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

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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.

 

Mixing adaptogens and nervines

This article is a brief guide to the adaptogens and nervines and how we could go about combining them. They are two powerful classes of herb useful for many problems. Although, it is better to use them after developing a good understanding of their traditional indications and contra indications.

It is thought adaptogens operate through gently modulating the sympatho-adrenal or hypothalamic-pituitary-adrenal axes of the endocrine system (Reviewed by Panossian, 2017), which are related to stress response, to adapt the organism to dealing with stress. These herbs are known as the Qi tonics or rasayana herbs in traditional Chinese or Ayurvedic medicine, respectively. They are called Qi tonics because they all have this characteristic of increasing a person’s overall energy or Qi. However, they are not simple stimulants like coffee, they also have a relaxing property to them which makes them so unique. Nervine herbs on the other hand, aside from the nervine stimulants, act to relax the nervous system to differing degrees. We may also define additional actions for nervines and adaptogens. For instance, the nervine American skullcap is also a nervine tonic and is thought to be effective for restoring normal sleep patterns. While the nervine lemon balm is also an effective carminative suited for reducing excessive digestive gas.

As well as herbal actions, adaptogens and nervines also have specific indications and affinities for different systems of the body. For example, astragalus and reishi are potent immune stimulators and so are suited for protecting against infections, while he shou wu and ashwagandha have an affinity for the male reproductive system and may improve sexual performance and drive. One common characteristic to adaptogens is they tend to be quite multi-purpose, like an herbal swiss army knife. Importantly, adaptogens and nervines also have different energetic properties, which relate to how warming, cooling, drying, or moistening they are on the individual’s constitution.

Scutellaria_lateriflora_-_Blue_Skullcap

(above) American skullcap, a nervine tonic and sedative. Best in a fresh tincture form.

Energetics

We have learnt from knowledge passed down through the generations that herbs, including adaptogens and nervines have certain energetic properties (i.e. warming, cooling, moistening, drying) (Figure 1). These should, ideally, be taken into account when selecting an adaptogen or nervine. A common finding, for example, if taking a drying herb like prickly ash, is that certain people who tend towards dryness (i.e. dry skin, constipation) tend to get dried out skin. This would be especially true for the vata constitution in Ayurveda (cold and dry). I observed this for the first time when testing prickly ash on myself, being a vata constitution dominantly, I was interested to see the skin almost immediately dry out and parts turn red on my hands after taking small doses of this potent herb (5-10 drops). Some time later, I also observed after taking a little too much ashwagandha, my hands dried out again. Ashwagandha is a drying and warming herb in Ayurveda.

Although some people still do not believe in herbal energetics, the same system of medicine based on heating, cooling, drying, or moistening herbs is found within ancient Greek, Ayurvedic, and traditional Chinese medicine. Perhaps, it is one of those things you must see for yourself first hand. David Winston provides more detailed information on energetics which are related to the taste of the herbs in his book, Adaptogens: herbs for strength, stamina, and stress relief (Winston, 2007).

adaptogennervineenergeticchart.png.png

Figure 1. Energetic properties of common nervine and adaptogen medicinal herbs.

The nervous-endocrine system spectrum

Another way of viewing adaptogens and nervines is to examine how stimulating they are to the nervous system (Figure 2). Certain adaptogens, such as Asian ginseng tend to be more stimulating and may cause insomnia, while ashwagandha tends to be more calming and therefore potentially useful for sleep. It has been said young people are usually more suited to less stimulating adaptogens as they often have more energy or Qi, while for older people the converse applies. More stimulating adaptogens may be taken in the morning only if an individual finds them overly stimulating.

Adaptogens combine well with the nervine herbs because they may reinforce their relaxing activity and allow a more complex combination of herbal actions. For instance, combining a calming adaptogen such as ashwagandha with the nervine tonic, American skullcap, amplifies the calming activity of ashwagandha and creates a relaxing pair for the nervous system. This could be useful for those persons suffering with nervous over excitation like, insomnia and or anxiety.

nervousendocrinediagramV7.png

Figure 2. The nervous-endocrine system spectrum.

Formulation strategies

Typical considerations when choosing herbs for a formula that mixes adaptogens and nervines are; constitution (e.g. pitta, vata, kapha), diseased tissue state (e.g. hot (inflamed), cold, wet, dry, tense, relaxed), actions, affinities, and specific indications of the herb. It is also appropriate to consider when using an adaptogen that some people are more prone to insomnia and are very sensitive and so may respond better to a calming adaptogen such as ashwagandha or holy basil. Equally, some people may have a lot of dry skin going on and therefore a moistening nervine like hawthorn berry may be more appropriate. I recommend studying Matthew Wood’s The Earthwise Herbal books for a more complete explanation of constitutions and tissue states (Wood, 2009).

It also is important to read up on contra indications for herbs, these can be obtained from the herbal encyclopedia on this site or webMD or other sites and text books.

A simple way widely practiced is to just pick an herb by its action, e.g. nervine sedative. Although this can work well and there is room for a variety of different ways of deciding which herb to use, I think it is good to learn from the ancient traditions of the world such as Ayurveda and TCM.

Specific indications

We will now turn to examine some specific indications from traditional knowledge and (preliminary) scientific studies. These indications have been collected from traditional text books and scientific studies, they usually come from multiple independent sources. References for specific indications are included in the herbal encyclopedia. I have also tested many of these on myself and can therefore confirm many of the indications.

Adaptogens

Ashwagandha: Insomnia, anxiety, nerve pain, sexual/ reproductive problems, autoimmune diseases, fatigue, musculoskeletal conditions such as fibromyalgia and both types of arthritis, cognitive problems such as ADD, ADHD, and dementia.

Asian ginseng: Autoimmune diseases, allergies, fatigue, cognitive problems, sexual and reproductive problems in men, fibromyalgia, longevity.

Gotu kola: Anxiety, nerve pain, fatigue, rheumatoid arthritis, psoriasis, dry scaly skin, cognitive problems, autoimmune diseases, longevity.

Holy basil: Autoimmune diseases, nerve pain, anxiety, insomnia, boosting strength of the immune system, cognitive problems, allergies.

Rhodiola: Depression, fatigue, longevity, cognitive problems, recovery from brain injury.

He shou wu: Sexual weakness/debility in men, musculoskeletal conditions, constipation, inflammation of the GI tract, fatigue.

Schisandra: Anxiety, insomnia, fatigue, liver complaints and disorders, weak digestion, hypertension, palpitations, poor appetite.

Reishi: Anxiety, insomnia, fatigue, asthma, inflammation of GI tract, musculoskeletal conditions, weak immune system, allergies, cancer, longevity.

Licorice: Fatigue, inflammation of GI tract, dry cough, constipation.

Cordyceps: Asthma, autoimmune diseases, fatigue, sexual problems in men, weak immune system.

Astragalus: Weak immune system, fatigue, allergies, poor appetite.

Shatavari: Sexual problems in both sexes (but particularly women), fatigue, insomnia, inflammation of GI tract.

Nervines

St. John’s wort: Nerve pain, anxiety, depression, stabbing pains, muscle pains, shooting pains, nerve irritation.

American skullcap: Insomnia, anxiety, nerve pain, tense muscles, muscle pain.

Milky oat seed: Emotionally unstable, depression, insomnia, anxiety.

Blue vervain: Muscle tension, anxiety, insomnia, epilepsy.

Kava: More severe insomnia, anxiety, pain, muscle tension.

Lemon balm: Insomnia, anxiety, cognitive problems, excess digestive gas, depression.

California poppy: Nerve pain, chronic pain, insomnia, anxiety.

Valerian: Tense muscles, insomnia, anxiety.

Hawthorn: Hypertension, constipation, ADHD, dry skin.

Example adaptogen or adaptogen-nervine pairs

A nice way of working on a formula is thinking about pairs we might use. We could build on these to make a triplet, or just use a more simple pair, depending on need. All of the pairs below are geared towards tonifying and building ones health, energy, and well being. There is quite a lot of overlap in terms of effect, but ashwagandha is more calming and panax more energizing.

These are pairs I have personally tried together and liked. Note, panax ginseng is contra indicated with high BP and ashwagandha with hyper thyroidism and St. John’s wort has a few potential issues, best to read about St. John’s wort in more detail here.

Panax ginseng and ashwagandha: Will increase depleted energy levels and vitality long term. Should have a positive impact on emotions and anxiety. Ashwagandha is good for muscleoskeletal and nervous system inflammation and pain. Will increase male sex drive. Ginseng should boost appetite and boost immune health as a preventative medicine. 6-year-old roots of Korean red ginseng are recommended and KSM-66 ashwagandha is a nice choice. This is pretty energetically balanced in terms of dryness and moisture, but towards the warming side.

Ashwagandha and St. John’s wort: A strong Indian-Western nerve tonic pair, suitable for neuropathic pain, muscleoskeletal inflammation, lowering anxiety, and improving the emotional state. Will increase energy more gently than by using panax ginseng. St. John’s wort should be used in a fresh as possible tincture from the fresh flowers.

Ashwagandha and American skullcap: This pair is well suited to anxiety and insomnia and have good anxiolytic synergy together. Does not cause daytime sleepiness. May be tried for nervous system damage and pain. Ashwagandha is good for muscleoskeletal pain and inflammation.

An example of mixing adaptogens and nervines

You can do a lot with nervines and adaptogens.  This is just an example of what we might consider when formulating. Tissue state is NA because the nervous system does not have wet, cold, dry, and hot states in the same way the joints or lungs do, for example.

St. John’s wort, skullcap, and ashwagandha are some of the best tonics for vata, they are only slightly drying, and are calming, and restorative. Particularly skullcap and ashwagandha are good for sleep. Although as previously mentioned, too much ashwagandha will dry out vata type people especially. Vata is symbolic of the wind element in Ayurveda with a tendency to change, these people may be hypermobile, thin, prone to anxiety and insomnia, dryness, weak digestion, and pale skin.

The addition of the moistening nervine, hawthorn berry, which I find effective in preventing dryness, means the below formula is suitable for vata dominant types or people prone to dryness.

In terms of actions, we have a strong nervine tonic element to the formula with St. John’s wort and ashwagandha.

Constitution: Dry cold/hot. Vata-pitta.
Condition/s: Tingling pains, insomnia. Vata aggravation.
Tissue state/s: NA
Systems/: Nervous system
Action/s: Nervine tonic, adaptogen, analgesic, nootropic, sedative, antidepressant
Energetics: St. John’s wort (warming, drying), ashwagandha (warming, drying), hawthorn berry (cooling, moistening)
Contraindications: Any pharmaceutical drugs, especially SSRIs because of St. John’s wort. Ashwagandha is contra indicated with hyper thyroid.

Summary

There is, unfortunately, a lack of scientific knowledge surrounding the medicinal properties of plants compared with mainstream drugs, however, what we do have is some strong traditional knowledge. I think it is best to research over multiple traditional sources when deciding to test a medicinal plant on yourself or others. If there are many different herbalists seemingly independently suggesting a plant is good for something, this is of course a good sign.

It is important to remember that herbs may interact with drugs, sometimes in a dangerous manner so this must be properly researched or a doctor consulted. However, sometimes herbs may help get a person off drugs, so it may work both ways. In my own practice, I have been able to safely remove myself from the drug, lyrica, using herbs like American skullcap and ashwagandha. Some medicinal herbs have specific contra indications like panax ginseng and high blood pressure, that are good to know about. However, as for the herbs described on this site, the truth is they are safer than drugs when used correctly. It is a widespread misbelief they are dangerous or ineffective.

Herbalism of different varieties is being more widely practised by folk herbalists, including bio-hackers, who will use just about anything and are very keen on scientific studies while they often shun traditional knowledge. I think what is needed is a more balanced approach drawing from the great herbal teachers of the world as well as any scientific developments. After all science will always have an incomplete understanding of medicinal herbs, it is up to the herbalists to experiment to find new specific indications and formula.

Further reading

David Winston: https://www.herbalstudies.net/_media/resources/library/HarmonyRemedies(1).pdf

Cautions and contraindications

Using adaptogens for energy instead of good sleep, lifestyle, and eating habits will lead to a sleep debt and burnout. Stimulating adaptogens may be best taken in the morning to avoid insomnia. We recommend reading this PDF by Paul Bergner, an herbalist highly experienced with using the adaptogens if you are thinking of using them on yourself or on others (link).

References

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.

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

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

Seeking herbal options for fibromyalgia

Fibromyalgia is present in as many as 2% to 8% of the population and is characterized by widespread neuropathic pain, and is often accompanied by fatigue, insomnia, and cognitive problems (Clauw et al., 2014). However, it is far from well-defined and it has been suggested fibromyalgia may be characterised as a kind of ‘bodily distress syndrome’, along with chronic fatigue syndrome, irritable bowel syndrome, and similar overlapping disorders (Wolfe et al., 2014). There are numerous nonpharmacological therapies for fibromyalgia such as exercise and cognitive behavioural therapy and also pharmacological therapies, such as tricyclics (e.g. amitriptyline), serotonin norepinephrine reuptake inhibitors (e.g. cymbalta), and gabapentinoids (e.g. lyrica) that may prove effective (Clauw et al., 2014). Amitriptyline and cymbalta have anti-depressant actions, while lyrica is an anti-convulsant. However, while some patients are satisfied with conventional approaches, many are left without anywhere near satisfactory relief. This article will discuss alternative approaches to treating fibromyalgia, mainly diet and traditional herbal medicine.

Diet

The Paleolithic diet has become popular with the mantra ‘eat the foods you were designed to eat’, this is a good option for individuals with fibromyalgia (Cordain, 2012). The idea is to return to foods similar to those we ate when evolving in the Paleolithic era, 2.6 million years to 10,000 years ago. This is when our bodies adapted genetically to eating a certain diet. The Paleo diet includes vegetables, fruits, nuts and seeds, grass (not grain) fed meats, and wild seafood. It is a plant based diet, around 80% vegetables and fruits, 20% meats. All grains (including breads, pasta, gluten-free, etc), legumes, diary, refined sugar, added salt, processed foods are removed.

It has been suggested a gluten free diet may help treat some cases of fibromyalgia (Isasi et al., 2014). Gluten sensitivity, which is a non-celiac reaction to gluten by the immune system, may be related to the development and severity of fibromyalgia. There is evidence a mostly raw vegan diet may reduce fibromyalgia symptoms (Kaartinen et al., 2000). This is a particularly good option for vegetarians, however, it contains very little B12, therefore supplementation with B12 would be sensible. There is some degree of overlap between the Paleo diet and the raw vegan diet described in this paper, as both favour a plant based diet and reject refined sugars and processed foods. This kind of approach will increase the overall health of the body through greater intake of fruits, vegetables, and fibre.

Vitamin D and magnesium

It has been suggested vitamin D deficiency may contribute to disease severity and fatigue in patients with fibromyalgia (Solmaz et al., 2015). In one study, the authors observed a negative correlation between fatigue and vitamin D level in fibromyalgia patients. They also found a similar relationship between pain scores and vitamin D level. While these data are not fully conclusive, it is certainly worth considering supplementation of vitamin D and magnesium if you are suffering with fibromyalgia. In another study, the authors found statistical improvement of tender joints and depression with magnesium treatment, but the effects were not as strong when the drug amitriptyline was used instead (Bagis et al., 2013). Both applied together were found to work better than either applied alone.

Traditional herbal medicines

Whilst conventional drugs like lyrica, amitriptyline, and cymbalta may prove helpful for fibromyalgia patients, they may result in unwanted side effects leading to discontinuation or they may not work for some aspects of the disease. Herbs tend to be gentler on the body and by combining multiple herbs with different actions it is possible to create a more complex formula that may approach treating fibromyalgia from a few different angles.

For instance, herbs like St. John’s wort and black cohosh have anti-depressant properties and may relieve some of the emotional burden associated with fibromyalgia, whilst they also have an analgesic effect and so target the nerve pain. Black cohosh and ashwagandha have an anti-spasmodic property and should help painful tight muscles, while skullcap has a nervine tonic action that should help to restore normal sleep patterns. When combined in this way, herbs may be more powerful than a single herb acting alone.

Ashwagandha

Withania_somnifera_04_wiki

Ashwagandha or withania somnifera has been used in Ayurveda for at least 3000 years (Castleman, 2001). It is mentioned in the ancient text, the Charaka Samhita, that recommends the root as a whole-body tonic, particularly for emancipation, reproductive powers, and longevity. It is classified as a rasayana in Ayurveda, or restorative herb for the body, also known as an adaptogen (Winston, 2007). Adaptogens are thought to work on the adrenal glands and modulate cortisol levels, amongst other mechanisms, to the effect of buffering the body against non-specific stress (Singh et al., 2011). Since fibromyalgia can be seen as a ‘bodily distress syndrome’, reducing the impact of stress in the body could have a significant positive impact.

Ashwagandha is known to have a profound anti-anxiety effect observed in human double-blind placebo controlled studies (Chandrasekhar et al., 2012). It also has an antispasmodic effect (Mishra et al., 2000), and may help relax painful tight muscles which are found in some fibromyalgia patients. Furthermore, ashwagandha is classified as a nervine tonic and so is thought by herbalists to have a restorative effect on the nervous system. There is data that suggests it helps nerves regenerate (Nakayama et al., 2007), supporting this theory to some degree. It’s gentle stimulating effect that occurs over time may help to treat the fatigue often associated with diseases. Overall, ashwagandha is an important herb for a worn out, stressed nervous system.

Black cohosh

Actaea_racemosa_-_Black_Cohosh

Black cohosh or cimicifuga racemose was originally used by the Native Americans as a medicine as they boiled its roots in water and drank the decoction for fatigue and arthritis (Castleman, 2001). It subsequently became known as an herb for all kinds of rheumatism including those types involving muscular pains (Hoffman, 1988). Similar to St. John’s wort, black cohosh also has quite a strong anti-depressant action so can help lift some of the psychological burden associated with fibromyalgia (Gladstar, 2000). It also acts as a nervine sedative so may help related sleep troubles (Jiang et al., 2015). While, similar to ashwagandha, it has an antispasmodic action, capable of relieving the painful tight muscles that may be associated with the disease. Black cohosh is often combined with ashwagandha in various formula to target fibromyalgia by herbalists (Winston and Kuhn, 2000).

Reishi

1280px-Jreishi2_wiki

Reishi or ganoderma lucidum is a mushroom has been used as a medicine in China for over 2000 years. It is traditionally used to replenish the Qi or vital energy, relax the mind, relieve asthma, and for many other conditions (Benzie, 2011). It was thought by ancient Chinese doctors to increase the duration of lifespan (Babu, 2008). Preliminary results indicate reishi has anti-convulsant, neuroprotective, and anti-inflammatory properties (Liu et al., 2003; Aguirre-Moreno et al., 2013). A double-blind placebo controlled clinical trial supports a medicinal effect of reishi against emotional disturbance (Tang et al., 2005). Reishi is classified as an adaptogen and nervine tonic by herbalists, similar to ashwagandha, and is thought to have wide ranging anti-stress and nerve restorative effects in the body.

Reishi also has an effect on the gut, as in mice reishi has been found to reduce obesity via the modulation of gut flora (Chang et al., 2015). Reishi acts as a prebiotic and may help balance the gut environment which is typically dysregulated in fibromyalgia. It also has a role in the treatment of fatigue associated with fibromyalgia because it gently stimulates an individual’s energy with time. Although, it also can also over stimulate some people, so a tincture can be used together with nervines, then the dose can easily be reduced if necessary. The traditionally used part of the mushroom is the fruiting body, that grows above the ground.

St. John’s wort

stjohnswortwikicommons

St. John’s wort or hypericum perforatum has a history of medicinal use that dates back to the ancient Greeks (Castleman, 2001). The Greek physician Dioscorides recommended flower extracts as a treatment for sciatica. It has been shown to have an anti-depressant action by many well controlled clinical studies (Ng et al., 2017), however, perhaps most of all, herbalists see it as a nervine tonic. It is thought St. John’s wort helps heal nerves and also has an analgesic effect, therefore has applications in treating many kinds of neuropathic pain (Winston, 2007). St. John’s wort is best in the form of a fresh tincture of the flowers, the colour of the tincture should be deep red to indicate its potency.

Skullcap

Scutellaria_lateriflora_-_Blue_Skullcap

American skullcap or scutellaria lateriflora was used by the Native Americans in North America as a sedative and tonic (Barceloux, 2008). Fresh aerial parts of the plant made into a tincture are indicated for anxiety, insomnia, painful tight muscles, and nerve pain. A tincture made from dried leaf material has a lot less medicinal power, but is widely marketed and sold anyway. Skullcap is thought to have a renewing effect on the nervous system and may help direct it towards health and balance (Hoffman, 1988). A mood elevating effect has been shown for skullcap in a double-blind placebo controlled human study (Brock et al., 2014), but I have only noticed a calming effect personally. St. John’s wort and black cohosh have a stronger mood elevating property. The anti-anxiety effect of skullcap has been verified in a well-controlled human study (Wolfson et al., 2003)

Kava kava

Starr_070515-7054_Piper_methysticum_wiki

Kava or piper methysticum is consumed traditionally by the Polynesians from New Guinea to Tahiti who have an ancient tradition of consuming the herb in ‘kava circles’ (Castleman, 2001). In the South Pacific, kava has been used as a treatment for headache, colds, arthritis, and as a sedative and aphrodisiac. The Eclectic physicians used kava for urinary tract pain, renal colic, chronic urethritis, neuralgia, mouth and throat pain, and dyspepsia (Kuhn and Winston, 2000). Kava is a strong sedative or hypnotic and can help both sleep and pain in fibromyalgia. It can be addictive, so high doses should be avoided. Best not combined with alcohol, it may stress out the liver. Do not use in individuals with a history of liver disease, with hepatotoxic drugs, or in pregnant or breast-feeding women.

Formulation notes

The below formula is an example of a compound of different nervines discussed that should help address the disease pattern of fibromyalgia. However, there are many different kinds of fibromyalgia, therefore personalisation may well be necessary for a better result. There may be underlying digestive problems or poor diet that may be necessary to improve upon. Also, different types of constitution may respond better to certain herbs, for example, ashwagandha is a little more suited to vata type people (cold and dry) as it is warming.

Nervine tonic and adaptogen compound

Ashwagandha (warming, drying)
Black cohosh (cooling, drying)
Kava kava (warming, drying)

Contraindications: Not for use during pregnancy and when breastfeeding. If on sedative medication be highly cautious regarding dose. Not for use in people with history of liver problems. Be very cautious if combining with drugs or alcohol, it is best not to do this because of the kava. Black cohosh is best used in small doses, for example, 5-30 drop doses.

Conclusions

Nature has provided many different solutions to help treat fibromyalgia and related conditions such as CFS. Perhaps the most important part of treating such a condition is the restoration of a normal sleep pattern, for this, the gentle sedative tonic American skullcap may help, or kava kava if a stronger nervine is required. Mild adaptogens such as ashwagandha and reishi also have a central role with their gentle calming yet activating action upon the nervous system. This article has given some nervine and adaptogenic herbs that could be used in the construction of a herbal formula for fibromyalgia.

Note: If you are not fully comfortable with a DIY approach for your condition for any reason, please do not hesitate to contact a local professional herbalist for more tailored assistance.

References

Aguirre-Moreno, Alma, et al. “Anticonvulsant and neuroprotective effects of oligosaccharides from Lingzhi or Reishi medicinal mushroom, Ganoderma lucidum (Higher Basidiomycetes).” International journal of medicinal mushrooms 15.6 (2013).

Babu, P.D. and Subhasree, R.S., 2008. The sacred mushroom “Reishi”-a review. The American-Eurasian Journal of Botany, 1(3), pp.107-110.

Barceloux, Donald G. Medical toxicology of natural substances: foods, fungi, medicinal herbs, plants, and venomous animals. John Wiley & Sons, 2008.

Benzie, Iris FF, and Sissi Wachtel-Galor, eds. Herbal medicine: biomolecular and clinical aspects. CRC Press, 2011.

Bagis, Selda, et al. “Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder?.” Rheumatology international 25.3 (2005): 188-190.

Bagis, Selda, et al. “Is magnesium citrate treatment effective on pain, clinical parameters and functional status in patients with fibromyalgia?.” Rheumatology international 33.1 (2013): 167-172.

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.

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.

Chang, Chih-Jung, et al. “Ganoderma lucidum reduces obesity in mice by modulating the composition of the gut microbiota.” Nature communications 6 (2015).

Clauw, Daniel J. “Fibromyalgia: a clinical review.” Jama 311.15 (2014): 1547-1555.

Cordain, Loren. AARP The Paleo Diet Revised: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat. John Wiley & Sons, 2012.

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

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

Jiang, K., et al. “Black cohosh improves objective sleep in postmenopausal women with sleep disturbance.” Climacteric 18.4 (2015): 559-567.

Gladstar, Rosemary, and Pamela Hirsch, eds. Planting the future: saving our medicinal herbs. Inner Traditions/Bear & Co, 2000.

Isasi, Carlos, et al. “Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia.” Rheumatology international 34.11 (2014): 1607-1612.

Kaartinen, K., et al. “Vegan diet alleviates fibromyalgia symptoms.” Scandinavian journal of rheumatology 29.5 (2000): 308-313.

Mishra, Lakshmi-Chandra, Betsy B. Singh, and Simon Dagenais. “Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review.” Alternative medicine review 5.4 (2000): 334-346.

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.

Liu, Y. H., et al. “Effectiveness of Dp2 nasal therapy for Dp2-induced airway inflammation in mice: using oral Ganoderma lucidum as an immunomodulator.” Journal of microbiology, immunology, and infection= Wei mian yu gan ran za zhi 36.4 (2003): 236-242.

Nakayama, Natsuki, and Chihiro Tohda. “Withanoside IV improves hindlimb function by facilitating axonal growth and increase in peripheral nervous system myelin level after spinal cord injury.” Neuroscience research 58.2 (2007): 176-182.

Singh, Narendra, et al. “An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda.” African Journal of Traditional, Complementary and Alternative Medicines 8.5S (2011).

Solmaz, D., et al. “AB0944 Vitamin D Deficiency Might Contribute Fatigue and Disease Activity in Patients with Fibromyalgia.” (2015): 1215-1215.

Tang, Wenbo, et al. “A randomized, double-blind and placebo-controlled study of a Ganoderma lucidum polysaccharide extract in neurasthenia.” Journal of medicinal food 8.1 (2005): 53-58.

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

Wolfe, Frederick, Brian T. Walitt, and Winfried Häuser. “What is fibromyalgia, how is it diagnosed, and what does it really mean?.” Arthritis care & research 66.7 (2014): 969-971.

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.

 

Nervine tonic herbs for protection and restoration

The nervous system is at the intersection between the mind and the physical body so maintaining it is of great importance. The nervine tonic herbs, otherwise known as the nervine trophorestoratives, are an important class of medicines that have an affinity for the nervous system and are said to support, repair, and strengthen its function (Hoffman, 1988). David Hoffman in his book, Holistic Herbal, writes, ‘The nervine tonics strengthen and feed the tissues directly… In many nerve problems, the aid of nervine tonics can be invaluable’. The nervine tonics are thought to work in the long term to nourish the nervous system, while in the short term often induce a feeling of relaxation and wellbeing. It is important to note, nervine tonics are not all equal and have additional actions (e.g. antidepressant, nootropic, relaxant, sedative, hypnotic, analgesic, adaptogen) and also energetics that require consideration (warming, cooling, drying, moistening).

From the North American and European system of herbalism, key examples of nervine tonics include; St. John’s wort, American skullcap, wood betony, milky oats, and blue vervain. From the Ayurvedic system of medicine, the medhya rasayana herbs possess similar properties and are said by Ayurvedic med Continue reading “Nervine tonic herbs for protection and restoration”

Regenerative herbs for the nervous system

This article will discuss in restoration of a damaged nervous system with herbal medicines. When joined to a healthy diet and exercise, herbal medicines may be particuarly useful in assisting an individuals partial or full recovery. Nerves may become damaged or impaired in various disorders including; neuropathy, brain trauma, and the cognitive disorders, like Alzhemers and dementia. Similar herbs are indicated for these disorders in traditional medicine, and in Ayurveda they are called the, ‘medhya rasayana’ herbs, or rejuvenative herbs for the brain and nervous system (Winston, 2007). This article will describe 5 regenerative herbs for the nervous system in more detail referring to traditional and preliminary scientific knowledge.

1. Ashwagandha

Withania_somnifera_wikicomoons

Ashwagandha is classified as a rasayana herb in Ayurvedic medicine, this means it has rejuvenating qualities that increase life-span, improve overall health, and fight disease (Ven Murthy et al., 2010). Ashwagandha is considering an adaptogen, a term that refers to a nontoxic medication that normalises various functions perturbed by body stress. It is hypothesised to do this by correction of imbalances in the neuroendocrine and immune system. The winanosides are thought to be the primary active compounds of ashwagandha and are found in the root. Alzheimer’s disease is hypothesised to be caused by deposition of amyloid β-peptide in plaques in human brain tissue (Hardy et al., 2002). In one study, the authors found that an ashwagandha root extract was capable of reversing amyloid induced toxicity in human neuronal cells (Kurapati et al., 2013), therefore supporting the potential for this herb to be a treatment for Alzheimer’s.

Ashwagandha also has anti-oxidant properties (Bhattacharya et al., 2001), and oxidative stress is associated with neurodegeneration (Federico et al., 2012). Another interesting study, in an animal model, found a withanoside from ashwagandha increased regeneration of a damaged nerves after injury (Nakayama et al., 2007). These studies point to the value of ashwagandha in restoring the health of the nervous system. Ashwagandha is a deep acting versatile tonic herb capable of acting on many systems of the body.

2. Gotu kola

Asiatic_Pennywort_wikicommons

Gotu kola, similar to ashwagandha, is classified as a medhya rasayana herb in Ayurveda. Originally it was used by local people in Sri Lanka as a tonic herb for longevity (Castleman, 2001). It was incorporated into both traditional Indian and Chinese medicine for longevity and to treat cognitive problems. Impaired anti-oxidant mechanisms have been implicated in Alzheimer’s disease (Markesbery, 1997). More recently, in animal models, it has shown to have anti-oxidant activities in the brain and to exert a protective effect against cognitive problems (Kumar et al., 2003). Another study found both in cellular ex vivo and in vivo animal models that gotu kola facilitated axon regrowth and remyelination after damage (Soumyanath et al., 2005). Although these were animal or cellular studies they point to the medicinal potential of gotu kola to restore a damaged nervous system. Gotu kola is more subtle than other restorative herbs, but it’s gentle property is also an advantage as does not over stimulate like many of the adaptogens do.

3. Ginkgo

ginko-biloba-1523580_1280_wikicommons

Ginkgo is a giant tree which grows up to 125-foot-tall and lives up to 1000 years (Castleman, 2001). It has survived since the Jurassic period, 170 million years ago (Zhou et al., 2003). Ginkgo, otherwise known as the maidenhair tree, has changed very little morphologically over 170 million years. It has long been used in Chinese and Indian traditional medicine (Castleman, 2001). However, it is the concentrated leaf extract that has been used in more recent times which has potent anti-oxidant properties (Bridi et al., 2001) and stimulates the circulatory system. The leaf extract could be considered a modern ‘medhya rasayana’. It has convincing support in human studies to reduce the severity of Alzheimer’s disease and dementia (Le Bars et al., 1997). A study using experimental models, found that ginkgo extracts enhanced axonal extension in Schwann cells and promoted peripheral nerve functional recovery (Hsu et al., 2004). Like ashwagandha and gotu kola, ginkgo is another herb with great potential to help restore the nervous system.

4. Bacopa

bacopa_wikicommons

Bacopa is classified as a medhya rasayana in Ayurveda (Russo et al., 2005). Bacopa can be found in the Caraka Samhita a text from the 6th century A.D. In this key text, it is recommended to treat cognitive problems. Bacopa has been found to have anti-oxidant activities in the rat brain (Bhattacharya et al., 2000). Well conducted human clinical studies support Bacopa as having cognitive boosting effects (Roodenrys et al., 2002). Bacopa has been shown to inhibit acrylamide (a toxic chemical) induced neuropathy in drosophila likely via raising anti-oxidant levels (Kunnel et al., 2013). Another study found that an extract of bacopa could reduce neuropathic pain in rats (Sahoo et al., 2010). These studies highlight the potential for bacopa to heal damaged nerves and boost cognitive faculties.

5. St. John’s wort

stjohnswortwikicommons

St. John’s wort’s importance in herbalism can be traced back to the ancient Greeks (Castleman, 2001). The Greek physician Dioscorides recommended it for sciatica, a nerve related disorder. St. John’s wort has anti-oxidant abilities (Zou et al., 2004), which may be related to its health promoting effects on the nervous system. A human clinical trial studying the effects of St. John’s wort on polyneuropathy found that it reduced pain with patients suffering from polyneuropathy, although the effect was not quite significant (Sindrup et al., 2001). This implies that if repeated with a higher patient number and a higher dosage the effects would be significant, however, another problem could be that the investigators used a dried extract of the herb and herbalists typically prefer the fresh tincture.

In another study using animal models, it was found that St. John’s wort reduced neuropathic pain (Galeotti et al., 2010), thus supporting the traditional use of the herb. St. John’s wort also has anti-depressant activity, these classes of medicines are linked to reducing neuropathic pain (Saarto et al., 2007). Additionally, treatment with the anti-depressant fluoxetine is linked to increasing neural plasticity in the mammalian brain (Vetencourt et al., 2008). St. John’s wort may function in a similar, but more complex manner.

St. John’s wort is best used in a tincture made from fresh flowers which has a deep red color. I believe it’s deep red colour indicates its potency. Overall, St. John’s wort is one of the most important nervine tonic herbs in our materia medica. It can help uplift individuals who have been suffering for some time.

Summary

Ashwagandha, bacopa, gotu kola, ginkgo, and St. John’s wort are some of the strongest tonics for the nervous system we have as herbalists. David Winston has reportedly used St. John’s wort with bacopa, ginkgo, and holy basil for brain injury with remarkable success (Groves, 2016). Holy basil is a notable omission to this article, as alongside gotu kola, it is one of the most gentle and less stimulating tonic herbs from the Ayurvedic system with a wide range of medicinal properties. In treating complex difficult nerve related conditions, a combination formula seems best to stimulate restoration through multiple pathways. For more detail on constructing a formula, I would refer you to a book by Maria Groves called ‘Body into Balance’.

Note: If you are not fully comfortable with a DIY approach for your condition for any reason, please do not hesitate to contact a local professional herbalist for more tailored assistance.

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.

Bridi, R., et al. “The antioxidant activity of standardized extract of Ginkgo biloba (EGb 761) in rats.” Phytotherapy Research 15.5 (2001): 449-451.

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

Federico, Antonio, et al. “Mitochondria, oxidative stress and neurodegeneration.” Journal of the neurological sciences 322.1 (2012): 254-262.

Galeotti, Nicoletta, et al. “St. John’s Wort reduces neuropathic pain through a hypericin-mediated inhibition of the protein kinase C γ and ɛ activity.” Biochemical pharmacology 79.9 (2010): 1327-1336.

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

Hardy, John, and Dennis J. Selkoe. “The amyloid hypothesis of Alzheimer’s disease: progress and problems on the road to therapeutics.” science 297.5580 (2002): 353-356.

Hsu, Shan-Hui, et al. “In vitro and in vivo effects of Ginkgo biloba extract EGb 761 on seeded Schwann cells within poly (DL-lactic acid-co-glycolic acid) conduits for peripheral nerve regeneration.” Journal of biomaterials applications 19.2 (2004): 163-182.

Kunnel Shinomol, George, Narayanareddy Raghunath, and Muchukunte Mukunda , Srinivas Bharath. “Prophylaxis with Bacopa monnieri attenuates acrylamide induced neurotoxicity and oxidative damage via elevated antioxidant function.” Central Nervous System Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Central Nervous System Agents) 13.1 (2013): 3-12.

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.

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.

Markesbery, William R. “Oxidative stress hypothesis in Alzheimer’s disease.” Free Radical Biology and Medicine 23.1 (1997): 134-147.

Nakayama, Natsuki, and Chihiro Tohda. “Withanoside IV improves hindlimb function by facilitating axonal growth and increase in peripheral nervous system myelin level after spinal cord injury.” Neuroscience research 58.2 (2007): 176-182.

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.

Saarto, Tiina, and Philip J. Wiffen. “Antidepressants for neuropathic pain.” The Cochrane Library (2007).

Sahoo, P. K., D. Pradhan, and P. Behera. “Effect of B. monnieri leaf extract targeted at adenosine receptor in diabetic neuropathic pain.” International Journal of Pharma and Bio Sciences 1.2 (2010).

Sindrup, Søren H., et al. “St. John’s wort has no effect on pain in polyneuropathy.” Pain 91.3 (2001): 361-365.

Soumyanath, Amala, et al. “Centella asiatica accelerates nerve regeneration upon oral administration and contains multiple active fractions increasing neurite elongation in‐vitro.” Journal of Pharmacy and Pharmacology 57.9 (2005): 1221-1229.

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.

Vetencourt, José Fernando Maya, et al. “The antidepressant fluoxetine restores plasticity in the adult visual cortex.” Science 320.5874 (2008): 385-388.

Ven Murthy, M. R., et al. “Scientific basis for the use of Indian ayurvedic medicinal plants in the treatment of neurodegenerative disorders: 1. Ashwagandha.” Central Nervous System Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry-Central Nervous System Agents) 10.3 (2010): 238-246.

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

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

Zou, Yanping, Yanhua Lu, and Dongzhi Wei. “Antioxidant activity of a flavonoid-rich extract of Hypericum perforatum L. in vitro.” Journal of Agricultural and Food Chemistry 52.16 (2004): 5032-5039.

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.

Herbal strategies to fight nerve pain

I found herbal medicine and began studying it when I realised it can work pretty well for my own problem, this was nerve pain. Your unlikely to get a miracle cure, but relief is possible and herbal medicine is generally gentler than drugs. I think herbal medicines are far under appreciated and have been neglected by mainstream medicine. There are many types of nerve pain and this article can only provide some general indications of what herbs may help, I also talk a little bit about diet which can be relevant.

Underlying causes, diet, and the immune system

I should first say, when approaching nerve pain, including disorders like peripheral neuropathy, small fiber neuropathy, fibromyalgia, sciatica, and carpal tunnel, the key is to always look for the underlying cause. For example, some people have a deficiency in B12 which is causing or aggravating their problem, others may have a trapped nerve and need physiotherapy or to see a chiropractor. Poor digestive health may be a contributor or underlying the nerve pain, so steps may be necessary to improve the health of the digestive system, the simplest way is changing the diet. Especially to remove refined sugars, processed foods, and excess carbohydrates. I should also say, B vitamins are key to the health of the nervous system (Watanabe et al., 1994), so the diet should include B vitamins through good quality meats (grass fed or wild) or a B complex could be tried. Remember vitamin B6 can be toxic in high doses so do research and be careful if taking this (Levine et al., 2002). Alpha lipoic acid, an anti-oxidant molecule, has been shown to improve certain kinds of neuropathic pain, therefore is worth considering (Ziegler et al., 1995).

Before we go into the nervine herbs, it is relevant to discuss immunomodulating herbs, immune dysregulation, and go further into diet. Certainly this has relevance in disorders like MS, however, in other neurological conditions inflammation and chronic nerve pain are actually intimately connected and we are increasingly appreciating chronic neuropathic pain as a neuroimmune disorder (Scholz and Woolfe, 2004). Although usual anti inflammatory drugs, like NSAIDs, are not effective at reducing neuroinflammation and neuropathic pain, herbs are more complex, and there is a huge range of different medicinal plants that have immune modulating activity.

Key tonic herbs for the immune system include reishi and ashwagandha, both also act on the nervous system to induce a state of calm (Groves, 2016). It is also important to change diet to remove pro-inflammatory foods and to eat more anti-inflammatory foods. A natural plant based Paleo type diet (removes grains, dairy, processed foods, and refined sugars) is a good option (Cordain, 2012). Although, I definitely prefer to avoid red meat as it is pro-inflammatory and pro-cancer and include legumes and chickpeas (Montonen et al., 2013). Small amounts of good quality seafood and white meat are sensible, but the emphasis is on vegetables and fruits. There is also evidence omega3 oils may be helpful in treating neuropathic pain. In one recent study, researchers found omega3 supplementation in mice helped assist in recovery from nerve injury (Gladman et al., 2012). It is best to find a good quality supplement with high strength EPA and DHA.

Many people with nerve pain also suffer with sleep issues. This is where good sleep habits can really help. Going to bed at the same time every day and getting up at the same time can help train the circadian clock (Roenneberg et al., 2007). Many of the nervine herbs mentioned below may improve sleep as they calm the nervous system. Getting good sleep will assist in the healing process. Also, some may find it useful to combine immunomodulating herbs with those that more specifically target the nervous system, induce a state of relaxation, may restore function, and also treat pain. These are the nervine tonic herbs, generally, the most important class of herbs for nerve pain.

The nervine tonics

Two key herbs from the Western herbal materia medica, that may restore the nerves and reduce pain, are St. John’s wort and prickly ash. St. John’s wort was used by the ancient Greeks to treat sciatica (Castleman, 2001). It’s popular use as an antidepressant is only a recent development, traditionally it was used internally to heal nerves and topically for burns and wounds. There is some scientific support of it’s ability to treat neuropathic pain in experimental models (Galeotti et al., 2010). St. John’s wort is perhaps the most important herb for nerve pain in our materia medica and it is best obtained in fresh tincture form with a very deep red colour. Not using a fresh tincture in this case I believe is a mistake.

Prickly ash is a circulatory stimulant and analgesic, Matthew Wood reports good success in treating nerve pain using a combination of prickly ash and St. John’s wort mixed in equal parts, and taken 1-3 times daily in small doses (around 5-10 combined in drops) (Wood, 2009). Other tonics for nerve pain from the European and North American system, other than St. John’s wort and prickly ash, include wood betony, blue vervain, and American skullcap that can be considered for inclusion into a formula (Groves, 2016).  However, my preferred two, are St. John’s wort and ashwagandha.

Outside of the Western system, traditional regenerative herbs for renewing the nervous system from Ayurveda, known as the ‘medhya rasayana’ herbs, include gotu kola, calamus, and ashwagandha (Groves, 2016). Ashwagandha, is a very powerful herb and a versatile rasayana (restorative) tonic, recent science suggests it can encourage new growth of nerves when they are damaged (Nakayama et al., 2007). It is also calming, anti-inflammatory, and can be energising.

Other option is a mushroom called lion’s mane, it has started recently to be widely used as a nervine tonic by herbalists (Groves, 2016), and there is preliminary scientific evidence that it can regenerate nervous tissue and encourage release of nerve growth factor (Wong et al., 2011). However, it has no traditional use as a herb for nerve pain. Cannabidiol, one of 2 primary medicinal components of cannabis, has recently emerged as a popular option for nerve and inflammatory pain. Human studies strongly support the use of CBD/THC cannabis extracts for neuropathic pain (Nurmikko et al., 2007).

Formulation notes

It can be useful in herbalism to consider the constitution and energetics as well as the plant’s action, for example, gotu kola is a cooling herb that is less suited for the vata constitution (cold, dry). Formulating it with ashwagandha (warming) makes a compound better suited for vata.

The herbs I have mentioned above are all constitutionally drying. Although this may not be an issue with some people, if taking drying herbs long term it may be better to formulate them with moistening herbs such as hawthorn berry or fresh milky oat seed. Long term intake of sufficient quantities of drying herbs in a person prone to dryness may result in dry skin and constipation.

Nerve pain pair (from Matthew Wood)

Fresh St. John’s wort (1 part) (warming, drying)
Prickly ash (1 part) (warming, drying)

Dose approx: 10-40 drops 2-3 times daily

Note: This formula is contraindicated with SSRIs, during pregnancy, and breastfeeding. St. John’s wort may decrease the effectiveness of pharmaceutical drugs and can cause easy sun burning. I have found prickly ash can be pretty drying to the constitution compared with say American skullcap.

Nerve pain pair II

These two are a good combination for the nerve pain.

Fresh St. John’s wort (1 part) (warming, drying)
Fresh American skullcap (1 part) (cooling, drying)

Dose approx: 20-60 drops 2-3 times daily
Note: This formula is contraindicated with SSRIs. St. John’s wort may decrease the effectiveness of pharmaceutical drugs and can cause easy sun burning.

Nervous system restorative formula

This is what I think I have had the most success with. The fresh tincture of the American skullcap is very useful for sleep.

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

Dose approx: 20-90 drops 2-3 times daily
Note: This formula is contra indicated with SSRIs. If on sedative medication be highly cautious regarding dose. St. John’s wort may decrease the effectiveness of pharmaceutical drugs and can cause easy sun burning.

If you are not feeling like making a formula, a very good commerical pre prepared formula for nerve pain is the Herb Pharm ‘nervous system tonic’. It contains St. John’s wort and American skullcap plus a few other herbs.

Conclusions

The best approach to nerve pain is a holistic one that takes into account the underlying cause of the problem, if known, and other factors in ones lifestyle, like diet and associated digestive health. The path back from serious nerve problems, or to manage them, takes time, patience, and willingness to troubleshoot. Conventional medicine does not currently have good solutions for nerve pain, but I believe the answers are out there.

Further reading

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

Note: If you are not fully comfortable with a DIY approach for your condition for any reason, please do not hesitate to contact a local professional herbalist for more tailored assistance. It is best to inform your doctor of any herbs you are planning to take especially if you have a pre-existing medical condition.

References:

Bibel, Barbara. “Body into Balance: An Herbal Guide to Holistic Self-Care.” (2016): 117-117.

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

Christopher, John R. Herbal home health care. Christopher Publications, 1976.

Cordain, Loren. AARP The Paleo Diet Revised: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat. John Wiley & Sons, 2012.

Galeotti, Nicoletta, et al. “St. John’s Wort reduces neuropathic pain through a hypericin-mediated inhibition of the protein kinase C γ and ɛ activity.” Biochemical pharmacology 79.9 (2010): 1327-1336.

Gladman, Stacy J., et al. “Improved outcome after peripheral nerve injury in mice with increased levels of endogenous omega-3 polyunsaturated fatty acids.” Journal of Neuroscience 32.2 (2012): 563-571.

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

Levine, S., and A. Saltzman. “Pyridoxine (vitamin B6) toxicity: enhancement by uremia in rats.” Food and chemical toxicology 40.10 (2002): 1449-1451.

Montonen, Jukka, et al. “Consumption of red meat and whole-grain bread in relation to biomarkers of obesity, inflammation, glucose metabolism and oxidative stress.” European journal of nutrition 52.1 (2013): 337-345.

Nakayama, Natsuki, and Chihiro Tohda. “Withanoside IV improves hindlimb function by facilitating axonal growth and increase in peripheral nervous system myelin level after spinal cord injury.” Neuroscience research 58.2 (2007): 176-182.

Nurmikko, Turo J., et al. “Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial.” Pain 133.1 (2007): 210-220.

Roenneberg, Till, C. Jairaj Kumar, and Martha Merrow. “The human circadian clock entrains to sun time.” Current Biology 17.2 (2007): R44.

Scholz, Joachim, and Clifford J. Woolf. “The neuropathic pain triad: neurons, immune cells and glia.” Nature neuroscience 10.11 (2007): 1361.

Watanabe, Tetsuya, et al. “Ultra-high dose methylcobalamin promotes nerve regeneration in experimental acrylamide neuropathy.” Journal of the neurological sciences 122.2 (1994): 140-143.

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

Wong, Kah-Hui, et al. “Peripheral nerve regeneration following crush injury to rat peroneal nerve by aqueous extract of medicinal mushroom Hericium erinaceus (Bull.: Fr) Pers.(Aphyllophoromycetideae).” Evidence-based complementary and alternative medicine 2011 (2011).

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

Ziegler, D., et al. “Treatment of symptomatic diabetic peripheral neuropathy with the anti-oxidant α-lipoic acid.” Diabetologia 38.12 (1995): 1425-1433.