ASHWAGANDHA (Withania somnifera)

Withania somnifera (ashwagandha) Photo

Most of you never heard of it. So by way of introduction I will say, “Here is an alternative to Boswellia serrata” (see my post of June 21th, 2016). Boswellia serrata is also called Indian Frankincense, and is the first cousin of Boswellia sacra that was the Frankincense given to Jesus by the Magi.”

Ashwagandha is called “The Prince of Herbs” in Indian (Ayurveda) Herbal Medicine. Benefits include neurological, immune, endocrine, and as a help in stress and anxiety and also as a potent antioxidant.

In one human clinical study, ashwagandha improved overall mental aptitude and reaction time. Ashwagandha could prevent memory deficit and cognitive impairment by inhibiting degeneration of neurons and repairing the damaged neurons.

In experimentally induced inflammation Withania somnifera (ashwagandha) seemed to be more potent than hydrocortisone even in small dosages and quite similar to the effect of aspirin without the gastrointestinal side effects. May I remind you that topical preparations like creams or gels are even safer as small amounts are applied in specific areas.

In summary, the opinion of herbalists is that Withania somnifera (ashwagandha) is more potent than boswellia and at least as potent as hydrocortisone and aspirin.

A very good summary of the tested clinical benefits of this wonderful herb was published in the “WHO monographs of selected medicinal plants.” Anyone who desires a copy please use the contact form to send us a message requesting a copy of the WHO monograph for ashwagandha.

Reviewed are: Anti-inflammatory effects – greatly summarized above, stroke and heart muscle protection, antioxidant activity, possible protection of short term memory and neuronal protection in Parkinson’s disease. The great majority of results are based on animal studies, however.

The same source suggests that powdered crude drug (mostly in the form of powdered root) could be taken as “an anti-stress agent”: 250 mg twice daily.

Finally, the monograph warns that, “Due to the lack of safety data and the fact that the crude drug has been used in traditional medicine to induce abortion”, its use should be avoided in younger women of child bearing age, during pregnancy and breastfeeding.

BOSWELLIA (Boswellia serrata)

Boswellia serrata Tree Photo

Boswellia is a genus of trees known for their fragrant resin which has many pharmacological uses, particularly as anti-inflammatories. The Biblical incense, frankincense, that Jesus was given as one of the royal gifts, was an extract from the resin of the tree Boswellia sacra which is one of four trees that do produce the valuable resin including Boswellia serrata.

Boswellia serrata resin is known as ‘Indian olibanum’, ‘Indian frankincense’, ‘dhup’ and ‘salai’ or ‘salai guggul’ and is found in the middle and northern parts of Eastern India. It has been available as a high quality extract in India for nearly 25 years.

Boswellia serrata Blossoms Photo
Boswellia serrata blossoms

The gum-resins of these trees have been used as medicine since time immemorial. Three ancient texts of medical knowledge in India – Ayurvedic Science, go back to about 700 BC. Hindus, Babylonians, Persians, Romans, Chinese and Greeks as well as the people of old American civilizations used natural resins primarily for embalming and for its incense in religious and cultural functions.

Recently, the boswellic acids that are a component of the resin have shown some promise as a treatment for asthma and various inflammatory conditions. In West Africa, the bark of Boswellia dalzielii is used to treat fever, rheumatism and gastrointestinal problems. Boswellia incense may even relieve depression.

The gum-resin is tapped from the incision made on the trunk of the tree and is then stored in specially made bamboo baskets for removal of oil content and getting the resin solidified and then graded according to flavor, color, shape and size.

Boswellic acids have been observed to inhibit human leukocyte elastase (HLE), which may cause or worsen emphysema. HLE also stimulates mucus secretion and thus may play a role in cystic fibrosis, chronic bronchitis and acute respiratory distress syndrome. The inhibitory action on this inflammatory process is unique to boswellic acids.

There are very few animal or human studies on the systemic or topical beneficial effects of this wonderful remedy done in the last few decades. My own personal and very humble opinion (as it also pertains to real non-homeopathic Arnica flower extracts) is that any studies to prove efficacy feels to me as trying to prove that a glass of cool water quenches thirst! We all know it works!

Boswellin®, a registered trademark by Sabinsa Corporation, was introduced to the US and European markets in 1991. This is available in capsules or tablets. Products containing boswellic acids range from 150-250 mgs/capsules or tablets, and are taken orally two to three times a day.

I have seen also a suggested dose of 300 to 400 mg. three times a day orally; so usually one gram per day. One source suggests 1,200 mg three times a day for Crohn’s colitis for “up to 8 weeks” and 400 mg three times a day for rheumatoid arthritis.

Shallaki®, contains 125 mg Boswellia serrata in each capsule manufactured by Himalayan Drug Company. This medicine has excellent anti-inflammatory and analgesic properties, useful in relieving joint-pains. The website of the company is himalayahealthcare.com and use the word “shallaki” to find this medicine.

There is a site called physicianformulas.com which I only mention because it is run by physicians, but I do not know personally. They have a 307 mg. Boswellic acid capsules that I would suggest taking three times a day. They and other manufacturers suggest a dose of 300 mg. or so once a day, and it is understandable, but if you have any misgivings about a higher dose, you could try a week of once a day and increase at least to twice a day. Share with us if do this.

It is reported that the eminent 19th century British physician Sir William Osler once exclaimed,

“When a patient with arthritis walks in the front door, I feel like leaving out the back door.”

Nowadays, I feel that we can always start with natural remedies, a thorough medical history, including obvious or hidden food/environmental sensitivities, chronic infections, and lesser therapies, before jumping to expensive or potentially toxic treatments. Amen.

Finally, the Physicians Desk Reference (PDR) for Herbal Medicines, Third Edition (2004) has an entry for “Boswellia carteri – Frankincense”, and has mostly positive remarks on the anti-inflammatory effects of Boswellia. The most common reason for inadequate response is a sub-optimal herbal dose.

Thank you for reading this long article, but if you have pain remember my RUB.

Amen also.

ARNICA (Arnica montana)

Arnica montana Botanical Illustration

One of the most trustworthy sources of information for medical doctors in the United States is the Physicians Desk Reference, or PDR for short. There is now a PDR for Herbal Medicines (PDR-HM) and the following statement and excerpt comes from the third edition of this work:

The medicinal use of Arnica goes back many centuries. The essential oil used as a natural remedy in many countries all over the world comes from the flowers leaves and roots of Arnica montana and related species.

The following beneficial actions are listed for Arnica:

wound-healing, antiseptic, and … analgesic properties …when applied topically.

Listed or known are antimicrobial, and anti-inflammatory effects. I purposely deleted the word mild from the quote above because elsewhere the words “marked analgesic action” are also used for Arnica.

One of the problems with the literature cited – as with much of the medical literature – is that dose is sometimes ignored or not even mentioned in the studies or the reviews. Unfortunately most American literature is based on homeopathic remedies. These preparations are highly diluted and do probably explain the number of negative studies in the literature. One professor of mine explained that the concentration of “the remedy” in a homeopathic preparation is so low that “you would be lucky if you get even one molecule of it.” Even so, the tenor of this PDR-HM is very positive, and I judge it a good source of information.

Several European countries have herbal medicine pharmacopoeias. One of the most trusted and quoted sources of medicinal herb information is the German Commission E Monographs. (Herbal Medicine, Expanded Commission E Monographs. 2000 by American Botanical Council).

 

Arnica Flower Photo
Arnica montana flower

 

Clinical Trials. Because of the previous statements, we choose to ignore the homeopathy-based studies mentioned in the PDR-HM or found elsewhere as per the references cited below. In one particular negative study cited in the PDR-HM a topical preparation of 0.4% Arnica gel was used (Gulick et al. 1996). This was clearly an inadequate concentration. The actual concentration in our Arthritis Rub is much higher and works every time. We find that when pain is severe it works better if a double application is used for the first 3 to 5 days. The PDR-HM cites un-referenced studies using a gel or a 20% tincture (!) as beneficial to treat muscle aches, edema, venous tone and “feeling of heaviness in the legs.”

There is a study comparing an Ibuprofen gel to topical Arnica for the treatment of osteoarthritis of the hands in 204 patients. Ibuprofen caused a 23.9 % reduction in pain and the Arnica group had a 26.6 % reduction. (Rheumatology International, April 2007; vol. 27, pp.585-91). An Arnica gel was studied to treat osteoarthritis of the knee. Pain was “significantly decreased” with maximum reduction of pain scores after 3 weeks of treatment. (Advances in Therapy. Sept/Oct 2002. Vol. 19 No. 5, pp.209-218).

Indications and Usage of Topical Preparations. Muscle pain especially if applied before and after activities that cause the discomfort. Joints aches and pains, rheumatic joint pain, and associated tendon involvement. The gel or cream should be applied to a wide area around the painful spot. Apply to black and blue areas of skin around blunt trauma. Do not use if skin integrity is broken or cut or scraped raw. It has been successfully used by plastic surgeons to decrease post-op edema and discoloration of the surrounding skin.

Contraindications. Known sensitivity to the daisy family: chamomile, marigold, yarrow. Do not use if pregnant.

Adverse Reactions. Do not use on cut or scraped skin, around eyes, or on mucosal membranes. Although we have not ever seen this phenomenon, the PDR-HM warns that prolonged use can cause sensitization. Discontinue use if a rash occurs. Although very common to see this warning, use along with anticoagulants is not contraindicated. As a precaution, you should tell your doctor to monitor your clotting/bleeding profile if you are going to use Arnica for a prolonged period in the face of anticoagulants.

A private communication with a source in Switzerland reported that this potential problem has been looked at in patients using a 20% topical preparation of Arnica and that not enough of the medicine was detected in blood tests to cause any change in the clotting/bleeding parameters. The warning is more on a theoretical basis without any actual clinical proof.

Overdosage. This is not a concern with the use of topical preparations. Arnica is toxic if ingested. Keep away from children or pets. It is used in very dilute amounts in some wines as a flavoring agent, and in mouthwashes.

Dosage and Mode of Use. Apply the rub to a wide area around the painful muscle, tendon or joint. Wait 5 to 10 minutes and repeat application. Do apply the rub first in the AM or before the activity known to cause pain. Do this again before bedtime or after the activity that causes the pain. After a few days a single application is usually sufficient.

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References. Gulick DT, Kimura IF, Sitler M et al. “Various treatment techniques on signs and symptoms of delayed onset muscle soreness.” J Athletic Training; 31:145-152. 1996.

NEVER TAKE ANY SUPPLEMENTS OR REMEDIES WITHOUT THE KNOWLEDGE OF YOUR DOCTOR.