As a relatively new blogger I have been aiming to post every week about health, wellbeing and herbal medicine. For the month of November I will take up the challenge to write an article every day of the month. If you would like to email any specific requests that you would like to learn more about feel free to contact me on: ewarrenerherbal:gmail.com I will do my best to respond to every query throughout the month and if I get too many I will ensure that they are written about as part of my usual blogging rota 🙂 wish me luck!!
Cinnamon as an evergreen tree native in South China, the Himalayas, India and Sri Lanka dependant on which species. It has been introduced to many other countries and it is cultivated for its bark which is used in economic, culinary and medicinal applications. It is one of the oldest spices known and has been recorded by different countries dating back to 2700BC. There are over 250 different species of Cinnamomum spp; scientific research has mainly employed Cinnamomum cassia and C. zeylanicum.
Botanical Family: Lauraceae (laurel family)
32 genera and 2000-2500 species
Ceylon Cinnamon, Cinnamon
|Chinese Cinnamon, Cassia Bark,
Cinnamon is cultivated in moist well drained soil, grows happily in partial shade. The tree can be propagated by ripe seed or cuttings from first year growth. Bark is harvested, peeled and dried into quills ready for consumption. Young branches are smooth and brown in appearance. Leaves grow in opposite formation new growth is red in colour developing to green when mature, are ovate with three prominent veins and are leathery in texture. Fruit forms as a fleshy ovoid drupe containing one fertilised seed turning dark purple to black when it is ripe, similar in size to an olive. Flowers are bisexual, small and pale yellow and grow in the axillary or terminal panicles.
|Details about the species ↓||Species of Cinnamon →||
|Height and Span||Height: 12-20 metres (40-70ft)
Span: 6-12 metres (20-40ft)
|Height: 10-18 metres (30-60ft)
Span: 6-10 metres (20-30ft)
|Significant descriptive information||Leaves: up to 20cm
Berries: single seeded
|Leaves: up to 18cm
Berries: purple, ovoid
Native: S India and Sri Lanka
|Minimum temperature: 15°C|
|Parts used||Inner bark, Leafy twigs, fruits and oil||Inner bark, leaves and oil|
Humans have used cinnamon for thousands of years; the spice played an important role global economics enabling colonial expansion during the 16th Century. Holland cultivated this spice improving its economic position in world trade. Cinnamon has been used as a spice flavouring food and in perfumery. It has been cultivated and imported throughout the world for its economic, culinary and medicinal uses. Due to extensive cultivation this spice is rarely harvested from the wild.
In Ayurvedic medicine cinnamon is used for hyperacidity, asthma, constipation-predominant IBS (stimulating digestive enzymes), dysentery-predominant IBS (to clear kapha and stimulate digestive enzymes), conjunctivitis, bronchitis, colds, congestion, water retention, hiccups, nausea, muscle tension and vomiting. In Traditional Chinese Medicine (TCM) cinnamon is used as a warming remedy indicated for ‘exterior cold’ or ‘wind-cold’. It is contained in several TCM formulas including Ma Huang Tang – Ephedra Decoction and Gui Zhi Tang – Cinnamon Twig Decoction, both formulas are diaphoretic enabling interior cold to be released through sweating. It has been known to the Chinese since 2700BC and given to patients who are deficient in Heart Qi and Yang.
Western Herbal Medicine uses cinnamon as a warming remedy for patients with a common cold or influenza. It supports patients with anorexia or who have suffered weight loss, stimulating appetite. Its antispasmodic and carminative actions are employed for people who experience colic, diarrhoea and indigestion. Cinnamon has also been used historically to ease toothache, arthritis and menstrual disorders and clear up urinary tract infections.
Cinnamon – Constituents
- Volatile oils composed of aromatic benzene derivatives and terpenes including:
- Cinnamaldehyde 60-75%
- Phenols – Eugenol (In C. zeylanicum 4-10%)
- Methyl eugenol
- Eugenol acetate
- Cinnamyl acetate
- Cinnamyl alcohol
- Benzyl benzoate
- Hydrocarbons: pinene, phyllandrene, caryophyllene, safrole, cymene and cineol
- Condensed Tannins (proanthocyanidins)
- Calcium oxalate
- Coumarin (Higher in C. cassia)
- Insecticidal compounds: cinnezalin and cinnzelanol
Cinnamon contains up to 4% volatile oils. Cinnamyl acetate is contained in high proportions and may be converted into aldehyde. Phenylalanine is a precursor of cinnamic aldehyde and eugenol. Cinnamon’s sweet taste is due to the cinnamaldehyde content. An alcoholic solution yields a blue colour when mixed with ferric chloride. C. cassia is more astringent than C. zeylanicum.
Medicinal Actions of Cinnamon
- Anti-infective (volatile oils)
- Anthelmintic/Vermifuge (dispels parasites such as worms)
- Mild analgesic
Research into cinnamons effects on sugar and fat metabolism has achieved significant results in animal studies. Cinnamon’s FBG reducing potential can be understood through its polyphenol content which is antioxidant in effect. Cinnamon is recognised as a functional food source of antioxidants which help to decrease oxidative stress by inhibiting the enzyme 5-lipooxygenase improving insulin sensitivity.
Antioxidant effects can be measured by oxidative stress markers enabling researchers to analyse the links between cinnamon and changes in glucose or lipid profiles. Plants are known sources of antioxidants which neutralise free radicals, endogenous or from external sources. Free radicals cause the body stress damaging cells and tissues within the body e.g. lipid peroxidation. Cooking and digestion of cinnamon has minimal impact on the levels and action of antioxidants and polyphenols.
Cinnamon may affect glucose metabolism through its coumarin content. Coumarins can cause photosensitive reactions which may produce allergic reactions; one patient taking cinnamon did develop a rash which resolved after discontinuing supplementation. Coumarins are forms of flavonoids which occur as glycosides; they have a role in plant metabolism and immunology; medical actions include: hypotensive and oestrogenic effects. Oestrogen has a physiological effect on metabolism and reduced blood pressure can improve risk factors of NIDDM. Aqueous extracts of cinnamon have produced biologically active insulin like action through in vitro research.
Scientific Research on Cinnamon
Research on cinnamon has focused on several of the actions and applications of the spice and its essential oils including its antimicrobial, antifungal, antioxidant and antibacterial effects. Areas of research include cancer, diabetes, hypertension and digestion. Nishida et al reported that cinnamon is effective in inducing apoptosis (cell death) to HL-60 cells which are involved in cancer (2003). Cinnamon’s anti-tumour action was statistically significant in this in vitro primary research. In TCM cinnamon is a component in a formula called Minjin Yoei To (NYT) which is prescribed to patients with lung cancer, evidence shows positive results in tumour marker levels and symptoms in patients with a lung carcinoma taking NYT for seven weeks.
Lipid and glucose metabolism, antioxidant, insulin sensitizing and insulin mimetic have been investigated in order to explore and discover the effects cinnamon has on diabetics. The majority of research conducted regarding cinnamon and diabetes have concluded that cinnamon is beneficial its prevention and control although there are conflicting studies. Analysis of cinnamon and lipid metabolism discovered that animal studies were more effective that human trials.
Disorders of lipid metabolism can lead to health conditions such as hyperlipidaemia, diabetes, obesity and cardiovascular diseases which increase the risk of further health implications. Cinnamon has been used traditionally for digestive conditions of the gastrointestinal tract-GIT which has a major role in lipid metabolism as it synthesises apolipoproteins required to transport lipids around the body and resynthesizes triglycerides. When levels of cholesterol and triglycerides are high health risks ensue including atherosclerosis, heart disease, stroke and hypertension although lipids are necessary for health with roles in energy homeostasis, reproductive and organ physiology. The use of statins to manage and reduce high levels of cholesterol is current procedure in orthodox medical professions once lifestyle factors have been explored. There is conflicting viewpoints on the use of statins in lowering lipid levels. Several metabolic disorders occur due to insulin resistance and research into cinnamon discusses its potential insulin mimetic properties. Research has looking into cinnamons effect on fat metabolism with mixed results.
It has been over four decades since the discovery of plasma lipoprotein transport systems in the body which have identified that fat production actually occurs in the liver and gastro-intestinal tract. The link between high lipid levels and cardiovascular disease (CVD) – hypertension, atherosclerosis and hypercholesterolemia has been explored and researched and the results are used by modern medicine to predict, prevent and treat people with lipid disorders. Further research is being done to determine how to lower lipid profiles and prevent cardiovascular diseases from occurring.
Cinnamon has the potential to activate lipid metabolism, further primary research should include human factors such as exercise levels, the state of a person’s endocrine and nervous system, diet and gender into account as current research has shown that these have an effect on fat metabolism.
Future research has been highlighted in to cinnamon’s potential to protect nerve cells from damage highlighting possible preventative strategies in the prevention of Alzheimer’s disease.
Chemical Composition of Cinnamon
- Moisture 9.9%
- Protein 4.65%
- Fat (ether extract) 2.2%
- Fibre 20.3%
- Carbohydrates 59.55%
- Total ash 3.55%
- Calcium 1.6%
- Phosphorus 0.05%
- Iron 0.004%
- Sodium 0.01%
- Potassium 0.4%
- Vitamins (mg/100g) B1 0.14; B2 0.21; C 39.8; niacin 1.9; A 175 I.U.
Clinical Applications of Cinnamon
Cinnamon has an anti-microbial, anti-fungal and anti-bacterial action helping to combat infections such as the common cold and influenza. It supports the body’s removal of toxins and act as a pain reliever. Clinical applications include flatulent dyspepsia, colic, diarrhoea, common cold, dyspepsia, abdominal distension from flatulence and nausea. The volatile oils in cinnamon have lipolytic properties supporting the body in the metabolism and digestion of fats suggesting a potential role in the treatment of diabetes.
Contra-indications, Adverse Effects and Drug Interactions
There is a potential for an allergic or irritant adverse reaction to cinnamon use due to the content of cinnamaldehyde in volatile oil. The German E Commission has approved both C. cassia and C. zeylanicum as safe herbs with medicinal properties. The bark is the approved part of cinnamon for use as a spice or for its medical properties and is generally regarded as safe even during pregnancy. Cinnamomum cassia contains coumarins which can damage the liver in high quantities which are not present in negligible quantities in C. zeylanicum. A study conducted for the Food Standards Agency assessed the dietary intake of cinnamon in multi-ethnic populations within the UK determined that there is no risk regarding coumarin levels when ingested as part of the diet. In the Handbook of Herbs and Spices it states that ingestion may cause nausea, vomiting and possible kidney damage and recommends that it isn’t used in pregnancy.
Dried bark: 0.5-1g(x3) daily
Oil: 0.05-0.2ml(x3) daily
Powder: 0.5-1g(x3) daily
Fluid Extract: 0.5-1ml(x3) daily
The maximum dosage of coumarins to ensure safety is 1.0mg/kg for coumarin in foods and 2.0mg/kg for coumarin in spices, pregnant women are recommended not to exceed a daily intake of 0.7mg/kg.
albicans is a member of the yeast family, a variety of fungi and it occurs within our bodies. It is present from the first few months in life and when the balance of our intestinal flora is healthy it remains without having any detrimental impact on our health and wellbeing. Health problems occur when the opportunistic yeast populations become prolific. This can occur when people take antibiotics – which is unfortunately too often than not!! Antibiotics destroy/kill all bacteria, so the candida which has been happily residing in the gut suddenly finds all its neighbours dying it jumps at the chance to take up the available space. C. albicans derives nutrients from our bodies via enzymes that it produces. Living naturally in the digestive system (lower intestines), vagina and also present on skin parasitically not symbiotically.
When the candida is in balance with our intestinal flora is acts like a yeast, but when it becomes a dominant habitant of the digestive system the invasive yeast branches out with hyphae (fungus like mycelium tract) and secretes a phospholipase disrupting cell membranes, causing inflammation leading to symptoms such as leaky gut syndrome, the candida now acting like a fungus can cross the walls of the intestines and affect other body systems and organs within the body. C. albicans produces over 79 toxic substances which can result in hypersensitive reactions causing symptoms such as muscle and joint pains, irritability, psoriasis, depression, headaches, fatigue, sexual problems (including infertility), memory loss, digestive disorders, itching, and learning problems such as Attention Deficient Hyperactivity Disorder (ADHD) and autism.
Common symptoms experienced with C. albicans include cold extremities, frequent urination, depression, sleep disorders irritable bowel syndrome (IBS), recurrent childhood ear, nose and throat infections, constant gas or bloating, endometriosis, constipation, heartburn, recurrent sinusitis and recurrent bronchitis. Allergic reactions to the yeast antigens can occur in chronic or recurring candida infections with inflammatory responses too!
Candida produces alcohol and acetaldehyde from its enzymic metabolism of sugar; acetaldehyde consumes B vitamins leading to depression, exhaustion and trembling. Exposure to acetaldehyde can also interfere with essential fatty acid (EFA) metabolism, the formation of acetyl-CoA and the availability of vitamin B6. Sugar is candida’s food source and in our diet there is above average sugar intake.
Nutrition has important implications on health, immunity and disease. Toxins in the body excreted by C. albicans can contribute to a multitude of diseases and disorders symptoms of which have been mentioned above. Without complete digestion of food and elimination of toxins, vitamins and minerals can become deficient even if they are consumed – therefore if you have digestive issues it would be beneficial to see a herbalist. If you have digestive issues you will struggle to assimilate the nutrients which you are eating and also you will struggle to access any supplements which you may also be taking.
Lots of food is prepared and processed prior to being sold for consumption, care should be taken when shopping for food to be aware of where it is sourced from and what goes into it. Medicines such as steroids and antibiotics, are given to animals reared for food and can be transferred to people when eaten. Oestrogens are given to increase meat yield and may be a causative factor of yeast infection, regular intake of meat and dairy may result in the absorption of antibiotic and hormone residues. Organic sources do reduce this risk but steroids and antibiotics used in animals and fruit production runs into water getting into tap water supplies. Drugs are designed to stay biologically active and are excreted quickly from animals and humans, passing into water supplies, possibly leaching into soils and accumulating in concentration in areas. Continuous exposure to pharmaceutical medication leads to resistant pathogens and possible allergic responses in people. This may explain why sperm counts are down in humans and animals after decades of women taking the contraceptive pill and excreting the medication in a biologically active form into the water supply. Our water is filtered but it doesn’t prevent pharmaceuticals from entering our drinking water, pharmaceutical medicines can also depress immunity.
The typical Western Diet isn’t nutritionally balanced either!! Overall it is low in fibre, high in refined starches (which are converted to simple sugars), contains saturated, trans and hydrogenated fats but not enough micronutrients, has high levels of preservatives and additives too. It contains a lot of fast processed foods and a multitude of foods that weren’t available prior to agriculture (Table is available at the bottom of this blog). Cultures who conform to the western diet experience the same issues – people on the western diet are generally overweight but undernourished due to the empty nutrients in the processed foods which are eaten!! The western diet results in health problems such as obesity, heart disease and diabetes. Refined sugar influences states of micronutrient deficiency and lowered immunity but are added to a lot of foods to make them taste more appealing to us.
Genetically people with the blood group O are slightly more susceptible to yeast infections, although diet, nutrition and lifestyle also contributes to the aetiology of disease. Foods which exacerbate candida include refined carbohydrates, carbohydrate rich foods and high levels of sugar. This makes a lot of sense when you realise that all carbohydrates are digested, broken down into simple sugars – sugar is the building block for all carbohydrates. Yeast based or fermented foods can aggravate symptoms in people hypersensitive to C. albicans such as vinegar, wine, beer, alcohol, yeast extracts and spreads, mushrooms and blue cheeses.
The immune system can control an overgrowth of candida with the body’s mucosa prevents overgrowth and controlling populations of yeast when healthy; a diet high in sugar combined with a weakened immunity increases susceptibility to infection. Incomplete digestion, digestive enzyme deficiencies and diets high in refined food can contribute to destructive cycles in internal health. Ingestion of reactive foods reduces metabolism which increased intestinal permeability and reduces the intestinal capacity to digest nutrients; this leads to nutrient deficiencies which weakens the immune system and allows yeast to colonize areas.
C. albicans irritates the intestinal lining via enzyme release causing inflammation which further increases the body’s reactivity to certain foods. Magnesium, EFA’s and Vitamin B6 deficiencies are common in yeast infections. Magnesium deficiency leads to inflammation and ischemia in the intestines. EFA deficiency reduces immunity and the ability of the body systems and increases inflammation. Vitamin B6 and zinc deficiencies can also compromise the immune system.
Increased sugar in the diet, imbalances in blood sugars and metabolism of starches, fats and proteins contribute to C. albicans overpopulation. Stress reduces immunity and mucus secretions and consumes essential micronutrients such as zinc and vitamin C increasing the negative immunosuppressant actions. As complex beings every action and choice we make can have an impact on health. Exacerbating factors include sugar-rich foods, hormone contraceptives, steroids and drugs which stimulate yeast production. Antibiotics which destroy healthy flora, symbiotic bacteria e.g. Lactobacillus acidophilus allowing other nonbacterial pathogens to multiply in its place. Antibiotics also damage intestinal mucosa: a physiological barrier to yeast infections and part of the innate immune system. Steroids and the contraceptive pill suppress immunity adding to the problem. Another contributing factor is amalgam fillings in teeth, due to mercury metal toxicity.
High protein and complex carbohydrates are more beneficial to patients than refined carbohydrates or sugars (although the only carbohydrates that I recommend are fruits and vegetables as they are packed with nutrients). Proteins are built up of multiple peptide chains of amino acids accessed from the amino acid pool after digestion, complete hydrolysis of proteins take place in the intestines. Amino acids are rapidly removed from the blood utilised by all cells in the body, especially the liver. Complex carbohydrates take slower to digest than refined products containing higher levels of dietary fibre and starch – but are still relatively new in the history of human diets as grains were only introduced 10,000 years ago – a blink of the eye in evolutionary terms! Insulin is released in the body to regulate the body’s blood sugars once carbohydrates have been fully digested. Complex carbohydrates ensure a slower release of sugars enabling blood glucose levels to remain balanced but due to they being relatively new to our diet can cause inflammation and symptoms of food intolerance which are similar to symptoms of candida – attempt an exclusion diet to see if your symptoms improve after reducing your carbohydrate content (remove bread, rice, pasta and pastries – you are allowed potatoes).
EFA’s such as linseed or evening primrose oil are recommended as they are high in omega 3 linolenic acid, a building block for anti-inflammatory prostaglandins and a bulking fibre. EFA’s are long chain polyunsaturated fatty acids, omega 3, also known as linolenic acid, works as a precursor of prostaglandins. Omega 6 – linoleic acid is a precursor of most prostaglandins, leukotriene’s and arachidonic acid. In plain English – Omega 3 is anti-inflammatory and Omega 6 can be pro-inflammatory. The western diet is high in Omega 6 which is pro-inflammatory. Physical characteristics of EFA deficiency include dry flaky skin, brittle nails and straw like hair – does this sound like you? Vegetable oils have disturbingly high ratios of omega 6, swap them for fruit oils such as olive oil and coconut oil and swap your margarine for butter too!! Just remember the portion size for fat is the size of an average dice.
Garlic is beneficial for reducing yeast overgrowth, it modulates the cardiovascular system, boosts immunity, and is anti-fungal and anti-oxidant. Anti-microbial effects of garlic against C. albicans can be attributed to its constituents – diallyl disulphide and allyl alcohol. Vitamin C is also beneficial as it detoxifies the body and enhances immune function, 200mcg daily of chromium normalises blood sugars, ginger helps by stimulating the circulation and grapefruit seed extract helps to clear yeast and other pathogenic microflora without disrupting the beneficial flora in the intestines. This is just the tip of the iceberg of beneficial foods and supplements to help with candida overgrowth.
Prevention and control of C. albicans is a slow process which can take months. Patients need to be strict, ensuring that they have optimum nutrition, increasing the intake of whole foods and supporting the body in the removal of toxins. The body’s natural defences and healing potential need improving and yeast activity needs reducing depriving it of sugars. Excretory organs need supporting to detox the body of toxins and damaged tissues need to be repaired and supported. Boiled water has a reduced surface tension and can carry toxins to be eliminated. At first patients should eliminate sugar rich foods and refined carbohydrates for 4-10 days, keeping a diary to find out which foods aggravate them.
Patrick Holford recommends a simultaneous four point plan consisting of:
- Anti- fungal approach introducing products such as propolis a natural bee product which is effective on fungal infections of the skin and body and can be taken internally or grapefruit seed extract is a powerful antibiotic, antifungal and antiviral which doesn’t affect good bacteria and also garlic as mentioned above (it you are on pharmaceutical medication check with a herbalist or your doctor before introducing grapefruit into your diet).
- Probiotics help to rectify damage caused by recurrent antibiotic use by re-establishing healthy colonies of good bacteria in the intestines which increase acidity by producing lactic acid and acetic acid which inhibits pathogenic flora. Hundreds of different species are found naturally in the intestines living off partially digested food, completing the digestion process, providing us with B vitamins, biotin, folic acid and vitamin K. Probiotics naturally re-inhabit our digestive tract with healthy bacteria, it also helps to improve our moods and emotions!!
- Supplements can be taken to correct imbalances of glucose tolerance, hormones and histamine levels and detoxify body such as Vitamin C to rid the bowel of toxins – but are only effective if our digestion is working well. If you experience bloating, wind, spots on the forehead, cramps, diarrhoea and/or constipation then your digestion isn’t up to speed and you may not be accessing/assimilating the supplements you are taking.
- Complying with an anti-candida diet – simple sugars such as lactose and fructose should be excluded, refined carbohydrates should be eliminated and wholegrain carbohydrates reduced. Avoid yeast, fermented products, refined carbohydrates and stimulants. It is stated that an anti-candida diet should be maintained for a year to consolidate newly corrected healthy gut flora. Avoid all sources of sugar, including fruit for the first month and yeast containing foods such as alcohol and vinegar. Avoid yeasted breads, pastries and pastas, processed and packaged including breakfast cereals, caffeine, condiments, mushrooms, malt products, dried and candied fruit, processed and smoked meats, luncheon meats, sugar and foods containing sugar. Vegetables, grain, beans, lentils, nuts and seeds can be eaten in plenitude.
C. albicans is parasitic yeast which can overpopulate areas of the body causing health problems and inflammation. It gains nutrition via enzymes, creating toxins which can add to symptoms. Diet is essential in the treatment of yeast overgrowth. Supporting homeostasis and redressing health imbalances a slow and painstaking process. Ecosystems observed in nature are delicately balanced and the same applies to the hundreds of different microflora found in the gut. Taking responsibility for certain actions and restraining from using several conventional medicines will help the situation, but immunosuppression of any kind, such as stress, can cause a relapse back to its original dysbiosis. Adherence of several factors including supporting the immune system enabling repair, eating nutritionally balanced whole foods, using anti-fungal agents and repopulating the intestine with non-pathogenic microflora are stringently required.
Table of foods in the western diet which weren’t available to pre-agricultural society
Copied from: Cordain, L. Eaton, S. Sebastian, A. Mann, N. Lindeberg, S. Watkins, B. O’Keefe, J. Brand-Miller, J (2005) ‘Origins and evolution of the Western diet: health implications for the 21st century.’ American Society for Clinical Nutrition. [Online] 81(2) 341-354 Available from: http://www.ajcn.org/content/81/2/341.full [Accessed 3rd January 2011]
Bauman, E (2009) Women’s Eating Habits & Health Concerns: Nutritional Support for Balancing Weight, Mood & Menopause. [Online] Available from: http://www.baumancollege.org/pdfs/articles/WomensEating.BCArticle.01-29-09.pdf [Accessed 11th January 2011]
Bellamy, I. MacLean, D (2005) Radiant Healing: The Many Paths to Personal Harmony and Planetary Wholeness. Australia. Joshua Books.
British Nutrition Foundation (2009) Carbohydrate. [Online] Available from: http://www.nutrition.org.uk/nutritionscience/nutrients/carbohydrate [Accessed: 5th January 2011]
Chaitow, L (2003) Candida Albicans. Great Britain. HarperCollins Publishers.
Chandramohan, S (2007) Pharmaceuticals in our drinking water. [Online] Available from: http://www.pharmainfo.net/reviews/pharmaceuticals-our-drinking-water [Accessed 14th January 2011]
Cordain, L. Eaton, S. Sebastian, A. Mann, N. Lindeberg, S. Watkins, B. O’Keefe, J. Brand-Miller, J (2005) ‘Origins and evolution of the Western diet: health implications for the 21st century.’ American Society for Clinical Nutrition. [Online] 81(2) 341-354 Available from: http://www.ajcn.org/content/81/2/341.full [Accessed 3rd January 2011]
D’Adamo (2006) Candida Albicans Infection, ABO and Secretor Blood Groups. [Online] The Individualist. Available from: http://www.drpeterjdadamo.com/wiki/wiki.pl/Candida_Albicans_Infection,_ABO_and_Secretor_Blood_Groups [Accessed: 7th January 2011]
DeWille, J. Fraker, P. Romsos, D (1979) ‘Various Levels of Dietary Polyunsaturated Fatty Acids on Humoral Immunity in Mice’ Journal of Nutrition 109 (6) 1018-1027
Fox, B. Cameron, A (1991) Food, Science, Nutrition and Health. Fifth Edition. Great Britain. Mathematical Composition Setters Ltd.
Galland, L (1984) ‘Nutrition and Candidiasis’ Journal of Orthomolecular psychiatry. 14(1) 50-60
Holford, P (2001) Improve Your Digestion. Great Britain. Phoenix Photosetting.
Holford, P (1997) The Optimum Nutrition Bible. Great Britain. Judy Piatkus Publishers Ltd.
Lemar, K. Passa, O. Aon, M. Cortassa, S. Muller, C. Plummer, S. O’Rourke, B. Lloyd, D (2005) ‘Ally alcohol and garlic (Allium sativum) extract produces oxidative stress in Candida albicans. Microbiology. 151 (10) 3257-3265
Oliver, S (2000) Banish Bloating. Great Britain. Simon & Schuster UK Ltd.
Scanlan, B.J. Tuft, B. Elfrey, J.E. Smith, A. Zhao, A. Morimoto, M. Chmielinska, J.J. Tejero-Taldo, M.I. Mak, I.T. Weglicki, W.B. Shea-Donohue, T (2007) ‘Intestinal Inflammation caused by Magnesium Deficiency Alters Basal and Oxidative Stress-Induced Intestinal Function’ Molecular and Cellular Biochemistry. JUl27 [Epub ahead of print]
Wright, B (1996) Cycles of Disease and Health. [Online] Colon Health. Available from: http://www.positivehealth.com/article-view.php?articleid=479 [Accessed: 10th January 2011]
The menopause is a natural part of female life and women should take it as an opportunity to reassess diet and lifestyle. It is defined by a woman going for one year without a menstrual period. There are three phases to the menopause; the peri-menopasue – menopausal symptoms leading to the eventual cessation of menstruation, the menopause – the absence of menstruation for a full year and post-menopause – the cessation of menstruation and sex hormones from the ovaries. Menstruation can be irregular due to the sex hormones oestrogen and progesterone fluctuating and eventually declining the transition of which may last up to 5 years. Genitourinary tissues are oestrogen dependant and symptoms during this transitional period can vary in intensity and frequency from person to person. Variable symptoms include hot flushes, changing moods, irritability, depression, cognitive changes, vaginal dryness, decreased libido as well as pain during sexual intercourse, reduced energy, sleep disturbances and weight gain. Tissue atrophy due to lack of oestrogen can also increase the risk and frequency of infections, increase urgency and pain during urination as well as cause stress incontinence. Are you experiencing the menopause – do any of these symptoms fit with how you are feeling?
The menopause is perceived as a deficiency disease – something which I disagree with, it is a natural part of female life!! The conventional medical approach to treating menopausal symptoms consist mainly of prescribing hormone replacement therapies (HRT) which are external sources of hormones possibly equine in origin (from horses!!). Studies have proposed that HRT may only be beneficial for first 16 weeks before becoming no different to placebo and side effects of prescribing oestrogen replacements include increasing the risk hormone affected cancers as well as gall bladder disease and thromboembolic disease. Progesterone replacement can increase cholesterol levels, oedema, weight and bleeding.
It is recommended that more foods containing phytoestrogens should be included in the diet during the transition from mother to wise women as they can help to reduce the frequency and severity of hot flushes. Epidemiological studies show low incidences of breast cancer where there’s a high intake in soy. Phytoestrogens can be classified as isoflavones and lignans and are diphenolic compounds, the phenolic ring can bind to oestrogen receptors mimicking oestrogen. Isoflavones are found in soy, pulses, cereals and legumes – and although isoflavones are beneficial I tend to recommend that people reduce the amount of cereals, beans, soy and pulses in their diet as they can cause inflammation. Lignans are found in seeds, cereals, fruit, vegetables and grains such as alphafa – more accessible and digestible food items (minus grains). Flaxseed and evening primrose oil are also oestrogenic.
Oestrogenic herbs can also contain phytoestrogens. They work differently from pharmaceutical drugs and are deemed safer by alternative practitioners such as herbalists and nutritionists as they don’t flood the body with external hormones; instead they seem to help the body utilise the oestrogen and progesterone available more efficiently rebalancing the tissue state naturally. Biochemically they bind to oestrogen receptors and can induce transcription of oestrogen responsive genes. I have written about the biochemical effects oestrogenic herbs can have on the body which you can access towards the end of this blog. Oestrogen has a physiological action on reproductive tissues and on bones, the central nervous system, and the cardiovascular system. Phytoestrogens show weakly oestrogenic activity, can conserve bone and show antibacterial, antifungal, antiviral, and anti-carcinogenic actions as well as reducing cholesterol.
Phytoestrogenic plants can help to stabilise a woman’s hormones. Herbs with hormone normalising phytoestrogens include evening primrose oil, red clover – Trifolium pratense, liquorice root – Glycyrrhiza glabra, agnus castus – Vitex agnus-castus, hops – Humulus lupulus, oats – Avena sativa, elder – Sambucus nigra, and sage – Salvia officinalis there are hundreds of plant sources. Evening primrose oil is hormone regulating, containing alpha and gamma linoleic acid which contribute to the reduction of vasomotor symptoms such as hot flushes; essential fatty acids are used to relieve menopausal symptoms. Liquorice demonstrates oestrogenic activity and can be relaxing or stimulating, energetically it is cooling and moist.
Red Clover demonstrates oestrogenic activity but scientific studies show positive and negative results on its effectiveness to reduce menopausal symptoms. I think that this may be due to how the studies were executed, the number of people in the study and their lifestyles and choices prior to undertaking the study. Variables can include a multitude of everyday choices including what they ate, previous health, family history and levels of stress at the time of the study. The solidity of the study will come under scrutiny too – is it a placebo, double blind study? I also feel that the social views of the people who ran the studies should be taken into account. Hot flushes occur most frequently at night and affect up to 80% menopausal women they can last up to 4 minutes but feel like longer when women experience them. In a positive study of red clover a reduction in number of hot flushes was seen compared to placebo but only showed a statistical difference when documented, explanation of the results included to be coumestin a compound of phytoestrogen. Care should be taken when using red clover as it contains coumarins and can affect warfarin intake. Dosage can be 12g of dried herb or equivalent daily.
Dong quai – Angelica sinensis is a hormone regulator that doesn’t contain phytoestrogens. It enhances the body’s endogenous oestrogen production to help to address symptoms including hot flushes and sweating. Prescriptions can treat painful or suppressed menstruation and hot flushes and relieve menopausal depression and anxiety especially if symptoms are related to deficient kidneys. Mixed results in several studies include statements that dong quai is no different to placebo. The herb may potentiate warfarin and caution should be taken if patients have oestrogen sensitive cancers. Dosage is 4-6ml tincture three times daily.
Uterine tonics can be given during the menopause to support reproductive organs and tissues whilst physiological and endocrine changes take place. Vaginal dryness is a common complaint during the menopause; uterine tonics would assist to reduce this discomforting issue with vulneraries. Amphoteric herbs improve the tone of the uterus, regulating bleeding; dong quai is amphoteric. Uterine stimulants improve the tone of the uterine muscles and tissues and include the herbs yarrow – Achillea millefolium, mugwort – Artemisia vulgaris and agnus castus. Other uterine tonics are black cohosh – Cimicifuga racemosa, motherwort – Leonurus cardiaca and raspberry leaves – Rubus ideaus.
Motherwort is a moderate strength relaxing uterine tonic, anti-spasmodic, carminative and emmenagogue. It can be a relaxant or stimulant dependant on the needs of the body and is defined energetically as cooling and drying. Motherwort is a cardio-tonic an action supported by flavones. It supports the heart and circulation, stimulates and strengthens the liver and is prescribed to reduce hot flushes, regulate hormones, relieve anxiety and reduce palpitations.
If the menopausal patient experiences anxiety or tension relaxing nervines can be utilised. Nervines can also relieve menopausal symptoms including forgetfulness, nervousness, weepiness, irritability, lack of concentration, anger, excitability and panic attacks. Nervine relaxants work directly on the nervous system reducing stress and putting the person at ease. When prescribing, each patient need to be treated as an individual, secondary actions and medicinal uses of herbs should be taken into account. Relaxing nervines include: lemon balm – Mellissa officinalis, chamomile – Matricaria recutita, lime flowers – Tilia x cordata, passionflower – Passiflora incarnata, skullcap – Scutellaria lateriflora, St Johns wort – Hypericum perforatum and wild yam – Dioscorea villosa.
Wild yam contains diosgenin, a steroidal sapogenin; clinical studies have found that the body can convert this into progesterone and dehydroepiandrosteron (DHEA) which is a 19-carbon natural steroid hormone. Its phytoestrogens can relieve night sweating, hot flushes and regulate hormones. Wild yam’s sapogenin content helps to relieve spasms, dysmenorrhea and uterine pain.
Anti-depressant herbs can relieve hormone-related depression and anxiety experienced during the menopause. This phase of life affects a woman physically, mentally and emotionally, when experiencing depression during the menopause insomnia, poor appetite, weight loss and low energy can be experienced. Antidepressant herbs include oats, ginseng – Panax quinquefolius, lavender – Lavendula angustifolia, rosemary – Rosmarinus officinalis, St John’s wort, vervain – Verbena officinalis and black cohosh. Clinical studies have shown that St John’s Wort does relieve mild to moderate depression in menopausal women.
Bitters are effective medicines; energetically they are cooling and drying, stimulating digestive secretions throughout the body. Prescribed generally for the menopause as a stimulant, digestion is a vital function of the body and it’s efficiency impacts on our health. Bitter can also improve water retention or depression related to a sluggish digestion. Several bitter herbs include: barberry – Berberis vulgaris, boneset – Eupatorium perfoliatum, dandelion – Taraxacum officinale, feverfew – Tanacetum parthenium, goldenseal – Hydrastis canadensis, holy thistle – Cnicus benedictus and mugwort.
Dandelion is useful as a diuretic reducing water retention. Energetically, dandelion is cooling and drying with tonic and astringent properties.
Herbalists such as myself can prescribe restorative, supportive and nutritious herbs such as oats and nettles – Urtica dioica. Both herbs can assist women going through the menopause. Oats helps to strengthen the nerves, promote sleep and reduce stress levels as well as nourish the bones. Nettles strengthen the adrenals but also supports the liver and kidneys, reduces anxiety and night sweats too. Energetically nettles are cooling and drying, a true stimulant with tonic and astringent actions.
The menopause varies in severity from person to person due to many biopsychosocial factors including diet, exercise, personality type, size, lifestyle and levels of stress; stress can deplete the adrenal glands and affect their functioning. Herbs like Ashwaganda – Withania somnifera can restore adrenal balance acting as a tonic for overworked people improving general and sexual debility supporting the adrenals during their “resistance” and “exhaustion” phases. Other Adaptogens that can benefit women during the menopause includes liquorice, Siberian ginseng – Eleutherococcus senticosus, schisandra – Schisandra chinensis, wild yam and astragalus – Astragalus membranaceus; all help restore the adrenal glands. Astragalus works as a vasodilator and schisandra supports the liver as well as the adrenals and improves memory, mood and sleep.
Research on ginseng has shown benefits improving sleep, mood and sense of wellbeing. Energetically it is a true relaxant herb with tonic properties. Hong Sam Red Ginseng is the root is steamed prior to being dried; this form of the herb is effective in the treatment of mild-moderate perimenopausal symptoms. Results can be dependent on the correct prescribing of ginseng: P. quinquefolius contain phytoestrogens which can be converted into female hormones whilst regulating immunity, P. ginseng’s phytoestrogens can be converted into male hormones and is hypertensive and Eleutherococcus senticosus doesn’t show hormonal qualities.
As a specific remedy there is a lot of clinical research on black cohosh – Cimicifuga racemosa doesn’t contain phytoestrogens but assists to balance oestrogen levels, reduce menopausal symptoms and improve emotional states. Positive results have been reported from clinical studies on its effectiveness in reducing menopausal symptoms. The herb may cause headaches and stomach upsets and shouldn’t be given to women with liver disease due to its possible hepatotoxicity; the dosage is recommended at 40-80mg daily for no more than 6 months.
Black cohosh can help to alleviate vasomotor symptoms such as hot flushes and sweating. Black cohosh corresponds medicinally to the reproductive system and it’s relaxing or stimulating adapting to requirements. It is a moderately strength relaxing nervine, alterative, antispasmodic and diaphoretic herb. It is used successfully in treating hot flushes in cancer patients, the active constituents include terpenes and glycosides which may function as Selective Estrogenic Receptor Modulators. The oestrogenic effect is due to its physiological activity on serotonin receptors in the body and may explain hot flushes and mood improving. Black cohosh doesn’t stimulate breast or uterine tissue; the mechanism may be via stimulation of the central nervous system. It is proven to be as effective as oestrogen in the reduction of menopausal symptoms and better than placebo at reducing flushes. Clinical trials have shown improvement in hot flushes, sleep disorders, sexual dysfunction and sweating, although side effects can include gastrointestinal disturbances, bradycardia, headaches and nausea.
There are many other herbs which can support a woman through the transition of the menopause. Herbs prescriptions should be tailored to the individual’s case history and health requirements. The menopause can be viewed energetically as a hot condition with symptoms varying from wet (hot flushes) to dry (vaginal moistness). Many strategies can be utilised to ease the patient from peri- to post-menopausal and care is needed when mixing oestrogenic herbs and pharmaceutical oestrogenic hormone replacement. Women with hormone-dependant cancers such as breast cancer or with any contraindications to HRT or venous thromboembolism should consult a professional when using oestrogenic phyto-medicinals. Herbs without phytoestrogens are available to support the patient including several bitters, adaptogens and uterine tonics. Although scientific studies can be found to discredit several of the herbs mentioned research into herbalism isn’t extensive enough. The use of herbs in the treatment of menopausal symptoms addresses social, emotional, physical and mental factors; symptoms which cannot be measured empirically. The vulnerability of osteoarthritis and countless herbs haven’t been mentioned in this blog, this isn’t to disvalue them, herbal medicine can support and balance women offering preventative options for osteoarthritis and many other symptoms associated with menopause.
Traditional Chinese Medicine diagnoses
Traditional Chinese Medicine (TCM) is used to treat menopausal symptoms, their diagnosed definitions of menopausal women include:
Kidney yin deficiency: The most common diagnosis, women suffer with hair loss, light vaginal discharge, vaginal dryness, dizziness, hot flushes, night sweats and insomnia among other symptoms. Their tongue is red with a light coating and their pulse is thin and rapid.
Liver qi stagnation: Women experience irritability, hypochondriac distension, constipation, palpitations, insomnia and emotional instability. Their tongue is red with a thin yellow coating and they have a wiry pulse.
Blood deficiency: Women suffer with dizziness, hot flushes, sweating and insomnia, dry skin with a sallow complexion, emotional instability and myalgia. Their tongue is pale with a thin coating and they have a thready pulse.
Uprising deficiency heat: Menopausal women who suffer with severe night sweating, hot flushes, irritability, dizziness and nervousness. They have a red tongue with a thin coating and a thready rapid pulses.
Kidney yang deficiency: This is the least common diagnosis in TCM and women experience heavy menstrual bleeding or ceased menstruation, soreness, oedema of face and limbs, cold limbs and appearance, loose stools, polyuria and urinary incontinence. Their tongue is pale with a thin coating and their pulse is deep thready and weak.
Biomedical physiological effects of herbs on the body during menopause
There are several ways in which phyto-medicinals can support and influence the body to improve symptoms and rebalance homeostasis:
- Herbs can bind to oestrogen receptors in the body and include: Pimenta dioica, Artemisia absinthium, Plantago major, Tanacetum parthenium, Hibiscus sabdariffa.
- Herbs can induce transcription of the oestrogen responsive reporter genes and include: Pimenta dioica, Artemisia absinthium, Plantago major, Tanacetum parthenium.
- Herbs can induce transcription of (oestrogen responsive genes) pS2, PTGES and PR and include: Pimenta dioica, Tanacetum parthenium Smilax domingensis, Artemisia absinthium.
- Herbs can modulate the effects of estradiol on (oestrogen responsive genes) pS2, PR and PTGES expression and include: Smilax domingensis, Pimenta dioica, Artemisia absinthium, Plantago major, Hibiscus sabdariffa.
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