Friday, 22 February 2019

Buying Good Quality Herbal Products

Having a THR (Traditional Herbal Registration) logo on your herbal tablets ensures good quality. Back in the 1990s there was continuing evidence of low grade, and, sometimes, dangerous unlicensed herbal products on sale in the UK. These lacked any product information – not even an indication for what condition to use them for - so consumers were not made aware of potential interactions with other medicines, side effects or if it was safe for children or pregnant women. In 2004, the THR scheme was introduced throughout the EU and, although complying with its stringent requirements has been a steep learning curve and a costly exercise for manufacturers, we now have reassurance that products on sale with a THR logo are of good quality.

The THR scheme has been a great success and will continue to be in place whatever Brexit throws at us! Standards for safety, quality and reliable patient information are key requirements, and agreed medicinal claims are allowed on the label of the final product. However, indications for use are only allowed to include minor, self-limiting conditions, which are appropriate for self-care. Of course, professional prescribing by herbal practitioners of these same herbs may go well beyond these indications.

Although granting a THR is dependent on a history of use of a herb and not on research evidence of its efficacy, that does not mean that there is no scientific evidence for its health benefits. While there will be at least some evidence from laboratory studies for all herbs with a THR, for many of the key herbs there is also clinical trial data, which I am trying to highlight in these Friday blogs. If you are thinking of buying a herbal product over-the-counter, make sure it has a THR logo! (You can find more information about THR herbals via the BHMA's website.)

Ann Walker PhD, FCPP, MNIMH, RNutr
Course Director DHM
Herbal Practitioner

Friday, 15 February 2019

Vitex for PMS/PMT

Article and Photo © Ann Walker
The berry of Vitex agnus-castus - or agnus-castus, as it is commonly known - is a key herb used in western herbal medicine, largely for women’s health. Its main applications are to support hormonal balance and normalise aberrations of the menstrual cycle, including alleviating symptoms of pre-menstrual syndrome/tension (PMS/PMT).

A team from the Netherlands combined (or ‘pooled’) results from 14 randomised clinical trials looking at the effects of Vitex for PMS (PMID: 28237870). They found a very large positive effect of the herb on PMS symptoms compared with placebo. However, they were very cautious in the interpretation of these findings, as the studies which were pooled together varied in design, dosage, quality of the preparations used and the methods of measuring PMS. The researchers concluded that while the pooled results showed a strong positive therapeutic effect of Vitex for treating PMS, there was still need for high-quality trials on Vitex for PMS patients using standardized extracts of the herb versus placebo or versus modern drugs like anti-depressants or oral contraceptives.

From being involved in studies of PMS myself (PMID: 9861593), I know that even taking a placebo, can result in up to 30% reduction in symptoms. So, trying to find an effect of an intervention like Vitex is not easy as it has to be more than the placebo effect. The large response to Vitex reported against placebo here is, therefore, impressive. Although not providing the ultimate proof of efficacy, these results, nevertheless, are still supporting data for the traditional view of Vitex as a useful herb to achieve hormonal balance in women and the herb is remains freely available for purchase in retail outlets.

PMID = PubMed identifier

Ann Walker PhD, FCPP, MNIMH, RNutr
Course Director DHM
Herbal Practitioner

Friday, 8 February 2019

Herbs for Anxiety

Article Ann Walker; Photo © Debs Cook
Many modern drugs, prescribed by doctors for anxiety, work by raising the level of a neurotransmitter in the brain called GABA (gamma-aminobutyric acid). GABA is the chief neurotransmitter that reduces brain-cell over-activity. By increasing the amount of GABA, drugs can typically have relaxing, anti-anxiety and anti-convulsive effects and can be very effective. However, long-term use of modern medications can have unwelcome side effects such as slower mental function and withdrawal symptoms.

A research group from Australia were interested in finding whether plant extracts with a history of safe use as medicines, might act in a similar way to these drugs (PMID: 29168225). They scoured the literature to find herbs that had been shown (a) to raise GABA levels in test-tube studies, (b) to reduce anxiety in lab animals and (c) to reduce anxiety in human studies. Ten herbs met these three criteria: Kava, Valerian, Gotu Kola, Hops, Chamomile, Ginkgo Biloba, Passionflower, Ashwagandha, Skullcap and Lemon Balm.

I know from clinical practice that herbal medicines can play an enormous part in supporting mental health and alleviating conditions such as anxiety. After starting my herbal practice, it was the strong positive influence that some herbs can have on mental function that was the thing that astonished me most in dealing with patients – something not highlighted in my training. All the herbs mentioned in this current review are well known to western herbal practitioners and nearly all would feature frequently in their herbal prescriptions. It’s great to see research revealing actual mechanisms of action to support the traditional use of these herbs!

PMID = PubMed identifier

Ann Walker PhD, FCPP, MNIMH, RNutr
Course Director DHM
Herbal Practitioner

Friday, 1 February 2019

Herbal Mix Alleviates PCOS Symptoms

Article & Photo © Ann Walker
Characterised by menstrual irregularities and often accompanied by the development of secondary sexual male characteristics, PCOS (polycystic ovarian syndrome) is a complex female condition, which is sometimes called a pre-diabetic state. Changes in diet and lifestyle aimed at weight loss should always first-line treatment for PCOS sufferers and can work well if strictly followed. However, to be successful, many women seek further support, particularly from herbal medicine.

In Australia, Professor Alan Bensoussan’s pioneering research team conducted a randomized controlled trial on 122 over-weight women with PCOS (PMID: 29178904). They divided them into two groups – one group was given lifestyle advice plus daily doses of herbal medicine and the other given lifestyle advice alone. The herbal medicine comprised Cinnamon, Liquorice, St John’s Wort, Peony Rroot and Puncture Vine.

After three months, menstrual regularity was greatly improved in the group taking the herbal medicine, compared with the control group. Furthermore, secondary outcomes of body weight, blood insulin, luteinising hormone (a hormone from the pituitary which helps to regulate the menstrual cycle), blood pressure, quality of life (reduction in depression, anxiety and stress) and pregnancy rates (among a sub-group wishing to become pregnant) were all significantly better or improved for those taking the herbs.

Prescribing mixtures of herbs, with several physiological actions, as used here are, is common practice among herbal practitioners. This approach is especially useful for conditions like PCOS with multiple presentation. In this study, liquorice and peony root were used to reduce the influence of testosterone, cinnamon to improve insulin sensitivity, St John’s wort to aid the resolve to lose weight, and puncture vine to aid hormonal balance.

PMID = PubMed identifier

Ann Walker PhD, FCPP, MNIMH, RNutr
Course Director DHM
Herbal Practitioner

Friday, 25 January 2019

Wild Blueberry for Memory

Wild Blueberry article by Ann Walker
I had not heard of the American Wild Blueberry (Vaccinium angustifolium), until I read a report of a study from the University of Reading (PMID: 29882843). This is my Alma mater and the University where I taught nutrition to food science BSc and MSc students for 35 years, so naturally, it caught my attention. The study was of 122 older adults who were randomised to three groups to take daily for six months either placebo, wild blueberry as a dried powder or wild blueberry as an extract. At the end of the study, the extract, but not the whole herb powder, showed, compared with placebo, improved memory and lowered blood pressure. This better result for the extract is not surprising as herbal extracts are at least five times the strength of powdered herbs.

Initially I assumed that the wild blueberry was the ancestor of the commercial blueberry, but this is not the case – it is a separate species and both are closely related to the European bilberry. All three species are characterised by their dark red pigments known as anthocyanins, which have an array of physiological effects on the body as shown in many laboratory studies. However, of the three species, bilberry was the first to be subjected to clinical trials, inspired by reports of British Royal Air Force pilots in World War II. They described how a good dose of bilberry jam just prior to a mission improved their night vision. While the bilberry is a low-growing shrub with poor yield, the wild blueberry – a taller plant - produces a worthwhile harvest in Canada, where it is cultivated and collected on a commercial scale. Not surprising then, that research attention is now turning to the wild blueberry.

I tried to find a comparison of the anthocyanin content of blueberry, wild blueberry, and bilberry to report in this blog, but failed. The level of the pigments depends on the variety as well as the species – sometimes the pigment is held mainly in the skin (as in the familiar blueberry) and sometimes more in the flesh (as in the bilberry). I can only conclude that the fruits of all these species are beneficial to health. Anthocyanins resemble the tannin-like complexes in grape seed and pine bark, and as such, they have been recommended for similar uses involving ‘tissue strengthening’ as in easy bruising, varicose veins, minor injuries, and surgery support. Areas which have received research attention include blood sugar control in diabetes and more latterly, brain function as in this present study.

PMID = PubMed identifier

Ann Walker PhD, FCPP, MNIMH, RNutr
Course Director DHM
Herbal Practitioner

You can discover more about Wild Blueberries over on the blog run by the Wild Blueberry Association of North America.
Wild Blueberry photo by Johan1127

Friday, 18 January 2019

Aloe Vera and Underactive Thyroid

Aloe Vera Photo & Article by Ann Walker

Aloe vera leaves are the source of two medicines with diametrically opposite effects on the digestive system: the inner gel (or juice) taken in sufficient doses can be used as a remedy for diarrhoea (it helps to normalise a digestive microbiome in disarray) and the outer part of the leaf – thanks to a yellow exudate (turning to a black resin on drying, called bitter aloes) – is a strong laxative. The article I describe here (PMID: 29527506) concerns the juice. An Italian researcher, who had Hashimoto’s thyroiditis (an underactive thyroid caused by autoimmune inflammation) just happened to self-medicate with 50 ml of aloe vera juice per day to improve her digestive function. Three months later she was surprised to find that, despite taking no modern medication throughout this time, her raised blood thyroid antibodies and thyroid function test results were moving towards normal and this effect was even more marked after six months.

This chance finding inspired the research group she worked for to plan a clinical trial to investigate further. They recruited thirty women with Hashimoto’s thyroiditis, who had not been treated with thyroxine medication, to take 50 ml aloe juice daily for nine months. At three months, evidence of normalisation of thyroid function was already evident and by nine months all subjects were within the normal range for all markers! By contrast, a control group (fifteen women, untreated and with the same condition) showed no significant changes in any of their raised markers. Although the mechanism of action is not yet understood, aloe vera juice does have a ‘dampening down’ effect on overactive immune systems. There is plenty of evidence from laboratory investigations on cultivated cells that aloe vera juice modulates immune function in several ways that would be beneficial in autoimmune inflammatory conditions.

Over the last 10 years, clinical trials reported on aloe vera on PubMed have been increasing to around ten a year. These have included investigations into the internal use of the juice for gastric reflux and its external use for burns, wound-healing after surgery and radiation damage following cancer treatment. This present study is the first indication that the internal use of aloe vera juice may be beneficial for normalising thyroid function disrupted by autoimmune disease - the most common cause of thyroid under-function.

PMID = PubMed identifier

Ann Walker PhD, FCPP, MNIMH, RNutr
Course Director DHM
Herbal Practitioner

Wednesday, 16 January 2019

5 Facts About: Chickweed

Chickweed article by Debs Cook
Spring is just around the corner, she says in the throws of Winter - if but a rather mild one thus far here in Derby - and round about this time of year wild edible green herbs are few and far between but we can take a leaf - pun intended! - out of our ancestors foraging books and go out and forage for wild Spring greens to add to our salads and smoothies even now! One such useful wild herb that can be found in winter is Chickweed (Stellaria media), unless there has been a good layer of snow recently, but that won't stop this rambunctious herb for long, as soon as the snow has melted, Chickweed bounces back!

raditionally used as a winter pot herb at this time of year due to its highly nutritious nature, although it grows all year round, it is one of the few herbs in the green in Winter and Spring. Like one of its other often foraged counterparts nettles, chickweed is a good source of chlorophyll, and contains vitamins and trace minerals. You can add the herb in small amounts to smoothies and green juices, it can also be dried and powdered and used to help thicken soups or stews, one of my favourite culinary ways of using Chickweed is turning it in to a yummy pesto ever since I discovered a recipe for it in Julie Bruton Seal's book 'Hedgerow Medicine' in 2008. Incidentally, did you know that Chickweed gets its name because it was used to feed chickens? It has also been used to feed caged birds such as budgies and canaries who are rather partial to its green goodness.

Chickweed has been a soothing remedy for skin conditions such as eczema and psoriasis for centuries, it’s useful for calming itchy skin and for cooling hot inflammations, as such, it was a popular and much used old external remedy when added to a poultice for treating boils, abscesses, and ulcers of the skin. It was also used to ease mild cases of constipation, and its high vitamin C content made it perfect to use in cases of deficiency of this vital vitamin in sufferers of scurvy. Its anti-inflammatory properties have also been used to help relieve muscle and joint pains.

1) Chickweed has astringent, anti-inflammatory, anti-rheumatic, anti-tussive, carminative, demulcent, depurative, emollient, expectorant, laxative, ophthalmic, refrigerant and vulnerary properties. The herb contains coumarins, flavonoids, mucilage, minerals, phytosterols, saponins, vitamins C, B6, B12, D and A. The saponins content of chickweed is believed to be how chickweed helps to soothe itchy skin.

2) 100g dry weight of chickweed herb contains 43 calories and 32g of dietary fibre, plus the following vitamins and minerals: -

• Calcium - 1,210g
• Iron - 25.3mg
• Magnesium - 529mg
• Niacin (B3) – 4.7mg
• Phosphorus – 448mg
• Potassium - 840mg
• Riboflavin (B2) - 0.13mg
• Selenium - 0.22mg
• Silicon – 0.57mg
• Thiamine (B1) - 0.21mg
• Vitamin A - 7,229 IU
• Vitamin C – 6.9mg
• Zinc - 0.52mg

3) Chickweed, as has been mentioned earlier, is a useful herb for skin health, it can be added to creams to soothe skin conditions such as eczema and a decoction can also be made and added to skin lotions and salves. Chickweed's emollient properties help to moisturise dry skin conditions. A poultice of chickweed when applied to a foreign body in the skin e.g. a splinter can help draw the splinter to the surface, it can also draw out impurities in skin infections such as boils. The astringent properties of chickweed make it useful when added to external preparations for soothing rashes, acne, eczema and psoriasis. Nicholas Culpeper in the 17th century recommended its use for treating skin conditions such as psoriasis and eczema saying that chickweed ‘is effectual for all imposthumes and swellings whatsoever, for all redness in the face, wheals, scabs and the itch’.

4) Chickweed was one of the herbs used by Dioscorides in the 1st century A.D. to treat such conditions as eye inflammation and earache. In fact herbalists for centuries have used chickweed either in eye-baths or compresses to help clear eye infection's such as ‘pink eye’ more commonly known as conjunctivitis, due to the herbs ophthalmic properties. John Gerard in the later part of the 16th century and Nicholas Culpeper recommended the distilled water of chickweed ‘for all heat and redness in the eyes ... as also into the ears...’ mixed with eyebright it makes a brilliant lotion for clearing the eyes and helping with general eye health.

5) Chickweed has long been used as a spring tonic and blood cleanser, either as a pot herb or as a tea or infusion, and has also been used in some dieter’s regimes, in fact an infusion of the herb known as ‘Chickweed Water’ was an old wives' cure for obesity. To make a chickweed infusion add 1-2 teaspoons of dried chickweed to a teapot or jar and pour on approximately 250ml of boiling water, allow too steep for 15 minutes; strain the liquid from the herb and use. A chickweed infusion can be added to the bath to help ease itching associated with insect bites and dry skin. Whilst Chickweed can be very good for you, its not good to eat it in large quantities because it contains saponins which are toxic, small amounts say a handful every now and again should be fine.

Debs Cook is a Herbal Historian and our Webmistress, you can see more articles by Debs over on her blog Herbal Haven.

Disclaimer: Whilst every effort has been made to source the most up to date and accurate information, we cannot guarantee that remedies in our articles are effective, when in doubt, consult your GP or a qualified Medicinal Herbalist. Remember also that herbal remedies can be dangerous under certain circumstances therefore you should always seek medical advice before self-treating with a homemade remedy, especially if you are pregnant, breast feeding or suffer from any known illness which could be adversely affected by self-treatment.