Integrating Herbs with Conventional Medicine

[seminar class]

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Objectives
 Identify the difference between nourishing and medicinal herbs
 Identify how nourishing herbs are provided
 Identify how medicinal herbs are provided
 Know reasons to use nourishing or medicinal herbs
 Learn about 9 popular herbs
 Learn some of the problems with herbal marketing and preparations
 Time for questions and individual concerns
Nourishing herbs
 Nutrient rich
 Bio-available
 Generally considered safe, side effects uncommon
 Dosage and strength less important
 Tend to be local, whole, and common
 Large amounts used, in contrast to medicinal plants
 Includes tonics
 Supportive to body systems
 Long term use is usually beneficial
 Internal use
 Infusions
 Water based
 Vinegar based
 Whole plant
 Cooked
 Raw (salad)
 External use
 Compress
 Poultice
 Salve
Medicinal Herbs
 Dosage and strength important or critical
 Tend to utilize more toxic parts of plant
 Stimulate or sedate
 More likely to have side effects
 Are often plants that are less common, or rare
 Long term use is generally discouraged
 More extensive knowledge is needed to use safely and effectively
 Tinctures
 Alcohol based
 Glycerin
 Extracts
 Capsules
Case Study: Prophylactic Use of Echinacea angustifolia and purpurea Tincture for Management of a Recurrent Staphylococcus Infection
 46 yo female CHF
 Heart cath age 53, followed by staph infection
 Broad spec. antibiotics no effect
 Echinacea ang. 30-40 drops every 3 hours
 Symptom improvement within 2 hours
 Two days both, stopped Ech. Symptoms returned within 4 hours
 Ech and Antibiotic together, no symptoms
 MD stopped antibiotics, pt. stopped Ech. Symptoms returned
 Ech. as before - symptoms gone
 One day without Ech, some symptoms
 Ech 10 drops day no symptoms
 For next 7 years, until death, two skipped days symptoms return -proven at least five times
Significant points
 Echinacea fought an antibiotic resistant infection
 Low dose (nourishing) as effective as high dose (stimulating)
 Low dose safe to use long term
 Long term use was necessary
 Mechanism of action for effect of low dose unknown
Popular Herbs
 The Herbs
Ginkgo biloba
St. John’s wort
Garlic
Echinacea
Goldenseal
Saw palmetto
Milk thistle
Black cohosh
Ginger
Powdered leaves
 Tincture or infusion
 Most ancient tree known
 Uses: cerebral insufficiency, Alzheimer’s Ds, intermittent claudication, tinnitis
Ginkgo
 Increases vascular flow
 diabetic peripheral vascular disease
 Raynauds syndrome
 Other circulatory benefits fro varicose veins, hemorrhoids, eye disorders
 Affinity for cerebral circulation
 Inhibits platelet activity factor
 Used to relieve tension, anxiety, elevate mood
 Contains flavanoids, terpene lactones, ginkgolides A, B, and C, bilobalide, quercetin, and kaempferol.
 ginkgolides control allergic inflammation, anaphylactic shock and asthma
 antioxidant
What to watch for
 Can increase blood flow
 Discontinue before surgery
 Do not use with menstrual flooding
 Do not use with other bleeding problems (ulcer, bruising, etc.)
 Not suggested with blood thinners, aspirin, etc.
 Gingko biloba & Dementia
 52 week RCT, double blind, multi-center
 Outcomes in 309 pts (ITT):
 Pt cognition: tx no change, placebo worse (p=0.04)
 Caregiver assess: tx slight improve, placebo worse (p=.004)
 Dose: 120 mg/d of EGb 761
 Safety: side effects equal
 Problems: high dropout rate (50% tx, 62% placebo)
 Ginkgo & Claudication
 Meta-analysis of Egb 761
 5 placebo controlled trials
 Moderate to large effect (0.75 Cohen’s d) on pain-free treadmill walking distance
 Ginkgo - Toxicology
 Adverse events
 GI complaints
 bruising & spontaneous bleeding
 Avoid if taking warfarin, heparin, or NSAIDs
 Can increase insulin levels
 May increase sedation with trazodone
 St. John’s Wort
Hypericum Perforatum
Used as tincture, extract in pill form, topically as oil or salve
Popular as anti-depressant.
Also used for muscle aches, nerve pain, nerve regeneration, for herpes outbreaks, bruising
 St. John’s Wort
 P450 Cytochrome system