The mature seeds of the cereal grass, oats, become the highly nutritious rolled oats used in breakfast porridge as a wholesome food for those who are debilitated, weak or healing from a long illness. Oats green (Avena sativa), on the other hand, comes from the stems and leaves which are harvested earlier while the grass is still green. Oats, in its various forms and extracts, has been traditionally used for its physical and psychological fortifying properties for centuries. 

Traditionally oats green is used for its nutritious and restorative powers, beneficial for relieving stress, anxiety, insomnia and depression. It is a wonderful tonic for the nervous system, supplying many of the nutrients that may be lacking. The results of a 2020 randomised, double-blind, placebo-controlled study in 126 people confirmed that chronic supplementation (four weeks) with oats green can benefit cognitive function and modulate the physiological response to a stressor. 

Oats green may have a potential role in the maintenance of cardiovascular health. A 24 week randomised, double-blind, placebo-controlled study in 37 adults over 60 years old, with excess weight, found that supplementing with 1500mg of oats green daily significantly improved measures of blood flow in the heart and brain compared with a placebo.

Butcher’s broom (Ruscus aculeatus) is a small native European shrub whose roots are used for the discomforts of chronic venous insufficiency (CVI), such as pain and heaviness, as well as for cramps in the legs, itching and swelling, for supportive therapy for haemorrhoids, such as itching and burning, premenstrual syndrome and diabetic retinopathy. 

The common name, butcher’s broom, came from European butchers who used the stems to clean their cutting boards, not only because they were stiff and solid, but also because the essential oil had antibacterial properties. Greek physicians used butcher’s broom to treat kidney stones. In the 17th century the English herbalist Nicholas Culpepper used butcher’s broom to help the healing of fractured bones. 

While not recent, there are a small number of human studies on butcher’s broom investigating its effect on lower leg oedema in patients with CVI. In one 2002 randomised, placebo-controlled trial 148 women, who had confirmed CVI for up to 15 years, were given butcher’s broom extract or placebo for three months. The authors concluded that butcher’s broom is a safe and effective treatment for patients suffering from CVI with efficacy being significantly better for the butcher’s broom extract compared to placebo. There were significant differences between the butcher’s broom group and placebo for the change of leg volume after eight and 12 weeks of treatment, for changes in ankle and leg circumferences after eight and 12 weeks of treatment, and for the changes in subjective symptoms such as heavy tired legs and a sensation of tension. 

Coleus (Coleus forskohlii) is a traditional Ayurvedic herb which belongs to the mint family. One of the constituents in coleus is called forskolin. Forskolin is an adenylyl cyclase stimulator which increases cellular levels of a molecule called cyclic adenosine monophosphate (cAMP). cAMP is a vital, cell regulating compound involved in a variety of cellular functions. Coleus has anti-inflammatory and digestive effects, and has been claimed to improve psoriasis by elevating cAMP levels. Further research is needed to confirm these effects since forskolin is most often used as a research tool in vitro, or outside the body, such as in a test tube or petri dish. Forskolin may act differently inside the body. 

Forskolin has been shown to increase the production of thyroid hormones and stimulate their release so it may have similar effects on the thyroid gland as thyroid stimulating hormone, leading to its reputation as a thyroid stimulant. In Ayurveda coleus is known as a herb that increases thyroid hormone production and secretion. It can help normalise thyroid hormone levels if a person has subclinical autoimmune thyroid disease. It may also be of benefit in the maintenance of a healthy metabolism, and positively affect fat and protein metabolism, making it useful for weight management assistance in obesity and type 2 diabetes. The insulin resistance and metabolic syndrome picture associated with non-alcoholic fatty liver disease can be treated with coleus.

Coleus and forskolin lower blood pressure and improve the contractility of the heart muscle making this herb relevant in the treatment of hypertension, congestive heart failure and angina. These actions are related to an increase in cAMP levels throughout the cardiovascular system which results in relaxation of the arteries and increased force of contraction. The net effect is an improvement in many cardiovascular functions. It may also be useful as a bronchodilator in asthma, emphysema and chronic bronchitis because increased cAMP levels result in relaxation of bronchial muscles. 
 

Celery (Apium graveolens) has been cultivated as a vegetable since antiquity however it is the dried seeds that are used for medicinal purposes. Matriarch of Australian herbal medicine, the late Dorothy Hall, said “celery seeds condense all of celery’s virtues into even greater concentration.” She recommended its use for people with diabetes because of its beneficial action on the liver, adrenal glands, fluid retention and digestion. “For the fluid-engorged diabetic, celery’s gentle but balanced persistence in stimulating liver, adrenals and kidneys can be beneficial indeed.” 

Celery has been used for acute, and chronic, painful or inflammatory conditions. It is used traditionally for the clearance of acidic metabolites via the kidneys and traditional sources recommend its use for rheumatism, arthritis and gout. 

A recent study conducted on humans found that celery seed extract is at least as effective as aspirin, ibuprofen and naproxen in treating arthritis, and relieved the stomach inflammation often caused by these medications.

On 20 December 2021, the Therapeutic Goods Administration (TGA) were advised not to amend the scheduling for amygdalin and hydrocyanic acid in the current Poisons Standard, which was implemented on 1 February 2022. The final decision states that amygdalin will remain in Schedule 10 (substances of such danger to health as to warrant prohibition of sale, supply and use) of the Poisons Standard. Found in the seeds of some edible plants, such as bitter almonds and peaches, amygdalin is a naturally occurring cyanogenic glycoside compound converted into hydrocyanic acid (cyanide) in the gut. The toxicity of amygdalin is highly variable and influenced by numerous factors, including other ingested plants or nutrients (e.g. plant enzymes or ascorbic acid), vitamin B12 and individual gut flora.

Complementary Medicines Australia (CMA) opposed the interim decision and made a submission that the zero tolerance for amygdalin, established by its entry in the Poisons Standard, is “not practicable”. However the delegate responsible for the decision for the advisory committee said: “I remain unconvinced that the risks associated with the presence of amygdalin in traditional Chinese medicines (TCM) are outweighed by any health benefits…” It would seem the TGA were influenced by the history of persistent misuse of amygdalin for the treatment of cancer. “Amygdalin has been prohibited since 1974 when it was supplied as Laetrile or vitamin B17, a purported treatment for cancer with serious toxicity and no clear evidence of therapeutic benefit. I am concerned that the down-scheduling of amygdalin may contribute to excessive use of amygdalin, particularly where people who have or who have had cancer are seeking alternative treatments.”

Devotees of almond milk lattes, and almond croissants, will be relieved that this is at odds with the regulations for foods, which are exempt from the Poisons Standard (Appendix A), and are therefore permitted to contain low levels of amygdalin. The delegate said: “I also do not support the down-scheduling of amygdalin at 5mg or less to unscheduled, to align with the limits set by the Australian New Zealand Food Standards (FSANZ). The FSANZ food limits are based on the Acute Reference Dose (ARfD) for a safe level of one-off exposure, rather than regular and possibly chronic ingestion, which is the assumed practice for a TCM…”

Substitutes for Wild Cherry (Prunus serotina) include:

Because the TGA did not alter the Poisons Standard for the trace levels (very small amounts) of amygdalin that can be found in wild cherry bark we recently ceased sales of this product. To assist you in clinic we have provided you with some substitute herbs below.

Wild cherry bark is a notable example of an antitussive, a remedy that quells coughing. Its powerful sedative action on the cough reflex means its main indication is dry, unproductive cough and thus it has a role in the irritating and persistent cough of bronchitis and whooping cough. It is especially helpful for coughs that prevent someone from sleeping or for the persistent dry cough that lingers long after other symptoms of a cold or flu have abated.

Wild cherry is high in antioxidants that can cool inflammation. Practitioners reach for wild cherry when there are signs of heat and excess whether it is a spasmodic dry unproductive cough, excess uric acid deposits causing painful gout or an excessive immune system response like seasonal allergies. It is also a great ally for aiding digestion (the aromatic and bitter aspects) and supporting heart health (modulating inflammation), similar to its close relative hawthorn (Crataegus monogyna).

Note: Wild cherry is energetically cooling so the substitutes have been chosen for their cooling or neutral energetics. Respiratory herbs with warming energetics, such as angelica, elecampane, hyssop, ivy leaf, rue and thyme, have not been included for this reason.

References
Notice of final decisions to amend (or not amend) the current Poisons Standard - ACMS #34, Joint ACMS-ACCS #28, ACCS #31. Delegate’s final decisions and reasons for decisions (ACMS #34, Joint ACMS-ACCS #28, ACCS #31 - June 2021 meetings) Australian Government Department of Health Therapeutic Goods Administration Commonwealth of Australia c2021 (updated 20 Dec 2021; accessed 11 Mar 2022). p5-6. Available from https://www.tga.gov.au/sites/default/files/notice-final-decisions-amend-or-not-amend-current-poisons-standard-acms-34-joint-acms-accs-28-accs-31.pdf

Notice of interim decisions on proposed amendments to the Poisons Standard - ACMS, ACCS and Joint ACMS-ACCS meetings, November 2020. Australian Government Department of Health Therapeutic Goods Administration (updated 3 Feb 2021; accessed 11 Mar 2022). Available from https://www.tga.gov.au/book-page/21-amygdalin-and-hydrocyanic-acid

For decades workplaces have been full of sick people with colds and flu “soldiering on”, dosed up on over-the-counter drugs, but the advent of a pandemic has seen the era of the flu martyr waning. “Presenteeism’” (where people turn up to work sick) has been replaced by convalescence. The word convalescence may conjure up romantic, Secret Garden-esque, images from wholesome 19th Century novels set in Victorian Britain. However, it simply means the gradual return to health after illness or injury, a gentle process of recovery and recuperation.

In the current health climate there are many people recovering from COVID-19 (estimated to be more than 220,000 people in Australia at the time of writing). While there is no miracle cure, there has been a lot of talk about certain supplements which can make life much more bearable during the illness but not much emphasis on the aftermath of the disease and the convalescing patient. According to the renowned herbalist Simon Mills “the neglect of convalescence may yet prove to be one of the most serious mistakes of modern medicine.” The seminal herbal textbook, Principles and Practice of Phytotherapy, says: “A good convalescence is a marvellous thing. It rounds off an illness and gives it meaning; it makes the sufferer stronger for having had the illness. In a way no vaccination could do, it arms and strengthens the immune defences and provides real protection against recurrence, possibly forever…”

When it comes to illness, sometimes the end is just the beginning. Recovery from COVID-19 can be slow, with the patient feeling very weak and lacking in vitality. Getting better takes time and deserves respect. People now realise that mandatory bed rest and increasing fluids will give the body a much better chance at fighting disease. And herbalists know that there are many herbs which can be used during the convalescence period along with attention to a nourishing diet and gentle exercise coupled with rest, clean sheets, fresh air and sunshine.

Nutritive and tonic herbs are frequently used to replenish minerals and vitamins spent during an illness. These are herbs such as alfalfa (Medicago sativa), fenugreek (Trigonella foenum-graecum), nettle leaf (Urtica dioica), oats green (Avena sativa) and rose hips (Rosa canina). Bitter tonics, such as gentian (Gentiana lutea) and dandelion root (Taraxacum officinale), speed recovery by stimulating the appetite as well as digestion. As illness can take its toll on the immune system herbs that build white and red blood cells have a part in convalescence. These herbs include astragalus (Astragalus membranaceus), echinacea (Echinacea spp.), reishi (Ganoderma lucidum) and schizandra (Schisandra chinensis). Adaptogens, and adrenal strengthening, herbs such as liquorice (Glycyrrhiza glabra), rhodiola (Rhodiola rosea), Siberian ginseng (Eleutherococcus senticosus) and withania (Withania somnifera) help with general strength and fatigue. Which herbs are prescribed depends largely on what the patient is convalescing from. For instance, if it is a respiratory disorder lung herbs such as mullein (Verbascum thapsus), garlic (Allium sativum) and thyme (Thymus vulgaris) can be used. Nervines (nervous system tonic herbs) such as St John’s wort (Hypericum perforatum) and vervain (Verbena officinalis) may assist with the depression that can follow a debilitating illness.

References

Kinman G, Grant C. Presenteeism during the COVID-19 pandemic: risks and solutions, Occupational Medicine, Volume 71, Issue 6-7, August-October 2021, Pages 243–244, https://doi.org/10.1093/occmed/kqaa193

Coronavirus (COVID-19) case numbers and statistics. Commonwealth of Australia Department of Health. (accessed 7 Mar 2022). Available from https://www.health.gov.au/health-alerts/covid-19/case-numbers-and-statistics 
Bone K, Mills S. Principles and Practice of Phytotherapy. 2nd ed. Churchill Livingstone Elsevier: Edinburgh;2013.p 86

Hoffmann D. Medical Herbalism. Rochester: Healing Arts Press. 2003. p. 339
 

Withania (Withania somnifera) has long been revered as a medicinal plant which can strengthen those who are tired by restoring healthy sleep cycles. Even the species name somnifera means sleep-inducing in Latin.

A January 2021 randomised controlled trial confirmed that withania can improve sleep quality and help in managing insomnia. In the study 40 healthy people and 40 people with insomnia were assigned to two groups, either withania (600mg/day) or placebo, and studied for eight weeks.   In both the healthy and insomniac people there was a significant improvement in the sleep parameters in the withania supplemented group. The improvement was found to be more significant in insomniacs than healthy people.

Follow the link below to read the full article.

References 

The Indian Government’s Guidelines for Ayurveda Practitioners for COVID-19 https://www.ayush.gov.in/docs/ayurved-guidlines.pdf 

Chopra A, Srikanth N, Patwardhan B; AYUSH CCRAS Research Group. Withania somnifera as a safer option to hydroxychloroquine in the chemoprophylaxis of COVID-19: Results of interim analysis. Complement Ther Med. 2021;62:102768. doi:10.1016/j.ctim.2021.102768 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372474/
 

Globe artichoke (Cynara scolymus) has a long history of medicinal use for the liver and for supporting digestive health. Human studies are suggesting that it can potentially protect the liver from damage and may help to improve liver status in those people who already have liver damage.

A 2021 randomised clinical trial investigated the positive effect of co-administration of globe artichoke leaf extract, with conventional medicines, on patients with non-alcoholic fatty liver disease (NAFLD). NAFLD is the most common cause of chronic liver disease worldwide. It is a condition in which excess fat builds up in the liver cells that is not caused by heavy alcohol use. The trial was based on patients randomly divided into three groups supplementing metformin (an antidiabetic agent used in NAFLD) and vitamin E; metformin and globe artichoke; and vitamin E and globe artichoke. The effectiveness of the therapy in the treated groups was evaluated using liver ultrasonography and the biochemical markers, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Serum ALT and AST levels are commonly used biomarkers to assess liver function and are considered indicators of NAFLD.

After 12 weeks of treatment, ALT and AST were significantly reduced in all study groups and the rate of liver fat accumulation had also decreased significantly in all study groups. Although larger clinical trials are needed, these results suggest that taking globe artichoke with metformin and vitamin E can have beneficial effects on improving complications in patients with NAFLD.

References

Panahi Y, Kianpour P, Mohtashami R, Atkin SL, Butler AE, Jafari R, Badeli R, Sahebkar A. Efficacy of artichoke leaf extract in non-alcoholic fatty liver disease: A pilot double-blind randomized controlled trial. Phytother Res. 2018 Jul;32(7):1382-1387. doi: 10.1002/ptr.6073. Epub 2018 Mar 9. PMID: 29520889.

Majnooni MB, Ataee M, Bahrami G, Heydarpour F, Aneva IY, Farzaei MH, Ahmadi-Juoibari T. The effects of co-administration of artichoke leaf extract supplementation with metformin and vitamin E in patients with nonalcoholic fatty liver disease: A randomized clinical trial. Phytother Res. 2021 Nov;35(11):6324-6334. doi: 10.1002/ptr.7279. Epub 2021 Sep 17. PMID: 34533249

Herbalists use plants for medicinal purposes so they are familiar with the fact that nature heals. However, the beneficial effects that exposure to the natural world has on mental and physical health is becoming more widely acknowledged. The increasing amount of evidence on the human need for nature makes it important to understand the drivers behind nature experiences. To add to this growing body of research a 2022 study of twins has revealed that a love of nature appears to be, at least in part, genetic. According to a large-scale study of twins in the United Kingdom, published this month in the open-access journal PLOS Biology, a person’s appreciation of nature, and their tendency to visit natural spaces, are genetic characteristics.

Researchers surveyed 1153 pairs of twins on the TwinsUK registry about how they experience nature, asking them to rate their familiarity with and desire to be in nature, and how frequently they visit natural spaces such as public parks and private gardens. They found that identical twins, who share almost 100% of their genes, were more similar to each other in their orientation towards nature and how frequently they visited nature compared to fraternal twins, who share around 50% of their genetic material. The results help to explain why some people have a stronger desire than others to be in nature.

While the results suggest there is a genetic influence over how people experience nature, environmental factors explained more than half of the differences between individuals. People living in urban environments tended to have less nature experiences, due to things such as limited access to gardens, highlighting the importance of availability in shaping nature-seeking behaviours. These inherited characteristics also declined with age, suggesting that genetics may become less influential as people age and experience a unique set of environmental conditions. This study provides the first evidence for a genetic component to both a predisposition towards nature and a tendency to visit natural spaces. The results also provide evidence of a complex interaction between urbanisation and the environmental effects in shaping a person’s nature experience. It points to the need for diverse urban planning to provide access to natural spaces and the benefits they offer for all.

Reference

People’s desire to be in nature and how they experience it are partially heritable (plos.org)