Category: Articles

Alternative Treatment for Arthritis

Eugene Zampieron, ND, Ellen Kamhi PhD RN

Description
The World Health Organization has proclaimed the years 2000-2010 the Decade of Joint Health, because joint health is such a widespread public health concern.

Arthritis is a general term used to describe a large grouping of health conditions, all of which manifest symptoms of pain and stiffness. Commonly diagnosed forms of arthritis include osteoarthritis, rheumatoid arthritis (autoimmune involvement), gout, psoriatic arthritis, ankylosing spondylitis, fibromyalgia and infectious arthritis (such as Lyme’s Disease).

The most prevalent debilitating forms are rheumatoid arthritis(RA), affecting 3 million people in the U.S., and the far more common osteoarthritis(OA), with 16 million diagnosed cases. Some estimate that as many as 40 million Americans suffer with osteoarthritis.
The most commonly recognized causes of arthritis are genetic predisposition, advancing age, obesity, trauma and “wear and tear.” However, the ‘wear and tear’ theory is probably an oversimplification, because many elderly people never develop arthritis, after years of wear and tear.1 The degeneration of joints in all types of arthritis involves ongoing biochemical processes that negatively alter metabolism essential to maintaining healthy joints.
Although conventional medical diagnostics attempt to assign patients a differential diagnosis of one specific kind of arthritis, in reality, many patients exhibit a continuum of symptoms. For example, even those who are officially diagnosed with osteoarthritis often have some degree of auto immune involvement.
Psychological and emotional factors also play a role in the development of arthritis. However, in this article we will focus on several physical parameters that we have seen in virtually all cases of arthritis, and will offer suggestions about specific botanical and nutritional interventions that are useful. For brevity’s sake, we will limit the discussion of glucosamine, since the use of this supplement is quite well known to pharmacists.
In this two-part article, we will review several important factors to consider in Arthritis:
1) buildup of toxic waste products in the tissues
2) a decrease in integrity of the lining of the gastrointestinal tract
3) an overabundance of disease causing microorganisms
4) decreased circulation to painful areas
5) pain management

BUILDUP OF TOXIC WASTE PRODUCTS
In ancient systems of medicine throughout the globe, rheumatic ailments are thought to
originate from the accumulation of toxins in the body. Traditional Chinese Medicine refers to this as phlegm, or toxic invasion of heat, wind and/or cold, while in the Ayurvedic system from India, it is called AMA, created by incomplete combustion of food in the gastrointestinal tract.

Both Phlegm and AMA have been equated with the Western medical concept of toxicity due to endotoxins, food allergens and toxins from environmental sources, which lead to the creation of circulating immune complexes (CIC’s).

In many forms of arthritis(especially RA) pain and inflammation can be caused by an overabundance of Circulating Immune Complexes(CIC’s). CIC’s are formed in the body when larger than normal molecules escape from the gastrointestinal tract due to decreased integrity of the gut lining. Other antigens can be introduced as environmental pollutants that enter the body through various mechanisms. These molecules are recognized by the immune system as a foreign invader, which incites the formation of antibodies, which then couple with the antigen, forming the CIC. In a healthy person, CIC’s are sequestered and neutralized, but in arthritis(and other diseases) they accumulate and begin to overburden the eliminative organs and initiate allergic and immune responses. When too many CIC’s accumulate, the kidneys and liver become overburdened, and cannot break them down. The CIC’s are often shunted to the connective tissue (including the joints) to be destroyed by the immune system. White blood cells are summoned by cytokines to destroy the CIC’s. However, in this process, normal or ‘innocent bystander’ tissue can be attacked and damaged. High levels of antioxidants should be standing ready to regulate and monitor this process, but in all cases of arthritis, regardless of the type, a deficiency of antioxidants is the rule. Pain, inflammation, and stiffness results from these repeated, unregulated attacks.

Supplementation with antioxidants, such as Vitamin C, Vitamin E, and glutathione, decreases this inflammatory response.

Alteratives are non-toxic herbs which assist the organs of detoxification and elimination (liver,bowels,kidneys,skin,lungs, and connective tissue), by removing deleterious substances such as environmental (xenobiotic) toxins as well as those generated internally (endobiotic toxins). Alteratives can be combined with regimes of cleansing or elimination diets, fasting, colon hydrotherapy, saunas, lymphatic drainage techniques and homeopathic detoxification and drainage remedies(detoxosodes) to further decrease the toxic load on the body, thus allowing the body to divert its energy into healing versus crisis management .
Herbal alteratives include Milk Thistle (Silybum marianum), Dandelion (Taraxacum officinale), and Burdock (Arctium lappa). Milk thistle has been proven to have several mechanisms of action, including anti-inflammatory activities linked to inhibition of 5-lipooxygenase. , as well as influencing the hepatic cytochrome P-450 enzymes. The ancient folkloric use of both burdock and dandelion for liver support have also been collaborated in modern scientific studies. ,

Sulphur containing supplements such as MSM, SAMe, and the amino acids cysteine, methionine, glutathione and taurine support the hepatic cytochrome p450 enzymes and enable the liver to process the onslaught of toxins.

DECREASED GUT INTEGRITY
Individuals suffering from joint and muscle pain due to autoimmune problems, such as rheumatoid arthritis, lupus and fibromyalgia, often have a condition known as “leaky gut syndrome.” This allows molecules that are usually too large to exit through the gastrointestinal lining to escape and enter the bloodstream, which leads to the formation of “circulating immune complexes”(CIC), implicated in the production of an inflammatory response resulting in joint and muscle pain. Furthermore, non-steroidal anti-inflammatory agents(NSAIDS), the pharmaceutical drugs usually prescribed for arthritic conditions, actually decreases intestinal integrity, which leads to a worsening of the overall disease process.
Specific nutrients which coat and soothe the intestinal lining, thus helping to heal “leaky gut”, can help arthritis. These include the traditional demulcent, soothing herbs such as marshmallow root and okra, and L-glutamine, an amino which reestablishes gut integrity and helps to re-grow flattened “villi”- the tiny finger like protrusions that line the GI tract, and act as a surface for the absorption of nutrients. Gingko biloba, well known for its effects on brain function, acts to increase circulation to the small capillaries within the GI tract. It also acts as an anti-oxidant, which can help to strengthen the intestinal lining, and heal a “leaky-gut”. Research on the mechanism of action of this herb is proceeding at a prolific pace. One study showed that it significantly inhibited histamine release, which is part of the allergic component due to leaky gut syndrome.

OVERABUNDANCE OF MICROORGANISMS
“Dysbiosis”, the proliferation of “unfriendly” microorganisms, including bacteria, yeast, fungi and parasites, is not widely recognized by conventional medicine as a cause of arthritis. Yet, these organisms are present in a large majority of people who suffer from muscle and joint pains. “Molecular Mimicry” is an additional complication, which arises when organisms in the gut camouflage themselves to resemble human tissue to escape detection by the immune system. When the immune system eventually makes antibodies to the bacteria, it also begins to make antibodies to the similarly structured human tissue, leading to an autoimmune cascade.

A variety of herbs act to discourage the growth of pathogenic organisms, while building and supporting the immune system:
Barberry root contains berberine, the yellow compound that is also found in Golden Seal Root. Berberine helps the liver filter out bacteria, and can inhibit the growth of streptococci and other microorganisms. It helps to kill parasites and tonifies the intestinal tract. In addition berberine acts as a natural Cox II inhibitor.
Citrus Seed Extract contains proanthocyanadins(OPC’s), biologically active flavonoids which help to heal irritations to the lining of the intestines. Citrus Seed Extract has a very high level of activity against micro-organisms.
Black Walnut Hulls is a time honored “vermifuge” (worm destroyer) used traditionally in Western Herbal Medicine. It is high in tannic acid which tonifies the digestive tract and helps rid the body of parasites.
Oregano Leaf Oil has been investigated scientifically and found to be an effective broad spectrum anti-microbial agent, with no known negative effects.
It is also important to “re-inoculate” the gastro-intestinal tract with ‘friendly’ bacteria, such as Acidophilus( Lactobacilli acidophilus). It promotes healthy immune function, and protects against the overgrowth of pathogenic microorganism, as well as providing an antiallergenic barrier. L. acidophilus generates lactic acid, acetic acid, and hydrogen peroxide, which can interfere with the proliferation of disease causing organisms.

POOR CIRCULATION
Poor circulation traps stagnant intracellular fluids in the joints and decreases the availability of nutrients needed for repair and growth of healthy tissues. This can be aided by stretching exercises and massage, along with the topical application of medicinal herbs.

Menthol is one of the principle essential oils derived from peppermint, and acts as a powerful analgesic when applied topically. Initially, it produces a cooling sensation to inflamed areas, followed by a profound cooling effect.

Capsiacin is a resin found in many species of ‘hot peppers’. Scientific studies have proven that Capsiacin depletes substance P, a chemical believed to be overabundant in the peripheral nerves of patients with arthritis, fibromyalgia and other painful syndromes. Substance P is released in response to injury or inflammation and pain.

Camphor is a penetrating, medicinal oil derived from the tropical tree, Cinnamonium camphora. When rubbed into painful, stiff joints, ligaments and muscles, it provides soothing “camphor-ice” relief. One mechanism of action of camphor is that it specifically inhibits catecholamine secretion.

Wintergreen(Gaultheria procumbens) is a low growing evergreen shrub found in the damp woods of the Eastern U.S. Oil of wintergreen has chemical properties similar to salicylic acid- an aspirin like compound with pain relieving properties.

Cloves(Eugenia caryphylii) and Allspice(Pimenta diocia) contain the essential oil Eugenol , which acts as an excellent anesthetic (numbs pain). Folk healers in the Caribbean use these herbs as liniments to relieve the pain of arthritis and painful muscles.
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Boswellia (Boswellia seratta) Boswellia is a gum resin extracted from the bark and trunk from a tree in India. The tree is scraped and the resin is allowed to exude from the tree until it dries. It has been used traditionally in Ayurvedic medicine to treat chronic pain and inflammation. Modern research has disclosed one of the anti-inflammatory modes of action of this botanical to be the inhibition of leukotriene biosynthesis through the impairment of 5-lipoxgenase(5-LO).

Pain Management
In natural medicine, the goal is to address the causative factors of illness through an examination of diet, lifestyle, allergies, toxic load, gut integrity, presence of microorganisms and psychological factors. Uncovering these factors, and making the behavioral changes that will positively effect the disease process, ultimately will lead to increased wellness. However, these steps take time, and the issue of pain management
needs to be addressed immediately, while the body readjusts to be in a less inflammatory state. While pharmaceutical drugs offer effective pain relief, their use long term is not desirable due a large number of secondary effects. NSAIDs, in particular, actually make the overall disease process of arthritis worse, by increasing ‘leaky gut’ and by depleting the very nutrients necessary for joint repair, including iron, folic acid and zinc. COX 2 inhibitors, introduced with a media blitz touting them as a much safer drug therapy, is now known to also have serious side effects.

White Willow Bark (Salix alba) contains glycosides, which are
converted in the body into active salicylates, similar to the chemicals
found in Aspirin. Thus, it is often referred to as Nature’s Aspirin, yet
does not cause gastrointestinal bleeding as does Aspirin.

Kava-Kava (Piper methysticum) is used in the South Pacific to relax
the mind and body, achieve a tranquil state, and ease pain and anxiety,
which often exacerbates pain.
Research on Kava reveals the active Kava
pyrones to be a strong skeletal muscle relaxant, and was used by the
Hawaiians for arthritis and for soothing tight and aching muscles.

Jamaican Dogwood (Piscidia spp.) was used historically as one of the
most effective pain relievers by the Eclectic (M.D.) physician’s at the
turn of the century ,used for fibromyalgia, joint pain, and the pain associated with
bone fractures. In the Amazon and Jamaican rainforests, the curanderos
(healers) and ‘Bush doctors’ use the plant to treat migraines, joint pain,
sprains, muscular aches and neuralgia.

In Traditional Chinese Medicine, Yan Hu Suo (Corydalis ambigua) has been used for thousands of years for its powerful analgesic properties. Research into the mechanism of action of Corydalis, in particular DHC(dehydrocorydaline) extracted from the root, suggests that Corydalis not only inhibits anti-body mediated allergic reactions, but also influences cell-mediated allergic reactions, through an inhibitory effect on antigen-induced histamine release from peritoneal mast cells. As we so often see in Natural Medicine, modern research collaborates what ancient healers have known for centuries!

Eugene Zampieron ND and Ellen Kamhi PhD RN are coauthors of ARTHRITIS- The Alternative Medicine Definitive Guide, and lead tours to interact with indigenous shamans

www.ecotoursforcures.com
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Natural Aphrodisiacs

December 2004
By Ellen Kamhi PhD RN

Ellen Kamhi, Ph.D.,R.N. , The Natural Nurse®, is the author of several books, including The Natural Guide to Great Sex . She is an appointed clinical instructor in the Department of Family Medicine at Stony Brook University, a professional herbalist for Nature’s Answer in Hauppauge, N.Y., and lectures to pharmacists and consumers nationally.

An aphrodisiac arouses or intensifies sexual desire. The word probably originated in the early 18th century, gleaned from the Greek, Aphrodisiakos- arousing sexual desire, and Aphrodite-the goddess of sexual love.

A variety of nutritional supplements are safe and effective libido boosters. Some of these have undergone scientific scrutiny to investigate their pharmacological mechanisms of action. Others have stood the test of time afforded by long time traditional use.

Humankind’s quest for substances that increase both the pleasure and potency of sexual encounters spans the ages. In civilizations past and present high honors and awards have been given to ‘healers’ (or drug companies) who have been able to produce effective sexual stimulants.

Aphrodisiacs work in several ways. They may directly increase the physical desire to have sex, stimulate the strength and endurance of an erection in men, and increase lubrication and genital sensitivity in women. There are very few substances that are scientifically proven to do this on a consistent basis. Most supposed aphrodisiacs act as tonics, increasing virility over time, usually by supplying nutrients which feed the glands and organs. Others may relate more to psychological and mind/body interactions.
Following, is a discussion of several natural substances that both ancient shamans and modern scientists credit with the ability to enhance sexuality.

Arginine

Arginine is an amino acid found in meat, nuts, eggs, coconut milk and cheese. It has many important functions in the body, including the formation of nitric oxide, which increases blood flow to the genitals. Arginine is touted as an ‘anti-aging’ factor due to its ability to increase strength and lean muscle mass. It has been shown to increase sperm motility and male fertility, and may be useful for erectile dysfunction. In women, Arginine, combined with other supplements, has been found to enhance sexual desire, reduce vaginal dryness, increase the frequency of intercourse and orgasm, and improve clitoral sensation and sexual arousal. 4 , 5 The dosage of arginine can vary from 500-3000 mg twice per day. There are occasional reports of gastrointestinal upset and diarrhea. With higher doses, Arginine is suspected of causing herpes outbreaks in infected individuals.
Damiana (Turnera aphrodisiaca)
Damiana has a long history of use as an herbal medicine in Mexico, dating back to the ancient Aztec and Mayan civilizations. Damiana extract contains several chemical constituents, such as flavone glycosides and p-arbutin 6, as well as the phytosterol, beta-sitosterol. Damiana extract binds to progesterone receptors, 7 which may have some connection to its use as a sexual enhancer. Damiana has been hailed as a helpful tonic for the digestive system, 8 as well as for its ability to tone the mucous membranes of reproductive organs. The species name “aphrodisiaca”, refers to the most renown, although not scientifically proven, use of this herb; as a sexual stimulant for both sexes. Damiana was listed in the National Formulary (1888-1947) for menstrual difficulties including headache, acne, insufficient flow, delayed menstruation in adolescent girls, irritability and lack of sexual desire. In Jamaican folk medicine, it is called “Ram Goat Dash Along”, because when male goats eat it, their libido appears to increase dramatically! The dose of a liquid Tincture/Extract is 10- 20 drops 3 times/day, or 300- 500 mg capsules 2 to 3 times per day. No cautions have been noted for the use of this herb, except an occasional slight laxative effect.

Deer Antler Velvet
Deer Antler Velvet has been prized in Chinese medicine for its use as a sexual stimulant, as well as a tonic. A 2000 year old silk scroll describes the use of deer antler as a remedy for over 50 illnesses. It is considered one of the strongest ‘yang’, or ‘male energy’ tonics. Yang energy is an important aspect of sexuality and libido in both men and women, as well as a primary indicator of overall health, strength and vitality. While deer antler velvet does not act as an immediate sexual stimulant it has been shown to have adaptogenic effects, enhancing overall strength and endurance, and decreasing muscle fatigue. 9 Deer Antlers are high in IGF-1 (insulin growth factor). 10 Maintenance of sufficient IGF-1 is linked to “anti-aging” factors in humans, including enhanced physical activity, muscle function, and testosterone and DHEA levels. 11 Deer Antler is high in amino acids, including arginine and the branched chain amino acids valine, leucine and isoleucine, needed for growth of muscle fibers. Scientific studies show that deer antler is useful for anemia, by increasing hemoglobin, as well as the number of red blood cells, 12 which supports energy and vitality. Deer antlers regenerate yearly 13, and undergo extremely active mitotic growth. One hypothesis of deer antler’s sexual enhancing effects, is that these quickly regenerating cells may act in a similar manner to stem cells, and provide ‘young and rejuvenating’ cellular substance to the body. Measurement of the proliferating cell nuclear antigen (PCNA) found that the entire antler is in a state of growth and renewal, especially the keratinocytes that make up the basal cell layer of the epidermis that forms the deer antler velvet. 14 Deer antler velvet contains several components that support the growth of healthy joint tissue, including several glycosaminoglycans such as chondroitin sulfate, keratin sulfate, hyaluronic acid, and dermatan sulfate. 15 The dosage is 500mg-1000 mg/ day. The only known caution is the possibility of mild stomach upset with larger than usual doses of this supplement.

Fenugreek ( Trigonella Foenum-Graceum)

Fenugreek has been recognized as a medicinal plant for centuries. The Egyptians, Greeks and Romans used the aromatic seeds extensively. It was a stable included in the diet of Harem woman to increase the size and roundness of their breasts, and is currently being promoted in several herbal ‘bust enhancing’ products. 16 Studies support the practice of modern midwives, as they continue the ancient tradition of recommending fenugreek to improve the milk supply of nursing mothers. 17 ,18 Traditional Chinese herbalists used fenugreek for male reproductive issues and kidney problems. 19 It is interesting to note that in Chinese medicine the kidneys are considered to be the area where sexual energy is stored. Fenugreek lowers blood sugar, 20 ,21 probably by increasing tissue insulin sensitivity. 22 The rich combination of nutrients in Fenugreek include the steroidal saponin diosgenin, 23 choline , trimethylamine (a sex hormone in frogs), Vitamins A, B 2, B 6, B 12, D, and essential oils. Diosgenin is an important precursor for the synthesis of a number of sex hormones, and also exhibits estrogenic effects.24 The aromatic compounds in the fenugreek seeds have a maple-syrup like odor, which freshens the breath; an added advantage in sexual encounters. The dosage of fenugreek in tea is 1 tsp. seed in 1 cup hot water, steeped for five minutes, 1-3 cups/day. In a liquid tincture or extract, the dose is 10-15 drops two times per day, or one 500 mg capsule two times per day. Although no adverse effects are known, if too much is used during nursing, the urine of mother and child may start to have a maple syrup odor, and could potentially lead to a misdiagnosis of ‘maple syrup urine disease.’ Fenugreek contains coumarin-like substances, and should be used with caution along with heparin, warfarin and other anti-coagulants.25 Due to its blood sugar lowering effects, using fenugreek may require a dose adjustment with glipizide and insulin.
Ginseng (Panax ginseng)
The name ‘ginseng’ refers to several plant species. The two most common are Panax Ginseng- called Chinese or Korean Ginseng and Panax quinquefolius- American Ginseng. Chinese and Korean ginseng are actually the same plant species, but differ in the preparation of the root. Korean ginseng is cooked, which turns the root a deep red. It is considered ‘hot ginseng’ and is the most stimulating form. “Panax” is derived from the Greek word ‘panacea’ due to the wide range of healing effects attributed to this root. Ginseng confers a youthful vigor to men and women alike. The human-shaped root was called ‘man with thighs spread apart’ by Native Americans. The ancient use of ginseng as a sexual stimulant is collaborated by recent studies. The jJournal of Urology reports that the “Mean International Index of Erectile Function scores were significantly higher in patients treated with Korean red ginseng than in those who received placebo.” 26 While ginseng ingestion appears to have no immediate effect on testosterone levels, 27 other possible mechanisms of action include the pharmacologically active component, ginsenoside-Rb1, which increases the secretion of luteinizing hormone(LH) by acting directly on the anterior pituitary gland. 28 The LH receptor plays an important role in both male and female fertility, and in male sexual development. 29 In addition, nitric oxide may be involved in the mechanism of action of ginsenosides on both the central nervous system and gonadal tissues, leading to increased copulatory performance and libido in animal studies. 30 Overall, there is abundant anecdotal and scientific support for the use of ginseng as a sexual enhancer. The usual dose of ginseng is 500-1000 mg/day. Cautions include “Ginseng Over Use Syndrome” which may produce symptoms of insomnia, irritability, anxiety, and heart palpitations. This effect is rare, and most often seen in young men using higher than recommended levels of ginseng. Ginseng use should be monitored by a physician in patients using warfarin, ticlopidine and other blood thinning medications, because it may enhance the blood thinning effects of these medications. 31

(Ho/He) Shou Wu (Polygonum multiflorum)
Ho Shou Wu is usually called Fo-Ti in the US. In China, it is revered for its mysterious properties of rejuvenation and anti-aging, and has been used for over 1000 years as a ‘royal tonic’ that nourishes the blood, cleanses the liver and kidneys and enhances sexuality and fertility in both women and men. According to legend, it has the unique ability to return grey hair to its natural color. The name He Shou Wu translates to ‘Mr. He’s Black Hair tonic’. While there are no studies on this cosmetic ability, Polygonum has been shown to improve cognitive function in mice, 32 protect heart tissue from oxidative damage, 33 and has been determined to have surprisingly high estrogen activity, which may account for its reported sexually rejuvenating effects. 34 The typical recommended dosage of Fo ti is 4-8 grams per day, which equals 4-8 ml of a (1:1) fluid extract. Fo ti may have a slight laxative effect, which can be reduced by lowering the dose. One case of possible liver toxicity has been reported. 35

 

Lychii Fruit (Lycium barbarum)

Lychii fruit, also called Wolfberry, and Go-Qi-Zi, has traditionally been used in China for thousands of years for its rejuvenating effects on sexuality and fertility. Lychii is a small red berry which is dried and prepared as a tea. Scientific studies have found that polysaccharides found in Lychii fruit protect both male and female sex organs from free radical damage. 36 ,37 In addition to protection of sexual tissue, Lycium barbarum polysaccharide-protein complex (LBP(3p)) has been shown to increase the expression of interleukin-2 and tumor necrosis factor-alpha in a dose-dependent manner in human mononuclear cells, 38, and eliminate fatigue, increase adaptability to an exercise load and enhance resistance. 39 All of this modern evidence supports the ancient chinese use of this tangy, delicious fruit for its sexually invigorating and anti-aging properties. The usual dosage is ¼- ½ cup of Lychii berries soaked in one cup warm water/ day. Although adverse reactions are rare, there is one reported case of a possible interaction between warfarin and Lycium barbarum L. 40 Lychii should be avoided during pregnancy and nursing, because it contains betaine, which may act as an abortifacient.
Maca (Lepidium meyenii)
Maca is a cruciferous vegetable like Kale and Broccoli, that grows in the Andes Mountains in Peru. Native people dig up the root-like tuber and brew it into a strong drink. Both men and women partake of this brew shortly before going off in couples for connubial enjoyment. Incan warriors used maca before battle to increase strength and endurance. Laboratory studies have shown a significant increase in sexual function in rodents. 41 Maca is high in essential fatty acids, minerals such as phosphorus, calcium, magnesium and zinc, along with vitamins B, C and E, various phytosterols, and other nutritional factors known for their importance to sexual function. The usual dosage is 300 mg- 500 mg per day. There are no reports of adverse effects.

Yohimbe (Pausinystalia yohimbe)

Yohimbe is derived from bark stripped from a tall evergreen West African tree. Yohimbine, the primary active constituent of yohimbe, is available as a prescription drug, yohimbine hydrochloride, used for erectile dysfunction in men. 42 ,43 Yohimbine’s mode of action includes blocking alpha-2 adrenergic receptors 44 and increasing dilation of blood vessels. Both of these processes are involved in achieving and maintaining an erection. The herbal form of yohimbe, has been used traditionally as a sexual stimulant, and has been shown to have similar mechanisms of action as the drug. 45 Dosage is important with this herb. A safe amount is 15-20 mg/ day. Follow label product directions carefully. Do not use with kidney or liver disease, high blood pressure, or heart arrhythmias. Possible side effects include anxiety, increased blood pressure, and heart palpitations. 46 These side effects are infrequent and reversible. It is interesting to note that some people who experience adverse effects with the herbal extract have no problem taking the prescription drug! Yohimbine can block the action of the drug brimonidine thus reducing its effectiveness in treating glaucoma. 47

Other supplements that are enjoying use as aphrodisiacs, although they have very little or no scientific documentation, include Horny Goat Weed (Epimedium grandiflorum), Muira Puama (Ptychopetalum olacoides), Oats (Avena sativa), Quebracho(Aspidosperma quebracho-blanco), Tribulus (Tribulus terrestes) and Zallouh (Ferulis harmonis).

1. Elam RP. Morphological changes in adult males from resistance exercise and amino acid supplementation. J Sports Med Phys Fitness 1988;28:35–9.
2. Scibona M, et al. L-arginine and Male Infertility. Minerva Urol Nefrol. Dec1994;46(4):251-53.
3. Stanislavov R, Nikolova V. Treatment of erectile dysfunction with pycnogenol and L-arginine. J Sex Marital Ther. 2003 May-Jun;29(3):207-13
4. Meston CM, Worcel M., The effects of yohimbine plus L-arginine glutamate on sexual arousal in postmenopausal women with sexual arousal disorder. Arch Sex Behav 2002 Aug;31(4):323-32
5. Ito TY, Trant AS, Polan ML. A double-blind placebo-controlled study of ArginMax, a nutritional supplement for enhancement of female sexual function. J Sex Marital Ther. 2001 Oct-Dec;27(5):541-9
6. Piacente S, Camargo EE, Zampelli A, et. al., Flavonoids and arbutin from Turnera diffusa., Z Naturforsch [C]. 2002 Nov-Dec;57(11-12):983-5.
7. Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med 1998;217:369–78.

8. Gracioso Jde S, Vilegas W, Hiruma-Lima CA, et. al., Effects of tea from Turnera ulmifolia L. on mouse gastric mucosa support the Turneraceae as a new source of antiulcerogenic drugs., Biol Pharm Bull. 2002 Apr;25(4):487-91.

9. Gerrard DF, Clinical evaluation of New Zealand deer velvet antler on muscle strength and endurance in healthy male university athletes. Agsearch Invermay. New Zealand. 1989:31

10. Elliott JL, Oldham JM, Ambler GR, et. al., Receptors for insulin-like growth factor-II in the growing tip of the deer antler. J Endocrinol 1993 Aug;138(2):233-242

11. Bonnefoy M, Patricot MC, Lacour JR, et. al. Relation between physical activity, muscle function and IGF-1, testosterone and DHEAS concentrations in the elderly. Rev Med Interne. 2002 Oct;23(10):819-27

12. Kim, K. W. and S. W. Park. 1982. A study of the hemopoietic action of deer horn extract. Korean Biochem. J. 15: 151-157.

13. Allen SP, Maden M, Price JS. A role for retinoic acid in regulating the regeneration of deer antlers. Dev Biol. 2002 Nov 15;251(2):409-23.

14. Matich J, Basford Nicholson LF. Et. al. Mitotic activity in the growing red deer antler. Cell Biol Int. 2003;27(8):625-32.

15. Sunwoo, H. H., Nakano, T. and Sim, J. S. 1997. Effect of water soluble extract from antlers of wapiti (Cervus elaphus) on the growth of fibroblasts. Can. J. Anim. Sci. 77:343-345.

16. Fugh-Berman A., “Bust enhancing” herbal products. Obstet Gynecol. 2003 Jun;101(6):1345-9.

17. Tiran, D. The use of fenugreek for breast feeding women. Complement Ther Nurs Midwifery. 2003 Aug;9(3):155-6.

18. Gabay MP. Galactogogues: medications that induce lactation. J Hum Lact. 2002 Aug;18(3):274-9.

19. Basch E, Ulbricht C, Kuo G, et. al. Therapeutic applications of fenugreek. Altern Med Rev. 2003 Feb;8(1):20-7.

20. Thompson Coon JS, Ernst E. Herbs for serum cholesterol reduction: a systematic view. J Fam Pract. 2003 Jun;52(6):468-78

21. Devi BA, Kamalakkannan N, Prince PS. Supplementation of fenugreek leaves to diabetic rats. Effect on carbohydrate metabolic enzymes in diabetic liver and kidney. Phytother Res. 2003 Dec;17(10):1231-3.

22. Puri D, Prabhu KM, Murthy PS., Mechanism of action of a hypoglycemic principle isolated from fenugreek seeds. Indian J Physiol Pharmacol. 2002 Oct;46(4):457-62.

23. Taylor WG, Zulyniak HJ, Richards KW, et. al, Variation in diosgenin levels among 10 accessions of fenugreek seeds produced in western Canada. J Agric Food Chem. 2002 Oct 9;50(21):5994-7

24. Aradhana. Rao AR. Kale RK. (1992) Indian Journal of Experimental Biology, 30(5):367-70.

25. Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician’s Guide. New York: Pharmaceutical Products Press, 1999, 313–5.

26. Hong B, Ji YH, Hong JH et. al. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report, Journal of Urology, 2002, Nov;168(5):2027-3

27. Youl Kang H, Hwan Kim S, Jun Lee W, et.al. Effects of ginseng ingestion on growth hormone, testosterone, cortisol, and insulin-like growth factor 1 responses to acute resistance exercise. J Strength Cond Res. 2002 May;16(2):179-83.

28. Tsai SC, Chiao YC, Lu CC, et. al., Stimulation of the secretion of luteinizing hormone by ginsenoside-Rb1 in male rats. Chin J Physiol. 2003 Mar 31;46(1):1-7

29. Laue L, Wu SM, Kudo M 1996 Heterogeneity of activating mutations of the human luteinizing hormone receptor in male-limited precocious puberty. Biochem Mol Med 58:192-198

30. Murphy LL, Lee TJ. Ginseng, sex behavior, and nitric oxide. Ann N Y Acad Sci. 2002 May;962:372-7.

31. Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692

32. Chan YC, Wang MF, Chang HC. Polygonum multiflorum extracts improve cognitive performance in senescence accelerated mice. Am J Chin Med. 2003; 31(2): 171-9.

33. Yim TK, Wu WK, Pak WF, et. al., The radical scavenging effects of stilbene glucosides from Polygonum multiflorum. Arch Pharm Res. 2002 Oct; 25(5): 636-9.

34. Oerter Klein K, Janfaza M, Wong JA, et. al. Estrogen bioactivity in fo-ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. J Clin Endocrinol Metab. 2003 Sep;88(9):4077-9

35. Park GJ, Mann SP, Ngu MC., Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol 2001 Jan;16(1):115-7

36. Wang Y, Zhao H, Sheng X , et al., Protective effect of Fructus Lycii polysaccharides against time and hyperthermia-induced damage in cultured seminiferous epithelium., J Ethnopharmacol 2002 Oct;82(2-3):169-75

37. Zhang B, Zhang X, Li W., The injury of Xenopus laevis oocytes membrane and its acetylcholine receptor by free radical and the protection of lycium barbarum polysaccharide, Zhongguo Ying Yong Sheng Li Xue Za Zhi 1997 Nov;13(4):322-5

38. Gan L, Zhang SH, Liu Q, Xu HB. A polysaccharide-protein complex from Lycium barbarum upregulates cytokine expression in human peripheral blood mononuclear cells. Eur J Pharmacol. 2003 Jun 27;471(3):217-22.

39. Luo Q, Yan J, Zhang S. Isolation and purification of Lycium barbarum polysaccharides and its anti-fatigue effect , Wei Sheng Yan Jiu. 2000 Mar 30;29(2):115-7.

40. Lam AY, Elmer GW, Mohutsky MA. Possible interaction between warfarin and Lycium barbarum L. Ann Pharmacother. 2001 Oct;35(10):1199-201.

41. Bo Lin Zheng, Kan He, Calvin Hyungchan Kim, et al., Effect of a lipidic extract from Lepidium meyenii on sexual behavior in mice and rats, Urology, April 2000, Vol 55: 4,598-602

42. Pushkar’ DIu, Segal AS, Bagaev AG, et. al. Yohimbine in the treatment of erectile dysfunction. Urologiia. 2002 Nov-Dec;(6):34-7

43. Ernst E, Pittler MH. Yohimbine for erectile dysfunction: A systematic review and meta-analysis of randomized clinical trials. J Urol 1998;159:433–6

44. Goldstein DS, Grossman E, Listwak S, et. al., Sympathetic reactivity during a yohimbine challenge test in essential hypertension. Hypertension. 1991 Nov;18(5 Suppl):III40-8

45. Ajayi AA, Newaz M, Hercule H, et. al., Endothelin-like action of Pausinystalia yohimbe aqueous extract on vascular and renal regional hemodynamics in Sprague Dawley rats. Methods Find Exp Clin Pharmacol. 2003 Dec;25(10):817-22

46. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 382–3

47. Berlan M, LeVerge R, Galitzky J, LeCorre P. Alpha 2-adrenoceptor antagonist potencies of two hydroxylated metabolites of yohimbine. Br J Pharmacol 1993;108:927–32.

Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS) is the most common disorder experienced by women during the menstrual years. Up to 90% of women are affected to some degree.[1]Many woman have just a few mild symptoms, while others suffer severe discomfort which adversely effects their quality of life. If the mood swings, irritability and depression are consistently severe, the disorder is called PMDD( Premenstrual Dysphoric Disorder), and is often treated by conventional physicians with fluoxetine hydrochloride ( Prozac® , Serafem®). Although drug therapies may help mask symptoms, it does little to address causative factors.

Guy Abraham, M.D. was instrumental in classifying the symptoms of PMS into 4 main categories, and in establishing the role of nutrition in PMS.[2]

PMS-A (anxiety) mood swings, irritability, crying jags

PMS-H (hyperhydration) bloating, weight gain, water retention, breast tenderness, constipation

PMS-C (cravings) many symptoms of hypo-glycemia(low blood sugar)- fatigue, vertigo(dizziness), sweet craving , ‘binging-out’, heart palpitations, headache, migraines

PMS-D (depression) crying bouts, insomnia, confusion, depression

Acne and other skin problems are also common. The bulk of these symptoms occur 7-5 days before the period begins, although some woman begin to experience problems shortly after ovulation, and spend half of each month in discomfort. Rarely does an individual woman fit exclusively into one of the categories, but instead may experience an overlapping of imbalances.

Hormone Imbalance

In most cases of PMS, there are patterns of hormone imbalance that can be uncovered through testing.

Estrogen/Progesterone

Research has consistently shown that an increased ratio of estrogen to progesterone, with a mild to moderate excess of estrogen and deficiency of progesterone(estrogen dominance), is a common factor in most of the women affected[3] [4]PMS symptoms are usually most prevalent during the luteal phase of the menstrual cycle; the 14 days following ovulation. Insufficient activity of the corpus luteum can lead to decreased progesterone levels. If progesterone levels are lower than 10-12 ng/ml, tested 3 weeks after the start of the last menstruation, corpus luteum insufficiency may well be involved.[5]

Prolactin/ Thyroid/ Adrenals

Other hormones that are linked to PMS include prolactin , thyroid and adrenal hormones.

Prolactin is normally produced by the pituitary gland and functions in milk production in lactating women. However, during periods of stress, lymphocytes will also produce prolactin. Some woman with PMS have elevated prolactin levels, [6]while others appear to be over sensitive to normal levels. Symptoms associated with prolactin  include abdominal tension, edema, weight gain and breast tenderness.[7]Prolactin levels can be further elevated due to low levels of Magnesium and Vitamin B-6. These nutrients stimulates the production of dopamine, which, in turn, limits the release of prolactin.[8] Low Zn levels also increase prolactin release.[9]

The thyroid may test within normal limits on blood tests and still be functioning at a low level. Woman can monitor their BBT(basal body temperature) with a basal thermometer for 1-2 months. If the BBT is lower than 97.8 degrees on average, compounded with a report of several symptoms associated with low thyroid function, an under-active thyroid may be suspect. Symptoms of an under-active thyroid include cold hands and feet, thinning hair, dry skin, slightly elevated cholesterol, mild anemia and constipation. Low thyroid function, even at a subclinical level can be a factor in PMS. [10]

The adrenal hormones, aldosterone and cortisol, are often slightly elevated in PMS, often due to chronic stress. New research is uncovering that not only the level of these hormones, but the level of response to them can vary in women with histories of reproductive endocrine-related mood disorders. Many women with PMS display abnormal responses, such as water retention and depression, to normal levels of these hormones. [11]

Pharmacies can offer saliva test kits that can be used by women to determine hormone levels.

Role of the Liver

The liver is involved in a great many metabolic processes in the body, including breaking down excess estrogens. If the liver is working well, it will break down aggressive estrogen into less harmful varieties, leading to fewer PMS symptoms.  As long ago as the 1940’s it was shown that the liver cannot efficiently break down excess estrogen without the presence of sufficient B vitamins.[12] The liver can also be challenged by the presence of a wide array of toxins, such as PBBs (polybrominated biphenyls), [13] that lead to increased demands on its ability to efficiently breakdown excess estrogen. The inability of the liver to properly detoxify estrogen leads to the overriding factor observed in PMS- Estrogen Dominance.

Estrogen Dominance

There are many causes of estrogen dominance. In rare cases it can be caused by a genetic abnormality. However, it usually is influenced by lifestyle choices, which women DO have control over. One of the main reasons women have too much estrogen is due to estrogens that are coming into their bodies from inorganic food and environmental toxins. These are called xenoestrogens.

Xenoestrogens- a common cause of Estrogen Dominance

Xenoestrogens are environmental chemicals with estrogen-like activity found throughout the environment, as by-products of pesticides, herbicides and the synthetic hormones routinely fed to animals, which is stored in their fat and transferred to people who eat them.[14] They also come from petrochemicals found in the coating inside canned food,[15]

and other plastics; even baby bottles!  Once inside the body, xenoestrogens can play havoc with the “normal” mechanisms of the reproductive cycle, leading to PMS, premature development of both girls and boys [16] , and serious illness such as cancer.[17]Investigations into the binding interaction for human plasma sex-hormone binding globulin (hSHBG) have revealed that xenoestrogens can displace normal estrogen from hSHBG binding sites and disrupt hormone balance.[18]

Natural Management of PMS

PMS is not caused by one single agent, but instead must be viewed as a multifactorial imbalance that requires a complete program to lesson the input of a number of causative factors. The pharmacist can act as a health counselor for PMS, and move beyond the restrictive role of dispensing drugs.[19]The outline below suggests an integration of therapeutic interventions in order of importance.

Diet

PMS is one health condition that conventional medicine suggests has dietary causes. Some of the well known culprits include too much caffeine, sugar, artificial sweeteners, processed foods and hydrogenated fats- in essence the Standard American Diet(SAD).

One well known symptom of PMS is carbohydrate craving. Research suggests that this may be an attempt by the woman to regulate mood changes that accompany PMS. In one study, consumption of a carbohydrate-rich, protein-poor evening meal during the late luteal phase of the menstrual cycle improved depression, tension, anger, confusion, sadness, fatigue, alertness, and calmness among patients with premenstrual syndrome. Because synthesis of brain serotonin, which is known to be involved in mood and appetite, increases after carbohydrate intake, premenstrual syndrome subjects may over consume carbohydrates in an attempt to improve their dysphoric mood state. [20]

A vegetarian based diet, high in organic dark, green leafy vegetables, whole grains and a small amount(if any) of free range antibiotic and hormone free animal products can substantially decrease or eliminate  most symptoms associated with PMS. This dietary regimen reduces intake of xenoestrogens. Results of a recent study found  “ A low-fat vegetarian diet was associated with increased serum sex-hormone binding globulin concentration and reductions in body weight, dysmenorrhea duration and intensity, and premenstrual symptom duration. The symptom effects might be mediated by dietary influences on estrogen activity…”[21] Woman should be encouraged to maintain the diet for a long period of time, since a three to four month ‘waiting period’ may be needed before the positive effects of dietary change take effect. This is a long term, lifetime commitment that will enhance overall health and well being as well as provide relief from PMS symptoms.

Exercise

The effect of exercise on PMS symptoms has been the focus of several studies, which indicate that exercise is successful in the diminution of all PMS symptoms. Moreover, it appears that these benefits are can be at obtained even with low levels of exercise intensity. [22] Pharmacists can make exercise videos available to their clients, and suggest them as part of an overall health and wellness approach to the alleviation of PMS.

Stress Reduction

PMS symptoms are related to the way a woman deals with stress. Stress plays a role in regulating adrenal hormones, as well as neurotransmitters involved with maintaining mental wellness. Stress reduction techniques such as meditation, prayer, yoga and cognitive behavior therapy can help to ameliorate anxiety, depression, negative thoughts, and physical changes associated with PMS. [23]

Liver Detoxification

The first intervention, after addressing the lifestyle issues of diet, exercise and stress reduction, is to work on detoxification of the liver. Several herbs are particularly useful in supporting the liver. These include Dandelion, Milk Thistle and Burdock Root.

Dandelion(Taraxacum Officinale)

Almost everyone can recognize a dandelion plant, used as food and medicine by cultures internationally. The inner strength of this plant is reflected by the amount of time, energy and money spent trying to eradicate it from suburban lawns! Dandelion is a storehouse of nutrients, including the following chemical constituents: caffeic acid p-hydroxyphenylacetic acid, chlorogenic acid, linoleic acid, linolenic acid, oleic acid, palmitic acid and other acids,  taraxacin(bitter), terpenoids , flavonoids, vitamin A (14,000 IU/100 g leaf- one of the greens highest in Vit A), carotenoids, choline, mucilage, inulin, pectin, phytosterols, potassium.

Dandelion supports the liver, and increases its ability to break down estrogen.

Dandelion has long been used in herbal medicine for its choleretic and diuretic properties. When tested against the pharmaceutical diuretic, Lasix, dandelion (2 g/kg) exhibited a comparable diuretic effect, without the potentially adverse side effects of Lasix, such as potassium depletion.[24]Although the mechanism of action of dandelion is not fully understood, dandelion extract was found to  diminish  enzymatically induced-lipid peroxidation as well as  reducing  cytochrome c in a concentration dependent manner. [25]

Dandelion is considered safe. However, due to the abundance of taraxasterol choline, a substance that hastens the movement of bile, it should be avoided in high quantities in persons with bile duct obstructions.[26]

Dosage: 3 cups of Dandelion Tea/day

Tincture/Extract: 20 ml 3X/day

Capsules: 500mg caps- 2 caps 2X/day

Interactions: None reported for Taraxacum Officinale. However, Chinese dandelion (Taraxacum mongolicum) interferes with absorption of quinolone antibiotics.

Burdock(Arctium lappa)

Burdock is found throughout the temperate zones around the world. The seed stalk produces the characteristic ‘burrs’, which one entrepreneurial gentleman used to develop the idea for ‘velcro’!

Burdock is a slow acting nutritional tonic that builds strength over time. It is highly nutritious, and contains minerals such as magnesium, calcium, potassium, and silica. Other chemical constituents include: Sesquiterpene lactones;  trideca-1,11-dien-3,5,7,9-tetrain; caffeic acid derivatives (including chlorogenic acid, isochlorogenic acid); 40% to 50% inulin , mucilages; volatile oils (phenylacetaldehyde, benzaldehyde, 2-alkyl-3-methoxy-pyrazines); phytosterols, tannins.

Burdock is a traditional Alterative or ‘blood cleanser’ in herbal medicine. In Chinese Medicine it is considered a ‘cooling’ herb, useful for ‘hot’ conditions, such as hot flashes, or swollen joints. It can help with frequent urinary tract infections, and has diuretic properties. Burdock root is listed as an official medicine in the Eclectic Materia Medica and the U.S. Pharmacopoeia..

Burdock extract has a high level of antioxidant activity, and produces a significant inhibitory effect on lipid peroxidation in the liver.[27]Burdock also has shown specific hepatoprotective effects from acetaminophen induced liver damage. [28]

According to the German Commission E, there are no known risks associated with the use of burdock. It is not recommended for use during pregnancy.

Dosage: fresh root- 6 inches of root per day

Extract: 20 drops 3X/day

Capsules: 2,  500 caps 3X/day

Interactions: None reported

Milk Thistle( Silybum marianum)

Milk thistle grows in the wild throughout Europe and North America. It has large purple flowers surrounded by a sharp array of thorns, hence the name ‘thistle’. Milk thistle is an excellent galactogogue (increases lactation). [29]The ripe seeds(actually tiny fruits-kenguil seeds) are gathered in late fall to extract the highly medicinal components. The fruit contains 1.5%-3% silymarin, the  most active known constituent, along with flavonolignans, tyramine, histamine, essential oils,  lipids, alkaloids, saponins, mucilages, flavonoids, and vitamins C, E, and K.

Milk thistle is used first and foremost for its protective and regenerative effect on the liver. In one study which examined the effect of silibinin on phase II liver enzymes, oral administration at doses of 100 and 200 mg/kg/day(in mice) showed a significant  increase in glutathione, S-transferase and quinone reductase activities in liver, lung, stomach, skin and small bowel in a dose- and time-dependent manner.[30] Scientific studies have shown that Milk thistle has at least two distinct actions on liver cells; membrane stabilization,[31] and increasing ribosomal proteins that helps the liver regenerate new cells. [32]Milk Thistle is a useful herb to help in all situations where liver detoxification is indicated. In relation to women’s health issues, it is especially helpful for all imbalances linked to excessive estrogen, including PMS, cystic breasts, fibroids, endometriosis and infertility.  It is also useful for alcohol, drug or chemically induced liver damage, including hepatitis, cirrhosis, and acetominophen toxicity [33] Silymarin inhibits 5-lipoxygenase which enhances its anti-inflammatory effects.[34] Milk’s thistle exhibits anti-tumor activity,  which may be due to its inhibition of promoter-induced edema , hyperplasia and a reduction in  the proliferation index.[35]

Dosage:

Tea: steep one TBS.  Finely ground seeds(fruit) and leaf powder in one cup hot water.

Tincture/Extract: 20 drops 2X/day

Capsules: 200 mg 3X/day

Milk thistle is often standardized to 75-80% silymarin.

Interactions: Milk thistle has no known toxic effects. Numerous studies have shown that it has protective effects on liver and kidneys when used along with prescription medications including acetaminophen, butyrophenones, and ifosfamide cyclosporine.[36] However, due to its marked effect on the liver, there may be a  potential for silymarin to influence hepatic metabolism of certain coadministered drugs.[37]

If the lifestyle modifications and liver cleansing herbs discussed above are instituted, most women will have an amelioration of most, if not all, PMS symptoms, both in quantity and intensity. [38]However, if further intervention is required, there are several nutritional supplements and botanical remedies that can be helpful for PMS.

Nutritional Supplementation

Calcium

Calcium comprises more of the adult body than any other mineral(approximately 2%), and is critical to a myriad of metabolic functions, such as the development and maintenance of bones and teeth, control of  the heartbeat and blood pressure,  transmission of nerve impulses, muscles contraction and relaxation, maintaining membrane integrity, and enzyme activation. Estrogen, which regulates calcium metabolism and intestinal calcium absorption, fluctuates throughout the menstrual cycle, which may lead to a disregulation of calcium homeostasis. In fact, there is a marked similarity in the overall symptoms of PMS and low calcium levels (hypocalcemia). Calcium supplementation has been tested in randomized, placebo controlled, double blind studies, and was found to result in a major reduction in overall symptoms associated with PMS. [39]

Although calcium supplementation can help PMS, dairy products often actually make PMS worse. This may be due to a sensitivity of some individuals to dairy products, or because the high protein content in milk, along with calcium, vitamin D, and phosphorus, may decrease magnesium absorption.

Calcium supplements vary in their bioavailability. When recommending Calcium supplements, be aware that dolomite can have high lead levels, calcium carbonate requires a low pH to solubilize, and often causes gastrointestinal side effects,[40]and bone sourced Calcium may cause consumer concern due to increased awareness of Mad Cow Disease. Calcium citrate is absorbed more easily than calcium carbonate and is relatively inexpensive.[41]Food consumption surveys conducted in the USA have indicated calcium intake for women are often below the US recommended daily allowance (1200 mg/day).  “ Evidence to date indicates that women with luteal phase symptomatology have an underlying calcium dysregulation with a secondary hyperparathyroidism and vitamin D deficiency. This strongly suggests that PMS represents the clinical manifestation of a calcium deficiency state that is unmasked following the rise of ovarian steroid hormone concentrations during the menstrual cycle.”[42]

Dosage: 1200-1500 mg/day

Magnesium

Magnesium is an important mineral that helps form bones, relax muscle spasms, activate cellular enzymes, and regulate nerve and muscle function(including the heart) and acid-alkaline balance. It is often referred to as the “anti-stress” mineral. Deficiency of magnesium is known to cause many symptoms usually associated with PMS, such as irritability, depression, confusion and muscle aches. However, determining if a woman is deficient in magnesium can be a challenge. Many sources of food that are thought to contain magnesium according to old nutrient charts (grains, legumes, vegetables, nuts and seeds), are actually low due to low levels in the soil and depletion due to processing and cooking. Measuring magnesium levels in the blood plasma will often fail to demonstrate low levels, although RBC magnesium levels have been shown to be low in PMS sufferers.[43] Therefore, woman who want to have a true picture of their magnesium levels should be encouraged to have a RBC magnesium level done. Estrogen enhances the utilization of magnesium.  However, if estrogen levels are high, which is often the case with PMS, and magnesium intake is less then optimal, estrogen-induced shifts of magnesium can be deleterious, leading to muscle spasms, migraine, and other PMS disorders.[44] In one study serum levels of magnesium were inversely related to the serum level of estrogen. [45]

Magnesium supplementation can help alleviate many measurable parameters of PMS, including cramps, irritability, fatigue, depression and water retention. [46] [47] Magnesium citrate, gluconate, and lactate are better absorbed than magnesium oxide. Magnesium glycinate is a well absorbed form, with minimum laxative effects.

Dosage: 300mg-400mg/day. Natural health care practitioners often recommend higher doses until symptoms are alleviated. Doses should be spread out throughout the day to avoid laxative effects. Supplementation with Vitamin B-6, along with magnesium, can help to increase cellular uptake of magnesium. [48]

Vitamin B-6(Pyridoxine)

Vitamin B-6 naturally occurs in three active forms: pyridoxine (PNP), pyridoxamine (PMP) and pyridoxal (PLP). Ninety percent of vitamin B6 is in the latter form. Vitamin B-6 is a coenzyme intimately involved with many vital processes such as the formation of amino acids, hormones, and neurotransmitters including serotonin and dopamine involved in mood regulation. Several studies show that supplementing with this nutrient(50 mg/day) alleviates PMS symptoms, especially those related to mood. [49] [50] However, other studies contradict this finding, and conclude that Vitamin B-6 is not a proven treatment for women with PMS,[51] and that studies on B-6 have been poorly done. [52] Phosphorylation of Vitamin B-6 into its active form(pyridoxal-5-phosphate) takes place in the liver. Inefficient liver function, often present in women with PMS, can lead to conversion difficulties.Vitamin B-6  is found in many foods, including fish, poultry, eggs, sunflower seeds, soybeans, lentils, avocados, kale and bananas.

Dosage: The RDI ranges from 1.3-2.0 mg/day, but a useful therapeutic dose is 25-50mg/day. Sufficient magnesium is required for utilization of B-6.

Cautions: Symptoms of sensory neuropathy have been noted due to overdose of B-6 at levels as low as 200mg/day.[53]

Vitamin E

Vitamin E is a fat soluble vitamin that acts as an antioxidant and free radical scavenger in cell membranes. It occurs in plant food sources, but cooking, processing and freezing destroys a high percentage of Vitamin E in foods. Supplementation with 400 IU daily has been shown to be advantages for health by favorably influencing lipid profiles, antioxidant status, [54] and heart health. [55]Vitamin E has also been found to help reduce many symptoms associated with PMS. [56]

Dosage: RDA is 12 IU to 16 IU daily, but studies suggest 400 IU as a beneficial therapeutic dose. D-alpha tocopherol, the natural form, is often preferred over the synthetic form (dl-alpha tocopherol). Some companies offer “mixed tocopherols” with d-beta, d-gamma, d-delta tocopherols and various tocotrienols, the way vitamin E occurs naturally in food. Dry Vitamin E (succinate) is water soluble and is the best form for those who have fat absorption problems.

Multi-Vitamin Mineral Supplement

As we discussed above, individual nutrients have been found to directly influence PMS. Several studies have noted a marked improvement following the use of a Multi-Vitamin Mineral Supplement which contains the individual nutrients discussed along with a balanced blend of other vitamins and minerals. [57] The preferred supplement must contain sufficient quantities of Mg (400mg), Vitamin B-6(50mg) and Vitamin E(400IU) in the d-alpha form.

Omega 3 Oils

Research results on the efficacy of the use of supplemental oils for PMS vary in outcome. While fish oil has several positive outcome studies, [58] the popular use of Primrose oil for PMS is not well supported by study results. [59] Since many women with PMS do not consume a sufficient amount of Omega 3 fatty acids, it is prudent to supplement with EPH-DHA, fish oils, or flaxseed oil.

Dosage: 2000mg /day
Botanical  Remedies

We will discuss three herbs that are enjoying popularity for PMS: Black Cohosh, Dong quai, and Chaste Berry.

 

Black Cohosh(Cimicifuga racemosa)

The Black Cohosh plant is a perennial bush in the buttercup family that can grow up to 9 feet high. It is found in woodlands throughout the Northeast. The root(rhizome) is used medicinally.

The plant has several common names, which reflect the many uses that have been attributed to it, including snakeroot, bugbane, rattleweed and squawroot. ‘Cohosh” is a Native American Algonquin word which refers to the ‘rough’ surface of the rhizomes. ‘Snakeroot’ reflects its use as a snakebite remedy. ‘Bugbane’ comes from the ability of the plant’s odor to repel insects. In Europe the flowers were stuffed into pillows for this purpose. When the dry seeds found on the plants in late fall are blown by the wind, they rattle, thus ‘rattleweed’. Several native cultures considered  ‘rattling’ an important sound used for sacred ceremony. Black Cohosh was also called ‘Squawroot’ because it was commonly used by Native Americans to assist in all manner of women’s ailments, including scanty, heavy, painful and irregular menstrual flow, inability to conceive, and menopausal symptoms such as hot flashes and vaginal dryness.

Black Cohosh root extract was regularly recommended by the Eclectic Physicians in the mid 1800’s for all female complaints, and is among an ever growing group of herbs where modern scientific analysis reveals the chemical constituents that help to explain the long-time observations of herbalists throughout history. The extract contains glycosides and isoflavones, which may impart an estrogenic effect. One specific isoflavone, formononetin, was shown to be able to bind to estrogen receptor sites in vitro. One study demonstrated that Black Cohosh measurably lowered luteinizing hormone (LH) levels in menopausal women. [60] Although most current studies focus on the usefulness of Black Cohosh for menopausal complaints, Black cohosh has been approved by the German Commission E for the treatment of PMS.

Dosage: tea made from dried root- 3-4 cups/day (1 cup water to 1/2 tsp dried root)

Capsules- 40 mg 2X/ day

Extracts- 2-4 ml/day

Black Cohosh may be standardized to 1 mg deoxyactin/20 mg extract, or 2.5% triterpene glycosides

Cautions: discontinue use during pregnancy. Headaches, dizziness, nausea, visual disturbance have been reported after taking large amounts ( over 3 grams/day)

Interactions: None reported.

Dong Quai (Angelica sinensis)

Dong quai is the medicinal root of a species of the Angelica plant family. The plant has the characteristic umbrella shaped flower tops of the Umbelliferae family. The medicinal part is the root, yellow to brown on the outside and white on the inside. Dong quai has been used medicinally in China, especially in formulas for women, for thousand of years. The name “ Dong quai” translates to “proper order”; it balances the entire female system, bringing things back into ‘proper order’.

Scientific research performed on extracts of Dong quai supports many of the ancient folkloric uses. Pharmacological effects include analgesic activity along with the ability to relax smooth muscle and tonify the uterus. [61] Dong quai can help to reduce high blood pressure, [62] , ease asthma and relax the coronary arteries. [63] Dong quai contains ferulic acid, which acts as an anticoagulant on blood cells, and ligustilide, which may explain its antispasmotic effect that aids menstrual cramps, headaches, and acts to tonify the uterus. Dong quai contains Vit A and E, folic acid, B-12, various essential oils and bioflavonoids. It relieves PMS symptoms such as bloating, mood swings, muscle aches and menstrual cramps and increases energy and vitality.

Dosage:

In Chinese medicine it is used as a dried root added to nutritious soups.

Root:  10 grams added to soup

Capsules: up to six 500 to 600 mg per day

Tincture/Extract: 1-2 ml 3 times per day

Cautions: do not use in pregnancy, May cause heavy bleeding. May cause photosensitivity or skin rash.

Interactions: Warfarin and other anticoagulants- may potentiate both therapeutic and adverse effects. Hormone therapies- may compete for estrogen receptor sites

Chaste Tree Berry (Agnus castus, Vitex)

The Chaste Berry Tree is indigenous to the Mediterranean area. It is an attractive bush with finger-like leaves and thin violet, blue or pink flowers. The fruit produced by this tree is a dark brown to black berry, about the size of a peppercorn, with a spicy pepper flavor.

The Chaste Berry has a long history of use as an herbal medicinal. It was first mentioned in the 4th century BC by Hippocrates, and was indicated in The King’s American Dispensary as a remedy for female problems. Its common name reflects the belief that eating the fruit decreases sex drive, and allows for increased chastity. . During ancient Greek and Roman times, the Priestess of the Temple would eat the berries to lessen the libido.  Another name for the plant, Monk’s Pepper, came from the use by medieval monks towards a similar goal.

Chaste Tree Berry is the herb with the best scientific documentation for its role in being specifically useful for PMS. [64] Chaste Berry effects the pituitary gland, by regulating the release of  prolactin. [65] Problems associated with high prolactin levels, or hypersensitivity to normal levels, include PMS, infertility and abnormal bleeding. Chaste Berry has been the subject of  placebo controlled double blind studies, which have uncovered some of the specific mechanisms of action, such as binding to opiod receptors.[66] It has proven to be especially useful if irregularities are due to a deficiency in the formation of the corpus luteum. Chaste berry increases the production of lutenizing hormone(LH), and decreases follicle-stimulating hormone(FSH).  This enhances the ratio of progesterone to estrogen. Chaste Berries may need to be used for several months to elicit the desired effect. Please note that this herbal remedy is often called Agnus Castus or Vitex- its all the same herb.

Dosage: tea- 1 cup of boiled water poured over 1 tsp of fresh or dried berries. Steep for 10 minutes. Drink 1-2 cups per day.

Extract- 10-40 drops 2X/day

Capsules- 1 cap(40 mg) 1X/ day

Cautions: Do not use during pregnancy. If using Chaste Berry to enhance fertility, discontinue use once conception has occurred. Skin rashes, and increased menstrual flow have been reported in a small number of users.

Interactions: Do not use along with birth control pills or other prescription hormone therapies due to possible competition for binding sites. It may weaken the effect of dopamine- receptor antagonists.

[1] Singh, B. B.; Berman, B. M.; Simpson, R. L.; et. al.,  Incidence of premenstrual syndrome and remedy usage: a national probability sample study. Altern Ther Health Med; 4:3, May 1998, 75-9

 

[2] Abraham, G.E., 1983. Nutritional Factors in the etiology of the premenstrual tension syndromes, Journal of Reproductive Medicine. 28:446-64

[3] Backstrom, T. and Mattson, B. “Correlation of symptoms in Premenstrual Tension to Oestrogen and Progesterone Concentrations in Blood Plasma,” Neuropsychobiol 1, 1975,80-6

[4] W. Wang, et. al, “Relationship between symptom severity and steroid variation in women with premenstrual syndrome.” Journal of Clinical Endocrinology 81, 1996, 1076-82

[5] Murray , Pizzprno, p732

[6] O’Brian, P.M., Symonds, E.M., Prolactin Levels in the Premenstrual Syndrome,” British Journal Obstetrics and Gynecology, 89, 1982, 306-8

[7] Meden-Vrtovec, H.; Vujic, D. Bromocriptine (Bromergon, Lek) in the management of premenstrual syndrome. Clin Exp Obstet Gynecol;19:4 1992, 242-8

[8] Delitala, G.A., Masala, S., et. al., Effect of pyridoxine on human hyposeal trophic hormone release: a possible stimulation of hypothalamic dopaminergic pathway. J. Clin Endocrinol Metab 42, 1976, 603

[9] Judd, A.M., Macleod, R.M., et. al, Zinc acutely, selectively, and reversibly inhibits pituitary prolactin secretion., Brain Res, 294,1984,190-2

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“The Natural Nurse®” Promotes Traditional Medicine

By Dave Tuttle

For more than 30 years, Ellen Kamhi, PhD, RN, also known as “The Natural Nurse®,” has been a pioneer in the field of holistic medicine, with interests ranging from nutraceuticals to indigenous herbs of the Amazon. In the process, she has become a catalyst for those who are passionate about finding natural ways to maintain optimal health and achieve disease-free longevity.

Ellen Kamhi, PhD, RN

Early Interest In Natural Healing
As Kamhi recalls, “When I was 12, I had a severe horseback riding accident. I was told my injuries wouldn’t heal and that I would need surgery. Instead of just accepting the doctor’s prognosis, I had my father take me to the library, where I looked up treatments for back injuries and found many therapies the doctor hadn’t mentioned, including the use of calcium, magnesium, and other supplements, as well as certain exercises. I used all of these to heal my back.

“When I returned to the surgeon and told him what I’d done, he dismissed it and said, ‘Oh, those are just old wives’ tales.’ I was very interested in why doctors didn’t know about these methods. That’s why I’ve dedicated my life to seeking information about natural healing and educating everyone about it.”

Kamhi has found many ways to do this. Along with business partner Eugene Zampieron, ND, she runs Natural Alternatives Health Education and Multimedia, Inc. They have authored six books and appear on five regularly scheduled radio programs as well as cable television. They lecture widely to health-related organizations and hold workshops on various aspects of holistic health. They also research indigenous plants that are useful for healing and lead international “eco-tours” to explore their application. While doing all that, she still finds time to see patients for nutritional and lifestyle counseling. And for fun, Kamhi throws in motorcycling and professional belly dancing.

At the heart of this unusually bright and energetic woman is an unwavering dedication to finding and disseminating information about natural healing. “That’s what led to my travels around the world and immersion in traditional medicine,” she says. “Traditional medicine refers to medicine that has been used for thousands of years by indigenous cultures. I refer to modern medicine, which focuses on drugs and surgery, as conventional or mainstream medicine, and one of my main goals is to get all the organizations to which I belong to use the word ‘traditional’ appropriately.”

The use of ginkgo biloba may help to correct erectile dysfunction.

How did a curious 12-year-old eventually become a widely respected holistic practitioner? After growing up on Long Island, Kamhi took a teaching job in Arizona and studied nursing. Her interest in holistic medicine was evident early on, as she was already an herbalist and practicing midwife before earning her nursing degree.

“The doctors would shake and shiver when they saw me,” Kamhi laughs. “I would always point out when they were giving various drugs in combinations that, according to peer-reviewed literature, could cause adverse effects—in other words, drug-drug interactions, which are very much ignored in mainstream medicine.”
Kamhi went so far as to leave notes on the doctors’ lunches, pointing out that their bologna sandwiches and cola drinks were filled with toxic chemicals and had unhealthy side effects. And that is how she earned her nickname. “The doctors would see me and say, “Uh oh, the natural nurse is coming,’ in a derogatory way.” But Kamhi had the lastlaugh, turning a once-derisive label into one that today is entirely positive.

Wide-Ranging Interests
The Natural Guide to Great Sex, Kamhi’s latest book, presents holistic alternatives to drugs for sexual dysfunction and offers a program to reverse some of the physical problems that cause such dysfunction. “I don’t talk only about herbs, nutrients, and foods,” Kamhi explains. “I also go into other areas such as energy medicine and exercise.”

Noting that erectile dysfunction is caused as much by circulatory difficulties as by psychological problems, Kamhi says that herbs such as ginkgo biloba, cayenne, and ginger can all be helpful in increasing circulation. She emphasizes that it is important, however, to know the effects of these herbs before using them.

One reason Kamhi is so impressed with Life Extension’s program for blood and hormone level testing is that patients and their health care professionals can ascertain each individual’s exact needs and requirements. She cautions that some substances, such as yohimbe, have potentially dangerous side effects and should be administered only under professional guidance.

“A comprehensive program of eating mostly organic foods, avoiding pesticides and foods laden with hydrogenated oils, stress reduction through meditation or yoga, and supplements is a highly effective protocol for erectile dysfunction,” notes Kamhi. Based on her study of the scientific literature on improving circulation, Kamhi estimates that about 85% of men with erectile dysfunction would benefit significantly from a strict holistic approach.

Does Kamhi think a holistic program is always effective and should be the treatment of first choice? Most of the time, though not always. She points out that drugs and surgery are often necessary life-saving interventions when holistic approaches have been exhausted. In a life-threatening emergency, drugs and surgery are usually the best immediate options.

Kamhi recommends using ginger to help improve circulation

Arthritis is another of Kamhi’s major interests. As coauthor, with Dr. Zampieron, of the book Arthritis: The Alternative Medicine Definitive Guide, she has helped spread the word about natural approaches that, if followed carefully, can cure some sufferers.

“I’m very excited about arthritis,” Kamhi explains, “because it is one degenerative illness where I’ve seen holistic intervention and self-care methods really work. In 35 years, I have not seen one patient follow these methods and not get some kind of result—anything from less severe pain to a complete cure.” The program is not an easy one, however, and the results it produces are directly proportional to the determination and commitment people apply to it.

Kamhi’s arthritis protocol uses organic food, ginseng, fasting, colonics, massage, and testing for food allergies. Patients usually take a large amount of supplements—some for treating a leaky gut, some for heavy metal detoxification, and some for fighting infectious microorganisms, which are often a part of the arthritic process.

“It’s a two-to five-year program,” Kamhi notes. Some of the important supplements in the initial phases include omega-3 oils, turmeric, ginger, vitamins E and C, glucosamine, antioxidants such as resveratrol, and various kinds of carotenoids.

Ellen Kamhi and Eugene Zampieron conduct a workshop on making herbal medicine.

Kamhi advises arthritis patients to work with both a natural health care practitioner and a rheumatologist who is aware of holistic approaches and is willing to accept them. “Basically, if the rheumatologists won’t work with you, you fire them,” says Kamhi. “We need to remember that health care practitioners are our employees, and that we can always hire another one.”

Another of Kamhi’s books, Cycles of Life: Herbs and Energy Techniques for the Stages of a Woman’s Life, reflects her lifelong interest in women’s health and addresses issues such as PMS, infertility, sexual problems, and menopause. Here again, she stresses optimal nutrition, supplements, exercise, and stress-reduction techniques such as meditation, yoga, deep breathing, and prayer.

Personal Life Extension Regimen
As a Life Extension member, Kamhi uses and recommends many Life Extension products and is impressed with the Foundation’s scientific studies. “The research is cutting edge,” she notes. “Life Extension frequently brings to market supplements that have been found to have positive effects, often years before other companies.” Kamhi mentions two important examples: carnosine, a glycation inhibitor and anti-aging agent, and benfotiamine, which helps guard cells against the negative effects of glucose.

Kamhi also sees eye to eye with Life Extension on vital health care issues. “Life Extension has not only consistently offered high-quality products, but also has been a front-runner in the political arena in keeping supplements widely available,” she says. Kamhi believes such advocacy is especially important today, because new laws may end up severely restricting the public’s access to supplements.

“I believe much more strongly in education than in regulation,” she explains, adding that a 1998 study published in the Journal of the American Medical Association found that prescription drugs, even when taken as indicated, are the fourth leading cause of death in the US. “Regulation does not lead to safety,” she points out, “and the pharmaceutical industry is the perfect example.”

Kamhi’s own self-care program is straightforward, though not always easy to follow, especially with her extensive travel schedule. She eats almost 100% organic food (“I eat very little; I think most people overeat”), takes supplements, exercises one hour every day, and does “spiritual work” (prayer and meditation) every day, first thing in the morning and last thing at night.

“I focus on all the things for which I’m thankful: my children, my loved ones, and my business. When things happen that aren’t great, I try to see what I learned from the experience and how I can do things differently in the future. I don’t blame other people when things don’t go to my liking. And I think all this has worked.”

The Raging Libido Diet

By Sharon Krum

Copyright 2004 Times Newspapers Limited
The Times (London)

January 17, 2004, Saturday

Ditch the Viagra -the best night of sex you will ever have could be
waiting in the herb section at the health food store. Sharon Krum
reports

On paper Ellen Kamhi has all the attributes necessary for a successful
career as a porn star. She talks about sex with abundant enthusiasm
although, she points out, she prefers to perform it. She can’t look at a
banana or cucumber without referencing its anatomical equivalent. And
when she contorts herself into yoga poses she’s not seeking serenity but
deeper orgasms.

So it’s understandable that there is both surprise and disappointment
when people learn that Kamhi is no X-rated starlet but a middle-aged
nurse and practitioner of holistic medicine whose real and abiding
fetish isn’t sex (though she rates it highly) but food and herbs.

“I’ll never criticise modern medicine. There is definitely a place for
it in our lives,” says Kamhi, who has been dispensing herbal remedies
from her New York natural health practice for 30 years. “But I believe
herbs, vitamins and foods used in specific quantities can be as potent
as prescription drugs, yet with fewer or no side-effects. So when you
have a health problem, you should always look to nature first.”

Which brings her to sex, or rather, dysfunctional sex, which Kamhi
claims has become the new “it” disease of the pharmaceutical
industry.Given that people love sex and don’t look like giving it up any
time soon, new drugs that restore libido (for menopausal women) or
enhance performance (for impotent men) are a veritable licence to print
money.

In the US, ten Viagra pills cost about $ 150 (£81), leading many men to
order, via the internet, from Mexico, lowering the cost by 30 per cent.
Though Kamhi understands the rush to bring prescription drugs into the
bedroom, she insists that there is no need. In her new book The Natural
Guide to Great Sex: Improve Your Love Life with Nature’s Alternatives to
HRT and Viagra, she promises that sustained erections and heightened
arousal can be found inside the supermarket and health food store.

“Everybody wants great sex, so I understand this obsession with
pharmaceuticals,” says Kamhi, 52, who certainly looks like a walking
advertisement for natural supplements, with glowing skin and an energy
level double most women her age. “But you have to calculate the cost.
HRT we now know has serious implications for cancer. An adverse reaction
for Viagra is headaches, strokes, in some cases death.

“Foods and herbs have fewer side-effects. The difference is that people
have to be patient. Some herbal remedies work instantly; some take a
month or longer. But they do work,” she claims. Unbelievable? She swears
it is all based on science.

Interestingly, some men who seek out Kamhi don’t even exhibit symptoms
of sexual dysfunction, their problem is simply too much Sex and the City
and Britney Spears videos. “Younger men today are bombarded with sexual
images in the media, making their expectations enormous. They expect
fireworks every time and think they are not performing adequately, when
really they are having just fine sex.”

But for men experiencing genuine impotence, Kamhi treats them with the
herb yohimbe, which she says provides a similar level of stimulus and
blood flow to the penis as Viagra:

“Yohimbe is bark stripped from a tree in West Africa. It stimulates
circulation to the genitals and will become active within an hour of
use.” Kamhi insists that all her recommendations have been verified by
scientific studies done in Germany, the US or the UK.

Korean ginseng, she maintains, also works well as a stimulant directly
before sex.

“Studies have shown an increase in the duration of erection. But taking
Korean ginseng on an ongoing basis will also increase testosterone
levels.”

For general male sexual wellness, she recommends oysters (no, it’s not a
myth, she claims), which are high in zinc. “It is often low in men who
have sexual dysfunction. Adding foods high in zinc, like oysters, as
well as pumpkin seeds and pine nuts, is essential for a healthy sex
life.” As are oats, the bane of many a childhood breakfast. “Oats
boost
sex drive. They contain zinc, proteins and minerals needed to produce
healthy seminal fluids. Men should eat a bowl a day.”

They should, Kamhi also instructs, use ginger and cayenne pepper in
their food before sex. “They are warming herbs and increase circulation
to the genitals.”

And now for the don’ts: carbs, fats, alcohol and fish and chips. “When I
was in London in May, I was shocked how much bread and fat the English
eat. Carbs and fats lead to hardening of the arteries, which decreases
circulation to the genitals.” Fried foods, she argues, particularly a
regular diet of fish and chips, contain trans (hydrogenated) fats, which
decrease testosterone and increase abnormal sperm (in animals). Alcohol,
she points out, lowers sexual response, although most men know this. “If
men want great sex they should stick to a diet high in vegetables and
fish and low in carbs and fats. And they should eat oats.”

Women mercifully are spared a return to porridge but Kamhi says there
are foods and herbs they too should ingest daily to increase or restore
sexual health.

“Unlike men, women have a real shift towards a decreased sex drive as
they age due to the decline in hormones,” she says. “But there are
foods
and herbs that can increase libido and support the production of
oestrogen to reduce hot flushes, just like HRT.”

Soya, of course, is considered a magic pill for women in menopause but
Kamhi warns them to tread lightly. “One ounce a day of soya milk or
foods is fine. But too much can interfere with thyroid function.” Much
better is to have one pomegranate a day, a fruit which she says contains
a form of oestrogen called oestrone.

Similarly, fennel contains oestrogen-like oestragole.

When it comes to great sex, Kamhi says that along with soft lighting and
a Barry White CD, herbs and minerals are a woman’s best friend. She
believes the mineral arginine can increase arousal of post-menopausal
women. And that the herb damiana, taken daily, can help a 50-year-old
feel like a newlywed.

But when daily maintenance isn’t enough and it’s time to break out the
nuclear weapons, Kamhi says that directly before sex women should
partake of yohimbe: “It can increases circulation to the genitals,
elevating sexual response. And magnesium before sex increases
circulation to female sex organs and can stimulate a stronger orgasm,”
she claims. Vitamin E, she swears, is a woman’s best friend when it
comes to vaginal dryness. “Women should eat avocados, rich in vitamin E,
and can use it intra-vaginally (using bottled oil) for lubrication.”

People have long used the dinner date as a prelude to seduction but
Kamhi says the reason why some meals end badly and others in the bedroom
all comes down to the menu. She instructs all cooks to light candles
then serve a smoothie made of vanilla (the smell is an aphrodisiac),
soya milk (for the phytoestrogens) and banana (potassium for sex drive)
laced with 30 drops of liquid extract yohimbe, damiana and ginseng.
Follow with oysters on the half shell and asparagus (for its phallic
overtones). Dessert should be limited to chocolate which, as all good
chocoholics know, can stimulate the production of endorphins -feel-good
chemicals.

Then, once in the bedroom with your hormones racing, Kamhi advises you
spend five to ten minutes doing yoga before hitting the sheets. She is
not joking: “Studies have shown that certain yoga postures can be
powerful before sex. For men, a shoulder stand drains blood out of the
lower body and releases stagnation in the genitals. For women, the
butterfly pose (see panel) directs energy to the genitals and opens up
the area often blocked by emotional issues.”

I delicately ask Kamhi, whose boyfriend is 59, how much of her own
advice they have taken as a couple. She is more than happy to talk about
her sex life, brag actually. “We have tried everything I recommend in
the book. We did the yoga positions, took the herbs and ate the foods,
and I have to say, we had great sex!”

she shrieks.

“My boyfriend said the yohimbe worked as well as Viagra, and taking
damiana, I could definitely feel a difference. I’m telling you, the best
night of sex you will ever have is waiting for you at the health food
store.”

The Natural Guide to Great Sex: Improve your Love Life with Nature’s
Alternatives to HRT and Viagra, by Ellen Kamhi, Godsfield Press, £12.99,
is published this month * People with chronic medical conditions, such
as high blood pressure, or those using prescription medications should
consult a doctor before using any herbs for sexual health.

BEST YOGA POSITION FOR SEX

Butterfly pose: this sitting stretch focuses on the inner thighs and
opens the genitals, heightening the sensitivity of this area.

1 Sit up straight on the floor.

2 Breathe deeply. Using your hands, hold the soles of your feet
together, and pull heels to within 12cm of your body.

3 Gently bounce knees up and down, 2-4cm, for two or three minutes.

HERBAL APHRODISIAC

Use liquid extracts of the following, which are available in most health
food stores:

Ginseng, ginger, oat, damiana, muira puama, passionflower.

Combine 20 drops of each extract in one-quarter cup of warm water. You
can add one half-ounce of Amaretto or some other flavored liqueur.

RECIPE FOR LOVERS

FENNEL, ORANGE, POMEGRANATE AND PINE-NUT SALAD

1 fennel bunch, thinly sliced stalks and bulb

1 orange, sliced into wedges (skin removed)

1 whole pomegranate

20 pine nuts

15 mint leaves

In a medium-size salad bowl, combine cut-up fennel and orange slices.
Scoop all the flesh out of the pomegranate and mix with the fennel and
orange slices.

Sprinkle the pine nuts and mint leaves on top of the mixture. Serve
within one hour of preparation.

(You’ll need an extra bowl to spit out the pomegranate seeds after
sucking off the red flesh.)

Women’s Wellness

An Overview

Women often develop a myriad of health issues linked to hormone
imbalance. Although a majority of these are believed to start in
midlife with the onset of menopause, in fact, a dysfunctional pattern
can begin during adolescent years or even at a younger age. The
severity of hormonal problems tends to increase with age, but this is not simply
due to the accumulation of years. In fact, the cumulative physiological
effects of a variety of stress mechanisms can cause a disruption of the
natural rhythms and balancing mechanisms of women’s hormones, which
could be responsible for compromising overall health along with sexual
and reproductive wellness. Millions of women continue to experience
dysfunctions such as PMS, depression, decreased libido, fibrocystic
breasts, food and sugar cravings, uterine fibroids, irregular or
excessive uterine bleeding and endometriosis, infertility and more.

Fluctuating estrogen and progesterone levels are commonplace as women
age, but during menopause the side effects of these fluctuations – hot
flashes, mood swings, decreased libido and memory impairment, to name
a few, can be particularly difficult to deal with. The common use in
conventional medicine of HRT (Hormone Replacement Therapy) was once
believed to be a panacea that would solve many of these problems.
However, there have been disappointing scientific findings concerning
the safety and efficacy of hormone replacement therapy. (JAMA, March
2001). The climbing cancer rates are alarming. Also, hormone therapy
does not grant the heart protective effect that was previously promised
in earlier studies; in fact, it looks as if heart deaths have increased
as well as cancer rates in women who have been using HRT. While we are
loosing faith in HRT as the answer, menopausal women still have an
interest in maintaining youthful vigor, sexual function and mental
capacity. Women are becoming more and more interested in finding
natural means to bolster or balance hormone levels other than drug
based hormone replacement therapy.

Herbs can be a significant part of an overall wellness program that can
be instituted towards this end. We will discuss specific herbs that are
well-known to be beneficial for women’s wellness, but first let’s focus
on the basics- diet and exercise.

Diet and Exercise

living healthy modelAn ORGANIC diet, high in dark green leafy vegetables and Omega-3 fatty acids is essential. This is important because pesticides and herbicides cause the accumulation of ‘xenoestrogens’ in the diet. These aggressive and often carcinogenic molecules fit into the estrogen receptor sites and cause many of the health problems that can be traced to estrogen dominance – PMS, infertility, fibroids, menopausal symptoms and most other ‘female issues’.

Another important nutrient is soy, which is known as a mild estrogen regulator. When the phytoestrogens in soy connect to estrogen receptor
sites, they block the uptake of the aggressive types of estrogen. When
we review the epidemiological evidence of those cultures that enjoy
soy-based diets, there’s an incredibly low incidence of menopausal
symptoms as well as cancer and other degenerative illnesses. Like soy,
Red Clover is also rich in estrogenic-like compounds. Red Clover is the
only plant containing all four major estrogenic isoflavones
Exercise is of paramount importance. Regular exercise, 30 minutes per
day, has a plethora of positive effects including weight control, mood
elevation, decreased cholesterol (the bad kind), better digestion,
sounder sleeping patterns and tonification of the glands which control
hormone levels, to name a few!

Other Helpful Herbs

Black Cohosh (Cimicifuga racemosa) is specifically used for its
beneficial effects on menopausal symptoms. The isoflavones in Black Cohosh have been shown to bind to estrogen receptor sites and lower lutenizing hormones, which
are linked to hot flashes. Black Cohosh can also help with PMS.

Dong Quai (Angelica sinensis) has been used in Chinese Medicine for
thousands of years to help normalize menstrual irregularities. It is also used for
anemia and as a systemic strengthener, helping to ‘build the blood’.
Dong Quai may increase bleeding, so don’t use it during pregnancy or if
heavy periods are a problem.

Chastetree Berry (Agnus castus, Vitex) is one of the most helpful herbs
for normalizing symptoms of hot flashes, fluid retention and mild
depression.

Wild Yam (Dioscorea spp.) is a traditional root food used by women
around the world to help promote women’s wellness, including fertility
issues, late periods and menopausal symptoms.

Red Raspberry (Rubus idaeus) has been dubbed ” The Vine of Female
Vitality”. The leaf of the vine is the part that is most often used as
herbal medicine. The medical journal Lancet published a study as far
back as 1941 describing the normalizing effect that Red Raspberry leaf
extract had on the uterus. Traditionally, midwives and herbalists claim
that it also helped tone the ligaments of the uterus to ease
childbirth,  reduce hemorrhage after birth and enrich colostrum, the
immune-stimulating first milk of nursing mothers.

 

Ellen Kamhi, Ph.D., R.N., is the author of Cycles of Life, Herbs and
Energy Techniques for the Stages of a Woman’s Life, which explores the
topic of women’s wellness in detail. She is also the co-author of The
Natural Medicine Chest and Arthritis, Alternative Medicine Definitive
Guide. Dr. Kamhi hosts a variety of radio and TV shows which focus on
the many aspects of natural medicine. In addition, she is the
co-founder of Eco Tours for Cures, which offers travelers the opportunity to
experience herbal knowledge and lifestyles of indigenous people.

Contact:

Ellen Kamhi PhD, RN, AHG, AHN-BC
www.naturalnurse.com
www.facebook.com/NaturalNurse
954-418-2388

Allergies- An Integrative Approach

Allergies are the 6th leading cause of illness in the United States. The National Institute of Health approximates the number of allergy sufferers at 40 to 50 million Americans, with a higher number that remains undiagnosed. [1] Yearly visits to physicians due to allergic symptoms  is estimated at 17 million. [2] The overall prevalence of some forms of allergies, such as allergic rhinitis and atopic eczema, are increasing substantially. [3]

Genetic predisposition is clearly indicated in the development of allergies. There is a 40%-60% chance of developing allergies if both parents have allergies, 20%-40% if one parent is allergic, and 5%-15% if neither parent is affected. In addition to genetics, the development of allergies may to due to multi-factorial causes, which includes overexposure to particular substances that initiates an ‘overreaction’ response by the allergic individual’s immune system. Some theories of the increased rate of allergies is that it is due to a decrease in breastfeeding along with early introduction of potentially allergenic foods to an infant’s diet, [4] and high levels of air and water pollution. [5]

The term ‘allergy’ refers to a grouping of symptoms that affects different body systems. The allergic patient may experience symptoms in only one, or several body systems. People may experience allergies that are due to a wide array of antigens (triggering substances), such as foods, pollen, environmental particles, animal dander, dust mites, cigarette smoke, ingredients in soaps, newsprint, latex and almost anything else that a person may come into contact with. Although many of the antigens that provoke allergic reactions are proteins, many non-protein components can illicit allergic reactions, such as toluene diisocyanate found in dry cleaning fluid. [6] The following is a grouping of symptoms that are commonly associated with different body systems. Respiratory symptoms: stuffy/runny nose, sneezing, coughing, watery eyes, wheezing, recurring ear infections, tickling or sore throat, asthma. Integumentary symptoms: swelling of hands and feet, itchy, dry, red scaling skin patches, dark circles under the eyes, swollen tongue. Digestive symptoms: bloating, flatulence, diarrhea, constipation, weight loss or gain, burning anal and underarm rash, abdominal discomfort.

Allergic reactions are initiated by the immune system’s over- response to substances it deems as distinct from itself. Although well tolerated by most people, in the allergic person contact with the offending substance (antigen), is the basis of the hypersensitivity reaction. [7] Immunoglobulins are specific antibodies that have the responsibility of tracking down and destroying antigens that are recognized by the body. There are five different classes of antibodies, IgE, IgA, IgG, IgM, and IgD.  Each of these specifically attack different categories of antigens. Every antibody is ‘antigen specific’, and is programmed to react to a specific kind of invader. In the case of allergies, these antibodies become overzealous, and begin to recognize substances that are usually benign, as if they were dangerous invaders. Once an antibody recognizes a suspected antigen, it attaches to it and forms an ‘antigen-antibody’ complex. This complex initiates the release of histamines and other chemicals that lead to inflammation, the common theme to all hypersensitivity reactions (allergies). The inflammatory response causes the release of chemical mediators, vasodilation, increased vascular permeability, edema and tissue damage. [8] Allergic reactions can range from a trivial annoyance such as an itchy rash and runny nose, to a fatal incident.

There are four different classes of allergic reactions: Type I (Immediate Hypersensitivity Reactions), Type II (Cytotoxic Reactions), Type III(Immune Complex Mediated Reactions) and Type IV(Cell Dependent Reactions). [9] Type I reactions occur almost immediately after exposure to an antigen, and range from a temporary outbreak of hives, skin rash, headache, GI symptoms, rhinitis, and asthma-like symptoms, to fatal Anaphylactic shock characterized by difficulty breathing, closing of the throat, decreased blood pressure, tachycardia, seizures and loss of consciousness. The symptoms can be local or systemic, depending on the port of entry of the antigen. [10] IgE immunoglobulins are widely believed to be responsible for Type I reactions. However, recent studies report that IgG, previously thought to only be involved with DELAYED reactions, may also be involved in the initiation of Type I reactions. [11] [12] [13] [14] This evidence supports complementary health care practitioners, who have been regularly testing  patients for both IgE AND IgG mediated reactions  for decades, although most conventional physicians still disregard IgG testing.

Type II- Type IV reactions are referred to as DELAYED reactions, since they can occur 24- 72 hours after encountering the offending substance. They involve IgG, and to some degree IgM, although many allergic reactions do not involve any antigen-antibody complex, but are due to the direct release of histamines and other inflammatory compounds by mast cells and other white blood cells.

Food allergies are widespread, and remain an under-diagnosed phenomena. Delayed food allergies are often the culprit behind eczema, difficulty concentrating, recurrent ear infections, chronic rhinitis and immunodeficiency in both children and adults.  [15] Severe reactions to common allergens such as milk, egg, peanut and sesame are on the rise. The threshold needed to trigger a severe reaction can be as low as a molecular amount. [16] Pharmacists can advocate for patients by suggesting that they see a physician who regularly performs both IgG and IgE testing to search for food sensitivities. In addition, pharmacists can instruct clients in keeping a food diary, and practicing avoidance and re-introduction of specific foods, in an attempt to track down offending substances.

Conventional medical treatment of allergies involves the use of a variety of pharmaceutical agents that are mainly focused on the reduction of symptoms. These include antihistamines that stop histamine release, decongestants to constrict the mucous membranes and decrease secretions, cromolyn sodium that interferes with the mast cell release of inflammatory chemicals, and steroidal inhalants. Drug therapies can be useful for acute symptom relief, but do not address the underlying cause of allergies, and often have a variety of adverse effects including insomnia, nervousness, irritability, dry mouth, constipation, urinary retention, rapid heartbeat, blurred vision, drowsiness and dependency.

Naturally oriented practitioners take a different approach. The first line of defense for the allergic individual is to address diet and lifestyle issues. HEPA air filters reduce exposure to mold, pollen, dust mites and dander. Neti pots, small ‘tea-pot’ like devices, are excellent to use as saline irrigators. This removes particle allergens from sensitive mucous membranes, and has been shown to decrease the inflammatory mediators histamine and leukotriene C-4. [17] Pharmacists can recommend the use of air filters and Neti Pots to their clients. The allergic person must avoid foods discovered to initiate an allergic response, while increasing the consumption of anti-inflammatory foods, such as cold water fish, Omega 3 oils, and dark green leafy vegetables. One study examined how the consumption of ALA (alpha-linolenic acid), effects the level of C- reactive protein(CRP), a known marker for inflammation, and found that dietary supplementation with ALA for 3 months significantly decreased CRP. [18] Eliminating food allergens ALSO tends to decrease sensitivity to inhalant allergens. The authors have had numerous clinical reports from patients with seasonal inhalant allergies, who were able to get through their previous ‘allergy season’ without the use of any medications, after removing common foods such as wheat and dairy from their diet. This makes sense, because many grains are in the grass family and cross react with other grass species. Several studies have documented cases of cross reactivity between food and pollen antigens. [19] Stress reduction, through techniques such as meditation and yoga, can help to decrease the frequency and intensity of allergic reactions. Endogenous serum cortisol acts as a natural anti-inflammatory mediator. Stress reduces serum cortisol, which leads to increased inflammation. [20]

Nutritional supplements such as vitamin C (500- 1000 mg) and magnesium (400 mg) have shown promise in clinical studies involving asthma patients, and may also be useful for allergies. [21] Other herbs and natural remedies can also be helpful.

Quercetin

Quercetin is an active bioflavonoid found abundantly in plants, including evening primrose leaf, onion and green tea. It is a strong inhibitor of basophil and mast cell degranulation. [22] Degranulation of mast cells is an active process that requires the influx of calcium, along with an increase in cAMP(adenosine monophospate). This activity leads to phosphorylation of the membrane around mast cell granules, which renders them permeable to water and calcium. The mast cell uses calcium-activated enzymes to assemble contractile microtubules, which pulls the granules towards the cell membrane, where the inflammatory contents are spilled outside the cell, unleashing an allergic reaction. [23] Quercetin prevents calcium from influxing into the cell. [24] Secondary mediators of inflammation, such as arachidonic acid metabolites, are released outside the cell via the action of the enzyme phospholipase A2. (Steroids act as anti-inflammatory agents due to their ability to inhibit phospholipase A-2.) Quercitin inhibits many steps along the eicosanoid membrane pathway, including phospholipase A2 and    lipoxygenase. [25] Quercetin taken along with vitamin C has been reported to reduce hay fever symptoms. [26] The authors have used quercetin clinically for a number of pathological processes, including inhalant allergies, food allergies, atopic dermatitis, chronic sinusitis, bronchitis, asthma, serous otitis media reoccurrences, and ITP. Recommended dosage: 500 -1000 mg three times a day on an empty stomach as a capsule, tablet or nasal spray. Cautions: Quercitin may raise levels of estradiol and should  be used with caution with hormone intervention. [27] Quercetin may inhibit the activity of enzymes that break down Felodipine into an inactive form, thereby raising blood levels of Felodipine. [28]

Baikal Skullcap Root (Scutellaria baicalensis)

 

 

The root of the Chinese Skullcap, Radix Scutellaria baicalensis, called Huang Qin in traditional Chinese Medicine, has been used for thousands of years, especially for inflammation and high fevers. It contains the flavonoids baicalin and wogonin, well researched for their anti-allergy and free radical scavenging properties. [29] [30] These components are similar in structure and mechanism of action to Quercetin. [31] Another component of Scutellaria, baicalein, has even a stronger anti-inflammatory and anti-allergic effect, specifically reducing leukotriene B4 and C4 production by inhibiting lipoxygenase. [32] The dose is typically 2-6g/day of the dried root or 4 to 12 ml per day of a 1:2 fluid extract. Cautions: No specific adverse reactions have been reported. However, due to structural similarity to quercetin  similar cautions may apply.

 

Nettles (Urtica dioica)

 

Stinging Nettles is a common plant found in damp waste areas around the United States and Europe. Touching the stingers on the nettle plant, causes an allergic reaction, probably due to the formic acid found in the stingers which initiates a localized histamine release. Traditional herbalists have historically recommended the juice of the nettle as an antidote to the rash caused by the nettle stinger, as well as the prophylactic use of nettle tea for spring allergies. In addition, the homeopathic remedy made from nettle,Urtica, is successfully used for hives and other allergic skin irritations. One preliminary study found that freeze dried nettles were helpful for symptoms of allergic rhinitis. [33] The authors have also encouraged the use of nettle herb for allergic patients, with favorable results. Typical dosage is 600 mg dried herb or 2-4 ml per day of fluid extract in divided doses. Cautions: may occasionally cause mild gastrointestinal irritation when used internally.

 

Mimosa (Albizzia lebbeck, Albizzia kalkora)

 

Albizzia is a member of the mimosa family that has been used in Ayurvedic practice for asthma and dermatitis, and as a sedative in Traditional Chinese Medicine. Several studies were performed on a bark extract of this plant, which showed advantageous actions against allergic symptoms, including anaphylaxis, [34] atopic allergy  [35] and gastrointestinal allergic symptoms such as diarrhea. [36] Albizzia has been shown to stabilize mast cell degranulation , depress levels of anti-allergy antibodies, and decrease the overaggressive action of T and B lymphocytes. A therapeutic dose of Albezzia is 3-6 ml/day of the 1:2 extract. [37]Cautions: No adverse reactions have been reported.

 

Coleus (Coleus forskohlii )

 

Coleus is a member of the mint family, and grows wild in Thailand , India and other areas. It has been used in traditional Ayurvedic medicine for allergic symptoms such as bronchitis and breathing difficulties. [38] In 1974 Hoechst Pharmaceuticals, along with the Indian Central Drug Research Institute, conducted studies on Coleus extract and found that it had muscle relaxant and antihypertensive effects.  The active constituent forskolin, extracted from the root of Coleus forskohlii , has been  found to increase Cyclic AMP [39] [40] , which causes bronchial relaxation. Forskolin has the added advantage of being receptor independent, which avoids the desensitization caused by the repeated use of B-adrenergic agonist pharmaceuticals. [41] Forskolin also inhibits the release of histamine from basophils, which decreases the allergic response. [42] The  recommended dosage of Coleus is  50 mg 2 times a day of an extract standardized to contain 18% forskolin. Cautions: Coleus may lower blood pressure.

 

 

  1. American Academy of Allergy, Asthma and Immunology (AAAAI). The Allergy Report: Science Based Findings on the Diagnosis & Treatment of Allergic Disorders, 1996-2001.
  2. CDC. Fast Stats A-Z, Vital and Health Statistics, Series 10, no. 13. 1999
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  5. Levetin E, Van de Water P. , Environmental contributions to allergic disease. Curr Allergy Asthma Rep. 2001 Nov;1(6):506-14

 

  1. Rea, William J. Chemical Sensitivity: Volume 1 Chapter 2  Lewis Publishers/ CRC press, Boca Raton, FL pg 8
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  3. Suen, Raymond & Gordan, Shalima; A Critical Review of IgG Immunoglobulins and Food Allergy-Implications in Systemic Health ;A Paper by US BioTek  Labs, Seattle, WA, 2003, page 1.
  4. Murray, Michael; Pizzorno, Joseph. Encyclopedia of Natural Medicine, Prima Publishers, Rocklin, CA., 1998, p. 467-468
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  19. Nishino, H., Naitoh, E. Iwashima, A et al. Quercetin interacts with calmodulin, (a calcium regulatory protein) Experentia 40:184-5, 1984.
  20. Yoshimoto, T.,Furukawa M. Yamamoto., S. et al.;Flavonoids: Potent inhibitors of arachidonate 5-lipoxygenase. Biochem Biophys Res Common 116:612-8, 1983.
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  22. Schubert W, Eriksson U, Edgar B, et al. Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17 beta-estradiol. Eur J Drug Metab Pharmacokinet 1995;3:219–24.
  23. Miniscalco A, Lundahl J, Regardh CG. Inhibition of dihydropyridine metabolism in rat and human liver microsomes by flavonoids found in grapefruit juice. J Pharmacol Exp Ther 1992;261:1195–9.
  24. Bochorakova H, Paulova H, Slanina J, et al. Main flavonoids in the root of Scutellaria baicalensis cultivated in Europe and their comparative antiradical properties. Phytother Res. 2003 Jun;17(6):640-4
  25. Lin CC., Shieh DE., The anti-inflammatory activity of Scutellaria rivularis extracts and its active components, baicalin, baicalein and wogonin. American Journal of Chinese Medicine 1996;24(1):31-6
  26. Bone, Kerry: Clinical Applications of Ayurvedic and Chinese Herbs-Monographs for the Western Herbal Practitioner , Phytotherapy Press, Warwick, Queensland Australia (1996) pp 75-79.
  27. Chang, HM :Pharmacology and Applications of Chinese Materia Medica, Vol 2, World Scientific, Singapore (1987)
  28. Mittman P. Randomized,double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Medica 56:44-7, 1990
  29. Tripathi RM, Sen PC, Das PK Further studies on the mechanism of the anti-anaphylactic action of Albizzia lebbeck, an Indian indigenous drug. J Ethnopharmacol. 1979 Dec;1(4):397-400.
  30. Tripathi RM, Sen PC, Das PK Studies on the mechanism of action of Albizzia lebbeck, an Indian indigenous drug used in the treatment of atopic allergy. J Ethnopharmacol. 1979 Dec;1(4):385-96.
  31. Besra SE, Gomes A, Chaudhury L Antidiarrhoeal activity of seed extract of Albizzia lebbeck Benth. Phytother Res. 2002 Sep;16(6):529-33.
  32. Bone, Kerry: Clinical Applications of Ayurvedic and Chinese Herbs-Monographs for the Western Herbal Practitioner, Phytotherapy Press, Warwick, Queensland Australia (1996) pp 94
  33. Abraham, Z. (1981) Glimpses of Indian Ethnobotany (S.K. Jain, ed) p 315. Oxford and IBM Publishing Co., Bombay, India
  34. Seamon KB, Daly JW. Forskolin: a unique diterpene activator of cAMP-generating systems. J Cyclic Nucleotide Res. 1981;7:201–224
  35. Laurenza A, Sutkowski EM, Seamon KB. Forskolin: a specific stimulator of adenylyl cyclase or a diterpene with multiple sites of action? Trends Pharmacol Sci. 1989;10:442–447
  36. Robbers, James E., Marilyn K. Speedie, and Varro E. Tyler. 1996. Pharmacognosy and Pharmacobiotechnology. P 88. Williams & Wilkins. ISBN: 0-683-08500-X.
  37. Marone G, Columbo M, Triggiani S, et al. Forskolin inhibits the release of histamine from human basophils and mast cells.Agents Actions. 1986;18:96–99.

 

 

Ellen Kamhi , The Natural Nurse®, (www.naturalnurse.com) and Eugene Zampieron (www.drznaturally.com) are the authors ofThe Natural Medicine Chest and Arthritis, The Alternative Medicine Guide. Dr. Zampieron is a Professor of Botanical Medicine at Bridgeport College of Naturopathic Medicine and Ellen Kamhi is a Professional Herbalist with Nature’s Answer in Hauppauge, NY.