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Thursday 14 October 2021

Herbal medicine: an ancient "Functional Medicine"

An individualised approach: addressing the whole person 
Increasingly it is appreciated that to achieve long-term recovery and ongoing health, it is necessary to adopt a personalised approach, considering the whole person, rather than simply stopping symptoms of the disease. Suppressing symptoms masks the underlying problem, usually resulting in the symptoms recurring at a later date.

A thorough consultation
Herbalists have the benefit of time; a luxury which allows us to take a thorough case history. This process takes a minimum of an hour. 

Initially this involves an in-depth discussion regarding the person's current problem, possible causes, triggers, patterns of symptoms. This is then followed by extensive questioning of all other body systems, with associated examinations and/or tests if deemed necessary.

It is the thorough nature of this case history taking which allows us to tailor the approach we take to the individual concerned. As an example, two people with "eczema" are unlikely to be given the same herb combination, as one person may have food intolerances and headaches, and another have a history of joint problems.

Individualised herbs: combination of herbs is vital
Herbalists very rarely give single herbs. Before I trained, I laboured under the impression someone would take one herb to try to help one symptom, another for another, and so on. I frequently hear this in my practice - someone will have tried "a headache herb". 

The reason though herbalists ask about all other body systems, is to allow us to combine herbs appropriate for the individual concerned, and also to ensure the herbs selected will work well together, helping the absorption of each other, for example.

Traditional use combined with science
Herbs have been used safely by our forefathers for generations. This knowledge is passed down to each new generation of herbalists. We now have the added benefit of being able to combine this tried and tested traditional use with emerging science. Every year a new raft of scientific studies are conducted attempting to uncover the role of the individual constituents of the herbs.

 For further information visit my website www.lynblythe.com



Herbal medicine: Good health naturally




 

Wednesday 3 February 2016

Free drop-in advice on health and herbal remedies

For anyone in Wiltshire:

Free drop-in advice on herbal remedies:

10am - 12 noon, Thursday 4th February, 2016, at Swindon Pulse Wholefoods (27 Curtis St). No booking required.

I’ll be there to offer free advice and guidance, and to give you the opportunity to ask any questions you may have regarding Herbal Medicine.

Saturday 12 September 2015

Rosehip Syrup

Thank you to everyone who attended my herb walk this morning.

Below, as requested, for those of you who don't have access to my Facebook page, is the recipe I use to make rosehip syrup.

Rosehip Syrup
Rosehips (the fruit of the wild rose, Rosa spp) are rich in many vitamins and minerals. Indeed, as fruit became scarce during the war years, rosehips were collected as a vital addition to the diet, having more vitamin C than oranges! Rosehip syrup was given to mothers for their children, and a Ministry of Food leaflet encouraged people to make their own syrup from the hedgerows.





Below is a traditional recipe for a rosehip syrup. Although heating the hips leads to some loss of vitamin C, this method serves the purpose of prolonging storage.




• Add 500g chopped rosehips to 1.5 litres water.
• Boil for 20 min's.
• Strain through double layer of muslin.
• Discard pulp, return the fluid to the pan.
• Simmer until volume reduced by half (approx will do!).
• Measure volume and add half as much sugar (eg. 500ml, add 250g sugar).
• Warm gently until sugar dissolved (stirring), then boil for 5 min's.
• Pour whilst warm into sterilised, warmed, glass bottles.
• Label and store in a cool place. Refrigerate once opened.


NB. Collect rosehips from areas where they will not have been sprayed and away from roadsides.

Thursday 28 May 2015

Free drop-in advice on health and herbal remedies

For anyone in Wiltshire:

Free drop-in advice on herbal remedies:

10am - 12 noon, Thursday 5th February, 2015, at Swindon Pulse Wholefoods (27 Curtis St). No booking required.

I’ll be there to offer free advice and guidance, and to give you the opportunity to ask any questions you may have regarding Herbal Medicine.

See www.lynblythe.com for more information on Herbal Medicine.



Saturday 9 May 2015

High blood pressure (Hypertension)




What is hypertension?
Hypertension is a long-term elevation of the blood pressure (BP) in the arteries. Two readings are taken when the blood pressure is measured with a sphygmomanometer. The first when the heart is beating (the systolic pressure) and the second, lower, reading when the heart is relaxing between beats (diastolic pressure). A "textbook normal" resting BP reading would be 120/80 mmHg, although this varies with such factors as level of activity, anxiety, exercise, etc.

Dangers of hypertension
Ongoing raised BP significantly increases the risk of having a heart attack, developing heart disease and/or having a stroke. It can also lead to kidney damage, narrowing of other blood vessels, potentially leading to such problems as skin ulcers, impotence, amputation or aneurysm (where damaged blood vessels eventually tear). The list of possible health problems due to raised BP goes on and on as all blood vessels are affected.

Symptoms 
Usually none!

High BP tends to remain asymptomatic and is usually found during routine examination. Occasionally it may cause headache or vision problems. Eventually symptoms emerge as the blood vessels become damaged, for example, skin ulcers.

There is also a much rarer form of hypertension, malignant hypertension, where the BP is severely elevated, causing headache, kidney failure, fits and coma. This though is a medical emergency, not the usual ongoing, chronic, raised BP seen more commonly.

Causes of hypertension
Hypertension is divided into two types:

Essential hypertension - accounts for approximately 95% of cases, and merely means the cause is unknown!

Secondary hypertension - accounts for the other approximately 5% of cases, and means the raised BP is secondary to a known cause (see below):
  • Kidney disease
  • Endocrine disease (eg. hyperparathyroidism, Cushing's syndrome - including secondary to steroid treatment)
  • Pregnancy
  • Coarctation of the aorta (a narrowing of the aorta since birth)
  • Drugs (including medications), alcohol, toxins

Variations in BP
There are normal variations in everyone's BP. Not only does normal BP alter from minute to minute, but it also shows variation throughout every 24 hour period, with the lowest readings occurring during the night. However, in normal circumstances, these fluctuations occur within a relatively narrow range, and are carefully controlled.

More recently it has become recognised that larger, abnormal, variations in BP and also the maximum BP reached, are strong predictors of stroke and other vascular events, not just the average BP as previously thought.

Herbs
A vast number of herbs have a long tradition of use to address hypertension.

Herbalists rarely use herbs singly though. Instead, the herbs most suitable for each patient are selected and combined with additional herbs based on the rest of the medical history (including any medications) and the possible underlying causes of the circulatory problems, mindful of the fact that not all herbs are suitable for all people. This results in a prescription which is most appropriate and more effective for each individual. It is often the case that what not to include is as important as what to include in a prescription!

Hawthorn (Crataegus spp)
Hawthorn, a member of the rose family, has been used safely for heart and circulatory problems for many generations.The flowering tops (ie. flowers plus new leaves) are picked in the Spring, and the berries in the Autumn.

Hawthorn berries


Cramp bark (Viburnum opulus)
Cramp bark has been used for many years to relax "muscle tension", making it a useful herb for a variety of complaints. Such "antispasmodic" herbs are commonly included in prescriptions for people with hypertension.

Cramp bark


Lime (linden) flower (Tilia spp)
Lime flower is another herb commonly included in hypertension prescriptions. It also has an antispasmodic effect. In addition it is believed to make a useful contribution towards helping atherosclerosis (hardening of the arteries), when used in conjunction with other herbs and some dietary modifications. It is pleasant as a tea. Indeed the tea has a long-standing reputation as a calming drink to aid sleep.

Lime flower


Olive leaf (Olea europaea)
Most people are now familiar with the benefits of good quality olive oil to health, including its positive effects on the cardiovascular system. However, the leaves have also been used as a medicine throughout history. Again, antispasmodic, but they are also thought to have numerous other beneficial effects, such as helping normalise fluctuating blood sugar levels (NB. Not to be used as an alternative to insulin treatment in diabetics though!).

Olive leaf


There are many other herbs which may be selected and included, depending on the individual concerned. Others include herbs such as bilberry, motherwort, yarrow, periwinkle. Frequently, herbs to protect the kidneys will be included, as ongoing hypertension can be damaging to these vital organs.


References and further reading
Edwards, J.E., Brown, P.N., Talent, N., Dickinson, T.A., Shipley, P.R. (2012). A review of the chemistry of the genus Crataegus. Phytochemistry 79 5-26

Kaeidi, A., Mahani-Esmaeili, S., Sheibani, V., Abbasnejad, M., Rasoulian, B., Hajializadeh, Z., Afrazi, S. (2011). Olive (Olea europaea L.) leaf extract attentuates early diabetic neuropathic pain through prevention of high glucose-induced apoptosis: In vitro and in vivo studies. Journal of Ethnopharmacology 136 188-196

Kwok, C.Y., Wong, C.N.Y., Yau, M.Y.C., Yu, P.H.F., Au, A.L.S., Poon, C.C.W., Seto, W.S., Lam, T.Y., Kwan, Y.W., Chan, S.W. (2010). Consumption of dried fruit of Crataegus pinnatifida (hawthorn) suppresses high-cholesterol diet-induced hypercholesterolaemia in rats. Journal of Functional Foods 2 179-186

NHS Choices
http://www.nhs.uk/Conditions/Blood-pressure-%28high%29/Pages/Introduction.aspx

Patient.co.uk
http://www.patient.co.uk/doctor/hypertension

Patient.co.uk
http://www.patient.co.uk/health/high-blood-pressure-hypertension

Rothwell, P.M., Howard, S.C., Dolan, E., O'Brien, E., Dobson, J.E., Dahlof, B., Sever, P.S., Poulter, N.R. (2010). Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet  375: 895-905

Simon, C., Everitt, H. & Dorp, F. (2010). Oxford Handbook of General Practice, 3rd Ed. Oxford: Oxford University Press. P252-257

Susalit, E., Agus, N., Effendi, I., Tjandrawinata, R.R., Nofiarny, D., Perrinjaquet-Moccetti, T., Verbruggen, M. (2011). Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: comparison with Captopril. Phytomedicine 18 251-258

Tuesday 3 February 2015

Free drop-in advice on health and herbal remedies

For anyone in Wiltshire:

Free drop-in advice on herbal remedies:

10am - 12 noon, Thursday 5th February, 2015, at Swindon Pulse Wholefoods (27 Curtis St). No booking required.

I’ll be there to offer free advice and guidance, and to give you the opportunity to ask any questions you may have regarding Herbal Medicine.

See www.lynblythe.com for more information on Herbal Medicine.

Seasonal Affective Disorder (SAD)



What is it?
Seasonal Affective Disorder (SAD) has been described as “a recurrent disorder involving seasonal episodes of depression, usually in the winter months”. Occasionally though, the depression may be felt in the summer.

This is not a new problem. It has been written that even in 200 AD a link between sunlight and depression had been recognised, and it was recommended that "lethargics are to be laid in the light and exposed to the rays of the sun"!  

Most of us are affected to some extent by changes in season, for example, feeling brighter and more energetic on a sunny day. However, for people with SAD, these changes in mood as the seasons change are far more pronounced, and consequently have a significant impact on quality of life during these times. Indeed, some people with SAD report feeling unable to get out of bed in the morning when their mood is at its lowest ebb.

Who does it affect?
SAD is thought to affect approximately 2% of adults, and to affect women twice as commonly as men. SAD is more common in countries where there are significant changes to number of daylight hours, temperature and weather conditions between seasons.

Symptoms
Some or all of these may be experienced:

• Low mood, feelings of guilt
• Apathy
• Lethargy
• Poor concentration
• Anxiety, panic attacks
• Irritability
• Sleep problems – usually more sleep
• Overeating, often with cravings for chocolate and high-carbohydrate foods
• Alcohol or drug abuse
• Weight gain
• Possibly lowered immunity, with increased incidence of illness
• Relationship difficulties, inability to socialise

Symptoms usually begin in the autumn months as daylight reduces, and start to improve in the spring. December to February tends to be when symptoms are at their most severe.

Children
SAD is rare in childhood. However, when children are affected, it may present as irritability and sluggishness.

What Causes SAD?
The exact cause(s) are unclear. Women in their reproductive years are most at risk, as is the case for all forms of depression, suggesting a hormonal link. Obviously, reduced daylight is another causal factor. It is thought that this relative lack of sunlight affects levels of the brain chemicals serotonin and melatonin.

Serotonin
Serotonin, also known as 5-hydroxytryptamine, is a monoamine vasoconstrictor, derived from the amino acid, tryptophan from protein. It is found in high concentrations in many body tissues, including the wall of the intestine, pineal body, in the blood, and the central nervous system. It is involved in mediating numerous functions, such as reducing stomach acid secretion and serving as a neurotransmitter (messenger in the nervous system).

People with SAD have been found to have reduced serotonin levels, especially in the winter. Given the number of widespread roles of serotonin in the body, it is easy to see how low levels would potentially result in many symptoms.

Melatonin
Melatonin is a hormone produced from serotonin in the pineal gland in the brain. Melatonin secretion is high at night (which makes us sleep) and low during the day (hence, we wake). It is involved in the regulation of sleep, mood, puberty and ovarian cycles. Indeed, the pineal gland plays a major role in establishing circadian rhythms ("body clock"). Bright light inhibits melatonin secretion, hence it is often recommended that people with insomnia should not use computers or be in other brightly lit situations immediately before bed.

People with SAD have raised melatonin levels. Studies have found that when people with SAD increase their exposure to light, their melatonin levels fall to within normal range, yet continue to experience the symptoms of SAD. This suggests that raised melatonin is not the only causal factor involved in developing SAD.

Disrupted circadian rhythm ("body clock")
The body normally regulates functions such as digestion, sleep and energy levels throughout each 24 hour period. However, reduced sunlight can disrupt this regulation, leading to SAD symptoms such as depression.

Other possible causes or triggers of SAD
Other triggers which have been suggested include:

  • trauma or a major stressful event
  • serious illness
  • medication
  • withdrawal from drugs or alcohol
  • relocation from a region nearer the equator 

Self-help 
General self-help strategies:
  • Exercise helps all forms of depression. Walking is an excellent, safe, exercise for most people.
  • Time outdoors, especially around midday (or sitting by a bright window) increases daylight exposure, so helping symptoms. Limit use of sunglasses when experiencing SAD.
  • Try to be optimistic, reminding yourself that the depression will lift.
  • Tell others you have SAD, so they are likely to be more understanding.
  • Avoid stress as much as possible.
  • Improve diet. Attempt to avoid eating excess carbohydrates. 
NB. Spending time in a sunny location (eg. a holiday) whilst affected by SAD may reduce symptoms temporarily, but then lead to an exacerbation on returning home, since SAD is usually a reaction to changes in season. 

Light Therapy
Light boxes are growing in popularity as a therapy to reduce symptoms of SAD (see links below). They emit bright light, but without the harmful Ultra Violet Radiation (UVR). Light boxes are available in different strengths and sizes. They are generally more effective when used in the early morning, and for approximately half to two hours, but the most effective use varies between people, with the brightness of the day and with the box used. It is advisable to not use them before bed though, as this may cause insomnia (see melatonin above).

Dawn-stimulating alarm clocks, although less bright than light boxes, can be used to gradually increase light in the hour before waking. This can be especially useful if someone finds it difficult to wake up in the morning when affected by SAD.

Occasionally, light therapy may cause headaches or blurred vision.

TANNING SALONS ARE NOT A TREATMENT FOR SAD!
....even though it is sometimes said that they are!

Talking therapies
Talking therapies can be a useful adjunct. Cognitive Behaviour Therapy (CBT), which aims to change mood by altering thought patterns, may help. Counselling and psychotherapy are worth considering.

NHS therapists (see your GP to be referred) often have long waiting lists. If considering consulting a therapist privately, it is important to look for one who is properly qualified and registered. The British Association for Counselling and Psychotherapy (BACP) has a list of such accredited practitioners in each area (see links below).

Medications
Antidepressant medications are often prescribed. These do not cure SAD, but may reduce symptoms. The antidepressant drugs usually given are SSRIs (Selective Serotonin Reuptake Inhibitors), for example, paroxetine (Seroxat), Fluoxetine (Prozac), Sertraline (Lustral).

Herbs
St John's Wort (Hypericum perforatum)
Many people have reported finding St John's Wort beneficial.

NB. Herbalists use whole plant extracts of St John's Wort, rather than extracts which contain isolated constituents from the plant, as tends to be the case in over-the-counter preparations. This is because whole plant extracts are believed to be safer, having been used safely in this way for many generations. In contrast, the use of isolated constituents is relatively new, and has been associated with side-effects.

St John's Wort (Hypericum perforatum)

St John's Wort has many useful actions. However, its effect on improving mood is believed to be partly achieved by blocking the re-uptake of dopamine, serotonin, noradrenaline and Gamma AminoButyric Acid (GABA).

Although it was once considered that the active constituents in St John's Wort were hypericin and pseudohypericin, it is know known that hyperforin, chlorogenic acid, rutin and quercitin are also required - hence the benefit of herbalists using whole plant extracts which do not remove these other vital constituents! It is likely, as is the case for the majority of herbs, that St John's Wort exerts its action through the synergy of its constituents. It is often the case, for example, that many constituents are required for the main active constituents to be absorbed.  

*St John's Wort can be used in conjunction with light boxes, as the function of these boxes is to act via the eyes (not the skin) and they emit visible light, not UVR, as reported by the Skin Cancer Foundation (see above, and also the relevant link below). It is usually advised to use a light box with a UVR filter in order to ensure this is the case.

St John's Wort may not be suitable for everyone. If in doubt, check!
 
Other herbs which have been used to help mood:
A great many herbs have been used to help mood. A few are mentioned below. Herbalists rarely use herbs singly. Instead, a few herbs are combined, with the individual's case history in mind. A carefully balanced prescription of herbs will select those which work well together and are most suitable for that particular person.

Lemon Balm (Melissa officinalis)
Lemon balm has a long history of use as a herb to help banish "the blues". Indeed, the 17th Century herbalist, John Evelyn wrote "balm is sovereign for the brain, strengthening the memory, and powerfully chasing away melancholy". Lemon balm has numerous other applications, for example, it is also taken by people to help alleviate anxiety and/or digestive problems. Studies are emerging which appear to back up these traditional uses. Furthermore, there is mounting evidence for the use of lemon balm to address Alzheimer's disease.

Rosemary (Rosmarinus officinalis)
Many old herbal texts describe rosemary as a "thymoleptic", ie. to improve low mood. The old saying "rosemary is for remembrance" refers to the age-old use of rosemary for increasing blood flow to the brain, so potentially improving memory. Rosemary has numerous other uses, as is often the case with herbs. These uses are increasingly supported by modern research.

Lavender (Lavandula angustifolia)
Lavender is another plant with a long history of traditional use for easing low mood, anxiety, insomnia and for improving memory. It also has uses in the gastrointestinal tract. Its use as a medicine is not new, having been popular since the late Middle Ages. The herbalist John Parkinson (1640) described lavender as being of "good use for all griefs and pains of the head and brain". It probably goes without saying that this is a wonderfully aromatic plant, rich in volatile oils, which studies show have antioxidant and anti-inflammatory actions.


References, useful links and further reading
British Association for Counselling and Psychotherapy (BACP) www.bacp.co.uk
For a list of accredited practitioners in your area, for talking therapies.

Grieve, M. (1931). A Modern Herbal. Mineola: Dover Publications. P76-77

Living Life to the Full www.llttf.com
Free online CBT information, supported by the Scottish NHS

Lumie www.lumie.com
For information on light boxes (as recommended by MIND)

MIND for mental health www.mind.org.uk 
Understanding Seasonal Affective Disorder (2013) – Fact sheet/PDF [online]. Available from: NHS Choices http://www.nhs.uk/conditions/Seasonal-affective-disorder/Pages/Introduction.aspx [Accessed15th January, 2015]

Partonen, T. & Magnusson, A. (2001). Seasonal Affective Disorder: Practice and Research. Oxford University Press. 

Persaud, R. (2007). The Mind. A User's Guide. London: Bantam Press. P205-211

Rang, H.P., Dale, M.M., Ritter, J.M., Flower, R.J. (2007). Rang and Dale's Pharmacology, 6th Ed. Philadelphia: Churchill Livingstone. P189-197 

Rosenthal, N.E. (2005). Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder. New York: Guilford Press.

Seasonal Affective Disorder Association (SADA) www.sada.org.uk 
For information and support

Seasonal Affective Disorder shop www.sad-lighthire.co.uk 
Information line: 01704 500 505
For information on light boxes and SAD (as recommended by MIND)

Simon, C., Everitt, H. & Dorp, F. (2010). Oxford Handbook of General Practice, 3rd Ed. Oxford: Oxford University Press. P1001

Skin Cancer Foundation
For information on how tanning salons are NOT a treatment for SAD!
http://www.skincancer.org/prevention/tanning/seasonal-affective-disorder
[Accessed15th January, 2015]