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Herbs. Are they Safe and Effective?

I have undertaken a course of study to become a certified herbalist. The course work is fascinating and the information extremely valuable. I have so many interesting items to share, but I'd like to start with issues of safety.

If you listen to the news media, you would think that herbs are all poisonous and dangerous. However, the actual statistics reveal a far different picture.

COMPARISON OF CATEGORIES OF POISONINGS
Category 1989
Fatal 		1989
Major 		1988
Fatal 		1988
Major
Antidepressants 140 1315 135 1187
Analgesics 126 705 118 663
Heart Drugs 70 286 65 246
Stimulants & Street Drugs 64 276 101 295
Fumes, gasses, vapors 46 129 39 128
Household cleaners 24 173 19 168
Pesticides 12 111 12 113
Plants, all 1* 32 1* 21

*One death was reported for each of the 2 years covered by this report. The cause of death and the plants involved are unknown. Statistics on plant toxicity from American Assn of Poison Control Centers

Further, compare these numbers to the statistics regarding death and injury for hospital admissions from the American Family Physician (Holland E.G., et al., AFR 1997; 56(7):1781-1788). The authors point out that an estimated one million patients per year are injured while in the hospital, and approximately 180,000 of these people will die because of those injuries. They also stated that drug-related morbidity (serious injury) and mortality (death) are common and are estimated to cost more than $136 billion a year.

In view of this data and given the relative toxicity of herbs, which are clearly safer than household cleaners we all use on a daily basis, why all the emphasis on herbal dangers? To fully comprehend the situation, I need to explain the concept of risk/benefit ratio. The words “risk/benefit ratio” present a very scientific, quantitative evaluation, do they not? Yet, the truth is, an actual calculation is never actually performed. The evaluation is subjective, based upon the belief in the idea that the drug or procedure is life-saving; therefore, a greater degree of risk is acceptable in that context.

However, herbs are regarded as useless for therapy; and, therefore, any degree of risk is unacceptable. In part, this viewpoint is based upon ignorance of the actual efficacy of herbal remedies, but much of it is simple prejudice. American healthcare is dominated by pharmaceutical companies. Anything not originating with the drug companies is automatically suspect. (This discussion does not begin to include the financial interests involved in media reporting; I would need a book to even begin that topic!)

There are, however, some genuine concerns regarding herbal safety. Perhaps the largest problem is that you can't be sure what is contained in the herbal remedy. This is an issue of ethics, and as such deserves close attention. For example, skullcap has been implicated as being liver toxic. However, it is common practice in the herbal industry to substitute germander (a much cheaper herb) for skullcap - without acknowledging the substitution. The label states that the product contains skullcap. Unfortunately, germander is extremely liver toxic. Tests on skullcap products implicated in liver damage indicate the presence of germander. Another common substitution is Aristolachia, a common and inexpensive herb, in a number of oriental herbal products. It is substituted for several more expensive therapeutic herbs. Unfortunately, Aristolachia causes severe kidney damage, including renal failure and malignancy of the urinary tract.

Another issue arises with oriental patent medicines that can be obtained in health food stores. Many of them have been removed from the marketplace because they contain pharmaceuticals, which are not listed on the label. In one study, 23.7% of these patent medicines were contaminated. (Ko RJ, Clinical Toxicology, 1999; 37(6):697-708.

What is the message? Be certain of your source of herbs to guarantee that no adulteration has occurred. In our office, we are switching all our herbal remedies to either the Medi-Herb or Metagenics line, because both of these companies conduct extensive raw material testing to assure potency and purity.

There are more issues concerning efficacy which I will cover in next month's letter. Also, I will report on a wonderful NON-ESTROGENIC herb for menopausal symptoms, as well as a wonderful combination formula for fibromyalgia and auto-immune disease. It's practically magic! I can't tell you how much relief I have found using it. So, watch your mailbox for more details.

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Rehmannia Complex - a Better Choice than Cortisone for Pain Control?

As promised, I wanted to tell you more about the herbs I have been studying. In particular, I am very impressed with Rehmannia Complex Phytosynergist (RCP). For those of us with auto-immune conditions such as rheumatoid arthritis, lupus, multiple sclerosis and fibromyalgia, this product is really a God-send. It contains the following herbs:

1. Rehmannia root which is an adrenal tonic and trophorestorative (i.e., it feeds and nourishes the adrenal glands), an adaptogen, an antipyretic (it fights fever), and an anti-inflammatory.
2. Hemidesmus root which is an immune suppressant which has anti-edema and anti-inflammatory properties.
3. Bupleurum root which is anti-inflammatory and hepatoprotective.
4. Feverfew leaf which is an anti-inflammatory.

Since auto-immune conditions are caused by a derangement in the immune system, these herbs directly impact the underlying cause of the disorder. In fact, the adrenal glands are responsible for immune regulation and Rehmannia rebuilds the adrenals, allowing your immune system to function more normally. Dr. Bone, of Medi-Herb, will only say that RCP is palliative, i.e., it reduces symptoms. He does not represent that it will cure auto-immune conditions. I do not want to contradict him; however, I find that it actually improves adrenal function and makes auto-immune conditions much less acute.

RCP was represented as being as effective as cortisone in eliminating pain. I wanted to try it out before I recommended it, and I am so impressed that I wanted everyone to know what a fabulous result I personally have had. It reduced my body pain by 80% after 4 days of use. I then missed a dose. Within 24 hours my body pain recurred. I then took it religiously for approximately 30 days, and when I again missed a dose, I did not experience the flare-up I did after 4 days. I was actually improved and the improvement continued for about 8 weeks. I am now going to resume taking the RCP, since my fibromyalgia symptoms have gradually returned. However, isn't that exciting? Something that actually deals with fibromyalgia pain! I also experienced an increase in energy and improved mood and outlook and being out of pain will do that for you!

If you suffer with auto-immune symptoms, particularly joint or body pain, I recommend you try RCP for at least 30 days to see what it does for you.

Of course, as with other herbal products, quality control is everything. Medi-Herb continues to be the herbal source I look to for myself and my patients. In Australia, Medi-Herb is a pharmaceutical company and must meet stringent standards of batch testing, documentation and control. Dr. Bone (the founder of Medi-Herb) is passionate about herbal therapy and is a practicing herbalist himself. I have enclosed a brochure which informs you of the issues which are important in quality herbal supplements.

As you may know, I have used various herbs for years. However, I can honestly say that I have never experienced the degree of clinical success with herbs that I have seen since beginning to use Medi-Herb products about a year ago. The improvement in my clinical results has convinced me that a quality product and ethical manufacturer are the only way to insure good results.

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Herbs - Variations in Quality and Non-Estrogenic Menopausal Relief

As promised, this month is a continuation of issues of herbal safety and efficacy. Last month, I touched upon the minimal number of adverse reactions to herbs, as compared to pharmaceuticals, and common household products. I also discussed risk/benefit ratio.

This month, I would like to share with you the interesting information I have recently learned concerning herbal activity and quality. There's a great deal of misinformation regarding herbs and particularly in the area of 'standardized extracts.' Often, a standardized extract simply means that there is a defined weight of herb per ml of extract. The problem comes in the quality of the raw materials. Let me give you two examples.

One sobering example is Andographis, an Ayurvedic herb which has recently become very popular as an anti-viral, anti-microbial agent. It is, in fact, very powerful when the raw herb contains significant quantities of the active compound: andrographolide. However, something unexpected has been happening in batches of raw herb product. The manufacturers of Medi-Herb test each lot of raw material using high performance liquid chromatography (HPLC), an extremely sensitive and reliable assay technique. The lot in question had been certified to contain 10% andographolide by gravimetric assay. (In essence, they just weighed it!) When assayed by HPLC, it became apparent that the raw product contained none of the active ingredient. And, in fact, it contained an unknown compound. Upon further chemical analysis, it turned out that the unknown substance was deoxyandrographolide, a by-product of andrographolide extraction!

Let me explain: The herbal supplier had extracted the active ingredient to sell to a pharmaceutical house as an antibiotic; then, the raw herb was dried and resold to an herbal manufacturer on the assumption that they wouldn't know any different. And, if the proper testing had not been done, no one would have been any the wiser.

Another example is Tribulus terrestis, an herb from Bulgaria which is very effective for menopausal symptoms. The original studies were standardized to 40 to 45% furanosterolic saponins (the active ingredients) by a very sensitive spectrophotometric method. Tribulus is very costly since the Bulgarian product is in limited supply. Imitators quickly came into the market (usually from China or India) representing that they have 40% saponins. However, upon spectrophotometric analysis, they actually have only 3% of the active ingredient. Again, the gravimetric method was used, which is inappropriate and gives an inaccurate result; and, hence, a useless remedy.

The issue which probably impacts the most people is standardization of Echinacea to levels of polysaccharides. In the first place, polysaccharide is a generic term which includes any polymer of sugar, starch or cellulose. It bears no relationship to the immunologically active components of Echinacea. The best way to determine whether your Echinacea product is immunologically active is to place it on your tongue. It should have a 'bite' or 'tingle,' since the active ingredients (alkylamides and caffeic acid esters) are quite acidic. Another issue is that many manufacturers are using Echinacea flowers or plant parts for their tinctures. The active component is the root, which is much less available since it must mature in the ground for a number of years. Also, the plant and flowers have a much higher risk of allergenicity than does the root-based extract.

I could go on and on. However, these are just some of the highlights that demonstrate the importance of quality control in herbal remedy manufacture: beginning with the first step of checking the raw product, right through the entire production process, up to the final product when the level of active ingredients again needs to be assayed.

The Medi-Herb product line which we have begun to work with fulfills all of these requirements. In fact, in Australia they are considered to be a pharmaceutical manufacturer and are subject to intense paperwork requirements certifying each lot of herb. In fact, they have 85% of the herbal market in Australia and which is pretty amazing when you think about it!

I personally have had major wins with two of the Medi-Herb products: Tribulus® and Rehmannia Complex Phytosynergist® (RCP). I'll discuss the RCP in detail next month. It's wonderful for auto-immune conditions, like fibromyalgia, rheumatoid arthritis and lupus.

However, with regard to Tribulus®: If you've been following my letters over the years, you know how concerned I have been about substituting estrogenic herbs for pharmaceutical estrogens. It's still the medical model, and I know that lifetime estrogen exposure is the largest risk factor in breast cancer. (For more information, see our web site: RichardsFamilyHealth.com) Tribulus® is entirely different. It works at the level of the pituitary and hypothalamus estrogen receptors, allaying the effects of estrogen withdrawal. In one study with Tribulus, 50 women were first given a placebo and then were given the herb. Their primary symptoms included hot flashes (100%), sweating (78%) and insomnia (82%). With active treatment with the herb, 98% experienced symptom improvement. The treatment with the placebo had no effect.

Personally, my experience with Tribulus® has been remarkable. Within the first 3 days of taking it, all of my insomnia had resolved. I was getting up 3 or 4 times a night and having trouble getting back to sleep. About the second or third night I was on the therapy, I slept 8 hours straight through! I thought I was in my 20's and 30's again. Getting more rest has had an incredibly positive effect on my outlook. I still have an occasional hot flash, particularly if I'm under a lot of stress. However, my symptoms are at least 85%-90% gone. Now that I've been using Tribulus® for several months, I have an even greater level of confidence in it. The dose begins at 2 in the morning and 2 in the evening for 1 to 3 months. Once symptom control is achieved, you can step down with your dose to 3 a day, and then 2 per day. Some women can actually stop the herb after several months on it.

The reason finding the minimum dose is important is that Tribulus® is expensive. Good quality Tribulus is in limited supply. However, when you do the math, you would have to take 13 tablets of poor quality (Indian or Chinese) Tribulus to get the same effect and if it would work at all! This is definitely an instance of 'you get what you pay for.'

Incidentally, Tribulus is also the specific for andropause, male impotence and erectile problems. Last weekend's herbal seminar went into detail on protocols for male endocrine disorders. Since I'm not a man, I have no first hand information on the efficacy of Tribulus for male endocrine disorders. So if you, or a man you know, is suffering from poor libido, erectile dysfunction, fatigue, irritability, depression and reduced bone density (which is associated with a reduced testosterone level), consider herbs for increased well-being and vigor. I have protocols which can really help. By the way, were you aware that cholesterol-lowering drugs can lower testosterone levels and lead to many of the symptoms mentioned above? How many men do you know who have been prescribed cholesterol-lowering medication?

Next month, I will share more with you concerning the marvelous properties of herbs in facilitating the body's healing mechanisms. I think it is absolutely amazing that the plants that grow around us contain the answers to so many of our challenges.

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Herbal Alternative to Flu Shots

Cold and flu season is upon us again. I would like to make some recommendations to keep yourself and your loved ones healthy during this time of year. It will probably come as no surprise to you that I don't think a flu shot is a good idea. Let me share with you some of the reasons why.

In the first place, the influenza virus mutates almost as fast as the common cold. Every year, vaccine makers play a guessing game as they try to predict which strain of the flu will be making the rounds this year. Since it takes several months to prepare a large quantity of flu vaccine, there is a pretty slim chance that the match will be good (CDC, Morbidity and Mortality Weekly Report, 14 May 1993.)

You may have missed the fact that in 1976 there was a huge public health fiasco when the flu vaccine actually paralyzed 565 infants with Guillain-Barrè Syndrome. Hundreds more suffered major side effects and the government eventually paid out more that $400 million in damages to the victims' families when it was proven that the government had foreknowledge that this particular vaccine was dangerous. When a top research scientist, J. Anthony Morris, tried to warn the public, he was fired by the Division of Biologic Standards, the federal agency in charge of vaccine safety! (Coulter, H., Fisher, B., A Shot In The Dark, Avery Press, 1991)

What you may not know is that there is a statistically significant connection between flu shots and Alzheimer's Disease. Hugh Fudenburg, MD, the world's leading immunogeneticist who has published about 850 peer-reviewed professional papers, explains: "If an individual had 5 consecutive flu shots between 1970 and 1980, the chances of Alzheimer's disease was 10 times greater than those getting . . . no shots." [NVIC International Conference, Sept 1997)

Much of the information contained in this letter is contained in the book The Sanctity of Human Blood: Vaccination is Not Immunization by Tim O'Shea. I highly recommend it as a well-researched and documented indictment of America's public health policy on vaccination.

Instead of flu shots, I recommend that you improve your own immune function. In fact, I have patients with the flu in my office every season - yet, I seldom develop the flu. One approach is to take the extremely potent Echnicacea we carry from Medi Herb, which is distributed in America by Standard Process. It's called Echinacea Premium and is more than twice as potent as over-the-counter Echinacea preparations. If you have some on hand, put a bit of it on your tongue. If it doesn't tingle, it's missing essential active ingredients.

Echinacea is safe to be taken prophylactically. It is not like golden seal, which contains an alkaloid that can damage the liver with long-term use. Echinacea simply revs up the immune system. Should you start to feel ill, immediately add our St. John's Wort to your protocol. The Medi-Herb product is, again, different from over-the-counter preparations. American processed St. John's Wort is processed only to maintain the active ingredient which is believed to be anti-depressant. However, Medi-Herb St. John's Wort which is produced in Australia preserves the anti-viral fraction, as well. The result: a potent anti-viral compound that is extremely effective against a wide range of viral illness, including herpes, influenza, colds, chronic fatigue associated with viral infections such as Cytomegalovirus, etc. It is not effective against "naked" viruses, like wart viruses.

So, to protect yourself, get started on Echinacea Premium right away. We keep a supply of it and the St. John's Wort on hand at all times. I hope this fall season you stay well; if not, call us so that we can help you get back on your feet as soon as possible.

References:

  1. Andersen DO, Weber ND, Wood SG et al. Antiviral Res 1991; 16(2): 185-196.

  2. Lopez-Bazzocchi I, Hudson JB, Towers GHN. Photochem.Photopbiol. 1991; 54(1): 95-98.

  3. Moraleda G, Wu TT, Jilbert AR et al. Antiviral Res 1993; 20: 235-247.

  4. Tang J, Colacino JM, Larsen SH et al. Antiviral Res 1990; 13 (6): 313-325.

  5. Hudson JB, Harris L, Towers GHN. Antiviral Res 1993; 20 (2):173-178.

  6. Lenard J, Rabson A, Vanderoef R. Proc Natl Acad Sci USA 1993; 90 (1): 158-162.

  7. Degar S, Prince AM, Pascual D et al. AIDS Res Hum Retroviruses 1992; 8 (11): 1929-1936.

  8. Carpenter S, Kraus GA. Photochem Photobiol 1991; 53 (2): 169-174.

  9. Lavie G, Valentine F, Levin B et al. Proc Natl Acad Sci USA 1989; 86 (15): 5963-5967.

  10. Meruelo D, Lavie G, Lavie D et al. Proc Natl Acad Sci USA 1988; 85 (14): 5230-5234.

  11. Kraus GA, Pratt D, Tossberg J et al. Biochem Biophys Res Commun 1990; 172 (1): 149-153.

  12. Takahashi I, Nakanishi S, Kobayashi E et al. Biochem Biophys Res Commun 1989; 165 (3): 1207-1212.

  13. De Witte P, Agostinis P, Van Lint J et al. Biochem Pharmacol 1993; 46 (11): 1929-1936.

  14. Panossian AG, Gabrielian E, Manvelian V et al. Phytomed 1996; 3 (1): 19-28.

  15. Lavie G, Mazur Y, Lavie D et al. Transfusion 1995; 35 (5): 392-400.

  16. Constantine GH, Karchesy J. Variations in Hypericin concentrations in Hypericum perforatum L. and commercial products. Pharmaceutical Biology 1998; 36 (5): 365-367.

If this article is of interest to you, see our other information on West Nile Virus

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High Carbs and CV Disease

Do you struggle with an inability to lose weight? Or, do you suffer from depression, anxiety and mood swings? Are you constantly tired? Do you have food cravings, or are you addicted to caffeine or alcohol? Has you doctor warned you that you are developing diabetes, or that your cholesterol or blood pressure are too high? All of these seemingly unrelated conditions have a common source: the American preoccupation with low fat diets. For the past 20 years, the American public has been bombarded with the message: "Fat is bad!" As a result, our food supply is now inundated with "low fat" foods, engineered foods and foods processed to remove natural fats. In every instance, low fat foods are loaded with carbohydrates.

The result: Americans are suffering from a variety of endocrine problems and degenerative diseases directly attributable to insulin resistance, excessive intake of refined carbohydrates and a lack of proper fat in the diet.

Actually, this information is not new. It has simply been ignored by the American food industry. In 1956 Thomas L. Cleave, Surgeon-Captain of the Royal Navy and research director of the British Institute of Naval Medicine, published a paper proposing that many chronic conditions were the result of a "master disease" resulting from the rise in popularity of sugary foods. He pointed out that it requires approximately 20 years "incubation" time for the chronic diseases to manifest themselves. Interestingly, the sudden rise in popularity of sugary foods just before the turn of the century coincided with the emergence of heart disease and disorders of the digestive tract as major killers after World War I. He cited other examples as well:

1. When Iceland's diet became Westernized in the 1930s and sugar and refined carbohydrate consumption rose significantly, diabetes became commonplace in the 1950s.
2. In studies of Africans, he found that wherever rapid dietary change introduced refined carbohydrates, heart disease and diabetes began to spread approximately two decades later.
3. Finally, he pointed out that studies ranging from Kurds to Yemenites to Zulus found that the refining and processing of foods appeared to bring a rise in chronic disease in less than a quarter century.(The Kellogg Report, The Impact of Nutrition, Environment and Lifestyle on the Health of Americans, Joseph D. Beasley, MD., and Jerry J. Swift, M.A., 1989, p 331)

Closer to home, we have the example of the Eskimos. Subsisting on a diet of almost pure protein and fat, heart disease, obesity, diabetes and dental caries were unknown. With the Westernization of their diet, all of these health problems became scourges in the Eskimo culture.

Another interesting and well-documented phenomenon is the increase in heart disease with the introduction of:"refined" white flour and the dramatic drop in deaths from heart disease as the American public began to buy and consume vitamins.

Vitamin Sales and Deaths
Year Deaths per
100,000 		Vitamin Sales
per $Billions
1920 <10
1930 -50
1940 -130
1950 -200
1960 -210
1970 -300 <$0.1
1980 -250 $0.75
1990 -175 $1.1

Source: US Dept. of Commerce & Nat'l Center for Health Statistics
Yet, Americans are continually bombarded with health advisories to eat very little fat, less protein and huge quantities of refined grain products. I believe the current food pyramid recommends 12 to 14 servings of grain daily! Please remember, these are refined grain products with all of the vitamins and minerals removed = pure carbs! In fact, the American diet is 75% grains. And, grain has only been part of our diet since the beginning of cultivation (approximately 10,000 years ago). Prior to that, humans were hunter/gatherers. Grains were unknown except for small amounts during the fall season. We are adapted to be omnivores, with the emphasis on fat, protein, fresh fruits and vegetables.

I have recently read a fascinating book, which I recommend highly, The Schwarzbein Principle, by Diane Schwarzbein, MD. Dr. Schwarzbein is an endocrinologist at the Sansome Clinic in Santa Barbara, specializing in diabetes. She found in working with her diabetic patients that those who followed the dietary recommendations of the American Diabetic Assn got worse! So, she began eliminating carbohydrates and increasing protein (including eggs and red meat) and fat. Her results were astounding! She has even reversed difficult endocrine conditions like Stein-Leventhal Syndrome (aka polycystic ovarian disease). And, her program has helped her patients attain and maintain normal weight. The major difference between Dr. Schwarzbein's program and The Zone Diet is that her emphasis is on natural, unprocessed foods; she eliminates the unhealthy fats and oils that are a part of Dr. Sears' program. I am integrating her recommendations into our programs here at the RFHC. The programs vary based upon your personal state of health and degree of insulin resistance.

One of the most compelling points (to me) that Dr. Schwarzbein makes is that we are misled when we look at the caloric content of foods. The average dietician will tell you that fat has twice as many calories as carbohydrates and therefore should be avoided. The truth about your metabolism is that your body needs both fat and protein to rebuild your cells. Protein and fat are the basic building blocks of the human body. So, they aren't burnt for fuel, but are used to repair your tissues.

When you eat carbohydrates, there are only 2 things your body can do with them: 1) burn them for energy and 2) store the excess away as triglycerides (storage fat).

I think one of the reasons people are confused by this concept is that they believe fat = fat = fat. Wrong! There are structural fats and storage fats. And, cholesterol, omega 3 and omega 6 oils, as well as monounsaturated oils, are all structural fats. The kind of fat we carry around on our hips or bellies is storage fat; and that is made from carbohydrates.

So, if you ingest a structural fat (like cholesterol, for example), your body doesn't burn it all down for fuel. A large percentage of it is utilized to rebuild cell walls and membranes, or to make hormones. Remember that the next time you reach for a sugary confection. Your body would benefit more from nuts, seeds or meat. Body builders know that the best way to build muscle mass is to have a high protein meal within 30 minutes of a work-out. They step up their metabolism and then provide the body with the raw products needed to build muscle strength.

If you are a vegetarian, you can still benefit by rebalancing your meals to include equal amounts of fresh vegetables (with some fruit), proteins, fats and grains. It's just a great deal harder. Most vegetarians in the U.S. err in that they eat far too many carbohydrates and too much junk food! The hardest thing for a vegetarian is to get enough protein without excess carbohydrate.

This information is life-saving, and is based upon physiology and clinical outcomes, not the latest fad or "research" funded by a giant food company. Once again, it proves that working with the way our bodies were designed is much more beneficial than trying to engineer our food. If you only remember one thing, remember this: Shop around the perimeter of the supermarket, purchasing only foods in the form that you could hunt or gather yourself. If you do that, you'll be started on the road to lasting health and well-being.

Whether you want to lose weight or have a more serious health challenge, we can help. For the most severe health problems, laboratory testing is a must! For a program individualized to your needs, call and make an appointment for a consultation today.

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Erectile Dysfunction

I would like to share some information on a fairly sensitive topic. It seems that ads about erectile dysfunction (aka impotence) are everywhere in the media these days. The latest ad features a racecar bursting through barriers and the slogan "Tune Up For Life," which goes by so fast it's almost subliminal. Although erectile dysfunction is a common experience of men in over 50, it was the unmentionable topic until a pharmaceutical became available to "treat" the condition. Once Viagra(tm) was approved for use by the FDA, the unmentionable became table conversation.

However, before you or someone you loves begins taking Viagra(tm), I think you should be aware of the warnings and dangers associated with its use and the fact that there are natural alternatives. The first is, yohimbine, the first substance approved by the FDA for erectile dysfunction. And the second alternative is muira puama (or potency wood, sometimes termed "herbal Viagra"). I hope to delineate the pros and cons of each.

First, Viagra(tm): A careful reading of the Physicians' Desk Reference (PDR) is enlightening. Although Pfizer (the manufacturer) has tried to couch their warnings in the most positive terms, there is much about Viagra(tm) to cause concern. The post-marketing experience has been sobering; to quote: "Serious cardiovascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack and hypertension, have been reported post-marketing in temporal association with the use of Viagra(tm). Most, but not all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Viagra(tm) without sexual activity...." (emphasis added) PDR, 55th Edition, 2001, pg. 2537.

In the PDR, the side effects are listed in decreasing order of frequency. So, the most common adverse effect is a heart attack, followed by sudden death, life-threatening arrythmias and strokes. Furthermore, the effects are unpredictable, as noted in the phrases I've emphasized. In addition, the PDR points out that men with impaired liver or kidney function are at risk from Viagra(tm). Yet, who are the very men who might be the target consumers? Older men, or men with diabetes, two groups at high risk for liver and/or kidney insufficiency. I certainly wouldn't want anyone I loved taking such risks with his health. Maybe the slogan should be "Play Russian Roulette With Your Life." It certainly would be more accurate.

Yohimbine (aka yohimbe or Rauwolfia serpentina) was actually the first substance approved by the FDA for the treatment of impotence. It has fallen out of favor due to its serious adverse effects, which can be life threatening. One of my sources states that the FDA now lists Yohimbe bark as an "unsafe herb." Traditionally, yohimbine bark has been used as an aphrodisiac, used to treat angina and hypertension, and smoked as an hallucinogen.

While the proposed physiologic mechanism of yohimbine would lead one to expect an anti-hypertensive action, clinical use has proven otherwise. An oral dose of 5 mg (which is far less than the recommended dose, 6 mg three times a day, for aphrodisiac effects) causes a significant increase in blood pressure in men with orthostatic hypotension (adrenal insufficiency). The response is associated with an increased heart rate and increased plasma noradrenaline levels (thereby stressing the heart).

Other reported side effects include anxiety, panic attacks, hallucinations, dizziness and headache. In susceptible individuals, it may result in psychosis. It can also cause severe hypotension, abdominal distress and weakness. Since it readily crosses the blood brain barrier, it may result in CNS overstimulation and paralysis. Again, men with kidney problems should not take this substance; nor should those taking anti-depressants. There have been no large scale studies on this product due to lack of funding, but what information is available is troubling. (Sources: PDR, 55th Ed, 2001 pg. 3164; The Review of Natural Products, 1st Ed, 2001 by Facts and Comparisons, a Wolters Kluwer Company, pp. 647 & 648; and Botanical Influences on Illness, by Melvyn R. Werbach, M.D. and Michael T. Murray, N.D. pp. 200 & 201)

Lastly, I would like to bring you up to speed on muira puama (potency wood, scientific name Ptychopetalum guyanna). Muira puama is a bush or small tree and is native to the Brazilian Amazon. Traditionally, it has been used internally as a tea for treating sexual debility and impotence, neuromuscular problems, rheumatism, grippe, cardiac weakness, gastrointestinal weakness and to prevent baldness. It is also used externally in baths and massages for treating paralysis and beri-beri. In 1925, a pharmacological study was published which indicated its effectiveness in treating disorders of the nervous system and sexual impotence which indicated that "permanent effect is produced in locomotor ataxia, neuralgias of long standing, chronic rheumatism and partial paralysis." (Dias Da Silva, Rodolpho, 1925. "Medicinal plants of Brazil. Botanical and pharmacognostic studies. Muira puama," Rev. Bras. Med. Pharm. 1(1):37-41, 1925) In 1930, a French study confirmed the efficacy of the plant for gastrointestinal and circulatory weakness and sexual impotence. It has been listed in the British Herbal Pharmacopoeia, where it is recommended for the treatment of dysentery and impotence. It has been in the Brazilian Pharmacopeia since the 1950s. Interestingly, in Europe, muira puama is also used for menstrual disturbances; and American herbalists and health care practitioners are using it for menstrual cramps and PMS, as well.

Recently, a study was conducted in Paris, France, with 262 men experiencing lack of sexual desire and the inability to attain or maintain an erection. The results indicated that muira puama is effective in improving libido and treating erectile dysfunction. 62% of the men with loss of libido reported that the extract of muira puama "had a dynamic effect." 51% of the men with erectile dysfunction felt that muira puama was beneficial. (Waynberg, J., "Aphrodisiacs: Contribuiton to the clinical validation of the traditional use of Ptychopetalum guyanna." Presented at The First International Congress on Ethnopharmacology, Strasbourg, France, June 5-9, 1990) The second study conducted by Waynberg in France evaluated the positive psychological benefits of Muira puama in 100 men with male sexual asthenia. (Waynberg, J., 1995, "Male Sexual Asthenia - Interest in Traditional Plant-Derived Medication. Ethnopharmacology, Mar 1995)

There are no reports of adverse side effects from muira puama in any of the sources I researched. There are, however, one or two cautions when utilizing potency wood. If you are arthritic and are taking nitric oxide quenchers (niacinamide, n-aceytlcysteine found in our product Arthrogen(R), you may not have a satisfactory effect from potency wood. Also, I wouldn't recommend taking muira puama in the presence of prostate cancer -- primarily because there is no data on how it may or may not affect tumor growth.

I found this information compelling enough, that at the RFHC, we now have begun to carry a product (Androplex(tm) which contains muira puama, gingko biloba leaf extract and panax ginseng (Korean red ginseng). The herbal extracts are standardized; and 2 capsules daily provide the amount of each substance demonstrated in clinical studies to have a positive effect on male sexual dysfunction. Korean red ginseng has a mild effect on erectile dysfunction and has been demonstrated to increase circulating testosterone in rats. Ginkgo biloba has only been studied in the test tube, using tissue samples. It is included in the formula because of its proven effect on peripheral blood flow and the assumption is made that it will, therefore, aid penile blood flow.

For women who have had a total hysterectomy (including removal of the ovaries) and who suffer from loss of libido, Androplex(tm) may prove beneficial (private communication Dr. Frank Strehl). However, if a woman wants to use Androplex(tm), I would have to assess adrenal function, as well, since women's sexual response is more complex than men's.

If you, or someone you love, would like a safe, natural alternative therapy for erectile dysfunction or loss of libido, call us and order a bottle. A month's supply is $28. Within the month, you should be able to determine whether it is working well for you.

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Safe Supplements and the Fear of Mad Cow Disease

Were you alarmed by the article regarding supplements in the Sunday LA Times on February 11th? The author attributed a slight dip in supplement sales to a lack of consumer confidence in their efficacy and worry about mad cow disease. I must admit that I was stunned. The danger of mad cow disease is so remote as to be miniscule. However, I can appreciate how scary the condition itself is. I'm sure it's enough to worry many.

Therefore, in this letter, I'd like to address the issue of supplement quality; and, in particular, sources for glandular extracts in the products carried at the RFHC.

First, with regard to quality, this is a real and serious issue. There are very few regulations on labeling in the nutritional supplement industry. There is always the danger that what you purchase may not contain what you think you are paying for. A good example is CoQ10. The CoQ10 we carry is the most biologically active available; and it gets results. I have a paper in my office detailing a study of seven brands of CoQ10 (including the Metagenics brand we carry). None of the products tested contained the amount of CoQ10 listed on the label, except the Metagenics product. Since CoQ10 is so unstable - it's sensitive to light, temperature and air; it also has to be combined with oil in order to be absorbed - it's not surprising that potencies were diminished in the commercial products tested. CoQ10 is also very expensive since the patent is owned by the Japanese. So, some companies pick up poor quality CoQ10 at a lesser price, and then sell it. It looks like a deal, but it has very little biological activity, if any. So, you are essentially wasting your money since you won't be getting the effect you expect. With CoQ10, that's particularly important, since you need it to protect your heart from heart failure. So, how can you, as the consumer, be certain of what you're buying? Your best insurance is purchasing supplements from a health professional who has tested the product for clinical efficacy, like we have at the RFHC.

There is also the issue of what supplements to take. There are literally thousands of products on the market. How do you know what you need? What's right for you? If you are taking products you don't need, you are wasting your funds, and you probably won't notice a dramatic improvement in your health. As you know, at the RFHC, we use blood tests to determine your biochemical individuality, and tailor a supplement program to your unique needs. That way, you maximize your results with the most targeted use of your supplement budget.

Finally, I'd like to address the issue of mad cow disease. The glandulars we use are all safe. Many of the companies use animal products from New Zealand (e.g.: Bezwecken & Professional Complementary Health Formulas). New Zealand has the strictest standards in the world around animal husbandry. All of the animals are raised organically, and the cleanliness of the island's stock is guaranteed by strict importation standards. Others of our suppliers (e.g.: Metagenics) use only the highest grade of certified animal products produced in the US. Nothing that is graded less than AAA is ever used. The United States imposed stringent requirements for feed lot cattle in 1997 (March, 2001 issue of Discover magazine) The stated purpose of the regulations was to prevent the spread of prion-borne diseases like mad cow disease. None of our suppliers use uncertified raw materials, specifically to protect the public from dumping of European meat by-products.

I can't address every supplement in the health food store; I can only vouch for the products we carry at the RFHC (we have almost 1,000 different items). The vast majority of the products at our office have demonstrated clinical efficacy through repeated use with patients, where the results have been confirmed by follow-up blood testing. And, I only deal with companies with the highest ethical standards. So, if you want to feel secure in your supplement needs, the RFHC is a reliable source of high quality, safe products

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The Truth About Estrogen

On December 20, 2000, the morning news programs were full of the "latest" health news - this time concerning estrogen and hormone replacement therapy. If you didn't hear it, the announcement was that estrogen is carcinogenic and women should rethink their use of it for prolonged periods.

For years, I've been pointing out that estrogen is a carcinogen. In fact, the "Physicians' Desk Reference" used to contain a warning that estrogen products should be used for no longer than 6 months, due to an increased risk of both uterine and breast cancer. However, about 10 or 12 years ago, the pharmaceutical industry decided to target menopausal women, as the next big potential market. I remember the concerted media campaign to make menopause a "disease," rather than a normal sequence of the life cycle. As a result, doctors were encouraged to prescribe estrogen for all menopausal women. The hook was that estrogen therapy would protect women against osteoporosis and cardiovascular disease. Expect doctors to continue prescribing and encouraging estrogen use. The current line is that "More women will die of cardiovascular disease than of cancer. So, the risk is worth it." I have to say, I don't know many women who would agree with that point of view.

In the first place, estrogen lack is not the culprit in bone loss. Bone loss begins before menopause, in the perimenopausal period. Once you stop ovulating, you lose progesterone, and progesterone is responsible for keeping your bones strong. More importantly, natural progesterone is not carcinogenic. However, most prescription products are progestins which are progesterone-like male hormones. The physiologic effects are very different.

Nor is their any evidence that lack of estrogen causes heart disease in women. The case is entirely circumstantial. We know that estrogen is protective to women of child-bearing age. However, that does not mean it is good for menopausal women. Diet and lifestyle are far more important in the development of cardiovascular disease than our hormone status. For more information on good diet and lifestyle choices, call the RFHC and order my lecture tape "Cardiovascular Disease: Is Your Diet Your Downfall?"

At the RFHC, I recommend natural, plant-based phytoestrogen (estriol, which is non-carcinogenic) for the 3 to 4 year period when hot flashes are most severe. Our product is a combination of estriol and natural progesterone. Also, I recommend support for the adrenal glands, when required, since our adrenals produce our entire supply of estrogen post-menopausally. After the hot flashes subside, I then recommend a woman shift to progesterone alone to maintain libido, well-being and bone density. In those women where vaginal dryness becomes severe (in the 6th and 7th decade of life), a small quantity of phytoestrogen can again be used to alleviate the problem. This is a far different protocol from lifelong use of prescriptions that contain estradiol (the most carcinogenic form of estrogen, except for Premarin which is the absolute worst!). For more information on the different forms of estrogen and what's best for you, you may order my lecture tape, "Hormone Replacement Therapy: Is It For Me? Do I Have a Choice?"

This is another instance where "current scientific knowledge" can lead us to a serious problem. What is a woman supposed to do who has been on estrogen replacement therapy for years? Is it enough to be told, "Oops! Sorry!"? I don't think so. My mother had that experience, and she died of breast cancer. I believe it's much better to err on the side of caution where a woman's health is concerned.

If you or someone you love is experiencing menopausal symptoms and would like a personalized program, please call us and make an appointment for a consultation.

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How much water should I drink?

I want to update you on what's happening at the RFHC. You may have noticed that you have not received the fall edition of Healthy Answers. That's because the publisher is expanding the format to include topics on a wider variety of health issues. Therefore, the magazine will resume early next year.

Also, I want to thank all of you who participated in our recent survey. We have received the collated results and are working to answer your concerns. Currently, we are doing the research preparatory to making some significant changes in both treatment protocols and our billing structure. Watch your mail for an update. I anticipate finalizing everything around the first of the year.

On November 20, 2000, the Los Angeles Times, in its "Health" section ran an article entitled "Hard to Swallow." According to the "experts" cited in the report, you can get all the water you need from eating fruits and vegetables. Maybe, if you're a tortoise. However, for those of us who want to maintain good health and strong bodies, this information is shortsighted, at best. Water is essential to metabolism. Everything you put in your mouth and which is absorbed is eventually filtered out of your bloodstream by your kidneys. The recommended amount of water daily is one-half your body weight times 0.8 (representing an 8 oz glass).

Body weight/2 x 0.8 = Water requirement

For example, if you weigh 120lbs, one-half of your body weight is 60lbs. Multiply that number by 0.8, and you need 48 oz of water daily (or 6, 8 oz glasses). Substitute your own weight into the equation to find out how much water you need.

There are several important reasons why it is important that you drink enough water. In particular, water will alleviate fatigue. If you experience mid-afternoon doldrums, try a glass of water and see if it doesn't perk up your energy. Additionally, many Americans experience constipation. Did you realize that optimally your bowel should evacuate approximately 20 minutes after you eat? The gastrocolic reflex is initiated when food enters the stomach, causing the lower bowel to empty its contents. The longer your colon retains fecal material, the greater the impact the toxic chemicals in the stool have on the intestinal mucosa. Some authorities correlate constipation with an increase in colon cancer. A leading cause of constipation for Americans is hard, dry stools. Drinking sufficient quantities of water (not caffeinated beverages) is the simplest and healthiest way to improve bowel function. Finally, extra fluid is particularly important when you fly, because you dehydrate more quickly at higher altitudes. Drink adequate water to minimize the effects of jet lag.

In my opinion (and personal experience), the LA Times article is just another example of junk reporting. Since medicine doesn't deal with optimum health, keeping healthy is outside of the training of most medical doctors. I suspect in a few years, we will be hearing "Be sure you drink enough water to stay healthy." We've seen Œmedical experts' flip flop before, on many other issues.

In the meantime, position yourself on the side of optimum health. If you need a personalized nutrition program, call the office and make an appointment so that we can set you on the path to vibrant health.

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Health Blog
Below is my latest post on my blog (or web log, if you are not terribly web savvy, like me). You can visit the site at www.drrichardstalksback.com for updates on news-worthy health related items.

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