Winter Maladies: Natural Approaches
June Russell's Health FactsCaveats: Conflicting Reports on Herbs[Garlic] [Ginkgo] [Kava] [St. Johnswort] [Related Link - Echinacea] Garlic
Certain studies found that garlic does not actually lower cholesterol: garlic supplements were used, not fresh garlic. One study in the Journal of the American Medical Association tested a garlic-oil preparation on patients with high cholesterol; the other, appearing in the Archives of Internal Medicine, evaluated garlic powder. Both studies were placebo-controlled and lasted 12 weeks. Neither supplement was found to have any effect on cholesterol levels. All garlic supplements are processed garlic, and they don't necessarily reproduce the effects of the whole fresh herb. Meanwhile, a number of previous studies indicate that fresh garlic indeed does lower cholesterol levels beside having other healthful effects on the cardiovascular system. If you have high cholesterol, include more fresh garlic in your diet. GinkgoThe value of any dietary supplement cannot be determined on the basis of one study alone, says Mark Blumenthal, founder and Executive Director of American Botanical Council in Austin, Texas. Impressive evidence supports the benefits and safety of Ginkgo biloba. There have been more than 125 clinical trials published on this herb over the last 20 years, with several recent studies having shown ginkgo's cognitive benefits both in healthy adults and in those demonstrating early signs of dementia.
JAMA published the results of a six-week placebo controlled study, which showed that when compared to a placebo, Ginkgo biloba did not improve memory function in healthy older adults. One limitation of the study is that it is hard to demonstrate improved memory in a person who does not have memory problems, notes Jerry Cott, a psychopharmacologist and an expert on dietary supplements. The doses and duration in this study were relatively conservative, consisted of low doses and shorter duration of trial (40 mg three times a day for six weeks). In reference to the well-publicized study in JAMA which concluded that Ginkgo biloba did not improve memory in healthy people over the age of 60 when taken for six weeks: six weeks is too brief a period to study the efficacy of most herbs (or drugs for that matter), and it is common knowledge that it takes as long as 12 weeks to produce benefits. Nowhere was there a mention of the dozens of positive studies on this useful herb. You need to take a minimum of 120 mg a day (standard extract) for at least 12 weeks.
The August 21, 2002 issue of the Journal of the American Medical Association (JAMA) studied the effectiveness of Ginkgo in enhancing the memory of elderly adults. More than 200 healthy men and women over the age of 60 who did not have any cognitive impairment was given either 40 mg of Ginkgo three times a day or a placebo. After six weeks, researchers concluded that the herb did not improve memory, attention, concentration, or cognitive function. I was shocked to see how poorly this study was designed. Normally, researchers who are studying the benefits of a drug or a nutritional supplement use volunteers who already have some degree of memory loss or even Alzheimer’s disease. This way you can demonstrate an improvement related to the therapy. In contrast, these researchers gave Ginkgo to 200 people who didn’t have any memory loss, and then claimed it was not effective because it did not give them "super memory." Based on this study individuals who are taking Ginkgo should not stop using it. A large number of positive studies presented in the Lancet and the British Journal of Clinical Pharmacology, and other mainstream medical journals have shown that Ginkgo is beneficial for treating memory loss and Alzheimer’s disease. Research studies have also shown that Ginkgo has great promise for the treatment of stroke and even normal aging of the brain. Typical of the mainstream media coverage is the headline, "New Study a Blow to Ginkgo’s Reputation." The weaknesses in a Williams College Study that tested the efficacy of Ginkgo biloba on cognitive function: the trial period was only six weeks, and with an additional two, four, or more weeks there would have been some positive results. The same week the study was released, Ginkgo was compared to snake oil on MSNBC, Reuters, CNN, and other news services. However, the Alzheimer’s Society in the United Kingdom sent out a press release stating that new research had provided promising evidence that Ginkgo biloba may improve both memory and overall function for people with dementia. And did we hear a peep out of CNN? Do you have to ask?
The Cochrane Collaboration is an international, not-for-profit organization that oversees systematic reviews of health-care interventions. Of the 33 previous trials of Ginkgo, the evidence convincingly shows that Ginkgo biloba may benefit cognition, emotional function, and activities of daily living in patients who are in the early stages of Alzheimer’s. Furthermore, in less than three months, many patients experienced positive results using a dose of less than 200 mg per day, and there were also no significant differences in adverse side effects between Ginkgo and placebo groups in the various studies.
According to a 14-week, double-blind, placebo-controlled trial presented at a National Institute of Mental health seminar in July 2002, the combination of Ginkgo biloba and Ginseng (Panax) can promote fast, accurate thinking, improve short- and long-term memory retention, and can reduce mental fatigue. The 256 healthy volunteers with neurasthenic complaints were between the ages of 38 and 66.
From the news media: "Ginkgo Supplements Don’t Help Memory!" MSNBC and CNN declared: "New Study a Blow to Ginkgo’s Reputation!" Even Reuters Health, a more reserved news outlet reported: "Study Suggests Ginkgo Ineffective Memory Enhancer." The only impression the public comes away with is that Ginkgo doesn’t work. Allen S. Josephs, MD, Section Chief of Neurology at St. Barnabas Hospital in Livington, NJ, said that it was appalling that the news media has been giving so much media attention to this ridiculously short term negative study on Ginkgo. He added that six weeks is not enough time for any supplement or drug to work when it comes to memory, and for the media to state that a six-week study would therefore, indicate that there would be no long-term benefit, is absolutely ludicrous. Also 120 mg is too low. Most herbalists and medical professionals who use alternative treatments suggest that it be more than 240 mg or more per day, and that the most effective results would be seen over a long period of time — not just a month and a half. In the past 35 years there have been over 300 clinical trials of Ginkgo biloba, and the evidence from those trials is overwhelmingly positive. The irresponsible media coverage may have drawn plenty of attention and upped readership, but it did so at the cost of misinforming their audience. Kava
The FDA has warned consumers about products that contain the herb kava. Several reports from Europe and the United States have linked serious liver-related diseases to the use of kava-containing supplements. However, an analysis by toxicologist Donald Waller, PhD, Professor of Pharmacology and Toxicology at the University of Illinois at Chicago, concluded that many of the cases of liver damage may have been explained by the concomitant use of alcohol or drugs, which are known to damage the liver. He stated that only a few cases appeared to be directly linked to the use of kava. Closer examination reveals that of the 30 European cases, 21 cases, a vast majority, involved the concomitant use of hepatotoxic drugs and/or alcohol. The fact is that a person is likelier to suffer from liver damage by taking the prescription anti-anxiety drug, Valium, as taking kava, yet Valium is taken by millions daily with little question, and with no major adverse publicity. Jerry Cott, PhD, former Chief of the Psychopharmacology Research Program at NIMH said there was a small clinical study from Duke University, published in Oct. 2002 that showed no adverse effects from kava on the liver.
The Medwatch site contains numerous "kava toxicity" reports of cases due to a product sold at a 1996 New Year’s Eve (dance) event, alleged to contain kava, but in fact contained a highly toxic industrial chemical, called 1,4-butane-diol — and absolutely no kava. The Los Angeles police department toxicologists within weeks published a report to this effect. Nonetheless, these spurious claims against kava have remained on the FDA website ever since. In general, anyone can report anything to Medwatch: no proof of actual content is required for a posting, which does not product the public from truly bad products, but may, as in this case, wrongfully malign others. Kava’s margin of safety far surpasses that of it’s pharmaceutical equivalent. At the end of 2001, German and Swiss health authorities announced that they held kava consumption responsible for more than 30 cases of somewhat serious liver toxicity, including four cases requiring transplantation and one death. The story spilled over to the U.S. The mainstream media was all too happy to report something negative about an herbal remedy, despite the fact that millions of people around the world had been using kava for years to effectively treat their anxiety and sleep disorders. Yet the main ingredient in Tylenol caused 114 reported cases of liver damage but was still widely available. All the while, ‘traditional’ physicians continued to prescribe Valium and other benzodiazepines like Xanax, Ativan, and Klonopin for anxiety and insomnia — man-made drugs, each with a long history of serious side effects. We knew better than to expect fair coverage of the kava situation. Hyla Cass, MD, author of "Kava: Nature’s Answer to Stress, Anxiety, and Insomnia, is an expert on this South Pacific herb. She pointed out that most of the 30 cases identified by European authorities involved the simultaneous use of kava and alcohol or other substances, including prescription drugs known to poison the liver. She noted that many mainstream over-the-counter and prescription drugs are far more likely than kava to cause liver damage. Dr. Cass still warned that kava should not be used by people with known liver problems or by people taking other drugs that may affect the liver. She also recommended limiting the daily use of kava to no more than 3 months at a time, and discontinuing if there is any sign of liver toxicity. St. Johnswort
There was a biased reporting of a study in which St. Johnswort was set up to fail: testing it’s efficacy in cases of ‘moderately severe major depression." The mainstream press reported that study as a failure for St. Johnswort because the herb performed only as well as a placebo. Not mentioned in any of the headlines was the fact that Zoloft (a drug specifically designed to treat major depression) performed no better than St. Johnswort in the same trial. A new review of 34 trials gives up a more accurate view of St. Johnswort as a treatment for mild to moderate cases of depression. The authors of a report in Phytomedicine also noted that only 1 to 3% of the subjects using St. Johnswort reported side effects, while 20 to 50% of the subjects who used the pharmaceuticals reported problems with the drugs. Even though this review generally shows St. Johnswort to be safe, the researchers pointed out that the herb may interact poorly with some medications such as cyclosporine (an immune system suppressor), warfarin (an anticoagulant), and birth control pills. This review of studies was ignored by the mainstream press, and barely covered at all in the medical press. When perceived to have failed in a single study, the headlines blared from every masthead, but when a comprehensive review of many studies clearly indicates that the drug giants with their vast resources, have as of yet been unable to come up with anything more effective for a moderate depression than a humble, flowering herb, you barely hear a peep. Related Link - EchinaceaRelated Links about Other Supplements
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