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MEDICINE & HERBS--ENEMIES OR ALLIES?

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ZIGGY ENJOYS BEE POLLEN

HERBS FOR TEA
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REISHI, ASTRALAGUS, PORIA, AND OTHER HERBS

TRUTH IS IN THE MIDDLE OF THE ROAD
 
I'd better add this edit, since some of the cognitively impaired among us have misinterpreted the title. There is no "middle of the road" when it comes to most medical situations, such as vaccination. If there's a vaccine for it, for instance, you get the vaccine, no ifs, ands or buts.

I happen to be a great admirer of chemistry, and, especially, of the chemistry of natural products. I consume an herbal extract every single day, an herbal extract that isn't even standardized. Horrors! Even more frightening to some, this extract is used by people all over the world, and has been used for centuries, probably millennia. There was anecdotal evidence all this time that this particular extract would have certain effects, and people consumed it, without a prescription. You can even buy it at grocery stores. This herbal extract is called coffee. A similar extract is called tea. Another type of extract that is common in many kitchens is called "broth."

If I have a medical problem, I go see a doctor. But, from examining the literature, it appears to me that there are certain things I can do dietarily that will improve my odds of remaining healthy. Pharmaceutical substances are wonderful for treating various conditions. I take metformin, for instance, and, unlike an herbal tea, it does exactly what I want it to do: it has a defined benefit (and even possible benefits well beyond what it is prescribed for.) I don't have to guess. I don't have to worry about whether that particular batch of herb has the chemical in it that I want or not, or whether it might have chemicals in it that I don't want. I would not trade it for some Billybob's magic herbal mixture. But botanicals can be considered nature's pharmacy--and metformin is an analog of such a botanical, from the French lilac plant--and some of those plants contain incredibly wondrous chemicals that I want a little of in my diet.

 
Some plants, like amanita mushrooms, are so potent that they can actually kill you, and some herbs, like ephedra, can be life-threatening when used improperly. Although the FDA and the medical profession recognize how potent plant chemicals can be, for the most part they refuse to recognize that some plain, simple herbs can be used either separately or adjunctively to treat common (and uncommon) ailments.
 
According to traditional medical thinking, herbs are too strong and dangerous for you to use, but they are, at the same time, somehow or another, too weak to have any effect on disease.
 
This thinking deprives us of health care options. If you are poisoned by amanita mushrooms, for example, you won't find the best antidote (an intravenous milk thistle extract) in American emergency rooms. If you ever suffer from amanita poisoning, charter a jet and fly to Europe, where you will receive sane treatment.  In his blog, Terra Sigillata, "Abel Pharmboy"--a nom de plume for a biomedical educator--describes the problems of dealing with medical bureaucracy in the case of treating amanita poisoning, a description well worth reading. Legalon, a patented soluble milk thistle derivative (silibinin hemisuccinate) from the German company Madaus AG, is available in European emergency rooms, and is standard treatment for amanita poisoning. It has been available since 1984. The Santa Cruz Sentinel article that describes the ordeal those two different California families went through to get their treatment is at http://www.santacruzsentinel.com/ci_11432584.
 
The same thinking that deprives us of access to many of nature's cures also deprives us of health care information. Not long ago, the FDA used your tax dollars to protect you against the "menaces" of cherry growers and walnut growers, who had been publicizing the results of scientific studies about the health benefits of those foods.  The FDA banned the growers from posting that information on their websites, and threatened to confiscate the foods as "drugs." This is the same FDA that turned a blind eye to the dangers of such drugs as Vioxx until those dangers were shoved in their faces.  You can't help but wonder what kind of whiskey is in the FDA's water supply; it might be better to ask if there is any water in their whiskey supply.

I am not an "herbalist," in the traditional sense, although I do use herbs. If you were to dry some carrots and powder them, you could probably take the powder to some place where carrots don't grow and market it, legitimately, as an "herb" or a "health" food. That doesn't mean that you now have to stop eating them because they have magically morphed into an "herb." Most herbs are nothing but foods or spices relabeled. I don't run around looking for some herb that, say, has a flower or leaf resembling a human organ in order to treat afflictions of that organ. Nor do I hallucinate that there is some kind of "chi" that bebops around inside the human body along invisible "meridians," or that this "chi" or "qi" can be augmented or diminished by various herbs, which is what practitioners of Traditional Chinese Medicine (TCM) believe.

You have to understand that, sometimes, these traditional systems are right for the wrong reasons. A bunch of tribesmen didn't sit down over a campfire thousands of years ago and then decide that there existed something called "chi," and that disturbances of this "chi" caused diseases, which could be treated with, among other things, various herbs. What happened is that they had been using herbs long before such fantasies were created: even animals do that, in what is called zoopharmacognosy, self-medication. Animals don't have any "systems of belief" to explain what they're doing. Systems of belief came along to explain why some things appeared to work and other didn't. I will guarantee you that if you have high blood pressure and you chew some rauwolfia root, it will lower your blood pressure, regardless of what you believe. If you're tired and listless, I would guarantee that a little tobacco leaf or coffee would change that rapidly, regardless of what fantasies you might have about the plants.

So those who denigrate traditional systems of "medicine" because of those systems' various fantasies about why, say, a certain herb works to treat a particular disease, are committing an egregious intellectual error. These systems may not be correct; they may be totally ludicrous. But look at it this way: Ptolemaic astronomy, in which the earth was the center of the universe, was incorrect--yet it could be used to accurately calculate the motions of the sun and moon. It was right, to within the accuracy of the day, but for the wrong reasons. Think about it like this: suppose your physician explains to you that the penicillin injection he's about to give you will cure your disease because it will placate the earth god, which you have angered. Would that keep the penicillin from working, or invalidate his protocol? Many well-meaning skeptics are totally blinded to the "right for the wrong reason" possibilities when it comes to explaining the protocols of "traditional" systems of medicine.

Plant materials are dilute mixtures containing chemicals, which have varying degrees of bioactivity. Some may be toxic, some may have nutritional benefits, some may have medicinal effects. If some plants contain chemicals that are so powerful that they can kill you, is it not equally likely that there exist plants that contain chemicals that could heal you? No sane person could argue otherwise.

I am no enemy of doctors.  I was born prematurely shortly after WWII and would likely not have survived had it not been for the medical profession, nor would I have been likely to survive other afflictions of my childhood, such as pneumonia and whooping cough, without the help of modern medicine.  I would have been dead many times over had it not been for medicine. When I was little, I had to keep an injectable dose of epinephrine handy at home. More recently, I have survived cancer and HCV. 


So don't accuse me of warring against medicine.  I despise idiocy of all sorts, whether on the part of health food wackos or on the part of "mainstream" medicine. I agree with Richard Dawkins: "there is no alternative medicine. There is only medicine that works and medicine that doesn't work." I despise the NCCAM for wasting money testing so much snake oil, while I despise traditional medicine equally for ignoring valuable medicinal herbs for too long. Those people in California shouldn't have had to go through that nightmare just to get Legalon; that's absurd.
 
I try to help fight a war against uncritical thinking, regardless of which "side" it might be on. We need a little more skeptical thinking in the world. Just look at the late night infomercials on "health" topics. I don't blame diseases on the presence of decades worth of gunk that supposedly accumulate in your colon ("death begins in the colon") as some ads and infomercials claim. It might be that, among the billions of humans on our planet, there are one or two individuals who do have residues of food they ate a year or two ago inside their colons, due to some kind of physiological abnormality, but the idea that you or I could be walking around with partially digested food inside us that we ate years ago has to be pure fantasy: yet some people believe it, and spend their good money on it, possibly ignoring a serious health condition to their detriment. See my Opinions page for comments on homeopathy and other absurdities.
 
What difference could it make if the substance that heals you comes from a pharmaceutical company or from a plant?  Medicinal mushrooms, such as reishi, maitake and shiitake, are promoted by many as having a miraculous power to stimulate the human immune system: I wouldn't go that far, but, whatever they do, which may involve modulation of various bodily systems, including parts of the immune system, has nothing to do with miracles. It can all be understood scientifically--i.e., there exists a rationale for it. If there exists a reasonable amount of empirical evidence to suggest that it might be beneficial in a particular instance, one does not need to know the mechanism to take advantage of it. You don't have to know how a helicopter operates to take advantage of one hauling you off of a mountain peak where you've gotten stranded. 
 
Your own immune system is often, but not always, the best defense against pathogens. However, when doctors run into an "untreatable" infection, such as MRSA, I continue to be puzzled as to why they don't try treating their patients with substances such as medicinal mushrooms in addition to antibiotics.
 
A different approach in such cases, either as adjunct or separately, would be to use medicinal honeys, an approach that has been slow to regain favor with mainstream medicine, due to the elements of quackery long associated with honey. Yet honey, no different than plants, contains phytochemicals of varying activity, depending on the plants of origin, and obviously some are bound to have some physiological activity. Honey from toxic plants is known to be dangerous to humans, so much so that historical records indicate that honey was used during the 1st century BC as a biological weapon:
"About one thousand of Pompeii's Roman troops were passing through a narrow mountain pass when they encountered a cache of honey. The soldiers, accustomed to raiding and looting to augment their provisions, halted their advance and eagerly devoured the honey-- and soon became afflicted with delirium and violent seizures of vomiting and purges! In such a condition they were easily defeated by the local Heptakomete defenders who took their cue to attack."  (https://m.reddit.com/r/AskHistorians/comments/2y5t9y/have_bees_ever_been_used_in_warfare/
There is laboratory evidence that certain honeys, such as manuka, are active against MRSA and other pathogens; go to PubMed or Google scholar, type in "manuka MRSA" and study the results. Kwakman, et al, for instance, discovered that, "After 24 hours of incubation, both honeys killed all tested bacteria, including methicillin-resistant Staphylococcus aureus, but manuka honey retained activity up to higher dilutions than RS honey" (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0017709).
 
When doctors limit themselves to their "standard" arsenal, they have to bemoan the fact that they have nothing with which to treat the disease as they watch their patients die.
 
If I were to become infected by an antibiotic-resistant microbe, I would be eternally thankful that doctors would have on hand antibiotics of last resort, such as Vancomycin: but, if those didn't work, I would be cursing those same doctors for not looking beyond their standard arsenal. I'm a great fan of evidence-based medicine and on making risk/benefit evaluations based on evidence. But when death is the only alternative, logic would dictate that one should make judgments based on less evidence. My general philosophy is that, if it is unlikely to hurt, but there's a strong indication, regardless of the source of this "indication," that something might help, then one should try it. If the hitherto-undiscovered aboriginal tribe called Beboppers, who live on the island of Neverland, have been using the borogove plant for thousands of years to treat recalcitrant infections, then I would say, go for it. There's no law that says that you can't search the literature, such as at http://www.ncbi.nlm.nih.gov/pubmed?term=maitake.

If I came down with that same infection while stuck in a jungle somewhere, I would be eternally thankful to the witch doctor or other native healer for using whatever jungle herbs were available, but I would be cursing that witch doctor for waving off the helicopter carrying a western doctor come to treat me.  If you're fighting a war, you don't ask, should we use the army or the navy, you use them both.  These two universes of treatments are not mutually incompatible, although individual practitioners invariably look at it that way.  I say, let's take the best of both universes.
 
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DRIED GANODERMA LUCIDUM ("LING ZHI"), ALSO KNOWN AS REISHI

CAUTION
 
I've mentioned substances that affect the immune system, and I've joked about those who promote various "miracle" immune stimulants. In contrast, those who fight quackery sometimes engage in their own bouts of stupidity in this regard. Some are now contending that it is impossible to stimulate the immune system. Well, I hate to tell them this, but that's what a vaccine does. Logic would also dictate that, since substances that repress the immune system exist, there would necessarily have to exist substances that have the opposite effect. Non-specific immunostimulants, including adjuvants, do exist. The drug imiquirmod is an immune stimulant, for instance: see http://onlinelibrary.wiley.com/doi/10.1046/j.0366-077X.2003.05628.x/abstract. Let's not deny facts simply to fight quackery. 

The problem is that, in the case of a patient with an autoimmune disorder, such as arthritis, you would not want to stimulate that part of the immune system responsible for the disorder. There are, however, so many different medicinal mushrooms (as well as herbs like astragalus) with such a range of activity that it ought to be possible to choose agents that do not aggravate the autoimmune problem.

Immune stimulation is not a panacea: it would have to be carefully considered--if at all--when part of the reason for the pathogen's virulence is the fact that it causes an over-reaction of the immune system, as in the case of the 1918 Spanish flu.  Immune stimulation can also backfire if the antibodies created to attack cancer cells also attack non-cancerous cells.
 
In addition, one would have to consider whether other side effects might exist.  Although having been used for millennia in the Orient, and generalized recognized as safe (GRAS), medicinal mushrooms--and, it appears, even culinary mushrooms--need to be scrutinized carefully. There is a 2006 report in the Japanese Journal of Clinical Oncology which suggests that extracts of a Brazilian mushroom, Agaricus blazei, produced by a Japanese chemical company and widely used in Japan, may have been responsible for severe liver damage in three cancer patients, two of whom died. Agaricus blazei contains small amounts of a highly toxic substance called agaritine, a hydrazine derivative, that is most likely responsible for the injuries (if the injuries were, in fact, due to the mushroom.)  If you insist on taking the substance, try buying a standardized extract from a reputable company such as Fungi Perfecti. 
One also needs to worry about artificial contaminants, such as pesticide residue or heavy metals, but these naturally produced toxic metabolites are especially concerning. Agaritine is a member of a class of chemicals called hydrazines, many of which are carcinogenic, in addition to being toxic in their own right. One researcher at the Eppley Institute for Research in Cancer in Nebraska, Bela Toth, has been publishing papers for about 40 years on carcinogenic substances found in plain old button mushrooms from your grocer. Your plain old normal button mushroom contains agaritine also; Toth states, "The common cultivated mushroom of commercial Agaricus bisporus contains relatively large amounts of the hydrazide...[agaritine]...an average-sized mushroom (15 g) could contain 45 mg of agaritine."  (http://pubs.acs.org/doi/abs/10.1021/jf00111a028)
 
In 1995, Toth stated, "It is apparent that a series of these chemicals, as well as the feeding of two raw mushrooms, induce many cancers in experimental animals....Thus far cancer epidemiologists have not initiated any research in revealing the effect of mushroom consumption in humans....At present, there is no reason for the public to panic." Agaritine is just one of the compounds in question, but its concentration is reduced in cooking, and it is not found in canned mushroom soup. Strangely enough, nobody seems to have paid attention to this remarkable series of papers, published in reputable journals such as Int J Oncol, J Agric Food Chem, Br J Cancer, Cancer Res, Food Chem Toxicol, Carcinogenesis, etc.
The polysaccharides in a. blazei are highly promising medicinals, but an improperly purified extract might be lethal, so I would avoid the species for now unless you buy the most expensive extract from the most reputable company.  The presence of these compounds is a powerful argument for using mushroom extracts instead of mushrooms, although, since hydrazines are not the most stable compounds on earth, simple cooking will perform a certain amount of detoxification. (Word to the wise: don't eat raw button mushrooms, such as are sometimes served with salads.) You may recall the 1989 scare over tryptophan when the FDA pulled it off the market; a number of people died from a blood condition called eosinophilia-myalgia syndrome that was eventually traced to an impurity in the tryptophan produced by a Japanese chemical company.
 
I have used maitake and reishi mushrooms off and on for a number of years; I buy the dried mushrooms by the pound.  Both mushrooms have benefits other than immune stimulation, including benefits to the cardiovascular system.  Reishi does increase blood-clotting time but it also lowers high blood pressure. 
 
Be careful when using the internet for "research," as many are prone to do: the majority of websites that discuss anything alternate when it comes to cancer treatment seem to be way out in la-la land.  I have my own hints for cancer patients as a Google website, but it deals with how to handle standard therapy and discusses some of the issues that don't get emphasized during regular treatment.
 
If you want to know the facts about a substance and its potential in treating a particular disease, use the search engine at PubMed; and type in the name of the disease and then the name of whatever it is that you think might be used in its treatment.  PubMed is a biomedical database for citations in MedLine and other resources.  The fact that there exists folk or anecdotal evidence for something not listed there does not mean that we should ignore it; we might never have known to study some substances, such as turmeric, that turned out to contain anti-inflammatory and even anti-cancer chemicals, had it not been for the fact that some scientist decided to see if there was any rationale behind its traditional usage.  On the other hand, if we blindly followed traditional usage, we might be using cinnabar--toxic mercury ore--to treat diseases, since that was part of Traditional Chinese Medicine; it might have short-term efficacy against something such as certain venereal diseases, but I don't think that you really want to be consuming mercury compounds. So you have to take the fact that something has been used for millennia with a grain of salt: the fact that people used it and passed the tradition of usage down from generation to generation doesn't mean that it has any effect at all, or even that it might not be harmful.  But you also have to realize that science has not studied everything yet.

Health food wackos love to jump on whatever jungle herb bandwagon is being hyped. You'll think twice about abandoning traditional medicine, though, when you look at the longevity statistics of those who live where those jungle herbs originate.  Native American populations were decimated by various diseases brought by the Europeans when they arrived centuries ago; the herbs and incense provided by their shamen did little good. A paleolithic diet does not defend you against smallpox.  It would not be difficult to imagine the difference that vaccines and antibiotics would have made, had they existed and been available then.

VARIETY IN THE DIET
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AN OLD-FASHIONED WAY TO GET ENOUGH ANTI-OXIDANTS

YOUR DOCTOR IS NOT YOUR ENEMY

 

Physicians often face the problem that many patients hide their use of "alternative" medicine because the patients know that many doctors are prejudiced against it. This can result in expensive, life-threatening complications, the most common probably involving the consumption of herbs that prolong bleeding time. This is doubly unfortunate because such complications reinforce the prejudice most physicians have against alternative medicine.

Cancer patients in particular are usually advised not to mix treatments.  Doctors do actually have a rationale sometimes when they tell you not to do somethingFor example, there are numerous chemicals and natural substances, such as soy, that increase your body's resistance to the effects of radiation.  But if you are being treated with radiation, the whole point is to kill certain cells; you don't want to be taking anything that helps the cancer cells survive Since all cancer cells by definition have abnormal metabolisms, it MIGHT be that a particular type of cancer cell would not absorb soy at all, and would therefore not be protected. Recent research has unearthed the fact that certain cancers, prostate and lung, are made more sensitive to radiation damage by soy isoflavones, so the advice that doctors were giving all these years about avoiding soy during radiation treatment turns out to be wrong (except when it comes to estrogen-dependent tumors).  Still, since cancers do vary, it might be wise to make sure that this is true of your particular type of cancer before you go running out spending all your money on soy isoflavones.

HERBAL EXTRACTS
 
Epidemiological evidence has led us to conclude that certain plants somehow can help the body fight diseases such as cancer and even to fight the aging process itself.  Populations that regularly consume cruciferous vegetables, such as broccoli, have lower incidences of certain cancers, which leads to the obvious hypothesis that some chemical(s) in the plant must prevent and/or fight cancer.  The main chemical "suspect" for this apparent activity is indole-3-carbinol.
 
It can take decades before such research has definitive results.  In the meantime, health food advocates have started consuming broccoli extracts and even the isolated indole-3-carbinol.  The problem is that the plant does not contain just one compound; cruciferous vegetables also contain sulphorphane, for example, that seems to have a similar effect.  If you take one chemical by itself, you have no idea whether you will benefit or not.  You also have to worry about the potentially adverse effect of too high a dosage.  Organic chemists have been blinded intellectually since they began to study medicinal plants by the idea that a given herb's effects are the result of "the" active ingredient.  This is sometimes true, but it is also possible--indeed likely--that the epidemiological evidence is the result of the combined actions of a complex mixture of compounds (synergy).
 
Our thinking about "the" cause of action often changes over time, as in the case of milk thistle.  Milk thistle has been used for centuries as a liver tonic, and for the last few decades, the extract (MTE) has been a popular health food supplement. At first, it was thought that silymarin was "the" active, beneficial constituent, so herb manufacturers started selling MTE that was "standardized" for "silymarin"--but silymarin is a mixture of several chemicals. Such "standardization" is not necessarily meaningful if the isomers or other components vary in their ratio to each other. These days you can buy supplements standarized for individual component flanonoids, such as isosilybin B and silibin, but it might be a better idea to consume a larger quantity of a cruder extract. 
 
Curcumin products are a perfect example of the benefit of the raw material; not long ago, the Life Extension Foundation changed its standardized curcumin to a product it claims has vastly improved bioavailability over its previous version, which used Bioperine to enhance absorption.  The change: they've added oil components of the raw herb!  In other words, they go to all the trouble to extract "the" active ingredients, then, because the active ingredients by themselves are not very absorbable, they went back to add some of the raw herb back in. (The newer version probably is much more bioavailable, though.)

More recent research gives us turmeric as a perfect example of how wrong this blindness can be to there having to be anything besides a "the" active ingredient. Curcuminoids are not all there is to turmeric; a curcuminoid-free extract of turmeric has been patented, and may be useful in the treatment of osteoarthritis. In an article published in the journal Inflammopharmacology, in December, 2012, Madhu, Chanda, and Saji report analgesic and anti-inflammatory properties from a patented polysaccharide extract of turmeric, Turmacin™. 
  
Curcumin and silymarin are both hepatoprotective, as well as chemopreventive against numerous carcinogens, and both actually interfere with the proliferation of a variety of cancer cells.  Curcumin, for example,  "is able to modulate many components of intracellular signaling pathways implicated in inflammation, cell proliferation and invasion and to induce genetic modulations eventually leading to tumor cell death" (2010 review by Teiten, et al, at http://www.mdpi.com/2072-6651/2/1/128/pdf). On the other hand, "there is accumulating evidence that curcumin may not be so effective and safe...A relatively high number of reports suggests that curcumin may cause toxicity under specific conditions....turmeric caused a dose and time-dependent induction of chromosome aberrations in several mammalian cell lines....there was equivocal evidence of carcinogenic activity in female rats, female mice, and male mice..." (A 2009 letter entitled "The Dark Side of Curcumin," by Burgos-Morón, et al, in the International Journal of Cancer.)
 
Vitamin E is yet another example of how our thinking has changed. We now know that humans and animals need both the alpha and gamma forms of vitamin E.  Most vitamin supplements have none of the gamma form.  Unfortunately, the alpha molecules actually displace the gamma in the body--but the molecules do seem to have different functionality, so that a lack of the gamma isomer might have adverse effects on arterial health. So when you see news commentators telling you that vitamin E is "bad" for you, there is a element of truth in what they are saying: supplementing with the common synthetic mixture of isomers or even the pure d-alpha isomer does have the drawback that the gamma isomer gets replaced (separate from the issue that megadoses of either one, in whatever combination, might not be the sanest thing to consume.) Recent studies have shown that the gamma isomer actually inhibits prostate carcinogenesis in mice (see http://www.ncbi.nlm.nih.gov/pubmed/19115203), which would explain why misled consumers, who consumed only the pure D-alpha form, ended up with a slightly increased risk of that particular cancer. 

There were elements of truth to what some of the far-out pioneers of the "health" food movement were saying all along. But going out and spending all your money on vitamin E to take every 10 minutes is not a wise idea either for a separate reason: we now realize that both the alpha and gamma isomers of vitamin E act as pro-oxidants to HDL cholesterol molecules.  In other words, they make it easier for the "good" cholesterol to be oxidized.  So the question to consider here is BALANCE.
 
Dr. Bruce Ames states, "γ-Tocopherol, the main form of vitamin E in the U.S. diet, unlike α-tocopherol, the main form of vitamin E in supplements, is an effective inhibitor of three different inflammatory pathways cyclooxygenase (COX), LTB4, and TNFα at physiological concentrations, both in human cells in culture and in rats....it is an effective nucleophile, unlike αT, and can inactivate lipid-soluble electrophilic mutagens such as nitrogen oxides. Epidemiological evidence [supports] the importance of dietary γT....γT also is effective in inhibiting prostate and lung tumor cells by interrupting sphingolipid synthesis."
 
 
A similar situation exists regarding vitamins K1 and K2, which turn out not to be bioequivalent.  There is limited evidence that some forms of vitamin K2 can actually reverse calcium deposition in arteries.
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RAW CAT'S CLAW
Many medical professionals espouse the belief that dietary supplements are no good by themselves and that the active vitamins and other nutrients are most effective when they are consumed in their natural state, as part of a food complex (eat your veggies!)  Strangely enough, there are health food wackos who feel the same way.
 
There do exist instances where the isolated nutrient can be harmful.  In the case of soy, for instance, although numerous epidemiological and animal studies have documented a variety of health benefits from unprocessed or minimally processed soy, evidence exists that highly processed soy products and isolated soy isoflavones can actually stimulate the growth of estrogen-dependent tumors.
 
The well-known Harvard Nurses' Health Study of 90,000 women, however, demonstrated the opposite in the case of folic acid: folic acid from supplemental sources was more protective against colon cancer (75% risk reduction among long-term supplement users) than folic acid from dietary sources.  One might easily speculate that supplement users are more health conscious in other ways, which would obviously skew the figures.  I am a little doubtful of any type of research that depends on voluntary reporting of dietary intake to calculate nutritional figures; I don't remember how many servings of anything I had last Wednesday, for example, except for the toast with compote that I share with my parrots. Even if a study's participants are supposed to be keeping a diary of food consumption, I find it difficult to believe that all of them are equally conscientious at keeping their records current and accurate. So I am going to look twice at the results of any study, which, in order for it to be accurate, all the participants would have to be suffering from OCD.
 
There is actually a basis for taking nutrients separately in some cases or with particular other nutrients in others; certain minerals, for example, are more absorbable when chelated.  In other cases, one substance can interfere with the absorption of another, such as fiber binding to fat (the fiber doesn't differentiate between "good" fat and "bad" fat.) 
 
One problem with telling you to just eat your veggies, like your mother told you, is that you can't eat enough of every different veggie to get all of the beneficial compounds that we know about, not to mention that the nutrient content of produce has measurably declined over the last few decades. In addition, it's physically impossible to load up on all the different ones at the same time.  It seems like hardly a week goes by without a news item about a study extolling the virtues of some particular fruit or vegetable. 
 
Doctors don't seem to approve of you taking isolated supplements, but if taking a supplement were always a bad idea, then how could it be so wonderful to take a pure prescription drug? I've never heard of a doctor telling a patient to take a tea made out of foxglove [the plant from which digitalis is derived] instead of prescription digitalis.
 
A reasonable compromise that enables you to get the nutrients you need would be to consume extracts of the plants you are interested in. There is no way to generalize about whether it's better to choose a crude extract, which has numerous constituents, or a standardized extract containing what is thought to be the most active ingredient.  If you standardize the extract for one chemical, you may be discarding something else that is active.  On the other hand, you might be getting rid of toxic substances. Herbalists seem to have a tendency to believe that whatever raw mixtures occur in nature are always synergistic and helpful to us, but this is quite obviously not always true.
 
To make an extract, you usually have to choose either a hydrophilic or hydrophobic solvent to extract the plant's chemicals.  If a plant's activity is due to both types of substances, neither extract will give you full activity.  A water extract, such as tea, obviously won't contain substances that don't dissolve in water.  Even different hydrophilic extracts, such as alcohol and water, can have completely different effects, as in the case of cat's claw.  When the active ingredients are unknown and a single extract is wanted for convenience, the best compromise is an alcohol extract. 
 
ENRICH YOUR FOOD WITH SUPPLEMENTS
THE SAME WAY THEY "ENRICH" WHITE FLOUR
 
Some things, like phosphatidyl serine, need to be taken by themselves on an empty stomach, but in general, I like the idea of supplements being available as part of a food complex.  In the case of non-heat sensitive substances, I like to add supplements to food during the latter stages of cooking.  Milk thistle is particularly well suited for this:  it  is not particularly soluble, and has low bioavailability except when complexed with other substance. 
 
I added MTE to many of my casseroles for years when I was dealing with liver issues (HCV and its aftermath, including fibrosis), but large amounts of it will not dissolve.  I have tried cooking the concentrated silymarin (as well as standardize curcumin) in pinto beans for hours, in various casseroles, in teas, and even in things like stewed dried wolfberries, with little success, but the raw substances seem to lack problems.  I wrote the manufacturer of one company recently regarding their fancy silymarin complex:
 

I appreciate your rapid response… to my letter.  Frankly, though, I am puzzled.  I fail to understand how the ability of a gelatin capsule to disintegrate could be considered relevant to its bioavailability. I understand, with tablets and other types of capsules, particularly enteric coated ones, that disintegration is important.  For instance, several years ago I accidentally noticed that a Nature’s Way HeartCare (standardized hawthorn extract) tablet had gone through my entire digestive tract completely unscathed, which means that I had been throwing my money away.  I still use the product, but I chew it up thoroughly before swallowing it, as I do now with virtually all supplements except for enteric and time-release formulations.

 

But gelatin capsules disintegrate so readily that you cannot even put one down on a moist countertop without it starting to dissolve. I could put sand into a gelatin capsule and it would disintegrate.  Note, if you look through the literature, there is a difference between disintegration and dissolution.

 

Silymarin and the other flavonoids in milk thistle are notorious for their insolubility.  Since their hepatoprotective effects are well known, teams in different parts of the world have approached the problem of enhancing their solubility by combining them with different substrates. Woo, et al, created a “SMEDDS” to do so:

 

It has a low bioavailability after being administered orally on account of its low solubility in water. In order to improve the dissolution rate, silymarin was formulated in the form of a self-microemulsifying drug delivery system (SMEDDS). …The SMEDDS consisted of 15% silymarin, 10% glyceryl monooleate as the oil phase, a mixture of polysorbate 20 and HCO-50 (1:1) as the surfactant, Transcutol as the cosurfactant with a surfactant/cosurfactant ratio of 1….The % release of silybin from the SMEDDS after 6 hours was 2.5 times higher than that from the reference capsule. After its oral administration to rats, the bioavailability of the drug from the SMEDDS was 3.6 times higher than the reference capsule. (Arch Pharm Res Vol 30, No 1, 82-89, 2007).

 

Qiu, et al, in Advances in Therapy, Volume 22, Number 6, 595-600, describe a solid dispersion technique they refer to as “dripping pills,” in which the silymarin is complexed with PEG 6000. 

 

Sun, et al, tried to solve the solubility problem by complexing silymarin  with polyvinylpyrrolidone as “solid dispersion pellets prepared by a one-step fluid-bed coating technique” (Powder Technology, Volume 182, Issue 1, 15 February 2008, Pages 72-80). 

 

Arcari, et al, describe an inclusion complex between silybinin and beta-Cyclodextrin:

 

The very low bioavailability of silybinin, the main constituent of silymarin, so far prevented the development of an oral pharmaceutical specialty based on this active ingredient. To overcome this difficulty, an inclusion complex between Silybinin and beta-Cyclodextrin was prepared. The new complex was compared in vitro tests (dissolution rate) and in a in vivo test (rat bile elimination) with silybinin, silymarin and one traditional formulation based on silybinin. The results show a dramatic increase in the dissolution rate of the complex (> 90% within 5 min) respect to the silybinin that confirm to be practically insoluble (< 5%). The in vivo results agree with the dissolution rates; after administration of the silybinin complex p.o., the silybinin concentration in the rat bile was near 20 times more than after administration of silybinin as is or in a traditional formulation. In the last two cases, the silybinin concentration was even 6 times less than after administration of the same amount of silymarin. These data show that the beta-CD complex solved the problem of the bioavailability of silybinin which, in the traditional formulation utilised as reference, proved to be not bioavailable. (Boll Chim Farm. 1992 May;131(5):205-9).

 

The best known commercially available formulation is the liposomal one.  Morazzoni, et al, created a complex between silybin and phosphatidyl choline in 1993, and it proved to be 10 times more bioavailable than the flavonoid by itself (Eur J Drug Metab Pharmacokinet. 1993 Jul-Sep;18(3):289-97).  In a later review, Kidd & Head state, “The standardized extract known as silymarin contains three flavonoids of the flavonol subclass. Silybin predominates, followed by silydianin and silychristin. Although silybin is the most potent of the flavonoids in milk thistle, similar to other flavonoids it is not well-absorbed. Silybin-phosphatidylcholine complexed as a phytosome provides significant liver protection and enhanced bioavailability over conventional silymarin.” (Altern Med Rev. 2005 Sep;10(3):193-203).

 

In other words, the insolubility and lack of bioavailability of the silymarin flavonoids (silybin is shown on the left) has been known far and wide for quite some time, and the attempt to create a bioavailable product has been the subject of numerous independent research attempts. 

 

Anyway, while I was waiting for that company to develop a more sane formulation of its silymarin, I continued to use the liposomal formulation sold by its competitors. When a new formulation comes out, I will probably use both.  I did not think about one possible problem of using silymarin at all until more recently: it turns out that the substance inhibits the growth of some cancers, apparently by inhibiting angiogenesis. Well, that's wonderful, but, I hate to tell you this, angiogenesis is a process that is necessary for your body to use to heal itself, especially in cases of trauma. Therefore, it does not seem wise to use that substance continuously.

Here's another example of how to "enrich" one's food: in the case of table spread, I use the brand Earth Balance®, which has a good oil mixture, and add a capsule of Tocomin® tocotrienols, a capsule of a carotenoid compex containing meso-zeaxanthin, astaxanthin and other carotenoids, a capsule of high EPA fish oil, a capsule of Member's Mark® Omega 3,6,9, a capsule of CoQ and a teaspoon or two of PPC (polyenylphosphatidyl choline).  It's easy to mix by letting the new tub soften; the intense color of the carotenoids and the CoQ makes it easy to tell when everything is evenly distributed.  The resulting mixture does not contain megadoses of anything:  the tubs contain dozens of servings.

COMMON SENSE
 
In trying to decide whether to change your diet or start taking a supplement, common sense would suggest that IF it has a high probability of benefiting you AND if it doesn't cause any harm and doesn't cost too much, then you should go ahead and use it.  It might take decades for studies to be conclusive enough for doctors to approve it, by which time you might be too dead to benefit.
 
A perfect example of what needs to be in everyone's diet is the pomegranate.  This fruit has been consumed for millennia with no known ill effects.  The pomegranate is mentioned in the Bible and the Koran.  So important was it that God was said to have caused the withering of the pomegranate tree (among other things) as a judgment (in Joel 1:12.)
 
There is LIMITED experimental evidence that pomegranate can reverse heart disease.  Pomegranates are seasonal items, and they're a lot of hassle to prepare when available, so an extract makes sense. I find it difficult to understand how anyone could argue against going on a pomegranate "kick."
 
Pills or capsules that contain pomegranate extract are available, and are certainly much handier to consume than pomegranates themselves.  The only risk you run with an extract, other than the possibility of solvent or other contamination if it was made by a less-than-reputable company, is--and we won't know this, probably for decades--it might turn out to be something like genistin, an isolated soy isoflavone that stimulates the growth of some cancers. The potential for harm from genistin is understandable because it mimics estrogens, but I think that the probability of any harm coming from consuming a pomegranate extract is extremely remote.
 
Resveratrol is one of the latest health food bandwagons.  Epidemiological studies reveal that populations with higher consumption of red wine live longer despite bad diets, and laboratory studies on one of the components of red wine, resveratrol, has shown various health and longevity promoting effects in vivo as well. This has led to health food advocates gulping down megadoses of resveratrol.
 
Red wine does seem to have health benefits, but, sorry, I'm not going to be guzzling it:  red wine is undoubtedly the best example of when it would seem to make more sense to take a supplement instead of a food. Nature's Way makes a formula, which includes red wine extract as well as red wine powder, along with a couple of other things. A logical way to consume it would be to add it to a food dish, so that, instead of consuming megadoses, you will absorb something much closer to what epidemiological evidence suggests might be useful.  Amazon health forums are entertaining when it comes to the pros and cons of such issues: see https://www.amazon.com/forum/health/ref=cm_cd_tfp_ef_tft_tp?_encoding=UTF8&cdForum=Fx1EO24KZG65FCB&cdThread=Tx3EO0B0MBXHDXK.

Regarding resveratrol, by the way, one should consider an Iowa State University study that found this, which is quite disturbing: "Staining of atherosclerotic lesions in the control and resveratrol-treated groups revealed that the resveratrol-treated rabbits had significantly more aortic surface area covered by atherosclerotic lesions (P < 0.02). Therefore, resveratrol promoted atherosclerotic development, rather than protect against it, by a mechanism that is independent of observed differences in gross animal health, liver function, plasma cholesterol concentrations, or LDL oxidative status." (http://www.ncbi.nlm.nih.gov/pubmed/8684261). 

EXTENDING LIFE?

 

The Life Extension Foundation started out, decades ago, supposedly to keep the public up to date on alternative biochemical approaches to retarding the aging process as well as fighting the diseases associated with aging.  That sounds like a noble goal, but they also sell supplements, so logic would dictate that they might not be totally unbiased. Gosh, coincidence of coincidence, it seems like whenever they talk about some “new” supplement that will cure all diseases known to man, as if by magic that supplement will be available from them, often via an advertisement just after the news article. That’s just coincidence, of course. They've had major battles with the FDA, so be warned that they are rather extreme in their anti-FDA rhetoric.


They have had some reputable physicians and scientists advising them, and, long ago, they did not promote non-evidence based medicine. It does appear to me that something there has changed. For instance, they've been promoting the woo of Suzanne Somers, who is now number 366 in the Encyclopedia of American Loons because of the things she imagines about human health. (See http://americanloons.blogspot.com/2013/01/366-suzanne-somers.html.) Another instance of the LEF's break from evidence-based information would be their promotion of a "Food Safe Allergy Test" a few years ago. That's a type of blood test which is not generally recognized by professionals in the field of allergies as being accurate or diagnostically relevant. Even Dr. Weil doesn't approve of that test.

 

The LEF's celebrity endorsements are particular disconcerting. A recent interview, for instance, talked up the "benefits" of an "alkaline" diet. That may well have been just the opinion of the person being interviewed, but the LEF doesn’t issue disclaimers when there are articles promoting such lunacy. This pH nonsense is widely promoted in the "alternative" universe, generally be those who wouldn't know the difference between a hydrogen ion and the planet Jupiter.

 

Twenty-odd years ago, I regarded them as a reasonable source of information on whatever was new on the health front. But, these days, I consider them no more reliable than Mercola or naturalnews, both founts of quackery. However, what supplements they sell are the highest in quality, at least according to independent laboratory tests. They are often the first to introduce a particular supplement to the US, as they were with gamma tocopherol, melatonin and CoQ.

Their prices are rather high, except during their clearance sales. The rash of food product contamination cases over the last few years has changed my buying habits.  Some things I would not worry about anyway, such as trimethyglycine (TMG); it's derived from sugar beets and ought to be dirt cheap, so why pay extra for it. But http://www.consumerlab.com/ has consistently ranked the LEF’s products as being pure, so, if there’s some oddball nutrient that you’ve decided will cure every disease known to man, and you want to buy it without worrying about it being contaminated with lead or something like that, then the LEF might be a good place to shop.

MADE IN CHINA 
 
These days, almost anything cheap seems to be made in China, and that holds true for vitamins and supplements. As well respected as China has been for its 5000 year history of herbal medicine--and I hold China's herbal tradition in very high regard--China's reputation is now blemished by its exports of impure vitamins and supplements, and even more blemished by the recent export of food products containing intentionally contaminated wheat gluten that killed and sickened untold numbers of pets.  Dare I mention the massive toy recalls occasioned by their use of lead-based paint or the jewelry recalls due to cadmium?  China was also the source of the cough syrup in a recent mass poisoning case in Panama that involved 260,000 bottles of cold medicine and a reported 365 fatalities. The contaminant in the cough syrup, diethylene glycol, an ingredient of antifreeze, is the same poison found in Chinese toothpaste that was pulled off of store shelves worldwide in a separate incident not long ago. It looks like Red China is trying to poison its way to world dominance.  I wrote the president of the PROC in November, 2007, detailing the concern that I, as an average American citizen, had about products from there, but, as you might expect, never received a response.
Google
 

WONDERING ABOUT HERBS?
 
Visit the Herb Research Foundation for honest, scientific appraisals of herbs. Although some information is available directly on their site, their information packets are not free. They describe themselves as "the world's first and foremost source of accurate, science-based information on the health benefits and safety of herbs---and expertise in sustainable botanical resource development."

The National Cancer Center gives a scientific perspective of herbs and other cancer topics, with references to actual studies instead of "they say" kind of stories that you find on wacko websites. Click here to visit the National Cancer Institute's web site.

M.D. Anderson Cancer Center is where I was treated. Click here visit their Department of Complimentary/Integrative Medicine.

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All content on this site, including pictures, is copyrighted, ©2006 through 2016, by George A. Butel.  All rights are reserved; text may be quoted freely with attribution, but critical commentary must give me the opportunity to reply.

Visit our hints for cancer patients Google page, which tells you some of the things I learned during cancer treatment, including a few things that "they" forget to tell you, such as having to be a little bit "anal" about trying to prevent opportunistic infections. I never had any during my treatment, so I think my obsession paid off.


LEGAL STUFF

This site has tips and observations about dealing with parrots, and a few of my own views about human and parrot health concerns. I have a degree in biochemistry, so I am qualified to make some statements about foods, medicines and supplements, but I am neither a veterinarian nor a physician, and I do not practice human or veterinary medicine. You should certainly double-check any ideas you might get from me, or anything that you might construe as advice, by consulting with an appropriate legally licensed professional.  All content on this site ©2006 through 2014 by George A. Butel.  If you see any typos or any information that you feel is inaccurate or ambiguous, please contact me by clicking here.
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