by Michael Tierra, L.Ac, OMD
Historically, women often have had to find their own ways to attend to the concerns and issues of the expectant mother. For over a thousand years, men dominated the professional class of healing in most societies, and women found little sympathy (as a result of the biblical tale of the Fall caused by Eve first partaking of the forbidden fruit). Without any imposed legal responsibility, men generally felt little consequence from sexual intercourse. This left the job of attending to the special needs of pregnancy to the '˜wise women,' '˜old wives' and midwives.
Despite this, during the Dark Ages, women who would assume the role of herbalist/helper/midwife to other women were condemned as witches and executed. Nevertheless, the valuable experiences and knowledge accumulated by those courageous women who carried forth the tradition have become a part of the herbal and practical lore of caring for the care of women both during and after pregnancy.
When a woman becomes pregnant, she it is common for her to experience and take on a healthy, vibrant aura '“ nature's reward for fulfilling a biological destiny. It is a major physiological change that has a profound and lasting effect. The bond between a mother and child, born or unborn, is probably the deepest connection that can a human may achieve. Often, this connection is so powerful that men (i.e., the husband or father of the child) wishing to share in the excitement may to have to put forth an extra effort to feel included. I call that sense of alienation that some men can feel, especially after childbirth when they are no longer the primary focus of their mate's attention, the "St Joseph Syndrome."
(Why St. Joseph?" you may ask. In the Bible, St. Joseph, the husband of Mary and the father of Jesus, is hardly given any consideration except as guardian; even his physiological role is denied by the church with the doctrine of the Immaculate Conception.)
The first piece of advice I have is this: Enjoy your changes. Along with the new positive energy bestowed upon women during pregnancy is the responsible realization that all you think, do or eat will have an effect on your developing fetus. The first thing is to consider avoiding all those problematic habits and foods because their effect may no longer just be on your own life but the life of your unborn child.
Following are a few valuable dietary and herbal approaches that should prove useful to women both during and after childbirth.
Although it is said that you are "eating for two," this doesn't mean that you double your normal caloric intake. The truth is you are only eating for about one and an eighth. This means that during the second and third trimesters, the baby should only necessitate an increase of approximately 300 calories per day.
The nutritional needs of the unborn child will be met by the best of all the foods and drinks you consume. If your nutrition is not sufficient or of the best quality, the first to suffer will be you, the mother-to-be. Pregnancy is definitely not a time to follow an extreme, rigid diet. An expectant mother often develops unusual food cravings, which are the body's way of signaling a need for specific nutrients. One of the most useful foods to include during pregnancy are mineral-rich sea vegetables (edible seaweeds). Learn to include seaweeds such as nori (best known as the seaweed used to roll sushi '“ but avoid raw fish during pregnancy), kombu (kelp), and wakame added to soups and stews. One can make a tasty condiment with roast kombu.
The most important macronutrient is protein '“ especially first class protein derived from dairy, fish and meat. Second class protein derived from vegetal sources such as beans can serve the needs of some women but not all. Each of us has a unique biological genetic history that may not be changed during the course of a single lifetime. When we experience frequent hunger and sweet cravings this often signals a need for more protein. Protein is the building block of life and everything about pregnancy is building.
One should eat a wide variety of foods each day to ensure getting all the vitamins, minerals, and other nutrients needed for you and your baby. Have different meals with a varied assortment of fruits and vegetables daily. The colors of foods indicate different nutrients so that you can have fun choosing different colored foods for the different nutrients they provide. The cheapest and best quality protein are eggs; two (ideally soft boiled) eggs daily each morning is a good daily practice. Otherwise it also good to vary the proteins you eat by alternating meats, fish, poultry, pork, eggs, beans, and nuts in your diet. Cultivating a taste for organ meats such as liver or heart also helps to strengthen those organs. Finally, eat a variety of whole grains in various forms.
Like the rest of the non-pregnant world, expecting mothers should look to the Food Guide Pyramid to determine what and how much to eat.
It is recommended that pregnant women consume a daily minimum of
Each food group provides different nutrients, so eating from all the food groups daily will help ensure a complete diet.
Select whole, organically grown and/or raised foods rather than processed foods when available. Prepackaged foods not only lack nutrients, but they are often laced unnecessarily with sugar, preservatives and additives which neither you nor your baby need.
Although most foods are perfectly safe for expecting women, certain foods and substances can be harmful to a growing baby. Avoid the following during pregnancy because of possible fetal toxicity:
Sushi containing raw fish
Shark, swordfish, king mackerel, tilefish (limit intake of other fish to no more than 12 ounces/week)
Raw or undercooked meat, poultry, eggs, fish, shellfish
Smoked seafood, cured ham
Soft cheeses such as Brie, blue, feta, goat cheeses
Hot dogs, sausages, other processed meats containing nitrates
Unpasteurized milk, juices
During pregnancy, the amount of fluid in your body increases, as do your daily fluid needs. Your baby needs fluids as well. Aim for at least eight 8 oz. glasses of fluid per day. This includes water, low fat or fat free milk, 100% fruit and vegetable juices, decaffeinated coffee and tea, and soup. While juices are a nutritious alternative to soda, they still contain a large amount of sugar, so avoid consuming excessive amounts. Also, limit caffeinated beverages to no more than two per day.
Women are often concerned about having difficulty losing the weight postpartum and consequently attempt to diet and restrict food intake. Pregnancy is not an appropriate time to diet. By possibly decreasing the amount of nutrients your baby receives such diets will affect the baby's growth and development. Your growing baby needs to be nourished consistently throughout the day. Furthermore, most of the weight gained during pregnancy is not body fat. Following is an interesting breakdown of the additional weight distribution in your body:
It has been proven that pregnant women have an increased need for folic acid, iron, and calcium. Therefore, it is recommended that expectant women take a prenatal vitamin to supplement a balanced diet. However, too much of certain vitamins and minerals can be harmful to your baby. Talk to your health care provider for the appropriate supplement and be wary of supplements that provide more than 100% of the daily value for any vitamin or mineral.
During the initial stages of pregnancy, many women suffer from severe nausea, morning sickness and food aversion. This may be seen as a period of cleansing and detoxification that precedes building. For some it can be extremely difficult to assuage.
The simplest treatment is ginger and red raspberry leaf tea. Raspberry leaf may be regarded as the best and safest herb to use throughout all stages of pregnancy. Two to four slices of fresh ginger, steeped for 15 minutes in a covered cup of boiling hot water or hot raspberry leaf tea, often relieves morning sickness. (For more on red raspberry leaf and its usefulness during pregnancy, see below.)
Ayurveda views morning sickness as an aggravation of '˜pitta' or the fire humour. There is an increase of digestive acids in the stomach, and an increased sense of smell, which both promote greater digestion and assimilation. Unfortunately, this increased sensitivity may also create the counter effect of (often extremely nauseating) aversion to certain foods and smells.
In addition to the raspberry leaf/ginger tea mentioned above, pregnant women can ward off morning sickness and nausea by consuming several small nutritious, protein-rich meals a day.
B vitamins (especially folic acid) are essential during pregnancy. Rather than taking a folic acid or other B vitamin pill supplement, try a daily teaspoon to a tablespoon of brewer's or torula yeast in a little juice or water. Not only does it fulfill a nutritional demand of the body, but this simple remedy has brought total relief to many women from morning sickness.
Another good practice is to soak 10 raw almonds overnight. In the morning, peel off the brown outer skin and eat the nuts. This provides much needed protein and also helps to relieve nausea.
The Chinese herbal tradition recommends a tea of processed pinellia root, poria mushroom and fresh ginger as a treatment for morning sickness. Make sure you obtain any formulas containing pinellia from a trusted source and be sure that the root is properly processed to remove its natural toxicity.
The Ayurvedic herb called shatavari (Sanskrit for "100 husbands" because of its traditional use for strengthening a women's reproductive capacity) is commonly used during pregnancy taken with calcium to prevent miscarriage.
To prevent miscarriage, Western herbalists will recommend a tea of false unicorn root, cramp bark, raspberry leaf and squaw vine. This is taken as a strong decoction, simmering an ounce of the herbal combination in a half quart of water over a low flame for 30 minutes. This is then strained and taken 1/2 to 1 cup three or four times a day.
Chinese herbalists use a special species of mistletoe (Viscum coloratum or Loranthus parasiticus) called sang ji sheng that grows on the mulberry trees to prevent miscarriage. It should be noted that other species of mistletoe should not be used for this purpose. It's best that you make an appointment with a traditional Chinese medicine doctor to have a formula specially prescribed.
Of all the herbs recommended for use to relieve all the discomforts associated with pregnancy and childbirth, the most enduring is red raspberry leaf (Rubus idaeus).
Raspberry leaf tea has been used medicinally for centuries to assist a woman throughout all phases of pregnancy. It strengthens the uterus while softening the cervix for ease of childbirth. It contains flavonoids, tannins, gallic and ellagic acid and fragarin. The tannins make it useful to regulate bleeding and to strengthen tissue while fragarin is known to be mildly oxytocic, which means that in very large doses it helps induce labor. In lower doses, this is not a problem; in fact, the tannins are more likely to overpower any oxytocic effects of fragarin and actually prevent miscarriage.
Raspberry leaf has the following uses:
Outside of pregnancy, raspberry leaf is also used for the following:
Raspberry leaf has been found to have potent antibiotic effects against infections and inflammations.
Many of the unsuccessful or mixed results using raspberry leaf is dosage related. Throughout the earlier stages of pregnancy, one should use a weaker dose. Steep a teaspoon to a tablespoon of the dried leaf in a cup of boiling water, then cover and allow it to sit until cool enough to drink.
The following is offered not as a recommendation but for historical reference and to illustrate that dose figures extremely importantly when using this (and any) herb.
Based on an article published in Rodale's Encyclopedia of Home Remedies, to achieve the full benefit of raspberry leaf during childbirth, it should be made full strength: steep one ounce of dried raspberry leaves in a pint (2 cups) of boiling water, covered, for 30 minutes. This is then strained. If made well in advance, the tea can be frozen in ice cube trays and then sucked during the pangs of labor. In addition a pot of strong brew should be prepared in the same way and taken all at once as warm as possible. This is not to induce labor but to facilitate and ease its course and to prevent complications.
Pregnancy is a natural process of life and should present no serious complications in normal circumstances. However, it is important that it be competently supervised by a qualified health care practitioner and any supplements offered should be with their consent and on the spot guidance.
RM, CM BaHS(Nsg), GradDip EdMyra Parsonsa, (Childbirth), Midwife and Research Assistant, RN, CM Dip Remedial TherapyMichele Simpson
b and RN, CM Cert Antenatal EdTerri Pontona, Nursing Unit Manager, Raspberry leaf and its effect on labour: Safety and efficacy, Australian College of Midwives Incorporated Journal Volume 12, Issue 3, September 1999, Pages 20-25
b and RN, CM Cert Antenatal EdTerri Pontona, Nursing Unit Manager, Raspberry leaf and its effect on labour: Safety and efficacy, Australian College of Midwives Incorporated Journal Volume 12, Issue 3, September 1999, Pages 20-25
A herb for women
Artemisia vulgaris L. (Compositae)
Part used: Leaves.
This perennial plant is found in many parts of the world. While it is used for different purposes in certain areas, in Europe it has proven effective chiefly in treating menstrual disorders. It has been shown to be helpful in regulating menstruation, and is therefor of value in the following conditions: amenorrhea (absence of menstrual flow), dysmenorrhea (painful menstruation), menopause, pre-menstrual tension.
Mugwort provides an excellent example of how a certain herb can be used differently in different parts of the world. In Europe, it is widely used for menstrual difficulties. In China, recent research indicates it may be of value against malaria. In Java, poultices of the herb are applied to old sores, scurvy, and other skin conditions. In the Philippines, it is used as an emmenagogue (an agent to induce menstruation). American indians have used it for bladder ailments, bronchitis, cold, colic, dysmenorrhea, epilepsy,fever, gout, hysteria, kidney ailments, poisoning, rheumatism, sciatica, worms and wounds.Interestingly enough, the Russians use it for many of these same conditions, but add fever, gallstones, gastritis, rickets and tuberculosis to the list. In Sumatra, it is smoked as an opium substitute. In other areas, sleeping on a pillow stuffed with Mugwort leaves is claimed to provoke dreams that reveal one's future.
Mugwort owes its properties principally to the essential oil it contains at levels between 0.02 to 2%(1). The composition of this oil has been recently studied(2); its principal constituents are cineol (or eucalyptol) with traces of thujone. A sesquiterpene lactone is also found. But Mugwort is also rich in mineral salts: potassium, phosphorus, iron...(4) Mugwort has always been a popular emmenagogue in Western Europe. It is effective in cases of dysmenorrhea, functional amenorrhoea,insufficient periods, menstrual pain and menopause.Besides these properties, it is interesting to note that according to latest scientific studies coming from China, Mugwort could contain an effective element against malaria.
The traditional supplement for high blood pressure.
Olea europea L. (Oleaceae)
Part used: Leaves
Historically, the olive tree has played a central role in Mediterranean civilization. Remember, for example, that Moses exempted from military service those men who worked at cultivating olive trees. In Scriptural and classical writings, olive oil is mentioned as a symbol of goodness and purity, and the tree as representing peace and happiness.
The value of olive oil as a food and cosmetic are well known; the medicinal qualities of the olive leaf, however, should not be overlooked. Modern investigation has confirmed its value in treating mild case of hypertension (high blood pressure). It is widely used in Europe for this purpose. Interestingly enough, it does not exert this action when taken as a tea. Only when the whole leaf is used does its hypotensive activity manifest itself.
The most valuable known constituents of the Olive leaf(1) are: flavonoid pigments, choline, abundant triterpenic derivatives (3 to 4%) including oleanolic acid, and above all iridoids, of which one,oleuropeoside, acts on the smooth musculature. The hypotensive action of the leaves of the Olive Tree is due to the oleuropeoside mentioned above. This activity has been confirmed by many famous researchers: Leclerc(4), De Nunno and Capretti(5), Balensard(6) and Petrov(7) can be mentioned among others. Besides this major action, it has been shown that the Olive leaf is endowed with hypoglycemic properties(8). The Olive leaf is also diuretic(3); it has been demonstrated that the diuresis is not caused by the water absorbed with Olive leaf in an infusion, as it is manifested only after ingestion of the powder(6). Finally it has been proven that oleuropeoside is coronary-dilatory, anti-arrhythmic and spasmolytic(7). It would therefore be worth using Olive leaves in cases of: - Moderate hypertension, as well as when the following properties are indicated: mild diuretic and hypoglycemic.
This medicinal herb has been used for many centuries in its country of origin, that is to say in Indonesia. It is appreciated for ailments of the bladder and kidney.
Orthosiphon began to interest researchers as early as the beginning of the 20th century. Since then, its diuretic properties and its cholagogue activity have been used in Europe. Some of its chemical components are well-known, even if they do not explain perfectly the therapeutic action of the plant. There are many potassium salts, saponosides, choline, betaine, triterpenic alcohols and flavonoids. It would be worth prescribing Orthosiphon in case of water retention, especially as a complementary treatment of obesity.
A certain number of pharmaceutical specialities with a sedative action are based on the Passion Flower; its chemical compound has been well studied. It includes:
In fact, it seems impossible to attribute the sedative action of the Passion Flower to one or more of these components. This is another example illustrating the role of the synergy of all the ingredients in a whole plant. All these principles seem to work together towards its sedative action whose mechanism has been studied by pharmacologists. The Passion Flower has antispasmodic properties (rabbit intestine)(5); it diminishes the mobility of mice and rats(6).
The Passion Flower is reputed to help people to have a restful sleep without any 'narcotic' hangover. Naturally, it would be worth prescribing the Passion Flower in cases of: -Nervousness -Distress -Anxiety -Insomnia.
In some parts of the world, Red Poppy is considered merely a weed. But in other areas, it has been used as a mild sedative for centuries. And in parts of Europe, it is even cultivated as a food. It has been shown to sooth irritable coughs and other respiratory problems. And it helps to calm over-active children, and has been used as a sedative, particular for the young and elderly.
Although the Red Poppy is considered to be a weed by harvesters, it has genuine medicinal properties that have been used for centuries. Its main chemical components include an isoquinoleic alcaloid,(called rhocadine), flavonoids and anthocyanosides. They explain the sedative action of the Red Poppy. It is especially recommended for children and old people. The Red Poppy is also known for its anti-tussive quality; it belongs to the famous mixture of the 'pectoral plants' which includes 7 medicinal herbs of which the activity is linked to the respiratory system.
It would be worth using Red Poppy Arkocaps in cases of:
The principal constituents isolated in the leaves of the Red Vine are of three types: -Vitamin C -Tannin(1). It is known that these substances, of a polyphenolic nature, have the capacity of fixing proteins. This permits them to be used in therapy as astringents for external application and as anti-diarrhoeics internally.
Anthocyanins, pigment which give the color red to fruit and leaves. These anthocyanins are responsible for the vitamin P action of the Red Vine. It is known that this vitamin P action does not correspond to a chemically defined vitamin, but represents a group of properties which provide vascular, capillary and venous protection(2),(3). A certain number of researchers have studied the mechanism of this action.For Hamond(4) the anthocyanins act on the cytoplasmic and lysosomial membranes of the cell,thus inhibiting the liberaion of enzymes which increase capillary permeability. Thus it would be worthwhile to use Red Vine principally for troubles of the venous circulatory system: -Varicose veins - Haemorrhoids -Capillary Fragility (rosacea)-Circulatory troubles associated with menopause and puberty. - Secondary use as an astringent in menorrhagia and in mild diarrhoea.
This very traditional European medicinal herb is rich in essential oils (cincole, borneol and terpenic carbons), flavonoids, phenolic acids and diterpenic lacone.This variety of components gives it a diversity of therapeutic uses. Among them, we can mention migrainous and hypertensive headaches. So, Rosemary Arkocaps may be advised in association with feverfew Arkocaps.
But the best known use of Rosemary concerns the digestive sphere. Thanks to its many phenolic acids, Rosemary has been known for a long time, as choleretic and cholagogue. It is interesting to use its stimulant action to help liver function, the production of bile and proper digestion. Finally, Rosemary is also diuretic. To resume, Rosemary Arkocaps are available as a complementary herb for some forms of migraine and as a basic herb for hepatic infections, spasms and digestive troubles.
Sage was the "Sacred Herb" of the Greeks, who considered it a panacea, a cure for all ills. "Cur moriatur homo cui Salvia crescit in horto? (Why should a man die whilst sage grows in his garden?) The corresponding English proverb states: "He that would live for aye, Must east Sage in May."
As might be expected, Sage has been recommended at various times as a cure for almost any problem conceivable. But certain uses of the plant have stood the test of time. A solution of sage (dissolved in water) is an effective cure for various mouth and throat conditions. Internally, it has been shown to be effective in reducing sweating and perspiration (caused by fever, etc). And because of its "estrogen-like" activity, it has been used to normalize menstrual problems, induce menstrual flow, dry up breast milk flow when time to wean, and alleviate other female disorders.
During the Middle Ages in Europe, it was noticed that the appearance of certain plants, either by their shape or color, resembled the human body, or a certain part of the body. In those days, there was a good measure of mysticism involved in the field of herbal medicine, and it was thought that this resemblance, or "signature" dictated the therapeutic use of the herb in question. This is the doctrine of "signatures." Probably the best known example of this is Ginseng. Because the root is shaped like a man's body, it was deemed useful in treating numerous "general" afflictions. Surprisingly, even though this sounds simplistic, it turns out that many of the conclusions drawn by these early herbalists have been shown to indeed result in effective remedies.
Sage was the sacred plant of the Greeks, who considered it to be a panacea. Modern chemists have defined its composition, and pharmacologists have confirmed many of the properties attributed to it by popular medicine. A table can be drawn up as follows (1): -An essential oil (1 to 2%) containing thujone, responsible for its anti-perspirant action (which has been studied by several researchers (2) and for its emmenagogic properties. Although Sage contains thujone, it has not been reported to be toxic.
Numerous polyphenois and flavonoids, most likely responsible for the choleretic (3), anti-spasmodic (4) and hormonal action. The hormonal action is of the oestrogenic type (someone has recently (5) described Sage as a typical 'Plant oestrogen').
Tannin, which give Sage - when used externally - astringent and healing properties (6). -A bitter principle: picrosalvin, to which Sage owes its anti-microbial action.
It would thus be worth prescribing Sage capsules in cases of:
Used commonly as a flavoring component in major categories of nonalcoholic beverages, Sarsaparilla benefits from a long tradition of folk medicine. It has even been used to treat syphilis. Its effectiveness has not been substantiated in the treatment of this acute ailment. However,Sarsaparilla has been proven to have real properties in the case of gonorrhea and certain skin conditions.
Sarsaparilla contains both male and female hormones (testosterone, progesterone and cortim) which explain its various capacities. Among the other components the most interesting are the steroidal saponins, of which the principal one is sarsapogenin(1). These saponins are responsible for the pharmacological effects to which
Sarsaparilla owes its reputation as a "depurative", diuretic and sudorific drug. The mechanism of these diverse effects is still not fully understood, but it is believed(2) that these saponins favor the elimination of metabolic waste products.
Sarsaparilla capsules may be given to treat a wide range of disorders such as: Pre-menopause, pre-menstrual syndrome, Chronic Rheumatism Forms of Dermatosis.
Seaweed constitutes a real concentration of the marine environment. It is rich in trace-elements, vitamins and mineral salts. Its iodine content can reach 1% of its dry weight(1). This richness in iodine permits the use of Seaweed in treatment of hypothyroidism(2); the totality of the elements it contains can have a favorable effect in activating and stimulating certain endoctrine glands, osmotic exchanges and the elimination of waste materials(3).
Seaweed also has polysaccharides(4) which form mucilage in contact with water; this mucilage distends the stomach without being assimilated, thus inducing reduction in appetite and a slight laxative effect. For this reason it would be worth using Seaweed in the following cases:
We are concerned with the variety of Senna called 'Tinnevelly Senna' or 'Indiana Senna'. The laxative and purgative properties of Senna were discovered in the 9th century by the Arabs, who spread its use to Europe. Even though Senna pods (called follicules) are also active, the foliols (division of the compound leaf) are used in preference. Their chemisty has been studied extensively. Their action is due to free anthraquinones, that is to say anthraquinone glycosides called sennosides, of which several types have been identified: A, B, C, D(1).
The laxative action of Senna is well-known, numerous researchers having studied the action of the anthraquinone compounds of Senna, classified as 'peristaltic laxatives'(2). Its laxative action works at the level of the colon and rectum. Among these researchers, Fairbairn(3), Hardcastle and coll.(4), Lemmens(5), Kisa and coll.(6), Kobashi and coll.(7) can be quoted.
It is very likely that whole Senna powder, while having an effective action, is less irritant for the intestines than anthraquinones in isolation(8). Thus Senna capsules should be temporarily given in cases of:
Siberian Ginseng belongs to the same family as ginseng from Korea and China. It is a common plant in Siberia, and during the past few years it has been studied extensively in the Soviet Union. The results of this investigation by the Russians have been extraordinary, showing that Siberian Ginseng causes an increase in both physical and intellectual capacities. It has become the anti-fatigue supplement "par excellence" in Russia, and is given to cosmonauts, olympic athletes and workers doing heavy physical work.
The terms most often associated with Ginseng are "fatigue" and "stress." Exactly who benefits from an agent that counters these conditions? - anyone who has been "burning the candle from both ends" - the athlete seeking improved performance - the harried business executive - the student cramming for exams - the person who is always sick, always "getting over" a cold - anyone who "feels tired all the time"
The traditional term used to describe ginseng is adaptogen." An adaptogen is an agent that "produces a state of increased resistance of the body to stress, overcoming disease by building up our general vitality and strengthening our normal body functions." Even the critics have to admit that "...favorable modification by ginseng of the stress effects of temperature changes, diet, restraint, exercise, and the like have been recorded. Moreover,useful pharmacologic effects in such conditions as anemia, atherosclerosis, depression, diabetes, edema, hypertension, and ulcers have also been documented." (Tyler) One example of the beneficial effects of Siberian Ginseng was reported in the medical literature by German investigators (Bohn) in October 1987. They demonstrated its beneficial effect on the immune system by conducting a double-blind, placebo controlled study on 36 healthy volunteers. Their results showed "a drastic increase in the absolute number of immunocompetent cells" in the blood of those taking the ginseng. In another study, from Russia, it was shown that children with dysentery recovered more quickly when they were given Siberian Ginseng. (Veresch) Siberian Ginseng, therefor, can be considered useful in conditions of stress, infection, fatigue, healing, improved performance.
What exactly is "fatigue?" If you look in the index of medical text books, you probably won't even find it listed. But doctors hear the term all the time-->Fatigue, of course, is a very real symptom of numerous well recognized medical disorders, and a thorough medical evaluation of the patient complaining of this problem is an absolute necessity. Because conventional explanations are often not found, however, less conventional approaches are gaining acceptance (food allergy,vitamin deficiencies, etc). Herbal supplements can be extremely helpful. Perhaps no other material has as long and successful as history of helping this problem as does Siberian Ginseng, the adaptogen and general tonic herb. The herb Hawthorn has been used for cases of fatigue caused by stress or nervous tension (often in conjunction with Ginseng). Eschscholtzia, for adults, and Red Poppy, for children, are often used to help alleviate sleeping problems. Hemp Agrimony is helpful from fatigue resulting from illness, and Green Tea is commonly used to fight the fatigue of travel (jet lag).
The chemical compound of Siberian Ginseng is complex. Among the many active substances which have been isolated, the most important seem to be 6 glycosides called eleutherosides(1), but vitamins,amin-acids and other principles are also found. It is difficult to dissociate the different components in the overall action of the plant. It has a non-specific stimulant action on physical and intelectual capacities. It differs from that of the traditional stimulants (caffeine or amphetamine type) which produce a "lift" followed by a depression. Siberian Ginseng is the "anti-fatigue" and "anti-stress" drug par excellence. It was for this type of action that Brekhman(1) created the ideas of an 'adaptogen', whereas Fulder(2) preferred the name "Biological optimiser". Dansberg(3) has confirmed this stimulating action experimentally on rats. It is a known fact that the Russian athletes use this herb during international sport meetings in order to benefit from its stimulating properties. For that reason, it was interesting to prove scientificaly the effects of the powder of Siberian Ginseng on athletic performances. In 1984, the research staff of Arkopharma Laboratories studied(8) a group of sprinters and long distance runners. Half of them took Siberian Ginseng Arkocaps every day, the remainder took nothing and served as witness group. Both groups were equally fit. After one month, the conclusion was as follows: out of the two identically matched groups subjected to the same practice during one month, only the group treated with Siberian Ginseng Arkocaps powder improved its "maximum" strength in a significant way. The stimulating action is reinforced by a protective action against various outside stresses: hard work(2), chemical stress -toxic and adrenal glands(6). It has an anabolic action(6) and Lazareff has even found an anti-tumor(7). Thus Siberian Ginseng can be beneficially used in all cases of: Overwork Convalescence Preparation for Examinations or Physical effort (in sport(8) or intensive work).
Nettle leaves are an excellent source of chlorophyll, which is widely used as a deodoriser in toothpaste, lotions, chewing- gum...(1). Besides chlorophyll, Nettle is rich in mineral salts, particularly iron and silica. It also contains vitamin C. The rest of their chemistry has been little studied, but experience has shown that Nettle has astringent, hemostatic, diuretic, and anti-rheumatic properties. The astringent and hemostatic properties are used in external applications(2); internally, the diuretic, anti-rheumatic and anti-gout properties are utilized. Several researchers, indeed, have proven experimentally that Nettle increases the elimination of uric acid(3).
It would be worth using Nettle internally as a:
The siliciou resin found in the joints of the female bamboo is used. Tabashir is a traditional natural remedy in the south of India and in Bengale. The great interest of Tabashir in phytotherapy is due to its silica content (97%). Silica is one of the most important components of the connective tissue: cartilage, articulation tendon, and some elements of the arterial walls, skin, hair and nails. Besides silica, Tabashir contains iron, calcium, choline and betaine. Tabashir Arkocaps have an effective re-mineralizing action that is very useful in cases of arthrosis, painful joints, fragility of the cartilage (osteoporosis), hair or nails and in prevention of the consequences of atherosclerosis. In general, Tabashir stimulates the natural defense of the organism (during growth, pregnancy, repair of fractures, senescence). See the following chapter on silica and its value for chronic and acuted vertebral ailments.
Silica is a very common mineral element and is found everywhere on earth. For a long time, its role in human pathology was neglected. But recently, Western researchers have been studying it closely. Silica is one of the most important components of the connective tissue, and we are finally beginning to understand the consequences of its deficiency on health. Studies have been particularly concerned with the role of silica in rheumatic diseases (arthrosis) and arterial illness (atherosclerosis).
Silica is necessary for the bones to fix calcium and improves the texture of collagen and, therefore, the suppleness of the body tissue. It has been established that in the case of demineralization of the bones, silica loss comes before calcium loss. Moreover, since silica is an element of structure, tissue depends on it for its elasticity. As soon as the amount of silica in the body tissue decreases, the calcium level goes up and elasticity is reduced. Also, silica accelerates the consolidation of fractures, probably due to the role it plays in fixing calcium.
A 25 year study in Finland has demonstrated that a deficiency in silica could increase the risk of coronary problems. As a matter of fact, the elasticity of the arterial walls is essential to absorb the variations in blood pressure. A supplement of silica is often necessary to restore a normal tonicity to the arteries. Silica is primarly provided by water, numerous vegetables and fruit. It is concentrated in skin peelings and in the integuments of cereals. But, as water may be deficient in silica, especially in chalky areas, and as modern nutrition, based more and more on refined food, no longer fulfills nutritional needs, there is a deficiency in silica.
During the Middle Ages in Europe, it was noticed that certain plants, either by their shape or their color, brought to mind a detail of the human body or a disease. By virtue of the quasi-occult properties which were given to vegetable herbs at that time, it was thought that this signature defined the therapeutic action of the herb in question. This is what one calls the doctrine of signatures. Even if there is obviously a lack of scientific sense in this doctrine, we may be surprised by the coincidence in the case of Tabashir, bamboo resin. Indeed, doesn't bamboo look like a spine? Its knots are like vertebras and its essential quality is to straighten itself after being bent. The famous Dr. Hauschka sets forth this doctrine to explain his interest in bamboo as he found its qualities effective against degenerative processes in the cartilages and conjunctive tissue. Whatever it may be, every prescriber, and especially those who work on spinal problems, can find in Tabashir Arkocaps an excellent source of aid.
Green Tea is tea in its natural state that has not undergone fermentation. Generally, it is the fermentaion process that releases the aroma and makes tea a pleasant drink. Only Green Tea (unfermented tea) has medicinal properties.
The main components of this tea are natural xanthines such as caffeine, theobromine, theophylline and tanni. The association of tannin with caffeine allows the caffeine to be released slowly into the blood. It is absorbed in small quantities and therefore does not cause insomnia. Green Tea is also diuretic. It fights against water retention. The slimming activity of this tea is probably due to another property: the caffeine of Green Tea helps in the secretion of adrenalin and keeps it at a high level. It is known that adrenalin is the hormone that frees fatty acids of the adipose tissues. This slimming activity has been proven in a double blind against placebo study conducted by Arkopharma Laboratories: 60 overweight women were divided into two equal groups. One took Green Tea Arkocaps and the other a placebo. Both groups followed a 1,800 calorie diet. This 30 day-long study concluded that the group who tested the Green Tea Arkocaps, had a significant weight loss and a reduction of waist measurement. Moreover, a significant decrease of the rate of blood triglycerides proved to be particularly active in the mobilization of fats. The clinical and biological tolerance levels were perfect, no side effects or sleep loss was reported.
The ancient herbalists quickly recognized the digestive properties of this plant. It is now used in certain vermouths and liqueurs. Germander is classified as a bitter tonic and anti-spasmodic. As a bitter tonic, it stimulates the digestive functions. Its healing functions have been confirmed in the laboratory through recent animal studies. One report showed it to possess remarkable ulcer- healing qualities. In Europe, Germander has been used with success as part of various weight reducing regimens, helping to stimulate the reduction of fatty deposits and cellulitis. In one book, it is referred to as the "fat-eater herb." Wall Germander can thus be used effectively for digestive disorders, ulcers and weight loss.
There are many Germanders, but the medicinal plant is the "chamaedrys". The latin word means "little oak" because of its dentate leaves which recall those of the oak. Its chemical compound has been thoroughly studied. Germander contains: -an important proportion of tannin(1), -a bitter principle identified as marubiin(2), -abundant flavonoids(3), -phenol acids, -a little essential oil, -diterpenic principles called teuchrine and teuchamaedrine(5).
Modern research has shown that Germander possesses some interesting pharmacological properties: -Germander is a bitter tonic(1), -it has an anti-spasmodic action(6)(7). These properties make Germander an interesting herb to stimulate the digestive functions and the metabolism of the tissues, -it is a complement in slimming diets thanks to its tannin. The tannin allows a decrease in fatty deposits in obesity and cellulitis. The major indications for use of Wall Germander will thus be: Digestive Troubles, in particular dyspepsia and stomach gas. In the Treatment of Obesity as a back-up treatment.
The leaves of the White Birch have always been known for their diuretic and choleretic properties(1). In the old days, writers attributed the diuretic effect of White Birch to betulin(2) which is a terpenic alcohol. Today, it is a known fact(3)(4) that White Birch owes its properties to flavonoids of which the most important is hyperoside (or quercetol 3-galactoside). These active principles are mainly found in old or yellowing leaves(5). This effective diuretic principle has the reputation of eliminating oedema of heart and kidneys, of decreasing the quantity of albumine without causing any irritation of the urinary tract. White Birch is particularly recommended to patients who suffer from gout. Besides, this popular medicinal herb is a component of a number of pharmaceutical specialities in Western Europe(5). Therefore, White Birch is useful in cases of: -Oedema -Retention of metabolites -Cellulitis -Urinary colic -Gout -Arthritis.
The chemical composition of Willow is well-known. The bark of this tree contains principally what has become a famous active ingredient, salicoside, the basis of salicylic acid (aspirin), before it was synthesized. Among other ingredients, we can mention oxalates and tannin.
But this salicoside is turned into salicylic acid by oxydizing in the organism. This explains the effectiveness of Willow bark in treating rheumatic pain. Moreover, salicylic acid has a sedative effect on the thermoregulation system and also causes a dilation of blood vessels. Consequently, the bark of Willow is often used in case of fever.
Yarrow is a plant with a good reputation in popular medicine. It is for this reason that its composition has been relatively well studied; it is complex and includes(1): An essential oil containing azulene, as found in Camomile, which has an anti-inflammatory action -Polyphenols: tannin, caffeic acid, flavones...-Sesquiterpene lactones -Nitrogenous compounds of the betaine group.
All these compounds are responsible for the different pharmacological actions of Yarrow which are: -An anti-inflammatory action due to its essential oil(2)(3). -A spasmolytic and choleretic action(4) due to its flavonoids. -A tonic and lightly antipyretic action(5). Consequently, Yarrow is useful in the treatment of: -Painful or insufficient periods -Digestive difficulties -Inflammation of the venous system (varicose veins, haemorrhoids) - Light fever and thrombotic conditions with hypertension.
First, let us give fat its correct name: lipid. Now, let us examine the chemical composition of lipids. Lipids are composed of three fatty acids joined to a glycerol spine. These fatty acids are not similar, insofar as each of them can have a various number of carbon atoms. You can imagine the number of possible combinations with three different fatty acids and their respective position on the molecule. This gives rise to the vast range of fats and oils that are in existence. Fatty acids are functionally the most important part of lipids. They are responsible for the role lipids play in the organism. Fatty acids consist of a number of carbon atoms, each one joined by several hydrogen atoms. Fat is "saturated" when carbon atoms have no double bond joining them together. This is generally the case in animal fat. When the molecule of fatty acid has one or more double bonds between two carbon atoms, fat is "unsaturated" or "polyunsaturated". Therefore, it is necessary to analyze this chemical compound molecularly because the effect fat has on the body depends on its structure.
At this stage, we can notice a difference in the physiognomy of a saturated and a polyunsaturated fatty acid. Saturated fatty acids are flat; unsaturated fatty acids are loop-shaped since they have double bonds binding two carbon atoms. We encounter the latter shape in the physiognomy of prostaglandins. It is the second bond between two carbon atoms which allows other atoms to attach themselves to them in order to produce prostaglandins whose role will be described later. Now, we can understand why plyunsaturated fatty acid is called the "precursor of prostaglandins".
This is a gimmick to identify saturated and poly)unsaturated fats: we must remember that the more double bonds there are, the lower the melting point is. If fat is solid at room temperature, it is saturated. If it is in liquid form, it is unsaturated or polyunsaturated. We must point out that two fatty acids are as important in the human diet as vitamins: linoleic and gamma-linolenic acid. The organism is unable to synthesize them. Therefore, they must be provided by food. They are common constituents of plant lipids and of some fish oils. We can say, in order to simplify, that lipids of animal origin are saturated. But there is one exception, which is extremely interesting: fish oils consist of both polyunsaturated and unsaturated fatty acids. We will se why they are so interesting later.
It is not necessary to report in detail the difference between LDL and HDL cholesterol. Just let us remember that LDL cholesterol (Low Density Lipoproteins) tends to increase the risks of atherosclerosis, as it transports cholesterol to the body tissues. However, HDL cholesterol (High Density Lipoproteins) tends to diminish them, as it transprts cholesterol away from the tissues. Many studies have demonstrated that polyunsaturated fatty acids have an action in lowering the cholesterol level. Even if this action has not yet been clearly explained, it is presumed to be due to the combination of three different processes: decreasing the absorption of cholesterol, affecting the distribution and metabolism of cholesterol and increasing the excretion of cholesterol. Studies have shown that saturated fats play an energetic role. They are either "burned" in order to give off heat and energy or are "stored". When there is too much saturated fat in the diet, this excessive storage results in atherosclerosis, thrombosis, gall-stones or obesity. Polyunsaturated fats play a very different and even more healthy role. They are called essential fatty acids. They take part in structuring the organism, as they act in the building of certain essential molecules, such as prostaglandins or lecithin. They make up the membrane of all cells. Moreover, they are the basis of lipoproteins which are the vehicle carrying cholesterol in the blood. In this way, cholesterol cannot be deposited on the arterial walls.
Consequently, it is recommended to have essential fatty acids as a dietary supplement. It is important to note that this supplement must be made with natural products. The modern manufacturing process of some products. The modern manufacturing process of some products reputed to be "healthy" (like margarines, for instance, that need hydrogenation), transform the molecules in such a way that they loose their properties and, are no longer recognized by the organism. As they are not metabolized, they are stored and cause damage.
Evening Primrose Oil is extracted from the seeds of this plant (Oenothera biennis Lamarkiana) by simple pressure without the use of heat, solvents, etc. This oil gives the body essential Omega-6 fatty acids: linoleic and gamma-linolenic.
Premenstrual syndrome disrupts the life of many women. It is characteized by headaches or migraines, painful tension in the breasts, bowel problems, irritability and anxiety. These troubles have been recently attributed to a deficiency of some fatty acids: gamma-linolenic and linoleic acids which are precursors of type 1-prostaglandins. The vegetable oil used in food and margaines could normally give linoleic acid. But the technological manufacturing process and cooking modify it in such a way that the organism is unable to produce type 1-prostaglandin with it. In order to avoid premenstrual syndrome troubles, it is obviously important to take some natural elements necessary to produce these prostaglandins: linoleic and gamma-linolenic acids.
Primrose Oil is an ideal nutritional supplement, because it give 72% of linoleic acid and 10% of gamma-linolenic acid. Moreover, these fatty acids are natural. This oil is particularly effective in treating the following disorders: -premenstrual and hormonal troubles, -circulatory troubles: varicose veins, hemorrhoids.
Borage Oil is extracted from the seeds of borage (Borago officinalis) by first cold pressing. Borage Oil gives the body two essential Omega-6 fatty acids: gamma- linolenic acid and linoleic acid. Borage Oil is the richest natural source of gamma-linolenic acid. Primrose oil also contains this acid. Gamma-linolenic acid is very useful as a direct precursor of type 1-prostaglandins. These prostaglandins are essential for a good activity of the skin cells. These functions concern, not only skin tissues, but also the nervous tissue, the circulatory system and the reproductive organs. We know that the organism is able to transform linoleic acid into gamma-linolenic acid. But the enzyme responsible for this action is often subjected to the influence of an unbalanced diet or weakened by old age. This is why it is recommended to take borage oil for the necessary gamma-linolenic acid which the body needs.
A supplement of borage oil is useful in cases of: -skin troubles (premature wrinkles, lack of elasticity) -to fight against aging of tissues -nervous troubles (stress, anxiety). Borage Oil can be applied externally by piercing the capsule with a needle, then spreading on the face and other parts of the skin that need to be treated (wrinkles, eczema, dry areas, stretch marks, etc.).
Castor Oil is obtained from the husked seed of Ricinus communis. Castor Oil has been traditionally used for several generations, in order to alleviate constipation. Its action is immediate. It is also used externally to tone down skin freckles. In this way, one only has to pierce the capsule with a needle and to apply the oil to the skin with light, gentle massages.
Olive Oil is extracted from the fruit of the olive tree (Olea europaea). It contains 70 to 85% unsaturated oleic acid and 9 to 14% unsaturated linoleic acid. In addition to its nutritional value (more than 85% unsaturated fatty acids), olive oil is commonly used in order to facilitate elimination of bile, digetion or to relieve the liver. When it is taken in the morning on an empty stomach, olive oil causes the gall bladder to contract, which facilitates the elimination of bile. Olive oil is also used in case of moderate arterial hypertension.
Mineral Oil possesses very long carbon chairs which cannot be assimilated by the organism. Mineral Oil is calorie free and is traditionally used in treating disorders of the intestinal transit such as constipation. It coats the walls of the bowels, makes the transit faster and decreases the assimilation of food. Consequently, Mineral oil is effectively used in weight loss diet.
Salmon Oil is obtained from salmon caught out at sea during the cold season. In a natural way, Salmon Oil brings essential Omega-3 fatty acids to the body: eicosapentaenoic and docosahexaenoic acids (EPA and DHA). EPA and DHA
It has been observed that the Eskimos of Greenland do not suffer from cardio-vascular troubles. Recently, research has proven that certain fatty acids in fish oil - fish is the favorite food of Eskimos - increase the protection of the organism against cardiac troubles and improve the glandular, nervous and enzymatic functions. These Omega-3 fatty acids are EPA and DHA. EPA allows the production of type 3-prostaglandins which have an action on the vicosity of blood, the arteries, cholesteol and triglycerides. DHA is an essential constituent of the cells' membranes, especially in the brain and retina. The organism is not able to produce enough type 3-prostaglandins for its needs because of a possible excess of saturated fats in the diet or due to old age. Prostaglandins are very important for our well-being. It is essential to avoid the physiological disorders that can result from a deficiency in prostaglandins. Our body must be able to provide their direct precursor: EPA.
Salmon Oil supplies 12% of untreated EPA. The value of EPA and DHA is proven at four different levels: -heart (protection against excess cholesterol, atherosclerosis, cardiac attack, angina pectoris). -blood circulation (varicose veins, sensation of heaviness in the legs, hemorrhoids). -aging (to fight cellular aging). -troubles due to unbalanced diet (obesity, inflammatory cases, rheumatism, cellulitis).
Certain herbs have been used throughout history to alleviate coughs, treat asthma, and relieve the symptoms of bronchial infections of many types. One such herb, Coltsfoot Tussilago farfara), is very popular for this purpose. In fact, a replica of the coltsfoot flower used to be placed above the doorway of Pharmacies in Paris, as an emblem of effective medicine. Coltsfoot combines an expectorant action with a soothing, healing quality thought to be due to its high mucilage content. What is interesting about coltsfoot, is that one of the ways it was used was to smoke it as tobacco. The smoke from the herb has been shown to be medically beneficial. Interestingly enough, the healing nature of coltsfoot smoke has shown benefit in a related, but perhaps unexpected area--as a tobacco substitute for those who want to stop smoking! Cigarettes made with Coltsfoot do not contain nicotine, but resemble regular cigarettes in most other ways. Thus, a person can smoke a herbal Coltsfoot cigarette and derive all of the same sensations of smoking a tobacco cigarette, except for the nicotine. This is very helpful, because most physicians feel that the smoking habit is composed of two factors: (1) the nicotine addiction (2) the mental habit, or "feel" of smoking . Being able to continue to enjoy the habit of handling, lighting, puffing, etc., the cigarette while breaking the nicotine addiction greatly increases the smokers ability to deal with the problem. Studies have shown that the gradual replacement of regular cigarettes with non-tobacco herbal cigarettes is an effective aid in tobacco detoxification. A study in France compared three groups of smokers. One group received only acupuncture and counselling. The second group received the same, but also received lobeline. The third group used herbal Coltsfoot cigarettes instead of the lobeline. After one month, the success rate on the third group (Coltsfoot cigarettes) was twice as good as the other two groups.
**Note, since these was written the cigarettes have been reformulated, and no longer contain Coltsfoot.
Michael Tierra, L.AC. O.M.D., Founding Member of the American Herbalist Guild
For many, herbal medicine represents our interdependent connection with nature. This exerts both direct and indirect effects on us in many ways, not least of which is an affirmation of our relationship with plants. Unfortunately, this is becoming all too frequently overlooked in an effort to capitalize on what, according to New Hope communications, the latest total herb sales was at 4 1/2 billion dollars for 1997. A significant part of the increase of sales is based not merely on the sale of popular herbs such as St John's Wort , Ginkgo, Echinacea, Garlic and Saw Palmetto, but specifically their use in the form of standardized extracts.
Standardized extracts arose out of the need to create a uniform product for clinical trials. Broadly speaking, there are two types. One is based on identifying and quantifying an extract to a characteristic chemical marker compound. The second, identifies and concentrates one or more as active constituents, making it closer to the level of a chemical isolate. This means that other naturally occurring constituents are displaced at the expense of one or a number of compounds.
Those who support standardized extracts believe that they represent a trend towards higher technological refinement. They believe that they will provide a more consistent, stronger and more effective product backed by chemical analysis to confirm the presence and ratio quantity of one or a number of characteristic plant constituents. They further assert that this will increase consumer confidence and that this is ultimately good for greater acceptance of herbs by the medical establishment and the mainstream.
Certainly many of these are positive in many of these respects but there remain important critical issues to consider. Quality and effectiveness may be compromised in a number of ways:
Is history repeating itself? The oft-repeated pattern of suppression followed by assimilation and relegated obsolescence of herbal medicine has occurred repeatedly since the suppression of tribal medicine and herbalists by the early church.
More recently, in 1901, the AMA whose supremacy was threatened by the growing popularity of homeopathic and Eclectic herbal medicine, reversed its ongoing antipathy "by cordially inviting them all to become members as long as they were prepared to give up their formal allegiance to Babels and sects. And once inside the fold they could, of course, practice exactly as they pleased: '˜when so elected, they are no longer homeopaths or eclectics, but are promoted to be plain physicians like the other of us'.".
From the 1920's to 30's herbal medicine went into decline as discoveries of various chemical drugs and antibiotics were discovered. As today, with the possibility of developing patents on research and standardization protocols for herbs, pharmaceutical companies from the late 20's to the present grow powerful and fat from huge profits made from the manufacture of patentable drugs.
From the late 1920's to the present, with the help of the FDA who "shared this disdainful view of herbs," the use of herbs was rapidly dropped from the United States Pharmacopoeia. Their reemergence reoccurred in the late 1960's as increasing numbers of people were experiencing side effects from the tendency to suppress symptoms with drugs. Furthermore, there was an entire generation of anti-war hippies who felt disaffected from the mainstream and became interested in herbal medicine as part of a movement towards independence and self sufficiency,
Today we find pharmaceutical companies rapidly entering the herbal market. They first had to see the possibilities of profit based on expanding markets and a patentable product. The potential market is huge and growing incrementally. The next step, however, was how to realize enough profit to justify a costly campaign of research to increase credibility. Herbs unlike chemical drugs, themselves are not patentable. However, a standardized product used for research is patentable.
An herbalist who was one of the first to examine and pass judgment on standardized extracts and highly concentrated herbal preparations was Dr. Alfred Vogel of Bioforce Company of Switzerland. In his laboratory at Roggwil, Switzerland, he concluded that tinctures of the whole plant were more effective than fluid extracts that were extra concentrated according to active principles. Vogel eloquent states:
The "other" factors that control the effects of the preparation are nowadays known as "information" and are of decisive importance in plant medicines to the reinforcement of the body's own curative powers. Depending on the dose involved, this "information" makes a considerable contribution to the effects of plant medicines. This "information" is destroyed by the artificial concentration of the active substances."
An overview of some of the main German companies that were among the first to produce standardized extracts may give us some intimation of the direction of the herbal movement in the United States.
Lichtwer-Pharma is in a suburb of Berlin. In 1981 they became established as a company to manufacture a small product range of herbs. These include garlic, valerian, St Johnswort, and hawthorn. The goal of the company has always been to make plant-based medicine that would be acceptable to conventional medical practice. To this aim, it has invested heavily in research and technology.
Focusing first on one of the world's most commonly recognized medicinal herbs, garlic, they were able through research to establish garlic's effectiveness against increased blood lipids. With heart disease in Germany and the US being the number one killer, they found that a high quality garlic product standardized to 1.3% alliin, 0.6% allicin release was effective enough to launch a worldwide campaign selling Kwai garlic. The venture was phenomenally successful worldwide, with the sale of Kwai garlic in 1992 at around 40 million dollars. Because of the huge money it spent in research while seeking a license for its garlic product, the company was able to aggressively market a prescription garlic product to doctors on the basis of its ability to strengthen the heart and counteract many of the conditions associated with aging.
The same formula for success occurred by targeting the most common mental illness, depression. Again, investing in a strictly controlled clinical trial they used a standardized extract of St John's Wort known as the "sunshine herb" because it stimulates bio-photons that increase sun absorption. To any vested pharmaceutical company the opportunity to validate the efficacy of a product leading to approval by investing sums of money for research is the formula for phenomenal success. Launched on the market in 1994 as Jarsin 300 and marketed to doctors by 1996, standardized extract of St John's Wort was outselling its rival, Prozac. Does this really mean that a high quality St John's Wort product will not prove to be as much as and perhaps even more effective than its standardized counterpart. In the case of hypericum this could be the case. Especially since recently it has been found that the active constituent that standardized St John's Wort has been standardized to, .3% hypericin, is inaccurate because it is really another of the 100's of compounds in St John's Wort that is the real active, hyperforin. Already, German pharmaceutical companies are gearing up to market St John's Wort standardized to its content of hyperforin.
While St John's Wort outstripped Kwai garlic in annual sales, both of these were completely dwarfed by the sale of Ginkgo Biloba standardized to 24% flavoglycosides by Schwabe pharmaceuticals. Gingko Biloba nuts are traditional in Chinese herbal medicine as a lung tonic for asthma but few if any Chinese know of the use of the leaves as a remedy against the ravages of '˜baby boomer' senile dementia. There may be an ancient reference for this use in the annals of Chinese medicine but essentially, this product sprang on the market with no reference to previous empirical data. As such it could be heralded as a triumph by western pharmacy over empiricism or traditional use. This was further underscored by the fact that based on their research, the most effective standardized form required 50 parts of the slightly yellowed autumn harvested leaves to be reduced to one part with further extraction with highly toxic solvents to arrive to produce this product. Sales of this product is unprecedented if for no other reason than the fact that there are no synthetic drugs known to be effective for senile dementia.
The pattern repeats itself, first launching it simultaneously as a prescription drug in Germany and France, total sales worldwide in 1992 of Gingko standardized extract was 195 million dollars.
A perusal of the editorial and advisory boards of leading magazines on herbs and alternative healing presents a wall of PHD's, MD's with perhaps a smattering of naturopaths and rarely a token clinical herbalist. Most are not on these boards because of their clinical experience in the use of herbs but because of their academic standing. Many of these such as Varro Tyler scarcely less than a decade ago could barely be counted as a supporter of herbal medicine.
I have always considered it profoundly naïve to expect that most researchers and academics whose funding directly or indirectly comes from pharmaceutical companies can be trusted to represent herbal medicine as an art and science distinct from the reductionist thought processes of contemporary medical science. As such, I find that the public media and various herb journals attempt to achieve credibility by including these unqualified individuals posing as having practical hands-on clinical herbal experience is very misleading. Certainly one of the most misleading of all stances that is all to often advocated is the patently inaccurate statements that the use of standardized extracts are the only way to assure identity, quality and efficacy.
As briefly described, by definition, a standardized herbal extract involves predetermining one or a number of biochemical constituents as either active or as marker compounds. The result involves two very distinct types of extracts.
One: a marker extract: This type establishes that a specified amount of a marker compound is present in the finished product. It must be remembered that a marker does not represent the active constituents but is selected as a biochemical constituent characteristic of the plant. In many cases, if this process uniformly increases all plant constituents to an intended level. In general, the insoluble compounds, such as cellulose and fiber, are excluded. In some cases the concentrated extracts remain dried and powdered while in others they are mixed with a neutral material such as corn starch, and in still others, the extract is mixed with the fine granules of the whole herb. The most important distinction is that marker extracts are not based on the concentration of a proven active constituent, but are used for positive identification or to create a higher degree of uniform potency. As for the latter, it as yet remains to be proven whether this is consistent with the potency of the whole herb.
Considering the fact that all herbal preparations are to a degree an extract, a marker extract that equally regulates all constituents, retains more relationship to the traditional way herbalists use herbs. Another problem is the propensity to overly promote one use over many others that it may have. This tends to be based on a named pathology, such as feverfew for migraines, St John's Wort for depression, devil's claw for arthritis. Traditional herbal medicine uses herbs more functionally rather than for the treatment of specific pathology. Felter described the Eclectic tradition's specific indications for hypericum as including a range of conditions from spinal injuries, concussions, chronic urinary disorders, to various pains associated with bruising, injuries and puncture wounds and finally as a sedative for hysteria which may in modern usage translate to its anti-depressive properties.
There are some differences as to how each herb is treated but in general the following is a list of some of the better known Marker Extracts.
|Examples of Marker Extracts: Artichoke (2-5% cynarin), Chamomile (1.2% apigenin/0.5% essential oil), Devil's claw (5%harpogosides), Echinacea (4%echinacosides), Ephedra (6-8%ephedrine/pseudoephedrine), Feverfew (2.6% parthenolides), ginseng (5-15% ginsenosides), Goldenseal (5% hydrastine), Horsechestnut (20% Aescin), Uva Ursi (20% Arbutin), Gotu Kola (10%asiaticosides), Green tea (20-50% polyphenols), Licorice (12% glycyrrhizin), St Johnswort (0.3-0.5% hypericin), Schisandra (2.6-4% schisandrins), Valerian (0.8-1% valerenic acid), Willow (8%salicin).|
Second: an active constituent extract : This regulates a specific biochemical constituent to a level that may not be naturally found in the plant. Concentrating 95% curcuminoids, for instance, in a standardized turmeric extract creates a product that while derived from the crude herb, is not expected to be naturally found concentrated at that level. This leaves only 5% of the other turmeric constituents with which the curcumin is combined.
There are at least three specific and obvious problems with pumping up one constituent of a product at the expense of its other constituents:
The problem of exclusively promoting an herb as a standardized extract overlooks the range of many of its other uses. For instance, Milk thistle seed extract is specifically sold as a liver protective agent while the Eclectics according to Felter and Lloyd as quoted in Ellingwood described a much wider use. These include a dull aching pain over the spleen that passes up to the left scapula associated with pronounced debility and despondency, splenic pain with or without enlargement. Further uses indicate that it was known to improve blood circulation especially in the pelvis making it particularly useful for dysmenorrhea, amenorrhea and irregular passive uterine hemorrhages.
|Examples of Active Constituents Extracts are Gingko (24% flavoglycosides), Milk thistle (80%silymarin), Grape seed (95% polyphenols), turmeric (95% curcumin), Saw palmetto (90% free fatty acids), Green tea (60%catechins), Cascara sagrada (20-30% anthraquinones), Bilberry (25%anthocyanosides), Pygeum (12% phytosterols), Kava (30-40% kavalactones).|
It is known that in fact, very few herbs in trade are reliably standardized to known active constituents as opposed to possibly inactive markers? Joerg Gruenwald is one of the editors for the German Commission E Monographs, a recently published book that is regarded as the highest recognized standard in the western world on medicinal herbs and plant products.
He states that: "only 5% of botanicals are standardized to the one and only known active constituent, but even this is changing day by day. Sennosides in senna are still regarded as the active constituent in senna but the kava lactones in kava or the ginsenosides in ginseng are questionable as to whether there are no other actives involved." He further points out that a "maximum of only 10-15 botanicals have undergone well controlled clinical trials and it is doubtful whether all of them will hold up to FDA standards."
This means that one who exclusively relies on using a standardized extract based on known active ingredients, except for a very few, might be just as well or even better served by using a quality non-analyzed herb product. Certainly it will be cheaper in cost and even the quality of herb used is likely to be superior because the manufacturer would be selecting herbs based more on quality than quantity. Despite these considerations, Joerg Gruenwald is of the opinion that standardized extracts are "in any case more valuable than non standardized extracts and more valuable to the consumer." Implying that presently there are shortcomings in present standardization methods, he echoes the opinion of a few researchers that there are shortcomings in current standardization methods, and offers the opinion that "the best way to standardize would be a bio-chemical standardization on the majority of active constituents."
Imagine telling a traditional Chinese herbalist that they should only use phytopharmaceuticals in the form of standardized extracts. Do you not agree that Chinese herbal medicine, an empirically based system that has demonstrated efficacy for 1000's of years is probably the most powerful "system" of herbal medicine on the planet? They do not treat primarily by named diseases but conditions that give rise to disease. This is what traditional herbal medicine is best able to do. Certainly concentrated extracts of all ingredients of high quality botanicals can be used in this practice and I use them a great deal in my practice as 5 to 1 dried extracts. They are not as effective as the nasty tasting herbs but there is better long-term patient compliance. So we lose and gain something in the process.
Except for researching the action of a specific or a limited group of plant constituents, why do we need them? What Rudy and Bonati are pointing to is that to truly standardize, every variable concerning the growth, harvest and preparation of a plant must be controlled. From their perspective, it is disadvantageous to use wild herbs because they may not be up to standard. Herbalists have for centuries used highly effective methods of selecting and sorting herbs according to their quality. This is also standardization. At the same time, there is a strong tradition that wild herbs are generally superior to cultivated.
The opposite is advocated by the advocates of standardization. Further, to accomplish the standard of standardization that is advocated to arrive at a truly standardized extract, it would require such tremendous technology that not only will smaller companies be pushed out of the picture, but it will only leave the pharmaceutical companies who have the $$ ability to even approximate such standards. Again the recurring leitmotif, why?
This movement while attracting more consumers to herbs is really luring them to what I am afraid is the ultimate eclipse of herbal medicine as an alternative. With the pharmaceutical companies in control, they have taken patients interested in herbal medicine and convinced them to come closer to accepting a more drug-like form called a "phytopharmaceutical." Now who is in charge?
Anything can happen at that point of evolution. All that needs to happen is for science to come up with a synthetic of something that has enough of the virtues of hypericum with perhaps none of the unproven risk of photosensitivity, to for doctors to persuade patients, under the advice of the pharmaceutical company, to use the '˜cleaner' and more effective hypericum-like synthetic.
Drugs go into obsolescence all the time. Once herbs are regarded as phytopharmaceuticals it is a short stretch for them to be considered as just another drug.
It seems that what we gain from this treatment of herbs is too little and what we lose, the ability to treat patients by a distinct medical paradigm encompassed by the term wholistic or traditional herbal medicine.
Currently the .3% hypericin of St Johnswort has been found to be inactive as an anti-depressant compared to a new compound called "hyperforin." Because of this the Germans are now revamping their products to standardize to hyperforin. Herbalist, Jonathan Treasure believes that this points out the essential "flaw in assuming that any single compound is the active." Considering the broader uses and applications of St John's Wort , it is "conceivable that hyperforin standardized products will be devoid of anti-inflammatory, anti-viral, vulnerary, analgesic and anti-neuralgic activity until some bright spark discovers the "active" for each of these actions."
Australian herbalist, Kerry Bone compared a standardized extract of turmeric at 75 to 95% curcumin with the constituents found in the whole root. He discovered that there were dozens of other constituents in whole unadulterated turmeric that also possessed anti-inflammatory properties. Some of these may be as potent or even more potent than curcumin. By concentrating curcumin to an unnatural 75 to 95% standard, some of the flavonoids and volatile oils (the warming element) are lost. Thus it may be that Standardized turmeric extract with 95% curcumin is most effective as an anti-inflammatory but not so effective as a digestive and circulatory stimulant. Again, there is nothing wrong with having both choices available turmeric high in the anti-inflammatory curcumin for joint and gall bladder inflammations and the whole root that can also be used for blood circulation and digestion. The unanswered question based on lack of research is whether the whole herb is as effective for inflammation as the standardized extract. Herbalists may argue that it is so then why bother making a standardized extract based on the high concentration of curcumin? Again, the reason for the original development of the standardized extract of turmeric was not because it would be superior but because it is more appropriate for controlled study and research based on the high concentration of curcumin.
Plant chemistry is extremely complex representing a vast number of chemical compounds. The complexity of this issue raises serious concern of what might be gained or lost if we limit ourselves to a standard of exclusively using only standardized extracts. The following is a citation on turmeric from Jim Duke's herbal database:
Turmeric '“ for arthritis:
Analgesic '“ Borneol, caffeic-acid, curcumin, p-cymene, eugenol
Antiedemic: borneol, caffeic-acid, caryophyllene, curcuminoids (Tetrahydrocurcumin>Curcumin>Triethylcurcumin), eugenol
Antiinflammatory: Azulene, bis-(4-hydroxycinnamoyl) '“methane; borneol, caffeic-acid, caryophyllene (IC50+100 uM), cinnamic-acid, curcumin; eugenol (11 uM), feruloyl-4-hydroxycinnamoylmethane; alpha-pinene, protocatechuic-acid, beta-sitosterol, vanillic-acid Inhibit Cyclooxygenase: Curcumin; galangin (5.% M)
Inhibit Lipoxygenase: Borneol, caffeic-acid (IC27+5 mM), cinnamic acid
Inhibit 12-Lipoxygenase: Curcumin
Inhibit Production of Tumor Necrosis Factor: Curcumin
From this we see that curcumin, as the standardized marker for turmeric are effective for the widest number of applications. Further, it is a compound that is certainly unique to the herb. There are a few conditions, such as the use of turmeric for skin conditions (antidermatic) and a lipoxygenase inhibitor where curcumin has no relevance. This means that a 95% curcumin standardized extract of turmeric cannot be relied upon to be effective for skin conditions (a known use for the herb in India). We notice the wide number of other compounds that are indicated for the rest of the conditions and again, in a standardized extract, with 95% curcumin, we'd better be right that this is the most active component of the herb.
The American Herbalists Guild (AHG) was founded in 1989 in Santa Cruz, California. The Guild was originally conceived among other reasons to "Develop a professional body that promotes and maintains excellence in herbalism, including individual and planetary health." The AHG is primarily intended to represent clinical herbal medicine in North America. Its professional membership, whose members are admitted through a process of peer review, represents a considerable number of years of collective clinical experience that should not be overlooked in any honest inquiry or discussion about the efficacy and safety of herbs. Considering the level of representation in the media's advisory boards and research projects, one hardly finds in many of them professional clinical herbalists among.
Concerning standardized extracts, generally, professional AHG member, Christopher Hobbs has stated in a feature article for the Vitamin Retailer (March, 1997), "while the scientific work around standardization has certainly given our industry more credibility, especially in the medical field and the mainstream --- don't equate standardization with efficacy and potency." While insisting on using high quality herbal products, most clinical herbalists would agree that standardization, too often used as a marketing ploy, does not necessarily guarantee that it exists in all projects sold as a "standardized extract."
The primary reason standardized herbal extracts exist is because they are considered necessary to achieve as much control in double blind studies as is possible. Researchers, however, never intended to establish that standardized extracts were superior to whole herbs or more conventional preparations.
According to herbalist, Bob Brucea, "Standardization does have advantages. It produces a consistently strong product with guaranteed constituents. When you consider the quality of most commercial herbs, this at least assures that they have something in it and that the correct herb is being used." He and many herbalists such as Canadian AHG herbalist, Terry Willard look to the brighter side with standardized herbal products enabling a quantum acceptance by more people including doctors and pharmacists who are accustomed to consistency and percentages of active constituents. As pioneer herbalist, Ed Smith satirically said, we need to accept the fact that "we baked the pie and now everyone wants to have a piece."
The major proponents of standardized extracts view herbs as medicine in a way that is fundamentally different from herbalists.
Dr. Rudolf Bauer, one of the leading botanical research scientists in Germany states the three primary reasons for the standardization of herbs into phytopharmaceutical drugs. He states that 1. "If phytopharmaceuticals want to be regarded as rational drugs, they need to be standardized and pharmaceutical quality must be approved, 2. Also, in pharmacological, toxicological and clinical studies with herbal drugs, their composition needs to be well documented in order to obtain reproducible results, 3, The World Health Organization (Who) has recognized this problem and has published guidelines to ensure reliability and repeatability of research on herbal medicines, 4. This concept should be followed not only in research, but also in the production and therapeutic application of phytopharmaceuticals."
The key here is the implication inherent in the word "drug" and the inclusion of herbs, which as "phytopharmaceuticals" are no longer herbs in the sense that a traditional herbalist might approach them but plants treated and rendered as close to the definition of a drug as possible. From the perspective of this paper, the question is what is involved in making a traditional medicinal herb conform to the standards of a drug i.e. phytopharmaceutical?
Herbs are described and identified as "chemovarieties" and "chemocultavars" that offer uniquely fascinating problems by the fact that they "are always mixtures of many constituents and it is much more difficult to characterize such a complex mixture than a pure compound." Conceding that the "active principle (s) of compound are not always known,"
Who is it that needs herbs in this form and used in this way? Researchers attempting to get a grant or funding for research on the medicinal properties of plants, the pharmaceutical industry and the medical establishment, which is not interested in being transformed by wholistic herbal medicine but into changing it into something that will be acceptable within their paradigm, and the herb industry who through marketing, can capitalize on the union of science and herbal medicine to develop a competitive edge in the market. It is understandable that this would not sit well with most clinical herbalists and the many who were drawn to the use of herbs based on a need to affirm their connection and interdependence with nature.
The question really is whether this is necessary and to whom and for what? Is it necessary for effective herbal practice? Hardly --- imagine telling a Chinese herbalist that it is best for he or she to use only chemically standardized herbal extracts in the form of phytopharmaceuticals?
It is a key point of this of this article, however, that standardized extracts, and I think we are mostly referring to active constituent extracts, have very specific applications as compared with commercial, non-analyzed whole herb products. As such they might not always be the best choice. Studies comparing the effects of standardized biochemical extracts with whole herbs or conventional preparations would be very enlightening. Unfortunately, so far there has been no enthusiasm for such a study because there is more profit to be made from the sale of standardized extracts.
Another reason favoring the use of standard extracts is that they assure positive identification that the herb is what it is claimed to be. Cheating and misrepresentation has been endemic in the field of herbalism at least since the time of the Egyptians and Greeks. We read in ancient records complaints of receiving bogus herbs or herbs of inferior quality. Michael McGuffin, co-founder of Zand Herbal Formulas and former chairman of the board of trustees of the American Herbal Products Association (AHPA) is one who sees standardization as a positive evolution in the use of herbs. He seems to agree with Michael Murray and Varro Tyler when he states that "a standardized extract can ensure that sufficient amounts of the herb's constituents are present to deliver an efficacious product." In fact, however, this is not quite accurate. What it does assure is that there is a sufficient amount of the "marker" compound.
While using standardized extracts based on a biochemical "marker" offer a high level of reliability in terms of knowing that one has the right herb, chemical deception has also occurred. Herbal extracts can and have, according to Jim Duke, been "spiked" to deceptively register a particular level of an individual marker compound in an adulterated extract using the wrong herb. Therefore, while a standardized extract of a particular herb may offer a degree of assurance that the product is what it claims to be, even with this method, it is possible to be deceived and cheated, winding up with the wrong herb in an adulterated form of a standardized extract.
Herbalist-acupuncturist David Maloney a licensed acupuncturist, Chinese herbalist and professional AHG member expresses concern that "when pharmaceutical companies start to use standardized extracts, we may perhaps see less scrupulous standards with the adulteration of artificially derived non-herbal compounds, say with coal tars, in order to increase profitability. This would comprise the additional compounds that are supposed to be with the "marker" and perhaps there may be no actual active constituents in the final product." He facetiously asks the question, "how many "markers" do we need in each herb to authenticate the product?"
One consideration is that standardizing to a single biochemical compound requires exponentially higher quantities of herbs. Unless we are confident in the overriding importance of an isolated chemical constituent, as opposed to the use the whole herb, it is wasteful to support the harvest of tons of herbs for this purpose. Furthermore, the harvest of such huge quantities of an herb invariably threatens quality. We certainly don't need to include as a description of standardized herbal products '˜standards' that herbalists consider important such as '˜organic' and '˜wildcrafted.'
Part of the implied assumption is that before the availability of standardized herbal extracts most herbal products were inferior. The truth is that there are many herbal companies who make high-quality herbal products. Further, one advantage a smaller company has over a larger one is that it needs less quantity to achieve superior quality, while the manufacturer of standardized products is more likely to sacrifice quality of botanical material for quantity. Whether using conventional herbal products or standardized extracts the primary guarantee is not in the form of the final product but developing confidence in the manufacturer.
Attempts at standardization of herbal products as previously stated, is not new. In fact it reaches far back perhaps to the first time someone threw some leaves into a cup of boiling water on a campfire to treat their upper respiratory condition, their digestion or their arthritis. Herbalists have defined standards of how and when to harvest medicinal herbs as well as how they may be dried, powdered and extracted in water or alcohol. All of these are processes of standardization.
Historically there have been highly sophisticated methods of herbal extraction and processing. They abound in folkloric, Traditional Western, Traditional Chinese Medicine (TCM) and East Indian Ayurvedic medicine. Some of these methods such as the detoxification of aconite by preparing it with salt and/or long boiling decoction are a mainstay of TCM practice. East Indian Ayurvedic medicine employed many ingenuous and complex methods of extracting, concentrating and preparing herbs for specific conditions. In this regard, the purified guggul sterones are traditionally extracted from crude guggul resin (commiphora mukul) in a botanical decoction consisting of equal parts chebulic myrobalan, emblic myrobalan and beleric myrobalan, a formula widely known in India as Triphala
While many believe that herbal medicine is generally safer for most conditions false assumptions are often made when this is based on the fact that it is because it is more natural. A natural poison can kill often as efficiently as a synthetic one. Traditionally, before the advent of modern synthetic drugs, the goal of healing was not predicated on whether it was a natural or unnatural method but only on whether it provided relief from suffering and disease.
What a standardized herbal extract purports to offer when it is standardized based on an active constituent, is the opportunity to use herbs in a more special way for specific predetermined therapeutic objectives. Ginkgo leaf standardized to 24% flavoglycosides to increase blood circulation, especially to the brain, is used instead of its more traditional use by the Chinese as a tonic for the lungs. Ginkgo is a special manufactured product using highly extracted leaf concentrate that has no precedent in traditional herbal practice. This is not inherently negative in any way. However, herbalists generally maintain that it is the interaction of the myriad's of biochemical constituents that is responsible for their action. Other concentrated extracts based on a presumed active constituent such as ginseng standardized with 5 to 15% ginsenosides, turmeric with 85% curcumin and kava with 40 to 40% kavalactones, the valepotriates of valerian, the hypericin of St John's Wort , are disputed even by researchers. In fact, they probably offer no advantage in terms of efficacy over the use of move conventional high quality herbal products. The fact remains that unless such distinctions are made, the exclusive recommendation for the use of standardized extracts is misleading.
All of these issues are contested today by herbalists and researchers throughout the world. One solution is to use of a Full Spectrum extract that combines the appropriate dose of active constituent extract mixed with the powder of the whole herb. Until these issues are resolved, this may be a way to receive the best of both alternatives.
In fact, many of the processes of standardization are not standardized. Many herbs sold as standardized extracts are not consistently standardized to one marker. Nettle root is standardized by one company to 5% amino acids, by another to 8% sterols, and a third uses 35ppm, scopoline. Because it is not certain which of its constituents are responsible for its therapeutic action, Echinacea can be standardized to at least three different constituents and each used as markers by different companies. These include echinocosides, polysacharides and polybutylides. In fact, given this inconsistency, one might be as well or better off (certainly in terms of price) purchasing a high quality herbal tincture.
AHG. herbalist and owner and founder of Herb Pharm, Ed Smith, mentioned how of the 100's of Kava products standardized with 30% kavalactones, there is disagreement as to what number of lactones to make the standard as well as the best ratio they should be presented. He further states that in order to make such high extractions of specific chemical constituents, it is impossible to harvest herbs at their optimum. It takes considerably more time and effort to harvest most herbs at their optimum stage in the quantities needed for extraction. The old US Pharmacopoeias specified the use of fully ripened saw palmetto berries. These are deeply blackish and purplish in color. Herbalists have witnessed migrant workers harvesting hundreds of tons of green, sometimes yellow or orange berries, which are then shipped to Europe to be made into standardized extract.
Ed posits that "the fact that such poor quality material is being used to make standardized saw palmetto is probably why the standardized form has to be used in much larger doses than the fluid extract from fully-ripened berries."
Does standardization actually favor the use of inferior botanicals? All herbal traditions regard wild as opposed to cultivated herbs as superior. This is because the wild herb possesses adaptive qualities based on subtle factors of biochemical composition and potency that would be lacking in the cultivated variety. Without investigating or disproving this time honored understanding, the thought process that favors standardization reverses this in an attempt to control what A. Bonati describes as the "inconstant" nature of vegetable drugs, "influenced by several factors, "age and origin, harvesting period, method of drying and so on. " From another perspective, in our determination to create biochemically standardized herbal drugs, representing "a body of information and controls that are necessary to guarantee constancy of composition --- hence the standardized quality --- of a phytopharmaceutical drug." One thing that this suggests is that it would be preferable to use what herbalists consider inferior herbs that are cultivated rather than superior wild herbs for the manufacture of standardized extracts. In fact, of course, it makes no difference so long as certain constituents are present as either actives or marker compounds.
Another founding member of the American Herbalists Guild David Winston, an East Coast herbalist with over 25 years professional experience, points out that there is no standard for how standardized extracts are manufactured. This raises the basic question as to what is the best extract? Since industry has no standard even as to what chemical to standardize to or even what chemical methods to use to make standardized extracts there may be a significant non-standardized variance in the finished product. Again, considering the increased cost of standardized herbal products, this raises the question in many instances of '˜why bother?'
As stated, Adjusted biochemical constituent extracts involve bringing the product close to a total isolate. According to a number of sources including herbalist and herbal manufacturer Bob Brucea, co-founder of the American Herb Association this typically involves the use of a highly toxic and strong solvent such as hexane, benzene, methyl-chloride, acetone, etc. with an affinity for the intended constituent. It is impossible to completely evaporate and eliminate all traces of these solvents so there will be an FDA approved residue in the finished product. Of more serious concern is the adverse environmental impact with the possibility of these eventually draining into the ground water supply. For many, these are grave concerns and in the absence of research comparing the efficacy of adjusted biochemical constituent extracts with whole herbs or conventional preparations they may not see a compelling need to use extracts that are manufactured with these highly toxic solvents.
It should not be news that the health industry including the herbal industry is driven by fads. It's not always clear how or where many of these originate. With literally thousands of known medicinal herbs, everyone would like to find the magic bullet for a given condition. Rather than clamoring for a limited number of herbs as a standardized extract for treating a plethora of diseases, we should be more concerned about selecting the most effective herb or herbal formula. Neither quality nor potency can compensate for the fact that an herb may be ineffective for a given condition.
One of the fears from the increasing promotion of herbal standardized extracts is that it may make it difficult for small manufacturers of quality products to remain in business. This would not be an issue if, as we have mentioned, a standardized product has been proven to be superior to that of a traditionally made product. Small herbal companies may make from one to five gallons of tincture at a time. Considering that the manufacture of standardized herbal extracts may be wasteful and encourage the harvest of inferior herbs and that the cost for a biochemical laboratory assay ranges from $100 to $450 per test, it is not profitable for a small company to standardize on such a small scale.
As AHG herbalist, Chanchal Cabrera states, "Technology applied to botanical agents increases prices dramatically"--- and this tends to make standardization more motivated by a "desire to make money than a desire to heal people or to understand herbal medicine."
Standardized extracts arose out of the need to create a uniform product for controlled double blind, crossover, placebo-controlled clinical trials. Based on this, it seems reasonable to assume that to achieve a similar level of response, one should have access to the standardized version that was used in the study. That is why the public keeps insisting on the use of St John's Wort with .3% hypericin even though hypericin is no longer considered the primary active constituent. What is missing from this equation is the fact that the basis for why the herb was selected was because of some prior level of traditional usage. With no proof that a standardized extract is superior in its effects to a quality traditional herbal product, there really is no reason to exclusively use the standardized version unless it is based on a high concentration of known active constituents. Even if this were the case as with the use of Ginkgo biloba leaf extract with 24% flavoglycosides, the use of the concentrated extract makes it uniquely indicated in a way that is quite different certainly in potency and the presence of tannins, from the properties of the whole leaf.
Chanchal Cabrera echoes the concern of many professional herbalists when she states, "The public is led to believe that these standardized products are somehow better than nature can make them and are more desirable than the simple plant remedy." Later she pointedly asks, "Who really benefits by this technological approach to herbs? Are any of the standardized products really all that much better than traditional remedies? Are we in danger of losing our "roots," of losing touch the earth-centeredness of traditional medicines?"
These sentiments are reiterated even more bluntly by Anita Hales an Alaskan herbalist, "I think politics and marketing are the main driving factors of standardization. Standardization is becoming a marketing buzzword to sell products that may not necessarily be better than another product. It's a typical move to mediocrity not necessarily improvement."
Martha Benedict, a California State acupuncturist and clinical herbalist with over 25 years of experience and a professional AHG member makes the point: Standardization of itself is a chimera. There are too many plant components, interactions and interdependencies for us to be so witless as to think we can CONTROL the outcome of a complex event merely by controlling one or a limited number of active components of a plant. What hubris! Are we about to recapitulate the same narrow thinking which makes Western medical drugs so dangerous?"
It is possible to guarantee optimum levels of all plant ingredients without laboratory analysis. An example of traditional methods used by herbalists for centuries were described in the St John's Wort monograph by Christopher Hobbs, published in Herbalgram No. 40. Attention was directed to understanding all levels of growing requirements, best stage for harvest even to the best time of day that was optimum for yielding the highest levels of all known "active" constituents (evening). Other factors such as proper drying and storage were also evaluated. Though it requires training and experience this is a part of the art and science of herbal medicine.
When it is necessary to establish the positive identification of a plant, high-pressure liquid chromatography (HPLC) and nuclear magnetic resonance is used. These readings establish a fingerprint of the chemicals contained in the plant or extract. To establish the identity of a plant, matching biochemical fingerprints are all that is needed. However, it is possible to use the same process to only establish the presence of the marker compound of a standardized extract. A good lab technician will check the level of all known constituents but by failing to evaluate the levels of all known constituents, a company can still make a claim as standardized.
High doses of herbs as standardized extracts have their place in modern herbal medicine but not to displace the use of herbs in other forms. Because of their natural diversity it is impossible to categorically describe all herbs and herbal products as a single entity. The notion that there is only one chemical compound responsible for an herb's action is similar to saying that there is only one compound that is useful in a specific food. Therefore an extract based on one or a number of presumed active constituents are highly questionable.
Extracts based on a predetermined marker extract, are less at issue and may offer substantial benefits in terms of identity and potency. However, unless such marker extracts are derived from the same high quality botanical sources as more conventional preparations, their quality may be compromised. The fact remains, that for both types of extracts there has been no studies confirming or denying their efficacy.
It is possible following good conventional manufacturing practices to simply make a stronger herbal concentrate that is not standardized to a marker compound. All extracts offer certain benefits but they also tend to increase the risk of adverse reaction so that the dose needs to be carefully regulated.
Other considerations may be at issue in an industry whose traditional consumer base has been among the most ecologically sensitive. While that is changing, it nevertheless remains ethically responsible to inform the public of the use of highly toxic and environmentally polluting compounds used in the preparation of certain herbal extracts.
What primarily began as a need for standardized herbal extracts for use in clinical trials, does not necessarily translate into these same extracts as being the best for normal usage. We might want to be a little more cautious in our effort to modernize herbs through the exclusive adoption of standardized extracts. For thousands of years herbalists have been using and prescribing herbs both singly as well as in complex formulas usually in the form of tea. Considering that we know little not only of the complex chemical compounds of plants themselves, but even less of their synergistic relationship to each other and how that may effect therapeutic activity, there is really no intrinsic need to abandon the use of other traditional formulations.
Pharmaprint has developed a process where standardized extracts can be made based on many markers. While this is commendable, it still begs the question of why and of what relevance is this to clinical herbal practice? Each herb processed in this way costs a minimum of $500,000 for each batch. They can then license these products to other manufacturers for resale. There is rumor that Nature's Herbs is interested and one of the largest drug manufacturers, Centrum is putting six of these "superior" products in the market place this year, with six more scheduled for next year. Who will be able to afford Pharmaprint's state of the art standardized extracts? Thus, the push is on. Pharmaprint is also creating prescription herbal drugs based on their process. Again, the effect will be to further devalue already demonstrated, quality non-chemically standardized products. At this point, it is difficult to access the potency and efficacy of these artificially standardized herbal products over whole, non-standardized herbs.
Michael Tierra, Founding Member of the American Herbalists Guild, California state licensed acupuncturist, herbalist, with an Oriental Medical Doctor degree. Author of several books including the best selling Way of Herbs (Pocket Books), The Way of Chinese Herbs, Planetary Herbology, Chinese Traditional Herbal Medicine and the East West Herbal Correspondence Course. He has an extensive website with articles, books, forums and chat room at www.planetherbs.com.