In every issue of Herbs for Health, professionals from a variety of health-care fields answer your questions about using medicinal herbs. In this issue, Kathi Keville and Robert Rountree answer your questions on fibromyalgia, sexual dysfunction, and nail infections.
Kathi Keville is the director of the American Herb Association and the author of eleven herb and aromatherapy books including Herbs for Health and Healing (Rodale, 1996). She teaches seminars throughout the United States.
Robert Rountree, M.D., is a physician at the Helios Health Center in Boulder, Colorado, where he practices integrative medicine. He is the coauthor of Smart Medicine for a Healthier Child (Avery, 1994) and Immunotics (Putnam, 2000) and is an Herb Research Foundation advisory board member.
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The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.
Could you tell me if there are herbal remedies for fibromyalgia? I know that diet is extremely important, but everything I’ve read talks about prescription drugs.
Maca helps treat decreased libido.
Keville responds: Dealing with fibromyalgia is tough, as I’m sure you have discovered. Holistic practitioners like to treat the cause of a condition, yet no one knows exactly what causes fibromyalgia or, for that matter, how to cure it. Fortunately, you can ease the symptoms.
Because the primary complaint is pain, especially in connective tissues, rubbing on a liniment helps warm and loosen muscles before physical activity. For general use, apply an anti-inflammatory oil of St. John’s wort (Hypericum perforatum) or arnica (Arnica spp.) over painful areas. Heat almost always brings relief, so run a hot bath and toss in a quarter-cup of Epsom salts along with five drops of lavender essential oil.
Experiment with taking herbal muscle relaxants such as chamomile (Matricaria recutita), catnip (Nepeta cataria), skullcap (Scutellaria lateriflora), and valerian (Valeriana officinalis) as tincture, pills, or tea in the evening. These herbs won’t offer much direct pain relief, but they will ease the muscle tightness that contributes to pain. And in case you’re one of the many people with fibromyalgia who suffer from insomnia, you will sleep better, too.
St. John’s wort can help repair an injured nervous system and is especially suggested if you feel depressed. Siberian ginseng (Eleutherococcus senticosus) is a great tonic for your nervous system and your adrenal glands.
Symptoms of pain and insomnia point to possible underlying nervous system and adrenal gland problems, another reason to take herbs such as the ones I’ve mentioned. If you need caffeine, drink green tea rather than coffee.
Rountree responds: Fibromyalgia is a mysterious condition—no consistent cause has been identified, and there’s no single treatment that benefits everyone. It’s typically treated with painkillers, anti-inflammatory drugs, and muscle relaxants, none of which are dramatically effective and all of which have side effects. However, at least one published medical study shows that patients with fibromyalgia tend to have low levels of magnesium in their tissues. So, magnesium supplements—especially magnesium malate, magnesium aspartate, and magnesium glycinate, which are highly absorbable—are an essential part of therapy. You can take anywhere from 300 to 1,000 mg daily, but be aware that the mineral can cause diarrhea. Using the more absorbable forms helps reduce the incidence of diarrhea.
Herbal therapies work on the same principle as drugs, but they are much less likely to cause side effects. I often prescribe a combination of nervines, herbs that calm the nerves, relax muscles, and relieve pain. Good choices are valerian root, passionflower (Passiflora incarnata), and kava (Piper methysticum). They can be taken individually or in combination throughout the day as needed. For the inflammatory component of fibromyalgia, I recommend a combination of two Ayurvedic herbs: curcumin, an extract of turmeric (Curcuma longa), and boswellia (Boswellia serrata). These are generally available in capsules and taken every four to six hours.
I’ve seen many herbs and medications for men with a sexual problem. What about for women? I never had a problem at all until I started menopause—help! We’ve already tried lots of things.
Keville responds: Because your problem began with menopause, I’ll guess that it involves either libido or vaginal dryness. Look to natural ways to maintain hormone levels. Estrogen is directly related to libido, and it promotes vaginal lubrication. Try taking supplements of black cohosh (Cimicifuga racemosa) or red clover (Trifolium pratense), two phytoestrogens that promote estrogen in the body. Soy foods and other beans containing phyto-estrogens can be added to your diet, too.
Many women find that American ginseng (Panax quinquefolius) works wonders to increase both libido and lubrication. It also helps increase energy and stamina and is thought to balance hormones. Another herb that helps in these arenas is Indian ginseng, also called ashwaganda (Withania somnifera). Take 500 to 1,000 IU of vitamin E daily—it influences hormonal activity. You’ll probably need to take these remedies for a few weeks before you notice any changes. You’ll find more information in the book I wrote with Christopher Hobbs, Women’s Herbs, Women’s Health (Botanica, 1998).
A mail-order source for all-natural vaginal lubricants is Botanica Erotica. Their number is (707) 829-6474. Also, have you tried aromatic aphrodisiacs? Jasmine has an age-old history of such use. Other tantalizing scents are vanilla, cinnamon, and ylang ylang. Buy a spray mister to lightly scent your bedroom and bedding, and light scented candles. Better yet, have your partner massage you with an aphrodisiac massage oil. Just be sure to buy aromatherapy products made from real essential oils (and don’t use straight essential oils directly on your body).
Aphrodisiac herbs include damiana (Turnera diffusa) and yohimbe (Pausiny-stalia yohimbe). Read up on these—or any other herbs you try—to familiarize yourself with their actions and possible side effects. Certain herbal tonics help make sexual organs healthier. Examples are motherwort (Leonurus cardiaca) and red raspberry (Rubus idaeus).
Rountree responds: Because your libido didn’t decline until after menopause, it’s highly probable that the decline resulted from a deficiency of one or more hormones. Even though you might have already tried hormone replacement therapy, it’s possible that the dose or form of the hormones used were ineffective. Sometimes a low dose of progesterone and/or testosterone cream can be helpful. To that end, I’d recommend salivary testing of estrogen, progesterone, and testosterone levels. You should also have a blood test for hypothyroidism, which can be a contributing factor.
My favorite herb for decreased libido is maca (Lepidium meyenii). Maca is a cruciferous vegetable that thrives in the barren, high-altitude soil of the Andes Mountains. It’s a traditional food that was cultivated by the ancient Incas and remains popular in that region.
Similar to adaptogenic herbs such as Siberian ginseng, maca has been reported to increase energy and stamina as well as libido and overall sexual function. These effects have been confirmed by both animal studies and the observations of herbalists and physicians. Its mechanism of action is not known, but it appears to enhance functioning of all of the sex hormones, so it can work for both men and women. I have used it extensively in my practice and have found it to gradually increase sexual drive after three to four weeks of use. A typical dose is 2 to 3 g daily. It is free of side effects and can be taken for extended periods of time.
Help for Infection Nails
I have a severe fungal infection on my nails. All of my toenails and most of my fingernails are infected. I tried a medication called Fulvicin once, and it helped but then the problem recurred within a few months. Any suggestions? Thanks.
Chino Hills, California
Keville responds: Several antifungal preparations are available at natural food stores. I find a solution or powder of black walnut husk (Juglans nigra) with tea tree oil (Melaleuca alternifolia) to be particularly successful. Scientific studies have found that other essential oils with antifungal ability are geranium, myrrh, lemongrass, cloves, and eucalyptus, so look for antifungal products that contain at least one of these. (A note of caution: Essential oils are too strong to use undiluted on your skin.)
Soak your nails for ten minutes a day in about one cup of apple cider vinegar with six drops of tea tree oil.
Remember that fungus thrives on poor air circulation and moist conditions, so do what you can to keep your nails dry and well aired. An herbal antifungal powder should help. One that is scented with sage oil will help decrease perspiration of your feet.
Neither herbal remedies nor drugs like Fulvicin completely eradicate the problem, as you’ve already discovered. Even though you can’t see it, that persistent fungus still lurks under your nails. When you use herbs as topical treatments, also work internally. The South American tree bark pau d’arco (Tabebuia spp.) is a specific antifungal that also enhances the immune system so it can better fight off fungal invasions.
Rountree responds: In my experience, chronic nail fungus is very difficult to treat by any means. As you noted, prescription medications can work temporarily but recurrences are frequent. And because the nails don’t have contact with the immune system, immune-stimulating herbs don’t have a noticeable effect.
The only remedy I’ve found effective is tea tree oil. It must be painted onto the affected nails daily. Or, you can dip your toes and fingertips into a solution made from 1 part tea tree oil to 9 parts alcohol or vinegar. Unfortunately, some people develop allergic reactions when the essential oil comes in contact with their skin, so be cautious.
Along with this, there are two herbs known for systemic antifungal effects that may be worth trying orally as supportive agents. The first is garlic (Allium sativum). Try fresh cloves (two to three daily) or a concentrated extract in tablet form (1 to 2 daily). Olive leaf extract (Olea europea) is a broad-spectrum antimicrobial agent with activity against a wide range of bacteria and fungi. Take 1,000 mg daily. Be persistent—you may need to follow this regimen for six months to a year before you see a significant change.