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.

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.

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.

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

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]

Having difficulty sleeping?

Insomnia, or difficulty sleeping, is a very common complaint, and one with far reaching consequences, as good quality sleep is necessary for the body to maintain normal physical and mental function.

Simply put, we need good quality sleep to maintain (or restore) good health.

Someone may have difficulty falling asleep (sleep-onset insomnia), or frequent or early awakening (sleep-maintenance insomnia).

Stages of sleep

Normal sleep involves alternating between two types of sleep:

(i) Slow-wave sleep - most sleep is of this type.
This type of sleep is sub-divided into stages 1-4, where stage 1 is the lightest stage of sleep, and stage 4 the deepest. Typically a person will move from stage 1 to 4 in less than one hour.

This is the deep, restful sleep. There is decreased blood pressure, respiratory rate and metabolic rate.
Although this phase of sleep is sometimes referred to as "dreamless sleep", dreams do sometimes occur, but are usually not remembered.

(ii) Rapid Eye Movement (REM) sleep - occurs in episodes throughout the sleep period.
REM episodes occur approximately every 90 minutes, each lasting between 5 and 30 minutes. When a person is very tired, the duration of REM episodes is short. As the person becomes more rested as their sleep progresses, the duration of their REM episodes becomes longer.

This stage of sleep is not so restful, and is associated with vivid dreams. The brain is highly active, and brain metabolism increases by as much as 20%. In fact, electroencephalograms (EEGs) show a pattern of brain waves similar to those seen during wakefulness. The heart rate and respiratory rate are often irregular.

Functions of sleep

Whilst it is accepted that sleep is very important to maintain health, the precise reasons remain unclear, and research into this continues. For example, since 50% of an infant's total sleep is of the REM type, compared to 25% REM sleep in an adult, it is proposed that REM sleep in infants is important for maturation of the brain.

As brain blood flow and oxygen use is higher during REM sleep, it is postulated that this type of sleep is necessary for body tissue repair. It certainly appears to be the case that as health recovers from some long-term illnesses, sleep quality and dreaming is restored and is seen as an indicator of health improvement.

The majority of Growth Hormone (GH) secretion occurs during sleep. It is thought that many of the functions of sleep are mediated via the release of this hormone. GH is sometimes called the "antiaging" hormone as studies suggest it stimulates tissue regeneration, muscle building, normalisation of blood glucose levels, to name but a few of its actions.

Various studies have linked insomnia to an increased risk of raised blood pressure, cardiovascular disease, anxiety and depression, in addition to impaired thinking and quality of life.

Tryptophan and brain serotonin

The amino acid, tryptophan (found in most proteins) is a precursor of the neurotransmitter, serotonin. This is important because serotonin is involved in mood (and many other widespread functions). Thus, low serotonin is thought to contribute to insomnia, as well as to anxiety and depression.

This would perhaps explain how poor diet and/or poor digestion (ie. low levels of available tryptophan) can lead to insomnia. (It should be noted though that supplementation with tryptophan is unlikely to remedy this situation as it cannot cross the various barriers into the brain. Clearly, the long-term solution is to address diet and digestion issues instead).

Causes and Treatments

Many insomniacs resort to over-the-counter preparations to address their lack of sleep, whilst others seek stronger medications from the GP, often with various unwanted side-effects. However, a thorough history taking will often reveal likely cause(s) of the problem, thus leading to a long-term solution, and eliminating the need for medications. 

Possible causes of insomnia are many and varied, and include existing health complaints such as Chronic Fatigue Syndrome, poor control of blood glucose levels, pain, restless leg syndrome, poor digestion (including food intolerances), low mood and side effects of medications.

As always, the importance of determining the cause of the insomnia in the individual cannot be overstated.

Herbs

Fortunately, over the generations, many herbs have been recorded as useful for helping sleep. Studies are now being performed which are attempting to elucidate their mechanisms.

Herbalists rarely use herbs singly though. Usually these herbs are combined with others in order to address the perceived underlying cause(s) of the problem in each individual person.

Chamomile (Matricaria recutita)

Chamomile

Chamomile tea has a long-standing reputation as a drink to promote sleep. Herbalists frequently use chamomile tincture, usually in conjunction with other herbs.

Marcello Spinella, an Assistant Professor of Psychology, has written that the calming, sedative effect of chamomile is a consequence of the constituent apigenin binding to benzodiazepine receptors. It is probable that many other constituents are also needed to achieve this effect though.

However, chamomile has far more wide-ranging uses than this. It has been described as the "Mother of the gut", hinting at its use for helping gut inflammation, nausea, bloating, spasms and generally aiding digestion. It has also been used by those with hayfever, sinusitis and catarrh, in addition to headaches, especially those caused by poor digestion or stress.

Cooled chamomile tea can be used to soothe hot/itchy skin conditions such as heat rash or urticaria (hives).

Passionflower (Passiflora incarnata)

Passionflower

Passionflower is another herb commonly used by those struggling to get a good night's sleep. Whilst various species have been used, Passiflora incarnata is the main one used in Europe. Again, as with chamomile, there is a long history of traditional use of this herb for sleep and for other nervous system complaints.

Modern research continues to investigate the mechanism of action of various constituents. It is thought that the various flavonoids are likely to be important.

Valerian (Valeriana officinalis)

Valerian

Valerian has been used to ease anxiety and aid sleep since Roman and Greek times. Dioscorides described it as having a mild sedative effect. It is said that a minority of people find it "stimulating" though - so it may not be the herb of choice for everyone!

Valerian has attracted a great deal of scientific interest, with numerous studies supporting this traditional use, although often the valerian was used in conjunction with other herbs too. The debate concerning the exact mechanisms continues. It is thought that GABA receptors are likely to be involved as these are also targeted by benzodiazepines, barbiturates and anaesthetics. Studies are investigating the possible importance of adenosine, serotonin and/or melatonin receptors. It has been reported that some studies concluded valerian was as effective as benzodiazepine sedatives, but without addiction, so it's definitely worth considering whether it might be a suitable alternative.

Limeflower (Linden blossom) (Tilia spp)

Limeflower

Limeflower is another herb commonly used in night-time teas. Traditionally it has been used to calm the mind, and for stress and panic, as well as for "nervous palpitations".

Generations of herbalists have also added limeflower to prescriptions for headaches, especially stress-induced, high blood pressure, catarrh, sinusitis and for colds and 'flu'. Limeflowers can be used to make a lotion to soothe itchy skin as they contain mucilage.   

Wild lettuce (Lactuca virosa)

Wild lettuce

Wild lettuce is a less well known herb, and hardly the showiest (!), but still often used by herbalists. It is gathered when it is in flower in late Summer, and the leaves and white latex used. Dioscorides (1st century AD) wrote that the effect of the wild lettuce resembled that of opium poppy - so, again, hardly a new sleep remedy!

Wild lettuce can also be made into a cough remedy, frequently in combination with liquorice. Herbalists also use it combined with other herbs, as appropriate, to address pain.


The list of herbs to help insomnia could easily go on and on and on....! The herb(s) most suitable though will depend on the individual and on the underlying cause of the insomnia. Additionally, not all herbs are suitable for all people. If in doubt, seek advice.



Useful references and further reading

Chevallier, A. (1996). The Encyclopaedia of Medicinal Plants. London: BCA.

Chien, K., Chen, P., Hsu, H., Su, T., Sung, F., Chen, M. (2010). Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based-cohort. Sleep 33: 177-184

Guyton, A.C. & Hall, J.E. (2011). Textbook of Medical Physiology, 12th Ed. Philadelphia: Saunders. P721-725

Johnson, E.O., Roth, T., Breslau, N. (2006). The association of insomnia with anxiety disorders and depression: exploration of the direction of risk. J Psychiatr Res 40: 700-708

Jones, D.S. (2010). Textbook of Functional Medicine. Gig Harbor: The Institute for Functional Medicine. P641-643

Neckelmann, D., Mykletun, A., Dahl, A. (2007). Chronic insomnia as a risk factor for developing anxiety and depression. Sleep 30: 873-880

Pizzorno, J.E. & Murray, M.T. (2006). Textbook of Natural Medicine, 3rd Ed. Missouri: Churchill Livingstone. P1829-1835

Roane, B., Taylor, D. (2008). Adolescent insomnia as a risk factor for early adult depression and substance abuse. Sleep 31: 1351-1356

Spinella, M. (2001). The Psychopharmacology of Herbal Medicine, plant drugs that alter mind, brain and behaviour. Massachusetts: The MIT Press. P226-229

Tortora, G.J. & Derrickson, B. (2006). Principles of Anatomy and Physiology, 11th Ed. Hoboken: Wiley. P565-567

Vgontzas, A., Liao, D., Bixler, E., Chrousos, G., Vela-Bueno, A. (2009). Insomnia with objective short sleep duration is associated with a high risk for hypertension. Sleep 32: 491-494

"Flu jab" .... to vaccinate or not?

The British Medical Journal (BMJ), one of the world's leading general medical journals, recently published an article which questioned the promotion and increased use of influenza vaccines today.

The BMJ article cites and questions a study published in the New England Journal of Medicine which had reported a 48% reduction in risk of death following the vaccine - this was criticised for being an apparently impossible statistic when "influenza is estimated to only cause around 5% of all wintertime deaths". Furthermore, the controversy continues over whether the vaccine significantly reduces the chances of someone contracting the illness at all, or reduces their chances of developing complications from influenza (Nichol, 2007; Simonsen, 2005; Simonsen, 2007; Doshi, 2013).

So, should you decide against the "flu jab", are there alternatives?

Food!
Trying to stay healthy whilst eating a poor diet is like trying to run your car on water!

However, this also necessitates good digestion, as we can only use what we can digest and absorb. Indeed, it is impossible to overstate the importance of resolving any digestion issues. So, counterintuitively perhaps, for any one with digestive symptoms, the first step in preventing a respiratory (or any other) infection, would be to address the cause of the digestion problems.   

Herbs
Herbs and herbal medicines may be thought of as an extension of diet, since they are plant-based. A major advantage of this is that they are readily bioavailable as they are recognised by the body as foods, unlike most vitamin and mineral supplements.

There is much available information documenting the difficulty in accurately predicting which strain(s) of the 'flu virus will be prevalent the following season in order to design a vaccine to match (and controversy over whether/how effective the vaccine is, even when matched). However, another advantage of using herbs (and diet) to combat potential infections, such as influenza viruses, is that herbs are made up of vast numbers of antimicrobial constituents, including antiviral and immune supporting, as well as constituents which aid the digestion and absorption of these active constituents. Added benefits are that these protect against all pathogens (viruses, bacteria, and others) in the environment - not just one strain of 'flu virus! Furthermore, the pathogens are, as yet, unable to develop resistance to these natural substances due to the vast numbers of constituents working together to produce the effect.

Which herbs?
There are too many antiviral and immune supporting herbs to list!
However, not all herbs are safe for all people.

It is generally accepted amongst herbalists that a combination of a smaller dose of a few herbs, specifically selected for an individual, with their medical history in mind (for example, existing respiratory or immune conditions), has a greater effect that a larger dose of one. In addition, this allows herbs to be added which will enhance the absorption of the others. Different herbs will also be selected for prevention as opposed to if someone is already fighting infection. Another important consideration is when, and for whom, a tincture (medicine), syrup, capsules, tea, etc, will be more effective.

Echinacea spp

Whilst echinacea is probably the herb that springs
to most people's minds, it is far from the only tool
in the herbalist's antiviral armoury!






Others with supporting research (and generations of traditional use) include elderberry, liquorice, ginger, Chinese skullcap, garlic, andrographis, rhodiola, boneset..... and many more, either as main antiviral "players", or as important adjuvants!

Pressing elderberry tincture (medicine) - a very messy task!

If you want to read more:

Doshi, P. (2013). Influenza: marketing vaccine by marketing disease. BMJ 346: 3037

Nichol, K.L., Nordin, J.D., Nelson, D.B., Mullooly, J.P., Hak, E. (2007). Effectiveness of influenza vaccine in the community-dwelling elderly. New England Journal of Medicine 357: 1373-1381

Simonsen, L., Reichert, T.A., Viboud, C., Blackwelder, W.C., Taylor, R.J., Miller, M.A. (2005). Influence of influenza vaccine on seasonal mortality in the US elderly population. Archives Internal medicine 165: 265-272

Simonsen, L.,Viboud, C., Taylor, R.J. (2007). Effectiveness of influenza vaccine. New England Journal of Medicine 357: 2729-2731

"Conkers"....and what to do with them!

I remember the excitement as a child as I waited for my Dad to drill a hole in the biggest conkers we'd found, and thread them on strings for me to take into battle in the school playground the following day!

How times have changed! That's a million miles away from what I do with them now......

Medicine making (tinctures macerating) L to R: Horsechestnut, Ginkgo, Marigold, Elderberry, Hops

Conkers (the seeds of the horsechestnut tree, Aesculus hippocastanum) are rich in saponins, flavonoids and tannins. Saponins are able to bind to both water-soluble and also fat-soluble molecules, a property which enables them to act as emulsifiers in herbal medicines, so allowing the oily constituents to better dissolve in the medicine.

Saponin rich herbs are not for everyone though! Large doses can be irritant to the digestive tract, so dosage is important, and they may be unsuitable for some people.

Herbalists use Aesculus hippocastanum to strengthen the walls of blood vessels, although other herbs appropriate for the person will also need to be added to the combination to help achieve the effect. Old herbal books refer to this action as a "venous tonic", used for varicose veins, haemorrhoids, oedema, sprains and bruises, to name just a few.

A simple ointment (or a more complicated cream!) can be made by infusing the conkers (broken up first) into good quality organic oil for a number of hours, then solidifying with beeswax (or similar).

Rosehips and inflammation

The fruits (hips) of the dog rose, Rosa canina, have been recorded as being an effective remedy for numerous inflammatory disorders in a variety of folk medicine traditions. Examples include arthritis, gout, haemorrhoids and inflammation in the intestine. Certainly, many herbalists add rosehips to a prescription of other herbs for people with these conditions.

Rosa canina (rosehip)

Active constituents contained in rosehips include phenolic acids, proanthocyanidins, tannins, flavonoids, unsaturated and polyunsaturated fatty acids, phospholipids, minerals, galactolipids and carotenoids (Chrubasik, 2008).

Preparing rosehip tincture

Although numerous studies conclude that rosehip preparations can be more effective than some orthodox medications, it has not yet been decided which of the constituents in rosehips bring about this anti-inflammatory and pain relieving effect.

This is a common theme throughout herbal medicine, and is thought to be because several constituents contained in the whole plant are required to work together to achieve the effect, for example, one constituent improving the absorption of others. It is frequently found that isolating (and sometimes strengthening) the constituents presumed to be the important ones, can actually either reduce the therapeutic effect, or bring about side-effects - so this is why herbalists use the "real" plant rather than a chemically altered version. Indeed, this is also the reason why herbalists combine several herbs in a prescription - to increase effectiveness and offset any adverse effects.

Here are my gathered rosehips, tincturing, soon to be pressed and bottled - although I did have to decant some off yesterday for someone who just couldn't wait!

Rosehips, tincturing

Here are some studies if you want to read more!

Bohm, V., Frohlich, K., Bitsch, R. (2003). Rosehip - a "new" source of lycopene? Molecular Aspects of Medicine 24 385-389

Christensen, R., Bartels, E.M., Altman, R.D., Astrup, A., Bliddal, H. (2008). Does the hip powder of Rosa canina (rosehip) reduce pain in osteoarthritis patients? - a meta-analysis of randomized controlled trials. Osteoarthritis and Cartilage 16 965-972

Chrubasik, C., Roufogalis, B.D., Muller-Ladner, U., Chrubasik, S. (2008). A systematic review on the Rosa canina effect and efficacy profiles. Phytotherapy Research 22 725-733

Lattanzio, F., Greco, E., Carretta, D., Cervellati, R., Govoni, P., Speroni, E. (2011). In vivo anti-inflammatory effect of Rosa canina L. extract. Journal of Ethnopharmacology 137 880-885

Orhan, D.D., Hartevioglu, A., Kupeli, E., Yesilada, E. (2007). In vivo anti-inflammatory and antinociceptive activity of the crude extract and fractions from Rosa canina L. fruits. Journal of Ethnopharmacology 112 394-400

Hawthorn, a herb for heart health

The value of hawthorn (Crataegus spp) to a herbalist cannot be overstated! Luckily, it is a frequent find in the UK hedgerows.

Hawthorn berries (Crataegus spp)

Hawthorn (Crataegus spp)

Flowering tops are picked in the Spring, and the ripe berries collected in the Autumn. These are used to make tinctures (medicines), or dried for teas (infusions) and capsules.

Whilst most herbs tend to have numerous widespread actions, hawthorn is almost exclusively a herb used for the heart and circulatory system by modern day herbalists, and hawthorn is regarded as one of the safest herbs in our dispensary.

The actions of hawthorn have been used to help people with conditions such as angina, mild to moderate heart failure, either high or low blood pressure (depending on which other herbs are combined with the hawthorn in the prescription), Raynaud's Syndrome, atherosclerosis, some menopausal symptoms, chilblains, varicose veins and many other cardiovascular complaints. The precise effect of a prescription will, of course, depend upon which other herbs the hawthorn is combined with. 

A vast array of studies support such clinical uses of hawthorn. For example, the European Journal of Heart Failure reported Crataegus to be beneficial in treatment of heart disease due to induction of cAMP-independent positive inotropy, peripheral and coronary vasodilation, protection against arrhythmias, having antioxidant properties and anti-inflammatory effects (see below for more).   

Although a gentle herb, anyone with an existing health condition, or currently taking medication, should seek advice before using any herbs.

Hawthorn and lime blossom tea

Editorial (2008). Towards a systematic approach in the assessment of efficacy of an herbal preparation: Hawthorn (Crataegus spp.). European Journal of Heart Failure 10: 1153-1157

Krzeminshi, T., Chatterjee, S.S. (1993). Ischaemia and early reperfusion induced arrhythmias: beneficial effects of an extract of Crataegus oxyacantha. L Pharm Pharmacol Lett 3: 45-48

Finally...a new facebook page!

So, I've finally started a new Facebook page! Take a look...

https://www.facebook.com/pages/Lyn-Blythe-Medical-Herbalist/131692193699888


 

Free Advice on Safely Tailoring Herbal Remedies to Your Individual Needs (proceeds to MS)

For anyone in Wiltshire:

FREE PAMPER DAY AT THE SWINDON THERAPY CENTRE FOR MS on Friday 2nd May (10am-2pm)
All proceeds to the MS therapy centre (a registered charity).

I will be offering FREE HEALTH CHATS and ADVICE ON TAILORING HERBAL REMEDIES to your individual health needs.

Swindon Therapy Centre for MS                      

Bradbury House,
Westmead Drive,
Swindon.
SN5 7ER.

See www.lynblythe.com for information on Herbal Medicine, and for a map and directions to the Swindon Therapy Centre for MS, or email lyn@lynblythe.com.

Other free therapies available include physiotherapy, massage, yoga, Nordic walking, Bowen Technique, reflexology, reiki, beauty treatments, Cyclossage massage bed.

Free open day

For anyone in Wiltshire:

I have Herbal Medicine practices in both Swindon and in Melksham, Wiltshire.

Come along to the open day at the clinic where I practise in Melksham.
Find out, with no obligation, whether Herbal Medicine could help you.

1-3pm on Saturday 18th January, 2014 at the Melksham Family Chiropractic Clinic.

There's a map on my website:
http://www.lynblythe.com/clinics.php

The humble dandelion (Taraxacum officinale)

The humble dandelion, Taraxacum officinale, uprooted by gardeners, is one of the plants most commonly used by Herbalists!

Taraxacum officinale (dandelion)

Research supports the use of the leaves as a diuretic. This effect has been used to reduce high blood pressure, but, whereas conventional diuretics can cause potassium loss, with associated side effects, this does not occur with dandelion as the leaves are rich in this mineral.

The root has been used by Herbalists throughout history as a digestive aid, to help constipation and to improve some joint and skin conditions. Studies increasingly support this use.

Dandelion is rich in vitamins A, B, C, D and minerals, including potassium, iron, copper, calcium and zinc

Taraxacum officinale (dandelion)

Herbal Medicine - a prescription tailored to your individual health.

A consultation with an Herbalist lasts at least an hour. During that time there will be a long discussion about the symptoms and ailment bothering you. The consultation then moves on to all other aspects of your health. This allows the Herbalist to gain a wealth of information about your current health, and also your past medical history  - all vital to the success of the prescription.

The herbalist aims to identify and address the cause of symptoms, rather than suppress them, as symptoms are warning signs to indicate a health problem.

A prescription of herbs is tailored to each individual, so two people with the same condition are unlikely to be given the same combination of herbs. Often there are many herbs which may address the problem concerned. The herbalist is trained to select the most appropriate for each individual, and to combine this with other herbs to support the effect.

As a consequence of the detailed consultation, the herbalist is often able to select herbs in a way which allows several health issues to be addressed at the same time.

An example of this is provided by considering a scenario of two people complaining of eczema. One person may have symptoms triggered by stress, but a medical history of raised blood pressure and poor sleep. The second person may have eczema triggered by a food intolerance, with a history of frequent headaches and digestive symptoms. Prescriptions for both are likely to have some similarities, but the combinations of herbs for each will also include important differences, allowing the specific underlying health issues of each individual to be addressed.

For more details on Herbal Medicine, visit www.lynblythe.com

Tinctures (medicines) in the dispensary

Hayfever (seasonal allergic rhinitis)

Now is the time to be thinking about hayfever - ie. before your symptoms kick in.

Symptoms occur following inhalation of airborne particles, such as grass pollen. Hayfever may be accompanied by asthma. Minimising exposure to known allergens may reduce symptoms. Sometimes, however, it is difficult to identify the allergen concerned, or it may be difficult to reduce exposure to it.

Can herbs help?

There are a great many reports of hayfever responding well to Herbal Medicine. However, each person is an individual, with their own unique medical history, so their hayfever must be addressed accordingly.

The Medical Herbalist's approach to hayfever: herb combining for the individual.

The first visit involves a discussion of the person's entire medical history, including their hayfever. This information allows a combination of herbs to be selected and tailored to the individual. The combination which works for one person, may not be appropriate for another.

For more details see http://www.lynblythe.com/why_visit_herbalist.php

There are many herbs which have been used traditionally for allergy such as hayfever. There is an increasing volume of scientific research focusing on uncovering some of the actions of these herbs.

The final prescription will include herbs with actions appropriate for the individual's hayfever symptoms, such as anticatarrhal, anti-inflammatory, expectorant, with simultaneous consideration of other health complaints, such as a tendency to cystitis or poor sleep. It is for this reason it is often stated that in addressing one complaint, other complaints are often helped too. This is also the reason why a combination of herbs is used - as one herb will not provide all required actions.

Nettle (Urtica dioca) is possibly the herb most commonly read about in hayfever self-help articles.

Nettle (Urtica dioica)

However, there are a great many more which are considered to be equally as useful. Golden rod (Solidago virgaurea) may be included in a hayfever prescription. This would be especially indicated for someone who also suffers from frequent urinary tract infections as it has a history of use for this complaint too (in conjunction with other urinary herbs). Eyebright (Euphrasia officinalis) is another example of a herb which has been used in hayfever, especially, although not exclusively, if the eyes are badly affected. In fact, its combination of astringent and anti-inflammatory constituents makes it a valuable addition to prescriptions for many conditions requiring mucous membrane repair, for example, sinusitis. Elderflowers (Sambucus nigra) also have a history of use by people with the catarrh accompanying hayfever. Unfortunately the sugary bottled cordial often found on supermarket shelves is not a substitute for the "real thing" found in the hedgerows!

Elderflowers (Sambucus nigra flos)

Depending on the specific symptoms and the medical history of the individual presenting, other more expectorant, and possibly antimicrobial, herbs may be added, in addition to herbs to support the immune system as part of a preventative strategy.

If symptoms are very severe, the herbalist may consider using a stronger remedy, such as Poke root (Phytolacca decandra) or Ephedra (Ephedra sinica). Research is uncovering which constituents in Ephedra might be responsible for it's reported bronchodilating and anticatarrhal effects.

For more details on Herbal Medicine, visit www.lynblythe.com