Galen's Watch

Nasal Irrigation for Seasonal Allergies

2013-04-25T13:50:14-04:00

Spring seems to have arrived after a shaky start! The last 2 posts on seasonal allergies covered supplements, herbs, probiotics, and nutraceuticals.

Seasonal Allergies: Astragalus, Pycnogenol and Silymarin

Seasonal Allergies and Probiotics

In addition to trying supplements either herbal or nutraceutical you could also try nasal irrigation for your allergies. Several studies have shown that nasal irrigation can reduce the symptoms of seasonal rhinitis.

One study listed below uses a product called Sinus Buster that contains homeopathic Capsicum (cayenne pepper) and eucalyptus. That is a homeopathic dilution of capsicum so don't be confused and whip up a batch of capsicum spray for your nose. It will be wildly awakening. I have seen someone snuff capsicum tincture up their nose and they survived but it was an eye watering experience. In this study the homeopathic spray was used twice daily for 2 weeks and compared to a placebo spray. The treatment spray group had relief in under 1 min, decreased pain and pressure that persisted for 60 minutes. There was no rebound congestion.

The second study compared buffered hypertonic solution to normal saline solution in children with seasonal rhinitis. The patients used the spray twice a day for 4 months. The hypertonic group did show greater improvement at 2 weeks compared to the normal solution but this seems to equalize between the the 2 groups at 4 weeks. There might be some indication to try a hypertonic solution but if you can't find it regular saline solution would be fine.

The last review took a broad look at nasal irrigation as an additional treatment to seasonal allergies. The reviewers chose 10 trials to report on. It was found that nasal symptoms improved 27.66% and there was a corresponding reduction in medication of 62.1% and an improvement in quality of life when patients used nasal irrigation.

To put a herbal spin on this I found an interesting article by Jim McDonald where he found an old recipe for Yerba Mansa nasal spray that he has tried and found to be very effective. I think it is an interesting idea to make a herbal saline solution. He also has a great article on sinusitis that has lots of great information in it.

Capsicum Nasal Spray for Non-allergic Rhinitis

Forty-two subjects were randomly assigned to ICX72 (Sinus Buster)* or control administered twice daily for 2 weeks. The formula ICX72 is a homeopathic preparation of Capsicum 3x and Eucalyptus. At the end of the study the ICX72 subjects compared to the placebo subjects had significant differences in the change of total nasal symptom scores and individual symptom scores. The ICX72 subjects average time to first time relief was 52.6 seconds and there was an improvement in nasal congestion, sinus pain, sinus pressure and headaches at 5,10,15 and 30 minutes persisting to 60 minutes for nasal congestion and sinus pain. There was no difference between groups in adverse effects. The ICX72 group compared to placebo subjects experienced no rebound congestion or impaired olfaction at the end of study.

*Active Ingredients: Capsicum 3x (capsaicin), Eucalyptus globulus TINC (eucalyptol) Inactive Ingredients: Ascorbic Acid (Crystallized Vitamin C), Purified Water, Rosemary Extract, Sea Salt, Vegetable Glycerin

A randomized, double-blind, parallel trial comparing capsaicin nasal spray with placebo in subjects with a significant component of nonallergic rhinitis. Ann Allergy Asthma Immunol. 2011 Aug;107(2):171-8. Epub 2011 Jun 29

Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: a randomized double-blind study. Int J Pediatr Otorhinolaryngol. 2012 Apr;76(4):583-8.

Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis. Am J Rhinol Allergy. 2012 Sep-Oct;26(5):e119-25.

Seasonal Allergies and Probiotics

2013-04-12T13:55:05-04:00

The last post referred to pycnogenol, astragalus and silymarin for seasonal allergies. This week it's probiotics. Two studies came up both involving children.

Lactobacillus salivarius or placebo was used in 199 children with allergic rhinitis for 12 weeks. There was a reduction in symptoms and a slight reduction in medication use.

When examined after 3 months of probiotic treatment, the Lactobacillus salivarius-treated group reported reduced nasal and eye symptoms compared with the UT (untreated) group.

The other study added the probiotic (Lactobacillus johnsonii EM1) to Levocetirizine (antihistamine) to 63 children. This study showed that Levocetirizine plus the probiotic was more effective than the antihistamine alone and that the effect persisted for at least 3 months.

With the many health benefits that have been shown lately about probiotics it might be worth trying a board spectrum probiotic, including natural probiotic foods or make your own fermented food this spring and eat some everyday. Dr Mercola has a good article.

Effect of Probiotics on Allergic Rhinitis in Children

One-hundred and ninety-nine atopic children with allergic rhinitis were randomly assigned to 4 × 109 colony forming units/g of Lactobacillus salivarius or placebo as a powder mixed with food or water for 12 weeks. The lactobacillus group had a reduction in rhinitis symptoms and allergy medication use.

Indian Pediatr. Indian Pediatr. 2013 Feb 8;50(2):209-13. Epub 2012 Jun 10.

A Randomized Prospective Double Blind Controlled Trial of the Effect of Probiotics on Allergic Rhinitis Confined to Df, Dp or Dust-sensitive Children.

Adding Lactobacillus johnsonii EM1 to Levocetirizine for Treatment of Perennial Allergic Rhinitis in Children

Sixty-three children (7-12 years) who had moderate to severe perennial allergic rhinitis (PAR) were randomized to 2 crossover treatment regimens of levocetirizine with Lactobacillus johnsonii EM1 (Lj EM1) (group 1) or levocetirizine alone (group 2) for 12weeks; subsequently treatments were reversed for another 12 weeks. Both groups had improved total symptom score (TSS) compared to the run-in period and the levocetirizine with Lactobacillus johnsonii group was more efficacious than group 2 at week 4,8 and 12. During the second phase the levocetirizine with Lactobacillus johnsonii showed continual and progressive improvement while the levocetirizine only group, did not. The 24-week, 2-phase, crossover treatment program showed that levocetirizine plus Lj EM1 was more effective for PAR than levocetirizine and that this difference persisted for at least 3months after discontinuation of Lj EM1.

Int J Pediatr Otorhinolaryngol. 2012 Jul;76(7):994-1001.

A trial of adding Lactobacillus johnsonii EM1 to levocetirizine for treatment of perennial allergic rhinitis in children aged 7-12years.

Seasonal Allergies: Astragalus, Pycnogenol and Silymarin

2013-04-09T08:23:07-04:00

It is hard to imagine spring is here as it is minus 13 C' with the windchill today and aged frozen snowbanks are holding firm in the shade. Soon the pollen will be in that wind and allergies will be on the minds of some of us.

All of these herbs or supplements have been found to reduce the symptoms of seasonal allergies.

Astragalus was used in a astragalus preparation (Lectranal) in patients with mild-to-moderate seasonal allergic rhinitis. hose patients with ragweed pollen allergy had significant improvement but everyone in the treatment groups did have improvement. The Lectranal website would have you believe that their preparation is the only way to get the needed compounds from Astragalus but as herbs are complex chemical compounds and often the 'active' compound is a mystery there is no reason someone could not use a whole plant astragalus preparation. As noted by Janet Zand LAc, OMD

The last important herb is Astragalus, the renowned Chinese botanical that strengthens the body's defensive or protective energy. It supports the body's ability to resist infections and other disease, and is used for its deep toning properties. Although Astragalus does not directly treat hayfever and allergy symptoms, it may be taken one to two weeks per month during the hayfever and allergy seasons.

If you plan far enough in advance (so go and grab a bottle now!) but it is never too late to start pycnogenol was found to reduce the symptom score of subjects with seasonal allergies and in a twist of the study those who took the supplement in advance of the allergy season (greater than 7 weeks) had the best results. The dosage was
pycnogenol 50 mg twice daily. Further details are in the write-up below.

The last study used 140 mg silymarin three times a day for one month. Silymarin is a Milk thistle (Silybum marianum) extract consisting of 7 flavonolignans and polyphenals. It is a potent antioxidant.

Astragalus membranaceus in Lectranal Preparation for Seasonal Allergic Rhinitis

Forty eight patients with mild-to-moderate seasonal allergic rhinitis (SAR) were randomized to either recieve Lectranal* or placebo for 6 weeks. Compared to placebo, Lectranal decreased the intensity of rhinorrhea. The treatment group had improvement from baseline compared to placebo in symptom score, quality of life, and the four main symptoms of SAR. Patients with SAR due to weed pollen had significantly improved variables with treatment.

Phytother Res. 2010 Feb;24(2):175-81.
Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis.

*Lectranal® is composed of a herbal and a mineral compound produced by using a patent-pending procedure. For hundreds of years, Astragalus membranaceus, a perennial plant, has been used in traditional Chinese medicine for the relief of indigestion, as well as to strengthen the immune system. Our scientists target compounds in the roots of Astragalus membranaceus that help relieve allergic reactions. Since we believe that these substances cannot be absorbed in their active form when taken orally, we have developed a new herbal and mineral complex that will enable their oral absorption. [from Lectranal website]

Pycnogenol Improves Allergic Rhinitis Symptoms When Given Well Before Hayfever Season

This study had 2 parts, one of which was carried out in 2008 and the other in 2009. This synopsis focuses on the 2009 part. Thirty-nine subjects were randomized to receive either pycnogenol 50 mg b.i.d. taken in the morning and evening with food or a placebo. The treatment started 5-6 weeks before the beginning of the 2009 allergy season but, due to the pollen season being delayed that spring, many subjects were using the product for 7-8 weeks prior to birch allergen onset. Subjects were allowed to use over-the-counter antihistamines as required. All subjects were allergic to birch pollen, but many subjects had other pollen allergies as well. The use of antihistamines was 36.7% in the pycnogenol group and 50% in the placebo group. In a sub-analysis, the use of antihistamines was 12.5% in subjects who started treatment > 7 weeks prior to birch pollen appearance . The total average nasal symptom score was lower in the pycnogenol group than the placebo group. The average eye symptom score was also lower in the pycnogenol group, but did not reach statistical significance. Researchers noted that symptom scores were significantly lower in the 2009 group than in 2008 even though there was a much higher birch pollen count in 2009.

Phytother Res. 2010 Aug;24(8):1115-9.
A randomized, double-blind, placebo-controlled exploratory study to evaluate the potential of pycnogenol for improving allergic rhinitis symptoms.

Effect of Silymarin in the Treatment of Allergic Rhinitis.

Ninety-four patients with allergic rhinitis were randomly assigned to silymarin 140mg tid or placebo for 1 month. Both groups received routine antihistamine treatment. The intervention group had a statistically higher improvement of clinical symptom severity compared to the placebo group. After the treatment with silymarin there was a rise in serum IgE level.

Otolaryngol Head Neck Surg. 2011 Dec;145(6):904-9. Epub 2011 Sep 27.
Effect of silymarin in the treatment of allergic rhinitis.

The Best of CAM Studies 2012 - Part 2

2013-03-22T12:59:46-04:00

Here is the second installment of the best CAM studies gathered in 2012. It is a snapshot of the kinds of studies that are published frequently.

Pycnogenol Supplementation Improves Cognitive Function in Students
The Effect of Multiple Micronutrient Supplementation in Sub-fertile Women Undergoing Ovulation Induction.
Cow's Milk Challenge in Children with Cow's Milk Allergy and Suspected Gastroesophageal Reflux Disease (GERD)
Intravenous Vitamin C for Treatment of Shingles.
The Effect of Herbal Extract (EstroG-100) on Pre, Peri and Postmenopausal Women.
Supplementation with Pycnogenol Improves Menopausal Symptoms
Therapeutic Effects of Calcium & Vitamin D Supplementation in Women with PCOS taking Metformin.

Take a look at a entire issue of Galen's Watch by signing up for our free newsletter in the top left corner. Subscribe to the journal watch and get $10 off!

Galen's Watch is a journal watch focused on all medical advances that impact complementary and alternative medicine practitioners.
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-Below are the studies with more detail and links to Pubmed.

Pycnogenol Supplementation Improves Cognitive Function in Students

Fifty-three students (18-27 years) were assigned to 100 mg Pyconogenol a day for 8 weeks and matched to an equivalent group of students. At the end of the study the Pycnogenol group showed significant improvements in several cognitive tests: improved sustained attention, memory, executive functions and mood ratings. The Pycnogenol group had a 58% increase in word recall (11% in placebo) and 12.5% decrease in time to complete task (no significant change in placebo group). Looking at college exams the pycnogenol group had a failure rate of 6.25% compared to the placebo group of 10.71%. The pycnogenol group had 9.6% higher test scores compared to the placebo group.

Panminerva Med. 2011 Sep;53(3 Suppl 1):75-82. Pycnogenol® supplementation improves cognitive function, attention and mental performance in students.

The Effect of Multiple Micronutrient Supplementation in Sub-fertile Women Undergoing Ovulation Induction.

Fifty-eight sub-fertile women undergoing ovulation induction were allocated to either take a multiple micronutrient supplement (MMN) or folic acid. The women underwent 3 cycles of fertility treatment with either clomiphene (Clomid) or gonadotropins (equal distribution within the group). The women had anovulatory infertility or at least one year of unexplained fertility. Women were excluded if they had been taking micronutrient supplement in the last 6 weeks, had moderate to sever endometriosis, very high or low BMI, or smoked or used alcohol excessively. The women in the MMN group had significantly higher cumulative pregnancy rate of 66.7% compared to those on folic acid alone (39.3%). The ongoing pregnancy rate of the women in the MMN group was 60% vs. 25% in the folic acid group. The MMN group had significantly fewer attempts to achieve pregnancy.

The MMN group took: Pregnacare Prenatal made by Vitabiotics, London, UK. http://www.vitabiotics.com/index.aspx plus 50 mg myo-inositol , 50 mg N-acetyl cysteine, L-arginine (100 mg), pantothenic acid (6 mg) and Biotin (150 mcg).

Reprod Biomed Online. 2012 Jan;24(1):54-60. Prospective randomized trial of multiple micronutrients in subfertile women undergoing ovulation induction: a pilot study.

Cow's Milk Challenge in Children with Cow's Milk Allergy and Suspected Gastroesophageal Reflux Disease (GERD)

Seventeen children (median age 14 months) with cow's milk allergy and suspected GERD underwent a cow's milk challenge. For the first 24 hours the infants were kept on an amino-acid based formula and for the 24 hours subsequent to the challenge. The total number of reflux episodes (105 vs. 65) and the number of weakly acid episodes (53 vs.19) were higher during the cow's milk challenge compared to the amino-acid formula. The number of weakly acidic episodes reaching the proximal, mid, and distal esophagus was higher during cow's milk challenge.

J Pediatr. 2012 Apr 17. [Epub ahead of print] Cow's Milk Challenge Increases Weakly Acidic Reflux in Children with Cow's Milk Allergy and Gastroesophageal Reflux Disease.

Intravenous Vitamin C for Treatment of Shingles.

The data of 16 participants with symptomatic herpes zoster received vitamin C intravenously Pascorbin® 7.5 g/50 ml) (2-4 times/week) for approximately 2 weeks in addition to standard treatment. The mean decline of hemorrhagic vesicles from baseline at 2 and 12 week assessments was statistically significant. Common complaints such as fatigue and general impairment improved during the study. Overall 6.4% of participants experienced post-herpetic neuralgia. Of the participants 37 for whom an assessment of previous medication was available was included in a Fisher's exact test. In comparison to previous treatment 37.8% had good efficacy compared to 92.1% in the vitamin C treatment group.

Med Sci Monit. 2012 Apr 1;18(4):CR215-224. Intravenous Vitamin C in the treatment of shingles: Results of a multicenter prospective cohort study.

The Effect of Herbal Extract (EstroG-100) on Pre, Peri and Postmenopausal Women.

Sixty-four pre-, peri- and post menopausal white Hispanic, white non-Hispanic and African American women were randomly assuaged to EstroG-100* 2 tablets a day or placebo for 12 weeks. The mean Kupperman menopause index score was significantly reduced in the treatment group from 29.5±7.4 at baseline to 11.3±5.8 compared to placebo group 29.2±6.6 at baseline vs 23.7±7.7 at week 12. There was an improvement in the treatment group in vasomotor, paresthesia, insomnia, nervousness, melancholia, vertigo, fatigue and rheumatic pain, as well as, vaginal dryness. There was no weight gain or serious side effects in the treatment group.

* EstroG-100, is a propietary formula of standardized extracts: Cynanchum wilfordii, Phlomis umbrosa and Angelica gigas

Phytother Res. 2012 Apr;26(4):510-6. The Effect of Herbal Extract (EstroG-100) on Pre-, Peri- and Post-Menopausal Women: A Randomized Double-blind, Placebo-controlled Study.

Supplementation with Pycnogenol Improves Menopausal Symptoms

Thirty-eight women with menopausal symptoms were given Pycnogenol® 100mg/day for 8 weeks and matched to 32 comparable women. After 8 weeks a subset of the six most common symptoms (hot flushes, night sweats, mood swings, irregular periods, loss of libido and vaginal dryness) showed a decrease from an average of 2.67/4 to 1.45/4. The control group showed no change from 2.72/4 to 2.73/4. The sensation of pain related to headaches, breast pain, the feeling of "electric shocks", tingling extremities, burning tongue and itchy skin all improved significantly in the pycnogenal group compared to baseline. Especially, the sensation of electric shocks and digestive problems improved significantly. Oxidative stress was significantly lower after 4 and 8 weeks in the pycnogenol group.

Panminerva Med. 2011 Sep;53(3 Suppl 1):65-70. Supplementation with Pycnogenol® improves signs and symptoms of menopausal transition.

Therapeutic Effects of Calcium & Vitamin D Supplementation in Women with PCOS taking Metformin.

One hundred infertile women with polycystic ovary syndrome (PCOS) were randomly divided into two groups. Group I was treated with metformin 1500 mg/day, Group II was treated with metformin 1500 mg/day plus Calcium 1000 mg/day and Vitamin D 100 000 IU/month for 6 months. BMI decreased in both groups and almost significantly in-group II. Group II showed an improvement in regulating menstrual abnormalities (70% vs 58%), follicle maturation (28% vs 22%) and infertility (18vs 12%) compared to group I. These results were not statistically significant. Within the PCOS patients 83% were vitamin D deficient and 35% of them were severely deficient. The serum 25-OH-vitamin D mean levels were 13.38 ± 6.48 ng/ml. Vitamin D deficiency was corrected in 74% of patients in Group II. This study showed the positive effects of calcium & vitamin D supplementation on weight loss, follicle maturation, menstrual regularity, and improvement of hyperandrogenism, in infertile women with PCOS.

Complement Ther Clin Pract. 2012 May;18(2):85-8. Epub 2012 Feb 20. Therapeutic effects of calcium & vitamin D supplementation in women with PCOS.

Valentine's Day, Love and Libido in Men.

2013-02-14T09:08:14-05:00

A few studies for men and the people that love them on Valentine's Day. My apologies that there are no studies for women's libido or sexual function. Nothing has come across my desk lately. :(

All of the studies involve supplements and in one case a herb, saffron. A variety of supplements were tried: Coenzyme Q10, pyconogenol, L-argenine, L-citrulline and soy isoflavones. Three were for erectile dysfunction. Twenty-four men with erectile dysfunction were randomly assigned to 1.5g a day of L-citrulline or placebo for 1 month. Fifty percent of the The L-citrulline had an improvement in hardness score and also a small increase in sexual activity. A second study used a combination of pycnogenol and L-argenine in the form of the proprietary formal supplement Prelox®. There was an improvement in erectile function, and testosterone levels. The study was sponsored by Horphag Research and they are a worldwide supplier of Pycnogenol®. It is available in full-free text for you to read. The third study used 200 mg of saffron each morning for 10 days and there was an improvement International index of erectile function questionnaire. The study however was extremely short and only a pilot study. You can read the study here

The other three studies are of interest. It the first study it was observed that men with restless leg syndrome were more likely to also have erectile dysfunction. The second study was In men with prostrate cancer. Two hundred men were given mg a day of isoflavones or placebo for 6 months during radiation therapy. The isoflavone group had less urinary incontinence, less urgency and better erectile function versus the placebo group. The last study was Coenzyme Q10 supplementation in Peyronie's disease. The CoQ 10 group had a 13.6% increase in disease progression in comparison to 56.1% in the placebo group.

Oral L-citrulline Supplementation Improves Erection Hardness in Men with Mild Erectile Dysfunction

Twenty-four men with mild erectile dysfunction (erection hardness score of 3) received a placebo for 1 month and then 1.5 g/d of L-citrulline for 1 month. There was an improvement to an erection hardness score of 4 (normal erectile function) in 8.3% of the placebo group and 50% of the L-citrulline group. The mean number of monthly intercourses was 1.37 ± 0.93 at baseline, 1.53 ± 1.00 at the end of the placebo phase and 2.3 ± 1.37 at the end of the L-citrulline phase. Patients reporting an erection hardness score of 3 to 4 reported being very satisfied.

Urology. 2011 Jan;77(1):119-22. Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction.

Pycnogenol and L-arginine Aspartate Improve Erectile Dysfunction

This double-blind, placebo-controlled trial of 124 men (aged 30-50 years) with moderate erectile dysfunction were given a complex plant extract (Prelox®, a formulation of pine bark extract and l-arginine aspartate) for 6 months. Using the International Index Of Erectile Function, the Prelox group had a statistically significant improvement from a baseline mean (SD) score of 15.2 (6.6) to 27.1 (2.1) after 6 months. In comparison, the placebo group increased from 15.1 (7.0) at baseline to 19.0 (3.1) at 6 months. The total possible score is 30. Mean (SD) total plasma testosterone levels increased significantly from 15.9 (2.3) to 18.9 (2.6) nmol/L after 6 months. The placebo group had an increase of 16.9 (2.4) to 17.3 (2.3) nmol/L.

BJU Int. 2010 Oct;106(7):1030-3. Epub 2010 Feb 22. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study.

Saffron for Erectile Dysfunction

20 male patients with erectile dysfunction were given 200 mg of saffron each morning for 10 days. After 10 days, there was a statistically significant improvement in tip rigidity and tip tumescence as well as base rigidity and tumescence. International index of erectile function questionnaire total scores were significantly higher in patients after saffron treatment.

Phytomedicine. 2009 Aug;16(8):690-3. Epub 2009 May 9. Evaluation of Crocus sativus L. (saffron) on male erectile dysfunction: a pilot study.

Men with Restless Legs Are More Likely to Suffer from Erectile Dysfunction

This community-based study of 23,119 men assessed the occurrence of Restless Leg Syndrome (RLS) and erectile dysfunction (ED). RLS was defined as having restless legs ≥ 5 times a month. Erectile dysfunction was assessed by questionnaire. None of the participants at follow-up had diabetes or arthritis. Men with RLS symptoms 5-14 times a month had an odds ratio for ED of 1.16, and symptoms of RLS >15 times a month increased the odds ratio to 1.78 relative to those without RLS.

Sleep. 2010 Jan 1;33(1):75-9. Restless legs syndrome and erectile dysfunction.

Soy Isoflavones During Radiation Therapy for Patients with Prostate Cancer

Forty-two patients with prostate cancer were randomly assigned to 200 mg soy isoflavone or placebo for 6 months, beginning on the first day of radiation therapy. Radiation therapy was administered in 1.8 to 2.5 Gy fractions for a total of 73.8 to 77.5 Gy. At 3 months, the soy-treated patients had less urinary incontinence, less urgency and better erectile function versus the placebo group. At 6 months, the soy-treated patients had less dripping/leakage of urine (7.7% vs. 28.4%), less rectal cramping/diarrhea (7.7% vs 21.4%), less pain with bowel movements (0% vs. 14.8%) and a greater overall ability to achieve erections (77% vs. 57.1%).

Nutr Cancer. 2010 Oct;62(7):996-1000. Soy isoflavones in conjunction with radiation therapy in patients with prostate cancer.

Coenzyme Q10 Supplementation in Peyronie's Disease

This randomized trial included 186 patients with chronic early Peyronie's disease (PD). The patients were assigned to either 300 mg CoQ(10) daily or placebo for 24 weeks. After 24 weeks, the mean International Index of Erectile Function (IIEF-5) , visual analog scale (VAS) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) were all significantly improved in the CoQ(10) group. There was also a decrease in plaque size and mean penile curvature in the CoQ(10) group and a slight increase in the placebo group. The CoQ(10) group had a 13.6% increase in disease progression in comparison to 56.1% in the placebo group.

Int J Impot Res. 2010 Aug 19. [Epub ahead of print] Safety and efficacy of coenzyme Q(10) supplementation in early chronic Peyronie's disease: a double-blind, placebo-controlled randomized study.

Round out your Knowledge: Great Herbal Blogs

2013-01-31T11:13:03-05:00

There was a time when I searched high and low for good CAM health blogs, especially herb blogs. I was looking for a herb community. Canada is big place and although there are herbalists here we don't often live close together. In school I was surrounded by herbalists but didn't realize that would not always be the case. I should have enjoyed that time more! Now I like to fill my RSS reader with interesting blogs. It's like my own personal newspaper covering only the topics I enjoy. Happily I have recently found quite a few blogs to enjoy and I want to share them with you. I will also add them to my blog roll on the right.

We can all learn from each other and I find each blog addresses an aspect of myself. Sometimes my herbal-poet needs some attention and at other times it's my herbal-wife or herbal-scientist! Whatever your area of focus, reading other blogs enriches us.

The Herb Geek.

I like the mix of this blog. It's about herbs, herb business, contains guest posts and a lot more. It is attractive and easy to navigate and a wonderful resource. I look forward to reading more.

Methow Valley Herbs

There is a lot of information here and it is delivered with intelligence and practicality. Read through the articles and make sure to check out the blogroll before you leave. It is an immense list and resource. Systematically I am going through the blog roll from Methow Valley and look forward to more gems.

Numen: The Nature of Plants

I have not ordered the movie Numen yet but am planning on it. It looks intriguing. Certainly you should view the clip, I think you will be hooked too! I am enjoying the blog where different herbalists are interviewed in depth. No two herbalists are the same and this highlights their uniqueness.

I am looking forward to more blog discovery and reading.If you have a favourite please share it in the comments.

CAM Studies for the Flu and Cold Season: Prevention and Length Reduction

2013-01-18T14:48:18-05:00

The hype around the flu seems to be at a all time high right now. I have not checked the flu-tracker or asked around much because does it really matter. I take care of myself and my family, we try to eat well most of the time, get enough sleep and practice a healthy lifestyle. If we do get the flu then I will work on supporting our health through it and relieving the symptoms. There are no guarantees.

I looked backed through the Galen's Watch issues and scanned for studies that either helped shorten the duration of acute illness or helped lower it's incidence.

Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes
Vitamin D Supplementation in School-aged Children Reduces Incidence of Influenza A
Probiotics Reduce Number of Missed School Days in Children
Intake of Lactobacillus plantarum and Lactobacillus paracasei Reduce the Risk of Acquiring the Common Cold
Whey Supplementation Stimulates Immune Response
Fermented Dairy Product (Lactobacillus casei DN-114001) Decreases Common Infectious Diseases in the Elderly
DHA Supplementation During Pregnancy Influenced Colds in Children at 1,3 and 6 Months

Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes

Seven hundred and fifty-five healthy subjects were allocated to receive either an alcohol extract from freshly harvested E. purpurea* (95% herba and 5% root) or placebo. Participants swallowed 3 × 0.9mL per day for illness prevention. This corresponded to 2400mg of extract per day. During acute stages of colds, the participants were instructed to increase the dose to 5 × 0.9mL per day; this totaled a daily dose of 4000mg of extract. Each single dose was diluted in water and retained in the mouth for 10s. A total of 293 adverse events occurred with Echinacea and 306 with placebo treatment. Echinacea reduced the total number of cold episodes, cumulated episode days within the group, and pain-killer medicated episodes. Echinacea inhibited virally confirmed colds and especially prevented enveloped virus infections. Echinacea showed maximal effects on recurrent infections, and preventive effects increased with therapy compliance and adherence to the protocol.

*Echinacea product was the commercially available Echinaforce drops produced by A. Vogel Bioforce AG, Switzerland. Echinaforce was prepared by alcoholic (57.3% m/m) extraction from freshly harvested E. purpurea with a combination of 95% herba (DER = 1:12) and 5% roots (DER = 1:11).

Evid Based Complement Alternat Med. 2012;2012:841315. Epub 2012 Sep 16. Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double-Blind, Placebo-Controlled Trial.

Vitamin D Supplementation in School-aged Children Reduces Incidence of Influenza A

The study randomized 334 school-aged children to either receive vitamin D(3) supplements (1200 IU/day) or placebo for December through March. Influenza A occurred in 10.8% of children in the D3 group and 18.6% of the placebo group. The reduction in influenza A was more predominant in children who had not been taking other vitamin D supplements and who started nursery school after age 3. In children with a previous diagnosis of asthma, two children in the D3 group had asthma attacks compared to 12 in the placebo group.

Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.

Probiotics Reduce Number of Missed School Days in Children

This double-blind, placebo-controlled study randomly assigned 326 children (3-5 years of age) to receive placebo, Lactobacillus acidophilus NCFM, or L acidophilus NCFM in combination with Bifidobacterium animalis subsp lactis Bi-07 twice a day for 6 months. With single and combination probiotics, but not placebo, reduced fever incidence, coughing incidence and rhinorrhea incidence were observed. Overall, fever, coughing, and rhinorrhea duration was decreased significantly, relative to placebo, by 32% (single strain) and 48% (combination). Antibiotic use and absentee days were also reduced. Results were better for the combination probiotics group than the single strain probiotics group. The researchers concluded that daily dietary probiotic supplementation for 6 months was a safe, effective way to reduce fever, rhinorrhea, and cough incidence, duration and antibiotic prescription incidence, as well as the number of missed school days attributable to illness, for children 3 to 5 years of age. In a 2008 study, it was found that that a regular, long-term intake of various synbiotics may improve health by reducing the incidence and severity of respiratory diseases during the cold season. That 3-stage prospective, randomized, double blind, placebo-controlled study was carried out over a 3-year period with several synbiotic preparations containing 3-5 strains of Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium lactis, lactoferrin and prebiotics such as either FOS (short-chain fructooligosaccharides) or GOS (galactooligosaccharides).

Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27. Probiotic effects on cold and influenza-like symptom incidence and duration in children.

J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 2:S224-33.A new chance of preventing winter diseases by the administration of symbiotic formulations.

Intake of Lactobacillus plantarum and Lactobacillus paracasei Reduce the Risk of Acquiring the Common Cold

Two hundred and seventy-two subjects were randomly assigned to receive either 109 cfu (colony forming units) of Lactobacillus plantarum HEAL 9 (DSM 15312) and Lactobacillus paracasei 8700:2 (DSM 13434) or placebo for 12 weeks. The probiotics group had a 55% reduction in common cold episodes versus 67% for placebo. The number of days with the common cold were also reduced in the probiotic group to 6.2 days compared to 8.6 days in the placebo group. The symptom score was reduced from 44.4 to 33.6 in the probiotic group. The proliferation of B lymphocytes was significantly counteracted in the probiotic group compared to the control group.

Eur J Nutr. 2010 Aug 28. [Epub ahead of print] Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections.

Whey Supplementation Stimulates Immune Response

Seventeen senior citizens were randomly assigned to receive whey (treatment group) or soy (control group) protein for 8 weeks. Four weeks into the study, the participants received a vaccine and antibody levels were measured against 14 pneumococcal types, and a detailed food questionnaire was administered. The serum response was higher in the whey group in 12/14 bacterial types. Whey supplementation led to a higher response in four of the more virulent strains. Calorie and protein intake in the whey group suggested better nutritional status.

Ann N Y Acad Sci. 2010 Mar;1190(1):97-103. Dairy proteins and the response to pneumovax in senior citizens: a randomized, double-blind, placebo-controlled pilot study.

Fermented Dairy Product (Lactobacillus casei DN-114001) Decreases Common Infectious Diseases in the Elderly

This double-blind, controlled trial enrolled 1072 individuals (mean age 76 years) and randomly assigned them to eat either 200 g/day of fermented or non-fermented dairy product for 3 months. The fermented dairy product was Lactobacillus casei DN-114001 (Danone Research). Common Infectious diseases (CID) of the gastrointestinal and respiratory tracts were recorded for frequency. The fermented dairy product significantly reduced all CID with an average duration per episode of 6.5 days (versus 8 days for the control group) and the cumulative duration of CID was 7 days (versus 8 days for the control). There was also a significant positive change for all respiratory tract infections and rhinopharyngitis. There was an increase in L. casei species throughout the fermented dairy product consumption. There was no difference between groups in CID severity, fever, medication, immune blood parameters, or quality of life.

Br J Nutr. 2010 Jan;103(1):58-68. Epub 2009 Sep 14. Consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114001 reduces the duration of respiratory infections in the elderly in a randomised controlled trial.

DHA Supplementation During Pregnancy Influenced Colds in Children at 1,3 and 6 Months

Pregnant women received 400 mg of DHA or placebo from 18-22 weeks gestation through parturition. Data from over 800 infants was collected at 1,3 and 6 months. At one month the DHA group experienced 26% shorter duration of cough, 15% less phlegm and 30% shorter wheezing. There was a 22% longer duration of rash in the DHA group. At 3 months the DHA infants spent 14% less time ill. At 6 months the DHA group experienced 20%, 13%, 54%, 23%, and 25% shorter duration of fever, nasal secretion, difficulty breathing, rash, and "other illness," respectively, but 74% longer duration of vomiting.

Pediatrics. 2011 Sep;128(3):e505-12.Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial.

Zinc Acetate Reduces the Duration of the Common Cold by 42%

The review examined the effect of zinc lozenges on the length of the common cold. Thirteen trials were included. There was no effect found in 5 trials that used a daily dose of zinc of less than 75mg. In 5 trials that used more than 75 mg zinc/day there was a 20% reduction in the duration of the cold. The highest reduction of 42% was seen 5 studies using zinc acetate in daily doses over 75 mg.

Open Respir Med J. 2011;5:51-8. Epub 2011 Jun 23.Zinc lozenges may shorten the duration of colds: a systematic review.

The Best CAM Studies of 2012- Part 1

2013-01-11T14:38:14-05:00

Over the next few weeks I am looking through all the CAM studies gathered in 2012 and highlighting some of the best. This sample gives you an idea of what kinds of CAM studies are being published and staying up with them can take hours of your time. All of these studies are on supplementation but I report on a broad spectrum of CAM studies covering these areas:

Botanical medicine or phytotherapy, homeopathy, acupuncture, vitamins, minerals, neutraceuticals and essential oils
The modalities of Traditional Chinese Medicine, Chiropractic Care, Orthomolecular Medicine, Medical Herbalism, Acupuncture, Homeopathy, Clinical Nutrition, Midwifery and Aromatherapy
Diagnostic principles, therapeutic skills and techniques used by complementary and alternative medicine practitioners
Complementary treatments used by practitioners including hydrotherapy, massage, yoga, meditation and other lifestyle practices.

Galen's Watch is a journal watch focused on all medical advances that impact complementary and alternative medicine practitioners.

The Effects of 90-Day Supplementation with Vitamin B Complex and Workplace Stress

Sixty participants were randomly assigned to vitamin B complex treatment or placebo for 3 months. The B complex contained vitamins B1(75 mg), B2 (10 mg), B3 (100 mg), B5 (68.7 mg), B6 (25 mg), B12 (30 µg) and folic acid (150 µg) taken twice daily. Controlling for individual differences in personality and work demands that the vitamin B group reported significantly lower personal strain and a reduction in confusion and depressed/dejected mood after 12 weeks.

Hum Psychopharmacol. 2011 Oct;26(7):470-6. The effect of 90 day administration of a high dose vitamin B-complex on work stress.

No Difference in Daily or Alternate Day Supplementation with L. Reuteri

Eighteen participants were randomly assigned to eat pudding with L. reuteri (10(9) CFU) daily or on alternate days for one week. Both groups had a similar drop in L. reuteri count 1 week after dosing ended and detectable L. reuteri was similar 1 and 2 weeks after dosing. L.reuteri count was higher in the alternate group on days 2-4 versus daily feeding but similar thereafter. Alternate day probiotic intake achieves equivalent to daily intake but colonization declines rapidly once dosing stops.

J Am Coll Nutr. 2011 Aug;30(4):259-64.Persistence of lactobacillus reuteri DSM17938 in the human intestinal tract: response to consecutive and alternate-day supplementation.

Improvement of sperm quality after micronutrient supplementation

This pilot study included 132 sub-fertile males in active treatment and 73 sub-fertile males in no active treatment. The active treatment group received a micronutrient* twice daily for 3 months. After 3 months the medium ejaculatory volume increased by 33.3%, sperm cell density by 215.5%, sperm motility progressive by 83.1% and total by 36.4%, and normal morphology rate by 23%. At 6 months there were 34 pregnancies the active treatment groups compared to 11 in the control group.

* L-carnitine 440 mg, L-arginine 250 mg, zinc 40 mg, vitamin E 120 mg, glutathione 80 mg, selenium 60 µg, coenzyme Q10 15 mg and folic acid 800 µg.

e-SPEN Journal, Volume 7, Issue 1, Pages e50-e53 Improvement of sperm quality after micronutrient supplementation

Melatonin for Tinnitus

Sixty-one adults with chronic tinnitus completed this randomized, double blind, crossover trial. Subjects received 3 mg melatonin or placebo nightly for 30 days followed by a 1 month wash-out period and then crossed into the opposite treatment arm. There was a significantly greater decrease in audiometric tinnitus matching and Tinnitus Severity Index scores from baseline observed after melatonin treatment compared to placebo. Melatonin was most effective in men who had bilateral tinnitus, noise exposure, no prior tinnitus treatment, absence of depression/anxiety, and greater pretreatment Tinnitus Severity Index scores.

Ann Otol Rhinol Laryngol. 2011 Jul;120(7):433-40. Melatonin: can it stop the ringing?

L-carnitine improves the asthma control in children with moderate persistent asthma.

One hundred children's (50 with moderate persistent asthma and 50 healthy controls) serum carnitine levels were measured and the asthma group was divided into 2 groups. One group was given 350mg L-carnitine tid and the other group was given a placebo for 6 months. Total and free carnitine levels were significantly lower in the asthma group than the control group. Both pulmonary function tests and childhood-asthma control test showed a significant improvement in the L-carnitine group.

J Allergy (Cairo). 2012;2012:509730. Epub 2011 Nov 23.L-carnitine improves the asthma control in children with moderate persistent asthma.

The Effects of L-theanine on Objective Sleep Quality in Boys with ADHD

Over 100 boys (8-12 years) who had been diagnosed with ADHD were randomly assigned to a total of 400 mg daily L-theanine (Suntheanine® -2 tablets after school and 2 tablets at bedtime) or placebo for 6 weeks. The subjects were evaluated for 5 consecutive nights at the beginning and end of the study using wrist actigraphy. The L-theanine group had significantly higher sleep percentage and efficiency scores and a non-significant trend for less activity during sleep. Sleep latency and other sleep parameters were unchanged. The Pediatric Sleep Questionnaire (PSQ) completed by the parents suggested the parents were not particularly aware of their children's sleep quality.

Altern Med Rev. 2011 Dec;16(4):348-54.

The effects of L-theanine (Suntheanine®) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trial.

Ginseng for Menopause?

2012-11-08T11:18:55-05:00

Often the herb ginseng is traditionally associated with stimulating sexual function and increasing energy in men, it is even called man root in some texts. However, more than one study has shown it's positive effects in women.Red ginseng is Panax ginseng that has been steamed before drying as opposed to white ginseng which is just dried.

In this latest study Red Korean Ginseng was given to postmenopausal women ( 45-60 years) daily for 12 weeks. The daily dosage was 3g of ginseng (including 60 mg of ginsenosides). Compared to the placebo group the red ginseng group had significant improvements in the Kupperman index (A numerical index that scores 11 menopausal symptoms: hot flushes, paraesthesia, insomnia, nervousness, melancholia, vertigo, weakness, arthralgia or myalgia, headache, palpitations, and formication) and in the menopause rating scale (psychological, somato-vegetative and urogenital symptoms). There were also some intersting cardiovascular changes. There was a 21% drop in total cholesterol in the red ginseng group compared to the placebo group. As well, there was also a reduction in LDL-C and triglycerides.

Ginseng has a very low toxicity and I was surprised to read that it is a popular herb used in pregnancy in Hong Kong. This is not to say I would recommend it in pregnancy but just wanted to draw attention to a use I had never heard of.

Effects of red ginseng supplementation on menopausal symptoms and cardiovascular risk factors in postmenopausal women: a double-blind randomized controlled trial.

Other studies that involve women and korean red ginseng:

Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group.

Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes.

Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study.

Recurrent Urinary Tract Infections? No More or at Least Less Often.

2012-10-24T11:16:30-04:00

This study found that Lactobacilli vs. antibiotics were less effective than when compared to trimethoprim-sulfamethoxazole for recurrent urinary tract infections (UTI). However, the probiotics were only 13.8% less effective than the antibiotics AND they did not increase the resistance to trimethoprim-sulfamethoxazole, trimethoprim, and amoxicillin like the antibiotic did. In fact the trimethoprim-sulfamethoxazole treatment increased it from approximately 20% to 40% to approximately 80% to 95% in E coli from the feces and urine of asymptomatic women and among E. coli causing a UTI. So the Lactobacilli were less effective but lead to less antibiotic resistance, which in the long run does not sound like a bad idea to me. In fact, "Approximately 60% of women in the United States experience a UTI, or acute cystitis, during their lifetime. Of these, 30% go on to have multiple recurrences.", so for these women it could be a helpful therapy.

Arch Intern Med. 2012 May 14;172(9):704-12.
Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninferiority trial in postmenopausal women.

BACKGROUND:
Growing antibiotic resistance warrants studying nonantibiotic prophylaxis for recurrent urinary tract infections (UTIs). Use of lactobacilli appears to be promising.
METHODS:
Between January 2005 and August 2007, we randomized 252 postmenopausal women with recurrent UTIs taking part in a double-blind noninferiority trial to receive 12 months of prophylaxis with trimethoprim-sulfamethoxazole, 480 mg, once daily or oral capsules containing 109 colony-forming units of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 twice daily. Primary end points were the mean number of symptomatic UTIs, proportion of participants with at least 1 UTI during 12 months, time to first UTI, and development of antibiotic resistance by Escherichia coli.
RESULTS:
The mean number of symptomatic UTIs in the year preceding randomization was 7.0 in the trimethoprim-sulfamethoxazole group and 6.8 in the lactobacilli group. In the intention-to-treat analysis, after 12 months of prophylaxis, these numbers were 2.9 and 3.3, respectively. The between-treatment difference of 0.4 UTIs per year (95% CI, -0.4 to 1.5) was outside our noninferiority margin. At least 1 symptomatic UTI occurred in 69.3% and 79.1% of the trimethoprim-sulfamethoxazole and lactobacilli participants, respectively; median times to the first UTI were 6 and 3 months, respectively. After 1 month of trimethoprim-sulfamethoxazole prophylaxis, resistance to trimethoprim-sulfamethoxazole, trimethoprim, and amoxicillin had increased from approximately 20% to 40% to approximately 80% to 95% in E coli from the feces and urine of asymptomatic women and among E coli causing a UTI. During the 3 months after trimethoprim-sulfamethoxazole discontinuation, resistance levels gradually decreased. Resistance did not increase during lactobacilli prophylaxis.
CONCLUSIONS:
In postmenopausal women with recurrent UTIs, L rhamnosus GR-1 and L reuteri RC-14 do not meet the noninferiority criteria in the prevention of UTIs when compared with trimethoprim-sulfamethoxazole. However, unlike trimethoprim-sulfamethoxazole, lactobacilli do not increase antibiotic resistance.

The Advantages of Second Best Comment on “Lactobacilli vs Antibiotics to Prevent Urinary Tract Infections”
Barbara W. Trautner, MD, PhD; Kalpana Gupta, MD, MPH
Arch Intern Med. 2012;172(9):712-714. doi:10.1001/archinternmed.2012.1213.

Approximately 60% of women in the United States experience a UTI, or acute cystitis, during their lifetime. Of these, 30% go on to have multiple recurrences.1 For women who suffer from frequent recurrences, effective preventive strategies are essential to free them from this disruptive illness. Unfortunately, the use of antibiotics for UTI prevention is becoming more problematic because resistance to commonly used agents is now widespread, infection caused by Clostridium difficile is increasingly common, and our appreciation of the importance of an undisturbed microbiome in health is growing. Therefore, investigations of antibiotic-sparing approaches to UTI prevention are of great interest to physicians and patients alike.