Ginger may be used in people with inflammatory and autoimmune diseases as an adjuvant therapeutic intervention.

The results of a September 2023 study from the USA show support for the potential of full spectrum ginger to affect neutrophil function in humans. This means ginger may possibly be used in humans with inflammatory and autoimmune diseases as an adjuvant therapeutic intervention. One of the corresponding authors said "ginger may have a real ability to complement treatment programs that are already underway." The authors said this study can set the stage for the eventual clinical testing of ginger in patients with neutrophil extracellular trap (NET)-driven autoimmune diseases such as lupus, antiphospholipid syndrome (APS), rheumatoid arthritis, vasculitis and even COVID-19.

Chronic, incurable autoimmune diseases such as APS and lupus are associated with significant morbidity, mortality and health care costs. While these diseases demonstrate unique clinical characteristics, there is convincing evidence that both are driven by a shared mechanism: dysfunctional and exaggerated neutrophil extracellular trap formation (termed NETosis). Excessive NETosis propels inflammatory and thrombotic (when blood clots block veins or arteries) cascades, contributing to end organ damage over time and to the progression of many autoimmune diseases, including APS and lupus. Recent studies by this research group and others have demonstrated that excessive NETosis affects immune tolerance resulting in autoantibody formation. This sets up a vicious cycle because at the same time disease-associated autoantibodies drive further NETosis. The researchers have revealed a particularly important role for neutrophils and NETs in the thrombo-inflammatory disease manifestations that are relevant to not only APS and lupus but also other diseases, such as COVID-19. Safe agents that restrain NETosis in patients might therefore improve outcomes across various autoimmune and inflammatory diseases. Researchers postulate that herbs with anti-inflammatory properties are potentially untapped resources in the search for agents that can combat pathogenic NETosis.

In this study researchers recruited nine healthy adults, aged 18 to 38 years, to receive a 100mg oral full spectrum ginger supplement daily for seven consecutive days. Blood samples were collected at baseline and on days seven and 14, with isolation of neutrophils, peripheral blood mononuclear cells and plasma. The researchers measured NETosis as a way to show the effect of ginger on inflammation. Blood samples from healthy adults showed an inhibition of NET after one week of daily ginger supplements. Measures of neutrophil cyclic AMP (cAMP) were significantly higher after seven days of ginger supplements compared with baseline levels, although these levels returned to near baseline one week after discontinuing ginger consumption. Oral ginger supplements reduced neutrophil phosphodiesterase (PDE) activity by 40% from baseline, similar to results seen with synthetic PDE4 inhibitors (anti-inflammatory drugs). These results build on previous studies showing inhibition of neutrophil hyperactivity in mice with antiphospholipid syndrome and lupus after injection with a purified ginger preparation. This study also replicated the results of a 2021 study showing effects of oral ginger on neutrophils in eight additional healthy adults who also showed reduced NETosis and increased cAMP after one week of ginger supplements. 

References

Ali RA, Minarchick VC, Zahavi M, Rysenga CE, Sturm KA, Hoy CK, Sarosh C, Knight JS, Demoruelle MK. Ginger intake suppresses neutrophil extracellular trap formation in autoimmune mice and healthy humans. JCI Insight. 2023 Sep 22;8(18):e172011. doi: 10.1172/jci.insight.172011. PMID: 37737262; PMCID: PMC10561719.

 Splete H. Ginger Consumption May Mitigate Neutrophil Dysfunction. Medscape Medical News WebMD c2023 (updated 22 Sept 2023; accessed 20 Oct 2023). Available from https://www.medscape.com/viewarticle/996737?ecd=wnl_recnlnew2_ous_230925_MSCPEDIT_etid5888596&uac=289474CK&impID=5888596

Red Clover, like dandelion (Taraxacum officinale), is a world citizen found as a field plant worldwide. Traditionally red clover is known as an alterative (blood cleanser) and lymphatic tonic, helpful in clearing skin conditions including acne, eczema, psoriasis, benign cysts of the breast and premenstrual breast tenderness. It can also be used as an eyewash for conjunctivitis. Add 5 to 10 drops of the liquid extract to an eye bath full of cooled boiled water. This wonderful cleansing herb is also well known as an antispasmodic and expectorant useful for those suffering from bronchial ailments or spasmodic coughs, such as whooping cough, and viral coughs like those of measles.  

With a small, but pretty, purplish (red) flower this leguminous plant is a favourite of old school herbalists. Our very own founder, pioneer of herbal medicine in Australia, Lyndsay Shume, says himself: “I think it's special. It’s a fantastic healer and a beautiful blood purifier. I’ve got the belief that if you can make your blood perfect then you’re probably perfect…We’ve (traditional herbalists) always said things are fixed through the blood. That’s what we believe.” Grandmother of Australian herbalism, the late Dorothy Hall, says “The ‘Red clover’ person may also have deep-seated infection foci like boils, carbuncles, infected sebaceous cysts, infected cystic acne, etc., where the evidence of the ‘bad blood’ is found just under the skin.” One of the most beloved herbalists of our time, the late Juliette de Bairacli Levy, says “often called “the prize herb,” …[it is] especially good for cleansing the blood, soothing the nerves, promoting sleep and restoring fertility.”  

In more recent years red clover has become a widely researched herb for menopausal health due to the presence of phytoestrogens. A recent meta-analysis found that red clover can alleviate menopausal symptoms such as hot flushes and vaginal dryness. English clinical herbalist Lucy Jones says: “I do wonder whether a large part of its action [for menopausal symptoms] is through its ability to help clean the blood and support the lymphatic system rather than just manipulate levels of oestrogen, or the appearance of oestrogen, in the body.” 

References

Hall D. Dorothy Hall’s Herbal Medicine. Sydney:Lothian. 1988. p. 254

Jones L. A Working Herbal Dispensary. Aeon Books:Glasgow. 2023. p303-4

Hall D. Dorothy Hall’s Herbal Medicine. Sydney:Lothian. 1988. p. 254-5

de Bairacli Levy J. Common Herbs for Natural Health. Ash Tree Publishing:New York. 1997. p. 43

Kanadys W, Barańska A, Błaszczuk A, et al. Evaluation of Clinical Meaningfulness of Red Clover (Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021;13(4):1258. Published 2021 Apr 11. doi:10.3390/nu13041258

Jones L. A Working Herbal Dispensary. Aeon Books:Glasgow. 2023. p303-4

Gościniak A, Szulc P, Zielewicz W, Walkowiak J, Cielecka-Piontek J. Multidirectional Effects of Red Clover (Trifolium pratense L.) in Support of Menopause Therapy. Molecules. 2023 Jul 3;28(13):5178. doi: 10.3390/molecules28135178. PMID: 37446841; PMCID: PMC10343205.

Aniseed, not to be confused with star anise Illicium verum, is one of the oldest medicinal plants primarily grown for its fruits (aniseeds). This warming, aromatic herb has a delicious, sweet liquorice-like flavour and is a commonly used, and very safe, herbal remedy that is well suited for all age groups from children to the elderly. 

In traditional herbal medicine aniseed is a useful carminative for the symptomatic treatment of mild, spasmodic gastrointestinal complaints including bloating, flatulence, colic, nausea and indigestion, and for catarrh of the respiratory tract where it is used as an expectorant in coughs and colds and also for whooping cough and asthma. Consumption of aniseed in lactating women works as a galactagogue to increase milk supply and also gives relief to their infants from gastrointestinal problems. It is also used traditionally as a diuretic to increase urine flow, as an appetite stimulant and to increase libido. It has beneficial effects on dysmenorrhea and menopausal hot flushes in women. 

Many countries around the Mediterranean region, such as Turkey, Greece, Italy, Spain and France, have traditional alcoholic beverages produced with aniseed such as arak, pastis, absinthe, ouzo, sambuca and raki. The common special feature of all these beverages is their unique behaviour during dilution with water. Adding a large amount of water causes the clear liquor to turn instantly into an opaque, translucent milky-white colour, a phenomenon known as the ouzo effect (also louche or spontaneous emulsification). This occurs when a strongly hydrophobic volatile oil, such as trans-anethole, is dissolved in a water miscible solvent, such as ethanol, and the concentration of ethanol is lowered by addition of small amounts of water. This observation illustrates the important role ethanol serves to help pull out the full spectrum of constituents in herbal material. 

References

HEC monograph

Whelan R. Dandelions. R.J.Whelan Ltd c2011 (accessed 11 Oct 2023). Available from https://www.rjwhelan.co.nz/herbs%20A-Z/aniseed.html

Botet R. The "ouzo effect", recent developments and application to therapeutic drug carrying. Journal of Physics: Conference Series. 2012;352. 10.1088/1742-6596/352/1/012047.

Özgüven M. Handbook of Herbs and Spices (Second Edition), Volume 2, 2012.

Devil’s claw is a weedy, perennial tuberous plant with visually striking fruits, some say diabolical (the other common name is wood spider), found in the Kalahari Desert in southern Africa. It is named after these fruits which have numerous characteristically long protrusions with sharp hooks as well as two straight thorns on the upper surface. To enable survival during long severe dry periods the plant forms potato like, water storing, secondary tubers which branch off horizontally from primary tubers. It is these secondary tubers that are harvested for their medicinal properties. Devil claw’s impressive reputation stems from its traditional uses which include treating dyspepsia, stimulating the appetite, constipation and as a bitter tonic for liver and gall bladder complaints. 

Devil's claw is a ‘celebrity’ among arthritis natural remedies being approved by German Commission E for the treatment of degenerative diseases of the musculoskeletal system. It is one of the most highly commercialised indigenous traditional medicines from Africa, with bulk exports mainly to Europe. It is commonly used for general body aches, especially muscle and joint aches and pains in the elderly. The hunter-gatherer San people of Botswana, among the oldest cultures on earth, say most aged people use it for painful muscles and joints, taking it daily on a long-term basis. 

An open study in people with rheumatic conditions assessed the safety and efficacy of 960mg (480mg twice daily) of devil’s claw in 259 patients over eight weeks. They reported significant improvements in pain, stiffness and function and 66% of patients had reduced or stopped their pain medication by week eight. Another randomised double-blind study compared the effects of treatment with devil’s claw (2610mg per day) and diacerein (100mg per day), a slow acting drug for osteoarthritis (OA). The study found that both treatment groups showed similar considerable improvements in symptoms of OA however those receiving devil’s claw required fewer rescue analgesics. 

References

Braun L, Cohen M. Herbs and natural supplements, 4th Ed. Sydney: Elsevier, 2015. p. 276

HEC monograph

Warnock M, McBean D, Suter A, Tan J, Whittaker P. Effectiveness and safety of Devil's Claw tablets in patients with general rheumatic disorders. Phytother Res. 2007 Dec;21(12):1228-33.

Leblan D, Chantre P, Fournié B. Harpagophytum procumbens in the treatment of knee and hip osteoarthritis. Four-month results of a prospective, multicenter, double-blind trial versus diacerhein. Joint Bone Spine. 2000;67(5):462-7.

Non-alcoholic fatty liver disease (NAFLD) is an obesity-related metabolic liver disorder that is increasing in prevalence. The Australian population is expected to experience substantial increases in NAFLD‐related disease burden in the coming decades. NAFLD is defined as the presence of excessive liver fat in the absence of other causes such as excess alcohol. The cause of NAFLD is complicated and involves lifestyle, nutritional factors, lipogenesis (the metabolic formation of fat), cell death, chronic low-grade inflammatory response and an altered gut microbiome. It has been associated with obesity, insulin resistance, type 2 diabetes, high cholesterol, high blood pressure and cardiovascular disease. Australian researchers say intervention is needed to slow the growth in obesity and metabolic syndrome. “Both lifestyle modifications and other therapeutic options must be considered to avert the coming epidemic of NAFLD‐related liver disease,” they say. Currently there are no approved drugs to specifically target or treat NAFLD. The recommended treatment is weight loss, achieved through change in dietary and physical activity behaviours, which can reduce liver fat, inflammation and fibrosis. The Mediterranean diet has been effective in reducing metabolic syndrome and cardiovascular risk factors, as well as NAFLD improvement by reduction of the severity of hepatic steatosis (fatty liver). A plant-based diet, with significant fibre, antioxidants, vegetable proteins, polyunsaturated and monounsaturated fat (nuts and seeds, fish, olive oil) has been emphasised. 

Studies in recent years have revealed that some medicinal plants could be thought of as a substitute for traditional NAFLD management methods. In relation to this the results from the first study of its kind, an Iranian randomised double-blind clinical trial published in August (2023), concluded that 1500mg (the dose was calculated from a related animal study which reported promising results) of pomegranate peel extract, along with a weight-loss diet, improved metabolic syndrome risk factors and reduced fatty liver in patients with NAFLD after eight weeks. Evidence shows that antioxidants in pomegranate peel act synergistically as a strong antioxidant network that causes various beneficial effects. In addition to its antioxidant properties recent studies show that pomegranate peel could be a promising candidate for the treatment of NAFLD by maintaining the balance of the microbiome of the digestive system and influencing the expression of key genes in the pathways of inflammation and liver lipogenesis and inhibiting the signalling pathways in liver fibrogenesis (the abnormal accumulation of fibrous tissue). 

In the trial, NAFLD patients received 1500mg of placebo (37 people) or pomegranate peel capsules (39 people) with a 500-calorie deficit diet (consuming 500 fewer calories than they normally do on a day-to-day basis) for eight weeks. Following the intervention the mean body weight, waist circumference, body mass index, body fat index and trunk fat, systolic and diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein cholesterol, fat free mass and fasting blood sugar decreased significantly in the pomegranate group in contrast to the placebo group. Also, high-density lipoprotein cholesterol, liver steatosis and stiffness improved in the pomegranate group. 

References

Adams LA, Roberts SK, Strasser SI, Mahady SE, Powell E, Estes C, Razavi H, George J. Nonalcoholic fatty liver disease burden: Australia, 2019-2030. J Gastroenterol Hepatol. 2020 Sep;35(9):1628-1635. doi: 10.1111/jgh.15009. Epub 2020 Feb 26. PMID: 32048317; PMCID: PMC7540570.

Barghchi H, Milkarizi N, Belyani S, Norouzian Ostad A, Askari VR, Rajabzadeh F, Goshayeshi L, Ghelichi Kheyrabadi SY, Razavidarmian M, Dehnavi Z, Sobhani SR, Nematy M. Pomegranate (Punica granatum L.) peel extract ameliorates metabolic syndrome risk factors in patients with non-alcoholic fatty liver disease: a randomized double-blind clinical trial. Nutr J. 2023 Aug 22;22(1):40. doi: 10.1186/s12937-023-00869-2. PMID: 37605174; PMCID: PMC10464300.

Barghchi H, Milkarizi N, Belyani S, Norouzian Ostad A, Askari VR, Rajabzadeh F, Goshayeshi L, Ghelichi Kheyrabadi SY, Razavidarmian M, Dehnavi Z, Sobhani SR, Nematy M. Pomegranate (Punica granatum L.) peel extract ameliorates metabolic syndrome risk factors in patients with non-alcoholic fatty liver disease: a randomized double-blind clinical trial. Nutr J. 2023 Aug 22;22(1):40. doi: 10.1186/s12937-023-00869-2. PMID: 37605174; PMCID: PMC10464300.

Barghchi H, Milkarizi N, Belyani S, Norouzian Ostad A, Askari VR, Rajabzadeh F, Goshayeshi L, Ghelichi Kheyrabadi SY, Razavidarmian M, Dehnavi Z, Sobhani SR, Nematy M. Pomegranate (Punica granatum L.) peel extract ameliorates metabolic syndrome risk factors in patients with non-alcoholic fatty liver disease: a randomized double-blind clinical trial. Nutr J. 2023 Aug 22;22(1):40. doi: 10.1186/s12937-023-00869-2. PMID: 37605174; PMCID: PMC10464300.

It’s not often you come across a book that so profoundly describes the Herbal Extract Company philosophy however A Working Herbal Dispensary: Respecting Herbs as Individuals, by full time UK medical herbalist Lucy Jones, has done just that and in doing so has found a place on the top shelf of our herbal medicine library. Published in July this year (2023) it is a photographically illustrated guide on how to understand and engage with medicinal herbs based on tradition and experience. With a deep respect for the inherent natural wisdom in herbs Jones herself says, in the introduction, that the “herbs themselves play a starring role.”

In her fascinating second book (her first is Self-Sufficient Herbalism 2020), Jones shares the individual characteristics and medicinal virtues of 108 of the key herbs that she works with in her practice. They are mostly Western herbs, with some from the Tibetan medicine tradition which she has also studied. The monograph of each herb includes physiological actions, energetic qualities, emotional aspects, historical applications, case studies from Jones’s clinic, recipes for the home herbal apothecary and a charming magical associations section. The main premise of the book is “herbs treat people, not conditions”. “If we are to treat someone effectively with herbal medicine, we need to understand the underlying root cause of that person’s health condition. A treatment protocol suitable for one person with a particular ‘health condition’ may not be at all appropriate for another with the same condition,” Jones says.

The book was conceived in response to what Jones has noticed as a “growing tendency to view herbs in a way that centres around ‘what condition they can be used for’ or ‘what chemical constituent they contain’”. Thus, she writes about each herb as an individual that she knows and values, rather than just as a list of conditions it treats or the constituents it contains. “I know these pieces of information can seem quite helpful, especially to those who are beginning their herbal journey; however I rail against seeing and describing herbs primarily in this way. I believe that our relationship with herbs is reciprocal. Viewing herbs primarily in terms of ‘how they can be used’ does not recognise and honour them as individual beings, with their own healing intelligence”. This vitalist model for healing is a refreshing approach compared to the “use this herb for that symptom” mindset that is sometimes termed “allopathic herbalism” or the “one solution syndrome”. Instead the reader is encouraged to move beyond this method and match the herbs to people, rather than to diseases and thinking of them as pharmaceutical alternatives which can lead to inconsistent results and therefore a lack of confidence. “To do this matchmaking well, we need to understand herbs as unique beings,” she says. This is the true gift of a herbalist.

Jones also comments on the fact that herbal practitioners usually work with whole herbs rather than isolated constituents. “We may know about certain ‘headline’ constituents, such as alkaloids or tannins, but each whole herb has a myriad other compounds alongside these that support and moderate its action in the body. It would be incredibly complicated and hugely time-consuming to try to isolate all of the chemical compounds in each herb, let alone to test how each of them affects the body. It gets even more complicated when we add in the fact that herbs work in relationship with us, since each human being has an individual constitution, lifestyle, diet, habitual thought pattern, and past medical history.” Keep an eye out for this book in the reference section of our educational material.

The evergreen shrub glossy privet, regarded as an environmental weed and invasive species in Australia, is a member of the olive family and has been used in traditional Chinese medicine (TCM) for more than 1000 years. The Latin lucidum means bright or shiny and refers to glossy privet’s eponymous leaves however it is the fruit that is used in herbal medicine. In TCM it is a commonly prescribed herbal material in a number of formulae used to tonify the kidneys and strengthen bone. Therefore, it has long been used for the treatment of osteoporosis in China and is a component of many herbal formulae for this condition. It has also been used for the treatment of eye and skin disorders such as tinnitus and blurred vision. It is also used for the prevention of grey hair.

Glossy privet is one of the most frequently used liver/kidney Yin tonifying TCM herbs for the treatment of liver cancer. As a tonic herb it is effective in improving chemotherapy induced bone marrow suppression, hair loss and immunosuppression. It has also been used to enhance the therapeutic effects of chemotherapy in TCM clinical practice. 

Glossy privet is commonly used in TCM herbal formulations for its positive impact on the immune system and to assist in fighting infections. In vitro studies have shown that it has these properties, but it has not yet been studied in humans showing a clinical benefit.

References

Yeon SW, Choi SR, Liu Q, Jo YH, Choi DH, Kim MR, Ryu SH, Lee S, Hwang BY, Hwang HS, Lee MK. Therapeutic Potentials of Secoiridoids from the Fruits of Ligustrum lucidum Aiton against Inflammation-Related Skin Diseases. Pharmaceuticals (Basel). 2022 Jul 27;15(8):932. doi: 10.3390/ph15080932. PMID: 36015080; PMCID: PMC9415915.

Feng X, Lyu Y, Wu Z, Fang Y, Xu H, Zhao P, et al. Fructus ligustri lucidi ethanol extract improves bone mineral density and properties through modulating calcium absorption-related gene expression in kidney and duodenum of growing rats. Calcif Tissue Int. 2014 Apr;94(4):433-41. doi: 10.1007/s00223-013-9825-4. Epub 2013 Dec 17.

Pang Z, Zhi-yan Z, Wang W, Ma Y, Feng-ju N, Zhang X, Han C. The advances in research on the pharmacological effects of Fructus Ligustri Lucidi. Biomed Res Int. 2015;2015:281873. doi: 10.1155/2015/281873. Epub 2015 Mar 22. PMID: 25874204; PMCID: PMC4385624.

Hu B, Du Q, Deng S, An HM, Pan CF, Shen KP, Xu L, Wei MM, Wang SS. Ligustrum lucidum Ait. fruit extract induces apoptosis and cell senescence in human hepatocellular carcinoma cells through upregulation of p21. Oncol Rep. 2014 Sep;32(3):1037-42. doi: 10.3892/or.2014.3312. Epub 2014 Jul 7. PMID: 25017491.

Sun RN, Zhang YN, Wang J, Liu HJ, Kong LB. [Active components of Ligustrum lucidum inhibiting hepatitis C virus replicase activity]. [Article in Chinese] Yao Xue Xue Bao. 2013 Sep;48(9):1390-6.