Herbal Apothecary

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Hearing the news these days, you might think the globe is littered with corpses of ephedra users. The megadoses taken by some individuals for the herb’s stimulant effect may indeed cause potentially fatal heart problems. However, let’s not forget that for centuries ephedra, also known as ma huang, has been used in China to treat bronchial asthma and related conditions — long before the herb and its alkaloids (ephedrine, pseudoephedrine, etc.) were added to energy supplements, diet products and over-the-counter cold remedies in the West.

I’m convinced the current demonization of ephedra is largely an overreaction. Viagra is associated with the deaths of more than 500 users, more than five times the number believed to have died as a result of using ephedra, but no public health officials are clamoring for a Viagra ban.

Still, the headlines about ephedra have made many herb users nervous and have focused new attention on herbal safety. No substance with pharmacological effects on the body is utterly, totally safe. Yet, assuming these substances are not used carelessly — as ephedra has been — many medicinal herbs have stood the test of time for safety and effectiveness. Here’s a roundup of some herbalists’ favorites.

Aloe (Aloe vera). Aloe is the best herb for minor wounds, especially burns. Many studies show aloe stimulates the creation of new skin cells. Aloe has anti-inflammatory action that helps minimize wound swelling, and antimicrobial and immune-stimulating action that helps prevent wound infection. I keep a small potted aloe in my kitchen so its soothing gel is always handy where most household burns occur. Just snip off a thick, leathery leaf, slit it open and rub the cool inner leaf gel on the burn.

Note: Use aloe only on minor burns and wounds. More serious wounds require professional medical care.

Black Cohosh (Cimicifuga racemosa). This herb was a key ingredient in one of the 19th century’s most popular patent medicines, Lydia E. Pinkham’s Vegetable Compound, introduced in 1876 to treat “female weakness” — that is, menstrual and menopausal complaints. Ol’ Lydia was right. Black cohosh contains compounds that mimic the effects of the female sex hormone estrogen. Based on decades of clinical experience, Germany’s Commission E, the expert panel that judges the safety and effectiveness of herbal medicines, endorses black cohosh for premenstrual syndrome (PMS), menstrual cramps and menopausal complaints.

Many studies have shown black cohosh particularly effective for hot flashes. Recently, a report by Columbia researchers analyzed 29 studies of various alternative treatments for this sometimes challenging phenomenon of menopause. Only black cohosh had convincing evidence of effectiveness. The easiest way to take black cohosh is to use Remifemin, an over-the-counter supplement available at many health-food stores. Follow label directions. It is also available as a tincture and in a variety of capsules and tablets.

Note: While black cohosh is safe for most women, those who are pregnant or nursing, or who cannot take estrogen, should consult their physician before using it.

Chamomile (Matricaria recutita). In The Tale of Peter Rabbit, the young bunny eats himself sick in Mr. McGregor’s garden, then gets chased out at the wrong end of the angry farmer’s hoe. When he gets home, his mother gives him chamomile tea. Peter’s mother was a wise herbalist. Chamomile soothes jangled nerves. Few of the people who have made tasty chamomile tea an herbal beverage bestseller know what a healer they also hold in their paws. . . er, hands.

Chamomile’s long history as a traditional tranquilizer is supported by recent research. Argentinean researchers have discovered that a compound in chamomile oil (apigenin) binds to the same cell receptors as the Valium family of tranquilizers and anti-anxiety drugs. This suggests similar effects. Japanese researchers exposed animals under stress to chamomile oil vapors. The animals’ stress hormone levels fell significantly. Try chamomile tea when you feel anxious, or add a handful of chamomile flowers to a hot bath and inhale deeply. Chamomile also is a stomach soother. Commission E endorses it for indigestion. If anxiety upsets your stomach, chamomile is your two-in-one remedy. To brew chamomile tea, use 2 to 3 heaping teaspoons of flowers per cup of boiling water.

Cranberry (Vaccinium macrocarpon). Cranberry is a fantastic herb for prevention of urinary tract infections (UTIs).

The Pilgrims supposedly ate cranberry dishes at the first Thanksgiving in 1621, but cranberry sauce did not become a national tradition until the Civil War. General Ulysses S. Grant ordered it served at Thanksgiving to Union troops. Around that time, women began using the tart berries to prevent UTIs. This treatment remained in folklore until 1984, when a report in the Journal of Urology showed that a daily glass or two of commercial cranberry juice cocktail did, indeed, reduce the risk of UTIs.

Since then, other studies have corroborated cranberry’s effectiveness and safety. The herb prevents bacteria from adhering to the bladder wall. Pure cranberry juice is too sour for most people to drink, which is why sugar is added to the juice sold commercially, turning it into “cocktail.” However, sugar may worsen UTIs, so if you can’t stomach the unsweetened juice, another approach is to munch a daily handful of dried cranberries or to take cranberry capsules (such as CranActin, made by Solaray). Follow label directions.

Garlic (Allium sativum). Garlic truly is an herbal wonder drug. Garlic appeared prominently in the world’s oldest surviving medical text, the Ebers Papyrus. Garlic was widely used to treat a host of medical problems throughout history but in modern times came to prominence during World War I as a battlefield antibiotic. After the war, scientists confirmed garlic’s antibiotic power. Commission E endorses the herb for infection prevention and treatment. Use mashed cloves directly on wounds and cover with bandages. Or eat it, especially for digestive tract infections. It’s most potent if you chew raw cloves, but that can be a challenge — and can upset your stomach. Lightly sautéed in food, it still retains much of its antibiotic power. Supplement capsules also work.

In addition, garlic helps prevent heart disease and stroke by reducing cholesterol. U.S. scientists reviewed five rigorous trials involving 365 people. They concluded that a daily dose of one fresh clove reduces total cholesterol levels by approximately 9 percent, which in turn cuts heart attack risk by about 18 percent. A highly publicized 1998 study from the Journal of the American Medical Association cast doubt on garlic’s cholesterol-reducing ability, but the study was seriously flawed. The weight of the evidence clearly favors garlic for cholesterol control. Garlic also helps prevent heart attacks and stroke by reducing blood pressure and by preventing the internal blood clots that trigger heart attacks and most strokes.

Finally, garlic’s antioxidant activity helps prevent cell damage at the root of most cancers. Many studies show that garlic helps prevent cancer. In the Iowa Women’s Health Study, researchers have followed the diet, lifestyle and health of 41,387 middle-aged Iowa women for many years. Those who ate the most garlic enjoyed the lowest risk of colon cancer. A few cloves a week cut risk by 35 percent.

Garlic’s close botanical relatives — onions, scallions, leeks, chives and shallots — offer similar, though less potent, health benefits.

Note: Garlic and its relatives have anticoagulant action. This helps prevent blood clots that trigger heart attacks and most strokes, but it may cause bruising and bleeding problems. If you take anticoagulant medication, use garlic sparingly, if at all. Don’t use the herb for two weeks before surgery.

Ginger (Zingiber officinale). An old Indian proverb says, “Every good quality is contained in ginger.” That’s not much of an exaggeration. Fleshy and aromatic, ginger has been used in cooking and healing since the dawn of history. Ancient Chinese sailors chewed gingerroot to prevent seasickness. Many studies have since shown that ginger does prevent motion sickness. Swedish Navy researchers tested it on 80 naval cadets in heavy seas. Compared with those who took a placebo, the ginger group experienced 72 percent less seasickness. Commission E endorses ginger to prevent and treat motion sickness.

Ginger also safely prevents morning sickness of pregnancy — important because pregnant women are often cautioned against taking pharmaceutical anti-nausea drugs. Ginger (and its close botanical relative, turmeric) also has anti-inflammatory action. Recently, Wisconsin researchers gave either a placebo or ginger (4 grams twice daily) to 261 elderly people with osteoarthritis of the knee. The ginger group reported significantly greater relief.

Use ginger liberally in cooking, or buy capsules at health-food stores or supplement shops.

Lavender (Lavandula angustifolia). Since ancient times, lavender has been used as a tranquilizer, sleep aid and digestive aid. Animal studies show that lavender oil is calming, and it increases the action of other sedatives. Studies at the Smell and Taste Research Foundation in Chicago have shown that some scents, including lavender, increase the type of brain waves associated with relaxation. Commission E endorses lavender for anxiety and sleep problems. Lavender also soothes an upset stomach.

The herb also may aid recovery from childbirth. After 635 new mothers had a vaginal delivery, British researchers gave them one of three bath oils: true lavender oil, synthetic oil or a placebo. After 10 days, those using true lavender oil reported the speediest recovery from perineal pain.

For lavender tea, use 1 to 3 teaspoons of flowers per cup of boiling water. For a relaxing bath, place a handful of lavender flowers in a cloth bag and run bath water over it. Or add strong lavender tea, tincture or oil to your bath.

Milk Thistle (Silybum marianum). Beyond antiviral medication for hepatitis, mainstream medicine has little to offer people with liver disease (cirrhosis, poisoning with various liver toxins and liver failure) except a liver transplant. Herbal medicine to the rescue: Milk thistle, actually a seed extract called silymarin, is the herb for liver health.

Silymarin binds tightly to the receptors on liver cell membranes that allow toxins in, thus locking them out. It’s a powerful antioxidant, which helps protect liver cells from damage. It spurs regeneration of liver cells and also stimulates the immune system.

Several European studies show that compared with hepatitis patients who did not receive silymarin, those who did recovered more quickly. Other studies show that milk thistle helps normalize liver function in people with cirrhosis. In one study, 170 cirrhosis sufferers received either a placebo or 200 mg of silymarin three times daily. Four years later, 31 people in the placebo group had died of liver disease, but among those who took silymarin, there were only 18 deaths.

Silymarin also cuts the death rate from amanita (“death cap”) mushrooms. With standard medical treatment (activated charcoal), up to 40 percent of amanita victims die. But in one German study of 60 amanita victims treated with silymarin, none died.

Commission E approves milk thistle extract for treatment of liver conditions.

Chances are you don’t have liver disease. But if you drink alcohol, take any medication or live in our polluted world, your liver is working overtime to filter toxins — and could probably use some help from milk thistle. Look for a standardized extract. Take 200 mg three or four times daily, or follow package directions.

Peppermint (Mentha ¥piperita). After feasts, the ancient Greeks ate mint to settle their stomachs. That’s the origin of today’s after-dinner mints. Peppermint is rich in menthol and carvone, both of which soothe the digestive tract. German researchers gave either a placebo or an over-the-counter digestive aid containing peppermint oil (90 mg) and caraway oil (50 mg), also a stomach-soother, to 45 people with chronic indigestion. After four weeks, the placebo group reported no change in abdominal distress, but 95 percent of the herb group reported significant improvement, with 63 percent “free from pain.” Commission E endorses peppermint for indigestion and abdominal distress.

Peppermint also helps treat irritable bowel syndrome, a common condition that causes abdominal cramps, bloating, flatulence and diarrhea or constipation.

Finally, the menthol in peppermint helps treat colds. It’s a mild anesthetic, so peppermint tea can help soothe a sore throat. And it’s a decongestant. Inhaling peppermint tea vapors helps relieve nasal congestion.

For indigestion or colds, make a tea using 1 to 2 teaspoons of dried herb per cup of boiling water. Tea also may help relieve irritable bowel syndrome, though most studies have used peppermint oil capsules.

St. John’s Wort (Hypericum perforatum). “Wort” is Old English for “plant.” St. John’s wort has been an herbal wound treatment since ancient times. But the herb owes its current prominence — and controversy — to the discovery in the 1980s that it has antidepressant properties. Since then, several studies have shown that St. John’s wort is an effective treatment for mild to moderate depression. The latest, a 2002 German review of 34 trials involving 3,000 people, concluded that the herb’s effectiveness is “comparable to pharmaceutical antidepressants.”

However, St. John’s wort, like ephedra, has taken some hits lately — two highly publicized studies, in 2001 and 2002, in the Journal of the American Medical Association concluded that it’s ineffective. Herb experts, notably the prestigious American Botanical Council in Austin, Texas, have criticized these studies as flawed, but since their publication, Americans have retreated from St. John’s wort. That’s a shame, because the weight of the evidence shows that it’s effective for mild to moderate depression.

Depression is a potentially serious illness. If you suspect you’re depressed, consult a physician. Studies showing antidepressant effectiveness have typically used a daily dose of 500 to 1,000 mg of St. John’s wort extract. Try this dose for PMS and menopausal complaints as well. Pilot studies suggest that St. John’s wort helps treat PMS and complaints of menopause.

Note: Do not take St. John’s wort in combination with any other antidepressant medication. The herb also may interfere with the metabolism of various prescription drugs — consult your physician. Don’t take St. John’s wort if you have HIV and are taking any of the protease inhibitors.

Saw Palmetto (Serenoa repens). During the 19th century, the fruits of this small palm tree native to Florida were considered to be aphrodisiacs. They aren’t. But saw palmetto is a wonderful herb for the urinary bane of older men: prostate enlargement (medically known as benign prostatic hyperplasia, or BPH). After age 40, men’s testosterone levels decline, while levels of a related hormone, dihydrotestosterone, increase — and stimulate overgrowth of prostate tissue. An enzyme, 5-alpha-reductase, converts testosterone to dihydrotestosterone. Pharmaceutical BPH treatments work by interfering with this enzyme’s action. Saw palmetto has the same effects.

Many studies show that saw palmetto shrinks enlarged prostates and relieves BPH symptoms, notably, having to get up several times at night to urinate. European researchers gave 1,098 BPH sufferers either saw palmetto extract (160 mg twice a day) or the main BPH drug, Proscar. After 26 weeks, both treatments showed about equal effectiveness. A review of 18 studies published in the Journal of the American Medical Association in 1998 concluded that saw palmetto is about as effective as Proscar. Commission E approves saw palmetto for treatment of BPH.

The recommended regimen is 320 mg of standardized extract daily, split into two or three doses.

Note: Neither saw palmetto nor pharmaceutical treatments cure BPH. They reduce prostate size and relieve its symptoms. However, surgery may become necessary.

Tea Tree (Melaleuca alternifolia). This Australian herb is not related to the Chinese plant Camellia sinensis, whose leaves give us the beverage tea. When British explorer Captain Cook first arrived Down Under in 1777, he found the indigenous people treating wounds and infections with crushed tea tree leaves. Turns out that tea tree oil is a powerful antiseptic. An Australian study shows that tea tree oil kills many bacteria and fungi that cause infection. When tested head-to-head against pharmaceutical antiseptics, tea tree oil is equally effective. It’s especially beneficial in treating fungal infections: dandruff, athlete’s foot and toenail infections that discolor and deform the nails. Buy 100 percent tea tree oil and apply it with a cotton ball or swab.

Note: Tea tree oil irritates some people’s skin. If redness or itching develop, discontinue use.

Turmeric (Curcuma longa). If you suffer from arthritis, turmeric is your herb. Turmeric is the Indian herb that gives curry blends their yellow color. The yellow pigment in this herb, curcumin, is also a natural COX-2 inhibitor, the latest rage in arthritis medication — though curcumin causes fewer side effects than the pharmaceutical products. Curcumin is a powerful antioxidant that helps prevent cataracts, colon cancer and Alzheimer’s disease. If your joints ache, take turmeric tablets. Naturopaths recommend buying curcumin tablets and taking 400 mg three times daily.

Valerian (Valeriana officinalis). Remember the Pied Piper, the itinerant flutist who avenged his mistreatment in Hamelin by luring the town’s children away forever? In the original 13th-century German fable, he used a combination of music and valerian, which hypnotized the children. Valerian is a great herbal sedative. Many studies confirm its safety and effectiveness. Compared with pharmaceutical sedatives, the herb causes fewer side effects and carries no risk of addiction. Most recently, valerian was shown to be safe and effective for children with insomnia. Commission E endorses valerian for sleep problems. Valerian tea tastes terrible, so use a commercial root extract or tincture.

Vitex (Vitex agnus-castus). Medieval Europeans believed the peppercorn-like fruits of this shrub suppressed women’s libido, hence the herb’s alternate name, chaste tree. This herb has no documented effect on sexuality, but it changes the balance of female sex hormones in ways that make it a good remedy for PMS.

German researchers assessed the PMS symptoms of 1,634 women and then had them take vitex (40 daily drops of a tincture) for six months. Ninety-three percent reported significant or complete relief. In a three-month German study, 175 PMS sufferers took either vitex or vitamin B6, a treatment known to relieve PMS. In the B6 group, 61 percent called their treatment helpful. In the vitex group, the figure was 77 percent. And a three-month British study of 170 women who took either vitex or a placebo showed the herb produced significant PMS relief.

Most vitex studies have used tinctures in which 100 ml of the solution has been standardized to contain the equivalent of 9 grams of berries. The standard dose is 40 drops daily for at least 12 weeks. It usually takes a few months to notice benefits. Vitex capsules also are available. The recommended dose is one 175-mg capsule daily. Follow package directions.

Note: Vitex causes no significant side effects, but stomach upset is possible.

White Willow (Salix spp.). Willow is herbal aspirin. In fact, aspirin was originally created from a compound in white willow bark, salicin, named for the herb’s genus.

A cup of willow bark tea is not as potent as a standard dose of aspirin, so some physicians have incorrectly labeled the herb “inferior.” For severe pain, you might need more punch than willow can provide, but for many everyday aches and pains, willow works fine — and with less stomach upset than aspirin.

Recently, Israeli researchers gave a high dose of salicin (240 mg per day), a low dose (120 mg per day) or a placebo to 191 people with chronic back pain. After four weeks, 6 percent of the placebo group was pain-free, compared with 21 percent of the low-dose salicin group and 39 percent of the high-dose group. Willow also helps treat osteoarthritis. German researchers gave 74 people with arthritis of the knee either a placebo or salicin (60 mg four times daily). After two weeks, the salicin group reported significantly greater relief.

Beyond pain relief, willow bark provides the same benefits as low-dose aspirin for prevention of heart attack and stroke.

Commercial standardized extracts of willow bark state the amount of salicin. Take up to 240 mg a day. It’s hard to know how much salicin you get when you make willow bark tea. Experiment for yourself to see how much provides pain relief. Soak 1 teaspoon of powdered bark per cup of cold water for 8 hours. Drink up to 3 cups a day. White willow tastes bitter, so you might want to add honey and lemon, or mix it with an herbal beverage tea.

Note: Pregnant women should not use this herb. Do not give willow to children younger than 16 with colds, flu or chicken pox. Like aspirin, the herb may cause Reye’s syndrome, a rare but potentially fatal condition.

Tea: A Cuppa Health

Like most Americans, I’ve always preferred coffee to tea. I drank tea mainly when I had diarrhea. But recently, I turned off the Mr. Coffee and went over to tea. For the past half-dozen years, evidence has accumulated that beyond its mild stimulant effect (noticeably milder than coffee), tea is a remarkably beneficial medicine.

Tea is unusually rich in antioxidants, compounds that help prevent the cell damage at the root of heart disease, most strokes and many cancers. A Dutch study shows that compared with people who drink no tea, those who drink one to two cups a day have significantly less risk of heart disease. Harvard researchers report that compared with abstainers, those who drink tea are more likely to survive a heart attack. As tea consumption increases, so do the odds of surviving.

Green tea was first shown to have cancer-preventive value in animals in the 1980s. Since then, it has been shown to reduce the risk of several cancers: esophageal, colorectal, pancreatic, lung and breast. The breast cancer study, from Japan, is particularly intriguing. Compared with breast cancer sufferers who drank little or no green tea, those who regularly drank a great deal of it (eight to 10 cups daily) had milder cases at diagnosis (fewer positive lymph nodes), a greater likelihood of estrogen-positive disease (which correlates with improved prognosis), less risk of metastases, less risk of recurrence and longer survival.

Finally, tea is a powerful immune stimulant, according to a recent Harvard study, so it helps the body beat all manner of illness.

Note: There are three types of tea: green, black and oolong. They all begin as leaves of Camellia sinensis. Green tea, the type preferred in Japan and China, is simply tea leaves, steamed and dried. Green tea is the most medicinally beneficial variety. For black tea, preferred in Europe and the United States, tea leaves are dried and then fermented, which gives it a darker color and richer, fuller-bodied flavor. Oolong tea is semi-fermented. Tea may also be named for the place it was grown (Ceylon, Darjeeling, etc.).

San Francisco health writer Michael Castleman is the author of 10 consumer health books including the million-seller The Healing Herbs (Rodale, 1991), updated and expanded into The New Healing Herbs (Bantam, 2002). Visit his website at www.mcastleman.com.

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