The traditional Western nervine herbs

The traditional Western nervines have an important place that cannot be replaced by using more exotic adaptogenic herbs, chemical supplements, or pharmaceutical drugs. Perhaps the most important roles of the Western nervines are to improve sleep and reduce anxiety or stress. These are common problems particularly in today’s society. However, they have a broader range of potential uses that include pain reduction, epilepsy, and improvement of mood. This is a short primer on the Western nervines and some ways in which we might begin to use them. Although I have included ashwagandha here, which is Indian and an adaptogen, I feel it is too important to leave out.

Actions

The Western nervine herbs, aside from those that are stimulating which are not to be described here, fall into additional categories or ‘actions’ depending on their effect of the nervous system.

Nervine relaxant: These herbs are very gentle and have a mild relaxing effect, they can be useful for mild insomnia or anxiety. An example of a nervine relaxant is German chamomile. They may be an important addition to a sleep formula, or their other actions may be called upon, such as a carminative effect.

Nervine sedative: These nervines are a bit stronger in terms of their relaxing effect, but do not tend to make one sleepy or unable to function normally. An example of a nervine sedative is American skullcap, this one is best in a fresh tincture.

Nervine hypnotic: This is the strongest category of nervines, but usually still pale in comparison in potency with pharmaceutical drugs. May be well suited for sleep and not so suited for daytime use. A good example being valerian.

Nervine tonic: These nervines are thought by herbalists to have a longer term renewing role to play on the nervous system, thus helping restore a better sense of overall health and a feeling of well being. Good examples here would be the fresh tinctures of St. John’s wort and American skullcap, a common nervine tonic pair. A popular nerve tonic in the U.S.A. is fresh milky oat seed tincture, that is said to support the nervous system.

Nervine analgesic: Nervines which have a role to play in reducing pain. For example, St. John’s wort is a nerve pain analgesic and California poppy is a more general mild analgesic.

Antispasmodic: Relaxing for tight muscles and muscle spasms. This can be related to problems with the nervous system. For tight tense muscles, we might try nervines such as black cohosh combined with ashwagandha. Another antispasmodic nervine is valerian.

Antidepressant: Several nervines have mood elevating properties. Good examples are lemon balm and St. John’s wort. Motherwort is another example.

(left) American skullcap, (middle) St. John’s wort, (right) California poppy

Energetics

This is a way of dividing herbs into categories based on their general effect on tissues, such as warming, cooling, drying, and moistening. If taking an excess of drying herbs, for example, an individual’s skin will become dried out. This kind of problem is quite quickly dealt with by reducing or stopping doses or switching to a more moistening formula. It is best to be responsive to the signs of the body.

Drying nervines may be used at a lower dose without causing constitutional dryness, but depending on an individuals constitution (how naturally inclined they are towards hot, cold, dry, wet), as the dose increases or frequency, they are more likely to cause problems such as dry skin. Another issue is the cooling nature of many nervines, cooling herbs have a tendency to slow down the digestive system (herbs such as blue vervain, for example), and thus they can be combined with warming nervines such as valerian, to mitigate this problem. Often it is those individuals that tend towards the dryness and cold, the Vata constitution, that get these problems more easily. Other individuals such as Pitta may feel too hot more easily, with too many warming herbs, this isn’t much of a problem as the formula or dose can be changed or stopped.

Moistening, warming nervines: Fresh milky oat seed

Moistening, cooling nervines: Hawthorn berry

Drying, warming nervines: Valerian, St. John’s wort, ashwagandha, damiana, wood betony

Drying, cooling nervines: American skullcap, chamomile, blue vervain, black cohosh, Californian poppy, lavender, lemon balm, motherwort, Jamaican dogwood

Herbal formula

These are a collection of mostly simple formula I have used for various problems. Oftentimes constitutional dryness is not a problem with these nervines unless the dose is high or frequent. However, dryness can be mitigated using hawthorn berry tincture (15-60 drops 2-3 times daily) or reducing or stopping the dose. Hawthorn berry can reduce blood pressure, so be wary of dizziness and signs the blood pressure is getting too low. In the case of American skullcap and St. John’s wort, in my opinion, it is best to use fresh tinctures, i.e. made from fresh plant material.

I) Pairs

St. John’s wort (1 part, 15-60 drops 2-3 times daily) and American skullcap (1 part, 15-60 drops 2-3 times daily). This is a nervine tonic pair that can be used for anxiety, mild insomnia, mild depression, and also tried for nerve pain. There should not easily be problems regarding dryness here, because both are only mildly drying compared to other herbs. Since it is a tonic formula, we expect some results in the more longer term, to relax an individual, improve sleep, and provide a sense of well being. Particularly, American skullcap if the dose is too high, one might feel a bit sedated. St. John’s wort is contra indicated with drugs generally and can cause easy sun burning.

St. John’s wort (1 part, 15-60 drops 2-3 times daily) and ashwagandha (1 part, 2-4 500mg capsules per day). This is another nervine tonic pair for anxiety, low mood, and certain types of pain. Ashwagandha is in many ways a stronger and more capable herb than most other nervines, as it also is quite a potent anti-inflammatory for the nerves and muscleoskeletal system, can reduce pain quite well, and improve sex drive. These two may improve mood quite nicely as they reinforce one another. Ashwagandha may improve sleep. St. John’s wort is contra indicated with drugs generally and can cause easy sun burning.

Ashwagandha (1 part, 2-4 500mg capsules per day) and American skullcap (1 part, 15-60 drops 2-3 times per day). This is again another nerve tonic pair for anxiety, poor sleep, and possibly nerve pain. This time more on the sedating side, because both ashwagandha and American skullcap can be classed as nervine sedatives. It is still suitable for daytime use at lower doses.

St. John’s wort (1 part, 15-60 drops 2-3 times daily) and California poppy (1 part, 45-120 drops 2-3 times daily). This is a simple pair I have used to combat pain, it relaxes the nervous system.

II) Triplets

St. John’s wort (1 part, 15-60 drops 2-3 times daily), American skullcap (1 part, 15-60 drops 2-3 times daily), ashwagandha (1 part, 2-4 500mg capsules per day). This is a nice nervine tonic formula that can be used to support the nervous system. St. John’s wort is contra indicated with drugs generally and can cause easy sun burning. If dryness occurs one could reduce the dose or try adding hawthorn berry tincture.

III) More complex sleeping formula

Only when herbs are combined together in more complex sleeping formula does the sedative and hypnotic strength of the formula really improve dramatically. Using a single herb like American skullcap may work, but when the case is more severe, often best in my opinion, to use a formula like these.

American skullcap (1 part 15-45 drops before bed), lemon balm (1 part, 15-45 drops before bed), valerian (1 part, 15-45 drops before bed). This is a moderately strong synergistic sleeping formula, it will lose effectiveness over the first few weeks a bit, but is suitable for more longer term use.

American skullcap (1 part 15-45 drops before bed), lemon balm (1 part, 15-45 drops before bed), valerian (1 part, 15-45 drops before bed), passion flower (1 part, 15-45 drops before bed), California poppy (1 part, 15-45 drops before bed), German chamomile (1 part, 15-45 drops before bed). This is quite a strong formula, if we use 45 drops of each this will end up around 6ml of tincture before bed, this will be too strong for the majority of people. If in doubt, start with low doses.

Safety and contra-indications

The herbal medicines described here are really quite safe in most situations, however, for pregnant and breast feeding women, many herbs are not safe to use. It is best to consult a trained herbalist if this applies to you. There also may be contra indications of certain herbs with medications and pre-existing medical conditions, that should be taken into account. For example, St. John’s wort is contra indicated with SSRIs. Hawthorn berry could overly potentiate the effect of blood pressure lowering medication. However, the reality is herbs are much safer than most people think and picking up some knowledge of how to use herbs medicinally is very helpful. The traditional Western nervines have proven themselves historically to support the nervous system and provide us with useful tools to combat the stresses of life.

(left) Wood betony, (middle) Damiana, (right) California poppy

 

 

A guide to treating insomnia with herbal medicines

Whilst mild insomnia may be treated more easily, for instance, just with one or two herbs (e.g. American skullcap) or better simple lifestyle changes, treating a more serious case is harder. It has taken me considerable work to learn what helps. Before going into the herbs, these are some basic lifestyle pointers that might help;

1. Exercise during the day and eat healthily, but do neither 1 hour before sleep.
2. Do not stare at bright screens at least 1 hour before sleep.
3. For the hour before bedtime aim to lie horizontally, remain awake, and relax. Avoid watching TV and excess conversation.
4. Cultivate a calm mind using techniques like meditation, qi-gong, yoga, etc.
5. Fix the time you get into bed, and when you get up, even on weekends.

The nervine herbs

Although lifestyle changes can get you a long way, certainly herbs are often required to induce and maintain sleep. The nervine herbs are those that act on the nervous system and we are looking for those with a sedative action. A lot of people use adaptogens for sleep, but sometimes this can be a mistake as they can over stimulate. Comparatively important Western nervine herbs like American skullap are being over looked. It is important to make the point that if the insomnia is bad, then one or two simple herbs is unlikely to work. What is required is a complex synergistic formula. I am now going to go briefly through some of the stronger sleeping herbs, before describing a few formula that may help.

Valerian

valeriana-officinalis-846615_1280

One of the great European hypnotic nervines. Used in herbal sleep formula throughout Europe and America. Induces sleepiness instead of just reducing anxiety like most sleep herbs, but does not maintain sleep well by itself. Tolerance is acquired rapidly, but it is suitable for long term use. Often combined with hops in a simple formula, but I haven’t found this combination that useful and we will talk about better combinations later. It isn’t very suited to daytime use as can cause sleepiness. It is also an effective antispasmodic and may help reduce muscle tension. Valerian is best used in an extra concentrated dried tincture or better yet fresh tincture. Doses are 10-15 drops and upwards. It is drying and warming on the constitution.

American skullcap

Scutellaria_lateriflora_-_Blue_Skullcap

American skullcap is a Native American remedy and is probably the most important nervine sedative in Western herbalism. In the specific form of a fresh tincture it is gentle in its relaxing effect and suitable for daytime use, but also effective to induce and maintain sleep. It is effective from 10-15 drops upwards. This is my favorite nervine herb, the dried tincture is almost useless, but people continue to sell it. If you have a good quality tincture the herb should cause a gentle relaxing feeling on the upper skull, especially the first time you use it, hence the name. It is also an effective antispasmodic and may help reduce muscle tension. American skullcap is cooling and slightly drying on the constitution.

Lemon balm

nature-grass-plant-flower-green-herb-839751-pxhere.com.jpg

This is another European herbal remedy and is verstaile in terms of its actions. It is a nice sedative, gently relaxing which can help support healthy sleep. It is suitable for daytime use as well. It also has a nootropic action, so boosts cognitive abilities, whilst also functioning as an anti-depressant. Again it is reasonable to start around 10-15 drop doses and work up, especially when combining with other herbs. Like skullcap, a fresh tincture is preferred, but a recently dried one will also function. It is also an effective carminative and may help reduce excess gas. Lemon balm is cooling and drying on the constitution.

Magnolia bark

Magnolia_officinalis_Houpu_Magnolia_სამკურნალო_მაგნოლია_(2).JPG

This is a traditional Chinese herbal medicine. It seems to be a pretty good sedative. I have been using 400mg capsules of the bark powder 1-2 per night. Otherwise known as, ‘houpo’, it has been traditionally used in China and Japan for the treatment of anxiety, asthma, depression, gastrointestinal disorders, headache, and other disorders. It is warming and drying to the constitution.

Passionflower is traditionally combined with hops and valerian for sleep, but I prefer to combine it with valerian and skullcap.

Calafornia poppy is another good option that I have used since originally writing this article. It is effective at higher doses such as 90 drops or so and may be combined with other great sleeping herbs such as skullcap and valerian.

An energetic spectrum of sleeping herbal remedies

Another problem is people on the whole under appreciate herbal energetics, it isn’t that complicated to understand. This system common to ancient Greek, Chinese, and Indian medicine classes herbs by their energetic effect on the body in terms of the 4 elemental forces (warming, cooling, drying, moistening). If excess drying and cooling herbs are taken, constipation and dry skin will start to take over. This is especially easy to do in the vata constitution (people who tend to weak digestion, pale skin, and dry skin). Let’s take a look at the energetic properties of common sleeping herbs and their strengths.

sleepherbenergetics.png

We can see the issue with the Western nervine herbs, all of them, apart from hawthorn and milky oat seed are drying on the constitution. When taking these drying nervine herbs just once daily, this may not be enough to see constitutional dryness appearing. However, if using a sleep formula consisting purely of drying herbs especially in a vata person twice daily or more, dry skin will likely occur and constipation. A solution is to formulate with moistening herbs like hawthorn berry and milky oat seed. Hawthorn berry is my favourite moistening nervine herb, it supports regular bowel movements and reduces dry skin. This can balance out drying nervines nicely. I have less confidence in milky oat seed, but this might be because our oat seed is not as good as that available in the USA.

Formulas

These formulas are quite strong, if you haven’t already tried lifestyle or individual herbs or pairs first – best to do this. A fresh tincture of American skullcap is good to start with. Start with lower doses first and be cautious if combining with sedative drugs.

Formula I

This triplet is well suited to inducing and maintaining sleep and there is excellent synergy here. Add hawthorn berry if dryness occurs (15-30 drops).

Fresh American skullcap (1 part)
Fresh lemon balm (1 part)
Valerian (1 part)

Dosage: Between 30-75 drops may be taken before bed, leaving an hour gap.
Contraindications: Be careful if using sedative drugs at the same time. Not for use by pregnant or breast-feeding women.

Formula II

This is stronger and can be taken as a single dose before bed. I believe this to be as effective as many conventional sleeping pills. Other sleeping herbs to consider include; magnolia bark, califorian poppy, and lemon balm. It may be helpful to rotate the formula. I have taken this six herb formula long term and found it very good.

Fresh American skullcap (1 part)
Passionflower (1 part)
Extra concentrated valerian (1 part)
German chamomile (1 part)
Lavender tincture (1 part)
Motherwort (1 part)

Dosage: Between 30-90 drops may be taken once before bed, leaving an hour gap.
Contraindications: Be v. careful if using sedative drugs at the same time. Not for use by pregnant or breast-feeding women.

Adaptogens

These are on the whole less suited to fixing sleep as they boost stamina and focus. However, there are some that are more relaxing, especially ashwagandha and holy basil. KSM66 ashwagandha is more stimulating compared with the traditional root powder.

Adaptogens that are suitable for sleep: Ashwagandha, holy basil, reishi, schisandra, cordyceps.

 

The search for herbal treatments for chronic pain

Chronic pain is a signal of some underlying problem, like a injury that has failed to heal, autoimmune condition, vitamin deficiency, gut dysbiosis, mechanical wear and tear, nerve damage, there are so many possible reasons. When using herbs to go after chronic pain, which can be due to many possible causes, it can be helpful sometimes to focus less on the specific diagnosis, and more the type of pain. Is it in the muscles, the nerves, or inflammatory? Then matching with these types of pain are herbal actions; antispasmodic, nervine, and anti-inflammatory/ alterative. This is a simple way to approach the situation. It is also important to learn the specific indications of each herb (their specialities) and also their energetics (warming, cooling, moistening, drying). Each herb often has certain affinities for particular tissues or organs in terms of its medicinal effect.

There are many causes of chronic pain, but generally, it is appropriate to make sure the diet is well balanced, without processed foods, refined sugar, and contains plenty of vegetables and fruits, whole grains, or if you eat meat, wild or grass-fed animal derived meats. The Paleolithic and ketogenic diets are worth considering. Yoga, Qi-gong, or other physical exercises should be used in any holistic strategy. However, there are a wide variety of chronic pain conditions that are not well understood and don’t yield to changing the diet, conventional medicine, acupuncture, chiropractor, or physiotherapy.

Traditionally, herbal therapies have been used for chronic pain and there are a wide variety of herbs to consider. However, they are suited for different kinds of chronic pain, so it is instructive to further break them down by action, affinity for body systems, energetics, and for treating certain diseases.

Anti-inflammatory and immune balancing

These herbs can oftentimes help reduce inflammation without overly suppressing the immune system. A few of these herbs are adaptogens from TCM and Ayurveda, they are known as Qi or rasayana tonic herbs in these systems of medicine and have a range of uses beyond reducing inflammation. They often help calm the nervous system as well, for example, and can reduce fatigue as they help boost energy reserves. They may have a balancing role to play on the immune system. Another herbal derivative we might put here is CBD, but I have included cannabis in the anodyne section.

Turmeric: General widely used Ayurvedic anti-inflammatory, appropriate for different types of inflammation. Applied especially in musculoskeletal conditions.

Boswellia: Another popular option from the Ayurvedic system of medicine. Often applied alongside turmeric for musculoskeletal conditions, but also has an affinity for the bowel and may help with disorders like Crohn’s disease and ulcerative colitis.

Chinese skullcap: A TCM herb that is often used in musculoskeletal conditions, but also in allergies. The Chinese skullcap, Scutellaria baicalensis, is often confused with its American relative, Scutellaria lateriflora, which is more of a sedative to help sleep and can help with conditions such as epilepsy. Chinese skullcap is more of an anti-inflammatory, but also seems to have some sedative properties.

Reishi: Increasingly used adaptogenic medicinal mushroom from TCM that contains triterpenes that are anti-inflammatory, but also contains polysaccharides that stimulate the immune system. Used in inflammation of the bowel, but also more generally in fighting chronic infections and inflammation. Reishi is also a relaxing adaptogen and may help improve sleep, anxiety, and reduce fatigue.

Slippery elm: A medicine from traditional Western herbalism that is very specific to the GI tract and reducing inflammation here. It comes from a bark of a tree and contains mucilage and tannins which are thought to form a soothing coating in the digestive tract. Slippery elm may interfere with the absorption of pharmaceutical drugs taken at the same time. WebMD recommends taking it at least one hour before or after taking other medication.

Ashwagandha: A widely appropriate Ayurvedic adaptogenic herb, that is often used in treating musculoskeletal pain related conditions, including fibromyalgia, rheumatoid arthritis, and osteoarthritis. Is also is applied in many disorders that effect the nervous system such as insomnia, anxiety, neuralgia, and multiple sclerosis. May help relax tense muscles. I have found the KSM-66 extract effective.

Gotu kola: Another Ayurvedic herb, often used alongside ashwagandha. Specific for conditions involving hot inflamed joints or skin, such as rheumatoid arthritis or psoriasis. It is applied by herbalists alongside ashwagandha and sarsaparilla in treating arthritis. Also used to treat nerve pain. Best used in a fresh tincture.

Holy basil: An Ayurvedic herb, used with reishi in treating allergies, but also useful for chronic inflammation and infections. Similar to ashwagandha and gotu kola in terms of medicinal potential and can be applied to help nervous system problems such insomnia, anxiety, depression, and neuralgia.

Sarsaparilla: Originally brought to Europe from Mexico by the Spanish. Sarsaparilla has a specificity towards chronic inflammation, and has been used to treat rheumatoid arthritis and psoriasis. It may be combined with gotu kola for a stronger anti-inflammatory action.

Anti-spasmodic

These herbs can reduce muscle tension that may be helpful in conditions such as fibromyalgia and sciatica. Many of these also may help sleep as they have a hypnotic or sedative action, hypnotics are stronger than sedatives, which are in turn stronger than relaxants. Magnesium should also be considered as a cheap and safe muscle relaxant, sometimes a nutritional deficiency may be underlying or contributing to a pain disorder, herbs cannot correct that.

Valerian: One of the great European nervines. Commonly known for its ability to help insomnia as it is a hypnotic, but this herb is an effective anti-spasmodic (calms muscles) and carminative (reduces excess digestive gas). May have a role to play in reducing pain where there are tense muscles. Can be used to help disrupted sleep related to chronic pain in a synergistic manner alongside other sedative herbs like American skullcap and lemon balm.

Black cohosh: A potent Native American remedy, traditionally used for rheumatic conditions such as arthritis and fibromyalgia. It also appears to be quite a strong anti-depressant and can help insomnia as it is a nervine relaxant. Only small doses of tincture are required (5-30 drops).

Blue vervain: Bred in North America from European vervain. A small amount of blue vervain goes a long way (1-10 drops). However, it is very bitter, cooling, and drying, therefore can be used alongside warming and moistening herbs. Traditionally applied especially against epilepsy, but also has a role in reducing anxiety. Reduces tension all over the body, particularly noticeable in the neck and shoulders.

Crampbark: Is commonly combined with valerian in treating muscle cramps.

Lobelia: Another herb used in dropwise doses (1-10 drops), effective at relaxing muscles, may also help anxiety and sleep.

American skullcap: A nervine tonic and sedative, good for helping restore normal sleep and may help nerve pain. Best used in a fresh tincture. Should notice a gentle relaxing sensation in the top of the head, if the quality is good, when taking 10-15 drops or so of the tincture. Although it is fine to take more, 30-60 drops for example. It is thought by herbalists to have a gentle restorative effect on the nervous system over time. It does not tend to over sedate. Good for nerve pain with St. John’s wort, this is a simple nerve pain pair.

Kava: A traditional remedy from the South Pacific, it is a strong hypnotic so may help sleep. Often taken for fibromyalgia and is an effective antispasmodic for muscle spasms. May have a role to play in reducing neuralgia. Is not considered suitable for those with a history of liver problems and there is potential for addiction at higher doses.

Anodyne

These are herbs that reduce pain. Jamaican dogwood, Californian poppy, kratom, and cannabis are more like conventional painkillers. As well as being anodyne, St. John’s wort is thought by herbalists to have a more restorative role on the nervous system.

Jamaican dogwood: From the bark of the tree and one of the stronger anodyne herbs in traditional Western herbalism. Good for pain, but also improving sleep where disrupted due to chronic pain. It also is antispasmodic and hypnotic. Has a strong taste. I think kratom or CBD is better. I have had headaches from higher doses of this one.

Californian poppy: Grows brilliant bright orange flowers. A gentler nervine than Jamaican dogwood, we might call it a sedative, suitable for reducing pain and improving sleep. I find you need at least 90-120 drops of this one to feel the effects, but it is very good, the dried tincture works well.

Cannabis: Legal hemp extracts that contain phytocannabinoids are often used to treat chronic pain and CBD is one of those compounds that has gained huge popularity. It is suitable for treating both inflammatory and neuropathic pain.

Kratom: A strong, versatile pain-killing herb from Asia, that may produce some similar effects to opioid drugs (at 4-8 gram doses). Contains mitragynine and 7-hydroxymitragynine that can bind to the body’s opioid receptors and provide pain relief. It also has anti-inflammatory properties. It is suitable in treating inflammatory and neuropathic pain. Has some potential for withdrawal symptoms if taking long-term high doses, to avoid this strains can be rotated, doses maintained quite low (e.g. 3g), or taper when coming off it.

St. John’s wort: A European nervine tonic, anodyne, relaxant, and anti-depressant. Specific for nerve pain, but also may improve sleep alongside other nervines, anxiety, and mood. Best used in a fresh tincture. The best option for nerve pain I think, alongside ashwagandha.

Circulatory stimulants

Certain herbs are thought to herb boost circulation and the supply of oxygen and nutrients to damaged tissues.

Prickly ash: A native American remedy from the bark of a North American tree, it is said to be a specific for nerve pain (according to Matthew Wood), like St. John’s wort. They are often used together for this reason. Prickly ash is also anodyne. Traditionally, prickly ash was used for rheumatism.

Ginkgo: The leaf extract comes from the ginkgo tree which is the oldest surviving species of tree in the world. However, traditional indications for ginkgo are less clear than other herbs, mainly because the leaf extract only became popular last century and has been used mainly as a nootropic. It has been found useful for various cognitive and circulatory problems.

Digestion modulating

Triphala: This is used is Ayurveda to normalise the digestive system and may be useful in disorders with a digestive component to them. Many chronic illnesses may be related to poor gut health. Triphala may be used for both constipation and diarrhea. Potentially useful for UC, IBS, IBD, and Crohn’s. This is an energetically balanced triplet of herbs.

Alterative herbs

These herbs are quite specific for reducing chronic inflammation and are thought to work by stimulating the excretory organs and altering metabolism in the body in poorly understood ways. They could also be classed as anti-inflammatory, as sarsaparilla is another alterative mentioned earlier, however, they are thought by herbalists, in some cases, to have a more curative role.

Nettles: Traditional Western herbalism speaks very highly of nettles and its chronic pain indications include arthritis and gout. Nettles is high in protein, vitamins, and minerals, so makes an excellent all round nutritive tonic. May be used alongside dandelion and burdock as a long-term traditional Western herbalism style treatment for arthritis.

Constructing a formula

Here is a basic formula for reducing nerve pain, and may have a renewing effect on the nervous system as a whole. It has an anti-inflammatory property due to the ashwagandha, for the nervous and musculoskeletal systems.

For more details on constructing herbal formula that are more specific to certain conditions, I would recommend Matthew Wood’s the Earthwise Herbal (2009) books, of which there are two, and particularly Maria Groves Body into Balance (2016).

American skullcap (fresh tincture) (1 part)
St. John’s wort (fresh tincture) (1 part)
Ashwagandha KSM-66, 2-4 capsules per day (400mg)

Dose: 20-90 drops 2-3 times daily.
Contraindications:
Do not use when pregnant or breastfeeding. Be careful if combining with sedative drugs regarding dose. St. John’s wort may not be appropriate alongside drugs as it may reduce their effect, best to consult a doctor if you are in this situation.

Summary

Herbs can help chronic pain, to manage and reduce it, improve mood and energy, and help sleep, perhaps they may even cure the condition, but it is important to have realistic expectations as they often are not miracle cures for complex conditions. They can also cause side effects and may even be dangerous. It is better if you are thinking of treating your self or others with medicinal herbs to first learn traditional herbalism. I recommend first reading text books by Maria Groves, David Winston, and Matthew Wood. Depending on the individual and how much this appeals to you it may be better to visit a local herbalist or naturopath. However, the truth on the matter is our non-toxic time tested medicinal herbs are underrated by society and they are far more effective and safe than we may have been led to believe.

Further reading:

https://traditionalroots.org/files/Winston-Analgesia-the-Search-for-Effective-Pain-Relief-NOTES.pdf

https://www.americanherbalistsguild.com/sites/default/files/ahgchronicpaingroves_0.pdf

Note: See the text books in the references section to learn more about how to use these herbs in more detail. It is good to develop an understanding of herbal energetics before using medicinal herbs, in case problems related to dryness are encountered, for example. This is an ancient system of dividing herbs into warming, cooling, drying, and moistening. For researching drug-herb interactions and contra indications, Examine and WebMD are helpful. Many of the above herbs are not at all safe during pregnancy or breast feeding.

References

Groves, Maria. Body into Balance. Storey Publishing, 2016.

Hoffman, David. Holistic herbal. Element Books, 1988.

Panossian, Alexander. “Understanding adaptogenic activity: specificity of the pharmacological action of adaptogens and other phytochemicals.” Annals of the New York Academy of Sciences (2017).

Winston, David, and Steven Maimes. Adaptogens: herbs for strength, stamina, and stress relief. Inner Traditions/Bear & Co, 2007.

Wood, Matthew. The Earthwise Herbal: A Complete Guide to New World Medicinal Plants. North Atlantic Books, 2009.

A tour through the plant nootropics

The term, ‘nootropic’, was coined by a Romanian psychologist and chemist in 1972 called Corneliu Giurgea from the Greek words that mean ‘mind’, and, ‘turn’ (Lewis, 2009). They are so called ‘cognitive enhancers’ which improve cognitive function, memory, creativity, or motivation in healthy individuals. They are thought to work by modifying neurochemicals in the brain, improving brain oxygen supply, or stimulating brain nerve growth (Joshi, 2013). Chemical nootropics include the racetams and derivatives, such as piracetam, which was the original chemical nootropic first described in the 1970s, and wakefulness enhancers such as modafinil, which is a stimulant. However, while the term nootropic is relatively recent, herbal practitioners have been using plants as a source of rejuvenation for the brain and nervous system for thousands of years (Russo et al., 2005).

In traditional Indian medicine, or Ayurveda, ‘medhya rasayana’, refers to a rejuvenative herb specifically for the mind and nervous system (Russo et al., 2005). These are herbs that were and still are specifically used to treat cognitive problems, as for example, bacopa, is found in the Caraka Samhita an ancient Ayurvedic text, where it is recommended for anxiety, poor cognition, and lack of concentration. Opposed to the chemical nootropics, which have only been around recently and there are some concerns over safety, herbs like bacopa have been fully integrated into the medicinal systems of the world for a long time and have good safety profiles. I will now describe the historical use and review the science of 8 of the best natural nootropics that come from plants.

1.Bacopa

Bacopa is a creeping medicinal herb found in damp, marshy areas throughout the Indian subcontinent (Russo et al., 2005). It grows purple flowers and oblong shaped fleshly leaves. It is known by locals as ‘brahmi’ a name it shares with another nootropic called gotu kola. The name brahmi is derived from ‘Brahma’, the creator God in Hinduism. The two ancient Ayurvedic texts the Caraka Samhita (2500BC) and Susruta (2300BC) both suggest bacopa improves cognitive powers by enhancing memory and concentration (Dhanasekaran et al., 2007).

These medicinal effects may be related to an anti-oxidant effect observed in the brain of experimental models (Bhattacharya et al., 2000). A study published in a Nature journal, Neuropsychopharmacology, demonstrated significant enhancement of memory retention after 3 months of bacopa application in healthy people (Roodenrys et al., 2002). Bacopa is used traditionally in the treatment of Alzheimer’s and dementia, this is supported with studies in vivo models showing reduction of beta-amyloid deposits in the brains of an Alzhemier’s disease animal model with bacopa treatment (Dhanasekaran et al., 2007). These studies point to the importance of bacopa as one of nature’s most powerful nootropics and it is worthy of more human clinical studies.

bacopa_wikicommons

2. Ginkgo

Ginkgo, otherwise known as the maidenhair tree, grows throughout Asia and has been described as a ‘living fossil’ because it is known to have existed 170 million year ago, in the Jurassic period (Zhou et al., 2003). It has changed little morphologically in the last 100 million years. In the Chinese medical text, Pen Tsao Ching, from 1578, ginkgo is described as a treatment for senility in ageing members of the royal court (Nakanishi, 2005). Ayurvedic physicians in India associated ginkgo with increased life-span (Castleman, 2001).

It is the leaf extract which is used to treat cognitive disorders and it has been speculated that ginkgo interferes with mitochondria dysregulation in Alzhemier’s through its anti-oxidant activity in the brain (Müller et al., 2017). A large double blind placebo controlled trial, published in the journal, JAMA, demonstrated a mild, but significant improvement of dementia with ginkgo treatment compared with the placebo group (Le Bars et al., 1997). This was effect was confirmed in a later study (Mazza et al., 2006). In addition to a multitude of other positive results in high quality clinical trials for various disorders, ginkgo has also been shown to be effective against anxiety in humans (Woelk et al., 2007). Finally, it was observed in a study using rats, that ginkgo increased lifespan as well as cognitive performance (Winter et al., 1998). These studies confirm ginkgo’s importance alongside bacopa as one our top herbal nootropics.

slipperyelm115527390182_52c9d3bd72_b_wiki

3. Ashwagandha

Ashwagandha is a small shrub native to India and is a member of the nightshade family (Castleman, 2001). Ashwagandha, similar to bacopa, is found in the Caraka Samhita (2500BC) where is it recommended as a whole body tonic (rasayana) especially for emancipated elderly people. The roots of ashwagandha contain the withanoloids thought to be responsible for ashwagandha’s medicinal properties, it has been shown they have anti-oxidant properties (Bhattacharya et al., 2001). Furthermore, ashwagandha extracts have been shown to reverse amyloid induced toxicity in human neuronal lines, highlighting their potential for treatment of Alzheimer’s (Kurapati et al., 2013).

A double-blind placebo controlled human study of healthy individuals observed improvement of cognitive and psychomotor performance with ashwagandha treatment compared with the placebo (Pingali et al., 2014). Another well controlled human study found ashwagandha to significantly reduce anxiety in humans compared with the placebo (Chandrasekhar et al., 2012). To summarise, while ashwagandha was not traditionally viewed as a ‘medhya rasayana’, but a more general tonic (rasayana) herb for the whole body, these studies imply it is a capable nootropic.

WithaniaFruit_wiki

4. St. John’s wort

If we take a looser definition of nootropic to include herbs that have an anti-depressant or mood balancing action, St. John’s wort is a highly influential herb. St. John’s wort is a medicinal plant native to Europe and yields bright yellow flowers (Benzie, 2011). Its name arises because it flowers around St John’s Day (24th June). The history of its use can be traced back to the ancient Greeks as the physician, Dioscorides (40-90AD) used it in the treatment of sciatica (Castleman, 2001). In modern times it has become known not so much as for nerve pain, but for depression, multiple high quality double blind placebo controlled trials confirm its antidepressant activity (Laakmann et al., 1998; Szegedi et al., 2005; Woelk et al., 2000).

In these trials it has been shown to be as effective as mainstream anti-depressants, but with better tolerance. However, excessive use, has been linked to serotonin syndrome (Dannawi, 2002), sun sensitivity and easy skin burning (Dannawi, 2002), and moderate use with increased pharmaceutical drug metabolism by the liver (Markowitz et al., 2003). This means St. John’s wort may not be suitable for application alongside other pharmaceutical drugs and should not be used in patient’s taking selective serotonin reuptake inhibitors (SSRIs). Regardless of these negative points, St. John’s wort is a potent medicinal herb which when used appropiately and in the correct context is an undoubted ally.

stjohnswortwikicommons

5. Holy basil

Tulsi is a small, fragrant plant that grows purple-green leaves it is found growing wild and also widely cultivated in India (Kuhn and Winston, 2000). Tulsi is sacred to the Hindu God Vishnu, and is often used in prayer and various rituals (Winston, 2007). It is also a rasayana herb similar to ashwagandha and turmeric and so with wide ranging medicinal effects that include effects on human cognition.

One double blind placebo controlled study found significant cognitive boosting effects in a group of healthy individuals (Sampath et al., 2015). A further well controlled study found it effective for reducing stress (Saxena et al., 2011). Researchers have also found that tulsi could reduce the amnesic effect of two chemicals, scopolamine and diazepam, and also aging induced memory deficits in mice (Joshi et al., 2006). These studies point to the potential of tulsi to promote cognitive power in healthy people, while indicating it may be useful for treating degenerative cognitive disorders.

Tulsi

6. Gotu kola

Gotu kola is a creeping herb native to India and Sri Lanka (Kuhn and Winston, 2000). It has small pink flowers and round-lobed bright green leaves. Gotu kola gained a reputation in Sri Lanka as a longevity promoter, and a local proverb went, ‘Two leaves a day keeps old age away’. Similar to bacopa, gotu kola is classified in Ayurveda in the Caraka Samhita (2500BC) as a ‘medyha rasayana’, an herb specific for improving the health of the brain and nervous system (Jana et al., 2010).

Similar to other herbal nootropics described here, using experimental models gotu kola has been shown to act as an anti-oxidant in the mammalian brain and also improve cognition (Veerendra et al., 2003). A study on humans, double blind placebo controlled, found gotu kola may improve anxiety in the short term (hours), although a long term investigation was not performed (Bradwejn et al., 2000). Although slightly less studied than herbs like bacopa, these studies imply the reported nootropic power of gotu kola from the traditional texts may be justified.

Gotu Kola (Centella Asiatica) Overview, Health Benefits, Side effects (3)

7. Rhodiola

Rhodiola is a hardy perennial that grows in harsh conditions from the Artic mountains of Scandinavia through to Siberia (Castleman, 2001). It grows on mountains and in cliff faces and yield bright yellow flowers. Rhodiola may have been used as long ago as the Vikings for its strengthening action to support long hours and heavy work (Panossian et al., 2010). It has been shown to have anti-oxidant activity in the mammalian brain of experimental models, to reduce cognitive damage, and neuronal injury induced by streptozotocin (Qu et al., 2009).

There is good evidence in double blind placebo controlled trials that rhodiola reduces fatigue and stress (Spasov et al., 2000; Shevtsov et al., 2003), with one of these studies reported improvement in capacity for mental work (Shevtsov et al., 2003). Another well controlled study supports the use of rhodiola for depression (Darbinyan et al., 2007). While further clinical studies are required of rhodiola to assess its potential for therapeutic impact, rhodiola is clearly an impressive nootropic.

1124px-Rhodiola_rosea_flowers_wiki2

8. Curcumin

Turmeric is a perennial which yields characteristic oblong shaped branched roots are brown coloured and the yellow colour inside them is due to curcumin, which is thought to be the medicinal constituent of the herb (Chattopadhyay et al., 2004). Turmeric has long been used in Ayurvedic medicine and traditionally considered a rasayana herb, similar to ashwagandha and holy basil (Winston, 2007). Studies using experimental models show that curcumin reduces oxidative damage and also amyloid pathology in mice with Alzheimer’s disease (Lim et al., 2001). This effect of curcumin has be observed in other animal studies and it was noted that it can partially restore distorted neurites in an Alzheimer’s model (Garcia‐Alloza et al., 2007).

In humans, curcumin has a mild, but significant effect against depression in comparison with a placebo (Lopresti et al., 2014). This supports a view where curcumin could be one herb as part of a formula for treatment, rather than a standalone option. There is a wide array of overlapping in vivo studies of curcumin that support its ability to protect the brain using animal models (Zhu et al., 2004; Scapagnini et al., 2006; Wang et al., 2005). There is a human trial that confirmed curcumin’s mood elevating effects and also supported an increase in cognitive abilities with treatment (Cox et al., 2015). Notably, this study used a special extract of curcumin called longvida which is thought to pass into the brain more effectively. These studies imply that curcumin is an important nootropic in our materia medica.

Plant Ordinary House Turmeric Houseleek

Conclusions

Scientific research into herbal nootropics in humans is only just starting as high quality studies are emerging in greater numbers. However, it is clear just from this review, that they are already several effective options to choose from with multiple positive results in human clinical trials. Single herbs are a popular and often a very effective option; however, the herbalist tends to opt for formulas of herbs when treating cognitive disorders. For example, David Winston, has found a combination of bacopa, St. John’s wort, ginkgo, and holy basil highly effective in treating patients with brain trauma (Winston, 2007). Combinational effects tend to increase the overall activity of the formula, and herbal medicine this way can be more powerful.

It is good to remember to respect these herbs and act with caution, larger doses tend to produce oversedation, dullness, or overstimulation that is counterproductive in either healthy people or in those with a cognitive disease. It may also be dangerous as in the case of St. John’s wort, where overdosing has been linked to serotonin syndrome (Dannawi, 2002). Additionally, the importance of good lifestyle is hard to underestimate with treating cognitive conditions, diet, exercise, and mindfulness can all work together to support the body and mind. Used within the context of good lifestyle decisions, herbs can be far more effective. When used from a sensible position, I think herbal nootropics have more to offer than chemical nootropics. To summarise, we can learn a lot from studying the ancient and successful medicinal traditions of the world while keeping up-to-date with the latest science.

Note

This is not supposed to be a ‘definitive’ list and there are several omissions such as calamus, lion’s mane, lavender, rosemary, lemon balm, and many more. If you are interested, I would refer back to David Winston’s book on adaptogens that includes a nootropics chapter (Winston, 2007). Many of the adaptogenic herbs have nootropic properties.

References:

Bhattacharya, A., S. Ghosal, and S. K. Bhattacharya. “Anti-oxidant effect of Withania somnifera glycowithanolides in chronic footshock stress-induced perturbations of oxidative free radical scavenging enzymes and lipid peroxidation in rat frontal cortex and striatum.” Journal of Ethnopharmacology 74.1 (2001): 1-6.

Bhattacharya, S. K., et al. “Antioxidant activity of Bacopa monniera in rat frontal cortex, striatum and hippocampus.” Phytotherapy Research 14.3 (2000): 174-179.

Bove, Geoffrey M. “Acute neuropathy after exposure to sun in a patient treated with St John’s Wort.” The Lancet 352.9134 (1998): 1121-1122.

Bradwejn, Jacques, et al. “A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects.” Journal of clinical psychopharmacology 20.6 (2000): 680-684.

Castleman, Michael. “The new healing herbs.” Bantam Book, New York (2001): 465-471.

Chandrasekhar, K., Jyoti Kapoor, and Sridhar Anishetty. “A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults.” Indian Journal of Psychological Medicine 34.3 (2012): 255.

Chattopadhyay, Ishita, et al. “Turmeric and curcumin: Biological actions and medicinal applications.” CURRENT SCIENCE-BANGALORE- 87 (2004): 44-53.

Cox, Katherine HM, Andrew Pipingas, and Andrew B. Scholey. “Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population.” Journal of psychopharmacology 29.5 (2015): 642-651.

Dannawi, Moemen. “Possible serotonin syndrome after combination of buspirone and St John’s Wort.” Journal of Psychopharmacology 16.4 (2002): 401-401.

Darbinyan, V., et al. “Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression.” Nordic journal of psychiatry 61.5 (2007): 343-348.

Dhanasekaran, Muralikrishnan, et al. “Neuroprotective mechanisms of ayurvedic antidementia botanical Bacopa monniera.” Phytotherapy Research 21.10 (2007): 965-969.

Garcia‐Alloza, M., et al. “Curcumin labels amyloid pathology in vivo, disrupts existing plaques, and partially restores distorted neurites in an Alzheimer mouse model.” Journal of neurochemistry 102.4 (2007): 1095-1104.

Jana, U., et al. “A clinical study on the management of generalized anxiety disorder with Centella asiatica.” Nepal Med Coll J 12.1 (2010): 8-11.

Joshi Pranav, C. “A review on natural memory enhancers (Nootropics).” Unique Journal of Engineering and Advanced Sciences 1.01 (2013): 8-18.

Joshi, Hanumanthachar, and Milind Parle. “Evaluation of nootropic potential of Ocimum sanctum Linn. in mice.” (2006).

Kuhn, Merrily A., and David Winston. Herbal therapy and supplements: a scientific and traditional approach. Lippincott Williams & Wilkins, 2000.

Kurapati, Kesava Rao Venkata, et al. “Ashwagandha (Withania somnifera) reverses β-amyloid 1-42 induced toxicity in human neuronal cells: implications in HIV-associated neurocognitive disorders (HAND).” PLoS One 8.10 (2013): e77624.

Laakmann, G., et al. “St. John’s wort in mild to moderate depression: the relevance of hyperforin for the clinical efficacy.” Pharmacopsychiatry 31.S 1 (1998): 54-59.

Le Bars, Pierre L., et al. “A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia.” Jama 278.16 (1997): 1327-1332.

Lewis, Paul. “The Ethical Brain: the Science of Our Moral Dilemmas.” Tradition and Discovery: The Polanyi Society Periodical 36.3 (2009): 66-67.

Lim, Giselle P., et al. “The curry spice curcumin reduces oxidative damage and amyloid pathology in an Alzheimer transgenic mouse.” Journal of Neuroscience 21.21 (2001): 8370-8377.

Lopresti, Adrian L., et al. “Curcumin for the treatment of major depression: a randomised, double-blind, placebo controlled study.” Journal of affective disorders 167 (2014): 368-375.

Markowitz, John S., et al. “Effect of St John’s wort on drug metabolism by induction of cytochrome P450 3A4 enzyme.” Jama 290.11 (2003): 1500-1504.

Mazza et al. “Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer’s dementia in a randomized placebo‐controlled double‐blind study.” European Journal of Neurology 13.9 (2006): 981-985.

Müller, Walter E., et al. “Therapeutic efficacy of the Ginkgo special extract EGb761® within the framework of the mitochondrial cascade hypothesis of Alzheimer’s disease.” The World Journal of Biological Psychiatry (2017): 1-17.

Nakanishi, Koji. “Terpene trilactones from Gingko biloba: from ancient times to the 21st century.” Bioorganic & medicinal chemistry 13.17 (2005): 4987-5000.

Panossian, A., G. Wikman, and J. Sarris. “Rosenroot (Rhodiola rosea): traditional use, chemical composition, pharmacology and clinical efficacy.” Phytomedicine 17.7 (2010): 481-493.

Pingali, Usharani, Raveendranadh Pilli, and Nishat Fatima. “Effect of standardized aqueous extract of Withania somnifera on tests of cognitive and psychomotor performance in healthy human participants.” Pharmacognosy research 6.1 (2014): 12.

Qu, Ze-qiang, et al. “Pretreatment with Rhodiola rosea extract reduces cognitive impairment induced by intracerebroventricular streptozotocin in rats: implication of anti-oxidative and neuroprotective effects.” Biomedical and environmental sciences 22.4 (2009): 318-326.

Roodenrys, Steven, et al. “Chronic effects of Brahmi (Bacopa monnieri) on human memory.” Neuropsychopharmacology 27.2 (2002): 279-281.

Russo, A., and F. Borrelli. “Bacopa monniera, a reputed nootropic plant: an overview.” Phytomedicine 12.4 (2005): 305-317.

Sampath, Suneetha, et al. “Holy basil (Ocimum sanctum Linn.) leaf extract enhances specific cognitive parameters in healthy adult volunteers: A placebo controlled study.” (2015).

Saxena, Ram Chandra, et al. “Efficacy of an extract of ocimum tenuiflorum (OciBest) in the management of general stress: A double-blind, placebo-controlled study.” Evidence-Based Complementary and Alternative Medicine 2012 (2011).

Scapagnini, Giovanni, et al. “Curcumin activates defensive genes and protects neurons against oxidative stress.” Antioxidants & redox signaling 8.3-4 (2006): 395-403.

Shevtsov, V. A., et al. “A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work.” Phytomedicine 10.2 (2003): 95-105.

Spasov, A. A., et al. “A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen.” Phytomedicine 7.2 (2000): 85-89.

Szegedi, A., et al. “Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John’s wort): randomised controlled double blind non-inferiority trial versus paroxetine.” Bmj 330.7490 (2005): 503.

Veerendra Kumar, M. H., and Y. K. Gupta. “Effect of Centella asiatica on cognition and oxidative stress in an intracerebroventricular streptozotocin model of Alzheimer’s disease in rats.” Clinical and Experimental Pharmacology and Physiology 30.5‐6 (2003): 336-342.

Wang, Qun, et al. “Neuroprotective mechanisms of curcumin against cerebral ischemia‐induced neuronal apoptosis and behavioral deficits.” Journal of neuroscience research 82.1 (2005): 138-148.

Winston, David, and Steven Maimes. Adaptogens: herbs for strength, stamina, and stress relief. Inner Traditions/Bear & Co, 2007.

Winter, J. C. “The effects of an extract of Ginkgo biloba, EGb 761, on cognitive behavior and longevity in the rat.” Physiology & behavior 63.3 (1998): 425-433.

Woelk, H., et al. “Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: A randomized, double-blind, placebo-controlled trial.” Journal of psychiatric research 41.6 (2007): 472-480.

Woelk, Helmut. “Comparison of St John’s wort and imipramine for treating depression: randomised controlled trial.” Bmj 321.7260 (2000): 536-539.

Zhou, Zhiyan, and Shaolin Zheng. “Palaeobiology: The missing link in Ginkgo evolution.” Nature 423.6942 (2003): 821-822.

Zhu, Yuan-Gui, et al. “Curcumin protects mitochondria from oxidative damage and attenuates apoptosis in cortical neurons.” Acta Pharmacologica Sinica 25.12 (2004): 1606-1612.

How to treat insomnia with herbal medicines

Firstly to get at the underlying cause, it is good to look at lifestyle with insomnia, spending time outside, exercising, and doing meditation or yoga are good ways to facilitate a good night sleep. Changing habitats like working or bright screens one hour before bedtime, is really important, to allow the mind to shutdown better. Fixing the time you go to bed and get out of bed helps. There are also some herbs that can help restore sleep, in this article, the protocol below can help guide you. Specifically, the nervine tonic herbs listed below are thought to help restore balance to the nervous system (Hoffman, 1988).

Herbs that work on the nervous system are termed nervines, these are suitable for treating insomnia, partly, as they reduce anxiety. Out of the herbs shown below we have one double blind human clinical trial that supports the use of American skullcap in reducing anxiety (Wolfson et al., 2003). St. John’s wort and milky oat seed have not been studied for anxiety or sleep in humans and their anti-anxiety indication is based on strong traditional knowledge (Hoffman, 1988).

Nervine tonic formula

Fresh American skullcap tincture (1 part) (cooling, drying)
Fresh milky oat seed tincture (1 part) (warming, moistening)

Dose: 20-40 drops, 2-3 times daily.
Contraindications: If on sedative medication be highly cautious regarding dose.

Good sleep guidelines

1. Choose a time for bed in order to get 8 hours of sleep. Make sure this is the same time every day. It is best to get up at the same time each day. This way you train your internal circadian clock.
2. Engage in light physical activity in the morning and afternoon. However, no intense physical exercise before bed is a good idea.
3. Do not nap during the day unless you absolutely have to.
4. Eat dinner at least 2-3 hours before bed, do not eat food after dinner.
5. Do not perform intense mental activity for 1-2 hours before bedtime, relax by listening to music, meditation, or very gentle yoga.
6. Do not expose yourself to bright lights 1 hour before bedtime, have only low lights.
7. Take 2-3 doses of the nervine tonic formula per day.
8. Get horizontal 30-60 mins before bedtime and no TV or bright screens.
9. Keep a balanced healthy diet.

This should help restore normal sleep. The nervine tonics may restore balance in the long term, while providing a gentle sedative action to improve sleep in the short term. The reason nervines are applied 2-3 times daily for sleep is that this helps relax the body during the day, thus preparing it for sleep at night.

Other options

The simplest option to help restore sleep is just to use fresh American skullcap, it is quite strong and non-addictive in low doses 5-15 drops. It combines very well with a fresh milky oat seed tincture for this purpose. Some herbalists also combine it with fresh St. John’s wort tincture in a three-way nervine tonic formula, in equal parts.

There are other Western nervine herbs that may be helpful, namely; wood betony and blue vervain, lavender, chamomile, or lemon balm, these nervines have a gently relaxing effect that may help sleep (Bartram, 2013). Kava kava is the strongest option, although potentially addictive at higher doses. Lemon balm is best used as a fresh tincture.

Personally, I find that the nervines work well together if more strength is needed. Like a combination of valerian, skullcap, lemon balm, St. John’s wort, and milky oats provides a nice overall sleep formula. Dr. Christopher believed that poor sleep begins during the day, and therefore it can be helpful to take a formula like this twice a day.

Constitutional medicine

Bitter nervines are drying and often cooling so it is best to be wary about causing constitutional imbalances such as dry skin and constipation (especially in the vata constitution). Therefore, it is usually best if taking bitter herbs long term to formulate them with moistening nervines such as milky oat seed or other moistening herbs such as licorice. Also, in long term use, it may be useful to combine cooling nervines with those that are warming, like milky oats or valerian to balance the formula energetically.

Adaptogens

Ashwagandha is a more calming Indian adaptogen which may help sleep (Kaushik et al., 2017), it also has an impressive array of other benefits and can be taken as a long term protective herb. Similarly, holy basil or tulsi, reduces anxiety and is another more calming adaptogen for sleep (Saxena et al., 2011). Reishi is another option in this class of herbs that can be sedating, although it is more energising than ashwagandha and holy basil. The KSM-66 extract of ashwagandha tends to be more stimulating than the traditional root powder.

Conclusions

In summary, the best solution for insomnia is a holistic one that takes into account underlying problems and the individual. The Western nervine tonics can be very effective for sleep, however, most important is sensible lifestyle changes.

This article which is more recent may be of interest.

References:

Bartram, Thomas. Bartram’s encyclopedia of herbal medicine. Hachette UK, 2013.

Hoffman, David. Holistic herbal. Element Books, 1988.

Kaushik, Mahesh K., et al. “Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction.” PloS one 12.2 (2017): e0172508.

Koetter, U., et al. “A randomized, double blind, placebo‐controlled, prospective clinical study to demonstrate clinical efficacy of a fixed valerian hops extract combination (Ze 91019) in patients suffering from non‐organic sleep disorder.” Phytotherapy research 21.9 (2007): 847-851.

Saxena, Ram Chandra, et al. “Efficacy of an extract of ocimum tenuiflorum (OciBest) in the management of general stress: A double-blind, placebo-controlled study.” Evidence-Based Complementary and Alternative Medicine 2012 (2011).

Wolfson, P., and D. L. Hoffmann. “An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers.” Alternative therapies in health and medicine 9.2 (2003): 74.

 

 

Herbal medicines can treat anxiety and depression

In this article I want to go through natural ways to treat anxiety and depression. The first thing to get clear is understanding the causes of anxiety and depression, although we may think it is because certain events happen to us or even genetics, the truth is when we attach, we suffer. This is what the Buddha outlined in the Noble Eightfold Path, as he understood the causes of suffering he also understood the way to its cessation. This is what modern science is now confirming with many clinical studies on mindfulness (Hofmann et al., 2010). However, mindfulness isn’t for everybody so tools like cognitive behavioral therapy can be used (Butler et al., 2006). Additionally, herbal medicine and diet changes may prove very useful as I will now discuss.

Herbal medicines for depression and anxiety

Herbs can be very helpful for certain people and I have come to believe they are overly ignored in our society. I think depression and anxiety should be seldom dealt with pharmaceutical drugs, herbal medicines offer a gentler, healthier, and effective solution. Take St. John’s wort, we know this works for depression because it has been very well studied, and a recent meta-analysis concluded it was effective for mild to moderate depression (Ng et al., 2017). So why aren’t we using it in the NHS as they use in their primary health system in Germany? The answer is cultural stigma; we are conditioned to believe in pharmaceutical drugs over herbal medicines and our research system is highly dependent on pharmaceutical companies which are not interested in funding natural healing methods. Having worked with pharmaceutical companies quite a lot myself, I think they have their place and so do their drugs, especially in very serious cases of diseases. However, they are far over used in my view. There are natural and effective ways to treat depression and anxiety. Many of the herbs used to treat depression in herbalism, called the nervines, also have a anti-anxiety effect as well. Let’s now turn to examine some of these medicines in more detail.

stjohnswortwikicommons

St John’s wort is effective for mild to moderate depression, but St. John’s wort was not thought of as an anti-depressant traditionally (Castleman, 2001). It was used internally to treat neuropathic pain and anxiety. It’s use goes as far back as the ancient Greeks as a treatment for Sciatica. St. John’s wort is best in a fresh tincture form with a deep red colour to it. St. John’s wort does have a few contraindications, such as with SSRIs and also it generally decreases the effectiveness of pharmaceutical drugs taken at the same time. I would like to point out, while the commonly used medicinal herbs can have side effects and contra indications, the truth is they are generally far less dangerous than chemical drugs.

A more traditional Western herb for depression is motherwort. 17th century herbalist, Nicholas Culpeper wrote, ‘There is no better herb to take melancholy vapours from the heart … and make me a merry cheery soul’ (Castleman, 2001). Lemon balm is another herb used traditionally for depression, and the 11th century Arab physician, Avicenna, wrote, ‘Balm causeth the mind and heart to become merry’. David Hoffman in his book, ‘Holistic Herbal’, states that lemon balm is ‘an excellent carminative herb….(with) anti-depressive properties’ (Hoffman, 1988). David Winston recommends a combination of St. John’s wort and lemon balm for SAD because of their uplifting properties (Winston, 2007). Lemon balm is another herb best in a fresh tincture to increase its medicinal potency.

motherwort

A nervine herb that is held is very high regard in Western herbalism is American skullcap which is an old Native American remedy and it is a relaxing tonic for nerves in fresh (not dried) tincture. One study found a significant anxiety reducing effect versus placebo in a double blinded trial (Wolfson and Hoffmann, 2003). Milky oats is another effective nervine and nutritive tonic medicine for the nerves, which David Winston has called, ‘the greatest nervous system trophorestorative’ (Winston, 2007). This is a good option if stress and anxiety are your problems. The idea of these tonic herbs, quite different to pharmaceutical drugs, is to restore the nervous system into balance.

14755637186_935b3da531_baskullcap_wiki

Finally a good herb to consider including in a formula for anxiety, this time from traditional Indian medicine, is tulsi. Tulsi has been found to reduce stress in a large double blind placebo controlled study (Saxena et al., 2011) and has a rich history of traditional use in India. Tulsi is a rasayana herb in Ayurveda, otherwise known as a rejuvenator, and is thought to nourish a person towards health and long life (Winston, 2007). Since plants are more like food and they are so diverse, the idea of special tonic healing herbs makes intuitive sense to me.

Diet

Finally, diet is very important as it is for managing pretty much any health problem. There is increasing evidence the gut microbiome is related to mental health (Foster et al., 2013). So if the diet is made cleaner, i.e. by removing processed foods and refined sugars, reducing or eliminating grains and dairy, and eating more vegetables and fruits this will help.

Formulation notes

Anti-depressive pair

Fresh St. John’s wort tincture (1 part) (warming, drying)
Fresh lemon balm tincture (1 part) (cooling, drying)

This formula is more specifically for depression, but may be helpful for anxiety.

Dose: 10-60 drops, 2-3 times daily
Notes: This formula is contra indicated with SSRIs. St. John’s wort may decrease the effectiveness of pharmaceutical drugs.

Nervine tonic triplet formula

Fresh St. John’s wort tincture (1 part) (warming, drying)
Fresh skullcap tincture (1 part) (cooling, drying)
Fresh milky oats tincture (1 part) (warming, moistening)

This formula is for balancing the nervous system which includes treatment of anxiety and insomnia, but also may be useful for nerve pain and depression. The milky oats balances it’s energetic properties as it has a moistening effect to avoid long term constitutional drying out in pre-disposed individuals, e.g. dry skin.

Dose: 15-60 drops 2-3 times daily
Notes: This formula is contra indicated with SSRIs. St. John’s wort may decrease the effectiveness of pharmaceutical drugs. If on sedative medication be highly cautious regarding dose.

Summary

We need to research more into medicinal plants for depression and anxiety, however, in the current lack of knowledge I think we can rely on traditional knowledge from strong traditions which often proves correct. After all more than 80% of the total population in the developing world dependent on herbs and up to 50% the approved drugs during the last 30 years are from from natural products (Veeresham et al., 2012). I believe natural ways to treat depression and anxiety are the way forward in the majority cases, so if you are suffering from these problems I think there is cause for optimism.

References:

Bodhi, Bhikkhu. “The Noble Eightfold Path–The Way to the End of Suffering.” The Wheel Publication (1984).

Hofmann, Stefan G., et al. “The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.” Journal of consulting and clinical psychology 78.2 (2010): 169.

Butler, Andrew C., et al. “The empirical status of cognitive-behavioral therapy: a review of meta-analyses.” Clinical psychology review 26.1 (2006): 17-31.

Ng, Qin Xiang, Nandini Venkatanarayanan, and Collin Yih Xian Ho. “Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis.” Journal of Affective Disorders 210 (2017): 211-221.

Castleman, Michael. “The new healing herbs.” Bantam Book, New York (2001): 465-471.

Hoffman, David. Holistic herbal. Element Books, 1988.

Saxena, Ram Chandra, et al. “Efficacy of an extract of ocimum tenuiflorum (OciBest) in the management of general stress: A double-blind, placebo-controlled study.” Evidence-Based Complementary and Alternative Medicine 2012 (2011).

Winston, David, and Steven Maimes. Adaptogens: herbs for strength, stamina, and stress relief. Inner Traditions/Bear & Co, 2007.

Veeresham, Ciddi. “Natural products derived from plants as a source of drugs.” Journal of advanced pharmaceutical technology & research 3.4 (2012): 200.

Wolfson, P., and D. L. Hoffmann. “An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers.” Alternative therapies in health and medicine 9.2 (2003): 74.

Brock, C., Whitehouse, J., Tewfik, I., & Towell, T. (2014). American Skullcap (Scutellaria lateriflora): A Randomised, Double‐Blind Placebo‐Controlled Crossover Study of its Effects on Mood in Healthy Volunteers. Phytotherapy Research, 28(5), 692-698.

Foster, Jane A., and Karen-Anne McVey Neufeld. “Gut–brain axis: how the microbiome influences anxiety and depression.” Trends in neurosciences 36.5 (2013): 305-312.

Winston, David, and Steven Maimes. Adaptogens: herbs for strength, stamina, and stress relief. Inner Traditions/Bear & Co, 2007.