The "Best Of The Best" Herbs (3)

2001 Alan Keith Tillotson

Understanding Herbs

GINGER ROOT (rhizome)

Latin: Zingiber officinalis

Sanskrit: Ardrakam Sunthi

Chinese: Gan jiang

WHAT IT DOES: Ginger root is pungent in taste, and warming, and mildly tonic in action. It improves digestion, reduces nausea, settles the stomach, and reduces inflammation.

RATING: Silver

SAFETY ISSUES: Ginger may increase absorption of pharmceuticals.

STARTING DOSAGE:

• Dried powder: 500-1500 mg one to three times per day

• Tea: drink freely Ginger acts as a digestive aid as well as a peripheral blood circulation stimulant, so it is useful for increasing poor circulation. Its pungent essential oils aid digestion by stimulating the activity of digestive enzymes (Platel K et al., 1998). However, despite its hot spicy taste, ginger inhibits the synthesis of the “bad-guy” inflammatory chemicals, prostaglandin and thromboxane (Kiuchi et al., 1992).

TCM doctors tell us that fresh ginger is better than dry ginger for easing nausea, indigestion and stomach pain, and for stopping diarrhea caused by poor digestion. Conversely, they tell us dry ginger is better for warming the body. The anti-inflammatory actions of ginger, noted centuries ago by TAM doctors, are strong enough to reduce muscular discomfort and pain in osteoarthritis and rheumatoid arthritis (Srivastava et al., 1992). They explain this action in a pungent herb, as due to the vipaka (post-digestive action) being sweet, and therefore nourishing and antiinflamatory.

I sometimes mix ginger with honey to form a paste (occasionally adding ground black pepper), which is a very simple anti-asthma formula suitable for young children in the early stages of the disease. Generally, this treatment needs to be kept up for several months to see its full effectiveness.

Suggestions for using ginger: • Ginger tea is a simple remedy for the common cold • When using fresh ginger, I tell patients to use a garlic press to extract the juice • I suggest adding ginger, garlic or onion when cooking with oils, as they contain antioxidants that keep the oil from degrading as quickly from the heat

Research highlights

• Because of its digestive and anti-nausea actions, ginger can be used to treat dyspepsia, nausea and vomiting associated with pregnancy, vertigo, dizziness and motion sickness (Schmid et al., 1994; Visalyaputra et al., 1998).

• It has also been shown to increase gastroduodenal motility (Micklefield et al., 1999).

• Pharmacological studies show that part of ginger root's antiinflammatory action is due to inhibition of the formation of inflammatory prostaglandins (Kiuchi et al., 1992).

GINKGO LEAF

Latin: Ginkgo biloba

English: Maidenhair tree

Chinese: Bai guo ye / Yin guo ye

WHAT IT DOES: Purified ginkgo leaf is bitter and astringent in taste, and stimulating and warming in action. It increases oxygen and blood flow to the brain and extremities, and increases nutrient and oxygen absorption by nerve tissue.

RATING: Silver

SAFETY ISSUES: Use cautiously with anti-coagulant drugs. Do not use with pharmaceutical MAO inhibitors. Avoid use prior to surgery.

STARTING DOSAGE:

• Standardized extract (6% terpene lactones and 24% flavone glycosides): 40-60 mg two times per day

• 1:2 Tincture: 35 drops two to three times per day

The Ginkgo tree is a fascinating and beautiful living entity, reputed to have survived the Ice Age. It is often planted along roadsides because of its ability to remain vibrant and alive in polluted city conditions. Ginkgo leaf has shown a powerful effect on various aspects of brain and nerve function and cerebral circulation in more than 500 studies. Some of its major uses include the treatment of vertigo and neurological disorders, memory and concentration problems, and diminished intellectual capacity due to poor circulation. It may also delay the onset of Alzheimer's disease.

I remember one patient who experienced a sudden vision loss caused by optic ischemia. After prednisone treatment failed to prevent the loss of vision (down to 20/200) during the first week, three ophthalmology specialists insisted that nothing further could be done, and that the damage was permanent. Dr. Abel and I intervened, and using a complex combination of TCM blood moving herbs including ginkgo along with antioxidant nutrients, we were able to restore this patient's vision to 20/80 within three weeks. 

When standardized in a 50:1 concentration, ginkgo belongs to a category of substances known as phytopharmaceuticals— halfway between crude herbs and pharmaceuticals. The herb is standardized because it is necessary to remove some slightly toxic phyto-chemicals from ginkgo before use, though the level of concentration does not need to be very strong. Nai-shing uses a 5:1 powder concentrate in her formulas, and I often use the 1:2 tincture. No adverse effects have ever been reported in these benign forms. I think these lower concentrations are best if you are creating a formula and want a milder medicine. I have found that well-prepared organic tinctures can often produce the desired results in very low dosage.

There have been limited reports of people developing bleeding or hemorrhage while taking ginkgo at the same time as anti-coagulant or platelet-inhibiting drugs. However, when you consider a German survey of data on millions of patient-years patient use (which means billions of ginkgo pills taken) without any reports of significant bleeding, I would think that the risks are very mild even in this area (DeFeudis, 1991). Caution is still wise, of course, and I do not suggest taking ginkgo if you are on bloodthinning medications, unless you consult a qualified health care practitioner.

I have found it very valuable for improving mental alertness and mood in some elderly patients, though I seldom use it alone. If taken in excess it can sometimes cause irritability. I have rarely found it to be an effective memory enhancer in younger persons with good circulation, though scientific reports do show some benefit on short-term memory. Ginkgo can be very useful in treating some cases of tinnitus, but you need to use it for a couple of months to see results. The high level of good scientific test results found with ginkgo are due to the fact that so much research has been done. Many, many others herbs will reach this level of proof in the coming years.

Research highlights

• Researchers performed a meta-analysis of all studies of ginkgo treatments for cognitive function in Alzheimer's patients. They concluded that there was a "small but significant effect of 3- to 6-month treatment with 120 to 240 mg of ginkgo biloba extract on objective measures of cognitive function" (Oken et al., 1998).

• Among the most encouraging studies are those that show improvements in depression with the elderly. Clinically depressed patients taking standard medications improved significantly with the addition of ginkgo (Schubert and Halama, 1993).

• Equally encouraging was an open trial showing that treatment with ginkgo was 84% effective in neutralizing sexual dysfunction caused by anti-depressant medicines, especially selective serotonin reuptake inhibitors (SSRIs) (Cohen and Bartlik, 1998).

• Animal studies have shown that ginkgo’s effect on nerve cell membranes may possibly restore age-related declines in serotonin receptor sites (Huguet et al., 1994). If this also occurs in humans, it may explain some of the beneficial effects of ginkgo on mood in the elderly (reported in Murray, 1996).

• Controlled trials have shown effectiveness with tinnitus (Meyer, 1986), acute cochlear deafness (Dubreuil, 1986), senile macular degeneration (Lebuisson et al., 1986), and diabetic skin lesions (Pepe et al., 1999).

• Patients undergoing cardiopulmonary bypass often have severe problems during recovery, including tissue necrosis. In one randomized controlled trial testing ginkgo extract (EGb 761), patients were given either the extract or a placebo five days prior to surgery. Doctors collected blood samples at crucial stages of the operations and up to 8 days post-surgery. Researchers saw a reduction in free radical generation and a significant delay in leakage of oxygen-carrying muscle proteins. These results suggest that pre-surgical administration of ginkgo extract can help prevent complications (Pietri et al., 1997).

• In an animal study using ginkgo in combination with superoxide dismutase (SOD), ginkgo’s inhibition of platelet activating factor (PAF) significantly reduced oxidative damage to intestinal membranes after induced ischemia in rats (Droy-Lefaix et al., 1991). This is a convincing argument for the use of ginkgo with low temperature dried wheat sprouts (which provide SOD) as an important intervention after ischemic injury, such as optic neuritis.

• When administered to Chernobyl workers involved in the infamous nuclear accident, ginkgo leaf extract inhibited blood levels of radiation-induced chromosome damaging factors by 83%. Researchers noted, however, that only the complete extract (as opposed to isolated components) exerted significant effects (Alaoui- Youssefi et al., 1999).

• Ginkgo increased pain-free walking distance more than 300% in diabetic and nondiabetic patients with arterial blockage disease (Li et al., 1998).

• In a randomized controlled trial, ginkgo leaf oral liquor was shown to significantly reduce clinical symptoms, airway hyper-reactivity and pulmonary function of asthmatic patients (Li et al., 1997). It has also shown benefit in children's asthma (Keville, 1996).

• In a multi-center randomized controlled clinical trial of 545 schizophrenic patients receiving 120 mg of ginkgo three times a day in addition to their regular neuroleptic medication, researchers found a general reduction in negative symptoms including thought disturbance (Luo et al., 1997).

• A double blind three-month study of 70 patients with vertigo showed that ginkgo significantly reduced the intensity, frequency and duration of the disorder. By the end of the trial, 47% of the patients taking ginkgo were symptom free, compared to 18% of those who received the placebo (Haguenauer et al., 1986).

• A randomized controlled study of ginkgo extract found it effective in treating breast and leg swelling and mood changes during PMS episodes (Tamborini and Taurelle, 1993).

• In a controlled blood flow study on ten healthy subjects, gingko decreased red blood cell aggregation (clumping) by 15%, and increased blood flow into the capillaries under the fingernails by 57% two hours after ingestion (Jung et al., 1990).

• Blood stasis can cause oxygen starvation of the venous lining tissue, leading to the development of varicose veins. In a randomized controlled clinical trial, ginkgo extract was one of four medicines shown to reduce circulating cells indicative of venous wall damage (Janssens et al., 1999).

• In a randomized, double blind and placebo controlled 5-way crossover design study ginkgo leaf extract was shown to improve memory, the best results occurring at a dose of 120 mg per day. The benefits were more apparent in individuals over the age of 50 (Rigney et al., 1999).

• In a controlled crossover study, ginkgo was shown to benefit glaucoma patients by increasing ocular blood flow (Chung et al., 1999), and an earlier controlled study of blood flow to the retina showed similar results. Researchers concluded that " damage to the visual field by chronic lack of blood flow (is) significantly reversible” (Raabe et al., 1991). 

GINSENG ROOT

Latin: Panax ginseng

Chinese: Ren shen

English: Essence of Man

WHAT IT DOES: Ginseng root is sweet and slightly bitter in taste, and warming in action. It strengthens the vital force (Qi), tonifies the digestive and immune systems, reduces fatigue, sharpens the mind and slows aging.

RATING: Gold

SAFETY ISSUES: Do not use during acute fevers. Do not use with hypoglycemia or hypertension. Overdose or taking late at night may cause nervousness and sleeplessness. May cause irritability in some sensitive individuals. Consult with your physician if you are taking cardiac glycosides.

STARTING DOSAGE: • Dried powder: three to nine grams per day • Concentrated powder extract: one to three grams per day Note: it is common to use a combination of the two forms

Wild ginseng root is collected in the mountains of northern China and in Korea. There are two common preparations of the cultivated root, sun-dried or roasted ginseng, and sweet red ginseng. Americans have known about the tonic effects of ginseng since colonial times, though I still find a lot of common misunderstandings about its use. It is a strong tonic of the vital force (Qi) and is especially useful when there is extreme deficiency presenting with symptoms of cold limbs, anemia, weak respiration, weight loss, chronic fatigue and a weak pulse. It strengthens the immune system, helps generate fluids and strengthens the heart. In our practice, we find it indispensable for keeping cancer patients strong when undergoing chemotherapy.

Ginseng root can also be lifesaving for the elderly. My dad began to lose weight and feel weak after he passed the age of 80, and Nai-shing made him a ginseng-based formula that immediately turned this situation around. Our relatives visiting from China were amazed when, at the age of 81, he chopped down and removed a large tree single-handedly. I hear they still tell this story in China.

Ginseng can be lifesaving if administered following sudden bodily trauma or shock, such as blood loss after an accident. In such cases, administer a large dose of ginger--about three grams of dried powder every two or three hours, up to 30 grams per day. Doctors in Chinese hospitals use a formula called "Generate the Pulse" (shengmai san) for the same purpose, and it is more effective than ginseng alone (Xuejiang et al., 1999). It is made from equal parts of ginseng root, ophiopogon root (mai men dong / Ophiopogon japonicus) and schisandra berries.

Research highlights

• Ginseng’s anti-aging effects are theorized to be a result of its ability to increase the body’s synthesis of DNA, RNA, and protein, as well as synthesis of gonadotropins and ACTH, all of which can prolong cell life (reported in Huang, 1999).

• Healthy male volunteers given ginseng root showed cardiovascular benefits, indicated by a substantial decrease in heart rate two weeks after the end of a nineweek experiment (Kirchorfer, 1985).

• It may also improve muscular oxygen utilization (Pieralisi et al., 1991).

• Ginseng may be of benefit to non-insulin-dependent diabetic patients. Researchers in one study reported that, "Ginseng therapy elevated mood, improved psychophysical performance, and reduced fasting blood glucose and body weight. The 200-mg dose of ginseng improved glycated hemoglobin and physical activity (Sotaniemi et al., 1995).

• Russian studies have shown that ginseng increases mental activity, efficiency of concentration and intelligence. This is accomplished partly through increased biosynthesis of neurotransmitters (reported in Huang, 1999).

GOTU KOLA LEAF

Latin: Centella asiatica, Hydrocotyle asiatica

Sanskrit: Brahmi, Mandukaparni

Chinese: Luo de da, Ji xue cao

WHAT IT DOES: Gotu Kola is bitter and astringent in taste and cooling in action. It is a brain and memory tonic, and an anti-poison, also useful for wound and skin healing.

RATING: Gold

SAFETY ISSUES: None known

STARTING DOSAGE:

• Dried decoction: two grams two to three times per day

• 4:1 concentrated powder extract: one gram two times per day

• 1:5 tincture: 20-40 drops two to three times per day

Gotu kola is often confused with another plant, bacopa (Bacopa monniera), which is also named brahmi, found more in the south of India. Gotu kola is the original plant found in ancient Sanskrit texts, and bacopa was added much later. Both plants are used for memory and concentration, but their energies are different. Gotu kola is cooling and anti-poison, while bacopa is warming and stimulating. Be sure to check the Latin name if you are purchasing these herbs to ensure you’re getting the right one.

Gotu kola is an annual small spreading plant found growing near rivers and ponds. TAM doctors use it as a brain and memory tonic, and have found it especially useful in children. In Nepal, during the ceremony for the first day of spring, gotu kola leaf is given to schoolchildren to help them in their studies by improving memory and concentration. It is very safe and extremely effective. TAM doctors also use it to cleanse the system of toxins and reduce inflammation. TCM doctors use gotu kola to clear up boils and toxic fevers. Gotu kola grows abundantly in India, China, Australia, Africa, Ceylon, Indonesia and Madagascar, so plants are harvested and used freely in the markets. Unfortunately, the chemical profiles differ among these species, and quality varies significantly. If you drink two or three cups per day of good quality gotu kola, you should notice the results quickly. The primary effects of gotu kola include both wound healing and improvement of mental clarity and emotional balance. It doesn’t surprise me that one herb can affect such seemingly unrelated physiologies. For one thing, the nervous system and skin both originate embryologically from the ectoderm, and the skin is a sense organ. I think further investigation is warranted to explore gotu kola’s effects on other sense organs such as the eye, as well as on neurotransmitters, immune status and other nervous system parameters. At our clinic we sometimes find it useful in treating attention deficit disorder (ADD).

Research highlights

• Western scientists have focused on the herb’s wound and skin healing effects. Numerous studies from around the world have demonstrated its efficacy in treating keloids, leg ulcers, phlebitis, slow-healing wounds, leprosy, surgical lesions, cellulitis, burns, dermatitis, venous disorders, and even cirrhosis of the liver (Maquart et al., 1999; Shukla et al., 1999; Hausen, 1993; Cesarone et al., 1992). These studies illustrate the plant’s numerous stimulating effects on the healing processes of the skin and connective tissue.

• The Indian Central Council for Research on Ayurveda and Siddha, citing more than ten pharmacological and animal studies of gotu kola, also found evidence of the following characteristics: CNS depressant, memory enhancer, anti-convulsant, antispasmodic, behavior and intelligence enhancer, and blood sugar regulator (Pandley et al., eds, 1996).

GRAPEFRUIT SEED EXTRACT

Latin: Citrus paradisi

WHAT IT DOES: Grapefruit seed extract is sour and bitter in taste and cooling in action. It is a relatively non-

toxic contact anti-microbial useful in chronic intestinal infections.

RATING: Yellow

SAFETY ISSUES: Avoid direct contact with skin or mucosal surfaces. Do not exceed recommended dosages.

STARTING DOSAGE:

• Topical wash: four to five drops in four to eight ounces of water (this makes a strong wash for external use only).

• Internal dilution: four to six drops in 1/4-1/2 cup water three times per day.

• Pill (usually equivalent to five drops of GSE): one pill three times per day in most cases

Grapefruit seed extract (GSE) is an anti-fungal and antibiotic. It is used to treat bacterial and fungal intestinal infections, ear and sinus infections, and vaginal infections. It is relatively non-toxic to human tissues compared to other anti-microbials, and can be used internally for fairly long periods of time (up to six months) with no apparent side effects. Studies have found it effective in fighting a wide variety of pathogenic organisms, including candida (yeast), herpes, staph, salmonella, E. coli, influenza, and various parasites including protozoa. It only works on contact, so it is ineffective in the treatment of blood diseases. Moreover, studies done on it show that it only effective when it contains preservatives added during manufacture, especially triclosan, an ingredient used in mouthwashes and toothpastes.

We use GSE in our clinic as part of a treatment for patients with chronic intestinal infections who exhibit symptoms such as severe chronic gastric gas, bloating and pain. These types of infections, termed intestinal dysbiosis, can contribute to widespread system problems including mental confusion, chronic fatigue, chronic vaginal yeast infections, muscle pain, chronic constipation and severely impaired immunity. Whenever using this herbal medicine, I advise the patient to use a good broad-spectrum acidophilus product to ensure preservation of the “good guy” intestinal flora. I also advise them to avoid simple sugars like the plague, as they feed the "bad guy" infection-causing organisms. It is important to recognize that not all strains of "bad guys" respond to this extract, and other agents may be needed.

Dr. William Crook brought one form of intestinal dysbiosis to the general public’s attention in his classic book The Yeast Connection. I have seen many, many female patients enraged when their doctors refuse to even consider chronic intestinal yeast infections as a cause of the above-mentioned problems. Although I hope gastrointestinal specialists learn to accept and treat this simple syndrome, most currently treat the idea like kryptonite. One of my patients told her doctor that the symptoms she had experienced for five years went away after two months of herbal treatment and dietary modifications. He almost threw her out of his office, exclaiming, "Don't you think my dozen years of medical training taught me anything? I'm a specialist!"

Effects similar to those of GSE/triclosan can be obtained with completely natural neem concentrate. However, neem contains very strong "natural" chemicals, some of which have insecticide-like properties. Neem is also clinically more difficult for some patients to tolerate than GSE.

You can use GSE used when travelling to disinfect local water supplies. Use ten drops of GSE per gallon of water, and let it sit for several hours. You can also disinfect toothbrushes by placing them in a water solution containing GSE.

As it turns out, GSE is not a completely natural product. Although very clinically effective, it is actually a combination product that essentially acts as a “mouthwash” for the intestines. Purists may want to avoid it, in spite of its clinical usefullness.

Research highlights

• A team of researchers in 1999 confirmed earlier reports (Sakamoto et al., 1996) that the microbial inhibiting effects of GSE, though quite effective, only occurred in samples containing the preservatives triclosan and methyl paraben (von Woedtke et al., 1999).

• Triclosan is an antimicrobial agent used in dentifrices, mouth-rinses and skin care products. It boasts a positive safety profile, and is non-toxic with no long or shortterm carcinogenic, mutagenic, or teratogenic actions (Bhargava and Leonard,1996; DeSalva et al., 1989).

GUGGUL GUM

Latin: Commiphora muku,l Balsamodendron mukul

Sanskrit: Guggulu

WHAT IT DOES: Guggul gum is bitter and pungent in taste, and hot in action. It is a longevity tonic that stimulates the breakdown of mucous, tumors, fat and cysts.

RATING: Gold

SAFETY ISSUES: Do not use during pregnancy. Excess use of concentrated guggulipid may cause headache, mild nausea, and vomiting (Singh et al., 1994). May cause reduced bio-availability of the drugs diltiazem (cardizem) and propranolol (Dalvi et al., 1994).

STARTING DOSAGE:

• Concentrated dried extract: one to two grams two times per day

• Standardized lipid: 500 mg (yield=25 mg guggulsterone) three times per day

Note: use only prepared extracts

Guggul gum has been used in Ayurvedic medicine for centuries to treat abnormal growths, tumors, cysts, arthritis, glandular swelling, cancer, inflammation, and as a rasayana for promoting long life and health. It is so important in TAM healing that it has its own group of compound medicines listed in the TAM Materia Medica. Two of the most well known medicines are yogaraja guggulu and kaisara guggulu. Yogaraja guggulu is used to treat enlargement of the abdomen, peritonitis, rheumatism, neurasthenia, sciatica, and nervous system (Vata) diseases in general. It also has significant anti-inflammatory properties (Pandley et al., 1996). Kaisara guggulu is used to treat weak digestion, constipation, boils, diabetic ulcers, abdominal tumors, leprosy, leukemia, psoriasis and inflammation-related (Pitta) diseases.

Guggul gum has been popular in the West since researchers discovered its significant cholesterol-lowering properties in human trials (Nityanand et al., 1989). The gum can be separated into base, acid and neutral fractions. The neutral fraction contains most of the cholesterol-lowering activity, while the acid fraction contains some antiinflammatory components.

Concentrated dried decoction extracts focusing on the cholesterol-lowering aspect are now being mixed with other cholesterol-lowering herbs and nutrients (such as ginger root and niacinamide) and sold as alternatives to Western drugs. I personally think this is probably a safer alternative to some of the Western cholesterol-lowering drugs.

Guggul gum in its traditional form is almost always used in combination with triphala and/or guduchi stem (Tinospora cordifolia). Both of these have strong antipoison, anti-oxidant, and anti-inflammatory properties. TAM doctors also divide guggul into two types, new and aged, and prescribe them differently. The aged form has been considered a major anti-cancer herb since ancient times.

Research highlights

• In human trials, a combination of guggul gum and puskaram tuber (Inula racemosa) proved superior to nitroglycerin in reducing the chest pain and dyspnea associated with angina (Miller, 1998; Tripathi et al., 1988).

• Guggul may also have value in acne treatment. In one study, a majority of patients with serious nodulocystic acne experienced a progressive reduction (about 60-70%) in lesions when treated with guggulipid, results comparable to patients who received tetracycline (an antibiotic) treatment. The researchers noted that patients with very oily skin responded remarkably better to guggulipid than the antibiotic (Thappa et al., 1994).

• Clinical studies done in 1956 by Chopra showed guggul’s ability to elicit significant improvement in psoriasis cases (Pandley et al., 1996).

• Guggul gum may also have mild thyroid-enhancing activity due to its effects on fats (Panda et al. 1999).

GUDUCHI STEM

Latin: Tinospora cordifolia

Sanskrit: Guduchi

English: Heart-leaved moonseed

WHAT IT DOES: Guduchi stem is bitter in taste and warming in action, and is a rasayana tonic for good health and longevity. It has anti-toxin and anti-inflammatory properties, reduces mucous, and has a calming, stabilizing effect on the nervous system (Vata).

RATING: Gold

SAFETY ISSUES: None known.

STARTING DOSAGE:

• Dried powder: two grams two to three times per day

• 4:1 concentrated powder extract: one gram two times per day. The guduchi plant is a long creeper with a succulent stem that grows in temperate and sub-tropical forests. It is used to treat fevers, hepatitis, gout, toxemia, and urinary diseases. It is also often used by itself as a tonic tea. Guduchi stem is a diuretic, helping expel toxins including uric acid through the urine. It is an aphrodisiac, useful in treating impotence and debility from chronic disease. Dr. Mana (my Ayurvedic teacher) told me this herb has the special power (prabhava) of restoring balance without ever causing over-balance (samanam). In our clinic we use guduchi stem to treat infectious or chronic diseases where there is a need to detoxify and strengthen without disturbing the system further, such as with chronic hepatitis patients or those undergoing chemotherapy.

Research highlights

• Studies have shown guduchi to have general significant anti-inflammatory effects as well as specific anti-inflammatory action in cases of rheumatoid arthritis and liver toxicity (Pandley et al., 1996).

• Guduchi stem was tested for its ability to handle changes in immune cells after rats were exposed to different types of toxins. It was found to normalize phagocytic function irrespective of the nature of change in the cells, complying with the definition of an adaptogen (Rege, 1999).

• Animals treated with the herb were able to significantly recover liver function in the weeks following experimentally inflicted damage. Their liver immune cells (Kupffer cells) were protected against the damage, while those animals not given the herb exhibited perpetuation of damage (Nagarkatti et al., 1994).

• Guduchi’s hepato-protective and immuno-modulatory properties were also shown to enhance the host defenses of a group of surgical patients, as indicated by the absence of post-drainage sepsis (Rege et al., 1993).

• Another group of researchers concluded that guduchi stem and shatavari root were potent immunostimulants, with value for patients receiving cytotoxic drugs, when they were found to protect mice against bone marrow suppression from cyclophosphamide, a chemotherapeutic agent (Thatte UM et al., 1988).

GYMNEMA

Latin: Gymnema sylvestre

Sanskrit: Gurmar

WHAT IT DOES: Gymnema is bitter in taste, and cooling in action. It improves blood sugar control in diabetics, numbs the taste of sweet completely (for about 20 minutes), and decreases appetite (for about 90 minutes).

RATING: yellow

SAFETY ISSUES: None reported. Should not be used by people with low blood sugars (hypoglycemia).

STARTING DOSAGE:

• 1:1 extract: five to 10 ml per day

• Pill: 500-1000 mg three times per day

Gymnema actually means "sugar destroyer." It grows in the wild forests of central India, all the way to Western Ghats and up to the Himalayas. Research indicates that gymnema stimulates insulin secretion. Japanese studies have shown that it improves glucose tolerance in animal models of diabetes, and other studies show that the effects can last for up to two months after discontinuation. This herb is a good long-term tonic for Type I and II diabetics. Results are best seen after long-term administration, over six months to a year. I prefer to use it in combination with several other herbs for blood sugar control, because it affects only a few aspects of the imbalance.

In case you’re curious, sugar tastes like sand for twenty minutes after you chew on a little gymnema.

Research highlights

• Triterpenoid saponins in gymnema are responsible for its dramatic sweet tasteblocking action (Baskaran et al., 1990).

• One animal study testing extracts of gymnema confirmed earlier conclusions of human studies that the herb stimulates insulin release, adding that it works by increasing permeability in the islets of Langerhans, allowing more insulin to escape into the blood (Persaud et al., 1999; Shanmugasundaram et al., 1990).

• In tests on diabetic rabbits, gymnema dried leaf powder not only helped control elevated blood sugars, it also corrected metabolic derangements in the liver, kidney and muscles (Shanmugasundaram KR et al., 1983).

• Gymnema does not seem to improve insulin resistance in diabetic rats, although other herbs have been known to do so (Tominaga et al., 1995).

• Gymnemic acids found in gymnema have been found to bind cholesterol, causing it to be excreted in the stool of animals (Nakamura et al., 1999).

• Gymnemic acids also bind glucose and a common fatty acid (oleic acid) in the intestine, causing reduced uptake into the blood (Wang et al., 1998, (Shimizu et al., 1997).

HARITAKI FRUIT

Latin: Terminalia chebula

Sanskrit: Haritaki

English: Chebulic myrobalan

Chinese: He zi

WHAT IT DOES: Haritaki fruit is sweet, sour and astringent in taste, as well as slightly bitter and pungent. It is hot in action. It strengthens immunity while exerting a mild laxative effect.

RATING: Gold

SAFETY ISSUES: Not for use by pregnant women due to laxative effect.

STARTING DOSAGE:

• Dried powder: two grams two times per day

• 4:1 concentrated powder extract: one gram two times per day

Haritaki fruit embodies all tastes except salt, one of the many reasons it is designated in TAM as a rasayana tonic, good for health and long life. It is also tridosagna, meaning it can be used with any type of health imbalance. Furthermore, it is an anulomanum—a mild laxative that aids digestion. Haritaki is used to nourish the heart, liver, and kidney, and to treat diseases of the eye, for which it is used both internally and externally. There are seven types of haritaki fruit:

• Vijaya: looks just a squash and can be used in any case.

• Rohini: is round in shape and more effective for healing.

• Putana: is small in size with big hard seeds, and is useful for external plastering.

• Amrita: is fleshier, and good for body purification.

• Abhaya: has five lobes, and is more effective for ophthalmic use (external).

• Jivanti: is yellow in color and good for all cases.

• Chetaki: has three lobes, is good to use in the form of powder, and is more laxative than the others. Chetaki comes in two varieties—white and black.

The mature (ripe) haritaki fruits are harvested during the autumn season, when they have the strongest medicinal and laxative effect. Drying the fruit properly in the sun to make a powder reduces the laxative effect slightly, and cooking or steaming reduces it even further, due to oxidation of the laxative chemicals. Traditional doctors disapprove of cooking the fruit when it should be sun-dried (a tedious process). The cooking process is thought to weaken the herb's medicinal effectiveness. However, TCM doctors often cook laxative herbs (such as rhubarb root, which is soaked in wine then fried) in order to remove the laxative properties, so they can be used for other purposes without discomfort to the patient.

Haritaki fruit contains anthraquinone-like (laxative) chemicals as well as tannins and astringents (reported in Kapoor, 1990). To bring out these opposing actions within a given product, Ayurvedic doctors administer it with warm water to strengthen the laxative action, and with ice cold water to promote the astringent action. For example, the juice mixed with cold water can be used as a mouthwash to treat spongy gums.

The post-digestive or delayed reaction of haritaki fruit (vipaka) is very strongly nourishing, so this is an excellent choice as a laxative in weak or elderly patients.

Haritaki fruit is part of triphala, the three-fruit formula. It is generally administered in triphala form rather than by itself to draw upon the tonic effects. Each of the triphala fruits is tonic, and together they act to balance the three primary balancing forces, Vata, Pitta and Kapha. At our clinic, following the Ayurvedic tradition, I add triphala to many, many combinations for this balanced tonic action. The wide variety of liver-protective, antioxidant, nutritive and antimicrobial virtues found in these three fruits lends much credence to this traditional practice.

TCM doctors use dried or cooked haritaki fruit to tighten up the stool for chronic diarrhea and dysentery and to "tighten" the lungs in chronic cough. By stating that it can be used for both hot and cold patterns of disease, they are acknowledging the balanced action of this herb.

Research highlights

• Researchers tested a 10% solution of haritaki fruit extract as a mouth rinse to study its effect on bacteria. The mouthwash significantly inhibited salivary bacterial count and total streptococcal (S. mutans) count for up to three hours compared to placebo, apparently by blocking their ability to utilize sugars (Jagtap and Karkera, 1999).

• Haritaki fruit was one of six Ayurvedic herbs administered to animal to test their adaptogenic potential. All six traditional rasayana plants were able to aid the animals against a variety of different stressors working in different ways (Rege, 1999).

• Alcohol extracts of 82 Indian medicinal plants were tested in vitro against several pathogenic and opportunistic microorganisms. Only five plants had a broad spectrum as well as potent action, one of which was haritaki fruit. The others were amla fruit, vibhitaki fruit, chitrakam (Plumbago zeylanica) and kutaja (Holarrhena antidysenterica). Subsequent animal testing showed no cellular toxicity (Ahmad et al., 1998).

• Tests of alcohol extracts revealed gallic acid and its ethyl ester, two potent antimicrobial substances that acted against even resistant strains of Staphylococcus aureus (Sato et al., 1997). In an AIDS model with immuno-suppressed mice, haritaki fruit was one of four herbs found to significantly reduce viral loads in a chronic lung infection (CMV) commonly found in AIDS patients (Yukawa et al., 1996).

• Haritaki fruit was one of four herbs screened out for potency to test for use with the anti-viral drug acyclovir against herpes (HSV-1) in a study at the Toyama Medical and Pharmaceutical University in Japan. When acyclovir was combined with any one of the herbal extracts and ingested in oral doses similar to human use, the results were significantly stronger than the use of the drug or the herbs alone, especially reducing viral loads in the brains of the animals (Kurokawa et al., 1995).

• Rabbit studies of the cholesterol-lowering actions of each of the triphala fruits showed that haritaki fruit had the strongest effect. Although all three fruits reduced cholesterol, haritaki fruit significantly reduced cholesterol deposits in the liver and aorta compared to controls (Thakur et al., 1988).

HAWTHORN

Latin: Crataegus pinnatifida, Crataegus laevigata

Latin: Crataegus Species

Chinese: Shan zha

WHAT IT DOES: Hawthorn berries and flower buds are sour and sweet in taste, and slightly warming in action. Hawthorn nourishes the heart, increases oxygen flow to the heart muscle, reduces blood vessel inflammation and helps digest fats and oils.

RATING: Gold

SAFETY ISSUES: Patients taking cardiac glycosides such as digitalis should inform their physicians that

hawthorn may potentate the drug’s effect, and dosage may need to be adjusted.

STARTING DOSAGE:

• Dried powder: 10-100 grams per day

• Concentrated powder extract: two to15 grams

• Concentrated syrup: one to four teaspoons per day

Similar (but not identical) species of hawthorn are used by both Chinese and Western herbalists to benefit the heart. Western herbalists consider it to be a tonic "food for the heart." At our clinic we use it in formulas for all heart and cholesterol-related problems. It is safe and effective for long-term use. For serious heart conditions, it may be best to use concentrated dried decoction extracts and syrups, which contain more of the beneficial pigment compounds. The darker the syrup, the better. TCM herbalists use the fruit to help patients digest fats and other heavy foods. Because the species are not identical, it is best to use the Western variety (C. oxycantha) to treat heart problems, and the Chinese variety (C. pinnatifida) to treat digestion-related disorders. It is very common in China to see children eating candy-coated hawthorn fruit on a stick.

Hawthorn is used to treat hypertension, hypercholesterolemia, palpitations, tachycardia, angina, cardiomyopathy, coronary artery disease (CAD) and varicose veins. The fruit contains high levels of procyanadins, which are known to be cardiotonic (Rehwald, 1995). The mature flower buds and young leafy spring tips are quite high in flavonoids and proanthocyanins, which are useful for treating diabetes and arthritis, as well as for strengthening and repairing connective tissue (reported in Upton, 1999). Some herbalists report that long-term use of hawthorn, six months to a year or more, can sometimes reverse essential hypertension. I have had two patients for whom this has been true, both able to go off their western medication. This clinically-observed effect may be due to gradual reduction of low-level inflammation affecting the inner walls of the vessels combined with hawthorn’s numerous other heart-protecting activities.

Research highlights

• German physicians combine hawthorn with digitalis in cases of rapid heartbeat with and without atrial fibrillation, and report it can also be used for heart conditions for which digitalis is not yet indicated (Blesken, 1992).

• Studies have shown hawthorn to be sufficiently strong to benefit patients with NYHA (New York Heart Association) stage II cardiac insufficiency (Weikl et al., 1996) as well as patients in stage I and stage II congestive heart failure (Ammon et al., 1981).

• Chinese researchers have also reported a beneficial effect on angina symptoms (Weng et al., 1984).

ISATIS ROOT & LEAF

Latin: Isatis tinctoria, I. indigotica

Chinese: Ban lan gen (root) Da qing ye (leaves)

WHAT IT DOES: Isatis root and leaf are bitter in taste and cold in action. They reduce fever and heat, cool the throat and kill microbes.

RATING: red, due to safety issues.

SAFETY ISSUES: Should not be used for extended periods of time, or in patients with severe weakness. Long-term use can reduce beneficial intestinal bacteria. Use only under the guidance of a trained

professional.

Note: In 1990, there were 38 reports in China and 16 in Taiwan of adverse reactions to isatis (Ko, 1999).

STARTING DOSAGE:

• Dried powder: two to three grams per day

• Concentrated dried decoction extract: one to four grams per day.

Isatis is one of the most effective TCM herbs used as an herbal antibiotic, antiseptic and anti-viral. TCM doctors use it whenever there are signs of fever or toxic heat from viral illness, blood poisoning, leukemia, hepatitis, meningitis, scarlet fever, laryngitis, tonsillitis, mumps, and other similar ailments. It is an effective alternative to Western prescription antibiotics in some cases. Although the root is used most commonly, the leaves are useful as well. TCM doctors say isatis leaves "go to the upper part of the body" more than the root, so leaves are used for upper respiratory infections along with the root.

I find it very safe for short-term use, less than three weeks. Long-term use can weaken digestion, and sometimes can induce a very interesting but reversible feeling of internal coldness, to the point of shivering. I have experienced this phenomenon, and it was a truly enlightening sensory introduction to the concept of "coldness." I always use this herb with caution, as it can induce nausea in sensitive individuals and weaken digestion over time. Isatis contains several potent dark pigments, including blue indigo and red-colored indirubin.

Research highlights

• Indirubin binds to and blocks enzymes that govern cell division, thus stopping the proliferation of blood cancer cells. An article in Nature Cell Biology reported the results of a study examining the effects of indirubin extract on chronic myelocytic and chronic granulocytic leukemia. According to the report, 26 percent of the chronic myelocytic leukemia patients showed complete remission and 33 percent showed partial remission. Remissions lasted up to several years. The toxicity of the extract was relatively mild (Hoessel et al., 1999).

• The Experimental Pharmaceutical Factory at the Beijing College of TCM found alcohol to besuperior to water for extracting indigotin and indirubin (Zhang et al., 1990). Additionally, meisoindigo, an indirubin derivative, seems to inhibit cancer cell replication more effectively due to its superior absorption (Ji et al., 1991). From an herbalist’s point of view, these two studies might argue for the treatment of leukemia with alcohol extracts of herbs containing indigo and indirubin, such as isatis, combined with digestion improving herbs such as black pepper or long pepper. Other herbs which have shown anti-leukemic action in the laboratory include boswellia gum and turmeric root.

• In a controlled rat model of chronic Pseudomonas aeruginosa lung infection mimicking cystic fibrosis, isatis and genkwa flower (Daphne giraldii / yuan hua) were each able to reduce the incidence of lung abscess and to decrease the severity of lung pathology (Song et al., 1996). We now know that alterations in fatty acid metabolism are responsible for many of the symptoms of cystic fibrosis symptoms, and that DHA (docosahexaenoic acid) derived from marine algae or fish is effective therapy for reversing these symptoms (Freedman et al., 1999). Consequently, I wonder if the combination of these TCM herbs and DHA would provide even greater benefit for this disease.

• In laboratory studies of mice, isatis root polysaccharides increased the weight of the spleen and number of white blood cells and lymphocytes significantly, as well as neutralizing some of the immune suppression caused by hydrocortisone (Xu and Lu, 1991).

• A number of studies of acute viral respiratory tract infections and infections normally requiring antibiotic therapy have demonstrated the efficacy of a combination of echinacea root, white cedar leaf tips and wild indigo root, which contains similar compounds to isatis (Wustenberg et al., 1999).

KAVA ROOT

Latin: Piper methysticum

 English: Kava / Kava-Kava

WHAT IT DOES: Kava root is bitter, pungent and slightly astringent in taste and warming in action. It

tranquilizes the mind, calms anxiety and reduces skeletal and bladder muscle spasms and pain.

RATING: yellow, due to limitations in usage.

SAFETY ISSUES: Do not use during pregnancy or nursing. Do not exceed recommended dosage. Do not use when depressed. Kava potentiates the effects of barbiturates, and benzodiazepines such as Xanax. Do not use in patients with Parkinson’s Disease. Extreme excess dosage over time may cause a reversible scaly rash. A single case use of kava root with alprazolam resulted in a coma (Almeida and Grimsley, 1996).

STARTING DOSAGE:

• Standardized extract: 100-250 mg one to three times per day.

Note: when standardized, extracts contain 30% kavalactones, also called kavapyrones

Kava root relaxes the central nervous system and can be used to treat conditions like irritable bladder syndrome, anger, anxiety, nervousness and insomnia. It is a very effective treatment for irritable bladder because it numbs pain as well as relaxing spasms. According to written accounts, inhabitants of the Pacific Islands have used kava root as a mild intoxicant since the1772-1775 voyages of Captain Cook. Typically, they would chew the root, then cover it with water. After it macerated for a while, they would strain it and drink the liquid (Felter and Lloyd, 1898). They now have more sophisticated uses for it, such as drinking the tea before marriage counseling sessions to prevent chair throwing. My experience with kava is that it induces a mild euphoria in the average person, but I suggest you keep quiet about it, as anything that provides too much pleasure is currently a source of great concern to our moral and political leaders.

Kava root may be a good substitute for some prescription medications for anxiety. However, a qualified physician should supervise any changeover. It is important to distinguish between anxiety and depression, as kava should usually only be used in cases of anxiety and irritability. It may exacerbate depression.

For clarification purposes, depression is when you want to lie in bed forever and hide from the world, and nothing matters. Anxiety is when your mind races out of control with fears and quickly changing ideation. I have seen many patients who were self-medicating with herbs, and did not seem to understand the differences between these conditions or the differences between kava root and St. John's wort. There are several combination products on the mass market that contain combinations of kava root and St. John's wort. This may be of benefit for persons suffering from both anxiety and depression. However, if it makes you too calm or makes you more anxious, you may not know whether to discontinue the herbs or double the dosage! Your best bet is to try each herb individually for a short period of time and determine which one is more effective for your condition. Some people may benefit more from the combination.

Research highlights

• Kava seems to work through a variety of biochemical mechanisms. The moodelevating actions may be due to the activation of the meso-limbic dopaminergic neurones (Baum et al., 1998).

• In s clinical multi-center randomized double-blind controlled trial of 101 outpatients suffering from anxiety, kava extract demonstrated a clear superiority over placebo according to the Hamilton Anxiety Scale. Adverse events were rare. The researchers reported these results as support for the use of kava extract "as a treatment alternative to tricyclic antidepressants and benzodiazepines in anxiety disorders, with proven long-term efficacy and none of the tolerance problems associated with tricyclics and benzodiazepines." (Voltz et al., 1997).

• A placebo-controlled randomized double-blind study tested the effect of a standardized kava extract on safety when taken with alcohol. Twenty males and females participated in seven skill performance tests over several days. The kava did not cause any negative additive effects. However, the kava and alcohol group showed a "remarkable" advantage over the alcohol group on the concentration test (Herberg, 1993).

• In a controlled double-blind crossover study comparing the effects of oxazepam (a benzodiazepine anti-anxiety agent) and a kava root extract on recognition and memory tasks, subjects were asked to recognize and recall words. Oxazepam caused a reduction in memory for both old and new words, while kava showed a slight increase in recognition rate (Munte et al., 1993) 

KUDZU ROOT/FLOWER

Latin: Pueraria lobata, P. tuberosa

Sanskrit: Bidari kand

Chinese: Gao gen

WHAT IT DOES: Kudzu is sweet in taste and cooling in action. The root is a general tonic that calms the nerves and heart, relaxes tension and spasms in the upper body. The flower reduces alcohol cravings.

RATING: Silver SAFETY

ISSUES: none known

STARTING DOSAGE:

• Dried powder: five to15 grams per day.

• Tea: cut the fresh or dried tuber into small pieces (about 1/2 inch in diameter), and decoct for about 30 minutes (Yang and Zhang, 1989).

We use kudzu root in our clinic according to TCM tradition, in formulas whenever we see chronic upper body tension, stiffness, muscle spasm and pain. It is also useful for reducing thirst and fever. Kudzu root may be mildly beneficial for treating heart conditions. Patients with angina and hypertension often report that they feel much better after using this herb for a period of time, confirming traditional Ayurvedic reports that it acts as a general tonic for health and long life. For the heart, it can be taken as a tea on a daily basis.

Kudzu vine is seen as a major ecological problem in the southern United States, where it is taking over and growing everywhere. Perhaps turning it into a cash crop would be of great benefit.

If you eat kudzu before you drink alcohol, you will be overcome by hangover nausea almost immediately due to a chemical reaction involving a component called acetaldehyde (reported in Duke, 1997). This will of course discourage alcohol use for a very long time, especially since the initial hangover isn’t the only one you experience. I suggest the government require manufacturers to put kudzu root right into all alcoholic drinks, along with some milk thistle seed to protect the liver, a little white peony root to aid in spatial coordination, and some B-vitamins to reduce toxicity. This would serve as an instant solution to most alcohol-related problems, including over-consumption, liver damage, morning-after hangovers and drunk driving.

Research highlights

• Compounds in kudzu root have been shown to suppress voluntary alcohol consumption in alcohol-preferring rats (Lin and Li, 1998).

• Individual saponins isolated from kudzu root have shown liver-protective activity in vitro with cultured rat liver cells (Arao et al., 1998, Arao et al., 1997).

• Kudzu contains phyto-estrogenic compounds, including daidzin and daidzein (Lin and Li, 1998).

• Women of the Bhil tribe of Madhya Pradesh use kudzu tubers to increase milk production, and it is also used on farm animals for the same purpose (reported in Pandey, 1996).

• In several Indian studies, extracts of kudzu tubers caused 100% post-coital antiimplantation activity in rats, hamsters and guinea pigs, leading to speculation that it might prove useful as a non-toxic abortifacient.

• In a study of 250 female patients, 50% of the pregnant participants taking kudzu tuber experienced pregnancy termination (Chandoke et al., 1981).

• Reviews of experimental studies and clinical application of kudzu root in China have also reported cardiovascular applications. The observed actions include increased blood circulation to the brain, anti-arrythmia, increased blood flow in the coronary artery, mild anti-hypertensive actions, and mild blood sugar lowering effects (Lai and Tang, 1989; reported in Yeung, 1983).

LEMON

Latin: Citrus limon

Sanskrit: Nimbu

WHAT IT DOES: Lemon is sour in taste, and cooling in action. It stimulates the internal organs, and helps resolve kidney stones and gall stones.

RATING: Yellow

SAFETY ISSUES: None known

STARTING DOSAGE:

• Fresh fruit—use as described below

The lemon is one of our most common fruits, and TAM doctors draw our attention to its differences from other sour fruits. Lemon is unique in that its trees bear fruit continuously throughout the year, it has the ability to constrict the capillaries, and it exhibits a cooling rather than a warming action. (This cooling action makes it a stimulating summer beverage.) It has several interesting medicinal uses.

TAM doctors believe lemon has medicinal value in treating indigestion, nausea, and loss of appetite. To stop even severe nausea temporarily, chew or squeeze a piece of lemon peel and inhale the spray. It only works for a few minutes, but this can be important if you suffer from hepatitis or morning sickness. Lemon is one of several citrus products than can inhibit tumor formation. When administered with a chemical carcinogenic agent, oils of orange, tangerine, lemon and grapefruit inhibited tumor formation in both the stomach and lungs of mice (Wattenberg et al., 1985).

I am very partial to organic lemons because the pesticides used on most citrus fruit are detrimental to your health.

Perhaps most importantly, research performed at the University of California in San Francisco showed that patients with kidney stones who could not tolerate traditional pharmaceutical approaches benefited when they supplemented their diets with four ounces of reconstituted lemon juice per day. Lemon juice is a natural source of citrate, and four ounces provide about six grams of citrate. This level doubles urinary citrate levels and lowers urinary calcium excretion, which is required to prevent kidney stone formation. If it was up to me, I'd make sure patients always use the juice of organic fresh lemons, which contain limolene, a phytochemical that helps dissolve gallstones and is found mostly in the white parts on the inside of the rind.