Herbal Medicine Today
Botanical Medicine Women’s Health Primary Care
History of Herbal Medicine
Several Herbal Traditions
European Medical Herbalism Traditional Chinese Medicine (TCM) Ayurveda Native American Herbal Medicine Eclectic Herbal Medicine Modern Herbal Medicine in the US Amazon Herbal Medicine Whole plant medicine Balance & harmony
Common Elements
Types of Herbal Preparations
Tea
Infusion - steeping leaves or flowers Decoction - simmering roots or stems
Tincture
Extraction in alcohol or glycerin
Oils/Salves - herbs infused in oil Capsules/tablets Baths/poultices
Definitions
Botany - study of plants Ethnobotany - relating to culture & tradition Pharmacy - science of making medicine Pharmacognosy - recognition of medicine Pharmacology - study of medicines &
effects
Chemistry - study of substances and their
interactions
Phyto - relating to plants
Definitions
Phytopharmacy - science of making plant
medicines
Phytopharmacology - study of plant
medicines
Phytopharmacognosy - recognition of
plant medicines
Phytochemistry - plant chemistry Phytopharmacy – science of the preparation
of herbal medicines
Homeopathic Remedies
Energy Medicine
A therapeutic system established 200 years ago in Germany by Samuel Hahnemann Medicines made from natural substances, plant, animal, or mineral Produced by a series of dilutions, resulting in the remedies have very small amounts of the original substances Thus, there are no side effects as from the original substance
Herbal Actions
Adaptogen – increases resistance to effects of
stress (Siberian ginseng, panax ginseng)
Alterative – restores proper bodily function
(nettles, red raspberry, oats, burdock)
Analgesic – relieves pain (Devil’s claw,
meadowsweet)
Antacid – relieves stomach acidity and distress
(meadowsweet, peppermint)
Anticatarrhal – removes excess mucus in
sinus and other areas (garlic, thyme, goldenseal, goldenrod, eyebright)
Herbal Actions
Anti-inflammatory – soothing tissue
inflammation (calendula, chamomile, ginger)
Antimicrobial – resists pathogenic
microorganisms, usually by strengthening the immune system (echinacea, elder, lavender)
Antispasmodic – relaxes muscular cramps
and sometimes psychological tension (valerian, boneset, chamomile, cramp bark)
Astringent – tightens tissues, decreasing
bogginess and drying secretions (red raspberry, goldenrod, goldenseal, oak bark)
Herbal Actions
Bitter – stimulates the appetite, aids digestion
and liver function (dandelion, gentian)
Bronchial dilator – opens the bronchial
tubes (mullein, coltsfoot)
Carminative – stimulating and soothing to the
digestive system, reducing gas (fennel, chamomile, meadowsweet, peppermint, valerian)
Cardiotonic – having a beneficial effect on
the heart (hawthorn, motherwort)
Herbal Actions
Decongestant (ephedra, eucalyptus, mint) Demulcent – reducing irritation and
protecting inflamed tissue through high mucilage content (marshmallow, mullein, slippery elm bark)
Emmenagogue - stimulates menstrual flow,
normalizes female reproductive system (false unicorn)
Expectorant (mullein, coltsfoot) Galactagogue - promoting milk production
(borage, fennel, nettles, fenugreek)
Herbal Actions
Nervine - having an effect on the nervous
system Relaxants/Sedative (chamomile, valerian, skullcap) Non-sedative (St. John’s wort) Stimulant - (coffee, peppermint)
Tonics - having a normalizing effect
(raspberry, ginseng, oats)
Vulnerary -promotes wound healing (comfrey,
lavender, St. John’s wort)
System Affinity
Circulatory – hawthorn, Siberian ginseng,
garlic, valerian, feverfew
Respiratory – mullein, coltsfoot, red
raspberry, eyebright, goldenrod, ginger
Reproductive – red raspberry, black cohosh,
blue cohosh, black haw
Genitourinary – saw palmetto, uva ursi,
hydrangea
System Affinity
Musculoskeletal – valerian, kava,
meadowsweet, devil’s claw, black cohosh
Nervous – skullcap, St. John’s wort, linden
flower, chamomile, valerian, kava,
Endocrine – kelp, fenugreek Gastrointestinal – chamomile,
marshmallow, slippery elm bark, meadowsweet, ginger
Herbs Used in Primary Care
Arnica (Arnica montana) Chamomile (Matricaria recutita) Comfrey (Symphytum officinalis) Echinacea (E. purpurea, E. angustofolia) Eyebright (Euphrasia officinalis) Garlic (Allium sativum)
Herbs Used in Primary Care
Eyebright (Euphrasia officinalis) Ginger (Zingiber officinale) Goldenrod (Solidago virgaurea) Lavender (Lavender off.) Mullein (Thapsis verbatum) Peppermint (Mentha piperita)
Mint
Herbs Used in Primary Care
Plantain (Plantago major) Skullcap (scutellaria laterifolia) Slippery Elm Bark (Ulmus fulva) St. John’s wort (Hypericum perforatum) Tea tree oil (Melaleuca alternifolia) Uva ursi Yarrow (Achillea millefolium)
Skullcap
Slippery Elm Ulmus fulva
Chamomile Matricaria recutita
Actions: nervine, antispasmodic, carminative, anti-inflammatory, antimicrobial, bitter, vulnerary Indications: insomnia, anxiety, depression, dyspepsia, diarrhea, colic, flu, colds, migraine, neuralgia, teething, vertigo, motion sickness, conjunctivitis, inflamed skin, urticaria
Chamomile Matricaria recutita
Dose: use the flowering top
Infusion: 1 cup (2 tsp herb) 1-3 x day Tincture: 1-4 ml 3 x day Homeopathic tablets: use 6x as needed for colicky or teething babies, irritable children
Caution - rarely, people are allergic to chamomile.
Common Conditions in Primary Care & Herbal Tx
Gastrointeritis - chamomile, slippery elm Varicose veins - horse chestnut, prickly ash
bark
Sprains and fractures - arnica, comfrey Respiratory conditions - mullein,
raspberry, echinacea, ginger, mint
Ear infections - garlic, mullein, echinacea Insect & spider bites - homeopathic ledum
& apis; herbal - plantain, yarrow
Herbal Treatment of Sinusitis
Goldenrod leaf (Solidago virgaurea) Ginger (Zingiber officinale) Marshmallow root (Althaea officinalis) Mullein (Verbascum thapsus) Peppermint (Mentha piperita) Red raspberry (Rubus idaeus) Echinacea (Echinacea spp.)(cone flower)
Herbs for Women’s Health
Common herbs used in pregnancy Herbs to avoid in pregnancy Herbs for the new mother Hormonal imbalance, PMS, menopause, infertility, osteoporosis, varicose veins
Herbs used in Pregnancy
Alfalfa - use for nausea, heartburn, anemia Arnica - topically as oil to prepare perineum False unicorn - traditionally used for history of miscarriage, before, during, and after pregnancy Wild yam - used to prevent miscarriage & preterm birth due to its antispasmodic action, calming the uterus
Beverage Teas in Pregnancy
Anise or fennel seed Lemon balm Nettle Oat grass Raspberry or strawberry leaves Red clover Spearmint
Morning Sickness
Alfalfa Dandelion Ginger Peppermint Spearmint
Morning Sickness Formula
Black horehound herb (Ballota nigra) Meadowsweet herb (Filipendula ulmaria) Chamomile flower (Matricaria recutita) Anise seed (Pimpinella anisum) Ginger root (Zingiber officinalis) Tincture: Mix 1/4 oz of 1st four in a 1 oz bottle, add 25 drops ginger root. Use 5-8 drops in mouth or 1 oz water as needed.
Uterine Tonics
Red raspberry (Rubus idaeus)
classic uterine tonic, tones uterus, increases milk flow, restorative after birth contains fragrine, alkaloid that gives tone to the uterus and pelvic muscles rich in vitamins & minerals, chelated iron use as tea during 3rd trimester
Partridgeberry (Mitchella repens)
Use for several weeks before due date, as tea, capsule, or tincture
Herbs for Anemia
Alfalfa Burdock Dandelion Nettles Red raspberry Floridex
Wild Yam
Partus Preparatory
Black cohosh - ripens cervix Blue cohosh - ripens cervix Castor oil - effective if cervix already ripe, to
initiate labor
Evening primrose oil (EPO) - cervical
ripener
Red raspberry - general uterine tonic herb
Mother’s Cordial
Blue cohosh (Caulophyllum thalictroides) Squaw vine (Mitchella repens) False unicorn root (Chamaelirium luteum) Black haw, cramp bark (Viburnum prunifolium) Mix equal parts of tincture. Take 1 dropperful daily in the last 4 weeks of pregnancy.
Bove, Mary
Herbs for Labor
Black cohosh Blue cohosh Lavender Motherwort Squaw vine
Black Cohosh Cimicifuga racemosa
Actions: nervine, anti-spasmodic, emmenagogue, alterative, hypotensive Indications:
for pain in ovaries, mylagias, tincture - 20 drops twice daily to ripen cervix in last 3 weeks of pregnancy, start with 5 drops twice daily, slowly increase for menopausal sx, painful or delayed menstruation, arthritic, muscular, and neurological pain, 1-2 ml tincture 3 x day
Motherwort
Leonurus cardiaca
Actions - sedative, emmenagogue, antispasmodic, uterine tonic, cardiac tonic, carminative, parturient, antianxiety, anti-arrythmic, Dose - use aerial parts, 2-4 tsp infused in 2 cup water, or 5 -30 drops tincture, repeat as needed.
Motherwort
Indications
menstrual and uterine conditions
delayed or suppressed menses, with anxiety
cardiac & circulatory problems, arrhythmias menopausal tension to calm the new mother for pain in early labor
Postpartum Perineum
Calendula flowers Comfrey root Yarrow flowers Rosemary leaves Mix 1 oz dried herb of each. Use 1 handful per pint of boiling water, steep 20 minutes, use as sitz bath or perineal wash.
Herbs to avoid in pregnancy
See separate handout Different list according to who makes it Some herbs are often listed as “to avoid”, yet can be very useful in the hands of a knowledgeable practitioner
ie, black cohosh, blue cohosh
Herbs for the new mother
Arnica Borage Chamomile Comfrey Fenugreek Lavender Milk Thistle Nettles
Milk Thistle Silybum marianum
Hormonal Imbalance
PMS Menstrual problems Infertility Menopause Osteoporosis
Estrogen - Actions
Increases endometrial tissue, body fat, blood clotting, risk of endometrial & breast ca, & GBD and autoimmune disorders Decreases sex drive, causes breast stimulation, salt & fluid retention, depression & headaches, loss of zinc & retention of copper
Estrogens
Natural estrogens
Synthesized from androgens in ovaries & adrenal cortex 3 types - estrone, estradiol, estriol
Xenoestrogens - toxic estrogen-like
chemicals, abundant in our environment - DDT, PCB, plastics
Synthetic estrogens - OCPs, HRT Phytoestrogens - plants having estrogenic
activity, isoflavones in soy, red clover,
Plants with Estrogenic Activity
Garlic Oats Coffee Carrots Fennel Licorice Hops Barley Apple Rice Anise Parsley root Cherry Clovers Pomegranate fruit Marijuana
Progesterone - Actions
Balances effects of estrogens
maintains endometrial health, prevents ca protects against fibrocystic breasts, breast ca helps use fat for energy natural diuretic, anti-depressant facilitates thyroid hormone action normalizes clotting, blood sugar, zinc & copper restores sex drive
Plants with Progesterone Activity
Wild yam (Dioscorea) Licorice (Glycyrrhiza) (Smilax)
Premenstrual Syndrome
Whole foods diet Minimize sugar, refined CHO, dairy, caffeine, & saturated fats Increase intake of fruits, vegetables, legumes, nuts, seeds, fish, & flax oil B-complex vitamins Herbals - Vitex, gingko Natural progesterone - from soy & yam, controversial, requires chemical
Chasteberry Vitex agnus castus
Acts on the hypothalamic-pituitary-ovarian (HPO) axis, which is easily disrupted in women<20 years old
Increases LH, favors progesterone Inhibits prolactin
Herbal actions:carminative, dopaminergic, galactagogue, HPO regulator, ovulaation stimulant, progesterogenic, uterine tonic
Vitex, cont
Qualities: cooling or warming potential, dry, neutral, tonic Toxicology: none known Indications: PMS, infertility, menopausal sx including mood changes, migraines, menorrhagia, polymenorrhoea, menstrual cramping, insomnia, hot flashes, to restore balance after hormonal contraceptives.
Vitex, cont
Known in writings of Hippocrates (450 BC), Dioscorides (500 AD), Pliney, the Eclectics, and others. Dose: is slow working, take for 3-6 months
Tincture - 1 ml 3 times daily Infusion - 1 tsp/cup 3 times daily Capsules - 1 daily
Menstrual Problems
Hormonal imbalance, often caused by poor diet, congestion in liver, adversely affecting hormonal relationships Treatment
Whole food diet, rich in fruits & vegetables Herbs: burdock
Mayan Uterine Massage - a technique taught by Rosita Arvigo, of the ancient art of abdominal massage.
Infertility
Vitex - normalizes hormones Mayan/Mexican Uterine Massage
Menopause
Hot flashes - Vitex, Insomnia, anxiety, depression, tension - St. John’s wort, oats, valerian, kava Genitourinary symptoms Hypertension & atherosclerosis hawthorn, motherwort, garlic,
Hawthorn Crataegus oxyacantha
Actions: cardiotonic, diuretic, astringent, hypotensive Indications:
most heart conditions, including hypertension, to prevent development of cardiac disease, as part of post MI program all persons over age 50, postmenopausal women
Hawthorn Crataegus oxyacantha
Scientific research in Europe
isolated constituents have insignificant effects whole plant effects are significant Based on a study by the German Federal Ministry of Health, hawthorn is recognized as a major heart remedy in Europe effects: improves coronary circulation, dilating coronary arteries, reducing angina; enhances nutrition and activity of heart muscles
Hawthorn Crataegus oxyacantha
No toxicity known Dose:
Tincture - 1-2 ml 3 x day Infusion - use 2 tsp dried herb, drink 3 x day Capsules - 2 caps 1-3 x day
Herbal Formula for Menopause
Chasteberry 2 parts St. John’s wort 1 part Life root 1 part If symptoms are accompanied by anxiety & palpitations, consider : Motherwort 2 parts Black cohosh 1 part
Osteoporosis
Contributing factors
Genetic makeup Diseases of thyroid and adrenals affecting retention of calcium Estrogen level Chronic stress depletes stores of calcium Dietary effects - coffee and red meat acidify the blood, pulling Ca++ from bones Calcium absorption
declines with age Exercise increases absorption Medications affect calcium absorption & excretion Lack of specific nutrients may deter absorption, ie Vit D, C, K Mg, Phosphorous
Osteoporosis Herbal Treatment
Chasteberry (Vitex) 2 parts Horsetail 1 part Celery seed 1 part Oats (avena sativa) 1 part Alfalfa 1 part This provides hormonal balance, antirheumatic, and calcium balancing effect Dose: Tincture - 5 ml 3 times day.
Infusion 2 tsp/cup, drink 3 times daily
Varicose Veins
Horse Chestnut Bark
Aesculus hippocastanum Astringent, anti-inflammatory, specific to blood vessels, esp veins
Prickly Ash Bark
Zanthoxylum americanum Stimulant (circulatory), tonic, alterative, carminative, diaphoretic, antirheumatic, hepatic
Dose: 1-2 tsp herb/cup 3 times daily
Tincture: 1-2 ml 3 times daily
Current Issues in Medical Herbalism
Traditional preparations & protocols Standardization
based on one constituent does not consider synergism of whole plant
Sources
Reliability of identification, quality No federal guidelines
Commercialization of herbal medicine
Designer herbs
Bibliography
Bove, M. 1995. “Herbs for Use in Pregnancy and Lactation”, in 1995 Gaia Symposium Proceedings on Naturopathic Herbal Wisdom. Gaia Herbal Research Institute, Harvard, MA. Foley, M. 2000. Embraced by the Essence. Holistic Wellness Foundation, Boulder, CO. Hoffmann, D.,1993. An Elders’ Herbal. Healing Arts Press, Rochester, VT.
Bibliography
Hoffmann, D. The New Holistic Herbal. Hoffmann, D. 1991. An Herbal Guide to Stress Relief. Healing Arts Press, Rochester, VT. Hudson, T. 1999. Womens’ Encyclopedia of Natural Medicine. Keats Publishing, Los Angeles, CA.
Bibliography
Idarius, B. 1999. The Homeopathic Childbirth Manual. Idarius Press, Talmage, CA. Mitchell, W. 2000. Applications of Botanical Remedies in Naturopathic Medicine. Manuscript, Seattle, WA. Weed, S. A Wise Woman’s Herbal for the Childbearing Year.
Resources Online
Www.phytotherapies.org - a database for practicing herbalist, a site organized by leading Australian herbalists, register free www.imaginaria.org - ethnobotany www.healthy.net/clinic/therapy/aroma/herb al www.herbs.org - Herb Research Foundation