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Q&A: Cayenne, Kidneys, and Estrogen

Health Professionals Answer Readers' Questions
By The Herb Companion Staff
March/April 1998
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It’s not unusual to see different responses to cayenne
—Robert Rountree, M.D.

In every issue of Herbs for Health, professionals from a variety of health-care fields answer your questions about using medicinal herbs. Medical doctor Robert Rountree and herbalist Rosemary Gladstar respond for this issue.

Hot Spots

Q. My husband and I both take cayenne capsules (40,000 units). We also bought a cayenne ointment for pain in my husband’s shoulder. When he used it, he felt a burning sensation on his shoulder and on the hand he had used to apply the ointment.

When I tried it myself, I didn’t feel anything, not even on my hand. Why and how could this be?
S. S.
Loveland, Colorado

A. Cayenne pepper (Capsicum annuum) contains a substance called capsaicin, which is responsible for the sensation of heat that occurs when it is eaten or rubbed on the skin. It appears to work by releasing substance “P” (for pain), a chemical messenger that activates pain fibers.

Capsaicin has been shown to be helpful in the treatment of arthritis and neuritis by ­initially elevating substance P in sensory nerves and then depleting it, which results in an overall decrease in pain. Unfortunately, the burning reaction is part of the process—it is simply an indicator that the capsaicin is working. Most people find this effect unpleasant but tolerable; however, a few patients need to add a topical anesthetic such as lidocaine.

A standard therapeutic dose is 40,000 units, but it is not unusual to see the widely different responses that you and your husband have had. This could be explained by your individual biochemistries or by different degrees of absorption through the skin. In your case, a higher potency ointment or larger amount may be effective. For your husband, I would recommend trying a small amount several times daily and using a disposable glove when he applies the ointment.

—Robert Rountree

A. Get your husband off that hot stuff! According to Mindy Green at the Herb Research Foundation, the recommended daily dose of cayenne is between 30 and 500 units. More than 3 g a day (3,000 units) can produce gastric ulcers, digestive disorders, rashes, and other skin eruptions. Your husband is taking far too much cayenne at 40,000 units daily and should completely discontinue its use for several weeks, introducing it over time in more reasonable amounts.

Cayenne is a wonderful healing herb and is used for ­chronic pain, heart conditions, circula­tory problems, cluster head­aches, poor digestion, and constipation. I recommend it often, and use it myself in a variety of situations. However, early on in my herbal career, I overdosed on it, taking far too much of this fiery herb and overstimulating my body to the point of spasms. I developed a healthy respect for the power of these small red peppers. High concentrations of capsaicin, the primary heat-producing chemical in cayenne, produces a counterirritant effect, meaning it works by activating pain fibers and increasing circulation. Like any strong herb, it should be used with prudence.

—Rosemary Gladstar

Diabetes and Kidneys

Q. I am a Type I diabetic, and my only complication has been the leaking of protein into my urine, which indicates kidney problems. For this, I take 5 mg of Vasotec daily, though my doctor has requested that I double that dose. What herbs can I use to improve my kidneys and to eliminate or reduce the Vasotec?
A. S. B.
Toronto, Ontario, Canada

A. The most important issue is to avoid further strain on your kidneys. Try to keep your total daily protein intake under 40 g and use plant protein sources such as soybeans if possible. It is crucial to keep your blood pressure low, but before increasing the medication you might try adding one or more herbal preparations.

Hawthorn (Crataegus spp.) contains compounds called proanthocyanidins that appear to inhibit the same angiotensin-converting enzyme that enalapril (generic Vasotec) does. In cases like yours, I prefer to use a standardized solid extract in doses of 100 to 600 mg daily.

Additional supportive herbs include ginkgo and bilberry (Vaccinium myrtillus) or grapeseed extracts, all of which improve the health of small blood vessels such as those in the kidney. I also recommend omega-3 fatty acids, which have been shown to improve the function of damaged or inflamed kidneys. The best sources are flax or fish oil. They are most effective when combined with garlic.

—Robert Rountree

A. Vasotec belongs to a group of ACE (angiotensin-converting enzyme) inhibitors that help regulate both the fluid volume and the degree of constriction of the blood vessels. Though fairly well tolerated when compared to some older angiotensin inhibitors, Vasotec can cause potassium retention, which leads to problems of the heart and kidneys. Consequently, the heart and kidneys should be both monitored and supported with natural therapies.

I recommend a combination of nettle leaf (Urtica dioica), dandelion leaf (Taraxacum officinale), and corn silk (Zea mays) in equal proportions daily to enhance kidney function. Though dandelion leaf is high in natural potassium, it does not create a potassium imbalance in the system. Marshmallow root (Althaea officinalis) and chickweed (Stellaria media) are also among my favorite protective herbs for the kidneys.

To increase the functional capacity of the heart, add hawthorn to your daily diet; the recommended dose is two capsules twice daily. Hawthorn is a natural ACE inhibitor and works similarly to Vasotec without its associated side effects. You might also increase the amount of onions and garlic in your diet because they protect the heart and lower blood sugar.

For blood-sugar regulation you might also investigate blueberry leaf (Vaccinium spp.) and bitter melon (Momordica charantia). Bitter melon is gaining recognition because of its insulinlike protein (polypeptide-P) which helps regulate blood sugar levels. And finally, ­burdock root (Arctium lappa) and Jerusalem artichoke (Helianthus tuberosus) have long been used for diabetes because of the insulinlike compound, inulin, which is concentrated in the roots/tubers of both plants.

—Rosemary Gladstar

Estrogen Replacement

Q. I had a complete hysterectomy due to endometriosis and ovar­ian cysts and have been on estrogen replacement therapy (ERT) on and off, but the synthetic estrogens do not agree with me. I am very much interested in natural ERT. What herbs and vitamins can I take to protect my heart and memory and guard against osteoporosis?
D. K.
Concord, North Carolina

A. Your need just might be filled with a group of compounds called phytoestrogens. These compounds appear to have most—if not all—of the benefits found in synthetic estrogen, but without the side effects. Pow­dered soy protein is the best source (soy milk is not), but it is important to find one that guarantees a high concentration of isoflavones, enough to give you at least 50 mg daily.

Another source is flax meal, which is high in a type of fiber called lignan that also has phytoestrogenic properties. To get the full benefit, eat about 1/4 cup daily, sprinkled in food, or in a “health shake”. I recommend grinding it from flaxseed yourself to avoid rancidity.

Finally, the best bet for protecting your heart and brain is to take a full array of antioxidants including carotenoids (beta-carotene, for example) and tocopherols (vitamin E). And, despite conflicting reports in the recent medical literature, I still think that calcium and exercise make a great combination.

—Robert Rountree

A. Though there are medical situations that require some women to take ERT, most women fare better on less invasive, more holistic methods of embracing menopause. Even, as in your case, when women have had complete hysterectomies, they often respond better to herbal therapies.

Since you are already on ERT, don’t stop abruptly. Rather, slowly reduce your daily dose of ERT over a period of several months. While reducing your ERT intake, add:

• 400 I.U. of mixed-tocopheral vitamin E. (If you are on heart medication, are diabetic, or have high blood pressure, the dosage should not exceed more than 150 I.U.). Vitamin E is a powerful antioxidant and enhances the health of the reproductive organs.

• 1,500 mg of evening primrose (Oenothera biennis), flaxseed (Linum usitatissimum), and/or black current seed oil (Ribes nigrum) daily. I generally prefer these in combinations.

• Two capsules twice daily of dong quai (Angelica sinensis) and/or Siberian ginseng (Eleutherococcus senticosus). These herbs have an adaptogenic effect on the entire system. Both have a regulating effect on hot flashes, apparently modulating temperature variations in the body.

• Hawthorn, motherwort (Leonurus cardiaca), and ginkgo are specific herbs for strengthening the heart, promoting circulation, and improving brain functions.

• To replace ERT in the body, I use the following herbs in combination: vitex (Vitex agnus-castus), wild yam (Dioscorea ­villosa), licorice (Glycyrrhiza glabra), motherwort, Siberian ginseng, and black cohosh (Cimicifuga racemosa) [For more information on black cohosh, see the article on page 38]. These herbs can be ­tinctured, powdered and encapsulated, and/or taken as a decoction.

• Perhaps the greatest fear ­facing meno­pausal women is the threat of osteoporosis. Osteoporosis is greatly reduced by regular weight-bearing exercise and further reduced by including calcium-rich foods in your diet. Sesame seeds, seaweeds, dark green leafy vegetables, and herbs such as nettle, oatstraw (Avena sativa), raspberry leaf (Rubus idaeus), and dandelion leaf are all rich sources of ­calcium. Eliminate foods that deplete calcium from the body, namely coffee, chocolate, and sugar.

At any point, if symptoms of menopause commence, stabilize your ERT dosage to your comfort zone while continuing to take the herbs. After a few weeks, begin reducing the dosage again.

—Rosemary Gladstar

Robert Rountree, M.D., is a physician at the Helios Health Center in Boulder, Colorado, co-author of Smart Medicine for a Healthier Child, and an advisory board member for the Herb Research Foundation.

Herbalist Rosemary Gladstar is founder of The California School of Herbal Studies, co-founder of Sage Mountain Retreat Center and Nature Plant Preserve, and author of Herbal Healing for Women. She has more than twenty years of experience as an herbalist, teacher, and herbal events organizer.


Send your questions to Herbs for Health “Q & A”, Herb Companion Press, 201 East Fourth Street, Loveland, Colorado 80537-5655; fax (970) 669-6117; or email us at H4H@iwp.ccmail.compuserve.com. Please provide your name and address, including your city.

The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.


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