Kratom leaves

 

See Part 1 of my series on kratom here.

I work at a local free clinic alongside other students and colleagues dispensing healing advice, free herbs and acupuncture. One of our regular clients is a woman who had been famous for her constant irritability and violent outbursts of anger. One day, unkempt, dirty, toothless, friendless, homeless, “crabby Judy” as I lovingly dubbed her, appeared in her customary angry and fitful self (though less so than as in previous months, thanks to our steady work with her). This time, she complained of chronic migraine headache and pain throughout her body. I decided to try giving her a teaspoon of the more uplifting white-veined kratom and administered some acupuncture on a bench outside of our clinic area. When I came back to her a half hour or so later, she specifically commented how her headache was nearly gone, her pains were greatly relieved, and in her own words she described how she felt “somewhat more uplifted.” Having treated her several times before, I could easily differentiate the beneficial difference kratom had on her psyche.

A wise man once told me that the most important aim of a healer is to instill hope in their patients. It is difficult to do this if a patient experiences the same complaints and pain as when they first came. My experience treating Judy that morning inspired hope in both of us; not that all of her life problems could be resolved but that with the help of a near-miraculous herb, kratom, we could each part with a sense of hope because she felt better.

I’m sure if you cut through the confusion and hype, you will see that kratom is not a cure-all, but many suffering people would find it useful.

Clinical Classification and Uses of Kratom

Mitragyna speciosa (Kratom)

Family: Rubiaceae (same family as coffee)

Energy and flavors: Warm and stimulating in small amounts; cool and sedating in large doses. Bitter.

Organs and channels affected: Liver, Lung, Heart, Large intestine

Chemical constituents: Over 40 alkaloids, especially mitragynine and 7-hydroxymitragynine. These are both opioid receptor cell agonists, occupying all but one of the opium receptor sites in the body. This is considered the reason that it can be used as an alternative to opioid drugs with none or few adverse side effects.  

Properties and actions: TCM: Relieves pain, Calms Shen, astringes Lung Qi, astringes the Large Intestine. Western: Analgesic, sedative, anti-anxiety, mild anti-depressive, anti-inflammatory, anti-diarrheal. Ayurvedic: pro-vata dominant because of its cooling and drying properties; anti-pitta because it is cooling; anti-kapha mainly because of its bitter flavor.

Uses and Indications:

  1. Pain
  2. Opiate withdrawal
  3. Alcohol withdrawal
  4. Speed-type drug withdrawal
  5. PTSD
  6. Anxiety
  7. Depression
  8. Insomnia
  9. Inflammation
  10. Diarrhea
  11. Cough

Note: Of the many indications described above, I have had particularly good results from individuals who suffer from PTSD with related severe bouts of anxiety and depression.

Dosage: Of the powder, 3 to 9 grams once to three times daily. Dosing is highly variable depending on the individual, the severity of the condition to be treated, the strain and strength of the kratom powder.

A widely published dosage recommendation is as follows:

  • 2 - 4 grams= mild stimulating effects (a teaspoon of powder is three grams)
  • 4 - 6 grams= medium effects (Stimulant or Sedative effects / Analgesic Effects)
  • 6 - 8 grams= strong effects (Sedative / Analgesic Effects; Too strong for most people)
  • 8 grams or Higher= very strong effects (Sedative / Analgesic Effects; NOT RECOMMENDED)

Note: The dosages above are not per-day doses but a dose taken at one time, once, twice or three times a day.

Always begin with the low to medium dose, usually about a teaspoonful. Its pain-relieving effects last anywhere from 4 to 6 hours. The dose can be repeated, increased or decreased as needed with the general rule that one should take as low of a dose necessary. The dose can be increased gradually based on and as needed basis according to the above dosage guidelines.

To reiterate: only take the minimum dose necessary. (I don’t recommend using it recreationally – it is actually just not that much fun!)

The Three Predominant Strains of Kratom Are Classified as Follows:

Red-veined

Green-veined “maeng da

White-veined

Considered the most sedative and pain relieving

Medium potency, most useful clinically

More stimulating, rather than sedating and pain relieving


All three strains share the same basic properties with various strengths and potencies as described above.

Since the powder is the form most commonly used, I usually recommend ingesting a teaspoon of the powder and quickly washing it down with water. Because the properties of kratom are based on its alkaloids, it is most powerfully absorbed when it is taken with a little apple cider vinegar mixed in water or lemon juice. Some people have trouble tolerating its bitter flavor; to offset this, some take kratom mixed with chocolate milk or chocolate.

Can You Build up a Tolerance to Kratom?

Though I have not witnessed this personally, some who need to use concentrated high doses for severe problems may find themselves building up a tolerance. This can lead to increased dependency. If possible, use it on an as-needed basis and to refrain from taking it every third day or so. If after using kratom for a while, you find yourself craving it, stop using it altogether for several days.

Much like caffeine withdrawal experienced by coffee quitters, after stopping kratom, some people may experience a few days of mild discomfort, which range from headaches, jittery feelings, nausea, etc. These symptoms are relieved as kratom is cleared from the system.  (see https://www.kratomscience.com/dosage-conversion-chart/)

Contraindications, Possible Adverse Reactions and Adulteration Issues

Kratom is generally safe and its effects are similar to the effects of Kava (Piper methysticum) in its anti-anxiety and calming effects. It is much stronger than kava for pain. Use with caution for symptoms associated with Yin Deficiency such as night sweats, dryness, constipation, unusual thirst, and itchiness. However, if it is still needed for its pain-relieving, anxiety-dispelling, and opiate-withdrawal properties, it would be best to take it with a Yin tonic. These are herbs with tonic, demulcent properties that help balance the drying effects of kratom, such as mai men dong (Ophiopogon japonica tuber) and/or marshmallow root.

Because it is sold as a recreational drug, some distributors have taken to spiking their kratom powder with substances to intensify its effects. Some kratom products (see Krypton Kratom) were found to be spiked with the opioid tramadol that is addictive. Deaths and severe reactions were associated with these adulterated products. Avoid this at all costs; find a reliable source of pure, unadulterated kratom. In general, avoid buying kratom from outlets specializing in dispensing cannabis and other intoxicating substances for private use. The exception to this may be the various “kava bars” which have sprung up around the country.  These bars sell mild psychoactive herbal drinks which are consumed in a public setting.

Is Kratom Addictive?

I’m sure that any herb that is a potent pain reliever, antidepressant, anti-anxiety agent and has a long-time reputation responsible for helping thousands of people throughout the world overcome addiction to far more dangerous drugs and alcohol, has itself the potential to be addictive to some. This is especially true since kratom is also widely used and abused recreationally. Kratom is controversial because some choose to abuse it by taking high doses (over 10 to 15 grams or more of the powder one or more times daily); these people are bound to develop a dependency or addiction to it. I once knew a man who regularly drank 15 cups of coffee each day. He, like many others who use coffee on a regular basis, or the highly caffeinated so-called “power drinks” widely sold throughout the country would have difficulty withdrawing from these substances.

While caution from overuse of any substance should be implemented, in the words of one of the many thousands who have found benefit from kratom said in a letter on drugabuse.com: “Making a substance illegal because there's potential for a fraction of the population to have trouble with it does not seem to me to be a logical approach.”

I’m mainly an advocate for the responsible clinical use of kratom as an effective non-addictive alternative to other psychoactive drugs with well-known adverse health effects. Even those who claim that it is addictive will say that it is mild compared to highly addictive drugs such as opiates, alcohol, speed, etc.

The opiate drug oxycontin was created because its pain-relieving effects are longer-lasting that morphine and other opiates. The company who first brought it to market in the 1990s, Purdue Pharmaceuticals, convinced and enticed hospitals and doctors to use it even for mild or moderate pain conditions. As a result, it was widely prescribed even to children and that was the beginning of the present opioid epidemic.

With kratom, we have an herb that has offered hope for thousands to help wean themselves off of these deadly drugs, but even so, some government agencies want to suppress it. Even if one were to concede that there can be some problems with people abusing kratom, those problems have no comparison to the already existing problem of opioid addiction.

Making Kratom Tincture

Kratom is widely sold as leaf powder. Powders have a limited shelf life (about 3-4 months for full potency), and ingestion can be challenging because of its flavor. Making a tincture assures potency for many years, and are convenient to take because the drops can be diluted in water or another liquid to mask the flavor.

The downside of kratom tincture is that it is alcohol-based and therefore not suitable for individuals who have a history of alcohol addiction. Also, it is too easy to consume more than is needed when it is a liquid as opposed to the limitation of taking it as leaf powder. With both of these considerations in mind, the following tincture recipe is given from KratomGuides.com.

Ingredients:

  • 1 quart vodka or diluted ethanol measuring 40 to 50% alcohol
  • 8 oz. (about 227 grams) of pure high quality Kratom leaf powder
  • About ½ ounce apple cider or white wine vinegar (which aids in the assimilation of the important kratom alkaloids)

Combine these ingredients in a wide-mouthed jar. Shake or stir daily for at least two weeks (although an extract made in this way could be used after a day or two).

When completed, carefully strain through fine mesh cloth. Bottle in 2- or 4-oz. amber dropper bottles at this point or allow to stand in a clear glass container for a day or so to allow any powder particulates remaining to settle to the bottom. Carefully decant the pure extract and bottle for use.

This is approximately a one to four ounce tincture, meaning that 1 part of the tincture is equal to 4 parts of the powder. One may have to experiment with the tincture dose but on average one might start with a dose of 30 to 60 drops which is approximately a half to one teaspoon.

Feel free to experiment with flavoring agents to make it more palatable. The most common is pure anise or fennel seed oil. One may only need a few drops to flavor. (Use caution when using pure essential oils for flavoring; consult a qualified practitioner and use food-grade oils from a reputable company. –M.T.)

2017 Reputable Sources for Kratom Leaf Powder

1.      BuyKratom.us – www.buykratom.us
This is the company I’ve been purchasing my Kratom from. I find them to be reliable, good quality and reasonably priced

2.      http://kratomguides.com/recommends/kratom-spot/

3.      http://kratomguides.com/recommends/pure-kratom/

4.      http://www.phytoextractum.com/?referrer=REF327161478868859


Read more about these companies at KratomGuides.com

Conclusion

Matt Wright, the general manager at Low Tide Kava Bar in Gulfport, Florida, described some of the signs held by demonstrators at a pro-Kratom rally held in Washington D.C. last year: “In support of keeping kratom legal there was a sign that read, ‘Death statistics of other illegal drugs from 2014: Heroin: 11,000; Cocaine: 5,000; Alcohol: 88,000; Opioid Pain Relievers: 20,000; Kratom: 0.’ There were also numerous other signs saying ‘Kratom Saves Lives,’ ‘Plants Not Pills,’ ‘Farm Not Pharma,’ and one heart-wrenching sign held by a young boy who appeared to be between 6 and 9 reading ‘Kratom Saved My Mom.’

This says it all.

Please at least go to https://www.americankratom.org/petition and sign the petition to the DEA to keep kratom legal.

 

 

Mitragyna speciosa by Uomo vitruviano

As of the beginning of August 2017, the National Institutes of Health (NIH) published notice of the state of the opioid epidemic in America. They estimated that of the 91.8 million people who were prescribed opiate pain killers, 2 million are addicted with an average of 142 dying from overdose daily. This means that every three weeks the same number of Americans die from opioids as died in 9/11.

Up to now, opioids and related compounds all derived from the poppy (Papaver somniferum) are the most reliable pain-relieving drugs since the American Civil war. Unfortunately, there is a price to pay when these drugs are too heavily used. That price is addiction, accompanied with the need to obtain more and stronger drugs to achieve similar pain relief. The problem for the addict is compounded, for as the drugs wear off there is even more intense pain and mental discomfort that acts as a disincentive to detoxification. Yet, another genre of pain-relieving drugs sold as over-the-counter anti-inflammatories includes acetaminophen, which are known to cause liver damage.

Most doctors agree that there is a need for another drug or substance to relieve pain; a few doctors even encourage their suffering and addicted patients to try the pain-relieving herb Mitragyna speciosa, commonly known as kratom. Herbalists, acupuncturists and naturopaths, however, have been overly wary of promoting yet another fad in the form of an herb that they have not heard of before. In the case of kratom, it is known to be widely used as a recreational drug and it has been the object of legal scrutiny. Its clinical value yet to be appreciated. 

The medicinal properties of all herbs were first discovered through trial and error. Kratom is no different. It has been used for thousands of years by natives of southeastern Asian islands for various health purposes, among them pain relief. Eventually, millions of individuals in America and Europe and throughout the world, seeking yet another drug with which to get ‘high,’ tried kratom. Kratom in normal low to medium dose is feeble compared to other drugs like cannabis but since the late 1800’s people have increasingly used it to withdraw from opiate and alcohol addiction and to relieve pain. On this note, consider how long it has taken for cannabis, once vilified as a dangerous recreational drug, to be found in recent years to offer potent health and medicinal benefits.

I’m a strong advocate for the use of kratom clinically and have had considerable personal experience using kratom leaf powder for the relief of chronic, intractable pain. In fact, I can’t think of any herb other than opioid drugs derived from poppies that provides such immediate pain relief and overall sense of well-being. 

How does kratom relieve pain?

There are more than 40 compounds in kratom leaves, including 25 alkaloids besides mitragynine which is the most abundant, occupying 1.2-2.1% of the total. Mitragynine is believed to be principally responsible for its pain-killing effects. Mitragynine is considered the main psychoactive constituent and functions as an opioid agonist, meaning that it has a special affinity for the opioid receptors in the brain.

Most people who take a sufficient amount of kratom internally will experience pain relief in less than a half hour.  Kratom is usually taken as a powder. Dosage is variable depending on the strength of the kratom, the severity of the condition for which it is intended, and the size of the person who takes it. Further, kratom is known to have both stimulant and sedating properties. Stimulant properties are associated with lower doses and sedation with higher doses. I will describe dosage guidelines next week, but clinically the goal is to use as low an effective dose as possible. Discounting whether it will act as either a stimulant like coffee to which it is related or a sedative like opium, I recommend beginning with a teaspoon (about 3 grams) of the powder swallowed and chased down with water once or twice a day. Regardless of its sedative or stimulant properties in an individual, kratom will relieve pain.

It’s taken me some time to complete this article because I first wanted to scour and interview patients, stores and others who have recommended or used kratom with great benefit to themselves and others. I took it myself for a minor shoulder sprain and was amazed at how benign it seemed; I had no adverse reactions, no disorientation, no grogginess, and my pain was relieved within 30 minutes. Even several hours later when the effects of kratom surely would have subsided, I realized that the pain did not come back. I know it doesn’t work for everyone that way but my experience suggested that the alkaloids in kratom were not only analgesic but anti-inflammatory as well.

Since then I have recommended kratom to several patients suffering severe chronic pain and depression. Their respective pain and discomfort was well managed and with no adverse reaction.

Cases

Cases 1 and 2 are from my own clinical experience. Case 3 was reported to me.

  1. A woman in her mid-70s had advanced osteoporosis of the spine that caused constant pain making it difficult for her to sleep at night. Acupuncture and carefully prescribed herbal treatments were of limited benefit. Realizing how important sleep is for healing, I decided to try kratom. That night she took only one teaspoon of green-veined maeng da kratom. She gratefully reported that it was the first night she could get 6 continuous hours of uninterrupted sleep.
  2. Another patient was a woman diagnosed with rheumatoid arthritis. She had severe and constant pains in all of her joints especially her fingers. Again the pain inhibited her ability to relax and get much needed sleep. At first she was suspicious of taking any substance to relieve pain. Perhaps she vaguely heard that kratom was being used as a recreational drug and she might get hooked. While she was still in my clinic, I was able to convince her to take a teaspoon of the powdered leaf followed by a glass of water. She predictably objected to the taste but I heard from her the next day that she had such tremendous relief from the single dose, but she was trepidatious of taking it daily. I convinced her that she should not be afraid to use as much as she needed. It turned out that she only needed to take one or two teaspoons of kratom for a week, during which time diet changes and deeper-acting herbs I gave her helped eliminate her pain completely, and she had no further need for kratom.
  3. It was personally reported to me by a saleswoman working at a local store specializing in selling cannabis and other psychoactive herbs that she has dozens of clients who purchase kratom strictly for its pain-relieving therapeutic value. According this saleswoman, these are people who have tried everything; many were already heavily drugged and addicted to doctor-prescribed opiates. Among the many cases she mentioned, the one that seemed most amazing to me was a woman with cystic fibrosis who had for a long time been on several different prescribed pain-killing opioid drugs and a number of different antidepressants. With great determination, she wanted to “get her life back” and decided to use kratom to wean herself off of all her drugs. (I don’t know what dose she needed to take, but generally speaking, the more severe the condition, the higher the dose of kratom.) Years later, this woman, still with cystic fibrosis, is able to completely manage her pain with red-veined kratom. Red-veined is the variety that has stronger sedative and pain-killing properties.

Interviewing other patients and practitioners, I learned how kratom is the only thing some have found to manage the pain associated with chronic fatigue syndrome, fibromyalgia and Lyme disease.

Not Just for Pain

Kratom also relieves depression, and unlike opiates, it can promote a sense of mental clarity with no grogginess when used in the above described doses. Further, as an alternative to antidepressants, kratom does not interfere with selective serotonin reuptake inhibitor drugs (SSRIs or antidepressants) so they can be used concurrently. By so doing, many have been able to withdraw from antidepressants by gradually replacing them with kratom. However, I strongly caution against this without the advice and guidance of their medical doctor.

Kratom and Opioid Addiction

One of the most important uses of kratom is to ease physical and psychological pain associated with opiates, including morphine and heroin and alcohol addiction. The use of kratom for opium addiction was first employed in Thailand around the end of the 1800s at a time when opium was proliferating throughout China and eventually spread to the islands of Indonesia and Thailand. It was so effective for that purpose that the Thai government made kratom illegal. The reason was not that it was harmful to the people or addicting but because the government was being denied a then important part of its revenue based on the taxes levied on the sale of opium. To this day, kratom is illegal in its native habitat where people had been using it medicinally for centuries. However, with the rise in heroin and alcohol addiction, there is a movement to get the government to rescind its kratom ban.

Legal Issues

How effective kratom has and continues to be for pain relief and drug addiction was shown when the US Drug Enforcement Administration (DEA) on August 30, 2016, proposed to place kratom into a Schedule I category of Controlled Substances. This is the same category in which the most addictive drugs such as heroin and methamphetamine are classified: completely illegal. This met with a widespread groundswell of protests, mostly by people who were using it for pain management or opioid withdrawal. Approximately 140,000 protesters signed an online petition and were able to enlist 51 members of the US House of Representatives with nine senators on their side in protest of the DEAs proposed ruling. As a result, the DEA temporarily withdrew its notice of intent and for the last year it has been inviting public comment. See the document Assessment of Kratom under the CSA Eight Factors and Scheduling Recommendation submitted to the DEA here.

At present, kratom is legal in all but six states (Alabama, Arkansas, Indiana, Tennessee, Vermont, and Wisconsin). Kratom is also illegal for use by the US military.  It could still be banned and we would lose access to one of the most valuable herbs in the world. According to the American Kratom Association, currently 26,000 Americans have asked President Trump to keep kratom legal. Over 1,000 doctors, scientists and law officers told the DEA they don’t want a kratom ban. In fact there have been no deaths reported from pure kratom. Unfortunately, some companies decided to spike their kratom with an illegal opioid called tramadol. The resultant product called “kryptom” did result in some deaths and is now banned from sale.

The risk of dying from pure kratom overdose (whatever that may be) is nil. In fact high dosage of kratom is self-limiting as people who do so experience temporary gastric discomfort, nausea, and vomiting.

I’ve never personally seen or heard of kratom addiction and to the extent that it may exist it is quite rare. Individuals can form a dependency, which some may describe as ‘addiction’ but this is described as mild and comparable to withdrawal from coffee.

At present, these are the facts:

  • 100 million Americans suffer from chronic pain;
  • Of these, 21 million are also dealing with substance abuse;
  • Of these, 2 million abuse prescription pain drugs.
  • Drug overdose, which has gone up 4 times, has become the leading cause of accidental death.

Why would the federal government or states rush to ban an opioid replacement that’s hundreds of times less deadly than synthetic opioids?

I recommend visiting some of the online kratom support sites such as the American Kratom Association to read more about kratom’s history, biochemistry and the many anecdotal cases attesting to the positive effects of kratom for pain control and opioid and alcohol addiction. If you visit the AKA link above, be sure to sign the petition to keep kratom legal. In my estimation, it is one of the most important medicinal herbs for pain management other than opium.

Next week, I’ll post the clinical classification, uses, dosage, and preferred administrations of kratom, along with some reputable sources. (See Part 2 of my series on kratom here.)

Kratom may be enjoying a lot of press these days in light of current events, but the benefits of a whole world of herbs is diverse and mighty. Thinking of studying the art and science of herbalism at East West? Mention this kratom blog and receive an extra $100 off enrollment on our already low-priced sale of the herb course. Offer valid through August 18.

 

 

Michael Tierra applies cups to a patient
with severe back pain at the East West Free
Clinic in Santa Cruz.

We have encountered many extreme acute chronic conditions among the homeless population that we’ve treated. The most common involve pain due to trauma or metabolic imbalance. Naturally enough, other common conditions perhaps just as prevalent are depression, anxiety and manic, bipolar disturbance.

Rheumatic and arthritic conditions are described in Traditional Chinese Medicine as Bi Zheng disease which includes a wide variety of back and joint pains. While diet and herbal therapy provide nutrients and healing at a deep level and ultimately provide the most lasting results, various physical therapies such as needling, bleeding, scraping, cupping, moxibustion and medicated oil massage  offer the most immediate relief.

This case was that of a homeless man, who had several laminectomies and possibly a disk fusion over a portion of his lower back in the area of L3 to L5. This man appeared to be in his late 30s and claimed to suffer from acute, disabling back pain for over 14 years. Laminectomy is a surgical procedure that removes a portion of the vertebral bone, called lamina. The muscles are pushed aside without cutting with the intention of leaving parts of the lamina intact. Disk fusions are performed when there is a problem with the disc space between the vertebrae causing painful pressure on the adjacent nerves.

I was not sure which of these or perhaps both procedures were performed on this man but it was obvious that he had at least three surgeries all in approximately the same area. Unfortunately he had no pain relief and more than likely a severe exacerbation of pain.

The man was married to a woman who loved and cared for him as best she could. Both lived on a small monthly disability and had temporary residence at the Santa Cruz Homeless Shelter. This is one of many cases where an individual suffering from such incapacitating health problems had little hope of being able to hold a job and better their living standard.

This man was taking and probably hooked on several severely addicting pain killers including oxycodone. Still, the pain throughout his body, especially his back, was constant and excruciating. He could barely move, let alone get on the table where we might try to relieve some of his suffering. With the assistance of three of us we finally got him lying face down. He was moaning and crying with every more. I palpated different areas of his back to determine where the pain was most severe and where the inflammation and blockage emanated. Again, he exhibited great sensitivity to pressure point palpitation.

I decided to use the most powerful method to relieve such conditions that I know: bleeding and cupping. Both are traditional ancient methods employed in many traditional cultures including Traditional Chinese Medicine dating back thousands of years.

Many people don’t realize that before the invention of small stainless steel needles, small sharp stones were used to extract a small amount of blood from precise areas of the body. Cupping used by creating a vacuum in a small cup applied to suck the skin and blood to the surface is used in diverse cultures ranging from throughout Asia, Greek and Central America. These were formerly considered folk traditions and are now part of the practice employed by some acupuncturists around the world.

I used small sterile diabetic needles, beginning with two points behind the knees called Weizhong or Bladder 40. These points treat lumbar pain and spasm of the lower back and extremities. They are powerfully anti-inflammatory and relieve pain. Translation of the name “weizhong” means “support the middle” because they also treat abdominal pain, vomiting and diarrhea. They are the most effective points for treating all lower back pains and for severe cases, they are most effective if they are caused to bleed. You may wonder if this was painful to this man. In fact his pain was so severe that he didn’t feel any of the quick tiny pricks which I then proceeded to do at particularly sensitive areas through his entire back, each time applying a cup and drawing out anywhere from a half to a teaspoon full of blood from each point.

After applying wan hua oil to the region, a special medicated oil to relieve pain and promote blood circulation, removing the blockage causing pain in the area, I pricked the two most painful areas near the areas where the surgery scars were evident and then applied two cups.

After 15 to 20 minutes I removed the cups, carefully wiping off the coagulated blood on the skin and inside each cup using as sterile measure as were available under the circumstances. This man’s pain was so severe, I considered this an emergency procedure. After removing the cups I lathered Ayurvedic Mahanarayana oil, the most powerful of all rejuvenative, anti-inflammatory and healing oils the world has ever known. “With a sesame seed oil base, this massage oil has some widely known homeopathic constituents like clove, camphor, turmeric, cow's milk, cedar bark, sandalwood, ginger and licorice. It also contains several historic Ayurvedic herbal tinctures known primarily in India, such as the herb blend dashmula, an asparagus extract called shatavari, the country mallow plant known as bala, and a mild sedative called tagar,” (http://www.wisegeekhealth.com/what-are-the-benefits-of-mahanarayan-oil.htm)  and these are about half of the total ingredients. This oil is available online. I use so much of it in my practice that I purchase a gallon at a time from Banyan Botanicals. http://www.banyanbotanicals.com/mahanarayan-oil/

After the cups were removed that man was reluctant to move and sit up for fear of experiencing the old pains he had before and during the process of getting on the table.

As you can see from the final picture, for the first time since our first encounter, the man was sitting up and specifically said “I feel good,” exclaiming that he hadn’t felt so much relief from pain in over 14 years of multiple and costly medical procedures and physical therapy.

I also prescribed an ancient traditional Chinese herbal formula for back and joint pains and both osteo- and rheumatoid arthritis called Du Huo Ji Sheng Pian (Wan) to be taken as pills three times daily. This formula contains up to 14 herbs and when taken over a period of weeks to 3 months is remarkably effective in treating back and joint pains especially of the lower body.

Among the powerfully anti-inflammatory, analgesic, blood-moving herbs in the formula are a species of angelica (Angelica pubescentis) and Loranthes, a particular species of mistletoe found growing on mulberry trees (do not use American mistletoe as it is toxic).

It is moments such as this that provide me with the most satisfaction and joy. 

I'm not sure when the use of poppy for the relief of pain was made illegal for herbalists, but it certainly is. In fact, in California one can be cited and made to uproot and discard any poppy plants that are even remotely suspected as being used for medicinal purposes. It is certainly clear why this is the case; the latex of the poppy plant has a long history of addictive abuse both in China and later in its extracted and refined form today as morphine and heroin.

However, herbalists are finding other members of the Papaveraceae family to have similarly powerful analgesic pain-relieving properties. Even California poppy, today one of the most popular herbs sold for insomnia in Europe, has somnolescent and mild analgesic properties.

Corydalis yanhusuo from itmonline.orgRecently, a study appearing in the January 20,2014 issue of Current Biology and conducted by a team of researchers together with Chinese herbal practitioners at the University of Irvine in California found yet another member of the Papaveraceae family, Corydalis yanhusuo, to also be an effective non-addictive analgesic for both acute inflammatory and nerve pain. (Image of Corydalis yanhusuo at right from http://www.itmonline.org/arts/pain.htm)

Tests were done on rodents who had induced inflammatory pain associated with tissue damage and infiltration of immune cells, and injury-induced neuropathic pain. The latter is particularly important because evidently Western medicine has no adequate treatments for neuropathic pain. This makes corydalis at least the second and arguably the most powerful herb one can use for the treatment of pain (the other herb commonly used by Western herbalists for nerve pain is St. John's wort, or Hypericum perfoliatum).

The teams screened 10 traditional Chinese medicines known as analgesics and nearly 500 compounds known for their pain-relieving abilities. Only dehydrocorybulbine (DHCB), the constituent found in Corydalis yanhusuo, produced a reproducible effect. Unlike poppy and its biochemical derivatives, DHCB does not necessitate the raising of doses with its subsequent addiction as do other conventional pain relievers. This is the first time that the coordinated efforts of both Chinese medical doctors and researchers East and West have been able to extract, identify and test a specific biochemical constituent that seems largely responsible for the remarkable analgesic properties of this medicinal herb.

These are several species of corydalis throughout the world, and indeed many of these may have the same or even greater analgesic properties, but the one most used in Traditional Chinese Medicine (TCM) for thousands of years grows in Siberia, Northern China and Japan. Corydalis yanhusuo is one of the herbs most frequently used by Chinese herbalists for the treatment of pain and various other circulatory problems. As such, it is also used for the treatment of cancer and coronary heart disease. It is classified as a powerful Blood-moving herb, which relieves the stasis that causes pain according to TCM theory. The root is administered in 4.5 to 9 grams per dose in a divided decoction, taken twice daily to alleviate menstrual cramps, chest pain and abdominal pain. According to Olivier Civelli, chief researcher at UCSC Irvine, more than 50 million Americans are affected by neuropathic pain, for which DCBH could be of great benefit. These people could receive the relief they need through this powerful herb.

As an aside, marijuana-infused oil or ointment (made with lard) is a traditional Central American folk use of the herb for the relief of arthritis, sprains and other aches and pains. Increasingly with the legalization of marijuana in some states, its use for pain has been widely acclaimed as medicine-makers produce their novel pain-killing marijuana ointments and tinctures. But remember, herbal formulas are usually (though not always) more effective than single herbs. A good formulation would be a combination of cannabis with corydalis.

Last time, I talked about moxibustion and its uses on the acupuncture point Stomach 36. There are several other uses and locations for moxa, which I will discuss in this and subsequent blogs. Best of all, moxa is an inexpensive treatment that can be applied at home. Following are a few more highly useful moxa points that yield profound, nearly immediate positive results.

back_painLower back pain

Indirect moxa applied for 10 to 20 minutes over the lower back and wherever reactive points can be located provides immediate and oftentimes long-lasting relief from pain. It is a far better treatment than the application of icepacks which stop the pain by cutting off circulation; moxa relieves pain by facilitating circulation.

The application of five stick-on moxa pellets directly on Governing Vessel 4 (Ming Men, or "Life Gate") located directly on the spine between the second and third lumbar vertebrae, supplements Yang Qi for the entire body and effectively treats lower back pain. Using indirect moxa about an inch and a half to the left and right of this point in the area of Bladder 23 on the small of the back will further add to the treatment. Of course, always try to find the sensitive trigger points as these are the most effective for treatment of acute pain.

feverColds, Flu and Fevers

Moxa on the point called Governing Vessel 14 (Da Zhui or "the Great Hammer") raises the Yang immune system of the entire body and is the most effective treatment for colds, flus and fevers. It is located directly on the seventh cervical vertebra of the spine.

The value of doing moxa on this point cannot be understated. It will induce perspiration, which is the first line of treatment for all invading pathogens. Being the meeting point of all the Yang acupuncture meridians, it is indicated for all exterior conditions, protecting the body from the invasion of exterior pathogens. It prevents and treats colds, flu, fevers, clears heat, and strengthens the neck and spine. It is also used for bone issues, arthritis, spurs, scoliosis, problems with the arms and hands, epilepsy, hypertension, insomnia and nosebleed.

It seems counterintuitive that one would apply heat to treat inflammation, but with moxa it is not only the heat that is having an effect, but the stimulation of circulation and the proliferation of white and red blood cells.

Next time: Moxa for insomnia and infertility.

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