Dear Patients and Friends:
Stress!! It’s the one word that has become synonymous with the American lifestyle. If there is one factor that is more important than almost any other to one’s health and well-being it is how a person handles stress. The health of your mind and spirit has an immense impact on the health of your body. When I see a patient who doesn’t get well in spite of proper diet, exercise and treatments, I suspect there is an underlying unresolved issue that is causing an emotional upset, preventing a person from healing. A big predictor of longevity is psychological resiliency – being able to roll with the punches and challenges life throws at us.
Hans Selye, M.D.
Dr. Hans Selye was a distinguished physician and endocrinologist who was born in Vienna in 1907. He is acknowledged as the “Father” of the field of stress research, having gained world-wide recognition for introducing the concept of stress in a medical context. During Dr. Selye’s medical studies, he observed that patients with various illnesses appeared to display the syndrome of “being sick.” He found stress was associated with stomach ulcers, high blood pressure, enlargement of the adrenals (stress glands on top of the kidneys that produce cortisol, hormones and adrenaline), heart attacks and other medical conditions. Dr. Selye’s theory was that stress played a role in every disease, and that failure to cope with or adapt to stressors can produce “diseases of adaptation.” In his reporting Selye indicated that although the adrenal glands are the first glands to respond to stress, they are also the first glands to fail under stressful conditions. He called his theory the General Adaption Syndrome. Dr. Selye published more than 1,700 articles and 39 books on stress.
There are multiple ways to help one reduce stress including exercise, meditation, acupuncture, massage therapy, prayer, medication when appropriate, and counseling, to name a few. In this issue of the newsletter I’m going to give an overview of adaptogens for stress management.
What Are Adaptogens?
Adaptogens are natural herbal products that help the body deal with stressors such as fatigue, anxiety, trauma, environmental stress, etc. Herbs identified as adaptogens may have their origin in various medicinal traditions, most often, utilizing herbs found in the local area a person or society lives in. Some herbs have their origins in Asia and other have a history in Ayurveda or in traditional Chinese or Indian medicine. In the 1940s, Dr. Nkolai Lazarev defined adaptogens as agents that raised the body’s ability to resist stress by countering undesired stressors that could be physical, emotional, biological, or chemical. This made sense to Western medicine and Western herbalism.
Most adaptogens have been used for thousands of years and involve using the whole herb or a combinations of herbs. Most Western medicine articles on different adaptogens tend to focus on a particular chemical or part of an herb, rather than the whole herb or synergistic effects of herbal combinations. Adaptogens are used by integrative physicians to counter stressors from overtaxing the body’s energy resources or to treat chronic fatigue. They may also be used in sports medicine to enhance athletic performance. In this article, I am going to discuss five adaptogens which, in my medical experience, I have found very useful for my patients. I will also highlight some of the
adaptogenic products we have available at the Center under the “product highlights” section at the end of this newsletter. This is by no means is a complete list. It’s important for a person to be very selective with the herbs and spices they use. Most people aren’t aware that you can start with an excellent, high-quality, properly grown herb, but if it is not harvested at the correct time and then optimally processed a great deal of the herbal potency can be lost.
Panax ginseng is a plant. The root is used to make medicine. Ginseng possesses unique active ingredients through plant saponins called ginsenosides. When they were discovered during the 20th Century by Japanese and Russian scientists they began to catalogue them which caused an explosion of research, resulting in over 5,000 published clinical and research studies to date. This number continues to grow, with work by scientists, most notably in America and Germany. Panax ginseng is not the same thing as American ginseng, Siberian ginseng, or Panax pseudoginseng.
According to MedLine, a service of the National Institutes of Health in the USA, Panex Ginseng is classified as “possibly effective” for:
- Thinking and memory. Taking Panax ginseng by mouth might improve abstract thinking, mental arithmetic skills, and reaction times in healthy, middle-aged people. Panax ginseng alone does not seem to improve memory, but there is some evidence that a combination of Panax ginseng and ginkgo leaf extract can improve memory in otherwise healthy people between the ages of 38 and 66.
- Diabetes. There is some evidence that Panax ginseng might lower fasting blood sugar in people with type 2 diabetes.
- Male impotence (erectile dysfunction, ED). Taking Panax ginseng by mouth seems to improve sexual function in men with ED.
- Chronic obstructive pulmonary disease (COPD). Taking Panax ginseng by mouth seems to improve lung function and improve some symptoms of COPD.
- Premature ejaculation (reaching orgasm too early) when a cream containing ginseng and other ingredients is applied directly to the skin of the penis.
ASHWAGANDHA (Withania somnifera)
Ashwagandha is one of the most vital herbs in Ayurvedic healing and has been used for over 6,000 years. It is frequently called “Indian Ginseng” but botanically ashwagandha and ginseng are unrelated. This herb belongs to the same family as the tomato and is native to India, North Africa, and the Middle East. While the leaves and fruit have valuable therapeutic properties, the root of the ashwagandha plant is the part most commonly used in Western medicine.
Over 200 studies are reported on ashwagandha, mostly animal studies, where there were benefits in stamina, immune function, anti-inflammatory effect, memory loss, and neuroregenerative potential. Ashwagandha induced a calming effect that was comparable to the drug Lorazepam and it also exhibited an antidepressant effect, comparable to imipramine, In one human, study subjects consumed 500mg twice daily of either ashwagandha extract or placebo for two weeks. Compared to those taking placebo, subjects taking ashwagandha showed a significant improvement at the end of the trial in reaction times, attention and alertness, and psychomotor performance skills. Ashwagandha also has potential benefits in boosting endurance, stamina, and sexual energy without a stimulant effect, helping a person enhance their resistance to stress, and helping calm and soothe anxiety while improving sleep.
LICORICE ROOT (Glycyrrhiza glabra)
Licorice (Glycyrrhiza glabra) has been used in food and as medicine for thousands of years. Also known as “sweet root,” licorice root contains a compound that is about 50 times sweeter than sugar. Licorice root has been used in both Eastern and Western medicine to treat a variety of illnesses, ranging from the common cold to liver disease to adrenal fatigue. It acts as a demulcent, a soothing/coating agent, and as an expectorant, meaning it helps get rid of phlegm. It is still used today for several conditions, although not all its uses are supported by scientific evidence.
Licorice that has the active ingredient of glycyrrhiza can cause sodium retention. People who regularly take large amounts of licorice — more than 20 g/day — may raise blood levels of the hormone aldosterone, which can cause serious side effects, including headache, high blood pressure, and heart problems. For people who already have high blood pressure or heart or kidney disease, as little as 5 g/day can cause these side effects, so it must be used with caution in patients with these conditions. This product can also interact with steroid medication, digitalis and other drugs. Usually, we limit licorice root products to 6 – 8 weeks of use to boost adrenal energy, and then they are discontinued.
Another type of licorice, called DGL or deglycyrrhizinated licorice, doesn’t have the same side effects and is sometimes used to treat peptic ulcers, canker sores, and gastroesophageal reflux (GERD). Whole licorice is still sometimes suggested for cough, asthma, and other breathing problems. Topical preparations are used for eczema and other skin problems.
RHODIOLA (Rhodiola rosea)
Rhodiola rosea, also known as Golden Root or Arctic Root, is native to Siberia and Northwestern China. Many studies support what even the ancient Chinese emperors knew – that Rhodiola rosea gives a terrific lift to body and mind. In one study of people with stress-related fatigue conducted in Sweden, Rhodiola exerted an anti-fatigue effect, increased mental performance, decreased the stress hormone cortisol in the blood, and reduced stress overall.
In another study reported in The Journal of Alternative and Complementary Medicine, Rhodiola rosea caused improvement in patients with generalized anxiety disorder. In yet another study of depressed people in Armenia there was significant improvement in overall mood as a result of taking Rhodiola rosea extract.
Over 300 human studies on Rhodiola showed that the plant has anti-stress, anti-anxiety, and anti-depressant properties, and that taking the extract of the root produces no significant negative effects.
Unlike many other herbs, when you take a preparation of this plant, you feel it. Typically users report enhanced energy, improved mood, greatly reduced stress, better sleep, and improved sexual vitality. These effects are largely due to a novel group of compounds in the root known as rosavins. The rosavins act in the brain in a variety of ways. Rosavins influence the levels and activity of neurotransmitters such as serotonin, dopamine, and norepinephrin. They also affect amino acids that mimic the effects of opiates in the brain, such as the beta-endophins.
SCHISANDRA (Schisandra chinensis)
Schisandra chinensis first gained recognition as an adaptogen in the official medicine of the USSR in the early 1960s, principally as a result of the large number of pharmacological and clinical studies carried out by Russian scientists in the preceding two decades. Schisandra is included in recent editions of the National Pharmacopoeia of the USSR and in the State Register of Drugs. In the far East regions of Russia, hunters used this plant to improve night vision, and to ward off hunger and fatigue. Russian studies have demonstrated this herb improves endurance, mental capacity, antioxidant function, helps in alcoholism, treatment of chronic sinusitis and ear infections or upper respiratory disorders, hypotension, wound healing, gastrointestinal dysfunction and has multiple other benefits. Animal studies have demonstrated a stress-protective effect against a broad spectrum of harmful factors including frostbite, heat shock, irradiation and heavy metal intoxication. The berries are used in traditional Chinese medicine where it is considered one of the 50 fundamental herbs. There it is most often used in either tea or in its dry form.
Green Teas and Lead Contamination
Studies of large populations that drink at least 2-3 cups of green tea daily have a reduced risk of heart disease, certain cancers, and type 2 diabetes mellitus. Supplements containing green tea may also assist in weight reduction and the risk of developing prostate cancer.
When one of my patients did not respond as well to calcium EDTA chelations to reduce an increased body burden of lead and cadmium as expected, a food source that might be contaminated was suspected. This person did drink green tea and was also a vegan. I turned to a ConsumerLab.com test report of green teas that included brands such as Bigelow, Celestial Seasonings, Lipton, Salada, and Teavana. The products were tea bags, loose tea, and a K-cup for brewing in a Keurig machine. ConsumerLab.com provides consumer information and independent evaluation of products that effect health and nutrition, is a privately held company, and has no ownership or interest in companies that manufacture or sell consumer products.
The bad news is lead, a very toxic heavy metal, is known to be taken up into tea leaves from the environment and can occur in high amounts in tea plants grown near industrial areas and busy roadways in China. ConsumerLab.com found that although the liquid portion of the brewed teas did not contain significant amounts of lead, when the tea leaves were included in the analysis, 2 – 5 mcg of lead per serving were found in four different products, including an “organic” green tea. No measurable lead was found in decaffeinated green teas or in a Japanese green tea.
The advice given was to be sure to use a filter or tea bag for your tea, and not to consume the tea leaves.
Chikungunya Virus Alert
Both the Center for Disease Control and the Florida Department of Health have issued alerts on a virus spread through the bite of an infected mosquito, similar to West Nile and dengue viruses. This virus has been in Asia and Africa for decades and most recently was found in the Dominican Republic, Haiti, Puerto Rico, and the U.S. Virgin Islands. Just this month a number of cases of this virus were reported in Cuba. Close to 5000 chikungunya cases have been confirmed in the Carribbean this year. Although as of this printing, no cases have been reported in the U.S.A., but it’s just a matter of time before American tourists bring this disease back to the States.
Symptoms typically start 3-7 days after a mosquito bite and most symptoms last 3-10 days, but in some cases, months. Symptoms may include high fever (>102 F), severe joint pain and swelling, back pain, rash 2-5 days after the fever starts, headaches, nausea and vomiting, and redness around the eyes.
About a quarter of persons bitten will have no symptoms. Persons at greatest risk for severe illness include newborn infants, the elderly, and those persons with other health conditions. There is no ‘cure’ for this infection and treatment is supportive.
Preventive measures including using approved bug spray if going out in tropical or wooded areas, getting rid of standing water, and dressing in long sleeves and pants.
Patient Success Story – Patients with Stress Relieved by Adaptogens
Mrs. M is a lady in her early 60s who was under chronic emotional stress from multiple sources. She was tearful much of the time and found herself feeling “shaky” at the most minor of upsets. Her stamina was non-existent. She did not want to take anti-depressant medications suggested by her primary care physician. Mrs. M was started on Licorice Plus twice daily and within 3 days had a dramatic improvement in her energy and a restored sense of calm and without further “shaky” episodes. She took this product for several months and then was able to discontinue it.
Mrs. S is a 57 year old lady with hypothyroidism who saw me initially in 2005 due to insomnia and fatigue. She was maintaining a vegan lifestyle, allowing her severe migraine headaches to resolve off milk products. At her initial comprehensive exam she was found to have a positive adrenal meridian reflex on muscle testing and was started on Licorice Plus twice daily. She was also switched from Synthroid to Armour thyroid, which contains T3 in addition to T4 thyroid hormone. Within several weeks her energy improved and her insomnia resolved. She felt well and saw her primary care provider for a number of years before returning to the Center. This physician changed her thyroid medication to Levothyroxin (T4) and Liodothyroine (T3). When she returned to see me she had stopped taking Licorice Plus and felt tired, in spite of her thyroid labs being in the normal range. Licorice Plus was restarted, with improved energy at her next revisit.
Mrs. M is a lady in her 40s who saw me for chronic fatigue. She had multiple sources of stress including family issues and job stress teaching kindergarten students. After conditions such as hypothyroidism, diabetes, anemia, etc. were ruled out, she was placed on ADHS (which contains Schisandra and multiple other adaptogens) after her kinesthetic testing showed adrenal meridian involvement. At her last visit, she stated she felt much improved and her stamina had returned back to normal. She was also sleeping better.
Success Story – Patient with Obesity and High Cholesterol Resolved on Releana Diet Program
Mrs. K is a lady in her late 50s who saw me initially in 2011 with a myriad of problems. One issue was a high cholesterol level that was treated by her primary care physician with statin drugs. She couldn’t tolerate various forms of this medication due to muscle pains. Her physician then switched her to a drug called Niaspan, which is a high dose vitamin B3 product. She began having leg pains after working up to four tables a day of this drug, but didn’t know if the pain was drug-related. She used to walk five miles a day, but this was no longer possible because of hip pain and foot pain. Mrs. K stated both parents had heart attacks and heart disease. Mrs. K was quite overweight.
This patient’s initial total cholesterol was high at 247mg/dL and her LDL (bad cholesterol) was also high at 174mg/dL. Her inflammatory markers including a cardiac C-reactive protein and homocysteine level were fortunately within the low risk range. Her fasting insulin level was also excellent at 9. Mrs. K was placed on Choleast, which is a Red Yeast Rice product that brought her total cholesterol down to 203 and her LDL down to 134.
Mrs. K later developed subclinical hypothyroidism were thyroid labs shows a mild elevated TSH (thyroid stimulating hormone) but normal T4 and T3 levels. She also had symptoms of low thyroid function, including increasing weight, brittle nails and hair loss. Her primary care physician placed her on Synthroid in low dose (which contains thyroxin or T4 only). The Synthroid did not help her symptoms even though her thyroid labs were returned within the reference range. When Mrs. K returned to see me, she did not want to take a glandular thyroid product for personal reasons, so a small amount of Cytomel (T3) was added to her Synthroid. In 2013 Mrs. K decided to try Armour thyroid, which is a porcine-derived glandular thyroid medication containing both T4 and T3, and within a short period of time she felt “a dramatic improvement” with improved energy, no dry skin, and no menopausal symptoms.
The patient decided to stop taking Choleast and an Advanced Lipid Panel in March 2014 showed a total cholesterol back up to 258mg/dL and an LDL cholesterol of 190mg/dL. Her fasting insulin level had jumped up to 15 and her cardiac C-reactive protein had also increased to 3.0, indicating inflammation, whereas several years ago it was below 1.0, which is a low risk value.
Mrs. K knew her weight was high at 205 pounds, but various diets had not been successful. She elected to go on the Releana diet program we offer at the Center, and she was able to lose 20 pounds in less than two months. A repeat lipid panel was dramatically improved. Her total cholesterol dropped over 100 points to 153mg/dL, her LDL dropped to 114mg/dL, her triglycerides went from 172 down to 90, her cardiac C-reactive protein went down to 1.0, and her fasting insulin level dropped from 15 all the way down to 6, indicating she was no longer in insulin resistance. And Mrs. K was on no cholesterol lowering supplements or medications, and she felt much better in general.