Newsletter Article

A randomised controlled clinical trial examining the effects of Cordyceps militaris beverage on the immune response in healthy adults

A study published earlier this year found that cordyceps can potentially be developed as an immune-boosting supplement. The study aimed to investigate the immunostimulatory effects of a fermentation of Cordyceps militaris (FCM) in healthy male and female volunteers.

 Healthy men and women were provided either FCM or placebo for eight weeks (10 for each gender). The immune cell markers, immunoglobulins and safety parameters were assessed initially at baseline and at four and eight weeks. Natural killer (NK) cells play an important role in innate immune responses to viral infections. FCM stimulates the human immune response by activating NK cells. The NK cell activity markedly increased in the male FCM group from baseline to four weeks after receiving FCM. Compared with those in the placebo group, the NK activity in women who received FCM for eight weeks significantly increased from baseline. Cytokines are signalling molecules released into the bloodstream by cells to activate or suppress an immune response. FCM reduced inflammatory cytokine secretion in men and women without toxicity.

This beneficial effect of FCM indicates its use as a new alternative approach as a natural immunostimulatory supplement. However, it should be noted that the mechanisms underlying the immune activator effects of FCM and its impact on immune-related disease in patients requires further investigation. Future studies should also recruit a larger number of participants.

References

Ontawong A, Pengnet S, Thim-Uam A, Munkong N, Narkprasom N, Narkprasom K, Kuntakhut K, Kamkeaw N, Amornlerdpison D. A randomized controlled clinical trial examining the effects of Cordyceps militaris beverage on the immune response in healthy adults. Sci Rep. 2024 Apr 5;14(1):7994. doi: 10.1038/s41598-024-58742-z. PMID: 38580687; PMCID: PMC10997757.

The first study of its kind to examine the effects of lion’s mane on cognitive performance in healthy subjects was published at the end of last year in the journal Nutrients. This unique investigation measured the acute benefits of lion’s mane and guayusa extract on objective cognitive performance, subjective cognitive perception and self-perceived happiness in low to moderate caffeine consumers. Guayusa is native to the Amazon rainforest and harvested primarily in Ecuador. Its leaves are typically brewed to make tea and touted for their caffeine and antioxidant content. The study takes a significant step towards understanding lion's mane's more immediate cognitive advantages for healthy adults in as little as 60 minutes post-ingestion. This research challenges the prevailing belief that lion's mane can only provide more long-term, chronic benefits (i.e. 30 to 60 days use). This study has also contributed to understanding the effects of lion’s mane on healthy adults, whereas most other studies so far have investigated its effects on participants with cognitive impairments and have shown benefits towards neurodegenerative diseases, while only a few have examined cognitive performance in healthy adults, and none have investigated the acute (i.e. single dose) cognitive effects. 

 Using a randomised, double-blind, placebo-controlled, crossover design the study involved 40 participants who were given a single dose of 650mg of guayusa extract, or 1mg of lion’s mane, or the placebo (maltodextrin), and were assessed before ingesting the dose, one hour after ingestion and two hours after ingestion. The assessments included neuropsychological tests, vital signs and subjective assessments of cognitive perception and mood, including “mental clarity, focus, concentration, anxiety/stress and happiness.”

 According to the results of the study, participants who ingested the lion’s mane extract demonstrated improved working memory, complex attention and reaction time two hours post ingestion and perceptions of happiness over a two-hour period. Guayusa significantly improved mental clarity, focus, concentration, mood and productivity. It also raised participants’ blood pressure, and significantly improved cognitive performance and self-perceived cognitive indices of affect over a two-hour period and perceptions of happiness two hours post ingestion. Interestingly, guayusa did not increase the sensation of jitters that have been commonly reported with caffeine. Lion’s mane and guayusa improved subjective ratings of “happiness compared to peers” and “getting the most out of everything” however, this occurred earlier in lion’s mane (i.e. one hour post ingestion).

 The researchers concluded by saying “although this study shows that continuous intake of lion’s mane is not necessary to stimulate positive cognitive benefits, a longer duration or higher doses of lion’s mane use may be needed to remodel nerve structures in the brain and potentially provide even greater effects acutely and/or chronically. In addition, the antioxidant effects of lion’s mane and [guayusa] may provide additional health benefits or more consistent improvements in cognition with chronic use.” 

References

McEvoy E. Proprietary lion’s mane extract shown to improve cognitive function in recent study. Nutritional Outlook c2024 MJH Life Sciences (updated 31 Jul 2024;accessed 6 Aug 2024). Available from https://www.nutritionaloutlook.com/view/proprietary-lion-s-mane-extract-shown-to-improve-cognitive-function-in-recent-study

La Monica MB, Raub B, Ziegenfuss EJ, Hartshorn S, Grdic J, Gustat A, Sandrock J, Ziegenfuss TN. Acute Effects of Naturally Occurring Guayusa Tea and Nordic Lion's Mane Extracts on Cognitive Performance. Nutrients. 2023 Dec 6;15(24):5018. doi: 10.3390/nu15245018. PMID: 38140277; PMCID: PMC10745489.

Respiratory ‘bug’ soup and ‘walking’ pneumonia

Recent reports suggest that Australia is experiencing a spike in respiratory infections with cases of Mycoplasma pneumoniae circulating in the community, particularly among children. Mycoplasma pneumoniae (mycoplasma) is a bacterium which can cause respiratory (chest) infections. It commonly causes mild respiratory infections and generally resolves without serious complications. It is sometimes called ‘walking’ pneumonia because the patient may appear well. In some cases it can lead to severe pneumonia (lung infection) needing admission to hospital. Like most respiratory pathogens, infection usually occurs during the winter months but can happen year-round. An increase in Mycoplasma pneumoniae circulation usually occurs every three to seven years as population immunity wanes. 

Mycoplasma spreads through respiratory droplets from coughing or sneezing and can occur in people of any age but is most common in school-aged children and young adults. Typical symptoms may develop over one to three weeks and include fever, dry cough, sore throat, fatigue, headache, malaise and, in some cases, shortness of breath. Royal Australian College of General Practitioners President Dr Nicole Higgins recently told the media: “We’ve got a respiratory bug soup at the moment, it’s multiple bugs that are impacting especially our children,” she said. “The general rule of thumb is if your child’s not getting better, get them checked out [for mycoplasma].” Mycoplasma infection is diagnosed by a nose and throat swab. Sometimes a doctor may also do a blood test or a chest x-ray to check for lung infection (pneumonia). 

Mycoplasma bacteria lack a cell wall and are a very important stealth pathogen which can make them drug resistant. There is a strong association between this bacteria and chronic fatigue syndrome, and other fatigue-based conditions, so it is imperative that successful eradication of the condition is ensured. This involves rest, sleep and recuperation, inhalations and chest rubs, sufficient dietary support to support the immune response and control symptoms, and herbal prescriptions to eradicate infection and restore respiratory function. Herbal medicine can support the immune system, reduce inflammation, reduce excessive secretions and alleviate the cough. Herbal formulas could include immunomodulating herbs such as astragalus (Astragalus membranaceus), cat’s claw (Uncaria tomentosa), echinacea (Echinacea spp.) and olive leaves (Olea europaea), anti-inflammatory herbs such as green tea (Camellia sinensis) and respiratory herbs such as elecampane (Inula helenium), thyme (Thymus vulgaris) and grindelia (Grindelia robusta). 

References

Mycoplasma pneumoniae infection. NSW Government NSW Health. State of New South Wales NSW Ministry of Health c 2023. (updated 23 May 2024; accessed 2 Aug 2024). Available from https://www.health.nsw.gov.au/Infectious/factsheets/Pages/mycoplasma-pneumoniae.aspx

McAnulty J. Legionella and Mycoplasma Pneumonia. NSW Ministry of Health (updated 3 Jan 2024; accessed 2 Aug 2024). Available from https://www.health.nsw.gov.au/Infectious/Documents/Legionella-and-Mycoplasma-Pneumonia-GP-alert_3January2024.pdf

Echinacea can safely prevent respiratory tract infections (RTIs) and associated complications, thereby decreasing the demand for antibiotics an April 2024 study has concluded. The results also support the beneficial effects of long-term, preventative echinacea supplementation. Despite medical advances RTIs are still the most frequent illnesses worldwide and are the leading cause of antibiotic prescriptions, primarily due to the risk for secondary bacterial infections. Approximately one-third of all RTIs affect children below five years of age, of which a disproportionally high number of 0.7 million cases are lethal. A higher fatality rate is also reported for elderly people and immunocompromised patients (these numbers do not account for the recent COVID-19 pandemic).

The prevention of RTIs may be achieved by taking echinacea species as antiviral and immunomodulatory actions have been reported. Recent literature has found a wide spectrum of activity for alcoholic extracts against enveloped respiratory viruses, including influenza viruses, respiratory syncytial virus (RSV), coronaviruses and SARS-CoV-2. Clinical benefits manifest not only in a reduced risk of RTIs but also of RTI relapses and secondary complications.

In the systematic review and meta-analysis a comprehensive search identified 30 clinical trials (39 comparisons) studying echinacea for the prevention or treatment of RTIs in 5652 subjects. Echinacea significantly reduced the monthly RTI occurrence, risk ratio and number of patients with RTIs. Echinacea reduced the risk of recurrent infections, RTI complications and the need for antibiotic therapy, with total antibiotic therapy days reduced by 70%. 

References

Gancitano G, Mucci N, Stange R, Ogal M, Vimalanathan S, Sreya M, Booker A, Hadj-Cherif B, Albrich WC, Woelkart-Ardjomand K, Kreft S, Vanden Berghe W, Hoexter G, Schapowal A, Johnston SL. Echinacea Reduces Antibiotics by Preventing Respiratory Infections: A Meta-Analysis (ERA-PRIMA). Antibiotics (Basel). 2024 Apr 16;13(4):364. doi: 10.3390/antibiotics13040364. PMID: 38667040; PMCID: PMC11047471.

Buchu, a fragrant evergreen shrub native to South Africa (particularly the Western Cape Province)belonging to the genusAgathosma, has a long history ofuse in traditional Khoisan medicine.The Khoisan people (indigenous people of the western region of South Africa) have utilised buchu forcenturies for various medicinal and spiritual purposes, including dance rituals, anointment, andbeautification.The traditional use of buchu encompasses the treatment of kidney and urinary tractinfections, cold, stomach ailments, rheumatism, gout and fever.

Externally, buchu was used as an antiseptic wash for wounds and as a compress for swelling, bruising,and sprains.A. betulinawas commonly consumed as an aqueous infusion (sometimes sweetened) or atincture in brandy. Vinegar infusions were used externally for antiseptic washes and embrocations.

Early European settlers in South Africa adopted the use of buchu andits use spread to Europe and theUnited States.Buchu was included in compendia until the 20th century for its diuretic effects and urinarytract applications but fell out of favour due to the emergence of antibiotics and synthetic diuretics. The Eclectics, a 19th-century medical school of thought in the US, considered buchu an aromatic stimulantand tonic for poor appetite, flatulence, and nausea.

References

HEC Monograph

A 2024 Italian review article focused on the therapeutic effect of lion’s mane extract in the treatment of conditions of the lower urinary tract in which intestinal inflammation may play a role. The researchers hypothesised that lion’s mane, in combination with conventional drugs or other supplements, might be considered a therapy to be used in chronic inflammatory conditions of the lower urinary tract, including chronic prostatitis, to improve inflammation, decrease symptoms and potentially as a prostate cancer prophylactic agent.

The researchers reviewed the available evidence on “pelvic cross-organ sensitisation” (where a problem in one area can lead to a problem in another) as a possible mechanism through which intestinal inflammation and dysbiosis may affect the lower urinary tract. They also reviewed the clinical and experimental evidence supporting the role of lion’s mane extract as an anti-inflammatory agent highlighting the role of several mechanisms which might make this mushroom suitable for the management of “difficult to treat” lower urinary tract disorders.

The researchers postulated that lion’s mane may be a potential therapy in inflammatory conditions involving the gut, such as inflammatory bowel disease (i.e. ulcerative colitis and Crohn’s disease) because of its potent anti-inflammatory and antioxidant effects. They said another mechanism where lion’s mane may promote beneficial effects in the gut could be through the modulation of gut microbiota (as a prebiotic), which seems to play a crucial role in the development and progression of inflammatory bowel disease, as well as in the treatment of several gastrointestinal pathological conditions. In addition, because of lion’s mane immunomodulatory action and its ability to modulate neurotransmission, the researchers hypothesised that lion’s mane might be able to improve symptoms and inflammation in the lower urinary tract, mainly in those cases arising from an altered gut microbiota, intestinal inflammation and/or increased intestinal permeability. 

References

Romano L, Napolitano L, Crocetto F, Sciorio C, Priadko K, Fonticelli M, Federico A, Romano M, Gravina AG. The potential therapeutic role of Hericium erinaceus extract in pathologic conditions involving the urogenital-gut axis: insights into the involved mechanisms and mediators. J Physiol Pharmacol. 2024 Feb;75(1). doi: 10.26402/jpp.2024.1.01. Epub 2024 Apr 3. PMID: 38583434.

Sharing herbs brings them to life and that is what the Herbal Extract Company did last month, attending two industry events that we were proud to sponsor.

On the last weekend in May we attended the Naturopaths & Herbalists Association of Australia (NHAA) Herbal Medicine Summit 2024 on the Sunshine Coast, joining a community of like-minded practitioners who are all as passionate as each other about natural medicine. This is the NHAA’s flagship education event for the year designed to keep practitioners informed, elevate their professional skills and advance patient outcomes. It was a stellar lineup as some of the most skilled and respected naturopaths and researchers in Australia presented over 20 expert-led sessions and panel discussions. More than 200 herbalists and naturopaths gathered to witness these top industry professionals and thought leaders share their knowledge and discuss hot topics such as sustainability, small scale medicinal herb farming, cannabis ethnopharmacology and patient access, oxymels, dosing, medicine making and adventures with alembics (an apparatus used in distillation) to harness plant material aromatics.

A new initiative, called Pearls of Practice, was very well received. This was speed mentoring, rapid fire style, with 20 round table topics including actioning sustainability in practice, genetic testing tips, starting a community clinic, important post-partum care and the new frontier of Artificial Intelligence.

Our practitioner consultants were kept busy giving delegates taste tests of our liquid herbal extracts including our new mushrooms cordyceps and lion’s mane, which we stacked together with reishi, as a special synergistic mix for the Summit. It was a weekend brimming with learning, connection and deep herbal wisdom from some of the brightest minds.

Earlier in the month the Wise Women Gathering 2024 was held at Webbs Creek, 90 minutes north of Sydney. Almost 200 people attended the three-day event which was a heart-warming testimony to the strength of traditional herbal medicine in Australia.

Our sales manager Lara Ryan presented a Herbal Wisdom session called Back to Our Roots: Medicinal Herbs for Women’s Resilience. With autumn being a time to work with root herbs it was very popular with more than 40 women attending to learn about the benefits of roots in women’s health. After sharing some Herbal Extract Company history, and our unique manufacturing process, Lara went on to deep dive into six root herbs: black cohosh, paeonia, shatavari, Siberian ginseng, teasel root and wild yam. Lara said there were two herbalist midwives in the group who shared their wisdom about using the roots medicinally in soups following birth, along with including the uterine tonic blue cohosh root (caution advised unless experienced) into the birth process and after birth support. After some taste testing the women made topical herbal creams using our natural base cream. Lara was also asked to sit on a panel about Wealth Building for Wise Women. The illustrious panel discussed how to monetise their healing skills.

While used for centuries in the traditional medicine of many cultures, functional mushrooms are having a moment in Western herbal medicine with exotic varieties capturing the popular imagination. This is because, being rich in nutrients and bioactive compounds, they can assist people to feel and perform better. The trailblazing mycologist, author, entrepreneur and perhaps, most famously, the protagonist of the 2019 documentary Fantastic Fungi, Paul Stamets, touts the benefits of mushrooms saying: “Mushrooms are food for the body and medicine for the soul.” The colloquial term “mushroom stacking” refers to the enhanced benefits from combining medicinal mushrooms to increase overall health outcomes. Stacking adaptogenic mushrooms can create a synergistic effect, amplifying the benefits of each mushroom. 

The growing interest in microdosing psychedelics was the genesis for the practice of stacking, which involves combining microdoses of psychedelics, primarily psilocybin-containing mushrooms, with other substances that are purported to accentuate the beneficial effects. In fact, the Stamets Stack is named after Paul Stamets who has been credited with introducing the concept of stacking. The eponymous Stamets Stack includes lion's mane, niacin (vitamin B3) and the active ingredient psilocybin (which in Australia is Schedule 9 (prohibited drug) except for prescription for authorised prescribers). Stamets claims that the combination of psilocybin and lion's mane has the ability to support the development of new neural pathways (neuroplasticity) and also repair existing neurological damage. 

The use of such admixtures appears to have a long history. Aztecs combined cacao with psilocybin mushrooms in a practice referred to as cacahua-xochitl, which literally means chocolate-mushrooms, and psilocybin admixtures composed of honey, flowers and herbs have been noted in historical records among both Indigenous and non-indigenous peoples. Mushrooms, henbane (also known as nightshade, Hyoscyamus niger), stinging nettles (Urtica dioica) and other active substances were commonly added to enhance the effects of beer during the Middle Ages. Chocolate and cacao remain popular additions to psilocybin, whereas adding Syrian rue (Peganum harmala), lion’s mane (Hericium erinaceus) and/or niacin appear to be a more recent phenomenon. 

The Herbal Extract Company’s mushroom stacking is focused on the practical use of this concept as it applies to functional mushrooms without the hallucinogenic “magic” properties. A popular combination for focus and cognition includes cordyceps (Cordyceps militaris), lion’s mane (Hericium erinaceus) and reishi (Ganoderma lucidum). It offers support for energy, brain health and stress support all at once. The results of a 2019 systematic review of in vivo studies suggest that dietary supplementation with lion's mane, reishi and cordyceps mushrooms may have a beneficial effect on cognitive impairment however further clinical research studies are needed. 

References

Plotkin M. The Mushroom Moment. Herbalgram. The Journal of the American Botanical Council. Winter 2024;139:36-41

Rootman JM, Kryskow P, Harvey K, Stamets P, Santos-Brault E, Kuypers KPC, Polito V, Bourzat F, Walsh Z. Adults who microdose psychedelics report health related motivations and lower levels of anxiety and depression compared to non-microdosers. Sci Rep. 2021 Nov 18;11(1):22479. doi: 10.1038/s41598-021-01811-4. PMID: 34795334; PMCID: PMC8602275.

Nkodo A. A Systematic Review of in-vivo Studies on Dietary Mushroom Supplementation for Cognitive Impairment (P14-021-19). Curr Dev Nutr. 2019 Jun 13;3(Suppl 1):nzz052.P14-021-19. doi: 10.1093/cdn/nzz052.P14-021-19. PMCID: PMC6574952.

Cordyceps appears to be a safe immunological adjuvant for the treatment of patients with mild to moderate COVID-19 according to an August 2023 randomised, double-blind, placebo-controlled study. The study's findings provide intriguing insights into the potential of cordyceps to enhance recovery and alleviate symptoms. Further research with larger groups is essential to validate these findings and uncover the full potential of cordyceps in COVID-19 treatment.

The study meticulously analysed biomarkers associated with inflammation, immune response and infection. A total of 58 patients were considered evaluable for the analysis with 30 in the cordyceps group and 28 in the placebo group. Cordyceps capsules, administered at a dose of 500mg three times a day for 15 days along with supportive treatment, showed effectiveness in patients with mild to moderate COVID-19 infection. This was evidenced by the proportionately higher number of recoveries on day five, the relatively shorter time for improvement of clinical symptoms, and the proportionately higher number of patients showing negative RT-PCR tests on day 10.

Mild symptomatic COVID-19 infection was defined as patients with uncomplicated upper respiratory tract infection. The patient had mild symptoms such as fever, cough, sore throat, nasal congestion, malaise and headache, without evidence of breathlessness or hypoxia. Moderately symptomatic COVID-19 infection was defined as pneumonia with no signs of severe disease (patients in respiratory distress). All mild patients received the standard of care treatment that included vitamin C, zinc supplements and antibiotics such as azithromycin or cefixime as per the institutional protocol in both groups. In both groups patients with moderate disease received antiviral treatment such as injections of remdesivir, anti-inflammatory agents such as prednisolone and anti-coagulants such as low molecular weight heparin, vitamin C and trace elements, as per the institutional protocol. Cordyceps was safe and well tolerated by patients, with no drug interruption or dose reduction due to minor adverse events in any of the patients. 

References

Dubhashi S, Sinha S, Dwivedi S, Ghanekar J, Kadam S, Samant P, Datta V, Singh S, Chaudry IH, Gurmet P, Kelkar H, Mishra R, Galwankar S, Agrawal A. Early Trends to Show the Efficacy of Cordyceps militaris in Mild to Moderate COVID Inflammation. Cureus. 2023 Aug 18;15(8):e43731. doi: 10.7759/cureus.43731. PMID: 37727187; PMCID: PMC10505833

A clinical trial on Bacopa monnieri extract, published in February this year, revealed significant enhancements in emotional and cognitive well-being among healthy adults. The Indian researchers claimed this is the most comprehensive study ever done on bacopa with extensive measures on memory, cognitive skills, anxiety, sleep, biomarkers and acute effects. They concluded that “our battery of cognitive functions test results shows that [bacopa] improves cognitive health, promotes concentration as early as three hours post dose on day one, increases overall memory, mental alertness, reasoning skills, mental flexibility, [brain-derived neurotrophic factor] BDNF [a key molecule involved in plastic changes related to learning and memory] levels, sleep quality and reduces anxiety and serum cortisol.”

Age-related cognitive decline substantially affects quality of life and freedom during old age. Cognitive functions such as memory, attention, language and executive functions are essential for day-to-day activities. They start declining gradually in the late 20s and this is further accelerated in the case of neurodegenerative conditions such as Alzheimer’s disease. Early interventions have been shown to help maintain normal and healthy cognitive aging. Cognitive enhancers, also known as nootropics, are prescribed to improve cognitive performance in elderly individuals and those with dementia. However, nootropics are increasingly being used by healthy people seeking to improve their attention, memory, focus, concentration and alertness. Students use nootropics to boost attention, increase alertness and to stay awake for an extended period. Bacopa, also known as brahmi, is a brain tonic and adaptogen known for its memory-enhancing properties and is widely used to improve cognitive functions.

In this randomised, double-blind, placebo-controlled, parallel group study 38 people took bacopa and 36 people were in the placebo group. They consumed either 300mg of a commercial bacopa extract or placebo every morning after breakfast for 12 weeks. The bacopa group showed significant improvements in both memory (verbal short-term memory, spatial short-term memory, working memory, visuospatial working memory and episodic memory) and cognition skills (concentration, alertness, reasoning and mental flexibility) over placebo from baseline to day 84, with effects on cognitive skills as early as day 14 and day 28 for memory. A significant acute effect on concentration was observed as early as three hours post single dose consumption of bacopa. Anxiety scores and sleep quality were also significantly improved for the bacopa group on days 28, 56 and 84 as compared to placebo. Serum cortisol levels were significantly reduced from baseline to day 56 and 84, whereas serum BDNF was significantly increased on day 84 for the bacopa group compared to placebo. 

References

Eraiah MM, Shekhar HC, Joshua L, Thomas JV. Effect of Bacopa monnieri Extract on Memory and Cognitive Skills in Adult Humans: A Randomized, Double-Blind, Placebo-Controlled Study. J Psychiatry Cogn Behav. 2024;8:168. https://doi.org/10.29011/2574-7762.000068