Mary was despondent. “I’ll never have my life back,” she sighed. At seventy-two years old, Mary had heart problems that were becoming unbearable. She would find herself at the hospital at least once a week with an uncontrollable rapid heartbeat known as tachycardia. But the digoxin that stabilized her heart rhythm left her feeling like she was wearing a lead blanket. Worse yet, it only worked for a short time. So the merry-go-round continued.
Mary was seeing a cardiologist, who was aware that she was seeking an alternative to taking digoxin. She was also under the care of a chiropractor in a holistic clinic, who suggested that she consult me. Heart conditions, including the arrythmia that Mary suffered from, are serious conditions. No patient should self-treat such conditions; if Mary hadn’t also been seeing a cardiologist, I would have refused to advise her on using Ayurvedic herbs for her condition. She also made sure her cardiologist knew she was taking the herb.
I suggested that she try the famed Ayurvedic heart herb, arjuna. Mary hasn’t made a trip to the emergency room since, and is working with her cardiologist to gradually reduce her heart medication.
Although it is rather new to us in the United States, arjuna is one of my favorite herbs. Countless times, I’ve seen it help people with just about any type of cardiovascular disease.
Arjuna is made from the bark of Terminalia arjuna, a deciduous tree that grows up to ninety feet tall throughout India. The tree’s thick, white-to-pinkish-gray bark is probably the most widely used cardiac herbal medicine in Ayurvedic medicine. Doctors in India use it for a variety of cardiovascular conditions; it is thought of as beneficial for nearly all heart and circulatory systems. Arjuna holds a position very similar to that of hawthorn (Crataegus spp.) in European herbalism. Among the diseases for which arjuna is prescribed in India are cardiac failure, hypertension, angina, endocarditis, pericarditis, and edema.
Alan Keith Tillotson, Ph.D., author of the forthcoming One Earth Herbal Sourcebook (Kensington Publishers, 2001), says that arjuna bark is “one of the most important heart tonics in Ayurvedic medicine, used to treat all forms of heart disease. It reduces the heart-damaging culprits of inflammation and mucus.”
Herb McDonald, a veteran herbalist with a clinical practice in Albuquerque, New Mexico, shares this view. He calls arjuna “far and away the number one cardiovascular herb. It’s the foundation of treatment for all cardiovascular diseases, especially arrhythmias.” McDonald also uses arjuna with guggul (Commiphora mukul) for high cholesterol. In fact, he now uses arjuna rather than hawthorn, he says.
McDonald recounts a case that proved arjuna’s value to him. The patient was an eighty-five- year-old woman with a history of circulatory disease, including two strokes. She was having regular episodes of rising heat sensations with palpitations, followed by a “crash” of feeling limp and heavy. When doctors could not find a medical cause, the woman was brought to McDonald’s clinic.
He had the patient’s daughter, a nurse, begin taking hourly blood pressure readings. The elderly woman’s blood pressure was alternating between 60 over 40 and 180 over 130 (normal blood pressure is 120 over 80, with somewhat higher being acceptable for older persons). McDonald had her take nine 730-mg capsules of arjuna per day. (Because few people will take nine capsules at a time, some practitioners recommend dividing the daily dose into several smaller ones, but it doesn’t affect how arjuna works.)
Within twenty-four hours, the patient’s episodes of blood-pressure fluctuation ceased. Her blood pressure remained stable.
Modern research and arjuna
Modern clinicians are just beginning to use arjuna for coronary artery disease, heart failure, and high cholesterol. The herb’s components include a variety of polyphenols, which probably account for much of its activity. They include three flavonoids (arjunone, arjunolone, and luteolin), four triterpenoid saponins (arjunic acid, arjunolic acid, arjungenin, and arjunglycosides), tannins, ellagic acid, gallic acid, and proanthocyanidinic oligomers. Arjuna also contains phyto-sterols, calcium, magnesium, zinc, and copper.
Arjuna seems to work by improving cardiac muscle function and the pumping activity of the heart. The saponin glycosides might be accountable for this effect, while the flavonoids and proanthocyanidinic oligomers contribute antioxidant action and strengthen veins.
Scientific information about arjuna is beginning to accumulate. Angina pectoris patients in particular may benefit from arjuna. A 1999 study indicated that arjuna was more effective than a standard drug for angina. Arjuna was effective for 80 percent of the patients, and the herb reduced the number of angina attacks from seventy-nine per week to twenty-four per week. In a recent study from India, patients with stable angina cut their heart pain in half after three months of therapy with arjuna alone. When the researchers examined the patients’ overall clinical condition, treadmill results, and heart strength, 66 percent showed improvement.
Arjuna is particularly effective for congestive heart failure. A recent experiment bears this out. A double-blind, placebo-controlled, two-phase trial of arjuna extract in patients with severe cases of the condition was conducted. Arjuna was added to the patients’ regular drugs. In just two weeks, breathing difficulties, fatigue, edema, heart contraction, blood pressure, and walking tolerance all improved. In the second phase of the study, the subjects continued taking the arjuna for two years. Their conditions continued to improve for the first two to three months of the study’s second phase, and the improvements were maintained during the entire two years.
Arjuna also benefits cardiomyopathy, or weakening of the lower muscles of the heart, and may help patients recovering from heart attacks. A 1997 study of heart attack victims demonstrated that arjuna was superior to drugs alone for a wide range of related symptoms, including angina, enlargement of the heart, and impaired pumping strength.
Help for more than the heart
Arjuna contains a wide variety of active phytochemicals. Its other uses include:
• Fighting bacteria. Arjuna has been traditionally used as an antibacterial herb, and now at least one study offers confirmation of its effectiveness. In a survey of thirty-four traditional antibacterial Indian plants, researchers tested the botanicals’ effects on E. coli, Klebsiella aerogenes, Proteus vulgaris, and Pseudomonas aerogenes. Arjuna showed significant effects against these bacteria; in fact, it was in the top three plants in the study.
• Preventing cancer. Arjuna is rich in cancer-fighting chemicals, including ellagic acid and gallic acid.
• Providing antioxidants. These compounds abound in arjuna. Among them are various tannins, including ellagiyannin, and other phenols.
On numerous occasions, I’ve seen arjuna used effectively in lowering cholesterol. Yet to this date, only animal studies confirm this action. In those studies, arjuna was able to reduce total cholesterol and increase HDL, the “good cholesterol.”
In my clinical experience, arjuna especially excels in treating disorders that involve heart rate. Mary’s dose began at a rather large 12 g per day; she started out at three capsules per day and increased by three per day until she was taking sixteen 730-mg capsules daily. When she reached that amount, her irregular heart rhythms disappeared like flipping a switch, with no side effects. Another client of mine, Jane, age sixty, was beginning to have just a hint of tachycardia. A dose of 730 mg per day–a single capsule–was all it took to relieve her condition.
A third client, Ed, age sixty-five, a lifelong martial arts instructor and physical fitness proponent, had what doctors call an “idiopathic” high pulse–meaning simply that they could find no medical explanation for it. Again, we tried arjuna. Ed’s dose was a whopping ounce per day of the bark. He made arjuna bark tea, learned to like a new beverage, and his pulse rate fell to normal for his age. (Arjuna tea is actually drunk as a beverage in India, but it is so sour that Americans usually don’t like it.)
Tillotson points out that Ayurvedic medicinal literature going back more than 1,500 years specifies the use of boiled arjuna bark in milk or ghee. Doctors would have their patients ingest the arjuna daily for up to a year.
A typical dose of dried arjuna bark is 1 to 3 g per day in capsules; it doesn’t matter whether you divide this into smaller doses, unless that makes it easier for you to take.
For congestive heart failure, 500 mg of extract four times per day has been used in studies. You can also purchase the bulk herb, dried and shredded, and brew it into a tea.
If the tartness bothers you, try adding gingerroot, cinnamon, clove, or black pepper.
Arjuna seems to be quite safe. No toxicity or adverse reports are noted in the scientific literature. You can find arjuna in many health-food stores, especially those that carry Ayurvedic herbs. A bottle of fifty 730-mg capsules usually costs about $11.
Karta Purkh Singh Khalsa has more than twenty-five years of experience with medicinal herbs and specializes in Ayurvedic, Chinese, and North American healing traditions. He is a licensed dietitian/nutritionist, a massage therapist, and a board member of the American Herbalists Guild.
For additional reading
Bharani, A. “Salutary effect of Terminalia arjuna in patients with severe refractory heart failure.” International Journal of Cardiology 1995, 49(3):191-199.
Dwivedi S., and M. P. Agarwal. “Antianginal and cardioprotective effects of Terminalia arjuna, an indigenous drug, in coronary artery disease.” Journal of the Association of Physicians of India 1994, 42(4):287-289.
Kapoor, L. D. Handbook of Ayurvedic Medicinal Plants. Boca Raton, Florida: CRC, 1990.
Kumar, P. U., et al. “Safety and efficacy of Hartone in stable angina pectoris–an open comparative trial.” Journal of the Association of Physicians of India 1999, 47(7):685-689.
“Terminalia arjuna” monograph. Alternative Medicine Review 1999, 4(6):436-437.