Introduction
Ginkgo Biloba, For
Your Memory
Herbs
To Help You Sleep
Herbs
For Anxiety And Depression
Herbs
For Your Heart
Herbs
For The Prostate
Summary
Introduction
A few months ago, I gave a talk at a local “Y” to a group
of seniors on the subject of herbal medicine. I opened the talk by asking
how many of those in the room were taking Ginkgo biloba, an herb that may
help slow memory loss in the elderly. Seventeen of the twenty-one people
who were there raised their hands. No big surprise, given the amount of
press Ginkgo has gotten in the last year or two. Then I asked how many
of them had shared with their doctor the fact that they were using this
herb. This time only one man raised his hand. People in the group had many
answers when I asked them why they were not willing to discuss this with
their doctors: “He wouldn’t be interested”; “She’d tell me to stop”; “He
wouldn’t know anything about it anyway.” It seems we have a long way to
go in teaching our doctors how to talk to their patients about alternatives!
Ginkgo
Biloba, For Your Memory
So what about Ginkgo? Does it work? Is it safe? Who should
take it?
Benefits for people with dementia
Well, there is some good medical evidence that Ginkgo,
taken at a dose of 120 mg per day, can slow down the progression of dementia
in older adults. The effect is fairly modest—it’s not a miracle cure by
any means—but it was significant enough to be recognized both by the patients
themselves and their family members. The effect was shown both in those
with Alzheimer’s and in those with dementia from other causes. A much larger
study, to involve almost 2000 people at a cost of almost $15 million, has
just been funded by the National Institutes of Health, and will be carried
out over the next two years. Compared to the earlier study, which involved
less than 200 people, this one should provide more conclusive answers about
how well Ginkgo works and who should take it.
Benefits for those without dementia
What about older adults without dementia who just feel
they have lost some of their edge and are looking for a way to get it back?
And what about younger adults who want to improve their performance at
work? Will they benefit from ginkgo? The answers are not yet in, though
one recent study in younger adults did show an improvement in short-term
memory in those taking ginkgo. This is just one study, though, and we need
additional testing and larger tests before we can answer these questions.
Is gingko safe?
In general gingko is quite safe, though some people will
experience upset stomach or nausea. The one concern has to do with ginkgo’s
blood-thinning properties. Ginkgo can interfere with the action of platelets,
a type of blood element which is crucial to blood clotting. There are a
few (and only a few) case reports of patients on ginkgo having unusual
or excessive bleeding. Given the huge numbers of people who have been taking
ginkgo over the past few years, the number of cases of bleeding reported
is actually very small. To be on the safe side, however, patients on strong
blood-thinning medications like Coumadin should probably not take ginkgo.
If you take aspirin or other blood thinners, you should discuss this issue
with your doctor. And if you are preparing for a surgical procedure and
you take gingko, you should probably stop a week or so before the surgery
to reduce the chance of any bleeding complications.
Choosing the right product
Finally, it is important to get a ginkgo product that
is at least similar to the extract used in the studies if you expect to get a similar effect. There are numerouse products on the market, many of which are not nearly concentrated enough to be effective. Yours should
be an extract standardized to 24 percent flavone glycosides and 6 percent
terpene lactones, the active ingredients in ginkgo products. Take the names
of these components to your pharmacist and tell him to make sure the ginkgo
he sells you includes each of them!
Herbs
To Help You Sleep
There are some wonderful herbs that you should try if
you share the sleep troubles that seem to plague many of my older patients.
Valerian
The first is valerian. This herbal medicine, made from
the root of the plant Valeriana officianalis, has worked wonders for some
of my patients. It smells and tastes terrible, so be prepared; but it is
also extremely safe and rarely causes even a stomachache. It is not
addictive. Contrary to the information in some sources, which claim it
resembles the prescription medicine Valium, its effects are very gentle
and not habit-forming. As with ginkgo—and every herbal medicine for that
matter—it is important to get a good quality product. With valerian I usually
recommend the tincture (herb in alcohol solution) because the recommended
dose of this herb varies widely from one person to the next and it is much
easier to adjust the dosage with a liquid formulation than with capsules.
I start my patients on 10-15 drops of the tincture, usually given in an
ounce or two of warm water. They take this 30-60 minutes before bedtime.
If this dose is not completely effective, they can go up to 40 or even
50 drops. Valerian does seem to work better if you take it on a daily basis,
rather than just now and then for sleep.
Additional sleep aids
A number of other herbs work nicely for sleep and can
be taken in the form of an infusion or a tea. These include chamomile,
oatstraw,
skullcap, and spearmint.
I usually ask my patients to mix several of these together and brew a strong
cup of tea an hour or two before bedtime. These herbs are all extremely
safe, and a hot cup of herbal tea in the evening can be wonderfully therapeutic.
If you are using raw herbs or teabags, it is important to make sure you
keep your supply fresh, since many of these will lose their potency if
they sit too long on the shelf.
Herbs
For Anxiety And Depression
There are a number of herbs I recommend to relieve anxiety
and depression.
Valerian
Valerian is indispensable for sleep problems, and it
can also be very helpful if you are suffering from anxiety. The dose is
usually about half the dose required for sleep problems, although again
this will vary from person to person.
Kava kava
Another herb that has become quite popular recently for
anxiety is kava kava. This herb, extracted from the plant Piper methysticum,
has been used for many years in the islands of the South Pacific. You can
find kava in either tincture or capsule form; as with ginkgo, you should
look for a standardized extract, this time with 70% kavalactones.
The proper dose is roughly 100 mg two to three times per day; it is fine
to use it less if it is needed only occasionally.
There are a few cautions to be aware of regarding the
use of kava. First, it may potentiate or increase the sedative effects
of other substances or medications, like alcohol or other tranquilizers;
second, you should not use it if you are suffering from moderate to severe
depression; and third, it is not recommended to be used daily for more
than three months at a stretch, simply because we do not know enough yet
about its long-term effects. I use kava often in my practice and consider
it quite safe, so don’t let these cautions scare you if it seems like the
right choice for you.
St. John’s Wort
I have many patients, both old and young, who have used
St. John’s Wort over the past few years for depression. Although it doesn’t
work for everyone, and is not for those with severe depression, I have
found it to be very helpful for some of my patients. The proper dose of
this herb is 300 mg three times per day, and again it should be a standardized
extract. Generally people choose to take St. John’s Wort in capsule form,
though it is also available in liquid formulations. It is milder than conventional
antidepressants and takes longer to work—up to six to eight weeks in some
people—but it is also much easier to tolerate in terms of side effects.
There are quite a number of studies from Europe finding that St. John’s
Wort, if used properly, works just as well as many conventional antidepressants.
One caution with this herb: if you are currently taking
a medication from the group of antidepressants called SSRI's—Paxil, Prozac,
Zoloft and the like—and you are looking to switch to St. John’s Wort, you
should probably stop the medication before starting the herb, as there
is some question as to whether it is safe to take both the herb and these
medications at the same time.
Herbs
For Your Heart
It is hard to think of an herb more versatile than garlic,
which has been used all around the world as both a food and medicine. I
find in my practice that the people garlic most benefits are those with
high cholesterol. In study after study, one clove of garlic per day—or
the equivalent in capsule form—has been shown to reduce cholesterol by
an average of 10 percent. Although this does not sound like much, when
you combine garlic with proper diet and exercise regimens, that 10 percent
extra may be the difference between needing a medication and being able
to avoid it!
There are only a couple potential downsides to garlic.
First is the odor—which, if it bothers you (or your spouse) you can avoid
by choosing the de-odorized capsule form. Second, there is a possible increase
in bleeding tendency similar to that seen with ginkgo.
Cooked garlic is not quite as good as raw, because the
cooking process causes some of the medicinal properties to be lost; however,
putting your garlic into a dish for the last two to three minutes of cooking
is probably fine.
Garlic has also been touted for its ability to lower blood
pressure, and many of my patients tell me they use it for this reason.
In my experience, though, I have not seen it work well for blood pressure
problems, and when you investigate the research, it turns out that, although
garlic does have an effect on blood pressure, this effect only lasts about
30-60 minutes after ingesting the garlic. So unless you want to eat a clove
of garlic every one to two hours, don’t count on it as treatment for your
high blood pressure.
Herbs
For The Prostate
One final herb, which my patients would never forgive
me for leaving out of this article, is saw palmetto.
A common problem in men over the age of 50 is a benign enlargement of the
prostate. This can create a difficulty with urination, and for this problem,
saw palmetto can be a real blessing.
It is taken twice a day in a dose of 160mg each time and
has no significant side effects. Many urologists are now recommending saw
palmetto routinely for treatment of BPH (benign prostatic hypertrophy)
because there is so much evidence that it works just as well in most people
as the conventional medications, with a much lower rate of side effects.
If you are on one of the standard medications and it is working for you,
but you are experiencing side effects, it is also fine to combine saw palmetto
with conventional treatment. This will enable you to lower the dose of
the regular medicine and reduce the side effects. One caution: contrary
to the claims made in some sources, saw palmetto is not a treatment for
cancer of the prostate.
Summary
Hopefully this discussion has given you some ideas about
herbs that might suit your needs, and how to use them. Now we just have
to encourage the doctors to be as informed as their patients are!
