Q and A

Soothe Digestion

After a period of intense digestive discomfort (constipation, nausea and ab- dominal pain), I recently was diagnosed with irritable bowel syndrome. Are there any foods and herbs that can help?
R.D.
Tempe, Arizona

Keville responds: Irritable bowel syndrome (IBS) generally is a catch-all term for a series of related disorders that produce similar symptoms. There are both foods and herbs that will help. That’s good news for many people who have discovered that Western medicine has little to offer people who suffer from this disorder.

Soothing herbs, such as calendula flowers (Calendula officinalis), marshmallow root (Althaea officinalis), chamomile (Matricaria recutita), hops (Humulus lupulus) and licorice root (Glycyrrhiza glabra), help calm the irritation and inflammation caused by IBS. (Do not use licorice root if you have high blood pressure.) These herbs also relax the nervous constriction of digestive muscles that promotes bowel problems.

Psyllium seed (Plantago spp.), which also is popular as a gentle, bulk laxative, is useful for IBS, especially when it is associated with constipation. Several studies conducted back in the 1980s tested psyllium in people who had IBS or similar disorders. Eighty percent of the participants reported less pain, constipation and diarrhea.

Another remedy to try is specially designed enteric-coated capsules that contain peppermint (Mentha ¥piperita) essential oil. These capsules do not release their contents until they reach the intestine, so the peppermint gets to the colon rather than being absorbed earlier in the digestive tract. Medical doctors have prescribed this remedy to IBS patients for a long time, and it is available in U.S. pharmacies.

There are many theories as to what causes IBS. One idea is that the syndrome is connected to the immune system. It certainly doesn’t hurt to take an immune-enhancing formula and see if you start noticing any improvements after a few weeks. A few of the herbs I’ve already mentioned — chamomile, marshmallow and licorice — help improve immunity, soothe the bowels and fend off food allergies at the same time. I’ve noticed that including immune herbs in the formula makes a big difference for many people. IBS can be triggered — and in some cases, perhaps caused — by food allergies, which seem to irritate the digestive tract, especially the colon. So try to determine if eating certain foods makes symptoms worse. This can be a little tricky, since symptoms often result many hours after eating, or even the next day. Try eliminating any suspected foods from your diet, at least temporarily, to see if it makes any difference.

Another factor to consider is stress. As you may have discovered, IBS comes and goes, and bouts of stress can bring it on. Look for ways that you can destress and make your life more relaxing. Also, take advantage of herbs that help you reduce your stress level. Hops and chamomile, as well as catnip (Nepeta cataria), are good choices, since they aid the digestive tract.

Khalsa responds: IBS is a common disorder of the intestines. In IBS, some experience constipation, while others deal with diarrhea; some even alternate between the two, or pass mucus with bowel movements. Frequent cramping and bowel urge without passing stool is common. More than 5 million Americans are living with IBS.

There is no recognized cause for IBS, and no cure in mainstream medicine. IBS can be a minor annoyance, or it can be disabling. Eating, having intestinal gas or having food in the colon can cause the colon to act up. Frequent culprits include chocolate, milk products, fatty foods, alcohol and caffeine. Women have more symptoms during menstrual periods, and many have increased symptoms with stress.

Probiotics assist digestive function and reduce the presence of negative organisms. In a four-week double-blind, placebo-controlled trial published in the Journal of Gastroenterology, 60 IBS patients were treated with the probiotic Lactobacillus plantarum. The probiotic largely reduced intestinal gas. A smaller double-blind trial using L. acidophilus also showed benefits.

Triphala, the famous Ayurvedic herbal combination, is a gentle internal cleanser. It has a high tannin content, so low doses (1 gram daily) treat diarrhea. In higher doses (7 grams daily), it treats constipation in a very slow, gentle way, toning the walls of the intestines while it works.

As Keville mentioned on Page 8, enteric-coated peppermint oil eases the symptoms of IBS, and acts as a relaxant for the muscles of the intestinal wall. In one double-blind trial, four out of every five IBS patients experienced reduced symptoms with enteric-coated peppermint oil.

Caraway (Carum carvi) oil has similar properties, reducing gastrointestinal mo-tility. A 1999 German study of peppermint and caraway oils showed a significant reduction in pain in 223 IBS patients. A study from 2000, published in Phytotherapy Research, again confirmed that a combination of peppermint and caraway oils effectively normalized intestinal movement.

Psyllium seed balances bowel function and relieves IBS symptoms, especially diarrhea. The mucilage in psyllium creates a soothing effect, which may relieve cramping. In a 1987 English study, 82 percent of the subjects had IBS symptom relief when taking a psyllium supplement. A study to find the optimum dose settled on 20 grams a day.

Some people with IBS cannot digest lactose. This may cause abdominal symptoms consistent with irritable bowel syndrome. People with IBS should perform a trial of milk avoidance.

Eating a special diet reduces IBS symptoms in some cases. The diet must be individualized to minimize the personal triggers. Use just enough fiber so that you have soft, easily passed and painless bowel movements. Eating more frequent, smaller meals usually works better than eating fewer large meals.

Elevate Testosterone Levels

I am 51 years old. Seven years ago, I was working very hard at weightlifting. When having some bloodwork done, the doctor noticed my testosterone levels were below normal. The doctor put me on a male hormone replacement (Androgel) and I have been on it ever since. Now that I know better, I do not want to use this drug any further. I would like some advice on what herbs to use to get off of this drug, and I will certainly be working with my doctor as I go through the process.
J.E.
Via e-mail

Keville responds: You are right to think that after taking Androgel for several years, your body may need a kickstart to produce a sufficient quantity of testosterone on its own, especially since your production was low already. It is great that your doctor is willing to help you wean yourself off the hormone, and it sounds like he or she might even be supportive of you taking herbs to help the process. It is a good step, since there is some evidence that taking testosterone may have detrimental side effects similar to the problems women develop from taking estrogen.

Weightlifting usually increases testosterone levels. However, some weight lifters have discovered that overtraining, and especially not allowing the body to recuperate adequately between training sessions, can lower testosterone. Getting enough sleep and eating a diet rich in nuts and olive oil are some simple lifestyle suggestions that can help elevate testosterone and keep it high. The stress from training too hard or emotional stress also can increase cortisol levels and slow down the body’s production of testosterone. You can try stretching exercises like yoga, chi gung or tai chi, which help lower cortisol.

There is no hard evidence that Asian ginseng (Panax ginseng) supports testosterone, but the Chinese historically have used the herb for hormone-related problems, and Western herbalists like myself also think it works well. Many Chinese men still turn to ginseng today when their testosterone levels begin to decline in their 40s and 50s. Unlike hormone-enhancing drugs, herbs will encourage your body to produce its own testosterone, rather than working as a replacement. The Chinese also recommend kidney tonic herbs to strengthen and balance hormonal production. Consider seeing a practitioner who can combine acupuncture with Chinese herb formulas to help the process of discontinuing the drug.

Khalsa responds: This definitely is a good project for herbal medicine. Ashwaganda root (Withania somnifera) is the first herb that comes to mind. This adaptogen is used in Ayurveda as a tonic and sedative. Studies show ashwaganda to be superior to ginseng as an antistress adaptogen. This rebuilding herb is the main tonic for men in Ayurveda, which considers ashwaganda to be a particularly powerful rejuvenative, and it is regarded as a premier sexual tonic. Over time, it will assist in recovering testosterone levels.

An animal study from 2001 showed that extracts of ashwaganda increased production of sex hormones and sperm, presumably by exerting a testosterone-like effect. In another double blind clinical trial, 101 healthy male adults (50 to 59 years of age) took 3 grams of ashwaganda daily for a year to determine the herb’s effect on the aging process. Significant improvements in hemoglobin, red blood cells, hair pigment and seated stature were observed. Serum cholesterol decreased, nail calcium was preserved and 71.4 percent of those who took the herb reported improvement in sexual performance.

A typical dose of ashwaganda is about 1 gram a day, taken over long periods (up to many years) as a rejuvenator, but, since ashwaganda is very safe, Ayurvedic practitioners often prescribe larger quantities for short-term use.

Yohimbe (Pausinystalia yohimbe) is another good possibility for you. Yohimbe is a West African tree. The bark is a traditional herbal aphrodisiac. Warriors who were preparing for battle would drink the bark tea to help them become aggressive and have more stamina. But yohimbe also helps make love, not war. Males in some African societies take yohimbe as part of marriage rituals. The herb developed a reputation for increasing libido, as well as for improving male sexual performance. Modest doses of yohimbe, taken over a few months, along with a tonic herb like ashwaganda, can produce a conspicuous increase in testosterone. In my personal clinical experience, yohimbe is very reliable in the proper dose. You might find it helpful to consult a professional herbalist to get the details right, however — the difference between a pleasant response and nervous discomfort can be a very small dose.

Most people take a dose that supplies 15 to 30 mg of daily yohimbine content, but some people respond optimally to 10 or even 5 mg daily. If using the raw herb in powder in a capsule, start with 200 mg total in one dose, not late in the day, and work up from there. It usually takes at least two to three weeks for the herb to begin producing results. Even in normal doses, side effects of dizziness, anxiety, hyperstimulation and nausea are relatively common.

Be very cautious using yohimbe if you are taking tricyclic antidepressants; phenothiazines; clonidine; drugs for lowering blood pressure; or central nervous system stimulants. It is best to use this herb under the guidance of a qualified herbalist.

Kathi Keville is the director of the American Herb Association (www.Aha Herb.com) and author of 11 herb and aromatherapy books, including Herbs for Health and Healing (Rodale, 1996). She teaches seminars throughout the United States.

Karta Purkh Singh Khalsa has more than 25 years of experience with medicinal herbs. A licensed dietitian/nutritionist, massage therapist and board member of the American Herbalists Guild, he specializes in Ayurvedic, Chinese and North American healing traditions.