perhaps to sexual function as well. It is another excellent adaptogen that leaves the system more resistant to stressors of many types, though it has a specific affinity to help those who are having trouble relaxing into sleep or lovemaking.

Cacao, Theobroma cacao

Theobroma means “food of the gods”, and chocolate fits the bill more than anything else on earth. Its uplifting and gently stimulating quaility is due to a precise cocktail of alkaloids that bring about a gentle euphoria and relaxation. Additionally, it enhances circulation and protects the cardiovascular system, increasing blood flow to the sexual organs while it enlivens and thrills the mind. Plus, with a little sweetness, it’s delicious!

Damiana, Turnera diffusa

Another herb from that magical cradle of power in Central America, Damiana has a totally unique flavor that is minty, spicy, and slightly bitter. It invigorates the circulation and improves sexual function while lessening the effects of the anxieties and tensions of the day.

Spring Tonics!

Traditionally, the days around the Vernal Equinox (mid to late March) and the month(s) after it were seen as a time of intense, rushing energy: days get longer and the sunlight more intense, the first signs of green growth emerge, and wildlife stirs again. Herbalists still consider this a time when the more inward, ‘congealing’ energies of Winter begin to transition into the more outward, ‘expansive’ energies of Summer – and when a little attention paid to the process can improve vitality, strengthen digestion and immunity, and keep us in tune with the changing seasons.
There are specific herbal allies that have gained a deserved reputation for aiding in this transition, and each has its own peculiar “virtues” and affinities. All, however, rely somewhat on two basic strategies: either enhancing digestive and eliminative function, or bolstering the power of the body’s immune and hormonal systems. Some do both! And generally, it was (and still is) considered a good idea to start with enhancing absorption and elimination, and then proceed with strengthening the underlying physiology.
The old recipes for “root beers” can be somewhat instructive in this regard: they often feature a combination of bitter roots (which enhance elimination) coupled with aromatic, sometimes pungent ingredients (which improve digestion) and hormonal tonics (to enhance energy and vitality). Many of the herbs and botanicals listed below can be combined along these lines to make a customized spring tonic for yourself or your friends and family, helping to ride along the tides of Spring and get ready for Summer.
The last detail in the herbalists’ crafting of vernal concoctions is an attention to the constitution and physiological peculiarities of the individual using the tonic. Generally, these are pretty obvious considerations – but one point to remember is to try to add “cooling” herbs for those expressing signs of overactivity, heat, and inflammation; and “warming” herbs for those showing signs of sluggishness, depression, chill, and frequent infections. Often eliminative herbs are more cooling, and tonic herbs more warm. Botanicals listed below have their traditional energetic value added as a start in this process.

Tree sap
Often from maples (Acer saccharum, and other species), the sap of Birches (Betula spp.) can also be used. I like to use the unheated, unfiltered sap as a tonic all by itself: this “tree juice” provides unaltered enzymes as well as sugars and minerals ready for optimal absorption. It can also be used as a base for decocting (simmering) some of the roots and barks described below. Usually, a pint to a quart daily is consumed – though more is not necessarily a bad thing! Alternatively, you can reconstitute a similar liquid by using about a tablespoon of maple syrup per pint of spring water.


Burdock (Arctium lappa)
This root, generally cooling in energy though somewhat tonic too, can be eaten as one would a carrot, or simmered into a tonic brew. It is best suited for those with dryer skin, and perhaps an underactive appetite. Its chief traditional use is for acne and other skin complaints. Use about 2 TBS per pint of water, along with other herbs.

Dandelion (Taraxacum officinale)
A true remedy that synergizes well with herbs for almost any ailment, Dandelion is a catalyst for change that gently and safely enhances digestive and eliminative function. When in doubt, this is the root to pick! Its yellow flowers remind us early on that it’s time to pay a little attention to our bodies this time of year. The root’s energy is somewhat cooling, and it enhances detoxification through the liver, helping to resolve gassiness and sluggishness that may have accumulated after a winter of congestive, thick foods. Use about 2 TBS of chopped root per pint of water.

Yellowdock (Rumex crispus)
These roots are more bitter, and are best for those who might have a tendency toward constipation. They combine well with any of the other cooling, bitter roots and improve liver function and elimination. Generally, I suggest using Yellowdock for shorter (1-2 weeks) periods than Dandelion or Burdock, but it is still quite a safe plant. 1 TBS of chopped root per pint is usually adequate to relieve somewhat sluggish digestion.

Echinacea (E. purpurea, E. angustifolia, and others)
This is a cooling, dispersive root that posesses a good degree of pungency as well. Its chief use as a springtime tonic is to help boost immunity, especially if there are or have been any swollen glands or recurrent respiratory infections associated with winter illness. It can also help dry, scratchy throats that sometimes linger into spring. While I often recommend an extract, the roots are excellent too provided they are simmered for a little while (10-15 minutes). This time of year the plants are just starting to poke up from the soil, making it easy to find and dig out of the garden. Use 2 TBS of chopped root per pint of water.

Wild Sarsaparilla (Aralia nudicaulis)
An abundant relative of Ginseng, this plant posesses starches and bitter saponins that counteract fatigue and gently warm the system to enhance vitality and elimination at the same time. It also has hormone-balancing effects, especially in relation to stress hormones, making it a good adjunct for those who have intense work or personal lives, or who rely heavily on stimulants. It is a little difficult to recognize and find early in the season, before the greens emerge, so marking it out in the fall can help with digging the long rhizomes in the spring. Use a piece or pieces of rhizome about the length of your index finger in a pint of water.

Spikenard (Aralia racemosa)
Another Ginseng relative, this is a sweet, spicy and warming root that is most indicated as a tonic for hormonal and respiratory function, particularly for those with chronic lung congestion. Use only 1 TBS per pint – it is a potent ally.

Dwarf Ginseng (Panax trifolius)
Also called groundnut, this is a nourishing and rebuilding tonic that is somewhat rare in the wild, so it should be used judiciously. It flowers early in the spring, and though only a few inches tall, packs a flavor and power that is quite excellent for warming deficient constitutions that have become sluggish and undernourished over winter. If you find a good stand of it (make sure you have the correct plant ID!), you can have one corymb (a round, underground “bulb” attached to a delicate white root) two or three times a week eaten raw, straight from the forest floor, or simmered into your tonic brew.

Goldthread (Coptis canadensis)
This is a very bitter, cooling, detoxifying and anti-inflammatory plant that you really don’t need a lot of. It chief indication is chronic inflammation, perhaps also involving the skin, and a more “oily” skin pattern that could benefit from drying. It enhances digestive function when taken before meals, improves sluggish bowels, and clears heat that settled into joints and muscles over the winter months. Some have reported an improvement in allergies and sensitivities. It is also evergreen, which makes it easy to find even under a little snow cover! Its thin rhizome is bright yellow, and the above-ground greens are useful too. Use one to two plants (4-5 inches of root total) per pint of tonic brew.

Sarsaparilla (various Smilax species)
Not a local Vermont plant, the root bark from this vine is still such a classic spring tonic that it bears mention. It has a distinctive, warming and spicy flavor that, while enhancing digestion, is most powerful at adjusting hormonal balance (thyroid, adrenal, and reproductive hormones) and I have always found it useful for stubborn skin conditions such as eczema and psoriasis (often worse after the dry indoor heat of winter). Sarsaparilla has a strong flavor, so experiment with taste until you find what you like. It is usually available at the herbs store; start with ½ to 1 TBS per pint.

Sassafrass (S. albidum)
The FDA doesn’t appreciate the use of this bark anymore, due to its safrole content, which is considered carcinogenic. Its distinctive spicy/sweet and warming flavor and energy make it perhaps the most classic “root beer” ingredient, evoking memories of times when there brews were actually made from plants… And, for a few weeks each spring, consuming sassafrass provides such a negligible amount of safrole that, truly, doesn’t compare to pumping gasoline in terms of cancer risk. I would use about 2 TBS of dry bark per pint of brew, but I really like the flavor. Experiment and add to taste.

Cleavers (Galium aparine)
This green, as well as its cousin sweet woodruff, comes out a bit later in the spring but makes an invaluable cooling tonic for folks who are prone to swelling from chronic inflammation, edema, or water retention. They can be juiced and an ounce of juice taken as a daily tonic, or steeped into a more complex tonic after roots have been taken off the fire. Use about 2 TBS of chopped herb.


Nettles (Urtica dioica)
Though green, this herb is actually a bit warming and drying. It is great for those who show signs of water retention (sometimes evidenced by a swollen, “scalloped” tongue), or those in need of iron and other nutritive minerals. Finally, its mildly detoxifying qualities can help in seasonal allergies. Herbalists use the young, fresh leaves in soups or steeped into an herbal brew after the roots are done simmering – about 2 TBS or more of chopped leaves per day.

Dandelion greens (Taraxacum officinale)
We would walk through the meadows, before they fully became green with grass, looking for the young rosettes of dandelions and collecting them whole, along with the crown of the root. Back home, my aunt would dress them with olive oil and wine vinegar, for an abundant (though bitter) spring salad. These greens improve digestion, enhance elimination through the kidneys, and are loaded with important minerals. Their reputation for cooling overheated constitutions extends to the cardiovascular system. They are excellent eaten fresh as part of salads or wilted in soups or stir-fry; alternatively, steep 2 TBS of chopped leaves into an herbal brew after the roots are done simmering.

Mustard greens (Brassica species)
There are a wide range of mustards that come up quick in springtime, since they are so tolerant of late frosts. They are warm and spicy, wake up the digestion and liver, and additionally contain compounds that show much promise in preventing and treating cancer. Of course, they are best as part of a wild food salad, or cooked in soups (though they lose a lot of pungency if cooked). I don’t normally brew these into tea.

Wintergreen (Gaultheria procumbens)
This is a very aromatic and cooling plant, rich in anti-inflammatory salicylates and endowed with wonderful flavor, another aroma often found in classic root beer preparations. It is a good digestive normalizer, especially if there is a lot of gas, bloating, and irritation; it can also help with chronic inflammatory conditions of the joints and back especially if these get worse over the more sedentary winter months. Steep 5 or 6 fresh leaves in 8oz of herbal brew, covered so as to not lose the volatile aroma, and do not boil!

Birch bark (Betula species)
The black birch is perhaps the most flavorful, but the bark of any species yields a wintergreen-like essence that is similarly cooling, and much more readily available. Use a good handful of crushed bark (perhaps a cupful) per pint of water, and add it to your brew for the last two or three minutes of simmering.

A note on preparation
Many of the plants mentioned above release their medicinal constituents during a process of light simmering, known as “decocting”. The resulting brew is often called a “decoction”. It is best accomplished by simmering the herbs in a stainless steel container, covered, for 15 minutes or so on low heat. Afterwards, the brew can be removed from the heat and more delicate greens added and left in the pot, covered, for another 10-15 minutes or so. Finally, strain the brew and drink immediately, or bottle for 1-2 days.

Soy (and phytoestrogens) are safe and helpful in breast cancer

December 9th's JAMA has an interesting study in it which is receiving a lot of press already. An analysis of over 5,000 Chinese women who survived breast cancer was conducted at Vanderbilt University. Dr. Xiao Ou Shu (and others) reviewed the women's intake of soy alone and in combination with Tamoxifen, and found significant evidence that consumption of soy at levels of about 1/4 cup of tofu daily is actually quite protective and lessens the chance of breast cancer recurring. There were over 30% fewer cases of recurrence in the women who consumed about 11 grams of soy protein daily.
This is excellent news and should serve as yet another piece of corroborating evidence that phytoestrogens are safe, useful adjuncts to both menopausal symptom treatment and cancer support, even in cases of estrogen-positive tumors.
The researchers at Vanderbilt postulated that the phytoestrogens "blocked" human estrogen from stimulating the estrogen receptor. A more sophisticated understanding includes an awareness of the two different estrogen receptor subtypes, and how phytoestrogens specifically activate the beta subtype. Estrogen-receptor beta seems to counteract the growth and division that human estrogen normally stimulates. It is very probable that phytoestrogens work at least in part by this mechanism in protecting against breast cancer.
One final note: the researchers in this current study kindly point out that soy from protein isolate or candy bars is probably not as good, and that the women in the study really ate whole-soy products like tofu and tempeh. To quote Gina Villani, director of heme/onc at the Brooklyn Medical Center:

"The take-home lesson is that whole foods are what we need to eat more of. Try to stay away from the processed stuff. Don't bulk up on soy milk or soy candy bars."

Ya think?

Safety of phytoestrogens reviewed

Am J Med. 2009 Oct;122(10):939-46.e9.

Side effects of phytoestrogens: a meta-analysis of randomized trials.

Tempfer CB, Froese G, Heinze G, Bentz EK, Hefler LA, Huber JC.

Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria. clemens.tempfer@meduniwien.ac.at

BACKGROUND: Phytoestrogens are widely used by postmenopausal women for the treatment of the climacteric syndrome. The risk of adverse effects of this treatment, however, is unknown. METHODS: Using a fixed-effects model, we performed a meta-analysis of side effects comparing phytoestrogen treatment with placebo or no treatment in randomized controlled trials. RESULTS: We identified 174 randomized controlled trials. Side effects were reported in 92/174 randomized controlled trials with 9629 participants. The overall incidence of side effects in the phytoestrogen and control groups was 2019/5502 (36.7%) and 1824/4806 (38.0%), respectively (P=.2; incidence rate ratio [IRR] 1.01; 95% confidence interval [CI], 0.95-1.08). Comparing various side effect categories, we found significantly higher rates of gastrointestinal side effects among phytoestrogen users (P=.003; IRR 1.28; 95% CI, 1.08-1.50). Gynecological (IRR 0.94; 95% CI, 0.74-1.20), musculoskeletal (IRR 1.20; 95% CI, 0.94-1.53), neurological (IRR 0.91; 95% CI, 0.70-1.19), and unspecific side effects (IRR 0.95; 95% CI, 0.88-1.03) were not significantly different between groups. Within side effect categories, we found no significantly higher rates of side effects in women using phytoestrogens. Specifically, the rates of hormone-related side effects such as endometrial hyperplasia, endometrial cancer, and breast cancer were not significantly different between groups. CONCLUSIONS: Based on the available evidence, phytoestrogen supplements have a safe side-effect profile with moderately elevated rates of gastrointestinal side effects. Rates of vaginal bleeding, endometrial hyperplasia, endometrial cancer, and breast cancer were not significantly increased among phytoestrogen users in the investigated studies.

Statin drugs and muscle weakness in exercise

"It is well known that exercise is an important disease management strategy for patients with dyslipidemia. It may be less well known that these individuals, if taking a statin and participating in strenuous activity, may be at a greater risk for muscle pain and discomfort, which can potentially lead to nonadherence to medications, physical activity, or both."

So concludes pharmacist Thomas L. Lenz who reviewed the literature on clinical trials of exercisers on statins. These drugs (Lipitor, Crestor, etc...) are by far the best-selling brand-name medications globally. They're for reducing cholesterol (though it's debatable whether they actually reduce cardiovascular mortality), so it's a shame that they seem to be mutually exclusive with exercise, one of the best (non-medical) ways to reduce LDL cholesterol, raise HDL cholesterol, and decrease death from heart disease. Reason being, they can cause long-term damage to muscle fibers that results in weakness and injury. In severe cases, widespread muscle damage can occur and can be life-threatening. Most athletes to whom they were prescribed could not tolerate their weakening effects.

What does statin-induced myopathy (muscle weakness) feel like as compared to just good-old-fashioned soreness? Lenz gives some information:

...muscle pain and discomfort that is most significant about 2 days following strenuous activity and subsides after a few days without other symptoms is most likely exercise-induced muscle soreness. If, however, the discomfort does not subside after a few days and is accompanied by flulike symptoms, patients should be advised to see their physician.

Herbal support for Influenza

By popular demand, here is a copy of some notes on the upcoming flu season. Looking at the flu trend reports from Google, it seems we're already seeing a national spike in H1N1 cases - and it's not (quite) even October yet! Not to be alarmist, but herbalists can play an important role now and in the future, given the issues with vaccination and the relatively ineffectual drugs like Tamiflu.

Influenza is an acute respiratory illness caused by an RNA virus from the Orthrosynovitic family, of which three serotypes are known (A, B and C). Influenza causes an acute febrile illness with myalgia, headache and cough. Uncomplicated influenza generally resolves over a two to five day period. However, in a significant minority, symptoms of weakness and malaise may persist for several weeks, particularly in the elderly. Complications of influenza include otitis media, pneumonia, exacerbation of chronic respiratory disease, croup and bronchiolitis. Additionally, influenza can cause a range
of non-respiratory complications including febrile convulsions, Reyes’s syndrome and myocarditis. The influenza virus is transmitted primarily via virus-laden large droplets from sneezing, coughing or talking. Transmission may also occur by direct
(for example, person-to-person) or indirect (person-to-person) contact and accounts for 30,000 deaths per annum, US.

H1N1 flu (“swine flu”) is an A subtype, generally affecting the upper respiratory passages and the lungs less so, though can be characterized by a spasmodic, dry cough esp. in the initial stages. Those over 65 appear to be at lower risk because of exposure to the H1N1 type, which is the same as the 1918 flu. This serotype has been largely absent for some time. Most at risk are pregnant mothers and infants under 6 months. H1N1’s most troubling characteristic seems that it spreads 2-3x more readily that most seasonal influenzas.

H5N1 flu (“bird flu”) is also an A subtype, but appears to be much more focused on the lungs for invasion, replication, and symptoms. This serotype has been implicated with the “cytokine storm” (see below), making it more dangerous to those with health immune systems.

H1N1, which caused Spanish flu in 1918, and the 2009 flu pandemic

H2N2, which caused Asian Flu in 1957

H3N2, which caused Hong Kong Flu in 1968

H5N1, a current pandemic threat

Serotypes are determined by the Hemagglutin and Neuraminidase surface markers on the viral capsule. These markers also serve to trigger immune reactions in respiratory epithelial cells.

The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea. People may be infected with the flu, including 2009 H1N1 and have respiratory symptoms without a fever.

In children, emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough

• 104 °F: up per range at which most bodily functions are not altered.
• 106 °F: threshold for possible seizure activity. Normally human body temperature does not rise above this.
• 108 °F: brain damage may occur due to protein destruction.
• 110 °F: human cells begin to die.
In infants aged 1 month, 101.4 °F may be a critical temperature. This rises to 102 °F at 2 months of age.

Clinically, this H1N1 strain seems to require management in 3 general phases:

1. Cool, clammy skin with weak (relatively) pulse requires warming herbs that are also immunomodulants. Ginger, Turmeric, Garlic. Avoid foods.
2. Warm, dry skin and perhaps facial flushing with strong pulse and development of spasmodic cough. Cooling diaphoretics like Peppermint, Bonest are traditionally indicated, along with respiratory antispasmodics. Cooling bitters, esp. Andrographis, can play a role here too.
3. Demulcents and restoratives are important for the final period which can last 2-3 weeks. Consider Licorice, Slippery Elm, Pleurisy Root.

Prevention is, of course, the best medicine. Consistently use Astragalus and Garlic, as well as assessing Vitamin D levels and supplementing as necessary. Modest, plant-rich diet and abundant sleep are also crucial. Finally, limit spread through hygiene and limited contact.

The cytokine storm does not seem to be a crucial component to the 2009 H1N1 flu, but remains a concern nonetheless. This is a severe inflammatory reaction which usually occurs in the bronchiopulmonary system and causes excessive destruction of healthy tissue. It may have been a contributing factor in the deaths related to H5N1 bird flu, as well as the US epidemics of 1957 and 1968.

This inflammatory reaction is set in motion by the immune system and involves cellular players such as helper T-cells, as well as chemicals (“cytokines”) such as interleukin-6 (IL-6), tumor-necrosis-factor-alpha (TNF), and mitogen-activated protein kinases (MAPK, specifically of the p38 variety. This latter agent seems to be a major initiating player and is overexpressed as part of the reaction to certain flu strains). Additionally, if exposed to strains that show evidence of initiating a cytokine storm, virus-infected cells seem to exhibit increased resistance to the inflammatory chemicals that would normally hurt them.

Caution may be advisable with herbal agents such as Echinacea and Elderberry which may stimulate TNF and other cytokines. However, this danger is unclear. More important is the addition of herbs that down-regulate dangerous cytokines while also exhibiting antiviral effects (for instance, St. John’s wort, Baikal Scullcap, Salvia milthiorrhiza, Ginger, Turmeric).

The role of vitamin D in the seasonal nature of the flu bears mention. It has been postulated (Bergner et.al.) that the crucial role of D in promoting healthy immunity.

The crucial role of vitamin D in the innate immune system was discovered only very recently. Both epithelial cells and macrophages increase expression of the antimicrobial cathelicidin upon exposure to microbes, an expression that is dependent upon the presence of vitamin D. Pathogenic microbes stimulate the production of an enzyme that converts 25(OH)D to 1,25(OH)2D, a seco-steroid hormone. This in turn rapidly activates a suite of genes involved in pulmonary defense. In the macrophage, the presence of vitamin D also appears to suppress the pro-inflammatory cytokines. Thus, vitamin D appears to both enhance the local capacity of the epithelium to produce endogenous antibiotics and at the same time dampen certain destructive arms of the immune response, especially those responsible for the signs and symptoms of acute inflammation, such as the cytokine storms operative when influenza kills quickly.

While it is unlikely that the increased deaths in healthy, young adults in the 1918 flu pandemic were entirely due to D deficiency, it is important to ensure adequate immunity esp. in the at-risk populations through testing (if necessary) and supplementation.

Herbal support and supplementation notes:

· Preventative health:

Vitamin D

The only supplement I recommend adding if your diet is adequately plant based. Recommended blood test levels are around 35 ng/mL, but that’s just for adequate calcium metabolism. For immune function, required levels are closer to 50 ng/mL. Supplementation with 5,000 IU daily is necessary.

Astragalus

As a preventative, it should be withdrawn once symptoms begin. Take 3-5 grams of root daily in capsule, or simmer 2-3 TBS in a pint of water and drink through the day. Tinctures are taken at 1 tsp doses once or twice daily.

Garlic

Directly antiviral, ameliorates influenza symptoms, and its pungent compounds have been found to reduce cytokine storm. 3-4 cloves daily is ideal, as close to freshly cut as possible (chop first).

· Herbs that are directly anti-influenza:

Note: for most antiviral herbs, frequent dosing is relatively important in order to maintain physiological levels of herbal medicine ahead of the viral replication curves. Viral populations can easily more than double in an 8 hour period, so it is beneficial to work with antiviral and anti-inflammatory herbs on a 6-8 dose/day schedule. This is a dose roughly every 3-4 hours.

Boneset

Infusion, 1 TBS per pint along with other herbs, sipped every hour or so. Tinctures can also be used, 45-60 drops in warm water every hour or so.

Elderberry

Amazing clinical results against most influenza strains. Safe for H1N1, perhaps caution in H5N1 or other cytokine-storm-inducing strains due to potential TNF stimulation.

Use syrups (1TBS 3-5 times daily) or a fresh preserved succus / juice at the rate of 1tsp every 2-3 hours.

Elder flower tea is useful also, as a cooling way to induce sweating in the latter phases.

Echinacea

There is evidence of activity against influenza viruses, especially when combined with Thuja and Wild Indigo (Esberitox). It is potentially contraindicated in cytokine-storm influenza. Use Esberitox, or a good fresh tincture at doses of 1tsp. every 3-4 hours. Usually best at the first signs of imbalance – fatigue, sore throat, headache.

· Herbs that reduce cytokine storm activity and buffer “hot” influenza symptoms:

Baikal Scullcap root

Reduces cytokine storm and acts as an inhibitor of influenza symptoms. Take 60-90 drops three times a day of a good tincture. Avoid in cases of diarrhea.

Salvia milthiorrhiza root

Immunomodulant for cytokine storm, esp. with a constricted, wiry pulse. Take ½ tsp. of a good tincture three times daily.

Ginger and Turmeric

Both rhizomes are anti-inflammatory and inhibit inflammatory cytokines. This protects respiratory tissue as well as relieving symptoms. Most indicated in the initial phases of the flu as warming agents. Add fresh ginger to teas, or use powders of both at doses of 1-3 grams 2-3 times daily (about ¼ to ½ tsp.).

St. John’s wort

This is a potent antiviral herb, prized as a restorative in deficient, depleted constitutions. Modern evidence points not only to its pharmacological effect on dampening the cytokine storm by suppressing IL-6 and MAPK, but also to its targeted and specific antiviral effect against the H5N1 strains of bird flu, both in the petri dish and in infected poultry. The dose of tincture is 90-120 drops three times daily.

Cannabis?

This herb is potentially a down-regulator of TNF in certain situations, and may have a role to play in especially “hot” influenza strains. It is also an activator of the endogenous cannabinoid system, which stimulates immunoglobulin production in the respiratory epithelium. Not for smoking – low doses of oil-based preparations are best.

Adjuvant herbs (beyond the virus and inflammation):

Dry, spasmodic cough:

A very intense and painful cough can accompany H1N1 2009 influenza. It usually appears after the first 24 hours or so, and affects the beginning of the bronchial tree causing violent coughing with whole-body spasms. The warm drying expectorants (such as Elecampane, Mullein, and Aster) are probably best avoided in favor of the soothing, demulcent expectorants listed below.

Licorice

Its antiviral action may be due in part to the inhibition of virulence factors such as the hemagglutin proteins on the viral capsule. While it is still unclear if it has specific inhibitory effect on H1N1 or H5N1 strains, it remains an excellent demulcent for people of all ages and reliably loosens the dry cough within a day or at most two. This is especially important to help with disturbed sleep. Tincture, 2 droppers in a little water every 2-4 hours. Infusion, 1 TBS of root per cup. 1-2 TBS of infusion every 2-4 hours.

Pleurisy root, Butterfly weed

This demulcent expectorant is particularly indicated if the re is a burning sensation in the chest wall that accompanies the cough. Any spitting of blood, while perhaps a clear sign of cytokine storm and certainly of the need for immediate treatment, was traditionally an indication for this herb. It is also relaxing and mildly diaphoretic. Take 30-60 drops of the tincture 3 times a day.

Lobelia

Strongly antispasmodic, it relieves the whole-body paroxysms associated with the dry bronchial cough and is also a gentle expectorant. Use 10-30 drops of tincture every 3 hours or so, depending on tolerance because it is quite nauseating if given in excess.

Wild Cherry, Peach pit

These herbs contain glycosides of hydrogen cyanide (HCN), which in small doses is calmative and strongly antispasmodic to the lungs. They are valuable as part of a comprehensive protocol that also includes expectorants and antiviral herbs. Cold-infusion is best. Heating dissipates HCN readily tincture is dosed 5-30 drops bid. Wild Cherry bark syrup: 1 pint overnight cold infusion of 1 oz bark; strain, add 2 lbs honey.

Diaphoretic herbs not previously mentioned:

Honeysuckle flower

This remedy from the Chinese pharmacopoeia helps to cool and break a fever. Best during the first and early second stages of the flu to release internal heat and bring warmth to the surface. Usually infused, along with Platycodon for the lungs, Catnip as another antiviral diaphoretic, peach pit as a pulmonary antispasmodic, and Licorice.

Catnip herb

Especially useful as a mildly calmative antiviral diaphoretic for kids. Usually added to tea blends, perhaps with a little Ginger and/or Licorice.

Peppermint

Has some mild antiviral quality, and certainly is cooling and helps break a fever, as well as improve the flavor of herbs such as Boneset. A classic formula: equal parts of Peppermint, Boneset, Elderflower, and Yarrow in the late first / early second stage of the flu, when heat is manifest but the skin still dry and the body still achy, with a tense, tight pulse.

Bitter tonic herbs with antiviral / mucosal tonic effect:

Goldenseal

Not antiviral, but astringent and tonifying to the upper respiratory mucosa. Can alleviate congestion and improve appetite in the second or third stages of the flu.

Andrographis

Also called the “king of bitters”, this herb has shown excellent results when combined with Siberian Ginseng in large trials for the flu. It has antiviral effect and also improves GI tract function and may help regulate cytokine activity and prevent the cytokine storm.

dried herb - 1.5- 5 g/day; tea- 1/2- 1 teasp. steeped in 8 oz water, drink 4oz 3 X day
tincture- 20-60 drops 3 X day. standardized tablets- 100mg. w/ 5mg andrographolide and deoxyandrographolide, take 4 tablets 3Xday

Adaptogenic herbs not previously listed:

Panax quinquefolium

This is the American ginseng root, and while most of the evidence in humans pertains to the cold rather than the flu, it has good immune-enhancing (modulating) effect. It is especially indicated if there is severe stress and/or recurrent infections of all types related to deficient immunity. Take ½ tsp. of tincture 3 times daily, or 2-7 grams daily as whole root or capsule.

Siberian ginseng, though a very different plant, can be used similarly.

Specific pulmonary anti-inflammatory herbs not previously listed:

Platycodon

The balloonflower is used in Chinese medicine to clear heat from the lungs. As such, it seems more specific for the dry, painful and recurrent bronchitis than for moist, low-grade symptoms. It makes a good addition to tincture formulas for those who always have “every cold go to the lungs”. 30-90 drops of tincture 2-3 times daily.

Hyssop

Yet another effective antiviral herb that is gaining more attention in modern times, it is an excellent herb for lung afflictions of the more moist / hot variety. As such, it perhaps has a role to play in the later phases of influenza and to help with recovery. Infusion is excellent, about 1 TBS / cup steeped with a lid 3 times a day.