The alterative herbs

The alterative herbs occupy an important position in traditional Western herbalism, although we have only a little information about how they work, many different and diverse traditional sources can attest to their medicinal efficiency. Overall, they are thought to work by acting as ‘cleansing’ agents, meaning they stimulate the activity of the excretory organs such as the liver and kidneys to remove unwanted materials from the body. Unfortunately, this is one of the least satisfying definitions we have of any herbal action and is regularly subject to scrutiny. However, what is clear is alteratives do work for certain kinds of problems and people, we just don’t know exactly how yet.

Alteratives appear to beneficially alter the course of chronic diseases with a specificity towards certain diseases that involve chronic inflammation or ‘damp heat’; such as psoriasis, acne, and rheumatoid arthritis. There is some preliminary scientific support for these ideas we will discuss later. As the definition is vague, it can be helpful to study some example definitions of an alterative from traditional herbalism text books. Of these examples, I find Maria Groves to provide the most clear and succinct definition.

David Hoffman: ‘Alteratives gradually alter and correct a ‘polluted’ condition of the blood stream and restore a healthier functioning. The way alteratives work is poorly understood, but they certainly work…(they are) perhaps the herbs most often used in the context of skin conditions, the roots of which lie deep within the metabolism of the individual. They cleanse the whole of the body, but their activity is focused in different areas, some in the kidneys, some in the liver… and they have to be chosen according to their specific indications’ (Hoffman, 1988).

Harvey Felter: ‘A drug which causes a favourable change or alteration in the processes of nutrition and repair, probably through some unknown way improving metabolism.’ (Felter, 1922).

John Scudder: ‘We suppose… They may change the condition of the blood by a direct influence exerted upon it… They may in some manner effect the removal of the worn-out tissues, and favour the process of nutrition… They may neutralize or change the character of decomposing or noxious agents that exist in the system as the result of some pathological process, or that have been introduced from without… They undoubtedly favor elimination by stimulating the excretory organs to increased activity.’ (Scudder, 1898)

Maria Groves: ‘Alteratives improve the body’s detoxification processes and efficient removal of metabolic wastes. They often encourage detoxification of the blood and interstitial fluid via the liver, lymphatic system, and the kidneys’ (Groves, 2016)

Alterative actions

Different alteratives have greater or lesser affinities for different excretory organs, but what is in common is they will stimulate activity of a particular organ to increase elimination. To explain further, Maria Groves subdivides alteratives to include those with the following actions (Groves, 2016):

Lymphagogues (lymph stimulants/ movers): Burdock root, red clover, sarsaparilla

Choleretics and cholagogues (liver stimulants/ movers): Dandelion, burdock root, yellow dock root

Diuretics (kidney stimulants/ movers): Dandelion, nettles, sarsaparilla

We will now turn to examine some of the classic alteratives from Western herbalism, considering both traditional knowledge and preliminary scientific data. One of the most well known and researched is sarsaparilla.

Sarsaparilla

sarsawiki

Sarsaparilla is a woody trailing perennial vine that may refer to one of a number of similar species scattered throughout the world (Kuhn and Winston, 2000). Sarsaparilla is cultivated in Mexico, Jamaica, China, and Central and Southern America. ‘Sarsaparilla’ as a name comes from Spanish words, prickly (zarsa), vine (parra), and small (illa). It is said sarsaparilla was used by the ancient Greeks as an antidote to poisons, however, it only became widely popular in Europe medicinally during the 16th century when Spanish explorers discovered the Caribbean species (Castleman, 2001). Native Americans and also Caribbean Indians used sarsaparilla to treat skin and urinary diseases. They saw sarasaparilla as a tonic herb for preserving youth and strength. Mexican sarsaparilla was transported to Spain around 1530 and then used as a treatment for syphilis and also as a ‘strengthening tonic’. It was used by Nicholas Culpeper, a famous 17th century English herbalist, for rheumatism and ‘many kinds of diseases’ (Culpeper, 1814).

In more modern times, David Hoffman in his text Holistic Herbal mentions sarsaparilla is a widely applicable alterative and that it may be used to aid proper functioning of the body as a whole (Hoffman, 1988). It is indicated for scaly skin conditions like psoriasis and also as part of a wider treatment for rheumatism, especially rheumatoid arthritis. For psoriasis, sarsaparilla is often combined with similar alteratives to increase medicinal power such as burdock root and yellow dock. Sarsaparilla roots contain a high relative abundance of steroidal saponins that are related to its medicinal properties (Challinor et al., 2012). Steroidal saponins display a range of bioactivities, including cytotoxic, hemolytic, anti-inflammatory, anti-fungal, and anti-bacterial properties.

Sarasaparilla is a relatively well studied alterative and preliminary studies give us insights into how alteratives may function physiologically. For example, gout is a disease associated with the accumulation of urate in the blood stream. In one study, the authors found an extract of sarsaparilla was effective in enhancing urate excretion via the kidneys of hyperuricemic mice (Wu et al., 2014). This supports the role of alteratives in the stimulation of the excretory organs that results in removal of unwanted compounds from the body. Another similar study investigated metabolic syndrome. Metabolic syndrome is a metabolic disorder associated with an increased risk of developing kidney failure, cardiovascular, and cerebrovascular diseases. In this study, using a mouse model of metabolic syndrome, the authors found sarsaparilla root extract was able to control weight gain and was able to decrease elevated levels of triglycerides (fatty molecules) by 60% (Amaro et al., 2014). This study supports the traditional role of alteratives as beneficial modulators of metabolism. While these studies were conducted in animal models, which are not as reliable, there is one human clinical trial of great interest.

In the 1940s when there was more interest in sarsaparilla, one study observed a greater improvement with sarsaparilla extract treatment in psoriasis patients opposed to those patients who received a placebo (Thurmon et al., 1942). 18% of those patients treated with the sarsaparilla extract experienced total remission, while only 6% on the placebo. This study was published in the New England Journal Of Medicine, a prestigious journal. However, in these early days experimental standards were less demanding and this clinical trial does not seem to have been blinded and statistical analysis was not performed. Regardless of this, I think this study shows great promise for the medicinal potential of sarsaparilla in humans. Perhaps in the future, as herbs become more popular again in Western culture as medicines, further studies will expand on the role of sarsaparilla extracts in treating psoriasis and other chronic inflammatory diseases.

Note: Alteratives are often rather drying to the constitution, so care must be taken not to dry some one out too much by using moistening herbs or avoiding the more drying alteratives. More moistening alteratives include red clover and burdock. They also have been known to be too much for older weak people to handle who may respond better to tonification (i.e. use of the adaptogens). It is best to generally proceed with caution with these herbs.

References

Amaro, Carol Arely Botello, et al. “Hypoglycemic and hypotensive activity of a root extract of Smilax aristolochiifolia, standardized on N-trans-feruloyl-tyramine.” Molecules 19.8 (2014): 11366-11384.

Challinor, Victoria L., et al. “Steroidal saponins from the roots of Smilax sp.: structure and bioactivity.” Steroids 77.5 (2012): 504-511.

Culpeper, Nicholas. Culpeper’s complete herbal. (1814).

Felter, Harvey. The Eclectic Materia Medica, Pharmacology, and Therapeutic (1922)

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

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.

Scudder, John. The American Eclectic Materia Medica and Therapeutics (1898)

Thurmon, Francis M. “The treatment of psoriasis with a sarsaparilla compound.” New England Journal of Medicine 227.4 (1942): 128-133.

Wu, Xiao-Hui, et al. “Smilax riparia reduces hyperuricemia in mice as a potential treatment of gout.” The American journal of Chinese medicine 42.01 (2014): 257-259.

The paleolithic style diet for natural healing

What is it?

The Paleo diet has gained popularity in recent years with its philosophy ‘eat the foods you were designed to eat’ (Cordain, 2012). Speculation about the importance of the Paleolithic diet can be traced back to Bovn Eaton in 1988, as he wrote in the New England Journal Of Medicine, ‘Physicians and nutritionists are increasingly convinced dietary habitats adopted by Western society over the past 100 years make an important contribution to coronary heart disease, hypertension, diabetes, and some types of cancer.’ (Eaton and Konner, 1988). He then went further writing, ‘Problems are virtually unknown among the few surviving hunter gatherer populations whose way of life and eating habits most closely resemble those of preagricultural human beings’. In a later review article, Cordain et al. (2005) outline 7 obvious detrimental changes to diet that have occurred since the Paleolithic era (in the last 10,000 years). These are summarised as follows;

  1. Glycemic load
    This is a way of quantifying how much an individual’s blood glucose will increase based on a defined amount of carbohydrate consumed. It is well established eating foods with a high glycemic load (e.g. white bread) compared with a low glycemic load (e.g. a banana) can lead to insulin resistance, this is related to developing; type II diabetes, hypertension, obesity, and coronary heart disease, we can call these ‘diseases of civilisation’.
  1. Fatty acid composition
    The modern Western diet has too many trans and saturated fats with too few omega6 fatty acids compared with omega3 fatty acids. High levels of trans and saturated fatty acids increase the risk of cardiovascular disease by increasing total and LDL cholesterol. The 6 major sources of saturated fatty acids in the United States diet are fatty meats, baked goods, milk, cheese, margarine, and butter. Of these, all but fatty meats, would have been outside the Paleolithic man’s diet. Additionally, the lean nature of wild animal meat compared with domesticated would have meant lower saturated fatty acids in our ancestors’ diets. A high omega6 to omega3 oil ratio which is related to disease and inflammation is due to higher intake of vegetable oils and meat from grain fed animals.
  1. Macro nutrients
    In the U.S.A. percentage of food energy is derived from the following; carbohydrate (51.8%), fat (32.8%), and protein (15.4%). However, it is known that hunter gatherer populations have increased relative protein (19-35%) and decreased carbohydrate (22-40%). A low carbohydrate and high protein diet has been found to improve insulin sensitivity and prevent muscle loss in obese women. Additionally, clinical trials have shown calorie restricted, but high protein diets are better in promoting weight loss in overweight persons compared with calorie-restricted and high-carbohydrate diets.
  1. Micro nutrients
    Refined sugars and vegetables oils because they comprise a considerable amount of the average modern Western diet and either contain none or very few beneficial nutrients displace important vitamins and minerals. Additionally, the emphasise on grains and milk in our diets, foods of lower relative nutrient content, displace fruits, vegetables, seafood, and lean meats, which have higher nutrient contents. This begun in the Neolithic era as farming became more common, but became worse as cereal milling methods in the Industrial era produced bread flour devoid of more nutrient dense germ and bran. The general displacement of more nutrient dense foods (vegetables, fruits, seafoods, and lean meats) by less nutrient dense foods (refined sugars, grains, vegetables oils, and dairy) has led to depletion in the population of essential vitamins and minerals.
  1. Acid to alkali balance
    Post digestion, absorption, and metabolism, typically foods break down to either acid or alkaline compounds that are released into the circulation. Fish, meat, eggs, poultry, dairy, and cereal grains are acid producing foods. While fruit, vegetables, tubers, nuts, and roots are alkaline producing. Legumes are neutral. Typical modern Western diets have a net acid load and as a result have a low grade pathogenic metabolic acidosis. That gets worse as kidney function declines. The Paleolithic diet is an alkaline diet because of the absence of cereals and nutrient poor foods that were introduced in the Neolithic and Industrial eras. An alkaline diet has many benefits that include preventing age related muscle wasting, osteoporosis, calcium kidney stonese, exercise induced asthma, and hypertension.
  1. Sodium to potassium ratio
    The introduction of manufactured salt to the food supply and the displacement of potassium rich foods during the Neolithic and Industrial eras has resulted in a 400% decrease in potassium intake and a 400% increase in sodium ingestion. A low potassium and high sodium diet is implicated in causing or aggravating hypertension, stroke, osteoporosis, colon cancer, asthma, and kidney stones.
  1. Fibre content
    The mean fibre content of the normal U.S. diet (15.1 g/d) is considerably lower than recommended (25-30 g/d). Refined sugars, dairy, vegetable oils, and alcohol are all devoid of fibre and make up 48.2% of the energy intake in the average U.S. diet. Refined grains are the most popular in the U.S. and they contain 400% less fibre than whole grains. Fresh fruit contains twice the fibre of whole grains and non-starchy vegetables approximately 8 times. Wild grown fruit and vegetables are known to contain considerably less fibre than the domesticated equivalents. Again, we see that there has been a displacement of fibre-rich plant foods by new staple foods during the Neolithic and Industrial eras. Fibre increases the rate of bowel movements and decreases the risk of chronic constipation. Chronic constipation is persuasive in our modern society and is thought to underlie the development of many diseases.


Other problems with non paleolithic foods

Gluten and dairy can aggravate the immune system

Beyond the nutritional problems of a non Paleolithic diet, there are also immunological disorders that have emerged, especially those related to breads and dairy. Obvious examples are celiac disease (Kaukinen et al., 2002) and lactose intolerance (Swagerty et al., 2002). Celiac disease is an autoimmune condition related to gluten in bread that involves the adaptive immune system (Fasano et al., 2015). There are also people with non-celiac allergies to gluten that also involve the adaptive immune system. However, it has become apparent that gluten can cause digestive upset in patients without either celiac disease or gluten allergies, this is called non-celiac gluten sensitivity (Biesiekierski et al., 2011). Non-celiac gluten sensitivity is a recent term and it refers to a non-allergic response to gluten, that may be driven by the innate immune system (Fasano et al., 2015). This can lead to various problems that include IBS and it is even linked to psychological illnesses and autoimmune diseases. However, firmly grounded in the Paleolithic diet theory is the idea that our health problems cannot be blamed on a single molecule and breads are complex carbohydrate based foods. They are not fibre rich compared with fruits and vegetables, when evolving we would not have consumed these types of foods.


Dietary lectins may aggravate the immune system of pre-disposed individuals

Common non Paleolithic dietary foods such as cereal grains and legumes contain glycoproteins called lectins (Cordain et al., 2000). It is thought, wheat-germ lectins can bind surface molecules on intestinal epithelial cells this can cause structural damage to the villi. These structural changes may lead to functional changes including increased intestinal permeability which may facilitate the passage of undegraded dietary antigens into systemic circulation.

In genetically susceptible individuals, the antigenic stimulation may lead to the triggering of autoimmune diseases such as rheumatoid arthritis via molecular mimicry. Molecular mimicry is a process whereby foreign peptides, similar in structure to internal peptides, may cause antibodies or T-lymphocyte cells to cross-react with both foreign and endogenous peptides. This can lead to tolerance for self-peptides being broken and autoimmune disease develops.


Foods included in the paleo diet:

Vegetables, fruits, nuts and seeds, grass (not grain) fed meats, wild seafood.

This is a plant based diet, around 80% vegetables and fruits, 20% meats.

Foods excluded in the paleo diet:

All grains (including breads, pasta etc), legumes, diary, refined sugar, added salt, processed foods.


Terry Wahls: An example of the paleo diet in action

Terry Wahls developed MS while at medical school and was diagnosed with it in 2000 (Wahls, 2014). By 2003, she needed a wheelchair, had secondary progressive MS, and found the drugs were not working. At this point, she started studying alternative methods for dealing with chronic illness and this led her to the Paleo diet. Using this diet, Dr. Wahls found she could ride her bicycle again after 4 years in a wheelchair. After her success in treating the MS she wrote a popular book called, ‘The WAHLS protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles’. The Wahls protocol is based on the Paleo diet, but has 3 different levels and added restrictions and guidelines. Below is a summary of these levels:

Note: additional guidelines are given about the number of portions, type, and colour of vegetables and fruits, and meal timings in the book.

Level 1: Wahls diet

No gluten or dairy containing food.

Level 2: Wahls paleo

No gluten or dairy containing food. All non-gluten grains, legumes and potatoes are reduced to two servings per week. Dr. Wahls writes it is preferable to remove grains and legumes entirely to reduce carbohydrate load, but also reduce phytates and lectins.

Level 3: Wahls paleo plus

All grains, legumes, and potatoes are eliminated. Starchy vegetables are limited to 2 servings per week or less. Fruit is limited to 1 serving per day. White-fleshed fruits are eliminated, such as apples, bananas and pears, as well as sweeter fruits like grapes, peaches, pineapples and mangoes.


A paleo inspired vegetarian diet

A good option for people who do not want to eat meat, but still want to learn from Paleolithic principles is to use legumes, brown rice, and small amounts of whole wheat and dairy instead, depending on your own sensitivity. This is what I do, I don’t eat meat.

Summary

Diet is the foundation of our lives in many ways and also of any sensible strategy to heal the body. The Paleolithic style diet has a lot we can learn from even if we are not all interested in becoming cavemen type people. Personally, I use legumes and rice instead of meat most of the time, but still eat a mostly plant based diet without much wheat and dairy. There is no one diet for everybody, but the Paleo diet is a useful roadmap to better, healthier, eating.


References

Christopher, John R. School of Natural Healing. Christopher Publications, 1976.

Cordain, Loren, et al. “Modulation of immune function by dietary lectins in rheumatoid arthritis.” British Journal of Nutrition 83.3 (2000): 207-217.

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.

Eaton, S. Bovn, and M. Konner. “A consideration of its nature and current implications.” N Engl j Med 312.5 (1985): 283-9.

Kaukinen, Katri, et al. “Celiac disease in patients with severe liver disease: gluten-free diet may reverse hepatic failure.” Gastroenterology 122.4 (2002): 881-888.

Swagerty Jr, DANIEL L., Anne D. Walling, and Robert M. Klein. “Lactose intolerance.” American family physician 65.9 (2002): 1845-1850.

Wahls, Terry L., and Eve Adamson. The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles. Penguin, 2014.

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”

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.

Do medicinal mushrooms work against cancer?

Edible mushrooms, such as reishi, maitake, and cordyceps, have long been used in Japan and China as food, but also medicines (Mizuno et al., 1995). These medicinal mushrooms have a deep history of medicinal use that extends back thousands of years in traditional Chinese medicine, and have long been associated with longevity (Castleman, 2001). In cancer research, there is special interest in the polysaccharides of these mushrooms present in the fruiting bodies and mycelium as they are responsible for anti-tumour and immunostimulating properties (Wasser, 2010). I will now critically discuss the current state of cancer science related to these polysaccharides and medicinal mushrooms.

PSK

A mushroom polysaccharide called polysaccharide-K (PSK) was originally extracted by Japanese researchers and used in various clinical trials in Asia together with conventional therapies (Fisher et al., 2002). The result of these trials were its acceptance as a mainstream anti-cancer drug in Japan to complement the existing chemotherapy and surgical techniques. PSK is a polysaccharide from the fungus Coriolus versicolor. PSK has shown efficiency in helping maintain remission in colorectal cancer patients after surgery (Torisu et al., 1990), a meta-analysis of different clinical trials in 2006 supported this discovery (Sakamoto et al., 2006). Another high quality study published in the Lancet found PSK supported ordinary chemotherapy treatment for gastric cancer after surgery and significantly increased five year survival and disease free survival rates (Nakazato et al., 1994). PSK increases the ability of the host to defend itself against the cancer (Fisher et al., 2002). It may do this by increasing white blood cell activation and response via increasing levels of specific cytokines. However, it is not just PSK which displays anti-tumour potential, there are several mushroom extracts which show promise.

Reishi

A mushroom of particular value in traditional Chinese medicine is reishi, this mushroom has been known as ‘the mushroom of immortality’ since ancient times (Castleman, 2001). Reishi has an array of health benefits and has anti-oxidant, anti-tumour, anti-inflammatory properties (Joseph et al., 2011; Baskar et al., 2008). An interesting study appeared in the American journal PNAS in 2013 on the mechanism by which reishi has anti-tumour effects (Liao et al., 2013). In this paper, they demonstrated that mice injected with reishi polysaccharides produced antibodies against lung cancer cells. This resulted in increased cytotoxicity against the cancer cells and reduction of inflammatory mediators associated with the tumour. However, although promising, this study was using an animal model and high quality human clinical trials are required to further assess the anti-cancer potential of reishi.

Ganoderma_lucidum_01_wiki

Human Studies

There are a number of human studies with some preliminary data which is interesting. A randomised placebo controlled study of reishi polysaccharides in patients with lung cancer found increase in leukocyte and natural killer cell activity (Gao et al., 2003). They also observed better quality of life in the reishi mushroom patients and stability of disease. Improvements were seen in the reishi group in reduction of cancer related fever, cough, weakness, sweating and insomnia. The dose for this study was 600mg of patented extract a day, which seems a little low, as herbalists suggest between 3-6 grams of polysaccharide extracts for serious diseases like cancer (Powell, 2015). This translates to somewhere in the region of 10g of mycelium or fruiting body extract of reishi per day. However, this study only suggests that reishi may be effective as a complementary treatment for cancer patients, much further work is required (Gao et al., 2003).

Currently, we can be sure at least that reishi stimulates the immune system as this was seen in another well controlled human study also (Wicks et al., 2007). Another study documented a patient with breast cancer who used reishi extract as a complementary therapy (Chen et al., 2007). According to this account, reishi helped reduce side effects from chemotherapy and radiotherapy, improved quality of life, and assisted tumour shrinkage.

Like reishi, there is similar interest in the turkey tail mushroom (trametes versicolor) and a phase I clinical trial indicated immune up-regulation in breast cancer patients taking extract of this mushroom (Torkelson et al., 2012). This mushroom made headlines in 2012 as researchers were given $5.4 million for continuing their investigation of its ability to assist conventional cancer therapy. This is a very large amount of money for a complementary medicine study. These pioneering researchers of the turkey tail mushroom are aiming to create effective natural anti-tumour therapies without the harsh side effects of pharmaceutical drugs. Similar to reishi, the turkey tail mushroom has been shown to be effective against tumours in mice (Harhaji et al., 2008).

Grifola_frondosa_57503_wiki

(Above) The maitake mushroom, another fungus where there is interest in it’s anti-tumour properties.

Conclusions

So it is not a good idea to throw away conventional medicine and run into the forest to hunt mushrooms. However, as research funding into complementary therapy grows, it is just a matter of time before convincing evidence regarding the human anti-tumor medicinal activity of mushrooms becomes available. In vivo and ex vivo experiments in experimental models imply mushrooms such as reishi, turkey tail, and cordyceps, will have a role in reducing side effects from chemotherapy, improving the efficiency of standard therapy, and possibly, even as a standalone therapy. The demonstrated efficiency of PSK in several high quality clinical trials supports the potential of medicinal mushrooms in the fight against cancer. What is needed now is more human clinical studies.

References

Baskar, R., et al. “Free radical scavenging activity of antitumour polysaccharide fractions isolated from Ganoderma lucidum (Fr.) P. karst.” (2008).

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

Chen, Alice W., and John Seleen. “Potential benefits of Ling Zhi or Reishi mushroom Ganoderma lucidum (W. Curt.: Fr.) P. Karst.(Aphyllophoromycetideae) to breast cancer patients.” International Journal of Medicinal Mushrooms 9.1 (2007).

Fisher, Monte, and Li-Xi Yang. “Anticancer effects and mechanisms of polysaccharide-K (PSK): implications of cancer immunotherapy.” Anticancer research 22.3 (2002): 1737-1754.

Gao, Yihuai, et al. “A randomized, placebo-controlled, multicenter study of Ganoderma lucidum (W. Curt.: Fr.) Lloyd (Aphyllophoromycetideae) polysaccharides (Ganopoly®) in patients with advanced lung cancer.” International Journal of Medicinal Mushrooms 5.4 (2003).

Harhaji, L. J., et al. “Anti-tumor effect of Coriolus versicolor methanol extract against mouse B16 melanoma cells: in vitro and in vivo study.” Food and chemical toxicology 46.5 (2008): 1825-1833.

Joseph, Soniamol, et al. “Antitumor and anti-inflammatory activities of polysaccharides isolated from Ganoderma lucidum.” Acta pharmaceutica 61.3 (2011): 335-342.

Liao, Shih-Fen, et al. “Immunization of fucose-containing polysaccharides from Reishi mushroom induces antibodies to tumor-associated Globo H-series epitopes.” Proceedings of the National Academy of Sciences 110.34 (2013): 13809-13814.

Mizuno, Takashi, Tadamoto Sakai, and Goro Chihara. “Health foods and medicinal usages of mushrooms.” Food Reviews International 11.1 (1995): 69-81.

Nakazato, Hiroaki, et al. “Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer.” The Lancet 343.8906 (1994): 1122-1126.

Powell, Martin. Medicinal Mushrooms-A Clinical Guide. Mycology Press, 2015.

Sakamoto, Junichi, et al. “Efficacy of adjuvant immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials.” Cancer Immunology, Immunotherapy 55.4 (2006): 404-411.

Torisu, Motomichi, et al. “Significant prolongation of disease-free period gained by oral polysaccharide K (PSK) administration after curative surgical operation of colorectal cancer.” Cancer Immunology, Immunotherapy 31.5 (1990): 261-268.

Torkelson, Carolyn J., et al. “Phase 1 clinical trial of Trametes versicolor in women with breast cancer.” ISRN oncology 2012 (2012).

Wasser, Solomon P. “Medicinal mushroom science: history, current status, future trends, and unsolved problems.” International Journal of Medicinal Mushrooms 12.1 (2010).

Wicks, Sheila M., et al. “Safety and tolerability of Ganoderma lucidum in healthy subjects: a double-blind randomized placebo-controlled trial.” The American journal of Chinese medicine 35.03 (2007): 407-414.

Powerful tonic herbs for the immune system

The rasayana or vital energy (Qi) tonic herbs from Ayurveda or traditional Chinese medicine (TCM) respectively are powerful, often slow acting medicines that act to improve, support, or balance various systems of the body (Winston, 2007). A general scientific term given to these herbs is ‘adaptogens’, a term coined by a Soviet scientist in the 1950s called Dr Nikolai Vasilievich Lazarev (1895–1974), adaptogen is a vague scientific term that means able to resist non-specific stress (Davydov and Krikorian, 2000). Adaptogenic tonic herbs are given special importance in both Ayurvedic and TCM and are considered deeply nourishing for the whole body. In TCM, they are thought to boost the bodies Qi or vital energy.

The adaptogen herbs appear to have a strong affinity for the human immune system. Since they often appear to have both immune stimulating and anti-inflammatory properties, depending on context, they are defined as, ‘immunomodulators’, ‘immune amphoteric’, or ‘immune tonic herbs’ by herbalists. The immune tonics are thought to have a balancing effect on the immune system and therefore have potential for tackling chronic infections, cancer, and autoimmune diseases. Although, certainly I am not advocating using them ahead of mainstream drugs in serious life threatening diseases in this article.

It is important not to confuse herbs that have joint anti-inflammatory and immune stimulating properties (e.g. reishi and astragalus) with herbs that just stimulate the immune system (e.g. echinacea). People with autoimmune diseases may have an aggravation of their disease if their immune system is stimulated, as observed in the case of echinacea (Lee et al., 2004). We shall now turn to examine some of the key immune tonics from our materia medica in more detail.

Reishi

Ganoderma_lucidum_01_wiki

Reishi is also a medicinal mushroom and a superior tonic in TCM. It is known as the mushroom of immortality and the ancient Chinese viewed it as an herb for increasing life-span (Babu, 2008). It has been traditionally used by herbalists across a diverse range of diseases including joint pains and allergic asthma (Winston, 2007). It is the triterpene acids from the fruiting body of reishi that have been found to have anti-inflammatory properties (Akihisa et al., 2007). While it is the polysaccharides from reishi that are responsible for its immune stimulating activity (Chen et al., 2004). It is suitable for boosting the immune systems defenses to prevent colds and other infectious illnesses alongside astragalus, for example.

Reishi has been found to stimulate host immunity in humans with advanced stage cancer (Gao et al., 2003), suggesting its traditional use to treat and complement cancer therapy is justified. A large double blinded human study found reishi was effective against chronic hepatitis B (Gao et al., 2002). A human study found reduction of inflammation in cells and tissues extracted patients with Crohn’s disease with reishi treatment (Liu et al., 2016), although in this case unfortunately a control group was absent, so merely suggests a potential of the herb for autoimmune disease treatment.

Although there is much scientific work that needs to be done to validate the traditional use of reishi, herbalists report reishi effective in treating a range of immunological disorders from various autoimmune conditions to cancer (Powell, 2015). It also is a jointly calming and stimulating herb and therefore may have a role in reducing anxiety, but also increases an individual’s vital energy or Qi with time, with a role in the treatment of chronic fatigue (Groves, 2016).

Ashwagandha

Withania_somnifera_04_wiki

Ashwagandha is considered a rasayana herb in Ayurvedic medicine which translates to rejuvenator. These herbs are said to guide the body towards health. Ashwagandha has been traditionally applied across a range of diseases including, arthritis, fibromyalgia, and polymyositis (Winston, 2007). Ashwagandha root extracts have been found to have anti-inflammatory properties and act as an inhibitor of the complement system (Rasool et al., 2006). It has been shown to have anti-inflammatory properties in animal models of arthritis (Gupta et al., 2014). Ashwagandha, turmeric, and boswellia have been found in formula to reduce the pain of osteoarthritis in humans in a double-blind placebo controlled study (Kulkarni et al., 1991). A later additional well controlled human study supported ashwagandha alone as effective against osteoarthritis (Ramakanth et al., 2016). It is important to mention ashwagandha is one of the less potent immune stimulating adaptogens compared with astragalus or reishi (and other medicinal mushrooms), for example.

Clinical herbalists find ashwagandha particularly useful for treating chronic inflammation (Groves, 2016). Similar to reishi, it has a combined relaxing and stimulating effect and therefore has potential for treating some sleep disorders, anxiety, and fatigue. Ashwagandha and reishi are two of the most widely appropriate herbs in our materia medica and may be considered as supportive tonics in many formula.

Holy Basil

Tulsi_Flower_wiki.jpg

Holy basil or tulsi is another rasayana herb in Ayurvedic medicine with a special affinity for the immune system. It is commonly used in Ayurveda to treat asthma and wide range of other conditions (Jeba et al., 2011). Holy basil has been found to have anti-inflammatory activity in an animal model and more specifically it inhibits arachidonate metabolism (Singh et al., 1996). It also has been found to have immunostimulating properties in experimental models with upregulation of antibody production (Jeba et al., 2011). These immune stimulating activities have also been clearly seen in humans (Mondal et al., 2011). In the human study of healthy individuals, significant increases in IFN, IL-4, T-helper cells, and NK-cells were observed after 4 weeks in comparison with the placebo arm. In support of these findings, herbalists find holy basil useful in treating chronic infections and chronic inflammation (Groves, 2016). Tulsi is one of the most calming of the adaptogenic tonic herbs and may improve sleep and anxiety. It may have a role in treating colds and other infections.

Astragalus

astragalus-115038_1920.jpg

Astragalus is found growing beside forests in Korea, China, and Japan (Kuhn and Winston, 2000). The alternative Chinese name, ‘huang qi’, means, ‘yellow vital force’. In reference to it’s stimulation of the ‘vital force’. Astragalus medicinal roots have been used in China for well over 2000 years and they were described within Shen Nong’s Materia Medica which was written in the Han dynasty (200-250AD), but contains teachings passed on in an oral tradition for many hundreds of years before this time (Shao et al., 2004).

Similar to reishi, astragalus has well known potent immune enhancing properties connected to its polysaccharides (Shao et al., 2004). The immune potentiating properties of astragalus were also detected in vivo as it increased the rejection of a foreign graft in an animal model, the authors concluded that astragalus may have applications in immune depleted patients (Chu et al., 1988). There is good scientific support in humans for astragalus’s role in reducing fatigue, as there was one positive well controlled trial conducted on cancer patients (Chen et al., 2012).

Astragalus is widely used as a tonic by herbalists to support the natural functioning of the immune system (Cho et al., 2007). It may be of application in individuals suffering with chronic infections and to prevent infections occurring. It may have a role in reducing allergies. It is less commonly used to treat autoimmune disorders in contrast to ashwagandha for example, but is especially known for building a strong immune response. It also may be combined with reishi in the treatment of chronic fatigue as both gently stimulate an individuals vital energy with time. It may be combined with echinacea in a pair to fight infections and boost immunity.

Formulation notes

The below formula shows a simple combination of immune tonics that which were discussed in this article. By combining herbs with similar actions it is possible to increase the activity of the formula. This tonic formula may have applications in supporting the immune system to prevent infections, it may also have applications in combating chronic fatigue through stimulating the vital energy. This is a mildly warming formula so is less suitable for pitta types and better for vata.

Immune and vital energy tonic compound

Astragalus (1 part) (warming, moistening)
Reishi (1 part) (warming, neutral)

Contraindications: People undergoing immunosuppressive therapy. Do not take while pregnant due to lack of data.

Summary

The immune tonic herbs are important allies against chronic infections and autoimmune diseases and have been employed by herbalists for many centuries. I should add it is important that these herbs are used in the correct context that includes a healthy diet, e.g. a plant based Paleolithic/ keto style diet and also good lifestyle decisions. This way many immune related diseases may be improved. The immune tonic herbs overlap strongly with the adaptogens, the adaptogens likely have a balancing effect on many systems of the body in a currently poorly scientifically defined way.

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. Inform your doctor before taking any herbs or supplements you are planning to take, especially if you already have a serious illness.

Further reading

http://www.healthylehighvalley.com/LHV/November-2012/Herbs-and-the-Immune-System/

References

Akihisa, Toshihiro, et al. “Anti‐Inflammatory and Anti‐Tumor‐Promoting Effects of Triterpene Acids and Sterols from the Fungus Ganoderma lucidum.” Chemistry & biodiversity 4.2 (2007): 224-231.

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.

Chen, Hung-Sen, et al. “Studies on the immuno-modulating and anti-tumor activities of Ganoderma lucidum (Reishi) polysaccharides.” Bioorganic & medicinal chemistry 12.21 (2004): 5595-5601.

Chen, Hong-Wen, et al. “A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study.” Clinical & Investigative Medicine 35.1 (2012): 1-11.

Cho, William CS, and Kwok N. Leung. “In vitro and in vivo anti-tumor effects of Astragalus membranaceus.” Cancer Letters 252.1 (2007): 43-54.

Chu, Da-Tong, W. L. Wong, and G. M. Mavligit. “Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo.” Journal of clinical & laboratory immunology 25.3 (1988): 125-129.

Davydov, Marina, and A. D. Krikorian. “Eleutherococcus senticosus (Rupr. & Maxim.) Maxim.(Araliaceae) as an adaptogen: a closer look.” Journal of ethnopharmacology 72.3 (2000): 345-393.

Gao, Yihuai, et al. “A Phase I/II Study of a Ganoderma lucidum (Curt.: Fr.) P. Karst.(Ling Zhi, Reishi Mushroom) extract in patients with chronic hepatitis В.” International Journal of Medicinal Mushrooms 4.4 (2002).

Gao, Yihuai, et al. “Effects of Ganopoly®(A ganoderma lucidum polysaccharide extract) on the immune functions in Advanced‐Stage cancer patients.” Immunological investigations 32.3 (2003): 201-215.

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

Gupta, Apurva, and Surendra Singh. “Evaluation of anti-inflammatory effect of Withania somnifera root on collagen-induced arthritis in rats.” Pharmaceutical biology 52.3 (2014): 308-320.

Jeba, C. R., Rama Vaidyanathan, and G. Rameshkumar. “Immunomodulatory activity of aqueous extract of Ocimum sanctum in rat.” International Journal on Pharmaceutical and Biomedical Research 2.1 (2011): 33-38.

Khan, Sheema, et al. “Molecular insight into the immune up-regulatory properties of the leaf extract of Ashwagandha and identification of Th1 immunostimulatory chemical entity.” Vaccine 27.43 (2009): 6080-6087.

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

Kulkarni, R. R., et al. “Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study.” Journal of ethnopharmacology 33.1-2 (1991): 91-95.

Lee, Alice N., and Victoria P. Werth. “Activation of autoimmunity following use of immunostimulatory herbal supplements.” Archives of dermatology 140.6 (2004): 723-727.

Liu, Changda, et al. “Anti-inflammatory Effects of Ganoderma Lucidum Triterpenoid in Human Crohn’s Disease Associated with Down-Regulation of NF-κB Signaling.” Inflammatory bowel diseases 21.8 (2015): 1918.

Mondal, Shankar, et al. “Double-blinded randomized controlled trial for immunomodulatory effects of Tulsi (Ocimum sanctum Linn.) leaf extract on healthy volunteers.” Journal of ethnopharmacology 136.3 (2011): 452-456.

Powell, Martin. Medicinal Mushrooms-A Clinical Guide. Mycology Press, 2015.

Ramakanth, G. S. H., et al. “A randomized, double blind placebo controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint pain.” Journal of Ayurveda and integrative medicine 7.3 (2016): 151-157.

Rasool, M., and P. Varalakshmi. “Immunomodulatory role of Withania somnifera root powder on experimental induced inflammation: An in vivo and in vitro study.” Vascular pharmacology 44.6 (2006): 406-410.

Shao, Bao-Mei, et al. “A study on the immune receptors for polysaccharides from the roots of Astragalus membranaceus, a Chinese medicinal herb.” Biochemical and biophysical research communications 320.4 (2004): 1103-1111.

Singh, Surender, D. K. Majumdar, and H. M. S. Rehan. “Evaluation of anti-inflammatory potential of fixed oil of Ocimum sanctum (Holybasil) and its possible mechanism of action.” Journal of Ethnopharmacology 54.1 (1996): 19-26.

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

Regenerative and therapeutic 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 treatment. 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’.

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.

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.

Why rasayana herbs are so important

Traditional Indian medicine or Ayurveda is ancient and dates back approximately 7000 years (Puri, 2003). Ayurveda has 8 different divisions which divide medicinal plants dependent on their actions. An important one is called the ‘rasayana tantra’. The word, ‘rasayana’, literally means the path that ‘rasa’ goes along (Rege et al., 1999). Where ‘rasa’ means ‘the primordial plasma’ and ‘ayana’ means ‘path’. In Ayurveda, the qualities of the rasa-dhatu (‘primary waters of the body’) influence the health of other ‘dhatus’ otherwise known as ‘tissues’ of the body. Therefore, any medicine that improves the quality of rasa should strengthen the well-being of all other tissues in the body. These are the rasayana medicines and are said to possess the powerful abilities of restoring youth, conferring longevity, and preventing and alleviating disease (Puri, 2003).

Rasayana herbs include the following; Amla, Arjuana bark, ashwagandha, bacopa, bala, bhringaraj, gotu kola, guduchi, holy basil, hoppea, shatavari, shilajit, and turmeric (Winston, 2007). These herbs can be taken for long durations without causing side effects, and in fact, indicated for longevity by the traditional cultures they were part of. Interestingly, these characteristics are shared with the ‘superior tonics’ in traditional Chinese medicine. I will now provide a summary of four of my favorite rasayana herbs from Ayurvedic medicine.

Ashwagandha

Withania_somnifera_wikicomoons

Ashwagandha is a small shrub and member of the nightshade family. The name, ‘ashwagandha’, can be translated as meaning ‘smells like a stallion’, and this refers to the smell of the root and the belief it bestows on the individual the strength of a stallion (Gardner et al., 2015). Scientific studies using experimental models have shown ashwagandha has numerous medicinal properties such as; anti-inflammatory (Chandra et al., 2012), anti-oxidant (Bhattacharya et al., 2001), neuroprotective (Kurapati et al., 2003), neuroregenerative (Nakayama et al., 2007), and anti-tumour effects (Widodo et al., 2007). There are a few human clinical trials of reasonable quality. For instance, one study found ashwagandha extract (300 mg root twice daily) reduced stress significantly versus a placebo in a study of 64 people. In another study, this time examining osteoarthritis, ashwagandha was applied in a formula as it often is in Ayurvedic medicine. The authors applied it alongside turmeric and boswellia to find it reduced pain and disability compared with the placebo group (Kulkarni et al., 1991). Taken together, these scientific studies and traditional knowledge of ashwagandha imply that it is a powerful medicine with the potential to rejuvenate and restore various systems of the body.

Gotu Kola

Asiatic_Pennywort_wikicommons

Gotu kola is a creeping medicinal herb native to tropical areas of India, Sri Lanka, and other parts of southeast Asia (Kuhn and Winston, 2000). Folk lore in Sri Lanka tells it increases longevity and lifespan, first observed from elephants who used to eat the gotu kola plant. Like ashwagandha, it has been found to have anti-oxidant properties and has support using experimental models for its use as a neuroprotective agent (Kumar and Gupta, 2003). Similar to other Indian and Chinese tonic herbs, it has been found to be able to suppress (Punturee  et al., 2005) or stimulate (Jayathirtha et al., 2004) the immune system in models, depending on the context, therefore it has immunomodulatory activity. Like ashwagandha, it has neuroregenerative properties and is capable of stimulating nerve regrowth in models of nerve damage (Soumyanath et al., 2005). There is one human double blind placebo controlled study which demonstrated significant effect versus a placebo in the reduction of anxiety (Bradwejn et al., 2000). I expect further studies of this important rasayana herb will support its traditional application for a wide variety of diseases which include psoriasis, rheumatoid arthritis, cognitive decline, and several others.

Bacopa

bacopa_wikicommons

Bacopa is a creeping medicinal plant that is found in damp, marshy areas throughout India (Russo et al., 2005). It grows white flowers and branches with bright green fleshly leaves. It is known as ‘Brahmi’, this word is derived from ‘Brahma’, who is known as the mythical creator God in one school of Hinduism. Bacopa has traditional use in Ayruveda as a medhya rasayana, a rejuvenative for improving the brain and nerves. It has been observed in vivo models to have anti-oxidant and anti-inflammatory activities (Bhattacharya et al., 2000; Channa et al., 2006). More precisely, anti-oxidant activity has been detected in the brain of models (Bhattacharya et al., 2000). This the authors hypothesised is responsible for cognition enhancing effects often seen in human trials (Roodenrys et al., 2002). These studies point to bacopa being useful in treating degenerative cognitive disorders such as Alzheimer’s. In the future, I expect more studies will confirm the medicinal potency of bacopa.

Turmeric

Curcuma_longa_of_Chinna_Salem

Turmeric is a perennial herb that has a short stem and big leaves which produce its characteristic oblong shaped, branched, brown coloured roots (Chattopadhyay et al., 2004). It is the root which contains curcumin which gives it a yellow colour and from which turmeric extract, which has medicinal properties, is extracted from. Turmeric is a tropical growing plant native to Southern Asia and notably is closely related to ginger, another medicinal herb. Turmeric has been shown using experimental models and human studies to possess anti-oxidant (Selvam et al., 2005), anti-inflammatory (Panahi et al., 2014), and anti-tumour (Kuttan et al., 1985) properties. Over 6 weeks it has been shown to decrease the pain of osteoarthritis in a double-blind placebo controlled trial (Panahi et al., 2014). Remarkably, in another well conducted study, it was shown to be effective at reducing depression (Lopresti et al., 2014). These human and experimental model studies support the traditional role of turmeric as a highly versatile rasayana herb capable of acting to improve seemingly unrelated diseases.

Conclusions

There is now an increasing body of scientific evidence to support the notion of the ‘rasayana’ herb, a powerful group of rejuvenative tonic herbs used in the ancient system of Ayurvedic medicine. I think this classification of herbs could be extended to include the ‘superior tonics’ of traditional Chinese medicine and several Western herbs. Rasayana (restorative) tonic herbs are a broad classification, but they must be; 1) non-toxic and non-habit forming even long term, 2) support and restore the function of organs or systems with time, 3) provide protection against disease and ageing. These characteristics are those of the ideal medicine.

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.

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.

Chandra, Sangita, et al. “Evaluation of anti-inflammatory effect of ashwagandha: a preliminary study in vitro.” Pharmacognosy Journal 4.29 (2012): 47-49.

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.

Channa, Shabana, et al. “Anti-inflammatory activity of Bacopa monniera in rodents.” Journal of ethnopharmacology 104.1 (2006): 286-289.

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

Gardner, Tanya, and A. H. P. Level. “The Characteristics, Benefits and Application of Ashwagandha in the West.” Image 2 (2015): 2.

Jayathirtha, M. G., and S. H. Mishra. “Preliminary immunomodulatory activities of methanol extracts of Eclipta alba and Centella asiatica.” Phytomedicine 11.4 (2004): 361-365.

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

Kulkarni, R. R., et al. “Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study.” Journal of ethnopharmacology 33.1-2 (1991): 91-95.

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.

Kuttan, Ramadasan, et al. “Potential anticancer activity of turmeric (Curcuma longa).” Cancer letters 29.2 (1985): 197-202.

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.

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.

Panahi, Yunes, et al. “Curcuminoid Treatment for Knee Osteoarthritis: A Randomized Double‐Blind Placebo‐Controlled Trial.” Phytotherapy Research 28.11 (2014): 1625-1631.

Punturee, Khanittha, et al. “Immunomodulatory activities of Centella asiatica and Rhinacanthus nasutus extracts.” Asian Pacific Journal of Cancer Prevention 6.3 (2005): 396.

Puri, Harbans Singh. Rasayana: ayurvedic herbs for longevity and rejuvenation. CRC Press, 2003.

Rege, Nirmala N., Urmila M. Thatte, and Sharadini A. Dahanukar. “Adaptogenic properties of six rasayana herbs used in Ayurvedic medicine.” Phytotherapy Research 13.4 (1999): 275-291.

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.

Selvam, R., et al. “The anti-oxidant activity of turmeric (Curcuma longa).” Journal of Ethnopharmacology 47.2 (1995): 59-67.

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.

Widodo, Nashi, et al. “Selective killing of cancer cells by leaf extract of Ashwagandha: identification of a tumor-inhibitory factor and the first molecular insights to its effect.” Clinical Cancer Research 13.7 (2007): 2298-2306.

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

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.

 

 

How do you increase lifespan using herbs and lifestyle?

To begin to answer this first we must examine what aging is. Aging is a really complex process, however, there is now a significant body of evidence suggesting the creation of reactive oxygen species and the ability to respond to this oxidative stress as key factors determining longevity (Toren and Holbrook, 2000). This has led some to suggest consuming more anti-oxidant containing foods will increase life span (Packer et al., 1995). In addition, from various studies it has become clear that chronic inflammation has a serious role in a wide range of age related diseases, including; diabetes, cardiovascular, and autoimmune diseases (Khansari et al., 2009). Inflammatory processes are also known to cause oxidative stress and reduce anti-oxidant capacity. Over produced free radicals tend to damage DNA and be a predisposing factor in cancer development. Heart disease, depression, aging, and cancer are characterized by an increased level of interleukin-1, a proinflammatory cytokine (Simopoulos et al., 2002). In summary, inflammation and oxidative stress are strongly linked to developing disease, disease severity, and reducing lifespan.

Vegetables and fruits are known to be rich in anti-oxidant activity and are strongly implicated in reducing the risk of cancer (Gundgaard et al., 2003). The anti-oxidant and anti-tumour activities of vegetables and fruits are thought to be related to additive and synergistic effects of many phytochemicals in them (Liu et al., 2003). These phytochemicals such as flavonoids and anti-oxidants have been associated with reduced risk of heart disease, stroke, and markers of inflammation (Holt et al., 2009). This leads one to ask, are there other natural products that can increase lifespan? We already know omega3 is effective against reducing the severity of many conditions such as autoimmune diseases, through its anti-inflammatory activity (Simopoulos et al., 2002). Increased intake of fish is linked to living longer and is especially evident in Japan (Mizushima et al., 1997). However, in the diversity of the natural world, it is likely other such naturally occurring compounds exist which can naturally fight inflammation, oxidative stress, and so disease and therefore increase lifespan.

This is when it is appropriate to introduce the concept of tonic herbs in Indian and Chinese medicine. In Indian herbal medicine, or Ayruveda, which dates back 7000 years, one of its 8 branches is called Rasayana Tantra (Puri et al., 2003). Rasayana medicine is rejuvenating medicine. In Ayruveda it is considered it the path to restore youth, alleviate disease, and bestow longevity (increase lifespan). Rasayana plants are said to have the following properties; anti-aging, life strengthening, brain and mind strengthening, and disease preventing. A similar approach can be observed in traditional Chinese medicine with the superior tonic herbs (Teeguarden et al., 1998). These superior herbs are understood to work towards health and strengthening the body, they are also supposedly completely non-toxic even at higher doses. They are thought of as being similar to foods and to work in the long term to give cumulative wide ranging beneficial effects to the body. Both Ayruvedic and Chinese tonics have become known as adaptogens in the West, a term that means they can resist stress and normalise various functions (Winston, 2007). This terminology was coined by Soviet scientist, Nikolai Lazarev, and was based on extensive research conducted in the USSR from the 1940s through to the 1960s. This work began as the USSR sought tonics to strengthen and improve the function of the Soviet people. I will now turn to cover two important tonic herbs closely linked to increasing lifespan.

An example of a Chinese tonic herb indicated for longevity is reishi (Castleman, 2001). It is known as the mushroom of immortality and was thought by Chinese doctors to increase the duration of lifespan (Babu, 2008). Reishi is known for anti-oxidant, anti-inflammatory, and anti-tumour effects (Jones et al., 2000; Akihisa et al., 2007). However, it is more complex than being an anti-inflammatory agent as it has been found to stimulate the immune system in humans (Jin et al., 2012), which is hypothesised to be the reason why it is popular in Japan and China for cancer treatment. This phenomenon of both stimulating the immune system and repressing excess inflammation is a typical property of the adaptogens and a reason why they are such powerful balancing tonic herbs. One study recently found that a reishi containing extract increased the lifespans of mice (Wu et al., 2011), this supports the traditional view in China of reishi, that it promotes longevity and overall health.

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Another explanation for why reishi may be a longevity promoting agent is it’s effect on the heart and blood pressure. Reishi has been found to lower blood pressure in hypertensive rats (Kabir et al., 1988). Furthermore, beta blockers, which lower blood pressure and stabilize heart arrhythmias have been found to increase the lifespan of mice (Spindler et al., 2013). β1-adrenergic receptors which are blocked by beta blockers tend to become more active as the aging process continues and their activation results in higher blood pressure and heart instabilities. A logical conclusion from this would be reishi may act in a similar, but more sophisticated manner to beta blockers, by lowering blood pressure and stabilizing the heart to confer longevity.

An example of a Ayruvedic tonic herb (a rasayana/ rejuvenator), indicated for longevity is gotu kola. Gotu kola is a weedy creeping herb native to tropical areas of India, Sri Lanka, and southeast Asia (Kuhn and Winston, 2000). It is said long ago, the native Sinhalese of Ceylon (now Sri Lanka) observed that elephants, renowned for their longevity, loved eating the round-lobed leaves of gotu kola (Castleman, 2001). Thus, the herb gained a reputation as a longevity promoter, a Sinhalese proverb said, ‘Two leaves a day keeps old age away’. Gotu kola has anti-oxidant and neuroprotective activities that could be linked to why traditionally it is used to treat cognitive disorders and confers longevity (Kumar and Gupta, 2003). Similar to reishi, it has the dual properties of being able to reduce inflammation, but also stimulates the immune system (Jayathirtha et al., 2004; Punturee et al., 2005). Gotu kola has similar balancing properties to reishi I think result in protecting the body from stress and so being able to increase lifespan.

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

Of relevance to this article is the mythical character Li Chin Yuen, a Chinese herbalist and martial artist, who is reported to have lived from 1677 to 1933 (http://www.bionity.com/en/encyclopedia/Li_Ching-Yuen.html) some 256 years. The article ‘Tortoise-Pigeon-Dog’, from the May 15, 1933 issue of TIME magazine described his history. He is said to have born in 1677 in Chyi Jiang Hsie, in the Szechuan province of China. He spent most of his life dwelling in the mountains gathering precious herbs and knowledge of longevity methods. In 1748, when he was 71, he moved to Kai Hsien to join the army as teacher of the martial arts. In 1927, Li Ching-Yuen was invited by General Yang Sen to see him in Wann Hsien, Szechuan. The general was fascinated by his young appearance, strength and abilities despite his advanced age. After his death, a year later, General Yang Sen decided to investigate the truth about his background and age. He wrote a report that was published later. In 1933, people interviewed from his home area recalled seeing him when they were just children, and said that he hadn’t aged much during their lifetime. Some others reported that he had been friends with their grandfathers. While it is unclear how much of this is true, Li Chin Yuen was said to have used gotu kola, reishi, fo-ti, and Asian ginseng during his lifetime and to have practiced a lot of qi-gong.

My view is, I suspect that Li Chin Tuen did live a very long time and this partly was due to him keeping down excess oxidative stress and inflammation, while protecting the various systems of the body (e.g. the heart) using diet and tonic herbs. He also seemed to keep a calm and relaxed body and mind with qi-gong, living in a natural environment, and in his own words he, ‘slept like a dog’. So increasing lifespan and protecting yourself from disease requires a holistic approach. Perhaps Li Chin Tuen’s most important lesson is that he lived a long time while cultivating a calm mind.

Note: This article is speculative and any adaptogen use should be accompanied with good lifestyle habits. Certain adaptogens are better suited for certain individuals according to their constitution. They also can cause insomnia in some persons and sometimes are better taken in the morning or dosage needs to be adjusted. 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:

Teeguarden, Ron. Radiant Health: The Ancient Wisdom of the Chinese Tonic Herbs. Grand Central Publishing, 1998.

Puri, Harbans Singh. Rasayana: ayurvedic herbs for longevity and rejuvenation. CRC Press, 2003.

Packer, L. “Oxidative stress, antioxidants, aging and disease.” Oxidative stress and aging. Birkhäuser Basel, 1995. 1-14

Finkel, Toren, and Nikki J. Holbrook. “Oxidants, oxidative stress and the biology of ageing.” Nature 408.6809 (2000): 239-247.

Kabir, Yearul, Shuichi Kimura, and Tsutomu Tamura. “Dietary effect of Ganoderma lucidum mushroom on blood pressure and lipid levels in spontaneously hypertensive rats (SHR).” Journal of nutritional science and vitaminology 34.4 (1988): 433-438.

Kaur, Charanjit, and Harish C. Kapoor. “Antioxidants in fruits and vegetables–the millennium’s health.” International journal of food science & technology 36.7 (2001): 703-725.

Gundgaard, Jens, et al. “Increased intake of fruit and vegetables: estimation of impact in terms of life expectancy and healthcare costs.” Public health nutrition 6.01 (2003): 25-30.

Liu, Rui Hai. “Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals.” The American journal of clinical nutrition 78.3 (2003): 517S-520S.

Khansari, Nemat, Yadollah Shakiba, and Mahdi Mahmoudi. “Chronic inflammation and oxidative stress as a major cause of age-related diseases and cancer.” Recent patents on inflammation & allergy drug discovery 3.1 (2009): 73-80.

Simopoulos, Artemis P. “Omega-3 fatty acids in inflammation and autoimmune diseases.” Journal of the American College of Nutrition 21.6 (2002): 495-505.

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.

Holt, Erica M., et al. “Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents.” Journal of the American Dietetic Association 109.3 (2009): 414-421.

Mizushima, Shunsaku, et al. “Fish intake and cardiovascular risk among middle-aged Japanese in Japan and Brazil.” Journal of cardiovascular risk 4.3 (1997): 191-199.

Jones, Susan, and Kainoor K. Janardhanan. “Antioxidant and antitumor activity of Ganoderma lucidum (Curt.: Fr.) P. Karst.—Reishi (Aphyllophoromycetideae) from South India.” International Journal of Medicinal Mushrooms 2.3 (2000).

Akihisa, Toshihiro, et al. “Anti‐Inflammatory and Anti‐Tumor‐Promoting Effects of Triterpene Acids and Sterols from the Fungus Ganoderma lucidum.” Chemistry & biodiversity 4.2 (2007): 224-231.

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

Jin, Xingzhong, et al. “Ganoderma lucidum (Reishi mushroom) for cancer treatment.” The Cochrane Library (2012).

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

Wu, Zimei, et al. “ReishiMax extends the lifespan of mice: A preliminary report.” The FASEB Journal 25.1 Supplement (2011): 601-2.

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.

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

Jayathirtha, M. G., and S. H. Mishra. “Preliminary immunomodulatory activities of methanol extracts of Eclipta alba and Centella asiatica.” Phytomedicine 11.4 (2004): 361-365.

Punturee, Khanittha, et al. “Immunomodulatory activities of Centella asiatica and Rhinacanthus nasutus extracts.” Asian Pacific Journal of Cancer Prevention 6.3 (2005): 396.

Spindler, Stephen R., et al. “β1-Adrenergic receptor blockade extends the life span of Drosophila and long-lived mice.” Age 35.6 (2013): 2099-2109.